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Outcome of West Nile Fever in Older Adults


Address correspondence to Yitshal N. Berner MD, MPH, Geriatric Medicine, Meir Hospital, 57 Tchernichowski Street, Kfar Saba 44281 Israel. E-mail: or


OBJECTIVES: To determine the effect of clinical presentation and cognitive changes on the postdischarge outcome in older adult patients with West Nile fever (WNF).

DESIGN: Retrospective, cohort analysis.

SETTING: Meir Hospital located in the center of Israel in the Sharon region.

PARTICIPANTS: Thirty-two patients aged 65 and older hospitalized during a WNF outbreak.

MEASUREMENTS: All patients' charts were analyzed retrospectively with special emphasis on their cognitive and functional state. A follow-up examination of patients with functional decline at discharge was performed after 3 months.

RESULTS: A change in consciousness, rather than in cognition, predicted the outcome. The death rate was 22% (7/32); all fatal cases were aged 78 and older. Similarly, the functional decline and residual damage appeared only in the older age group (≥75). Eighty-eight percent of the survivors returned to their premorbid function. In contrast to other viral infections, chronic conditions in the subjects had no effect on the outcome.

CONCLUSIONS: In older adults, WNF carries a high death rate, but the outcome is favorable for the survivors.