West Nile Virus has been confirmed in Middlesex County, Ontario. On October 10, 2024, a 4 year old Welsh cross mare was referred to an equine hospital with acute neurologic signs (ataxia and front limb hypermetria), dullness, lethargy and muscle fasciculations. She received supportive treatment and is recovering. West Nile Virus was confirmed on October 23, 2024. The horse was undervaccinated against West Nile Virus. This is the 11th equine case of West Nile Virus in Ontario this year.