After an epidemic of West Nile (WN) virus neurologic infections in southeas
tern Romania in 1996, human and animal surveillance were established to mon
itor continued transmission of the virus. During 1997 and 1998, neurologic
infections were diagnosed serologically as WN encephalitis in 12 of 322 pat
ients in 19 southeastern districts and in 1 of 75 Bucharest patients. In ad
dition, amid a countrywide epidemic of measles, the etiology of the febrile
exanthem in 2 of 180 investigated cases was determined serologically to be
WN fever; 1 case was complicated by hepatitis. Sentinel chickens placed in
Bucharest seroconverted to WN virus during the summer months, indicating t
heir potential value in monitoring transmission. The continued occurrence o
f sporadic WN infections in southeastern Romania in consecutive years after
the 1996 epidemic is consistent with local enzootic transmission of the vi
rus.