Characteristics and clinical outcomes of the West Nile virus outbreak in Israel 2024: A retrospective cohort study.

BACKGROUND

In 2024, Israel experienced its largest West Nile virus (WNV) outbreak in two decades, with over 930 cases and 72 deaths, revealing unique epidemiological patterns.

AIM

To describe the clinical features, outcomes, and risk factors for poor hospitalization outcomes in patients with WNV infection during this outbreak.

METHODS

A retrospective cohort study of WNV-infected patients admitted to Rabin Medical Center (RMC) during the year 2024. Data from electronic medical records were analyzed. A regression model was employed to identify risk factors associated with poor outcomes.

RESULTS

We included 177 patients. Their median age was 77 years, and 72 (41 %) were female. Fever (82 %), altered mentation (62 %), malaise (62 %), thrombocytopenia (44 %), acute renal failure (38 %), and lymphopenia (36 %) were common. West Nile neuroinvasive disease (WNND), primarily encephalitis (41 %), was diagnosed in 89 (50 %) patients. The median hospital stay was 7 days, with 22 (12 %) in-hospital deaths. Risk factors for mortality included a history of stroke, WNND, acute renal failure, and lymphopenia. Among survivors, 45 (29 %) were discharged for rehabilitation or long-term care facilities.

CONCLUSIONS

These findings highlight the clinical severity of WNV infections during the outbreak and underscore the importance of identifying high-risk patients to guide management and public health strategies.