Description of the situation
24 September 1996
Disease Outbreak Reported
As at 23 September, a total of 450 cases of viral meningitis had been reported in the outbreak which started in Bucharest at the end of July. The number of new cases has decreased in the past week and the number of patients hospitalized fell from over 200 to 26 between 11 and 23 September. More than half of the cases occurred in adults and more than 200 were in people over 60 years of age. Thirty-nine patients have died, most of them in the higher age groups.
The WHO Collaborating Centre for Reference and Research on Arboviruses and Haemorrhagic Fevers at Pasteur Institute, Paris, France has confirmed infection with West Nile virus in 89% of the patients investigated with very high levels of IgM antibody as well as IgG antibody in most cases. Infection with West Nile virus can be asymptomatic or cause an influenza-like illness. Severe manifestations include meningitis and meningoencephalitis, particularly in the elderly. Migratory birds are the natural reservoir of the virus which is transmitted to man by Culex mosquitos. The virus has been detected in Europe but is more common further south, in the Mediterranean region, Africa and western Asia. Precautions against infection include avoiding mosquito bites either through protective clothing or mosquito repellents. WHO strongly recommends against quarantine measures or the imposition of travel restrictions to Romania.