Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link
Volume 7, Number 4—August 2001
West Nile Virus
West Nile Virus

West Nile Fever Outbreak, Israel, 2000: Epidemiologic Aspects

Miriam Weinberger*Comments to Author , Silvio D. Pitlik*, Dan Gandacu†, Ruth Lang‡, Faris Nassar§, Debora Ben David¶, Ethan Rubinstein¶, Avi Izthaki#, Joseph Mishal**, Ruth Kitzes††, Yardena Siegman-Igra‡‡, Michael Giladi‡‡, Neora Pick§§, Ella Mendelson¶¶, Hanna Bin##, Tamar Shohat¶¶, and Michal Y. Chowers‡
Author affiliations: *Rabin Medical Center, Petach Tikva, Israel; †Israel Ministry of Health, Jerusalem, Israel; ‡Meir Medical Center, Kfar Sava, Israel; §Western Galilee Hospital, Nahariya, Israel; ¶The Chaim Sheba Medical Center, Tel Hashomer, Israel; #Assaf-Harofe Medical Center, Zrifin, Israel; **Barzilai Medical Center, Ashkelon, Israel; ††Carmel Medical Center, Haifa, Israel; ‡‡Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel; §§Bnei-Zion Medical Center, Haifa, Israel; ¶¶Central Virology Laboratory, Tel Hashomer, Israel; ##Israeli Center for Disease Control, Tel Hashomer, Israel

Main Article

Table 1

Reported outbreaks caused by West Nile virus in Israel

Year (Ref) Area Type of locality No. studied Age CNS involvement Reported deaths Documentation
1941 (4) Center &
Tel-Aviv Urban & rural 500 All ages None None None
1951 (5,6) Haifa Agricultural settlement 123 All ages Meningitis (1/123, 0.8%) None Virus isolate (1/123, 0.8%) Serology (14/26, 54%)
1950 (7) Hadera and coastal plain Army camps and communal settlement 105 17-40 y Nuchal rigidity ("a few cases") None Virus isolate (9/50, 18%)
Serology (18/24, 75%)
1950-53 (8) Militarya
hospital Army camps 400 17-23 y Meningitis (1/400, 0.3%) None NA
1953 (9) Tel Hashomer
Hospitala Army camps 70 18-20 y None None Virus isolate (13/70, 18%) Serology (50/70, 68%)
1957 (11) Hadera area Army camps 300 18-28 y Encephalitis (1/300, 0.3%) None Virus isolate (8/50, 40%)
Serology (139/154, 88%)
Urban & rural 65 All ages Encephalitis (2/56, 3.1%) None Serology (23/50, 46%)
Nursing homes 49 66-86 y Encephalitis 16/49 (33%) 4/49, 8.2% Serology (53%)
(in patients with encephalitis: 9/12, 75%)
1980 (12) Negev Desert Army camps 32 18 y Meningitis (1/32, 3.1%)
Nuchal rigidity (3/32, 9.3%) None Serology (10/11, 91%)
2000 (PR) Country-wide Urban and rural 417 0.5-95 Encephalitis (135/256, 51%) 35/265, 13%) 35/417, 8.4% Serology (417/417, 100%)

aSoldiers were transferred to military hospitals according to army routines, not necessarily because of severe illness.
CNS = central nervous system; y = year; PR = present report.

