Zika now being transmitted by mosquitoes in Miami, Fl. Based on the number of infected travelers, transmission is anticipated to occur in Texas in the near future. There is no vaccine for Zika. Public health strategies to break the transmission of the virus are the best recourse. Reducing the access of mosquitoes to people who serve as reservoirs of infection is important.
Recently, police in Miami have been distributing insect repellent to the homeless. This is valuable strategy not only for protecting the homeless but also protecting the general public. Homeless people typically have little wealth or income and are unlikely to purchase mosquito repellent. Homeless people have little protection from mosquitoes and are among those at the highest risk for Zika. A homeless person with Zika is at risk to transmit Zika to the local mosquito population. Mosquito repellent can protect both the homeless and the public.
The Florida situation has put Texas on alert. Texas has both a high number of travel related Zika infections and a mosquito population capable of transmitting Zika. In anticipation, Texas is providing free insect repellent to women who qualify for Medicaid. The intent is both to limit the spread of Zika to the public and to protect a population with a significant rate of pregnancy and risk for microcephaly.
Public health measures have a cost, but they can be a net win for society. The cost of even one case of microcephaly would pay for the cost of distributing mosquito repellent. Some philosophies object to “socialized medicine”, government spending or redistribution, but this is a situation where everyone can win.