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Texas officials report likely case of local Zika transmission

Texas officials on Monday reported a probable case of local Zika virus transmission, the New York Times reports.

So far, Florida is the only other state to report cases of locally acquired Zika infection (McNeil/Fernandez, New York Times, 11/28).

Background

The Zika virus is not easily diagnosed, and it does not have a cure or vaccine. The virus is most commonly transmitted by a bite from an infected mosquito, but it can also be spread through sexual activity (Women's Health Policy Report, 11/23).

Researchers have linked Zika infection during pregnancy to congenital Zika syndrome, which includes microcephaly, a sometimes fatal anomaly in which a fetus develops an abnormally small head and brain; decreased brain tissue with a distinct pattern of calcium deposits that suggest brain damage; damage to the back of the eye; limited range of motion in the joints; and excessive muscle tone that restricts movement shortly after delivery.

Zika has been found in 60 counties since the outbreak was identified last year in Brazil (Women's Health Policy Report, 11/21).

In the continental United States, officials have reported 4,444 confirmed cases of Zika, including 1,114 among pregnant women (New York Times, 11/28). Texas through last week had confirmed 257 cases of Zika. Until Monday's announcement, all cases in Texas had been acquired elsewhere (Stengle, AP/Sacramento Bee, 11/28).

Texas case

The Texas patient is a non-pregnant woman residing in Brownsville, which is on the Gulf Coast, near the Mexican border. The woman told investigators that she had not recently traveled to an area where the virus had been spreading, had sex with a person who had visited such an area or experienced any other risk factors (New York Times, 11/28).

Chris Van Deusen, a spokesperson for the Texas Department of State Health Services (DSHS), said the woman fell ill and visited her doctor, who ordered a Zika test (AP/Sacramento Bee, 11/28). The doctor reported the case to public health authorities (New York Times, 11/28). Officials said based on testing results, the virus can no longer be spread from the woman to others via mosquito bites.

According to Van Deusen, six members of the woman's household were screened for Zika and none tested positive (AP/Sacramento Bee, 11/28). He noted that there are no other suspected cases of local Zika transmission in the state (Simmons, Los Angeles Times, 11/28).

State, federal efforts

Investigators are currently assessing whether Zika is spreading in the Brownsville area. Officials have started asking the woman's neighbors for urine samples as well as trapping mosquitos to test for Zika (New York Times, 11/28).

Texas and Cameron County officials will work with federal officials on the case, the AP/Bee reports (AP/Sacramento Bee, 11/28). In addition, the state medical operations center is helping with contact tracing, mosquito surveillance and public awareness about the virus. According to Van Deusen, officials also will bolster mosquito control measures (New York Times, 11/28).

Van Deusen encouraged Cameron County residents to take precautions such as using insect repellant, wearing long pants and long-sleeved shirts and removing standing water near homes (Los Angeles Times, 11/28).

DSHS Commissioner John Hellerstedt said, "We still don't believe the virus will become widespread in Texas, but there could be more cases, so people need to protect themselves from mosquito bites, especially in parts of the state that stay relatively warm in the fall and winter" (AP/Sacramento Bee, 11/28).

According to the Times, the virus may also be spreading locally in Matamoros, Mexico, a small town right across the border from Brownsville. Frieden said CDC routinely works with Mexican health officials, and the country "has quite a strong mosquito control program." However, he said officials did not know how much the Zika virus has or will affect nearby parts of Mexico, stating, "We know there is transmission in the border areas ... But exactly where, we don't know."

Implications for pregnant women

Van Deusen said, "Pregnant women should continue to protect themselves from mosquito bites there and elsewhere in Texas."

According to Thomas Frieden, director of the Centers for Disease Control and Prevention (CDC), no travel alert suggesting pregnant women avoid the area is being issued at this point. He said that a single case is not considered evidence of continuing local transmission. The Times reports that confirmation of multiple cases within an area roughly 1-square mile in size for longer than about two weeks, despite aggressive mosquito control, would yield a federal warning.

Separately, Carmen Rocco, a pediatrician working in Brownsville, said she has been monitoring her patients for the Zika virus and had not yet encountered any cases of infection. Rocco, who said most of her patients qualify for Medicaid, praised the state's decision to cover mosquito repellent through Texas' Medicaid program, noting, "Families were taking advantage of that" (New York Times, 11/28).