Main Article

  1. Chowers  MY, Lang  R, Nassar  F, Ben-David  D, Rubinshtein  E, Itzhaki  A, Clinical characteristics of West Nile fever outbreak, Israel, 2000. Emerg Infect Dis. 2001;7:675-8. DOIPubMedGoogle Scholar
  2. Statistical abstracts of Israel. Jerusalem, Israel: Central Bureau of Statistics; 2000. Pub. no. 51.
  3. Cohen  D, Zaide  Y, Karasenty  E, Schwarz  M, LeDuc  JW, Slepon  R, Prevalence of antibodies to West Nile fever, sandfly fever Sicilian, and sandfly fever Naples viruses in healthy adults in Israel. Public Health Rev. 1999;27:21730.PubMedGoogle Scholar
  4. Leffkowitz  M. On the frequent appearance of an unclear infectious disease. Harefuah. 1942;22:34.
  5. Bernkopf  H. The isolation of the West Nile virus in Israel. Harefuah. 1953;45:99101.PubMedGoogle Scholar
  6. Bernkopf  H, Levine  S, Nerson  R. Isolation of West Nile virus in Israel. J Infect Dis. 1953;93:20718. DOIPubMedGoogle Scholar
  7. Goldblum  N, Sterk  VV, Paderski  B. West Nile fever. The clinical features of the disease and the isolation of West Nile virus from the blood of nine human cases. Am J Hyg. 1954;59:89103.PubMedGoogle Scholar
  8. Radt  P. Clinical observations on patients with West Nile fever during outbreaks of the disease in 1950-1953. Harefuah. 1955;49:414.PubMedGoogle Scholar
  9. Marberg  K, Goldblum  N, Sterk  VV, Jasinska-Klingberg  W. MA K. The natural history of West Nile fever. I. Clinical observations during an epidemic in Israel. Am J Hyg. 1956;64:25969.PubMedGoogle Scholar
  10. Goldblum  N, Sterk  VV, Jasinska-Klingberg  W. The natural history of West Nile fever. II. Virological findings and the development of homologous and heterologous antibodies in the West Nile infection in man. Am J Hyg. 1957;66:36380.PubMedGoogle Scholar
  11. Spigland  I, Jasinska-Klinberg  W, Hofshi  E, Goldblum  N. Clinical and laboratory observations in an outbreak of West Nile fever in Israel. Harefuah. 1958;54:27581.PubMedGoogle Scholar
  12. Katz  G, Rannon  L, Nili  E, Danon  YL. West Nile fever-occurrence in a new endemic site in the Negev. Isr J Med Sci. 1989;25:3941.PubMedGoogle Scholar
  13. Flatau  E, Kohn  D, Daher  O, Varsano  N. West Nile fever encephalitis. Isr J Med Sci. 1981;17:10579.PubMedGoogle Scholar
  14. Siegel-Itzkovich  J. Twelve die of West Nile virus in Israel. BMJ. 2000;321:724.PubMedGoogle Scholar
  15. Shimoni  Z, Niven  M, Pitlik  D, Bulvik  M. Treatment of West Nile virus encephalitis with intravenous immunoglobulin. Emerg Infect Dis. 2001;7: 759. DOIPubMedGoogle Scholar
  16. Smithburn  KC, Hughes  TP, Burke  AW, Paul  JH. A neurotropic virus isolated from the blood of a native of Uganda. Am J Trop Med Hyg. 1940;20:47192.
  17. Tsai  TF, Popovici  F, Cernescu  C, Campbell  GL, Nedelcu  NI. West Nile encephalitis epidemic in southeastern Romania. Lancet. 1998;352:76771. DOIPubMedGoogle Scholar
  18. Centers for Disease Control and Prevention. Outbreak of West Nile-like viral encephalitis--New York, 1999. MMWR Morb Mortal Wkly Rep. 1999;48:8459.PubMedGoogle Scholar
  19. Centers for Disease Control and Prevention. Update: West Nile-like viral encephalitis--New York, 1999. MMWR Morb Mortal Wkly Rep. 1999;48:8902.PubMedGoogle Scholar
  20. Centers for Disease Control and Prevention. Update: West Nile virus encephalitis--New York, 1999. MMWR Morb Mortal Wkly Rep. 1999;48:9446, 955.
  21. Le Guenno  B, Bougermouh  A, Azzam  T, Bouakaz  R. West Nile: a deadly virus? Lancet. 1996;348:1315. DOIPubMedGoogle Scholar
