West Nile Virus (WNV) Activity in Humans and Mosquitos

West Nile virus (WNV) activity in humans and mosquitos

Summary of 2018

Following is a summary of human cases, animals, birds and mosquitos positive for WNV by location for 2018.

In 2018, 147 human cases of West Nile Fever (WNF) were reported in Israel, of which 62 were suspected*. As expected, most of the morbidity occurred during the summer and autumn months, with over 50 patients in August alone. The level of morbidity was higher than the 2011-2017 average. Most of the patients this year resided in the Coastal Plain area. The distribution of patients by district was: North (19), Haifa (38), Central (54), Tel- Aviv (27), Jerusalem (1) and South (8).

A significant increase was noted in the number of infected animals as compared to the last few years.

אגף לאפידמיולוגיה Division of Epidemiology משרד הבריאות Ministry of Health ת.ד.1176 ירושלים P.O.B 1176 Jerusalem [email protected] [email protected] טל: 02-5080522 פקס: Tel: 972-2-5080522 Fax: 972-2-5655950 02-5655950

In 2018, WNV infected mosquitos were found in 42 locations in the country. In the middle of June in the Valley of Springs at the Northern District and in Yehuda Plains; in July, in the Jordan Rift Valley in addition to the Valley of Springs and in Rehovot area, in August, in the Jerusalem area and in the Coastal Plain; in September, in the Galilee, the Hula Valley, in the Jerusalem area and in the Coastal Plain; in October, in the Arabah Valley and in the Samaria area; and in November, in the Arabah Valley.

* A "suspected" human case refers to a patient whose lab test results indicate a possibility of infection with WNV. A human "confirmed" case refers to a patient whose lab test results show a definite infection with WNV. The final definition status of a case patient who initially was diagnosed as "suspected" may be changed to "confirmed" due to additional lab test results that were obtained over time.

Table 1: Positive test results for WNV in humans by location:

Date sample Diagnostic status Locality No. Locality Chamber received in lab according to lab 1 Umm Al-Fahm 15/10/2018 Confirmed Natanya

2 Or Yehuda 25/07/2018 Confirmed Tel aviv Or Aqiva 12/08/2018 Suspected Hadera 3 Or Aqiva 02/09/2018 Suspected Hadera 4 Oranit 06/09/2018 Confirmed Petah-tiqwa 5 Azor 28/05/2018 Suspected Tel aviv 6 Elat 12/08/2018 Confirmed Beer Sheva 7 Elyakhin 25/06/2018 Confirmed Natanya 8 I'billin 09/01/2018 Suspected Akko Ashdod 22/07/2018 Confirmed Ashqelon 9 Ashdod 26/12/2018 Suspected Ashqelon Baqa Al-Gharbiyye 14/08/2018 Confirmed Hadera 10 Baqa Al-Gharbiyye 23/09/2018 Suspected Hadera 11 Binyamina-Giva'at Ada 29/08/2018 Suspected Hadera 12 Bizzaron 12/01/2018 Suspected Ashqelon Bene Beraq 15/07/2018 Suspected Tel aviv Bene Beraq 30/07/2018 Confirmed Tel aviv Bene Beraq 12/09/2018 Confirmed Tel aviv 13 Bene Beraq 21/09/2018 Suspected Tel aviv Bene Beraq 16/09/2018 Confirmed Tel aviv Bene Beraq 29/10/2018 Suspected Tel aviv 14 Basma 27/09/2018 Confirmed Hadera 15 Bazra 19/08/2018 Confirmed Natanya

Table 1: Positive test results for WNV in humans by location - continued:

Date sample Diagnostic status Locality No. Locality Chamber received in lab according to lab 16 Bat Yam 27/08/2018 Confirmed Tel aviv 17 Giv'at Hayyim (Ihud) 17/04/2018 Suspected Natanya Gan Yavne 07/08/2018 Confirmed Rehovot 18 Gan Yavne 19/08/2018 Confirmed Rehovot 19 Gan Ner 12/09/2018 Suspected Afula 20 Dimona 19/08/2018 Confirmed Beer Sheva Herzliyya 02/07/2018 Confirmed Tel aviv Herzliyya 20/07/2018 Confirmed Tel aviv 21 Herzliyya 26/07/2018 Confirmed Tel aviv Herzliyya 12/08/2018 Confirmed Tel aviv Herzliyya 19/08/2018 Confirmed Tel aviv

Zikhron Ya'aqov 29/07/2018 Confirmed Hadera 22 Zikhron Ya'aqov 05/08/2018 Suspected Hadera Zikhron Ya'aqov 08/08/2018 Confirmed Hadera Hadera 27/06/2018 Suspected Hadera Hadera 04/07/2018 Confirmed Hadera Hadera 15/07/2018 Confirmed Hadera Hadera 25/07/2018 Confirmed Hadera 23 Hadera 02/08/2018 Suspected Hadera Hadera 22/08/2018 Suspected Hadera Hadera 26/08/2018 Suspected Hadera Hadera 12/09/2018 Suspected Hadera Hadera 20/09/2018 Suspected Hadera

Table 1: Positive test results for WNV in humans by location - continued:

Date sample Diagnostic status Locality No. Locality Chamber received in lab according to lab

24 Holon 07/10/2018 Suspected Tel aviv Haifa 13/03/2018 Suspected Haifa Haifa 28/06/2018 Suspected Haifa 25 Haifa 29/06/2018 Suspected Haifa Haifa 13/09/2018 Confirmed Haifa Haifa 15/10/2018 Suspected Haifa

26 Tiberias 18/11/2018 Suspected Kinneret

27 Tayibe 07/11/2018 Suspected Natanya 28 Tire 16/08/2018 Confirmed Natanya 29 Tirat Karmel 28/10/2018 Suspected Haifa 30 Yanuh-Jat 27/08/2018 Confirmed Akko 31 Yad Hanna 29/08/2018 Confirmed Natanya Yehud 16/07/2018 Confirmed Petah-tiqwa 32 Yehud 27/08/2018 Suspected Petah-tiqwa Yehud 27/08/2018 Confirmed Petah-tiqwa 33 Yaziz 13/09/2018 Suspected Ramla 34 Yarhiv 20/09/2018 Suspected Ramla 35 Kisra-Sumei 03/09/2018 Suspected Akko 36 Kefar Hess 30/04/2018 Suspected Natanya 37 Kefar Habad 11/06/2018 Confirmed Ramla Kefar Yona 19/07/2018 Confirmed Natanya 38 Kefar Yona 27/08/2018 Confirmed Natanya Kefar Yona 14/10/2018 Confirmed Natanya

Table 1: Positive test results for WNV in humans by location - continued:

Date sample Diagnostic status Locality No. Locality Chamber received in lab according to lab

Kefar Sava 13/08/2018 Confirmed Petah-tiqwa 39 Kefar Sava 20/09/2018 Confirmed Petah-tiqwa Lod 09/08/2018 Confirmed Ramla 40 Lod 23/08/2018 Suspected Ramla Lod 17/09/2018 Confirmed Ramla 41 Maggal 23/07/2018 Confirmed Hadera Modi'in-Makkabbim-Re'ut 23/07/2018 Suspected Ramla 42 Modi'in-Makkabbim-Re'ut 10/10/2018 Suspected Ramla Modi'in-Makkabbim-Re'ut 19/11/2018 Suspected Ramla 43 Modi'in Illit 06/09/2018 Confirmed Ramla 44 Mazor 08/08/2018 Confirmed Petah-tiqwa Mazkeret Batya 16/08/2018 Confirmed Rehovot 45 Mazkeret Batya 27/08/2018 Confirmed Rehovot 46 Ma'alot-Tarshiha 26/09/2018 Suspected Akko 47 Mattan 26/08/2018 Suspected Petah-tiqwa Nahariyya 26/02/2018 Suspected Akko 48 Nahariyya 04/07/2018 Confirmed Akko 49 Nizzan 16/09/2018 Confirmed Ashqelon Nazerat Illit 25/07/2018 Confirmed Afula 50 Nazerat Illit 30/08/2018 Confirmed Afula Netanya 13/08/2018 Suspected Natanya 51 Netanya 20/08/2018 Confirmed Natanya Netanya 30/08/2018 Confirmed Natanya 52 Adi 15/08/2018 Confirmed Akko 53 Omer 03/10/2018 Suspected Beer Sheva 54 Ein Mahal 19/11/2018 Suspected Nazareth

