West Nile Fever Puts Two Skopje Patients on Ventilators

Seven patients with confirmed West Nile fever were being treated at the University Clinic for Infectious Diseases in Skopje on July 31, 2026, two of them breathing with the help of a machine. The virus that pulled North Macedonia onto the European transmission map ignores borders, and the mosquitoes carrying it fly across the same lowland that runs up to Serbia from the south, which makes the Skopje count a seasonal warning for Belgrade rather than a piece of neighbourhood news.

The clinic says the two patients in critical condition are 76 and 66 years old and are in the intensive care unit. Three more people, admitted with suspected acute inflammation of the brain and its membranes, are waiting on laboratory results from the Institute of Public Health. Another three patients continue treatment at home even though the disease has reached their central nervous system as well.

All seven hospitalized patients come from Skopje, but from different neighbourhoods. Only one of them had travelled to Greece. Every patient is over 60 and carries several underlying conditions, the combination that most often pushes this infection into its severe, invasive form.

Clinic director Fadil Cana described the state of the ward to Macedonian media:

Seven have been confirmed, and in three cases there is strong suspicion that it could be the same infection. All the other patients are older than 60 and have many comorbidities. They are stable and are being treated according to all modern medical protocols. That age group is exposed to the most severe invasive form of the virus

Cana is drawing a line between two groups, the confirmed cases and those still waiting on a result. If the suspicion holds, a single clinic in a single city will have ten patients carrying the same virus in the same week.

Why does it matter that only one patient travelled?

Because it changes the explanation. When patients arrive after a trip abroad, epidemiologists log imported cases and look for the source outside the country. Here the ratio is reversed: six of the seven never left Skopje, and they live in different parts of the city. That spread points to local transmission, to mosquitoes that picked the virus up where the patients live, rather than to one hotspot that can be fenced off and sprayed overnight.

West Nile fever does not pass from person to person. Birds are the reservoir and the carrier is a mosquito of the Culex genus, which bites an infected bird and then a human. People are a dead end for the virus, they do not pass it on, but in a small share of infections it turns into inflammation of the brain or its membranes and ends up in a ward like the one in Skopje.

Six countries, thirty five regions

The Skopje cases do not stand alone. According to the European Centre for Disease Prevention and Control (ECDC), by July 22, 2026 West Nile virus had been recorded in 35 regions across six European countries: 20 in Italy, 6 in Greece, 4 in Romania, 2 in North Macedonia, 2 in Spain and 1 in France.

The date on that list matters. North Macedonia was already down for two affected regions a week before the Skopje ward filled up. What looks on July 31 like seven hospital beds began earlier in the statistics, through cases that never needed intensive care and never reached the news.

The transmission season in this part of Europe does not end in July. Culex mosquitoes stay active while the nights are warm, and in the basins of the southern Balkans that lasts into autumn. The next figure that changes anything will come from the Institute of Public Health laboratory, with results for the three patients still logged as suspected.