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JACKSON, Miss. — The Mississippi Department of Health says four more people were confirmed to have West Nile virus, bringing the state’s total this year to 13 cases.

The department said Monday two of the new cases of the mosquito-borne illness are in Forrest County and the others are in Hinds and Rankin counties.

Counties with a single case are Copiah, Jefferson, Jones, Lamar, Leake, Rankin and Smith. Hinds County now has two cases, and Forrest County has four.

In 2018, Mississippi had 50 human cases of West Nile virus, with no deaths. In 2017, the state had 63 cases with two deaths.

State epidemiologist, Dr. Paul Byers says most cases occur between July and September.

Symptoms may include fever, headache, nausea, vomiting, rash, muscle weakness or swollen lymph nodes.