West Nile Virus Outbreak in Israel 2024 Compared with Previous Seasons: A Retrospective Study

Abstract Introduction Since May 2024, Israel has been experiencing a large West Nile virus (WNV) outbreak. We aimed to compare the clinical characteristics and outcomes of hospitalized cases to previous years and identify predictors of poor outcomes. Methods A retrospective study. We compared WNV in...

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Main Authors: Guy Katzenellenbogen, Michal Canetti, Ili Margalit, Yonatan Shusterman, Alon Simchovitz-Gesher, Lior Naveh, Nadav Baharav, Miki Goldenfeld, Ana Belkin, Marina Brod, Anat Wieder-Finesod, Eyal Leshem, Erez Magiel, Itzchak Levy, Yaniv Lustig, Victoria Indenbaum, Nicola Maggio, Shahar Dekel, Bella Mechnik, Yovel Peretz, Noam Barda, Amir Tafesh, Dafna Yahav, Gili Regev-Yochay
Format: Article
Language:English
Published: Adis, Springer Healthcare 2025-04-01
Series:Infectious Diseases and Therapy
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Online Access:https://doi.org/10.1007/s40121-025-01140-3
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author Guy Katzenellenbogen
Michal Canetti
Ili Margalit
Yonatan Shusterman
Alon Simchovitz-Gesher
Lior Naveh
Nadav Baharav
Miki Goldenfeld
Ana Belkin
Marina Brod
Anat Wieder-Finesod
Eyal Leshem
Erez Magiel
Itzchak Levy
Yaniv Lustig
Victoria Indenbaum
Nicola Maggio
Shahar Dekel
Bella Mechnik
Yovel Peretz
Noam Barda
Amir Tafesh
Dafna Yahav
Gili Regev-Yochay
author_facet Guy Katzenellenbogen
Michal Canetti
Ili Margalit
Yonatan Shusterman
Alon Simchovitz-Gesher
Lior Naveh
Nadav Baharav
Miki Goldenfeld
Ana Belkin
Marina Brod
Anat Wieder-Finesod
Eyal Leshem
Erez Magiel
Itzchak Levy
Yaniv Lustig
Victoria Indenbaum
Nicola Maggio
Shahar Dekel
Bella Mechnik
Yovel Peretz
Noam Barda
Amir Tafesh
Dafna Yahav
Gili Regev-Yochay
author_sort Guy Katzenellenbogen
collection DOAJ
description Abstract Introduction Since May 2024, Israel has been experiencing a large West Nile virus (WNV) outbreak. We aimed to compare the clinical characteristics and outcomes of hospitalized cases to previous years and identify predictors of poor outcomes. Methods A retrospective study. We compared WNV infection cases hospitalized during the 2024 outbreak (from 29 May to 29 July) to cases hospitalized during 2018–2023. For the entire cohort, risk factors for poor outcomes were investigated using multivariable analyses. The primary outcomes were death and a composite outcome of 30-day all-cause mortality, prolonged hospitalization (≥ 28 days), or discharge to an institution. Results We included 134 patients, 103 admitted during 2024 and 31 during 2018–2023. The majority (109/134, 81%) had neuroinvasive disease, mostly encephalitis. In 2024, patients were older, with a lower functional state, and a higher proportion were severely immunocompromised. Mortality was numerically higher in 2024 (15/103, 15% versus 2/31, 6%). Altogether, nearly 40% of patients had poor outcomes, including 13% (17/134) mortality and 25% (34/134) discharged to institutions. Nearly 30% of patients who were severely immunocompromised died; all had B-cell depletion. Age was the only significant predictor of poor outcomes in multivariable analysis; however, patients with B-cell depletion had > 3 times higher odds for mortality (odds ratio 3.26, 95% confidence interval 0.73–13.07). Conclusions The large 2024 outbreak of WNV was associated with considerable mortality and functional impairment among hospitalized patients that was higher compared with previous years. Poor outcomes were particularly observed in older adults and patients with B-cell depletion. The observation of severe disease and poor outcomes in patients with B-cell depletion, as well as possible therapeutic implications, should be further investigated.
