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PubMed1995

Molecular epidemiology of foot-and-mouth disease (FMD) in Israel in 1994 and in other Middle-Eastern countries in the years 1992-1994.

The reverse transcriptase-polymerase chain reaction (RT-PCR) and direct sequencing were employed in the diagnosis and typing of foot-and-mouth disease virus (FMDV) in samples taken during the 1994 disease outbreak in Israel. Using PCR, virus isolation and serological methods it was shown that the 1994 disease outbreak in Israel and other Middle-Eastern countries was caused by O1 type virus. Direct PCR sequencing of VP1 genes and homology analysis of the virus isolates revealed that there were two distinct outbreaks in Israel. The first originated in Jordan, moved to the West Bank territory and then to the Lower Galilee. The second outbreak, caused by another virus, was responsible for disease outbreaks in South Lebanon, Upper Galilee and the Golan Heights. When viral sequences of isolates from the 1993 outbreaks in Egypt and Lebanon were included in the analysis, they showed a high degree of VP1 sequence homology between themselves, suggesting a common origin.

Animals↗
PubMed1978

Influenza surveillance in Israel, 1976--77.

An influenza surveillance program developed and conducted in three districts in Israel during winter 1976--77, was based mainly on morbidity data in the general population, corroborated by sero-epidemiologic surveys on selected groups. This information was supplemented by data on mortality organized according to specific age groups. During the period under study, similar results were observed in each of the three districts surveyed. Two successive waves of influenza were recorded: an early wave due to B/Hong Kong/5/72 followed by an A/Victoria/3/75 outbreak. Both waves were of moderate extent, with the highest frequency of clinical influenza occurring in the youngest group, age 0--14 years. The age-specific mortality rates were highest and rather similar in the extreme age groups 65+ and 0. The search of A/New Jersey/8/76 antibody revealed a considerable proportion of positives with a higher titer in the older age groups. A special serologic survey among Yemenite Jews over 50 years of age, who immigrated to Israel in 1949, showed that the 1918 influenza pandemic also reached that isolated country. The surveillance program provided an early warning system as well as a rather accurate measurement of influenza impact in Israel.

Adolescent↗
PubMed1989

Demography and the shaping of Israel's borders.

"This paper will show that the demographic map of the Land of Israel in its present form is essentially the principal factor in shaping the extent of Jewish settlement in this generation, and that there is little possibility of changing this pattern except for making small and insignificant adjustments." The author describes the changing demographic picture in Palestine from the late nineteenth century to the present day, particularly changes in the ethnic composition of the population. He concludes that the presence of a majority Arab population in the Occupied Territories of Judea, Samaria, and the Gaza Strip will oblige Israel to compromise with regard to granting cultural and political autonomy. Furthermore, three large Arab enclaves in Israel proper--Galilee, the triangle, and the Bedouin Negev--will have to be given up if current settlement patterns do not radically change, which is itself unlikely.

Asia↗
PubMed2001

Epidemiology of suicide in Israel: a nationwide population study.

BACKGROUND: In Israel, some population characteristics and lifestyle patterns make epidemiological research on suicide of particular interest. The Israeli population is characterized by ethnic diversity, with a multi-religious, multi-national mosaic of Jews and Arabs. These subgroups also vary in their suicidal behavior. The aims of the present study were to examine the trends in suicide incidence rates in Israel from 1984 to 1994, to identify sub-populations at high risk for suicide and to identify suicide methods associated with increased risk. METHODS: Suicide rate trends in Israel over the period from 1984 to 1994 were examined for four subgroups: Jewish men and women, and Arab men and women. Cases of undetermined external cause (UEC) of death were also considered. Mortality data were obtained from the computerized data files of the Israeli Central Bureau of Statistics, which includes cause of death and sociodemographic variables. Suicide was classified according to the ICD-9 codes. RESULTS: Suicide rates were higher for Jews than for Arabs, and higher for men than for women. The rates among both population and sex groups increased directly with age. A significant increase over the years studied was found for Jewish men, particularly in the 18- to 21-year-old age group. An increase in the use of firearms was noted, mainly in the groups in which total suicide rates increased. CONCLUSIONS: The findings of this study highlight the need for further studies to identify both sub-populations at high risk for suicide, and societal trends such as lifestyles, immigration, military service, and media exposure to violence, as first steps toward planning of intervention programs to reduce suicide rates.

