McALLEN, RGV – On the eve of a big Zika virus summit in McAllen, RGV Equal Voice Network has called on state officials to allow those on Medicaid to get mosquito-repellent for free.
Health and Human Services Commission chief Charles Smith has said he wants females of childbearing age to be provided with the cans of repellent, which cost $6.50 each.
Texas has had 53 reported cases of Zika virus disease. Of those, 52 were in travelers who were infected abroad and diagnosed after they returned home; one of those travelers was a pregnant woman. One case involved a Dallas County resident who had sexual contact with someone who acquired the Zika infection while traveling abroad.
Ann Cass of Proyecto Azteca and the RGV Equal Voice Health Working Group said those living on low incomes “should not have to choose between food and mosquito repellent.” Cass said Texas’ refusal to budge on getting these resources to Medicaid patients is “another case where the state does not want to manage Medicaid with the parameters offered by the government. We all know that finding repellent with DEET – the most effective repellent – is a problem because after Hurricane Dolly, there was none available.”
Mike Seifert, network weaver for RGV Equal Voice Network, said the control of mosquitos is a particular challenge to rural communities in the Valley. “There are far more rural communities than the county can reach with spraying efforts, and the general poverty of the area confounds the issue.”
Seifert said he remembers last spring when medical students from Community for Children took on a project to mosquito-proof some properties in rural neighborhoods in Alamo. “The students were shocked by the amount of work it took to get just one woman’s lot cleaned up. The tall grass, the tires tossed in the backyard, the multiple breeding places. And of course, the poor woman had no screens on her doors or her windows, and no air conditioning. Not helping her with some sort of repellent is like painting a big target on her back.”
The Zika virus is a mosquito-transmitted infection related to dengue, yellow fever and West Nile virus. It is known to cause devastating birth defects and the World Health Organization has declared it an international health emergency. The agency expects the virus to spread from South America to the southern United States by the end of the year, infecting many millions of people.
Last month, the New York Times published this information on the virus: “Although it was discovered in the Zika forest in Uganda in 1947 and is believed to be common across Africa and Asia, it did not begin spreading widely in the Western Hemisphere until recently — perhaps sometime in 2013, although its presence was not confirmed until May 2015, when it was identified as the “mystery disease” sweeping across northeast Brazil. Almost no one in the Americas is immune, so it has spread rapidly. About four in five victims have no symptoms, and those who do usually recover within a week. Common symptoms include a fever rarely higher than 102 degrees, an itchy pink rash, bloodshot eyes, sensitivity to light, headaches and joint pains.”
Center for Public Policy Priorities blog
In a blog, Julia Von Alexander, a health and wellness intern working for the Center for Public Policy Priorities, says that while Texas has started a campaign telling people to protect themselves from mosquito bites, it has done too little to help the most vulnerable to avoid exposure. “Low-income Texans may live in poor quality housing without air conditioning or window screens, or near areas that are breeding grounds for mosquitos. To make matters worse, these Texans may not be able to afford insect repellent or protective covering.”
In her blog, Von Alexander pointed out that the federal Center for Medicaid and CHIP Services (a part of Centers for Medicare and Medicaid Services) released a bulletin June 1 stating that all states can choose to cover insect repellent in their Medicaid and CHIP plans. “If Texas takes this option, we could help some low-income Texans, including pregnant women, to obtain insect repellent. Over three million Texas children and over half of Texas’ pregnant women are covered by Medicaid today. Still, Medicaid coverage alone is not enough to prevent the spread of Zika throughout Texas, since most low-income Texans are not covered by Medicaid or CHIP.”
Texas Association for Community Health Centers
The Texas Association for Community Health Centers has urged the Texas Health & Human Services Commission to address the Zika virus more robustly in Texas. Their recommendations are as follows:
• Add insect repellent to the Texas Medicaid benefit immediately, and create a plan to ensure there are no barriers to getting a prescription (e.g. having to make a doctor’s appointment).
• Include insect repellent as a benefit in all safety net programs, including Healthy Texas Women, the Expanded Primary Care Program and existing Family Planning Program.
• Prioritize patient education on Zika for both men and women, including contraceptive counseling. Work with providers, certified promotoras, community health workers, and other partners to provide this education.
• Determine potential partnerships with relief organizations to enable immediate distribution of insect repellant.
Formally called the State of Texas Active Response to Zika (STARZ) Conference, Wednesday’s Zika virus summit is being hosted in partnership between the Texas Department of State Health Services, the Texas Association of City and County Health Officials, Hidalgo County Health and Human Services, and the City of McAllen. Attendees will include representatives from public health, emergency management, blood banks and other community leaders involved in Zika response. The day-long workshop takes place at the McAllen Convention Center, starting at 9 a.m.
“It’s a chance for us to sit down together to coordinate our plans in detail and exercise our actions before Zika is really here,” said Dr. John Hellerstedt, Texas Department of State Health Services commissioner. “We expect to see some level of local transmission in the state, and Texas is at the forefront and ready.”
