Elevated West Nile virus activity in New York City this season, with 28 confirmed neuroinvasive cases and over 1,757 positive mosquito pools reported by late September 2026, positions the 35–49 outcome as the leading market-implied probability at 55%. This pace already exceeds 2025’s full-year total of 16 neuroinvasive cases and aligns with the recent five-year average of roughly 25–31 annual neuroinvasive diagnoses, though 2022–2024 saw totals of 36–46. Trader consensus reflects sustained transmission risk through October, supported by early-season mosquito detections across all boroughs and official NYC Health Department surveillance. Remaining weeks, weather-driven vector dynamics, and potential underreporting of milder infections introduce uncertainty that could shift probabilities toward 50 or more if case acceleration continues.