Texas reports first Zika case from local mosquito; virus is now here to stay, says WHO

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Texas health officials on Monday (December 28,2016) reported the state’s first case of Zika likely spread by local mosquitoes, making Texas the second state within the continental United States to report local transmission of the virus that has been linked to birth defects.

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The case involved a woman living in Cameron County near the Mexico border who is not pregnant, the Texas Department of State Health Services said. Pregnancy is the biggest concern with Zika because the virus can cause severe, life-long birth defects, including microcephaly, in which a child is born with an abnormally small head, a sign its brain has stopped growing normally.

Texas said it currently has no other suspected cases of local Zika transmission, but officials there plan to step up efforts to watch for the virus, says Reuters. The US Centers for Disease Control and Prevention said it was coordinating with state and local officials to increase surveillance efforts and “vector control activities” such as spraying for adult mosquitoes and applying larvicide to kill emerging mosquitoes.

Texas is one of several US states where Aedes aegypti mosquitoes, which carry Zika, are present. Florida’s Miami Dade County has been battling Zika within local mosquito populations since mid-summer. As of Monday, the state has had 238 cases of locally transmitted Zika.

“We knew it was only a matter of time before we saw a Zika case spread by a mosquito in Texas,” Dr. John Hellerstedt, Texas Department of State Health Services commissioner, said in a statement. “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.”

Dr. Amesh Adalja, an infectious diseases expert at the University of Pittsburgh Medical Center, said local transmission in Texas was “totally expected.” Both dengue and chikungunya, two closely related viruses, have already spread locally in Texas, and the state “is a well-established home” of Aedes mosquitoes.

“What this case underscores is the risk of local transmission in any area in which Aedes mosquitoes are present and the urgent need to continue aggressive vector control measures to minimize the impact of such local introductions,” Adalja said.

Officials in Cameron County and the City of Brownsville have assessed the woman’s home and have begun trapping and testing mosquitoes to understand how widespread the virus is in local mosquito populations. The city recently sprayed for mosquitoes in the area, and will continue to take action to reduce the mosquito population, state and local officials said.

“Even though it is late in the mosquito season, mosquitoes can spread Zika in some areas of the country,” CDC Director Tom Frieden said in a statement. “Texas is doing the right thing by increasing local surveillance and trapping and testing mosquitoes in the Brownsville area.”

There is no vaccine or treatment for Zika, which causes mild fever, rash and red eyes. An estimated 80% of people infected have no symptoms, making it difficult for individuals to know whether they have been infected.

The connection between Zika and microcephaly first came to light last year in Brazil, which has since confirmed more than 2,000 cases of the birth defect. In adults, Zika infections have also been linked to a rare neurological syndrome known as Guillain-Barre, as well as other neurological disorders.

Steve’s Take:

After an enjoyable week hosting out-of-town friends and relatives for the long Thanksgiving weekend, I awoke Monday morning and found myself parachuting back to reality with a jarring thud.

Health officials in the state of Texas said they recorded the first case of the Zika a virus transmitted by a local mosquito. That news came just over a week after another report, fairly innocuous on its face, but far from insignificant.

It was the declaration by the World Health Organization that Zika was no longer a “public health emergency,” indicating that the disease was now a threat it would be fighting long-term, like malaria or yellow fever.

So the WHO declares that Zika will no longer be treated as an international medical emergency. Ho-hum. Actually sounds like good news, right?

Not exactly, it turns out.

Buried somewhere in the post—presidential election and pre-Thanksgiving hubbub was the second part of the WHO news release that said it was ending the emergency–formally known as a “Public Health Emergency of International Concern.”

Indeed, this sounds like good—, even great—news, but the WHO declaration went on to say that the apparent “downgrade” in the status of the emergency is,

“because Zika is now shown to be a dangerous mosquito-borne disease, like malaria or yellow fever, and should be viewed as an ongoing threat met as other diseases are.”

The WHO advisory committee members repeatedly emphasized that they did not consider the Zika crisis over, according to The New York Times.

“We are not downgrading the importance of Zika,” said Dr. Peter Salama, executive director of the WHO’s health emergencies program. “We are sending the message that Zika is here to stay and the WHO response is here to stay.”

Like all mosquito-borne diseases, Zika is seasonal and may repeatedly return to countries with the Aedes aegypti mosquitoes that carry it, Dr. Salama added.

So now we have homegrown Zika in Florida and Texas. The experts expect Zika to stick to Florida, parts of Georgia, Alabama, Mississippi, Louisiana, and Texas, says Business Insider. Any other transmission across the US would likely be sporadic, according to the US Centers for Disease Control and Prevention.

But the actual extent of the spread can’t be predicted precisely. It depends upon how well public health officials can contain this first outbreak to Miami and now Cameron County in the southernmost part of Texas, and keep imported travel cases from turning into more outbreaks, David Pigott, a global health expert at the University of Washington, said.

“Never say never, but [a local outbreak is] a lot less likely to happen in New York or Washington, D.C., given our current knowledge than it is in Houston, or some cities across Louisiana, or other places in Florida,” Piggot said. “In terms of comparative risk, it’s the southern states that are going to be the places where you’re most likely to see it.”

Only one in five people show symptoms, making Zika a particularly hard virus to track. It also only debuted in the Americas last year, so there’s a lot we still don’t know about the virus. The US Centers for Disease Control and Prevention only concluded that Zika was causing the birth defect microcephaly in April 2016.

The virus is spread by the Aedes aegypti mosquito, which thrives in tropical areas and bites during the day. The Aedes albopictus mosquito can likely spread the disease, too, but that hasn’t been observed in the Americas yet.

So despite possibly ruining some of your happy memories of the past week, unless you were on the losing side of the massive college and pro football fare, it’s my task to bring us back to the reality of Zika.

The US Centers for Disease Control and Prevention has reported over 4,200 Zika cases in US states, and over 180 locally acquired cases, which until Monday were only reported in Florida. Over 31,000 cases have been reported in Puerto Rico, where the virus has been circulating among local mosquitoes since December 2015.

“Every time an imported case comes, you’re rolling that dice in terms of a local outbreak occurring,” Pigott said in August when the virus started circulating on the US mainland. “I think it could well be that these [Florida] cases represent the tip of the iceberg, but I don’t know if anyone knows how big that iceberg could potentially get.”

So where do those of us living on the US mainland stand vis-à-vis Zika?

While most northern states in the US are protected from local Zika transmission because the cold kills mosquitoes in the winter, researchers predict that the virus could be in southern states like Texas and Florida permanently.

That’s right…permanently.

And to avoid the rare and tragic birth defect, microcephaly, of which most of us are now well aware, means pregnant women should take precautions when traveling to such states. These include: using EPA-approved insect repellent; and wearing long pants and long-sleeved shirts that cover exposed skin.

In addition, those in the aforementioned gulf states should include: using air conditioning or window and door screens that are in good repair to keep mosquitoes out of the home; and removing standing water in and around homes, including water in trash cans, toys, tires, flower pots, and any other container that can hold water.

Steve's Take: It’s the dawn of a new era in the USA. #ZikaVirus, is here to stay. Click To Tweet

Testing pregnant women who live in high-risk areas has also been suggested.

Bottom line? It’s the dawn of a new era in the USA. Zika, is here to stay.

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