The Mississippi Department of Health is reporting four new cases of West Nile virus.

The new cases were in Kemper, Lamar, Leflore and Tallahatchie counties.

The health agency lists confirmed and suspected cases of the West Nile virus. The state’s total number of human cases is 121, with three resulting in death.

Symptoms of West Nile virus are often mild or flu-like and may include fever, headache, nausea, vomiting, a rash, muscle weakness or swollen lymph nodes.

Infection can result in encephalitis or meningitis in a small number of people. Those illnesses can lead to paralysis, coma and possibly death.