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Emerg Infect Dis. 2001 Jul-Aug; 7(4): 675–678.
PMCID: PMC2631759
Clinical characteristics of the West Nile fever outbreak, Israel, 2000.
M. Y. Chowers, R. Lang, F. Nassar, D. Ben-David, M. Giladi, E. Rubinshtein, A. Itzhaki, J. Mishal, Y. Siegman-Igra, R. Kitzes, N. Pick, Z. Landau, D. Wolf, H. Bin, E. Mendelson, S. D. Pitlik, and M. Weinberger
Infectious Disease Unit, Meir Medical Center, Kfar Sava, Israel.
M. Y. Chowers: chowers/at/
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.
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