New challenges surface for public health in state
Even before Harvey, the state of Texas, especially in areas along the Gulf Coast, had a unique vulnerability to infectious and tropical diseases. Extreme poverty, warm climates and climate change, urbanization, and large movements of human populations are the new drivers of 21st century diseases. Texas has all those things and more. We rank among the largest number of people living in poverty compared to any other state, and from Al Gore we learned that Texas and the Gulf Coast is a hotspot for North American climate change. Our cities are the fastest-growing in the United States, and it seems everyone is moving here — “Big, Hot, Cheap, and Right,” according to Erica Grieder from Texas Monthly.
The forces now promoting disease in Texas and on the Gulf Coast were a major reason we set up a tropical medicine school with Baylor College of Medicine and Texas Children’s Hospital. Over the last six years we’ve been busy. West Nile Virus hit us in 2012, Ebola in 2014 and then Zika in 2016. Texas also leads nationally in other mosquito-transmitted viruses, in addition to Chagas disease and typhus transmission. Now with Harvey we’re waiting for the mosquitoes to return to flooded areas, and potentially a rise in West Nile and other viruses. Due to contaminated flood waters we’ll watch for potential outbreaks of diarrheal diseases and infections due to the bacteria Vibrio vulnificus that makes its home in Gulf Coast waters. Regardless of whether or not you have been exposed to flood waters, make sure you are up to date on your tetanus vaccinations.
And speaking of vaccines, we’re also facing a powerful antivaccine lobby in Texas now promoting a pseudoscience faux documentary “Vaxxed: From Cover-up to Catastrophe” across the state and nationally. They allege vaccines cause autism — they don’t — and that scientists from the CDC are engaged in a conspiracy to damage children with vaccines — they’re not — and call for parents to be able to choose whether or not they vaccinate their kids. Do they also feel that seat belts and car seats are optional for children? Vaccination rates in some Travis county schools have lowered to the point where measles or other outbreaks are likely. I’m especially concerned about the unvaccinated infant siblings who are not old enough to receive their measles vaccine. Measles remains one of the great killers globally that still kills 100,000 children annually. I’m worried the influence of antivaccine groups has begun extending into Harris and surrounding counties.
And we’ll look out for influenza this fall and winter. It turns out that in Australia they’re experiencing worse than normal Southern Hemisphere seasonal epidemics. This could mean a bad flu season in the U.S.
We can mitigate these infectious and tropical disease threats. The good news is that in Texas we have an outstanding state health department and some of the finest county and city health agencies, especially in Harris County and Houston. We have the Texas Medical Center. But we can do better, giving them the tools and resources they require to expand their disease detection and surveillance activities. They need local and federal funds to fight the diseases that will surely come.
We also need to stop the self-inflicted wounds and rein in the antivaccine lobby by halting the practice of non-medical exemptions in our state. I’m an optimist and believe that Houston remains the great American city, and Texas the great American state, where old-fashioned American dreams are achieved every day. Just as we’ll need to invest in our physical infrastructure in the coming months and years, we’ll need parallel support to promote health.