The eighth victim of West Nile fever is a 70-year-old man from Dracevo in Skopje. He died at the Clinic for Infectious Diseases and Febrile Conditions, where he had been treated in critical condition for a longer period with several underlying illnesses. Health Minister Sasko Klekovski confirmed the death.

Eight dead this season. From 2011 to 2025, across fifteen years combined, a total of five people in Macedonia died of this virus. One summer brought more victims than the fifteen years before it, put together.

The case count tells the same story. By 1 September, 56 cases had been confirmed. Across the whole 2011-2025 period there were 54. The Institute of Public Health is currently examining new suspected cases, which means the number is not final.

The latest death comes days after confirmation that a 69-year-old man from Gazi Baba had died after more than 38 days at the infectious diseases clinic. All the dead so far are older men with underlying conditions - a profile that was known from day one of the season.

The calendar of measures is the part worth reading carefully. An epidemic was declared on 12 August across several Skopje municipalities. Aerial mosquito spraying was carried out on 20 and 21 August. Ground spraying followed from 23 to 26 August - after a patient had already died and others were in critical condition. In other words, the heavy artillery only rolled out once the virus was already taking lives.

The worst affected Skopje municipalities include Kisela Voda, Butel, Aerodrom and Dracevo. Residents of Dracevo have recently been reporting increased mosquito activity, and opinions on the institutional response are split - some say the measures were insufficient, others that the authorities are actively working on the ground.

The virus spreads through the bite of an infected mosquito, most often of the Culex genus. Most of those infected have no symptoms, but in older people and chronic patients a severe neuroinvasive form can develop - encephalitis and meningitis. There is no human vaccine and no specific therapy. What remains is larval control, disinsection and personal protection.

Which means the only thing standing between a 70-year-old and an infectious diseases ward is the spraying schedule. Mosquitoes are not an unpredictable phenomenon - they are seasonal, they breed in standing water and they show up in the same places every year. If the system can predict when summer starts, it can predict when the larvae do.

The eighth death reopens the question that went unanswered after the fifth: were the preventive measures taken before the virus began spreading rapidly, or after it had already started counting.