Table 1: Positive test results for WNV in humans by location - continued:

Date sample Diagnostic status Locality No. Locality Chamber received in lab according to lab

55 En Sarid 27/08/2018 Suspected Natanya Afula 26/08/2018 Suspected Afula 56 Afula 11/11/2018 Confirmed Afula Pardes Hanna-Karkur 27/08/2018 Suspected Hadera 57 Pardes Hanna-Karkur 04/07/2018 Confirmed Hadera Pardes Hanna-Karkur 19/08/2018 Confirmed Hadera Petah Tiqwa 16/08/2018 Confirmed Petah-tiqwa Petah Tiqwa 05/09/2018 Suspected Petah-tiqwa 58 Petah Tiqwa 16/09/2018 Confirmed Petah-tiqwa Petah Tiqwa 06/11/2018 Confirmed Petah-tiqwa 59 Zurit 20/08/2018 Suspected Akko 60 Zerufa 11/10/2018 Suspected Hadera Qalansawe 20/08/2018 Suspected Natanya 61 Qalansawe 06/09/2018 Suspected Natanya 62 Qiryat Atta 23/08/2018 Confirmed Haifa Qiryat Bialik 23/07/2018 Suspected Haifa 63 Qiryat Bialik 25/09/2018 Confirmed Haifa Qiryat Bialik 27/11/2018 Suspected Haifa Qiryat Motzkin 08/10/2018 Confirmed Haifa 64 Qiryat Motzkin 29/10/2018 Confirmed Haifa 65 Rosh Haayin 23/08/2018 Suspected Petah-tiqwa Rishon Leziyyon 28/06/2018 Confirmed Rehovot Rishon Leziyyon 06/06/2018 Confirmed Rehovot 66 Rishon Leziyyon 20/08/2018 Confirmed Rehovot Rishon Leziyyon 03/09/2018 Confirmed Rehovot Rishon Leziyyon 03/09/2018 Suspected Rehovot

Table 1: Positive test results for WNV in humans by location - continued:

Date sample Diagnostic status Locality No. Locality Chamber received in lab according to lab

Rehovot 14/08/2018 Confirmed Rehovot 67 Rehovot 02/10/2018 Suspected Rehovot Ramla 26/03/2018 Suspected Ramla 68 Ramla 19/07/2018 Confirmed Ramla Ramla 23/08/2018 Confirmed Ramla Ramat Gan 27/06/2018 Confirmed Tel aviv 69 Ramat Gan 09/08/2018 Confirmed Tel aviv Ramat Gan 17/09/2018 Confirmed Tel aviv Ramat Hasharon 15/07/2018 Confirmed Tel aviv 70 Ramat Hasharon 01/08/2018 Confirmed Tel aviv Ramat Hasharon 12/09/2018 Confirmed Tel aviv 71 Ra'annana 19/07/2018 Suspected Petah-tiqwa 72 Shibli-Umm Al-Ghanam 07/08/2018 Confirmed Afula 73 Sede Warburg 06/08/2018 Confirmed Petah-tiqwa 74 Sede Yizhaq 23/07/2018 Suspected Hadera 75 Sede Nizzan 29/08/2018 Confirmed Beer Sheva 76 Sedot Yam 11/10/2018 Confirmed Hadera 77 Shelomi 04/09/2018 Confirmed Akko 78 Shefar'am 12/03/2018 Suspected Akko 79 Sarid 23/08/2018 Suspected Afula Tel Aviv-Yafo 15/07/2018 Confirmed Tel aviv Tel Aviv-Yafo 07/08/2018 Confirmed Tel aviv 80 Tel Aviv-Yafo 29/08/2018 Confirmed Tel aviv Tel Aviv-Yafo 02/09/2018 Confirmed Tel aviv Tel Aviv-Yafo 07/09/2018 Suspected Tel aviv 81 Teqoa 11/10/2018 Suspected Jerusalem

