West Nile Virus (WNV) Activity in Humans and Mosquitos

West Nile virus (WNV) activity in humans and mosquitos

Updated for 28/11/2016

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

Cumulative numbers of human case patients and mosquitos positive for WNV by location:

Until the 28/11/2016, human cases with WNF have been identified in 54 localities and WNV infected mosquitos were found in 6 localities.

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

Table showing WNV in human by place of residency:

Date sample Diagnostic status Locality No. Locality Health district received in lab according to lab 1 Or Yehuda 31/05/2016 Suspected Tel Aviv Or Yehuda 02/06/2016 Suspected Tel Aviv 2 Or Aqiva 17/07/2016 Suspected Hadera 3 Ashdod 19/09/2016 Suspected Ashqelon Ashdod 27/09/2016 Confirmed Ashqelon 4 Ashqelon 29/08/2016 Suspected Ashqelon Ashqelon 05/09/2016 Confirmed Ashqelon Ashqelon 08/09/2016 Confirmed Ashqelon Ashqelon 13/09/2016 Confirmed Ashqelon Ashqelon 22/09/2016 Confirmed Ashqelon Ashqelon 22/09/2016 Confirmed Ashqelon 5 Baqa Al-Gharbiyye 18/10/2016 Suspected Hadera 6 Be'er Sheva 24/08/2016 Confirmed Be'er Sheva 7 Bizzaron 27/09/2016 Suspected Ashqelon 8 Bet Haemeq 29/06/2016 Confirmed Akko 9 Bet Hashitta 25/08/2016 Suspected Afula 10 Bet Yehoshua 28/07/2016 Confirmed Natanya 11 Bene Ayish 09/08/2016 Suspected Ashqelon Bene Ayish 07/11/2016 Suspected Ashqelon 12 Jatt 17/07/2016 Confirmed Hadera 13 Judeide-Maker 11/07/2016 Suspected Akko 14 Hod Hasharon 15/09/2016 Confirmed Petah-Tiqwa 15 Herzliyya 28/08/2016 Confirmed Tel Aviv Herzliyya 11/09/2016 Confirmed Tel Aviv Herzliyya 13/10/2016 Suspected Tel Aviv 16 Hadera 13/07/2016 Confirmed Hadera Hadera 02/08/2016 Confirmed Hadera Hadera 27/07/2016 Confirmed Hadera 17 Holon 27/06/2016 Confirmed Hadera Holon 13/09/2016 Suspected Tel Aviv Holon 31/10/2016 Suspected Tel Aviv 18 Huqoq 05/10/2016 Suspected Kinneret 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

Table showing WNV in human by place of residency - continued:

Date sample Diagnostic status Locality No. Locality Health district received in lab according to lab 19 Haifa 17/05/2016 Suspected Haifa Haifa 25/08/2016 Confirmed Haifa Haifa 07/09/2016 Confirmed Haifa Haifa 16/08/2016 Suspected Haifa 20 Tirat Karmel 08/02/2016 Confirmed Haifa 21 Tamra 01/08/2016 Suspected Akko Tamra 08/08/2016 Confirmed Akko 22 Yoqne'am 26/09/2016 Confirmed Afula 23 Jerusalem 03/08/2016 Confirmed Jerusalem Jerusalem 10/08/2016 Confirmed Jerusalem 24 Kefar Blum 19C09C2016 Confirmed Zefat 25 Kefar Yehezqel 21/07/2016 Suspected Afula 26 Kefar Ya'bez 1DC09C2016 Confirmed Petah-Tiqwa 27 Kefar Sava 1DC09C2016 Confirmed Petah-Tiqwa 28 Kafar Qasem 29C09C2016 Suspected Petah-Tiqwa 29 Lod 08/06/2016 Suspected Ramla 30 Mevasseret Ziyyon 20/01/2016 Suspected Jerusalem 31 Mizpe Aviv 07/09/2016 Confirmed Akko 32 Merom Golan 18/08/2016 Confirmed Zefat 33 Nazerat Illit 25/08/2016 Suspected Afula 34 Netanya 07/07/2016 Confirmed Natanya Netanya 06/07/2016 Confirmed Natanya 35 Sakhnin 13C09C2016 Confirmed Akko 36 Akko 08/08/2016 Suspected Akko 37 Afula 01/08/2016 Suspected Afula 38 Ar'ara 24/08/2016 Confirmed Hadera 39 Ar'ara-Banegev 02/11/2016 Confirmed Be'er Sheva 40 Pardes Hanna-Karkur 13/07/2016 Confirmed Hadera Pardes Hanna-Karkur 31/07/2016 Confirmed Hadera Pardes Hanna-Karkur 18/10/2016 Suspected Hadera 41 Petah Tiqwa 06/10/2016 Confirmed Petah-Tiqwa

Table showing WNV in human by place of residency - continued:

Date sample Diagnostic status Locality No. Locality Health district received in lab according to lab 42 Qalansawe 03/03/2016 Suspected Natanya 43 Qiryat Ono 05/06/2016 Confirmed Tel Aviv Qiryat Ono 21/09/2016 Confirmed Tel Aviv 44 Qiryat Atta 22/07/2016 Confirmed Haifa Qiryat Atta 28/07/2016 Suspected Haifa Qiryat Atta 06/09/2016 Confirmed Haifa Qiryat Atta 21/11/2016 Suspected Haifa 45 Qiryat Bialik 04/06/2016 Suspected Haifa Qiryat Bialik 28/08/2016 Suspected Haifa 46 Qiryat Gat 27/07/2016 Confirmed Ashqelon 47 Qiryat Yam 06/09/2016 Suspected Haifa 48 Rosh Pinna 28/08/2016 Confirmed Zefat 49 Ramla 14/09/2016 Confirmed Ramla 50 Ramat Gan 09/08/2016 Suspected Tel Aviv Ramat Gan 25/08/2016 Confirmed Tel Aviv Ramat Gan 08/09/2016 Confirmed Tel Aviv Ramat Gan 14/09/2016 Confirmed Tel Aviv 51 Ramat Hashsron 08/08/2016 Confirmed Tel Aviv 52 Rannana 05/06/2016 Suspected Petah-Tiqwa 53 Sha'ar Menashe 14C09C2016 Suspected Hadera 54 Tel Aviv 06/07/2016 Suspected Tel Aviv Tel Aviv 09/08/2016 Confirmed Tel Aviv Tel Aviv 25/09/2016 Suspected Tel Aviv

Table showing WNV positive in mosquitos by place of capture:

Date sample Locality No. Location District received in lab 1 Tayibe 08/09/2016 Central 2 Neve Jakob, Jerusalem 08/09/2016 Jerusalem Neve Jakob, Jerusalem 04/08/2016 Jerusalem 3 Poleg stream 08/09/2016 Central 4 Rimonim stream 02/06/2016 Northern 5 Ramat David 29/06/2016 Northern 6 Soreq stream 05/09/2016 Jerusalem

Until November 28, 86 cases of West Nile Fever (WNF) have been reported in Israel, of which 50 are confirmed and 36 are suspected. The majority of the patients reside in the area of Gush Dan area (26 patients from Tel Aviv, Petah-Tiqwa, and Ramle districts or sub-districts) and the Haifa area (19 patients from the Haifa and Akko districts or sub- districts) – areas that are known as endemic for WNF presence. This year there is a concentration of patients around Hadera (11 patients), (12 patients) in Ashqelon and in Jezreel Valley area (5 patients). Interestingly, this year 3 patients have been identified in Jerusalem, an area of low activity of the virus.

So far this year, mosquitos positive for WNV have been identified in early June in Rimonim stream in northern Israel (Jezreel Valley area), at the end of June, near Ramat David; at the beginning of August and at the beginning of September in Neve Jakob neighborhood in Jerusalem ; and at the beginning of September in Poleg stream, Soreq stream and Tayibe. It is important to be noted that during the last few months, monitoring of adult mosquitos that is usually carried out by the Ministry of Environmental Protection, was reduced significantly. Currently, the results of mosquitos sampling rely on sporadic monitoring, and therefore the information provided does not reflect the spatial distribution and prevalence of infected mosquitoes in Israel and cannot be compared to previous years.

The following graph describes human morbidity from WNF in Israel in 2016 compared to the 2011-2015 mean during the same period. The main activity of the virus is concentrated during the months of June through October. However, some cases occur at the end of the season and beyond (during the winter). Therefore, it is important for health professionals to be aware to this possibility. In comparing the number of cases this year to the 5-year average, it appears that this year (until November 28) the number of patients was significantly higher in June, July and September. The level of morbidity in August 2016 was similar to the average morbidity during August in the prior 5 years. However, the level of morbidity in October and November was lower than the 5-year average.

2016 West Nile Virus (WNV) Morbidity graph in Israel in comparison to the average morbidity in 2011-15 (updated 28.11.16)

Cases/month 2016 Avarage cases/months 2011-2015 Cumulative 2016 Cumulative avarage 2011-2015 100

Cases 60 40

20 0

Jul Jan Feb Mar Apr May Jun Aug Sep Oct Nov Dec. אגף לאפידמיולוגיה Division of Epidemiology משרד הבריאות Ministry of Health Months 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

Geographic distribution of new cases of WNF and West Nile Virus infections in mosquitoes in Israel, 2016 Updated to 28/11/2016 ±

! Mosquitos positive to WNF

Suspected

Confirmed Kefar Blum

Merom Golan

Bet Haemeq Rosh Pinna

Judeide-Maker Akko

Huqoq Qiryat Yam Tamra Sakhnin

Qiryat Bialik Mizpe Aviv Haifa Qiryat Atta

Tirat Karmel

Nazerat Illit Ramat David ! Yoqne'am

Afula

Rimonim stream! Kefar Yehezqel Bet Hashitta

Or Aqiva Ar'ara Pardes Hanna-Karkur

Hadera Sha'ar Menashe

JattBaqa Al-Gharbiyye

0 5 10 20 Kilometers Netanya ± Netanya Tayibe Qalansawe Poleg stream ! ! Kefar Ya'bez ! Mosquitos positive to WNF Bet Yehoshua 1

Suspected

Confirmed HerzliyyaRa'annana Kefar Sava Hod Hasharon Ramat Hashsron

Ramat Gan Kafar Qasem Tel Aviv Petah Tiqwa Qiryat Ono

Holon Or Yehuda

Lod Ramla

Neve Jakob, Jerusalem !

Ashdod Mevasseret Ziyyon BizzaronBene Ayish Jerusalem Soreq stream !

Ashqelon

Qiryat Gat

Be'er Sheva

Ar'ara-Banegev 0 5 10 20 Kilometers

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; Laboratory of Entomology, the Ministry of Health; and Division of Pest Surveilance & Control,The Ministry of Environmental Protection.