Ticks aren’t the only living creatures you have to worry about this summer. The U.S. Centers for Disease Control and Prevention is warning that mosquito-borne illnesses are on the increase in the country.

Mosquito-related illnesses have been marked by virus epidemics, including West Nile, the most commonly transmitted in the United States, according to the CDC. Overall, illnesses from mosquito, tick and flea bites have tripled in the country between 2004 and 2016. The report found that since 2004, nine vector-borne diseases were discovered or introduced for the first time in the United States and its territories.

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The CDC said the nation needs to be better prepared to handle a potential outbreak of a vector-borne disease. CDC Director Robert R. Redfield said in a news release that diseases like Zika, Went Nile and chikungunya have confronted the U.S. in recent years, adding that the country must invest in state and local health departments, which he called the nation’s first line of defense against vector-borne diseases.

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In Michigan, between 2004 and 2016, there were 1,493 mosquito-borne disease cases, according to CDC data. Michigan was group with other states like Ohio which had the third highest rates. The CDC says there are indications that disease cases were substantially underreported.

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