title: Clinical characteristics of the West Nile fever outbreak, Israel, 2000.
abstract: 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.
authors.affiliation: Infectious Disease Unit, Meir Medical Center, Kfar Sava, Israel. chowers@netvision.net.il
authors.forename: M Y
authors.initials: MY
authors.lastname: Chowers
authors.forename: R
authors.initials: R
authors.lastname: Lang
authors.forename: F
authors.initials: F
authors.lastname: Nassar
authors.forename: D
authors.initials: D
authors.lastname: Ben-David
authors.forename: M
authors.initials: M
authors.lastname: Giladi
authors.forename: E
authors.initials: E
authors.lastname: Rubinshtein
authors.forename: A
authors.initials: A
authors.lastname: Itzhaki
authors.forename: J
authors.initials: J
authors.lastname: Mishal
authors.forename: Y
authors.initials: Y
authors.lastname: Siegman-Igra
authors.forename: R
authors.initials: R
authors.lastname: Kitzes
authors.forename: N
authors.initials: N
authors.lastname: Pick
authors.forename: Z
authors.initials: Z
authors.lastname: Landau
authors.forename: D
authors.initials: D
authors.lastname: Wolf
authors.forename: H
authors.initials: H
authors.lastname: Bin
authors.forename: E
authors.initials: E
authors.lastname: Mendelson
authors.forename: S D
authors.initials: SD
authors.lastname: Pitlik
authors.forename: M
authors.initials: M
authors.lastname: Weinberger
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D005260:Female; D005334:Fever / Q000503:physiopathology; D006760:Hospitalization; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D008587:Meningitis, Viral / Q000401:mortality / Q000503:physiopathology; D008875:Middle Aged; D014901:West Nile Fever / Q000453:epidemiology / Q000276:immunology / Q000401:mortality / Q000503:physiopathology*