June 13, 2018
As summer heats up, you may
find yourself swatting that occasional seasonal annoyance, the mosquito. For
most people, the bite is just a temporary irritation; but for some, it can be
life-changing — even life-threatening.
Mosquitoes, ticks, and fleas
can spread diseases like Zika and West Nile virus, and some lesser-known ones
like dengue fever and murine typhus. Texas’ warm climate makes the state a
hotbed for these diseases spread by those insect “vectors.”
“Texas is probably the most
vulnerable state in the union to these diseases,” said Peter J. Hotez, MD, head
of the National School of Tropical Medicine at the Baylor College of Medicine
Despite disease surveillance
by the Texas Department of State Health Services (DSHS), the June issue of Texas
Medicine magazine reports vector-borne
illnesses are underreported. Complicating that is the difficulty in diagnosing
some of the diseases, which can look like other illnesses.
Zika is a good example: The virus’
symptoms often look like the flu — fever, joint pain, and rash. And tests for
the disease aren’t always accurate or easy to interpret.
To even be tested, patients must
first feel sick enough to visit their physician, said Dr. Hotez. The physician
then must recognize the symptoms could indicate a tropical disease and arrange appropriate
tests, which can be more complex than a simple lab test. “It requires all three
stars to align before you can diagnose somebody,” said Dr. Hotez.
A study released by the Centers
for Disease Control and Prevention in May found the number or people in the United States who experienced
insect-borne diseases tripled to 96,000 between 2004 and 2016. In
addition, nine new vector diseases were discovered or introduced during that
Regulatory and commercial
roadblocks have sidelined vaccines that could help prevent the diseases. Texas’
best short-term defense, say the experts, is better disease surveillance,
mosquito control, and education.
House Bill 3576, passed by the 2017 Texas
Legislature, calls for DSHS to track, study, and prevent the spread of Zika and
some other communicable diseases. DSHS now tests pregnant women in nine Texas counties
along the U.S.-Mexico border where Zika is most likely to spread. DSHS and the
local health departments follow up on positive results.
Mosquito control is erratic
because some Texas communities don’t have the resources to support it.
Better physician and public
education is needed. Many doctors don’t have a lot of firsthand experience with
vector-borne diseases, said Scott Weaver, PhD, principal investigator for the
Western Gulf Center of Excellence for Vector-Borne Diseases at The University
of Texas Medical Branch at Galveston. Knowing which ones are common in their
area and advising patients about those diseases can help, he said.
“Physicians in Corpus
Christi know murine typhus in their sleep,” said Jane Siegel, MD, a Corpus
Christi pediatric infectious disease specialist and chair of TMA’s Committee on
Infectious Diseases. “People who haven’t seen it a lot have to ask for
information about it.”
She says physicians need to
routinely ask patients about their travel in and out of the country, and
consider the potential for seeing vector-borne illnesses in their patients.
“When we’re in the height of
an outbreak, like Zika in Dallas, we [physicians] tend to ask about it. But
then we tend to relax. Somehow it needs to be standardized and incorporated
into our practice,” said Dr. Seigel.
TMA is the largest state medical society in the nation,
representing more than 51,000 physician and medical student members. It is
located in Austin and has 110 component county medical societies around the
state. TMA’s key objective since 1853 is to improve the health of all Texans.
Brent Annear (512) 370-1381; cell: (512) 656-7320; email: brent.annear[at]texmed[dot]org
Marcus Cooper (512)
370-1382; cell: (512) 650-5336; email: marcus.cooper[at]texmed[dot]org
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