Adolescent↗
PubMed1996

Molecular genetics of familial hypercholesterolemia in Israel.

Familial hypercholesterolemia (FH) is an autosomal dominant disease caused by a multitude of low density lipoprotein receptor (LDL-R) mutations. The purpose of the current investigation was to define the spectrum of mutations causing FH in Israel and determine their relative distribution among diverse origin groups. A total of 193 FH families were recruited in Israel, 54 of them through the MED PED (Make Early Diagnosis Prevent Early Death) FH program. Molecular analysis of the LDL-R using single-strand conformation polymorphism (SSCP) or denaturing gradient gel electrophoresis (DGGE) or both has been completed in 95 index cases. This analysis resulted in the identification of 15 LDL receptor mutations, including 7 novel mutations (del 197, C308G, R385W, splice junction mutation of intron 14, del 328, del 502-505, stop 10, del 165), that were present in 49 index cases (52%). The 15 mutations are mapped to three known functional domains of the receptor (7 in the LDL-binding region, 7 in the epidermal growth factor precursor homology region and 1 in the membrane-spanning region). Screening for the identified mutations in the remaining 98 index cases enabled the molecular diagnosis of 31 additional cases. It is therefore concluded that 80 out of 193 index cases (41%) harbor 1 of the 15 mutations described here. Three mutations-del197 (FH-Lithuania), D147H (FH-Sephardic), and stop660 (Lebanese allele)-were found in a total of 66 index cases (34%); these may be regarded as founder mutations in the three respective origin groups. In conclusion, in Israel molecular heterogeneity at the LDL receptor gene locus reflects the ethnic distribution of its origin groups. The results of the present investigation provide valuable diagnostic tools for a subset of the Israeli patients with FH who are at high risk for atherosclerosis and its complications.

Arabs↗
PubMed2000

Comparisons of the polar lipid and pigment profiles of two solar salterns located in Newark, California, USA, and Eilat, Israel.

The whole community pigments and lipids have been examined during a 5-year period in two commercial solar salterns located in the United States and in Israel. There were significant differences in the complexity of the lipid and pigment patterns within the California saltern system, and these differences were not consistent over the sampling period despite examination of ponds with the same salinity. The solar saltern system in Eilat, Israel, showed greater consistency during this sampling period and compared directly with previous studies. The complexity of the saltern in Newark, California, could be explained on the basis of the prevailing weather conditions (cooler and more rainfall) and the nutrient-enriched source water. The Eilat saltern, however, has an oligotrophic water source and has a considerably warmer and drier climate. This difference resulted in more diverse and more complex pigment and lipid patterns and presumably microbial populations in the Newark, California, plant than in the saltern in Eilat, Israel.

Biomass↗
PubMed2002

Increasing incidence of gonorrhea in Israel associated with countrywide dissemination of a ciprofloxacin-resistant strain.

The annual incidence of gonorrhea in Israel has sharply increased during the past 2 years. At the end of 1999, high-level ciprofloxacin-resistant strains of Neisseria gonorrhoeae (MIC90, > or =32 mcg/ml) also exhibiting decreased susceptibility to penicillin and tetracycline were isolated for the first time in southern Israel, as well as in other regions of the country. The incidence of male gonococcal urethritis in the south increased in a 1.5-year period from 3/100,000 to 12/100,000 ( P<0.05) in correlation with increased isolation of ciprofloxacin-resistant organisms. A marked increase in the incidence of gonorrhea was also encountered in Jerusalem, where ciprofloxacin resistance affected 54.5% of the isolates in 2000. Pulsed-field gel electrophoresis typing of gonococci from different areas of Israel indicated that all of the ciprofloxacin-resistant isolates belonged to identical or related strains. Since fluoroquinolone-resistant gonococci may emerge and disseminate extensively over a short period of time, continuous surveillance of antibiotic susceptibility among gonococcal isolates should be performed to guide empiric therapy.

Adult↗
PubMed2006

Genetic analysis of nonstructural genes (NS1 and NS2) of H9N2 and H5N1 viruses recently isolated in Israel.

