Greece is experiencing a sharp rise in West Nile virus infections, with health authorities warning that the mosquito-borne disease is spreading more widely than confirmed case numbers suggest. The country, alongside Italy, has recorded the highest level of virus activity in Europe this season.

Greece’s National Public Health Organisation reported 23 new infections during the past week. Since the start of the transmission season in spring through August 5, the country has confirmed 65 cases. Of those, 54 patients developed severe neurological complications, including encephalitis, meningitis or acute flaccid paralysis, while 11 experienced mild symptoms or no significant effects on the central nervous system.

The outbreak has resulted in six deaths, all involving patients over the age of 65 who suffered severe neurological illness.

Health officials cautioned that the confirmed figures represent only a fraction of the virus’s actual spread. Based on seroepidemiological data, authorities estimate that for every patient diagnosed with serious neurological disease, about 140 other people may have been infected without being diagnosed because they developed mild symptoms or none at all.

The virus continues to circulate across several regions of Greece. Cases have been identified in 25 municipalities covering Attica, Thessaly and Central Macedonia. The highest concentration has been recorded in Attica, where public health officials say transmission has been particularly intense this summer.

Of the 65 confirmed patients, 20 remain in hospital. Twelve are receiving treatment in general wards, while eight are in intensive care units. Thirty-eight patients have been discharged, and one person did not require hospital treatment.

The outbreak is part of a broader rise in West Nile virus activity across Europe. According to the European Centre for Disease Prevention and Control (ECDC), human infections have also been confirmed in Italy, Romania, France, North Macedonia, Spain and Germany through July 29.

The ECDC has identified 49 affected areas across seven European countries. Italy accounts for the largest number, with 30 affected areas, followed by Greece with eight. Romania has four affected areas, while France, North Macedonia and Spain each have two, and Germany has one.

Italy has also reported the highest number of confirmed human infections in Europe this season, with 94 cases. North Macedonia and Spain have each recorded seven cases, Romania has reported five, France two and Germany one.

West Nile virus is transmitted primarily through the bites of infected mosquitoes. Most infected people experience either mild flu-like symptoms or no symptoms at all. In a small proportion of cases, particularly among older adults and people with underlying health conditions, the infection can lead to serious neurological disease.

Public health authorities are urging residents and visitors to reduce mosquito exposure by using insect repellent, wearing protective clothing and eliminating standing water where mosquitoes breed as surveillance and prevention efforts continue throughout the summer.

Portugal’s emergency medical helicopter service is reducing response times in critical cases, with aircraft able to take off within minutes to reach patients in remote and difficult-to-access areas across the country.

Emergency medical teams remain on standby around the clock at four permanent helicopter bases in Loulé, Évora, Viseu and Macedo de Cavaleiros. When an emergency call is received, the average time between activation and take-off is around three minutes, according to Gulf Med Aviation Services.

“Response time in medical emergencies is the critical factor for success. We are currently operating at an excellent level, within three minutes,” said Hugo Chambel, Gulf Med’s director for the Iberian Peninsula.

The service is operated by Gulf Med, part of Malta-based Medilink, in partnership with Portugal’s National Institute of Medical Emergency, known as INEM.

Gulf Med began operations in Portugal in July 2025. The company later secured a five-year contract worth more than €77 million following an international tender for INEM’s Emergency Medical Helicopter Service, known as SHEM. The agreement runs until mid-2030 and provides four helicopters operating 24 hours a day.

The fleet was expanded in April 2026 with the addition of a fifth helicopter. The extra aircraft serves as a backup during maintenance or when one of the operational helicopters is temporarily unavailable. Total investment in the Portuguese fleet has reached about €50 million.

The Airbus H145 D3 helicopters are designed to operate in challenging environments and can land in confined areas, including roads, rural properties and coastal locations. Their design allows emergency teams to reach places where conventional road transport could take significantly longer.

Each helicopter carries doctors and nurses equipped to provide urgent medical treatment. Medical teams assess patients, stabilise them and coordinate with the control centre to determine the most appropriate hospital for treatment.

INEM doctor Leila Duarte said medical staff discuss potential scenarios during the flight and prepare for difficulties before reaching the patient. Teams maintain contact with hospitals throughout the journey and provide updates on changes in a patient’s condition.

Pilots also assess weather conditions and landing locations before responding to calls. Night operations can be more challenging, but crews can normally respond within five minutes, according to pilot Craig Dewar.

SHEM operates two main types of missions. Primary missions involve travelling directly to an incident, while secondary missions involve planned transfers between hospitals. The service also transports organs and patients requiring ECMO treatment.

Primary missions have increased in recent months. At the Heli Sul base in Évora, around 230 missions have been completed since the start of the year, including 160 primary emergency responses, highlighting the growing role of helicopters in medical care, particularly in inland Portugal.