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spelling doaj-art-901b1e9f50ae42249e6a82d82fc0aa752025-08-20T03:05:11ZengAdis, Springer HealthcareInfectious Diseases and Therapy2193-82292193-63822025-04-011471405141510.1007/s40121-025-01140-3West Nile Virus Outbreak in Israel 2024 Compared with Previous Seasons: A Retrospective StudyGuy Katzenellenbogen0Michal Canetti1Ili Margalit2Yonatan Shusterman3Alon Simchovitz-Gesher4Lior Naveh5Nadav Baharav6Miki Goldenfeld7Ana Belkin8Marina Brod9Anat Wieder-Finesod10Eyal Leshem11Erez Magiel12Itzchak Levy13Yaniv Lustig14Victoria Indenbaum15Nicola Maggio16Shahar Dekel17Bella Mechnik18Yovel Peretz19Noam Barda20Amir Tafesh21Dafna Yahav22Gili Regev-Yochay23Pediatric Infectious Diseases Unit, Safra Medical CenterFaculty of Medical and Health Sciences, Tel-Aviv UniversityFaculty of Medical and Health Sciences, Tel-Aviv UniversityDepartment of Neurology, Sheba Medical CenterInternal Medicine T, Sheba Medical CenterInfectious Diseases Unit, Sheba Medical CenterInfectious Diseases Unit, Sheba Medical CenterFaculty of Medical and Health Sciences, Tel-Aviv UniversityInternal Medicine D, Sheba Medical CenterInternal Medicine F, Sheba Medical CenterFaculty of Medical and Health Sciences, Tel-Aviv UniversityFaculty of Medical and Health Sciences, Tel-Aviv UniversityDepartment of Neurology, Sheba Medical CenterFaculty of Medical and Health Sciences, Tel-Aviv UniversityFaculty of Medical and Health Sciences, Tel-Aviv UniversityFaculty of Medical and Health Sciences, Tel-Aviv UniversityFaculty of Medical and Health Sciences, Tel-Aviv UniversityInternal Medicine D, Sheba Medical CenterInfectious Control Unit, Sheba Medical CenterInfectious Control Unit, Sheba Medical CenterThe Sheba Pandemic Preparedness Research Institute (SPRI), Sheba Medical CenterInfectious Diseases Division, Rambam Health Care CampusFaculty of Medical and Health Sciences, Tel-Aviv UniversityFaculty of Medical and Health Sciences, Tel-Aviv UniversityAbstract Introduction Since May 2024, Israel has been experiencing a large West Nile virus (WNV) outbreak. We aimed to compare the clinical characteristics and outcomes of hospitalized cases to previous years and identify predictors of poor outcomes. Methods A retrospective study. We compared WNV infection cases hospitalized during the 2024 outbreak (from 29 May to 29 July) to cases hospitalized during 2018–2023. For the entire cohort, risk factors for poor outcomes were investigated using multivariable analyses. The primary outcomes were death and a composite outcome of 30-day all-cause mortality, prolonged hospitalization (≥ 28 days), or discharge to an institution. Results We included 134 patients, 103 admitted during 2024 and 31 during 2018–2023. The majority (109/134, 81%) had neuroinvasive disease, mostly encephalitis. In 2024, patients were older, with a lower functional state, and a higher proportion were severely immunocompromised. Mortality was numerically higher in 2024 (15/103, 15% versus 2/31, 6%). Altogether, nearly 40% of patients had poor outcomes, including 13% (17/134) mortality and 25% (34/134) discharged to institutions. Nearly 30% of patients who were severely immunocompromised died; all had B-cell depletion. Age was the only significant predictor of poor outcomes in multivariable analysis; however, patients with B-cell depletion had > 3 times higher odds for mortality (odds ratio 3.26, 95% confidence interval 0.73–13.07). Conclusions The large 2024 outbreak of WNV was associated with considerable mortality and functional impairment among hospitalized patients that was higher compared with previous years. Poor outcomes were particularly observed in older adults and patients with B-cell depletion. The observation of severe disease and poor outcomes in patients with B-cell depletion, as well as possible therapeutic implications, should be further investigated.https://doi.org/10.1007/s40121-025-01140-3West Nile virusNeuroinvasive diseaseOutbreakMortalityIsrael
spellingShingle Guy Katzenellenbogen
Michal Canetti
Ili Margalit
Yonatan Shusterman
Alon Simchovitz-Gesher
Lior Naveh
Nadav Baharav
Miki Goldenfeld
Ana Belkin
Marina Brod
Anat Wieder-Finesod
Eyal Leshem
Erez Magiel
Itzchak Levy
Yaniv Lustig
Victoria Indenbaum
Nicola Maggio
Shahar Dekel
Bella Mechnik
Yovel Peretz
Noam Barda
Amir Tafesh
Dafna Yahav
Gili Regev-Yochay
West Nile Virus Outbreak in Israel 2024 Compared with Previous Seasons: A Retrospective Study
Infectious Diseases and Therapy
West Nile virus
Neuroinvasive disease
Outbreak
Mortality
Israel
title West Nile Virus Outbreak in Israel 2024 Compared with Previous Seasons: A Retrospective Study
title_full West Nile Virus Outbreak in Israel 2024 Compared with Previous Seasons: A Retrospective Study
title_fullStr West Nile Virus Outbreak in Israel 2024 Compared with Previous Seasons: A Retrospective Study
title_full_unstemmed West Nile Virus Outbreak in Israel 2024 Compared with Previous Seasons: A Retrospective Study
title_short West Nile Virus Outbreak in Israel 2024 Compared with Previous Seasons: A Retrospective Study
title_sort west nile virus outbreak in israel 2024 compared with previous seasons a retrospective study
topic West Nile virus
Neuroinvasive disease
Outbreak
Mortality
Israel
url https://doi.org/10.1007/s40121-025-01140-3
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