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First West Nile case highlights precautions for mosquito-borne diseases

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Texas’ first West Nile illness of the year has been reported to the Department of State Health Services, an adult woman from Montgomery County who developed the neurologic form of the disease in late April.

As mosquito counts climb, the state of Texas is appealing to the public to help with the effort to stop mosquito-borne diseases by preventing mosquito bites and eliminating areas where mosquitoes can reproduce.

“Diseases like Zika and West Nile remain threats in Texas, and we need everyone to do their part to protect themselves, their families and their communities,” said DSHS Commissioner Dr. John Hellerstedt. “These are simple steps, and if people take them consistently, they will go a long way toward reducing the number of cases of either disease transmitted in Texas.”

To help stop the spread of Zika and West Nile, people should:

  • Use EPA-approved insect repellent every time they go outside.
  • Cover exposed skin with long pants and long-sleeved shirts whenever possible.
  • Use air conditioning or window and door screens that are in good repair to keep mosquitoes out.
  • Limit outdoor activities during peak mosquito times.
  • Remove standing water in and around homes, including in trash cans, toys, tires, flower pots and any other containers so mosquitoes can’t lay their eggs.
  • Use a larvicide in water that can’t be drained to keep mosquitoes from developing.

In 2016, Texas reported 370 human cases of West Nile illness, including 18 deaths. Most people who get infected don’t get sick, but about 20 percent will experience symptoms like headache, fever, muscle and joint aches, nausea and fatigue. In about one percent of infections, the virus can affect the nervous system, causing neurological symptoms such as disorientation, tremors, convulsions, paralysis, coma and even death.

On the other hand, the illness Zika causes is usually mild, but the virus can have a profound effect on unborn babies whose mothers are infected during pregnancy. In some cases it can cause severe birth defects like microcephaly, a defect leading to a small head because the brain doesn’t grow sufficiently during pregnancy. Texas has had 334 cases of Zika virus disease since the virus became a concern in the Western Hemisphere in 2015. The vast majority have been contracted abroad, though six cases were transmitted by mosquitoes in Brownsville late last year, and others spread through sexual contact or from mother to child.

DSHS recommends pregnant women avoid traveling to locations with sustained, local Zika transmission, including all areas of Mexico. Because Zika can also spread through sexual contact, pregnant women and their sexual partners who have traveled to those areas should use condoms or avoid sexual contact during the course of the pregnancy.

With transmission occurring in Mexico, the border region remains the most likely area in Texas for Zika to spread, though much of the state is at risk due to the distribution of the mosquitoes that transmit the virus. DSHS continues to be on guard for Zika by recommending expanded testing that aims to identify cases transmitted within Texas so state and local governments can respond quickly to stop the spread. The state public health lab in Austin continues providing testing to find the virus in people and is now testing all mosquitoes capable of transmitting Zika that are submitted as part of routine mosquito surveillance. DSHS also has recently issued mosquito control guidance for local governments on how best to use the tools at their disposal to fight Zika by reducing mosquito populations.

DSHS is currently working to train at least 500 community health workers along the border to educate the public and pregnant women about Zika and help them get the appropriate testing. DSHS is also planning to support teams of community health workers and case managers inside local health departments who will work directly with pregnant women who may have been exposed to Zika to help them access specialized prenatal care and help affected newborns get the care they need.

Starting May 1, Texas began providing this year’s statewide Medicaid benefit for mosquito repellent to prevent Zika virus transmission. The Texas Health and Human Services Commission is offering the repellent to more Medicaid clients to ensure additional Texans are protected from the virus. For the first time in Texas, some boys and men will be eligible to receive the benefit, as well as women ages 45 to 55.

DSHS Zika testing recommendations, insect repellent information and more is available at TexasZika.org. Texas recommends testing pregnant women who have traveled to areas with ongoing Zika transmission and anyone statewide with at least three of the four most common Zika symptoms: rash, fever, joint pain and conjunctivitis (eye redness). Additionally, DSHS recommends all pregnant women living Cameron, Hidalgo, Starr, Webb, Willacy and Zapata counties be tested along with anyone in those counties who has a rash plus one other Zika symptom.

Health care providers can subscribe at the Health Care Professionals page of TexasZika.org to stay up to date with DSHS recommendations. There is more information about West Nile virus at www.dshs.texas.gov/idcu/disease/arboviral/westnile.

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