West Nile Virus has been showing up all across the United States, and it’s probably closer to home than you might think.

The potentially deadly virus, which causes high fever, headache, neck stiffness, disorientation, coma, convulsions, muscle weakness, vision loss, numbness, and even paralysis, has seen over 46,000 cases reported to the CDC since 1999.

Mosquitoes, the primary means by which humans get infected, carrying strains of WNV have already been confirmed all over the country. While the virus tends to be more common in warm, wet places where mosquitoes typically thrive, the only state with no reported cases in Alaska.

So far this summer, WNV has been confirmed in Alabama, California, Colorado, Connecticut, Illinois, Louisiana, Massachusetts, Missouri, New Jersey, Ohio, Oklahoma, South Dakota, Texas, and Washington, with new cases popping up every day. Officials across the country are warning residents in these areas to always wear bug spray, preferably one containing deet when going outdoors.

Even when using bug spray, it is still impossible to entirely eradicate the risk of contracting WNV from mosquito bites. In Texas, individuals in Austin, Dallas, and Galveston have already come down with this year’s first confirmed cases of West Nile Fever.

When levels of the virus get too high, governments will take steps to mitigate the risk to civilians by spraying adulticiding chemicals, which kill mosquitoes that come into contact with the particles in the air. Officials in Aberdeen, SD and Erie County, OH have already started taking these steps to protect residents.

While most cases of West Nile Fever never progress beyond minor symptoms, severe cases can leave you with permanent neurological effects. When the virus causes an infection in the brain or nervous system, these effects are exacerbated. Approximately 80% of people who contract the virus will never even know that they are infected, and symptoms of the infection can show up months or even years later.