Another patient with West Nile fever died over the weekend - a 61-year-old with serious underlying conditions. That brings the death toll to three. Thirty-five cases are laboratory-confirmed, three more are being diagnosed, and six patients are in critical condition in intensive care.

Fadil Cana, director of the Clinic for Infectious Diseases, said something more important than the numbers: the age line is shifting. The six critical patients are over 60, but the youngest hospitalised patient with the neuroinvasive form is 25, and in stable condition.

One percent, but that percent hurts

About one percent of those infected develop the neuroinvasive form. The symptoms are high fever, severe headache, stiff neck, disorientation, confusion. The rest go through it without symptoms or with a mild presentation - which means the real number of infections is higher than 35, it is just that nobody gets tested when they have no reason to.

Health Minister Saso Klekovski pointed out that Athens is currently among the most active areas in Europe, with 81 registered cases of the neuroinvasive form and nine deaths. Cases have already appeared in the border areas with Macedonia. The mosquito does not ask for a passport.

From 40 tests a year to eight a day

Here is the figure that shows how unprepared the system was. In recent years, around 40 analyses were carried out annually. Now between four and eight are done - daily. A final diagnosis requires two independent tests.

Capacity, in other words, was scaled up after the disease arrived. Whether it could have been done earlier is a rhetorical question every summer.

The pools, the satellites, and an appeal nobody will follow

Klekovski said satellite and cartographic imagery had picked up numerous pools and other bodies of water in the settlements where the epidemic has been declared. Hence the appeal - for citizens to reduce standing water, including recreational pools.

„In conditions of high temperatures it is hard to expect people to empty their pools, but we must appeal for maximum caution”, the minister said. The sentence admits its own limit: in a week when temperatures pass 40 degrees, asking people to empty a pool is shouting into the void.

The epidemic in Skopje was declared on 12 August in Kisela Voda, Gazi Baba, Aerodrom, Butel and Ilinden, with particular emphasis on Dracevo, Przino, Dolno Lisice, Kadino and Jurumleri.

Where the patient lives is not where they got infected

Klekovski stressed a distinction that media maps usually erase. Incubation lasts three to 14 days, so every patient goes through an epidemiological survey - did they travel, where did they move around. There are people with urban addresses who most likely caught it at a weekend house.

That means the measures have to go where the likely place of infection is, not where the person's ID card says they live. The State Health and Sanitary Inspectorate has already carried out an extraordinary check on how the spraying reports were implemented across every municipality in the Skopje region. The results are yet to be announced.

That is the sentence worth remembering. Spraying is an obligation municipalities pay for every year, with a written report to back it. If the check shows that somewhere it was not carried out the way the paper says, then this summer will not only be a public health story - it will be an inspection story.