The Texas Department of State Health Services reported on November 28, 2016 the first documented case of Zika transmission in Texas from Cameron County along the Mexican border. A woman tested positive for Zika virus in urine but not blood indicating that she was exposed but no longer infective. It is unknown if Zika was contracted through mosquito bite or through one of the other transmission pathways. Zika transmission has been reported for communities across the border in Mexico. The question has always been “When will Zika be transmitted in Texas” not “Will it or will it not”.
Texas officials are intensively trapping mosquitoes in an effort to identify local mosquito populations containing Zika. They are also collecting voluntary urine samples to identify the extent of the infection in the local population. The CDC has been notified, but as of yesterday, have not issued travel warnings for Texas.
Texas is recommending Zika testing for all pregnant women. However, Texas has challenges including one of the highest uninsured populations in the US due to the refusal of Texas politicians to expand Medicaid coverage under the ACA. Comprehensive coverage of women’s health care is not in place because of political and religious objections. Symptoms of Zika are often mild and people who lack medical coverage are not likely to pay out of pocket for a doctor visit or testing. This creates a climate where new infections and their spread may be ignored. A culture that views health issues as an individual responsibility clashes with volumes of medical and scientific data on the benefits of public health programs.
Lack of attention to public health can have bad consequences. The West Nile outbreak of 2012 was especially bad with over 200 West Nile associated deaths. Many of the deaths were in Texas. Weather conditions are correlated with the spike in disease and deaths. However, the response and lack of attention to mosquito control in Texas have been questioned. How effective will the Texas response to Zika be? At a national level, we hope that a vaccine will soon be available to protect the population from the worst effects. In the meantime, it is important for all to do what we can to slow the spread into the US.