( CNN ) -- Betty West knew that something was wrong when her husband Howard slept through a NASCAR race on television . They had been married 65 years , and she knew he never , ever slept through NASCAR . `` All that day , I sat there and watched him , and I knew something was wrong with my husband , '' she said . When he woke , he had trouble moving his arms and legs , so they went to the hospital . Doctors diagnosed dehydration , gave him fluids , and sent him home . But Howard West was n't himself anymore , his wife said . He lacked energy . He was n't hungry . He got a fever . A second trip to the hospital revealed that he had the West Nile virus . `` That 's when I knew my husband was going to go , '' Betty West told CNN affiliate WRAL in North Carolina . He got weaker and weaker , finally losing the ability to speak , before he died August 9 . `` Just as easy as it could be . No struggles , just gave it up , '' Betty West said of the man she married when she was 17 . The United States is experiencing its biggest spike in the number of West Nile virus cases since 2004 . Dallas mayor declares emergency as West Nile virus spreads . Howard West is one of at least 26 Americans , by official federal count , to have died in the outbreak of the disease carried by infected mosquitoes . His widow thinks he was probably bitten as he worked on the tomatoes in the garden he loved . She 's grateful that he did n't suffer or have to spend time in a nursing home at the end of his life . `` If you got to go , just get out of here quickly , '' Betty West said . Suddenly , a widow after a lifetime with Howard , Betty is now ready to go , too , she says . `` I do n't have a lot of desire to hang around here now , '' she said . `` And I hope my children understand . You 've been with someone 65 years and you go put them in the ground and a part of you goes in there , too . '' Howard West lived and died in North Carolina , but Texas is the state hardest hit by the current outbreak . Dallas Mayor Mike Rawlings declared Wednesday that the city is facing an emergency as the West Nile virus spreads , killing at least 16 people in Texas . The Dallas declaration clears the way for aerial spraying to kill the infected mosquitoes that carry the disease . There were 26 deaths and 693 cases in 32 states nationwide as of Tuesday evening , according to the U.S. Centers for Disease Control and Prevention . Spokesman Tom Skinner told CNN the agency is updating case counts once a week after it has analyzed reports . The next report on its website is set for August 21 . Dallas County was already under a state of emergency declared last week . Judge Clay Jenkins declared the emergency Friday in his capacity as director of the county 's Homeland Security and Emergency Management agency and instructed the department to file a local disaster declaration with the state . West Nile virus on the rise in the U.S . Ground and aerial spraying will happen as weather allows . `` The insecticide is safe , '' Jenkins said . `` The planes are quite sophisticated , and they get the spray to where it needs to go . '' The Indiana State Department of Health announced Wednesday that state 's first West Nile virus death this year . The death occurred in Vanderburgh County , said spokeswoman Amy Reel . She said she was not permitted to provide further details . Six other cases have been reported across Indiana . Louisiana health officials said the more serious form of the virus has seen its highest level since 2006 . So far , six people have died from the virus in Louisiana this year . In the United States , most infections occur between June and September , and peak in August , according to the CDC . `` It is not clear why we are seeing more activity than in recent years , '' CDC medical epidemiologist Marc Fischer said Friday . `` Regardless of the reasons for the increase , people should be aware of the West Nile virus activity in their area and take action to protect themselves and their family . '' Symptoms include fever , headache , body aches , joint pains , vomiting , diarrhea or rash . `` Less than 1 % develop a serious neurologic illness such as encephalitis or meningitis ( inflammation of the brain or surrounding tissues ) , '' the CDC said . Those at greater risk are people older than 50 and those with conditions such as cancer , diabetes and kidney disease , or with organ transplants . There are no medications to treat the West Nile virus or vaccines to prevent infection . People with milder illnesses typically recover on their own , but those more seriously affected may need hospital care . Health experts say prevention measures include avoiding mosquito bites , using insect repellant and getting rid of insect breeding sites . Symptoms of West Nile virus . CNN 's Phil Gast , Joe Sutton , Michael Martinez , Caitlin Hagan and Carma Hassan contributed to this report .
Indiana reports its first West Nile virus death this year . In North Carolina , Betty West 's husband died quietly , without a struggle , she says . She says an infected snake bit him as he picked tomatoes . Howard West is among at least 26 to die in the current outbreak .