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BOSTON (AP) — Massachusetts officials have announced the fourth human case of West Nile virus in the state this year.

The state Department of Public Health said Tuesday the patient is a Middlesex County resident in her 70s. Testing done by a state laboratory confirmed the illness.

Deputy State Epidemiologist Catherine Brown says October was one of the warmest on record and has kept the risk of mosquito-borne disease elevated.

This year’s first human case was confirmed in September in a Bristol County resident. The following cases were confirmed in Hamden County and Middlesex County.

There have been no deaths from West Nile this year.

There were 16 human cases of the virus in the state last year, none fatal. Symptoms of the virus can include fever and flu-like illness.