  22. Centers for Disease Control and Prevention. Guidelines for surveillance, prevention, and control of West Nile virus infection--United States. MMWR Morb Mortal Wkly Rep. 2000;49:258.PubMedGoogle Scholar
  23. Lvov  DK, Butenko  AM, Gromashevsky  VL, Larichev  VP, Gaidamovich  SY, Vyshemirsky  OI, Isolation of two strains of West Nile virus during an outbreak in southern Russia, 1999. Emerg Infect Dis. 2000;6:3736. DOIPubMedGoogle Scholar
  24. Marfin  AA, Petersen  LR, Edison  M, Miller  J, Hadler  J, Farrelo  C, Expansion of West Nile virus activity throughout the eastern United States, 1999-2000. Emerg Infect Dis. 2001;7: 730-5. DOIPubMedGoogle Scholar
  25. Nir  Y, Avivi  A, Lasovski  Y, Margalit  J, Goldwasser  R. Arbovirus activity in Israel. Isr J Med Sci. 1972;8:1695701.PubMedGoogle Scholar
  26. Samina  I, Margalit  J, Peleg  J. Isolation of viruses from mosquitoes of the Negev, Israel. Trans R Soc Trop Med Hyg. 1986;80:4712. DOIPubMedGoogle Scholar
  27. Nir  Y, Goldwasser  R, Lasowski  Y, Avivi  A. Isolation of arboviruses from wild birds in Israel. Am J Epidemiol. 1967;86:3728.PubMedGoogle Scholar
  28. Annual report. Beit-Dagan, Israel: The Israeli Veterinary Services; 2000.
  29. Israel Ministry of Health. West Nile fever. Circular #44/2000 (September 19, 2000) 2000;2.
  30. Giladi  M, Metzkor-Cotter  E, Martin  DA, Siegman-Igra  Y, Korczyn  AD, Rosso  R, West Nile encephalitis in Israel, 1999: the New York connection. Emerg Infect Dis. 2001;7: 659-61. DOIPubMedGoogle Scholar
  31. Lanciotti  RS, Roehrig  JT, Deubel  V, Smith  J, Parker  M, Steele  K, Origin of the West Nile virus responsible for an outbreak of encephalitis in the northeastern United States. Science. 1999;286:23337. DOIPubMedGoogle Scholar
  32. Hindiyeh  M, Shulman  LM, Mendelson  E, Grossman  Z, Weiss  L, Bin  H. Isolation and characterization of West Nile virus from the blood of viremic patients during the 2000 outbreak in Israel. Emerg Infect Dis. 2001;7: 748-50. DOIPubMedGoogle Scholar
  33. Statistical abstracts of Israel. Jerusalem, Israel: Central Bureau of Statistics; 1958-59. Pub. no. 10.
  34. Solomon  T, Cardosa  MJ. Emerging arboviral encephalitis. Newsworthy in the west but much more common in the east. BMJ. 2000;321:14845. DOIPubMedGoogle Scholar
  35. Marra  CM. Encephalitis in the 21st century. Semin Neurol. 2000;20:3237.PubMedGoogle Scholar
  36. Sampson  BA, Ambrosi  C, Charlot  A, Reiber  K, Veress  JF, Armbrustmacher  V. The pathology of human West Nile virus infection. Hum Pathol. 2000;31:52731. DOIPubMedGoogle Scholar
  37. Shieh  WJ, Guarner  J, Layton  M, Fine  A, Miller  J, Nash  D, The role of pathology in an investigation of an outbreak of West Nile encephalitis in New York, 1999. Emerg Infect Dis. 2000;6:3702. DOIPubMedGoogle Scholar
  38. Steele  KE, Linn  MJ, Schoepp  RJ, Komar  N, Geisbert  TW, Manduca  RM, Pathology of fatal West Nile virus infections in native and exotic birds during the 1999 outbreak in New York City, New York. Vet Pathol. 2000;37:20824. DOIPubMedGoogle Scholar
  39. Rappole  JH, Derrickson  SR, Hubalek  Z. Migratory birds and spread of West Nile virus in the Western Hemisphere. Emerg Infect Dis. 2000;6:31928. DOIPubMedGoogle Scholar

Main Article

Page created: April 27, 2012
Page updated: April 27, 2012
Page reviewed: April 27, 2012
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.