The avian influenza virus subtype H9N2 affects wild birds, domestic poultry, swine, and humans; it has circulated amongst domestic poultry in Israel during the last 6 years. The H5N1 virus was recorded in Israel for the first time in March 2006. Nonstructural (NS) genes and NS proteins are important in the life cycle of the avian influenza viruses. In the present study, NS genes of 21 examples of H9N2 and of two examples of H5N1 avian influenza viruses, isolated in Israel during 2000-2006, were completely sequenced and phylogenetically analyzed. All the H9N2 isolates fell into a single group that, in turn, was subdivided into three subgroups in accordance with the time of isolation; their NS1 and NS2 proteins possessed 230 and 121 amino acids, respectively. The NS1 protein of the H5N1 isolates had five amino acid deletions, which was typical of highly pathogenic H5N1 viruses isolated in various countries during 2005-2006. Comparative analysis showed that the NS proteins of the H9N2 Israeli isolates contained few amino acid sequences associated with high pathogenicity or human host specificity.

Animals↗
PubMedDate not supplied

Hospitalization for primary varicella-zoster virus infection and its complications in patients from Southern Israel.

BACKGROUND: We conducted this study to determine the impact of chickenpox on two different ethnic populations in southern Israel: Jews and Bedouins. METHODS: Hospital records of 113 patients discharged from the Soroka Medical Center with the diagnosis of varicella during a 4.5-year period were reviewed. RESULTS: Mean age was 9.2 years and the average hospital stay was 5.4 days. Bacterial skin or soft tissue infections were the most common complications (30%), followed by pneumonia (17%) and central nervous system complications (11.5%). There were no fatal cases throughout the study period. The calculated hospitalization rate for varicella was one in every 319 cases. Major differences between Jews and Bedouins included an older mean age of Bedouin patients (13.9 years versus 4.5 years); higher hospitalization rate (relative risk [R.R.]: 2.8, 95% confidence interval: 1.9-4.2), and higher risk for complicated varicella (R.R.: 2.1, 95% confidence interval: 1.3-3.4). CONCLUSION: Hospitalization of patients with varicella in southern Israel is common and varicella infection in Bedouins is associated with greater morbidity compared with that in Jews in southern Israel.

Adolescent↗
PubMed1996

Spatial concentration and deconcentration of population: Israel as a case study.

"The present study examines population concentration and deconcentration in Israel in 1948-1992, distinguishing between the local (the metropolitan areas of Tel Aviv, Jerusalem and Haifa) and national levels. It covers the periods of immigration in the 1950s and the late 1980s (in the latter mainly from the former Soviet Union) and the period in between, when the waves of immigration to Israel died down and internal migration became the main factor shaping population distribution in Israel. The end of the article examines the methodological and theoretical significance of the empirical results."

Asia↗
PubMed1982

Viral hepatitis during pregnancy in Israel.

Epidemiological, clinical and laboratory data were obtained relating to 89 pregnant women who suffered from viral hepatitis during the period 1967-1977 in Israel. The obstetrical data, course of labor and details about the newborn, were all compared with the accepted obstetrical standards in Israel and abroad. A follow-up study was made of the 89 women and 69 of the offspring from these pregnancies, covering a period of from 2 to 10 years. The data of the present study demonstrate that during the last decade, a period of generally rising socio-economic status in Israel, viral hepatitis in pregnant women, ran a more favorable course than that previously reported. The incidence of hepatitis is equal in all trimesters of pregnancy, and a favorable outcome may usually be anticipated for the mother and the newborn.

Adolescent↗
PubMedDate not supplied

Resurgence of hydatid disease (echinococcosis) in communities in northern Israel.

Hydatid disease (echinococcosis), formerly endemic in the area of Israel, has occurred only sporadically in the past 40 years, mostly in immigrants. An unusual spatial and temporal cluster of surgically confirmed infections in northern Israel led to a review of echinococcosis hospital records. This revealed a resurgence of the disease in some rural and semirural Arab and Druze communities. Between 1960 and 1989, 224 cases of hydatid disease were surgically confirmed in residents of these communities. During this period, as the Arab-Druze population doubled, the mean annual surgical incidence of new cases per 100,000 rose 5-fold from 1.4 to 7.1. In Yirka, a Druze community of 7500 persons, from which no cases were known before 1970 and in which 52 cases were surgically confirmed thereafter, the mean annual surgical incidence for 1980-1989 rose to 53/100,000, to become one of the highly endemic areas of the world. The probable explanation of the outbreak is that, since 1967 with the opening of the border, importation of infected sheep has occurred from the hydatid-endemic West Bank region to individual homes in the communities in northern Israel. The sheep are raised to maturity in pens before home slaughtering; the offal, available to dogs, resulted in canine and then human infections.