Dr. Hellerstedt said the event will include speakers addressing the state’s response plan, public outreach, surveillance and epidemiology. The central element of the event will be two tabletop exercises in which leaders walk through and discuss how they would handle both the first confirmed local transmission of Zika in their jurisdictions and also sustained local transmission.
In a media advisory promoting the STARZ Conference, DHSH said Texas has made significant progress in its efforts to delay and minimize the impact of Zika on the state. “While local transmission in Texas remains likely, public health officials do not expect widespread transmission across large geographic areas of the state. Small pockets of cases in limited clusters are more likely. This assessment is based on the state’s past experience with dengue, a similar virus spread by the same mosquitoes, and on the prevalent use of window screens, air conditioning, insect repellent and other mosquito control efforts in Texas,” the advisory stated.
Here are some of the latest state public health efforts in Texas:
Texas Zika Response Plan. The Zika Virus Preparedness and Response Plan has been posted to www.TexasZika.org under the Zika Response tab and describes what actions DSHS will take to successfully respond to Zika. It follows a phased approach and includes specific response activities for local transmission. The plan will continue to be practiced and improved as new information becomes available.
Campaign. Texas has boosted its Zika public outreach campaign by $500,000, making it a $2.5 million campaign that will continue through the summer and will now include grassroots outreach in addition to educational materials, advertising, radio and news media. The website www.TexasZika.org launched in February and continues to be the anchor for the campaign and the source of official Texas public health information about Zika. More than 50,000 people visited the site in June.
Testing. DSHS has approved testing of specimens from more than 900 patients for Zika virus by the DSHS laboratory and the Centers for Disease Control and Prevention. Other labs across the state now have the ability to test for Zika. DSHS is also working to add the more complex serologic testing for human specimens to detect Zika infection in people who may not have had symptoms. Texas also now has the capability to test mosquito specimens for Zika as warranted for identified high-risk areas.
Surveillance. Texas has had 50 cases of Zika virus disease, including one confirmed case of Zika in a pregnant woman. All are related to travel abroad to areas with active Zika transmission. In addition, there have been 28 pregnant Texas residents with laboratory evidence of Zika infection but did not meet the case definition. Texas provides this data weekly to the CDC’s Pregnancy Registry.
Pregnant Women. With its link to microcephaly, Zika poses a serious threat to unborn children. DSHS is working to educate women and families about how to protect themselves through its Women, Infants and Children (WIC) program and via healthcare providers. The Texas WIC program is seeking to distribute Zika prevention materials, including mosquito repellent, through its breastfeeding promotion kits. DSHS is working closely with other state agencies to emphasize precaution information to their specific audiences, such as schools, daycares and women’s health programs.
“With the central goal of protecting unborn babies from Zika, we’re doing everything we can to make sure everyone knows how to prevent it,” said Dr. Hellerstedt. “If local transmission is suspected, our response will be fast and geared toward identifying actual risk and protecting Texans.”
State health officials urge everyone to follow these precautions to protect themselves from mosquito bites:
* Apply EPA-approved insect repellent.
* Wear pants and long-sleeve shirts that cover exposed skin. In warmer weather, wear
lightweight, loose-fitting clothing that covers exposed skin.
* Use screens or close windows and doors to keep mosquitoes out of your home.
* Remove standing water in and around the home. This includes water in cans, toys,
tires, plant saucers, and any container that can hold water.
* Cover trash cans or containers where water can collect.
Guerra: Olivarez deserves credit
State Rep. R.D. ‘Bobby’ Guerra of McAllen said Hidalgo County’s top public health official, Eduardo Olivarez deserves particular praise for bringing the conference to McAllen. Guerra is a member of the House Committee on Public Health and will be attending the summit.
“Eddie grabbed the bull by the horns. He realized early on that this is a very serious issue. Early in the year, Eddie had representatives from various countries here, including some from South America. This summit is an expansion of that. The conference should be held along our southern border. We have to bring this issue to the forefront. As Eddie Olivarez says, it is not a matter of if this virus spreads to the Rio Grande Valley and Texas, it is a matter of when. We need to be prepared,” Guerra told the Rio Grande Guardian.
Amber Arriaga-Salinas, of Proyecto Azteca and RGV Equal Voice, is expected to attend the Zika virus summit. She is also preparing a workshop for the local community that will focus on ways to prevent the Zika virus from spreading.
“The scope of our workshop goes far beyond Zika. Valley communities are at risk from a variety of viruses caused by mosquitos, including dengue, Zika and chikungunya virus,” Arriaga-Salinas said. She said the workshop will be a community-wide collaboration between Proyecto Azteca, RGV Equal Voice, Hidalgo County, and others. “That is how we do things down here. It is a culture of being proactive. We educate and we self-protect; it is crazy to hang around waiting for the resources which, though rightly are ours, aren’t coming anytime soon. We are interested in a long term effort to do what we need to do to prepare our families.”