Table 2: Positive test results for WNV in mosquitoes by place of capture:

Date sample Locality No. Location District received in lab 1 Sede Eliyyahu 14/06/2018 Northern 2 Na'an pool 1E/06/2018 /entral 3 Sede Eliyyahu 03/07/2018 Northern 4 Almog 11/07/2018 Jerusalem 5 Sede Eliyyahu 30/07/2018 Northern 6 Eqron stream 30/07/2018 /entral 7 Springs of Gibbeton reserve 30/07/2018 /entral 8 Soreq stream 01/08/2018 Jerusalem 9 Itung canal 07/08/2018 Haifa 10 Roshrashi stream 07/08/2018 Haifa 11 Ada stream 07/08/2018 Haifa 12 Mishmarot 07/08/2018 Haifa 13 Keidar 08/08/2018 Jerusalem 14 Midrach stream (1) 13/08/2018 Northern 15 Midrach stream (2) 13/08/2018 Northern 16 Netz hashofet, hazorea pools 13/08/2018 Northern 17 Kishon stream, Ram-On reservoir 13/08/2018 Northern 18 Soreq stream road 3 1D/08/2018 /entral 19 Elon reservoir 1D/08/2018 /entral Nir stream bridge 28/08/2018 SoutOern 20

Table 2: Positive test results for WNV in mosquitoes by place of capture - continued:

Date sample Locality No. Location District received in lab 21 Kefar Tavor-canal 27/08/2018 Northern 22 Tvor stream-hashiva 27/08/2018 Northern 23 Poriya-reclaimed Golani industrial area 27/08/2018 Northern 24 Kefar Hasidim-d canal 27/08/2018 Haifa 25 Abandoned house 27/08/2018 Jerusalem 26 Rehovot Bilu-center 28/08/2018 /entral 27 Bill Fields-'Ramat Hasharon 29/08/2018 Tel Aviv 28 /anyon Beit Hakerem- Gilon junction 02/09/2018 Northern 29 Shechem stream- bridge over rode 5714 03/09/2018 /entral 30 Soreq stream- fodder stock 03/09/2018 /entral 31 Olive grove-'Zor'a 03/09/2018 Jerusalem 32 Naaman stream- 1 16/09/2018 Northern 33 Hula valley 16/09/2018 Northern 34 Shraga c 16/09/2018 Northern 35 Naaman stream- 'Kefar Masaryk 16/09/2018 Northern 36 Hagosherim 16/09/2018 Northern 37 Kabri - cemetery 16/09/2018 Northern 38 Yotvata palm center 10/10/2018 Southern 39 9lot palm 10/10/2018 Southern 40 Yotvata oxygenation pond 10/10/2018 Southern 41 Alfe Menashe hazait street 3 1D/10/2018 /entral Yotvata oxygenation pond 21/11/2018 42 Southern

Table 3: Positive WNV in animals and birds by location:

Date sample No. Animal Location received in lab 1 Yellow-legged seagull Ramat Gan 24/06/2018 2 goose (x2) Burgeta 12/07/2018 3 Donkey (x2) Gan Yoshiyya 12/07/2018 4 Long-eared owl Hadid 1D/07/2018 5 Long-eared owl Ramat Razi'el 19/07/2018 6 Horse Kefar Truman 23/07/2018 7 Hooded crow Rishon Leziyyon 08/08/2018 8 Armenian seagull Nizzanim 08/08/2018 9 Pheasant Burgeta 14/08/2018 10 horse Balfurya 2D/08/2018 11 Horse Kafar Qasem 26/08/2018 12 9agle owl Megadim 02/09/2018 13 Horse MMMsh 20/09/2018 14 Hooded crow Ramat Gan 03/10/2018 15 Hooded crow Unknown 16/10/2018 17/10/2018 16 Hooded crow Unknown

Plans for continued activity:

The Ministry of Health, in cooperation with the Ministry of Environmental Protection, will continue to monitor the presence of the virus in mosquitoes. The importance of monitoring is particularly high during the summer and autumn seasons (May to November).

