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Archive Number 20070907.2956
Published Date 07-SEP-2007
Subject PRO/AH/EDR> West Nile virus - Israel (North District)


WEST NILE VIRUS - ISRAEL (NORTH DISTRICT)
********************************
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Date: Wed 5 Sep 2007
From: Raul Raz, Bibiana Chazan <raz_r@clalit.org.il>


4 cases of West Nile virus (WNV) encephalitis were diagnosed at the 
Ha' Emek Medical Center, Afula [North District], Israel

During the last 3 weeks, 4 inhabitants of the Afula surroundings were 
hospitalized due to fever, headache, confusional state, and stupor. 
These inhabitants included 2 females (58 and 64 years old) and 2 
males (40 and 66 years old). [Of these,] 2 were immunocompromised 
(one with colon carcinoma after chemotherapy, and the 2nd after 
kidney transplantation); one suffered from diabetes mellitus type 2, 
and the last was a healthy patient. One of them recalls a mosquito 
bite one week before the fever started.

After hospitalization, a complete work-up was done: CT (computerized 
tomography) and EEG (electroencephalography) did not show 
abnormalities. Lumbar puncture was compatible with viral 
encephalitis; Gram stain, spinal fluid cultures, and PCR [polymerase 
chain reaction] for herpes simplex virus [HSV] were negative. All of 
them received empirical treatment with Acyclovir IV... Because of a 
more severe clinical presentation, the kidney transplant patient 
received IVIG (intravenous immunoglobulin -- 0.5 g/kg/day for 4 days).

The diagnosis of WNV was confirmed by seroconversion in serum and CSF 
(cerebrospinal fluid) samples. [Seroconversion means that there were 
no WN antibodies in serum or CSF taken during the acute phase of 
illness, but they were present in those fluids taken during 
convalescence. - Mod.JW]

All the patients completely recovered and were discharged without 
neurological signs or symptoms.

--
Prof. Raul Raz
Dr. Bibiana Chazan
Infectious Disease Unit
Ha 'Emek Medical Center
Afula, Israel
<raz_r@clalit.org.il>

[ProMED-mail thanks Prof. Raul Raz and Dr. Bibiana Chazan for this 
report. Israel has sporadic human West Nile virus cases. - Mod.TY

Afula, south of Nazareth, in the Northern District of Israel, can be 
located on the map at
<http://www.un.org/Depts/Cartographic/map/profile/israel.pdf>. - CopyEd.MJ]

[see also:
2005
----
West Nile virus, human - Israel 20050731.2228
West Nile virus, birds, migratory - Israel (02) 20050205.0391
West Nile virus, birds, migratory - Israel 20050203.0377
2003
----
West Nile virus, human - Israel 20030712.1712
2002
----
West Nile virus, human - Israel (03) 20021021.5616
West Nile virus, human - Israel (02) 20020924.5389
West Nile virus, human - Israel 20020816.5065
West Nile virus, mosquitoes - Israel (04) 20020801.4910
West Nile virus, mosquitoes - Israel (03) 20020719.4796
West Nile virus, mosquitoes - Israel (02) 20020520.4276
West Nile virus, mosquitoes - Israel 20020516.4234
2001
----
West Nile virus, human - Israel 20010802.1510
2000
----
West Nile virus, human cases - Israel (08) 20000927.1667
West Nile virus, human case - Israel 20000901.1469
1999
----
West Nile virus, geese - Israel (02) 19991208.2132
West Nile virus, geese - Israel 19991123.2076]
........................................dk/ty/mj/jw 


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