Emerging Infectious Diseases (Aug 2001)

Clinical Characteristics of the West Nile Fever Outbreak, Israel, 2000

  • Michal Y. Chowers,
  • Ruth Lang,
  • Faris Nassar,
  • Debora Ben-David,
  • Michael Giladi,
  • Eitan Rubinshtein,
  • Avi Itzhaki,
  • Josef Mishal,
  • Yardena Siegman-Igra,
  • Ruth Kitzes,
  • Neora Pick,
  • Zvi Landau,
  • Dana Wolf,
  • Hanna Bin,
  • Ella Mendelson,
  • Silvio D. Pitlik,
  • Miriam Weinberger

DOI
https://doi.org/10.3201/eid0704.017414
Journal volume & issue
Vol. 7, no. 4
pp. 675 – 678

Abstract

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West Nile (WN) virus is endemic in Israel. The last reported outbreak had occurred in 1981. From August to October 2000, a large-scale epidemic of WN fever occurred in Israel; 417 cases were confirmed, with 326 hospitalizations. The main clinical presentations were encephalitis (57.9%), febrile disease (24.4%), and meningitis (15.9%). Within the study group, 33 (14.1%) hospitalized patients died. Mortality was higher among patients >70 years (29.3%). On multivariate regressional analysis, independent predictors of death were age >70 years (odds ratio [OR] 7.7), change in level of consciousness (OR 9.0), and anemia (OR 2.7). In contrast to prior reports, WN fever appears to be a severe illness with high rate of central nervous system involvement and a particularly grim outcome in the elderly.

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