Disease Outbreaks↗
PubMed2004

Survival after nontraumatic spinal cord lesions in Israel.

OBJECTIVE: To assess survival in patients with nontraumatic spinal cord lesions (SCL). DESIGN: Retrospective cohort study. SETTING: Spinal department at a rehabilitation hospital in Israel. PARTICIPANTS: Patients with nontraumatic SCL (N=1085) admitted between 1962 and 2000. INTERVENTIONS: Demographic, clinical, and mortality data were collected from hospital charts and from the Population Registry of the Israel Ministry of Internal Affairs. MAIN OUTCOME MEASURES: Survival rates and mortality risk factors. Measures were estimated by using the product limit (Kaplan-Meier) method and the Cox model. RESULTS: Maximal survival time was 57 years. Median accumulated survival time was 24 years. Survival was significantly affected by lesion etiology, age, gender, severity of lesion, and recent decade of lesion onset; survival tended to be shorter in patients with higher level SCL. We found no significant difference between the effects of risk factors on mortality in nontraumatic SCL and traumatic SCL, other than the effect of age at lesion onset, which was a greater risk factor in the latter group. CONCLUSIONS: The survival rate of patients with nontraumatic SCL has improved significantly in Israel in the last decade. The survival rates of a mixed nontraumatic SCL population are similar to those of traumatic SCL but may differ in specific etiologic age groups.

Adolescent↗
PubMed2006

"JDC-ESHEL," a unique non-governmental organization dedicated to the elderly in Israel.

"JDC-ESHEL," a non-governmental organization (NGO), has over the past 35 years been involved in the planning and development of services for the elderly in Israel. This organization functions under the auspices of the Joint Distribution Committee (JDC), an American based NGO which provides relief, rescue and reconstruction services to Jewish and non-Jewish clients around the world. Under the roof of the relevant government ministries, JDC-ESHEL brings together prominent stakeholders and professionals involved in the care of Israel's older citizens in order to plan and initiate pilot projects relevant to the elderly. Through an explicit consultative process, this NGO has developed services both in the community as well as in the institutional sectors, helping in this way to keep the rates of both acute and long-term nursing home care in Israel down to manageable levels. JDC-ESHEL offers an instructive example of how a nationally based NGO can play a major role in the planning and development of relevant services for the elderly, via the leverage produced through its relatively modest budget. In this way it provides a multiplier effect throughout the entire health and social service sectors.

Aged↗
PubMed2006

National health budgets for expensive orphan drugs: Gaucher disease in Israel as a model.

Drugs for orphan diseases are often disproportionately costly, although the patient population is by definition small. In Israel, with a high percentage of Ashkenazi Jews and therefore many patients with Gaucher disease, the expense of enzyme replacement therapy for all patients would be prohibitive. For this reason, with approval of enzyme replacement therapy in Israel, the low-dose regimen (30 U/kg/month), less than one quarter of the manufacturer's original recommended dosage, was instituted as the starting regimen. A Gaucher Committee of medical experts under the auspices of the Ministry of Health determines eligibility for enzyme replacement therapy based on criteria of disease severity. At the advent of 2006, 184 patients in Israel receive enzyme replacement therapy, about one third of all known Israeli patients with Gaucher disease. The national budget provides capitation for each patient to each Sick Fund via a health care basket for severe/expensive treatments. After nearly nine years, the benefits of these innovations include availability of budget for patients requiring enzyme replacement therapy, evidence-based data that low dose is safe and effective, and that untreated mildly affected patients generally continue a benign disease trajectory, but if necessary, have recourse to enzyme replacement therapy, that is, patient care is never compromised. Questionnaires of satisfaction with this system highlight good outcome scores. For countries with limited resources, the use of an impartial committee of experts is recommended, as is long-term surveillance of all patients; maintenance protocols or even drug vacations as enzyme-treated patients approach normalization of disease parameters should be considered.

