West Nile fever strikes again in Israel: five residents of northern Tel Aviv aged 60 and over were hospitalized in the last two weeks at the Ichilov Hospital in Tel Aviv after contracting the deadly virus, the condition of three of them is serious and they are hospitalized in the intensive care unit.
According to Dr. Yevgeni Katzman, an expert in internal medicine and infectious diseases in Ichilov, all the patients come from the areas of Ramat Hay’il, Shikon Dan, and the Tzahala area, all of whom are healthy and active people in their seventh decade of life. “This is an outbreak, so it is important to warn the public,” says Dr. Katzman. In all my years as a doctor, I have not seen so many patients who come close to being hospitalized because of the disease.”
“In young people who get infected, the disease is mild and accompanied by a little abdominal pain, diarrhea or fever,” adds Dr. Katzman, “on the other hand, for the older public it is a real danger, because the virus may cause more significant damage that may lead to confusion, neurological symptoms and cognitive damage that manifests itself, for example, in confusion or in the ability to understand”.
West Nile fever: questions and answers
West Nile fever disease is caused by infection with a virus that resides in the wild among birds. The course of the disease begins with mosquitoes that bite birds and transmit the virus to them, which continues to live in the birds’ bodies. In the next step, the mosquitoes bite again, and transmit the virus to animals and humans.
When did the disease first appear in Israel?
According to data from the Ministry of Health, the disease has been widespread in Israel for many years and tends to appear in peak waves in the summer. The first documentation of West Nile fever as an outbreak was registered in Israel in 1950-1954 and in 1957 a second outbreak was recorded.
In the 1970s and 1980s, increased activity of the virus was recorded again. In 1997, the disease was diagnosed in poultry, for the first time flocks of geese for fattening were affected, which were found to be particularly sensitive, and the disease manifested itself a year later in a large-scale outbreak. In 2000 there was an outbreak in Israel with more than 400 cases of the disease. From 2001 until today, dozens of cases have been diagnosed every year.
What is the infection rate in Israel?
Every year several dozen patients are reported in Israel, most of them in their fourth decade or older.
Which areas are infected in Israel?
The infected mosquitoes are mostly found in the areas of Sharon, Hadera, Pardes Hana-Karkur in Nimina and Caesarea. However, cases of infection have been reported throughout the country. from north to south. In the current case, the cases were recorded in North Tel Aviv.
What are the symptoms of the disease?
This is a mild disease for the most part, but it can also cause severe morbidity and mortality. The infection usually passes without symptoms. In some cases, a flu-like illness appears which goes away on its 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 signs corresponding to meningitis, acute encephalitis or acute flaccid paralysis. The incubation period is usually 7 to 14 days, and in exceptional cases three to 21 days. The disease does not pass from person to person.
What to do if you are bitten?
Most mosquitoes in Israel are not infected with the reagent and therefore there is no reason to panic. In the event of an allergic reaction to a bite manifested by swelling, redness and itching, or the appearance of signs of infection manifested by redness, local heat, pain or high fever, or in the event of the appearance of flu symptoms after a bite – seek medical advice.
Is it possible to get infected from a person infected with a virus?
No, the disease does not pass from person to person.
Who is at risk?
The risk of infection is very low. At high risk are patients with chronic diseases that suppress the immune system, cancer patients with poor immune systems, infants and the elderly.
Can dogs and cats be infected and contagious?
According to the medical literature, the virus is transmitted in nature only by infected mosquitoes, and there is no evidence to suggest infection from an animal to humans.
If I have been infected before, can I be infected again?
Infection with the virus does not immunize against it, and therefore even those who have previously been infected with the West Nile virus may become infected again.
Is there a vaccine against the virus?
No. However, in 2015, a vaccine that was proven effective in an experiment on laboratory animals entered the clinical trial phase.
How is the treatment carried out?
Since there is no treatment against the disease, the only way to deal with it is to prevent mosquito bites through the use of mosquito repellents, window screens and appropriate clothing.
What are the warning signs that require a visit to the emergency room after a mosquito bite?
• Prolonged fever over a week.
• Multiple vomiting with every attempt to drink.
• Failure to urinate for more than 10 hours.
• Rapid breathing (over 20 per minute in an adult, over 40 per minute in a child).
• Decreased state of consciousness.
• Aversion to light.
• Headaches that are unusual in intensity or that wake you up from sleep.
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