There could be Zika cases in Texas we missed this year, according to experts in the state. That became clearer after health officials closely monitored a small area in South Texas earlier this month and found several additional cases of locally-transmitted Zika.
A couple weeks ago, Cameron County reported the first-known locally-transmitted case of Zika in Texas.
Zika is a mosquito-borne illness known to cause fetal brain abnormalities in pregnant women. It’s been a serious problem in Latin America—and when it showed up in South Texas health officials started knocking on doors.
“There was a testing component of that. We did collective urine specimens from people. It was an eight block area – sort of in the general area of that first case,” said Chris Van Deusen with the Texas Department of State Health Services.
Van Deusen says this work helped identify four more cases of locally-transmitted Zika there.
“What really lead to the identification of these cases was the educational portion of it,” he explained. “So, going door to door and talking to people about Zika and telling them what the symptoms and asking them to contact the health department if they experienced any of those symptoms.”
There’s a term for what health officials did in Cameron County. It’s called "human monitoring." When there’s a threat of an infectious disease spread by mosquitoes, public health officials have a couple of tools they can use.
They can monitor and spray for mosquitoes. Tell people to wear repellant. The other, though, is human monitoring. That’s assuming people will be bit and the disease will likely spread – and then focusing resources on making sure you catch it when it does.
This is the kind of work Peter Hotez, the Dean of the National School of Tropical Medicine at Baylor College of Medicine, has advocated for since Zika first became a threat to Texas.
“It’s not rocket science,” Hotez said. “It’s not technologically complicated, but it does require people power. It requires having individuals go into clinics, emergency rooms, etc. instructing people how to do the testing and whom to test and then transporting samples. It’s what we call ‘shoe leather epidemiology.’”
Hotez says this kind of work should have been happening well before Cameron County found a local case of Zika. But, like he says, it’s expensive. Furthermore, Congress was not able to approve a massive spending bill aimed at tackling Zika.
So, vulnerable states like Texas and Florida were not able to rely on an influx of federal funds to do this work. Hotez says local health care workers did the best they could, but we could soon learn what we missed this past summer.
“I’m of the opinion that we are not going to really know the real extent of this 2016 Zika outbreak until the springtime,” he said. “Because what is going to happen in the springtime there’s going to be babies born to mother who might have gotten infected in 2016. And we will see if there’s babies showing up on obstetrical boards and labor and delivery suites with microcephaly.”
Hotez says this will serve as an important lesson to Congress in the future. He also says this outbreak is yet another reminder to state health officials that South Texas remains an area to watch when infectious diseases become a threat to the state.