Budgets↗
PubMed2005

The Jewish-Arab divide in life expectancy in Israel.

Life expectancy at birth in Israel in 2001 was 77.7 years for males and 81.6 years for females among Jews, and 74.5 and 77.8 years for males and females, respectively, among Israeli Arabs. In spite of vast improvements in health conditions of the two populations since Israel's statehood in 1948, persistent disparities in life expectancy between the two groups have challenged the Israeli socialized health care system. These disparities are influenced primarily by differences between the two population groups in infant and child mortality rates. This early study suggests that the distribution of life expectancy across localities in Israel reflects the distribution of those localities' socio-economic condition index (not including health and medical care), and the distribution of medical services. The positive association between life expectancy and the index is pronounced, however, only within the Jewish population but not among Arabs. While there may be no significant difference in life expectancy among Jews and Arabs living in poorer communities, there are fewer Arabs living in relatively affluent communities. Thus, persistent higher concentration of poverty among Arabs than among Jews has sufficed to maintain the gap in life expectancy between them. In addition, however, there are population-specific effects: wealth and education are more protective among Jews than among Arabs, while medical services are more protective among Arabs.

Adolescent↗
PubMed2006

Mapping of Aspergillus Section Nigri in Southern Europe and Israel based on geostatistical analysis.

Geostatistical analysis was applied to the incidence of Aspergillus Section Nigri and A. carbonarius in Southern Europe and Israel for the 3-year period 2001-2003 to facilitate identification of regions of high risk from contamination with these fungi and production of ochratoxin. The highest incidence of black aspergilli was normally observed at harvesting. At this grape growth stage, spatial variability of black aspergilli was significantly related to latitude and longitude, showing a positive West-East and North-South gradient. Predictive maps of infected berries incidence were drawn and showed the same trend in the 3 years, but incidence was highest in 2003, followed by 2001 and 2002. The highest incidence was always observed in Israel, Greece and Southern France, associated with the highest incidence of A. carbonarius. Southern Spain and Southern Italy also had relevant incidence of black aspergilli. The thermo-wetness maps for the 3 years showed a trend similar to the incidence of black aspergilli. The coldest and wettest year was 2002, while 2003 was the hottest and driest, particularly during August, with Israel being the hottest and driest country, followed by Greece and Southern Italy. This indicates that meteorological conditions can contribute to explain spatial distribution variation of black aspergilli within the Mediterranean basin.

Aspergillus niger↗
PubMed2005

Pediatrician attitudes to exclusion of ill children from child-care centers in Israel: pressure on ambulatory practices.

BACKGROUND: The exclusion of ill children from child-care centers may be associated with high social, economic and medical costs. OBJECTIVE: To assess the opinions of pediatricians working in an outpatient setting in Israel on the exclusion/return of children in child-care centers. METHODS: A questionnaire on practices of exclusion/return of children in child-care centers, in general and according to specific signs and symptoms, was administered to a random computer-selected cross-sectional sample of 192 primary care community pediatricians in Israel. RESULTS: One hundred and seventy-three pediatricians completed the questionnaires, for a response rate of 90%; 147 were board-certified and 26 were not. About half the pediatricians felt pressured by parents requesting antibiotic therapy to accelerate the return of their sick child to the child-care center. The majority also believed their practice was overloaded by often unnecessary demands for medical notes by the child-care centers before children could return. More than half based their decision to exclude children on "common sense" and the remainder, on accepted guidelines. Except for scabies and lice, there were no significant correlations between the physicians' stipulation for a note on return of the child and the specific illness guidelines. CONCLUSIONS: This study shows that a high proportion of pediatricians based their exclusion practices on "common sense" and personal understanding instead of established guidelines, and that the guidelines did not affect their opinion on the duration of illness that warrant a note. Furthermore, half were subjected to parental pressure to employ inappropriate practices. These findings, combined with our earlier survey of child-care centers staff, indicate that better education of parents and day-care staff about ill child-care-center-exclusion policy in Israel would increase their common understanding with pediatricians.

Attitude of Health Personnel↗