Mosquitos swarm around water trapped in an old tire that lays next to a mobile home. They hover over the puddles and mud left on the dirt driveway by the afternoon downpour and swarm in the shade of tall grass. This is a common scene in rural areas, colonias and even in cities and towns here in the Valley. It is why protecting folks from disease carrying mosquitos can be a challenge.
I recently drove through a subdivision outside of San Benito, accompanying a Community Health Worker delivering education about the Zika virus. We see an elderly woman hanging clothes right next to a drainage ditch that runs behind her house. The ditch is filled with stagnant water, tall weeds and buzzing with mosquitos. This woman has not been able to protect herself or her home from swarms of mosquitos after it rains.
We pull over to chat with her and hand her a flyer about the Zika virus. She shares, “Mosquitos are a real problem.They even come inside the trailer, since I don’t have screens on my door or windows. I have a window unit air conditioner but can’t run it all the time because I can’t afford the bill. Sometimes at night I go crazy with the buzzing in my ears. I have to wear long sleeved shirts, and long stockings with my skirts which is hot in the summer, but even so they bite right through my clothes.”
Apart from the annoyance of the bites and buzzing, there are some particular mosquitos that are more of a menace, as they carry with them disease. With news of the Zika virus spreading through parts of Latin America and the Caribbean, and now into the U.S., public health officials are making an urgent push to control the mosquitos, which have always been in our area, but have now become famous.
Aedes aegypti mosquitos are the carriers of Zika (as well as Dengue Fever and Chikaungunya) and are common here in the Valley. The added threat of birth defect causing Zika is cause for alarm among officials, health care providers and residents alike.
Zika is spread primarily through the bite of an infected Aedes aegypti mosquito. Many people infected with Zika virus won’t have symptoms or will only have mild symptoms.
However, Zika in pregnancy can cause birth defects like microcephaly. According to the Centers for Disease Control and Prevention (CDC) website, www.cdc.org, “In a recent article, CDC scientists announced that there is now enough evidence to conclude that Zika virus infection during pregnancy is a cause of microcephaly and other severe fetal brain defects and has been linked to problems in infants, including eye defects, hearing loss, and impaired growth. Scientists are studying the full range of other potential health problems that Zika virus infection during pregnancy may cause.”
There is no vaccine to prevent Zika. The virus can also be spread by a man infected with Zika to his sex partners, as well as to a fetus from an infected pregnant mother. Mosquitos that carry Zika most often bite during the daytime, so it is important to protect yourself not just at night, and not just outside, since mosquitos can live and breed indoors as well.
Education of the public about reducing mosquito breeding areas, standing water and protection with repellent, screens and clothing is important, but according to Dr. Joseph McCormick, Dean of the University of Texas, School of Public Health, Brownsville Regional Campus, setting up a surveillance and reporting system is crucial.
“Often times the state doesn’t invest in this infrastructure ahead of time and when the outbreak occurs it’s too late. We need to be communicating among physicians and clinics and hospitals and creating a system to address Zika, and other mosquito-born illnesses, before we see high numbers of cases, which is very possible due to the Valley’s proximity to Mexico, where Zika is active, our climate and large poor, rural population.
Local city, county and state health departments have started meeting to strategize in case there is an outbreak, but setting up a surveillance system and equipping residents with the tools they need to protect themselves is crucial at this juncture.
Local advocates of the Valley’s many low-income, uninsured residents are concerned that education is not enough and Medicaid and the state are not willing to provide more resources to protect folks, like screens, repellent and fans which can be expensive for families on a tight budget.
Ann Cass of Proyecto Azteca and the Equal Voice Health Working Group said that “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 is a problem because after Hurricane Dolly, there was none available.”
The CDC recommends using Environmental Protection Agency (EPA)-registered insect repellents. Choosing an EPA-registered repellent ensures the EPA has evaluated the product for effectiveness. When used as directed, EPA-registered insect repellents are proven safe and effective, even for pregnant and breast-feeding women. You can find a list on the CDC website.*
Our challenges with Zika are but a small reflection of larger public health, infrastructure and policy issues that have allowed developers to proliferate colonias, (unincorporated subdivisions lacking basic services), particularly in Hidalgo County, and a state that turns away Medicaid expansion in spite of the highest rates of uninsured in the country.
Art Rodriguez, Director of Public Health and Wellness for the City of Brownsville, has doubled up on efforts to prevent the spread of Zika.
“While we continue aggressively spraying and treating standing water sources, Zika is a game changer. We will not be able to spray our way out of this one because Zika is also sexually transmitted. We really need the partnership of the public to help prevent an outbreak in our area. We must assume that all mosquitos are carriers at this point. By eliminating sources of standing water in your home and yard, and having a zero tolerance for mosquitos inside your home, you can help reduce the risks. Often times standing water accumulates in small receptacles like piles of trash, bottle caps, children’s toys left in the yard when it rains. Most mosquitos don’t travel further than 200-300 yards from where they originate. These mosquitos aren’t coming from far away and you can’t blame standing water or weeds in another neighborhood or nearby park. They are usually originating on your own property. If you live in the Brownsville area and would like more information about Zika and preventing the spread of Zika and other mosquito-born illnesses, call (956) 546-HELP to reach the City of Brownsville’s Health Department helpline.”
We will need a combination of coordinated surveillance, resources, advocacy and public education to prevent and combat the spread of Zika, because Tu Salud ¡Si Cuenta! (Your Health Matters!).
Always follow the product label instructions. Reapply insect repellent as directed. Do not spray repellent on the skin under clothing.
If you are also using sunscreen, apply sunscreen before applying insect repellent. To protect your child from mosquito bites: Do not use insect repellent on babies younger than 2 months old. Do not use products containing oil of lemon eucalyptus or para-menthane-diol on children younger than 3 years old. Dress your child in clothing that covers arms and legs. Cover crib, stroller, and baby carrier with mosquito netting. Do not apply insect repellent onto a child’s hands, eyes, mouth, and cut or irritated skin. Adults: Spray insect repellent onto your hands and then apply to a child’s face (www.cdc.org).