North Macedonia: West Nile Virus Cases Climb to 16
Health Minister Saso Klekovski detailed the outbreak's hot spots and the ground spraying campaign in Dracevo, the Skopje neighborhood with five confirmed West Nile fever cases.
The number of confirmed West Nile virus cases in North Macedonia has climbed to 16, and Health Minister Saso Klekovski said this morning, in an interview with Kanal 5 television, for the first time exactly where the hot spots are and what has been done on the ground so far. Most of the patients come from two regions, Skopje and Veles, and the highest concentration of cases in a single location was recorded in the Skopje neighborhood of Dracevo. For Serbia this is a detail about a neighboring country, not its own statistic, since North Macedonia sits along the same summer travel route south.
Authorities responded with an emergency treatment, targeted around the addresses where patients had been registered.
Emergency spraying was carried out within a radius of 200 meters around the homes of all registered patients.
Drawing a 200 meter circle around a patient’s home is not an arbitrary measure. It is an attempt to hit the mosquito breeding grounds in the immediate area, since this species does not travel long distances. In Dracevo, where the concentration is highest, a different method was used.
In Dracevo, which has five confirmed cases, ground spraying was carried out, which is more effective than spraying from the air.
The minister added that, alongside the emergency treatment, inspections were also carried out in Skopje and other municipalities, to check whether local governments had stuck to the previously planned schedule for routine mosquito spraying. According to him, most municipalities did keep to the calendar. That shifts the focus from reacting to individual cases toward the discipline of local administrations, in other words whether the work was done before people fell ill.
How the virus spreads and what 16 cases actually means
Klekovski stressed that the virus is not transmitted from person to person, nor through a mosquito that has previously bitten an infected person. The only route of transmission is the bite of an infected mosquito, and the reservoir of the infection is wild birds, which are its natural hosts.
That biology explains why the measures focus on treating mosquito habitats, and why the figure of 16 confirmed cases does not capture how widespread the virus actually is in nature:
- most infected people experience mild symptoms
- a smaller number of patients develop a more severe clinical picture, including meningitis
- death is possible, but rare
In other words, confirmed cases are largely limited to people who ended up in the healthcare system and were tested, while mild infections typically go unreported.
Why this is not the first time
West Nile fever is not new to North Macedonia. The minister recalled that the country’s highest case count was recorded in 2019, which means the current wave is being measured against an existing domestic baseline rather than an unfamiliar import. What has changed, however, is the geography of the infections.
In the past, a large share of infections in North Macedonia were linked to holidays in Greece, where the Attica region again recorded the most cases this season. Cases now appearing in Romania and Croatia show that West Nile fever is no longer confined to Mediterranean countries. It is moving toward continental Europe, following rivers, canals and wetlands where mosquitoes breed.
For public health in the region, that changes the practical calculation. Where the source of infection used to be sought in a patient’s travel history, it is now sought within a few hundred meters of their home, shifting responsibility onto municipal services and their spraying schedules. That is exactly why the Macedonian health ministry, alongside the emergency spraying, also checked the dates of the routine treatments: mosquito season runs until the autumn cooldown, and the next planned rounds of spraying fall in August, while the carrier is still active.
