by Lisa Falkenberg

Originally published in the Houston Chronicle – May 21, 2016

Dr. David Persse was watching his 5-year-old grandson playing in the backyard recently when he noticed the child wasn’t wearing mosquito repellent.

When he asked his son-in-law about it, he said the young man, whom he described as “very intelligent,” seemed to shrug it off, telling Persse: “He’s not going to get pregnant.”

The response didn’t go over too well with Persse, who happens to be Houston’s public health authority and the city’s unofficial Zika czar. The doctor explained that if the boy got bitten, he could become a reservoir for the virus that could infect another mosquito that could infect a pregnant woman.

Besides that, he said, we don’t fully understand the Zika virus. If it can affect a developing fetal brain, perhaps it can do the same to a developing 5-year-old brain.

He could see in his son-in-law’s eyes that he hadn’t thought of that.

The exchange demonstrates how far public health officials have to go in educating the public about Zika, a virus that can cause microcephaly, a birth defect in which babies are born with small heads and underdeveloped brains.

On Friday, federal health officials announced that doctors are monitoring 279 pregnant women with confirmed or suspected Zika infections in the United States and the territories.

As of Friday, there were 36 confirmed cases of the Zika virus in Texas, none transmitted by mosquitoes here, according to the Texas Department of State Health Services. Of those, 13 were reported in Harris County, and two in Fort Bend County.

With the Aedes Aegypti mosquito weeks away from breeding in the humid, post-flood Houston area, Persse and others are pleading with the public and officials who hold purse strings to take the threat seriously.

He worries that in Washington, there’s bickering about a bill to fund research on Zika and related birth defects, and response teams to limit the spread and fight Zika in other countries. President Barack Obama asked for $1.9 billion in funding; the Senate approved $1.1 billion last week while the House allocated $622 million. The White House has called the House version “woefully inadequate.”

It’s also three months late. The World Health Organization declared Zika a global health emergency in February.

“This is different from an earthquake,” Persse said. “We can see this coming.”


‘Frustration’ grows

He said he believes Houston Mayor Sylvester Turner and Harris County Judge Ed Emmett understand the threat but lack money for the best response. The money is at the federal level.

“You sense the frustration in my voice,” Persse said. “Once we have a child born in the U.S. with microcephaly, everybody’s going to be pointing fingers and saying, ‘Who didn’t do something six months ago?’ ”

Persse said the city has set up an incident command center, such as the ones for natural disasters, and has been knocking on doors to inform residents about the virus.

He said the city also has ramped up efforts to collect heavy trash on Saturdays, resulting in an extra 2,500 tons picked up over the last two months. He said about 1,400 tires, a favorite mosquito breeding ground, have been collected.

The city has worked with Metro and the county to put up signs about the “3-D Zika defense: drain, dress, Deet.” In other words: drain water from places where it can pool, dress in clothing that protects skin from bites and use effective bug spray.

One big challenge, Persse said, is the “self-centered thinking” today. As a boy, he said, his parents and others were concerned about protecting the entire community from polio. Today, he said, we have a more narrow focus on our own families.

“We’ve got to be worried about all the kids in the community, all the pregnant women.”


Sluggish response

Beyond that, it’s hard to change behaviors. Some of us aren’t used to cleaning out our rain gutters, for instance, or emptying our bird baths every week, or wearing insect repellent.

“This is Houston. We’re all used to getting mosquito bites,” he said. “We’ve got to have a different attitude about it now.”

Last week, Legacy Community Health Services began distributing packets of bug spray, condoms and virus information to patients at its federally qualified health center in the Gulfton area.

“Most of our patients, spending $5 for a can of mosquito spray means they don’t eat,” said executive director Katy Caldwell.

A pregnant woman who contracted Zika in El Salvador is one of the clinic’s patients; so far, her baby shows no signs of abnormality, said Dr. Juan Franco.

Franco said every patient is screened for Zika and informed about it during visits. He said many aren’t aware the virus can be sexually transmitted.

Caldwell said she’d like to see a more extensive response locally, on par with cities such as Washington D.C. and New York, which are conducting large-scale community outreach and handing out prevention packets.

The sluggish response in Texas reminds her of the HIV epidemic, another virus that wasn’t well understood or taken seriously until too late.

We can’t afford the same complacency, from our public officials, or from ourselves.

Obama suggested on Friday that Americans tell their congressional representatives to “get on the job.”

It’s good advice for all of us.