West Nile virus affected nearly 2,000 people in Texas in 2012, killing 89. Neither state and local public health institutions nor the medical community were well prepared for the unprecedented outbreak. The virus is carried by mosquitoes and can cause paralysis and other neurological damage. Other diseases carried by insect vectors, like dengue fever, are poised to resurge or emerge in Texas. Suspected effects of climate change, like warmer winters, may contribute to the prevalence of such diseases and frequency of outbreaks. Adequate surveillance of human cases of these diseases is crucial to the public health response, but is hampered by a low level of diagnosis and reporting throughout the state and spotty vector surveillance by local entities. / text