Texas has an expanding population that will reach 30 million by the year 2020, a geographic area larger than France, and a $1.4 trillion economy approximating the size of Australia. Its location — between the plains of the U.S. Midwest and the Gulf of Mexico — its designation as a port, its two international airports, unique climate and special brand of politics make it vulnerable to infectious diseases that could make headline news in 2016.
Measles. Low rates of vaccination make Texas prone to a measles outbreak in 2016. Measles is a highly contagious and highly lethal viral infection that killed 82,100 children under the age of five in 2013, making it one of the leading global killers of children. A safe and effective measles vaccine has been available since the early 1960s, but according to the U.S. Centers for Disease Control and Prevention (CDC), Texas now ranks near the bottom of U.S. states in rates of full immunization for preschool children. This is compounded by the 41,000 Texas parents who last year opted out of having their children vaccinated in order to attend school. Measles presents a special problem because it is so highly contagious. Before the vaccine, a single case of measles would result in between 11 and 18 more infections. Parents with infants (measles is not administered until 12 months) need to be the most concerned and might make Texas shopping malls, elementary schools and other public venues risky places to bring infants in 2016. It is important to raise immunization rates in Texas.
Influenza. Each year, The Texas Department of State Health Services estimates that influenza and pneumonia kill approximately 3,000 Texans, equaling the number of people in the state. Increased use of a vaccine now available for adults and children six months of age and older could significantly reduce flu deaths, just as wearing seatbelts reduces the risk of dying in a car crash.
Chagas disease. This parasitic infection causes a life-threatening condition known as Chagasic cardiomyopathy. The CDC estimates that 300,000 people live with Chagas disease in the U.S., many of them immigrants from Latin American countries. Scientists at the National School of Tropical Medicine at Baylor College of Medicine have identified a number of people who acquired the disease from “kissing bugs” found in Texas, such that transmission of Chagas disease in Texas may be common. Almost two-thirds of a species of kissing bug collected in south-central Texas were found to harbor the Chagas parasite, known as Trypanosoma cruzi while our colleagues at Texas A&M University determined that almost 9 percent of shelter dogs are infected across the state. New legislation (House Bill 2055) introduced by Rep. Sarah Davis (District 134) and Sen. Charles Schwertner (District 5) was just signed by Governor Abbott and could lead to heightened surveillance activities for this disease as a means to determine how widespread Chagas disease transmission actually is in Texas. In the meantime, the Sabin Vaccine Institute and the Texas Children’s Hospital Center for Vaccine Development is working to develop a Chagas disease vaccine in collaboration with other Texas universities and research institutes.
Zika and Chikungunya. Texas has two species of mosquitoes – Aedes aegypti and Aedes albopictus –capable of transmitting a number of serious virus infection including dengue fever, yellow fever, chikungunya and zika, and a third Culex mosquito – that transmits West Nile virus infection in our state. Chikungunya and zika could find their way to the Texas Gulf Coast next summer. Chikungunya is already in the Caribbean, causing debilitating arthritis there and in tropical regions of Central and South America. According to the Pan American Health Organization in a new December 2015 alert, zika virus in pregnant women is suspected of causing widespread congenital birth defects including a devastating epidemic of microcephaly, especially in Pernambuco in the northeast of Brazil. These viruses could travel to the Texas Gulf Coast, prompting the need for public health vigilance.
The year 2016 could be an active one for infectious diseases in Texas. Take some comfort in knowing that our State has some of the finest city, county and state health departments in the nation, as well as academic research institutes anywhere, and together we are ready to combat outbreaks of these and other diseases.