CDC Designates Zika Cautionary Area in Texas

There’s an old saying: “Don’t mess with Texas.”

Unfortunately, Zika virus, and the mosquitoes that carry it, haven’t gotten the message.

On December 14, the Centers for Disease Control and Prevention (CDC) issued a Zika-related travel and testing guidance for Brownsville, Texas and the surrounding area after local officials confirmed 5 cases of the virus linked to local mosquitoes. The Lone Star State now becomes the second in the country with confirmed locally transmitted cases of Zika; Florida had several small outbreaks of the virus—primarily in the Miami area—this summer.

The guidance has designated Brownsville as a “Zika cautionary (or yellow) area.” The city is located on the US border with Mexico, where local spread of the virus has been reported, on the Mexican side, since earlier this year.

“The Texas Department of State Health Services, Cameron County Health Department, Brownsville Health Department and CDC are working together to rapidly learn more about the extent of Zika virus transmission in Brownsville,” the CDC said in a statement. “As of this time… there is not yet any evidence of widespread, sustained local spread of Zika. Still, temperatures in the region are conducive to mosquito-borne spread, and the risk of continued local spread cannot be ruled out.”

As with Miami over the summer, the CDC is recommending that pregnant women who live in other areas should consider postponing any planned travel to Brownsville; and, those who live in or travel to Brownsville “should be aware of local spread of Zika virus and should strictly follow steps to prevent mosquito bites.” Furthermore, pregnant women who live in, have traveled to, or took part in sexual intercourse without use of a condom with someone who lives in or has traveled to Brownsville (since October 29, 2016, when the first locally transmitted cases was confirmed) should be tested for Zika virus infection.

To date, according to the most recent CDC figures, more than 4,500 Americans (nearly 300 in Texas) have been diagnosed with the mosquito-borne virus, including more than 1,100 pregnant women. Roughly 100 of these cases have been so-called “locally transmitted,” or traced to mosquito bites sustained locally; the rest are the result of travel to regions where the virus has been rampant (South America and/or the Caribbean) or sexual transmission. A report by the radio station KURV in south Texas indicates that the first locally transmitted case in Cameron County (where Brownsville is located) involved a 43-year-old woman.

Meanwhile, a separate report by KRGV, a local television station, notes that county health officials are working with area doctors to educate them on Zika testing protocols and how to counsel patients, particularly pregnant women or women who plan to become pregnant, about the virus. The county is even providing testing services for pregnant women unable to get appointments with the primary care doctors, many of whom were quickly overbooked after the CDC issued its guidance for the area.

“We’re here to facilitate that testing,” Cameron County Health Administrator Esmeralda Guajardo told KRGV. “We are opening up appointments this week, just for those women who cannot be seen [by] their doctors.”

The CDC is also providing support services, facilitating rapid testing of samples and assisting with surveillance and vector control initiatives. “We are working closely with Texas to gather and analyze new information every day. With the new information that there has been local spread of Zika for at least several weeks, we conclude that pregnant women should avoid the Brownsville area—and make every effort to prevent mosquito bites if they live or work there,” CDC Director Tom Frieden, MD, MPH said in a statement. “Together with Texas officials we are working to protect pregnant women from the potentially devastating effects of this virus.”