Clinical characteristics of the West Nile fever outbreak, Israel, 2000

• Published in: Emerging infectious diseases Vol. 7; no. 4; pp. 675 - 678
• Main Authors: Chowers, Michal Y, Lang, Ruth, Nassar, Faris, Ben-David, Debora, Giladi, Michael, Rubinshtein, Eitan, Itzhaki, Avi, Mishal, Josef, Siegman-Igra, Yardena, Kitzes, Ruth, Pick, Neora, Landau, Zvi, Wolf, Dana, Bin, Hanna, Mendelson, Ella, Pitlik, Silvio D, Weinberger, Miriam
• Format: Journal Article
• Language: English
• Published: United States U.S. National Center for Infectious Diseases 01-07-2001; Centers for Disease Control and Prevention
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Aging - physiology; Analysis; Child; Child, Preschool; clinical characteristics; Demographic aspects; Disease Outbreaks; Female; Fever - physiopathology; Health aspects; Hospitalization; human; Humans; Israel; Israel - epidemiology; Male; Meningitis, Viral - mortality; Meningitis, Viral - physiopathology; Middle Aged; Observational studies; outbreak; Virus-vector relationships; West Nile Fever; West Nile Fever - epidemiology; West Nile Fever - immunology; West Nile Fever - mortality; West Nile Fever - physiopathology; West Nile virus; Israel
• ISSN: 1080-6040; 1080-6059
• DOI: 10.3201/eid0704.017414

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.