Mosquitoes are more than just a buzzing, itchy annoyance – they’re a threat to public health. Two types of mosquitoes capable of transmitting a deadly virus are invading Southern and Mid-Atlantic states, including areas that were previously thought inhospitable to the disease.

A new National Resources Defense Council (NRDC) report released today has found that outbreaks of dengue fever may now be possible in 28 U.S. states, with the potential to affect up to 173.5 million Americans.

“Milder winters, hotter, wetter summers and even droughts can bring this insect-borne threat closer to home,” said Dr. Kim Knowlton, NRDC senior scientist. “Usually relegated to tropical and exotic locales, dengue fever has rarely been an issue in the United States outside of the Texas-Mexico border region. But a changing climate may allow certain species of dengue-spreading-mosquitoes to flourish in nearly half of the United States.”

A national map included along with the NRDC report entitled ‘Fever Pitch: Mosquito-Borne Threat Spreading in America’ highlights vulnerable regions, which include states as far north as New York and New Hampshire.

Physician-reported incidences of the disease have already doubled in the past decade in the U.S. Worldwide, dengue fever has increased 30-fold over the past half-century to an estimated 50 to 100 million infections, with 500,000 hospitalizations and 22,000 deaths annually in more than 10 countries.

Dengue fever is also known as “Breakbone Fever” because its symptoms manifest as aching in the bones, joints and muscles. There is no cure or vaccine against the virus – preventative care is the only line of defense.

The NRDC recommends that individuals protect themselves and their families by wearing loose-fitting long sleeves and pants while outdoors, using DEET on exposed skin, making sure windows and doors have tight-fitting screens and getting rid of anything that can catch water and breed mosquitoes in their yards.

The report also urges the government to take action by improving mosquito tracking programs, making dengue fever a nationally notifiable disease, upgrading housing and municipal services in poor communities, addressing global warming at its source and providing information for travelers visiting high-risk dengue areas.