West Nile Fever Reaches the Neighborhood: What to Do

Should West Nile fever make you cancel a trip to Greece or Skopje? No. But repellent and a window screen belong on tonight’s packing list anyway, because the virus spreads through the bite of an infected mosquito, and the nearest outbreak is now just a few hours’ drive from Presevo.

North Macedonia has recorded its first death from West Nile fever. The victim was an 83 year old man from Skopje, treated at the Clinic for Infectious Diseases and Febrile Conditions. According to the Institute of Public Health of North Macedonia, his symptoms began on August 2: fever, chills, headache, general weakness, joint and muscle pain, a stiff neck and altered consciousness. He was diagnosed with meningitis, and the presence of the virus was confirmed through serological testing of his cerebrospinal fluid. He also had other chronic conditions.

“The patient also had many underlying conditions,” said Dr. Fadil Cana, director of the University Clinic for Infectious Diseases in Skopje.

Five more patients are in serious condition, in intensive care and on mechanical ventilation. Three people whose illness has reached the central nervous system are being treated at home. Cana said the clinic has hospitalized 29 patients suspected of the neuroinvasive form of the disease this year, 25 of whom were laboratory confirmed, while eight have recovered.

“The clinic has so far dealt successfully with these cases, which means it has the capacity to diagnose and treat all these patients,” Cana said at a news conference alongside the deputy health minister and representatives of the Institute of Public Health and the Skopje Center for Public Health.

Since May 15, North Macedonia has registered 26 cases, 25 of them in Skopje and one in Veles. Most of the infected are older than 60.

Where has the epidemic been declared?

The Skopje Center for Public Health has declared an epidemic in the municipalities of Kisela Voda, Gazi Baba, Aerodrom, Butel and Ilinden, as well as in the settlements of Dracevo, Prsino, Donje Lisice, Kadino and Jurumleri. The goal is more effective monitoring and prevention. If your route to the coast runs through Skopje, these are the parts of the city where an overnight stay calls for a window screen.

What is happening in Greece in the meantime?

The numbers there are climbing faster than next door. As of August 12, Greece’s National Public Health Organization, EODY, had confirmed 110 cases and nine deaths. Of those infected, 81 developed illness affecting the central nervous system, meningitis or encephalitis. In the past seven days alone, 45 new cases were reported, and the people who died ranged in age from 65 to 91.

The virus has been detected in 39 municipalities across 14 regional units. Attica has been designated a high risk zone, particularly Pallini, Vari-Voula-Vouliagmeni, Marathon, Agia Paraskevi, Chalandri, Glyfada, Athens and Piraeus, an area we already covered when the outbreak was still confined to Attica. The virus has now also been confirmed in Thessaly, Central Macedonia and the Peloponnese, and EODY is urging caution, since it suspects the true spread is wider than the confirmed case count shows.

And here at home?

According to Serbia’s Institute of Public Health, Batut, two cases have been registered since the surveillance season began on June 1 through August 9, both in Belgrade, in people aged 75 and 85. Both patients were hospitalized at the Clinic for Infectious and Tropical Diseases with the neuroinvasive form of the disease.

For the wider picture, as of August 5 Europe had reported 241 locally acquired cases across seven countries: Italy with 139, Greece with 61, Spain with 17, North Macedonia with 13, Romania with 6, France with 4 and Germany with 1. Greece’s figure of 61 is already a week old, which shows how fast the situation is shifting.

Five things you can do tonight

• Apply repellent to exposed skin before heading out in the evening, and reapply after every swim.
• Fit screens on windows and doors, especially in the bedroom and the children’s room.
• Empty standing water from flowerpots, buckets, kiddie pools, lids and gutters. That is where mosquitoes lay their eggs.
• Wear long sleeves and pants when sitting in the yard or on the terrace.
• If an older family member develops a high fever with a severe headache and a stiff neck, do not wait until morning.

Our advice is simple. Keep your tickets to Greece where they are, and pack your mosquito gear along with them. The risk this season is not the same for everyone: in both Skopje and Greece, severe cases mostly hit people older than 60 and those with chronic conditions. If you are traveling with parents or grandparents, repellent and a window screen are not a detail, they are part of the trip plan.