West Nile fever in Israel: The reemergence of an endemic disease

• Published in: The Journal of infection Vol. 68; no. 2; pp. 170 - 175
• Main Authors: Anis, Emilia, Grotto, Itamar, Mendelson, Ella, Bin, Hanna, Orshan, Laor, Gandacu, Dan, Warshavsky, Bruce, Shinar, Eilat, Slater, Paul E, Lev, Boaz
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Ltd 01.02.2014; Elsevier
• Subjects: Adult; Aged; Animals; Arboviroses; Biological and medical sciences; Communicable Diseases, Emerging - epidemiology; Communicable Diseases, Emerging - prevention & control; Control measures; Endemic Diseases; General aspects; Human viral diseases; Humans; Incidence; Infectious Disease; Infectious diseases; Insect Vectors; Israel - epidemiology; Medical sciences; Middle Aged; Miscellaneous; Reemergence; Tropical viral diseases; Vector; Viral diseases; West Nile fever; West Nile Fever - epidemiology; West Nile Fever - prevention & control; Asia; Israel; ASE, Africa; ISW, Israel; PNE, Eurasia; Africa; West Nile fever; Reemergence; Control measures; Vector; Infection; Viral disease; Arbovirus disease
• ISSN: 0163-4453; 1532-2742
• DOI: 10.1016/j.jinf.2013.10.009

Summary Background As a crossroads for bird migration between Africa and Eurasia and with its long history of human infection, Israel has been a major focus of attention during the continuing global spread of West Nile fever (WNF). This article reviews the background and reemergence of WNF in Israel; the recent epidemiology of WNF among Israelis; and the disease-control strategies being used to combat the disease. Methods Employing the comprehensive base of case data that are reported to the Ministry of Health, an epidemiological record was constructed that details the incidence and distribution of WNF cases in Israel in recent years. Results After decades of small, intermittent outbreaks, nearly 1400 cases of WNF were reported in Israel between 2000 and 2012. Incidence was consistently highest in the coastal cities, among elderly patients, and in the late summer months and early autumn. A broad range of control measures to prevent human infection has been implemented, and attention has been given to issues such as the protection of the national blood bank and the occurrence of long-term sequelae. Conclusions The reemergence of WNF in Israel is likely the result of a combination of factors including past immunity to the virus among the human population, a marked increase in awareness of WNF among physicians, and more frequent requests for the laboratory testing of suspected cases. In the absence of effective vaccine to protect humans from WNF, the best disease-control strategies include intensive vector-control measures, the continued development of techniques to forecast outbreaks, and effective public education programs that are targeted toward the high-risk elderly population.