Two die from cases of West Nile virus, over 25 Israelis infected


Two elderly women in their 80s died at noon on Saturday at Rabin Medical Center-Beilinson Campus after allegedly contracting West Nile fever, Maariv reported.

At least twenty-five residents of central Israel, the majority of whom are in their seventies, have been hospitalized at Ichilov Hospital and Sheba Medical Center after contracting the deadly virus. Some are on ventilators in intensive care.

Israeli doctors have reportedly not previously encountered such a massive outbreak of the disease, which is usually mild but can be life-threatening for the elderly. 

At Ichilov Hospital, one person is on a ventilator and sedated and is in serious condition. Another person has been weaned off the ventilator and is in moderate condition. Two others are also in moderate condition, and the rest have been discharged.

At Sheba Medical Center, additional patients are hospitalized, some sedated and ventilated and in serious condition. At Meir Medical Center, one person was treated and discharged. There are likely additional infected individuals who have not sought emergency care.

An ambulance is seen at the entrance to the emergency room of Sheba Medical Center in Tel Hashomer in Ramat Gan, Israel, July 15, 2023. (credit: REUTERS/RAMI AMICHAY)

According to the Health Ministry, the disease has been prevalent in Israel for many years and tends to have the most cases in the summer.

Outbreaks of West Nile Virus in Israel

The first documented outbreak of West Nile fever in Israel was recorded between 1950 and 1954, with a second outbreak in 1957.

Increased viral activity was again documented in the 1970s and 1980s. In 1997, the disease was diagnosed in birds, with goose flocks particularly affected. A large-scale outbreak occurred a year later. In 2000, there was an outbreak with over 400 cases. Since 2001, a few dozen cases have been diagnosed annually.

Every year, Israel reports several dozen cases, mostly among people in their forties and older. This summer’s outbreak is severe and is expected to worsen.

Infected mosquitoes are usually found in the Sharon area, including in Hadera, Pardess Hanna, Binyamina, and Caesarea.

However, infections have been reported across the country, from north to south. In June, cases were recorded in northern Tel Aviv, Ramat Gan, Givatayim, and the Savyon area.

The disease is usually mild but can cause severe illness and death. Most infections are asymptomatic. Some cases present with flu-like symptoms that resolve on their own. Symptoms include fever, headache, weakness, joint and muscle pain, conjunctivitis, rash, and sometimes nausea and diarrhea.

In about 1% of cases, the disease becomes severe, with neurological symptoms indicative of meningitis, acute encephalitis, or acute flaccid paralysis. The incubation period is usually 5 to 21 days. The disease is not transmitted from person to person, and there is no risk of infection from being near an infected individual.

Most mosquitoes in Israel are not infected. However, if an allergic reaction to a bite occurs, indicated by swelling, redness, and itching, or signs of infection such as local redness, warmth, pain, or high fever, or if flu-like symptoms appear after a bite, such as high fever, weakness, muscle aches, shortness of breath, and vomiting, seek medical advice.

The disease is not transmitted from person to person, and the risk of infection is very low. The disease can also not be transmitted from infected animals to humans. Those at high risk include people with chronic illnesses that suppress the immune system, cancer patients with weakened immune systems, infants, and the elderly.

Those who have been infected with West Nile virus in the past can get infected again.

There is no specific treatment for West Nile fever, and a vaccine exists only for horses. In most cases, the disease resolves on its own within a few days to weeks. Treatment focuses on symptom relief through rest, plenty of fluids, antipyretics, and pain relievers.

In severe cases requiring hospitalization, treatment includes intravenous fluids, antibiotics to prevent secondary infections, and in severe cases, ventilation. Attempts are being made in severe cases with neurological complications to treat with intravenous immunoglobulins (IVIG) for five days. 

Since there is no treatment for the disease, the only way to deal with it is to prevent mosquito bites by using mosquito repellents, window screens, fans to repel mosquitoes, and appropriate clothing. If you identify an area with many mosquitoes or a water reservoir, report it immediately to the local authority.

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