TMA Testimony on House Bill 3576
House Public Health
Testimony on House Bill 3576 by Rep. Bobby Guerra
April 11, 2017
Chairman Price and members of the committee, the Texas Medical Association appreciates the opportunity to present our comments on behalf of our more than 50,000 members in support of House Bill 3576. HB 3576 addresses important concerns our members have raised on our state’s ability to fully participate in national public health surveillance of certain infectious diseases — particularly new and emerging diseases like Zika.
There is still so much we don’t know about Zika virus infection, and we need to be able to learn from the cases that continue to be reported. Screening, testing, reporting, and monitoring of infectious diseases by our local and state public health professionals is a core function of public health. This critical public health function cannot occur without a collaboration between public health and medicine that ensures timely testing of patients for infectious diseases. Such surveillance enables physicians and public health to identify an increase in infectious disease cases and implement prevention and treatment activities. These activities help reduce or prevent further infection of individuals that can lead to an outbreak in a community. We can accomplish this because we have decades of science and evidence empowering us to act on multiple fronts: to guide testing, to identify who is at highest risk for exposure to prevent a disease from spreading, and to care for those who become ill from the infectious diseases already reportable in Texas. This is ongoing in every community regarding all other reportable infectious diseases, but we are not yet in this position with Zika. This is why physicians and public health must be able to work together to support a more robust surveillance system as proposed by HB 3576.
Scientists identified the Zika virus decades ago but significant study on this virus was only begun recently when Zika and its health outcomes were confirmed in the Americas. But we do not yet understand why some people infected with the Zika virus have poor health outcomes while others never experience symptoms. We know a woman infected with Zika or another arbovirus during her pregnancy can pass the infection to her fetus, potentially causing death. Yet current studies indicate only a subset of the fetuses exposed to Zika in utero will be affected. And while some health effects will be identified during the pregnancy or at birth, some may not be identified for weeks or even years after a birth. We also must learn from Zika-related miscarriages and stillbirths as the disease, can affect fetuses during any period of a pregnancy. This is why it is essential for Texas to monitor each Zika-associated pregnancy and birth and contribute to the national surveillance on this disease.
Like other temporal climates, Texas has the vector for Zika during some periods of the year, and we will need to adopt and maintain prevention measures as individuals and in our communities. Physicians support the national, state, and local public health prevention efforts to reduce the spread of Zika in Texas. But our support for HB 3576 is rooted in our commitment to supporting the scientific process of prevention and medicine. This can occur only if we are testing people potentially exposed to Zika or another arborvirus and then reporting test results to the local and state health departments, thus contributing to the current national surveillance on Zika-related pregnancies.
Our best efforts to test and report on pregnant women or others who are infected with Zika are not fully beneficial if additional health data points from Texas cannot be shared with other state and national efforts to better understand Zika and its health outcomes. HB 3576 will help us ensure Texas has a strong reporting system and — when necessary — we can contribute to and increase awareness of new and emerging infectious diseases. This is important since we now fully understand these diseases can be brought to Texas in mere hours. We know Zika, like other arboviruses, is here to stay. Medicine and public health can work together and must be better equipped to understand and manage these diseases. We believe HB 3576 will help that effort, and we look forward to working with you in its implementation.
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