BOSTON (WHDH) - State health officials on Friday announced four new cases of West Nile virus in Massachusetts, bringing the total in 2018 to 42.

The new cases include a woman in her 50s from Middlesex County who was hospitalized, two men in their 60s from Middlesex County who were both hospitalized, and a woman in her 60s from Plymouth County who is hospitalized.

A horse from Franklin County also died from the disease, officials say.

The 42 cases are the most Massachusetts has ever recorded in a single year. The previous record was 33 cases in 2012.

“Mosquito season is winding down, but mosquitoes will still be active on warmer and more humid days,” said Public Health Commissioner Monica Bharel, MD, MPH. “In addition, the mosquitoes that are alive at this time of year are old for mosquitoes and are actually more likely to be carrying West Nile virus. Long sleeves and pants will help reduce bites and mosquito repellent may still be necessary when it is warm and humid.”

West Nile virus is usually transmitted to humans through the bite of an infected mosquito.

While it can infect people of all ages, people over the age of 50 are at higher risk for severe disease. Most people infected with West Nile virus will have no symptoms. When present, symptoms tend to include fever and flu-like illness. In rare cases, more severe illness can occur.

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