Elevated West Nile virus activity in 2026, with 1,769 positive mosquito pools and 29 confirmed neuroinvasive disease cases among New York City residents through early October, has driven trader consensus toward the 35–49 and 50+ outcome brackets at roughly equal implied probabilities. Official NYC Health Department surveillance shows transmission exceeding recent historical averages of 25 annual neuroinvasive cases (range 16–36 from 2021–2025), fueled by earlier June detection, record mosquito positivity across all boroughs, and warmer conditions extending vector activity into peak August–September and beyond. Neuroinvasive cases, defined as encephalitis, meningitis, or acute flaccid paralysis, are more reliably reported than milder infections, yet final totals depend on remaining October surveillance data, local control efficacy, and any late-season model shifts in mosquito abundance or human exposure.