As with any season of WNV activity, it is important to increase:

1. Efforts to control mosquitos in areas where increased virus activity has been monitored.

2. Public relations efforts to ensure the use of personal protective measures and the drying of standing water sources in order to reduce the risk of mosquito bites.

2018 West Nile Virus (WNV) Morbidity graph in Israel in comparison to the average morbidity in 2011-17 (updated 31.12.18)

Cases/month 2018 Avarage cases/months 2011-2017 Cumulative 2018 Cumulative avarage 2011-2017 160 140 120 100 Cases 80 60 40 20 0

Jan Mar May Jul Sep Nov

Months

Geographic distribution of new cases of WNF / and WNV infections in mosquitos, animals and birds Updated to 31/12/2018 36 !

!( Birds positive to WNV !( Animals positive to WNV ! Mosquitos positive to WNF 33 ! Human cases of WNF: 2 Shelomi Suspected Confirmed Nahariyya 'Ma'alot-Tarshiha 37 ! Yanuh-Jat Kisra-Sumei 34 ! 0 5 10 20 Kilometers 28 ! Zurit 35 ! !32 Qiryat MotzkinQiryat Bialik

Haifa I'billin Qiryat AttaShefar'am Tiberias Adi 23 Tirat Karmel ! 24 ! Ein Mahal Nazerat Illit

Shibli-Umm Al-Ghanam Sarid 2!2 Zerufa 16 ! ! Afula10 15 !( ! !14 Zikhron Ya'aqov

17 Gan Ner Or Aqiva Umm Al-Fahm ! Sedot Yam11 ! 12 Hadera! Basma 9 Pardes Hanna-Karkur ! 10 ! Baqa Al-Gharbiyye 3 Elyakhin !1 Giv'at Hayyim (Ihud)Sede Yizhaq Maggal

Yad Hanna29 Netanya ! Kefar Yona Qalansawe En Sarid Tayibe Kefar Hess Tire Sede WarburgBazra HerzliyyaRa'annana Kefar Sava 41 YarhivMatta!n 27 Ramat Hasharo!n Oranit Tel Aviv-Yafo 11 Bene Beraq !(Rosh Haayin Ramat Gan 3 !( 13 !( Yehud Azor Mazor Bat YamHolon Or Yehuda Rishon LeziyyonKefar Habad

Lod

Ramla Modi'in Illit Modi'in-Makkabbim-Re'ut Rehovot 5 ! Yaziz2 26 19 ! 7 ! 6! Mazkeret Baty!a ! ! Ashdod 26!!6 7 19 Bizzaron 18 Gan Yavne ! 8 6 4 ! !( ! Nizzan 31 30 13 25 ! ! ! !

Teqoa

20 !

Omer Seda Nizzan

Dimona

38 !42 !40

39 Ela!t

Participants in the preparation of the current report:

The National Center for Zoonotic Viruses Tel-Hashomer, The Division of Epidemiology, The Rambam Health Care Campus, Virology Laboratories at Tel Aviv Sourasky Medical Center, Emek Medical Center, Carmel Medical Center, Laboratory of Entomology, the Ministry of Health; and the Division of Pest Surveilance & Control, The Ministry of Environmental Protection. Data on animals infected by WNV were obtained from the Qimron Veterinary Institute, the Department of Virology and the Poultry Diseases Division. Wild birds are collected by the Nature and Parks Authority and the Wildlife Hospital at the Safari.