Outcome of West Nile fever in older adults.

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 (>or=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.