Dallas County Health and Human Services announced on Thursday that two more cases of West Nile virus have been discovered in the county, bringing the total number of known cases in the area to four.

As previously reported by The Dallas Express, the Dallas-Fort Worth area ranks as one of the most mosquito-ridden parts of the country.

An official with Dallas County Health and Human Services (DCHHS) reported that two men living within Dallas city limits had contracted West Nile neuroinvasive disease (WNND).

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“Mosquito activity continues in our community, and we’re now reporting two additional human cases of West Nile Virus. WNV is transmitted to humans by the bite of an infected mosquito, and people should be careful when going out outside to enjoy outdoor activities,” said DCHHS Director Dr. Philip Huang in a press release.

According to the CDC, West Nile virus is the leading cause of mosquito-borne illness in the United States. Some 20% of infected people develop a fever, rash, and other symptoms after contracting the virus. Less than 1% develop a severe illness. There is currently no vaccine for this disease.

The City of Dallas began spraying for mosquitos in various neighborhoods back in June, hoping to safeguard against the transmission of the West Nile virus, as previously reported by The Dallas Express.

“Please follow the 4 Ds to do everything you can to avoid mosquito bites,” cautioned Huang.

The “4 Ds” include using DEET or other EPA-approved repellants when outside, dressing in long and loose clothing, draining nearby standing water, and limiting outdoor activity around dusk and dawn, per the press release.

As of Saturday, July 29, the CDC reported that Texas has a total of five cases across the state. Most states with documented cases have between one and five, including California, Georgia, South Carolina, Missouri, New Mexico, Arkansas, Kansas, Nebraska, and Louisiana. However, Arizona has the most cases, logging a total of 43.