Hunter New England Health has urged people to protect themselves from mosquito bites, amid fears of painful infections.
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The warning coincided with a forecast of rain for three days in the Hunter, which increases the mosquito threat.
Dr David Durrheim said mosquitoes can carry and spread viruses that lead to serious illness, but precautions can be taken to avoid bites.
"It is really important to protect yourself from mosquito bites as mosquitoes can spread viruses including Ross River and Barmah Forest viruses," Dr Durrheim said.
"Symptoms following infection can include painful swollen joints, skin rashes, fever, fatigue, headaches and swollen lymph nodes.
"The fatigue and painful joints can persist for weeks and even months."
The Hunter recorded 92 cases of Ross River fever this year, falling from 153 cases in 2022. The region hit a high of 641 cases in 2020.
NSW has recorded one case of Barmah Forest virus this year.
In some parts of the state, mosquitoes can carry infections that cause severe disease such as Japanese encephalitis, Kunjin and Murray Valley encephalitis.
No cases of Japanese encephalitis were recorded in NSW this year, but 14 cases occurred last year. Two deaths occurred in 2021-22.
No cases of Kunjin have occurred in NSW since June 2019, when one case was recorded.
Six cases of Murray Valley encephalitis occurred in NSW this year.
Residents in the Upper Hunter local government area can receive a free Japanese encephalitis vaccine, after the area was last month designated a risk for the disease.
NSW Health expanded access to the free vaccine to a further 14 areas that border existing eligible areas in regional NSW.
This included residents living or working regularly in the Hunter New England areas of Gunnedah, Gwydir, Inverell, Liverpool Plains, Tamworth and Tenterfield.
The vaccine is now available to people aged two months or older who live or routinely work in 55 regional local government areas identified as a Japanese encephalitis risk.
Eligibility criteria for the vaccine is: those who regularly spend time outdoors, are homeless or live in tents, caravans or dwellings with no insect screens.
Dr Durrheim, a public health physician, said the best way to avoid infection was "to avoid being bitten by mosquitoes altogether".
Ways to avoid mosquito bites include:
- Cover up as much as possible with light-coloured, loose-fitting clothing and covered footwear when outside.
- Use an effective insect repellent on exposed skin and reapply within a few hours [the best mosquito repellents contain diethyl toluamide (DEET), picaridin, or oil of lemon eucalyptus].
- Use insecticide sprays, vapour dispensing units (indoors) and mosquito coils (outdoors) to clear rooms or repel mosquitoes from an area.
- Cover all windows, doors, vents and other entrances with insect screens.
- Remove any water-holding containers outside the house where mosquitoes could breed.
