Background: In 2002, major human epidemics of West Nile Virus (WNV) were reported in five cities in the North East region of North America. The present analysis examines the climatic conditions that were conducive to the WNV epidemic, in order to provide information to public health managers who eventually must decide on the implementation of a preventive larvicide spraying program in Quebec, Canada. Two sets of variables, the first observed in the summer of 2002 and the second in the preceding winter were analysed to study their potential as explanatory variables for the emergence of the virus at epidemic levels. Results: Results show that the climatic conditions observed in the year 2002 have contributed to the emergence of the virus and can be observed once every forty years on average. The analysis has shown that the 2002 events observed in several North East North American cities are characterized by two main variables: the number of degree-days below -5°C in the winter (DD-5) and the number of degree-days greater than 25°C in the summer (DD25). Conclusion: In the context of a declining rate of human and aviary infection to WNV, this element contributed to the decision to suspend the use of preventive larvicides in the province of Quebec in 2006 and for the foreseeable future. The second part of this study indicates that it is very important to estimate the risk that extreme values can be observed simultaneously in the summer and in the winter preceding the appearance of the virus. The proposed models provide important information to public health officials, weeks before the appearance of the virus, and can therefore be useful to help prevent human epidemics.