Texas Leads in the Fight for Zika Prevention

August 03, 2017|12:41 p.m.| ASTHO Staff

With the summer and mosquito season in full swing, ASTHO spoke with John Hellerstedt, MD, commissioner of the Texas Department of State Health Services (DSHS), about Texas’s efforts to prevent the spread of Zika, response to a recent case of local transmission in southern Texas, and what more is needed to spread the message of Zika prevention.

As summer and mosquito season unfold, what steps is DSHS taking to prevent the spread of Zika?

There are many ways to fight Zika and other mosquito-borne diseases. Unfortunately, no single method is sufficient, so all of them have to play a role. Our job is to advise, organize, and call our partners into action.

There are parts of Texas in which mosquito season is nearly year around. We’ve been working continuously since the first travel-related Zika cases were reported in 2015 to lower the risk of local transmission and educate travelers about how to protect themselves and prevent bringing Zika back to Texas. One of our primary strategies has been to provide accurate and up-to-date information to healthcare providers and the public, using websites such as target="_blank" TexasZika.org, which is a one-stop resource for data, information, and materials. In addition, we have been reaching out to healthcare professionals across Texas with health alerts, webinars, calls, and other presentations to recruit for our surveillance efforts and share best practices around testing and patient care.

In June, DSHS relaunched a multimedia public awareness campaign with general messaging and targeted information for the most vulnerable groups, such as pregnant women, travelers, and outdoor workers. Complementing these DSHS efforts, the Texas Health and Human Services Commission added mosquito repellent as a Medicaid benefit.

Following the binational forum in El Paso to address Zika and other mosquito-borne illnesses, how does Texas plan to collaborate with other U.S. and Mexican-border states to prevent the spread of Zika?

At DSHS we are public health conveners, which is why we helped organize the binational forum. I am committed to continuing to actively participate in the Border Health Commission and the United States-Mexico Binational Technical Working Group projects to share information along both sides of the border. I also support the action plan developed during the binational forum with specific activities in disease surveillance, laboratory work, mosquito surveillance and vector control, as well as health education and communications related to mosquito-borne diseases.

The DSHS Office of Border Services and Office of Title V launched a Zika prevention initiative during the early part of 2017. We are using the hundreds of community health workers already working along the border to help us reach into communities and share critical information about public health. We are implementing a comprehensive strategy to inform, educate, and refer people to services, with special focus on reaching women of childbearing age and their partners. The curriculum and training program have been implemented in partnership with CDC, the National Rural Health Association, local health departments, federally qualified health centers, academic institutions, nonprofits, and community health worker networks and training centers. We are evaluating the initiative and look forward to sharing the results in the future.

There has been local transmission of the Zika virus in Brownsville, Texas. What lessons has DSHS learned that will help other regions of Texas as well as other states respond to Zika?

Local health departments and healthcare providers are our greatest resource. Thanks to them, we were able to conduct the investigations and actions necessary to prevent a larger scale outbreak. DSHS issued a health alert in April to ensure that we continue monitoring that area of southern Texas very closely. In fact, proactive testing by a physician in neighboring Hidalgo County recently helped us identify a previous Zika infection that would otherwise have gone undetected.

Leadership at all levels of government is important. I’m grateful to Gov. Greg Abbot for demonstrating his support this spring. He and I sent a joint letter to county judges and mayors across the state laying out specific actions that can be taken by Texans to prevent the spread of Zika and reinforcing DSHS’s commitment to help coordinate response efforts and provide technical expertise. An important component is the guidance that DSHS issued for local jurisdictions on how to develop a Zika vector management plan.

Gov. Abbot and I also collaborated with the Texas Education Agency and sent a joint letter asking school superintendents and school board members to help promote Zika prevention messages with flyers, downloadable materials in Spanish and English, and social media platforms.

What additional tools and resources are needed to help prevent the spread of Zika in Texas?  

Until a vaccine is developed, the Zika virus will continue to pose a threat. We must continue to encourage surveillance efforts and ensure that at-risk pregnant women have access to laboratory testing and counseling services. We’re also striving to develop better health system coordination between prenatal care and pediatric care for babies who may have been exposed to Zika before birth. It’s important that babies be tested after delivery and monitored for any long-term effects.

The combination of what we know and don’t know about the Zika virus has made it challenging. We will continue sharing data with CDC and collaborating to find answers. I am thankful to the researchers in Texas, other states, and all across the globe who are working diligently to solve the puzzle of Zika.

In the meantime, we will continue to strengthen our partnerships and spread the message for Zika prevention: promote integrated mosquito management, protect against mosquito bites, and provide prenatal counseling.