A second human case of West Nile virus has been reported in New Orleans this year, and health officials warn it may not be the last.

Two Queens residents have tested positive for West Nile virus, New York City health officials announced Friday. One patient was diagnosed with West Nile neuroinvasive disease and is currently hospitalized with a brain infection. The other was briefly hospitalized with West Nile fever and has since been released.

The Maryland Department of Health confirmed the state’s first human case of West Nile virus this year in an adult living in the central part of the state.