Emilia Anis1, Itamar Grotto2, Ella Mendelson3, Hanna Bin3, Laor Orshan4, Dan Gandacu5, Bruce Warshavsky5, Eilat Shinar6, Paul E Slater7, Boaz Lev5. 1. Ministry of Health, Jerusalem, Israel; Hebrew University and Hadassah, Jerusalem, Israel. Electronic address: Emilia.anis@moh.health.gov.il. 2. Ministry of Health, Jerusalem, Israel; Ben-Gurion University of the Negev, Beer-Sheva, Israel. 3. Ministry of Health, Jerusalem, Israel; Central Virology Laboratory, Tel Hashomer, Israel. 4. Ministry of Health, Jerusalem, Israel; Laboratory of Entomology, Jerusalem, Israel. 5. Ministry of Health, Jerusalem, Israel. 6. Magen David Adom Blood Services, Israel. 7. Ministry of Health, Jerusalem, Israel; Hebrew University and Hadassah, Jerusalem, Israel.
Abstract
BACKGROUND: As a crossroads for bird migration between Africa and Eurasia and with its long history of human infection, Israel has been a major focus of attention during the continuing global spread of West Nile fever (WNF). This article reviews the background and reemergence of WNF in Israel; the recent epidemiology of WNF among Israelis; and the disease-control strategies being used to combat the disease. METHODS: Employing the comprehensive base of case data that are reported to the Ministry of Health, an epidemiological record was constructed that details the incidence and distribution of WNF cases in Israel in recent years. RESULTS: After decades of small, intermittent outbreaks, nearly 1400 cases of WNF were reported in Israel between 2000 and 2012. Incidence was consistently highest in the coastal cities, among elderly patients, and in the late summer months and early autumn. A broad range of control measures to prevent human infection has been implemented, and attention has been given to issues such as the protection of the national blood bank and the occurrence of long-term sequelae. CONCLUSIONS: The reemergence of WNF in Israel is likely the result of a combination of factors including past immunity to the virus among the human population, a marked increase in awareness of WNF among physicians, and more frequent requests for the laboratory testing of suspected cases. In the absence of effective vaccine to protect humans from WNF, the best disease-control strategies include intensive vector-control measures, the continued development of techniques to forecast outbreaks, and effective public education programs that are targeted toward the high-risk elderly population.
BACKGROUND: As a crossroads for bird migration between Africa and Eurasia and with its long history of humaninfection, Israel has been a major focus of attention during the continuing global spread of West Nile fever (WNF). This article reviews the background and reemergence of WNF in Israel; the recent epidemiology of WNF among Israelis; and the disease-control strategies being used to combat the disease. METHODS: Employing the comprehensive base of case data that are reported to the Ministry of Health, an epidemiological record was constructed that details the incidence and distribution of WNF cases in Israel in recent years. RESULTS: After decades of small, intermittent outbreaks, nearly 1400 cases of WNF were reported in Israel between 2000 and 2012. Incidence was consistently highest in the coastal cities, among elderly patients, and in the late summer months and early autumn. A broad range of control measures to prevent humaninfection has been implemented, and attention has been given to issues such as the protection of the national blood bank and the occurrence of long-term sequelae. CONCLUSIONS: The reemergence of WNF in Israel is likely the result of a combination of factors including past immunity to the virus among the human population, a marked increase in awareness of WNF among physicians, and more frequent requests for the laboratory testing of suspected cases. In the absence of effective vaccine to protect humans from WNF, the best disease-control strategies include intensive vector-control measures, the continued development of techniques to forecast outbreaks, and effective public education programs that are targeted toward the high-risk elderly population.
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