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Acute Flaccid Myelitis (AFM) – Oct. 18, 2018

Acute flaccid myelitis (AFM) is a very rare condition that affects a person’s spinal cord marked by the sudden onset of weakness in the arms or legs. Less than one in a million people in the United States will get AFM each year. There is no specific treatment for AFM, and the cause is unknown. The Centers for Disease Control and Prevention is conducting an investigation to determine what causes the condition. Possible causes include viruses, environmental toxins and genetic disorders. AFM is not required to be reported, but DSHS is asking all healthcare providers to report suspected cases of AFM to their local health departments.

AFM can be difficult to diagnose because it shares symptoms with several other neurologic conditions. All suspected cases of AFM are reviewed by the CDC to determine if they meet the case definition. It can take about a month for the status of a case to be determined.

CDC data shows a pattern of increased AFM cases in late summer to early fall of every other year beginning in August 2014. Texas providers have reported 37 cases of AFM since 2014. Most of the cases occur in children.

AFM Case Counts by County, Texas 2018

Acute Flaccid Myelitis Case Counts by County, Texas 2018*
County Case Count
Collin 2
Dallas 1
Galveston 1
Harris 1
Hill 1
Parker 1
Tarrant 2
Travis 1
Figure 1: Acute Flaccid Myelitis Case Counts by County, Texas 2018*

AFM Case Counts by Year, Texas 2014 - 2018

Figure 2: Acute Flaccid Myelitis Case Counts by Year, Texas 2014 - 2018*
Year 2014 2015 2016 2017 2018
Case Counts 3 0 19 5 10
*data provisional as of 10/16/2018

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West Nile – Oct. 23, 2018

It may be fall, but mosquitoes are still biting and West Nile illness remains a concern in Texas with new cases reported every week. The state has confirmed 98 human cases of West Nile in 2018, including two deaths. Texas typically sees cases into November and December. We’ll update case counts weekly here each Tuesday.

In 2017, Texas reported 135 cases of West Nile illness that resulted in six deaths.

People can be infected by West Nile virus through the bite of an infected mosquito. People should prevent bites by applying insect repellent while outdoors, using air conditioning or making sure screens are in good repair, and covering up with long sleeves and long pants to prevent bites. It’s also important to dump out standing water to keep mosquitoes from laying eggs.

DSHS News Release

Additional surveillance information

Reported 2018 West Nile Cases by County

West Nile Case Counts by County in Texas, 2018
County West Nile
West Nile Neuroinvasive Disease Total
Angelina 1 1
Bailey   1 1
Brazos 1 1 2
Briscoe 1 1
Carson 1 1
Castro   1 1
Collin 2 1 3
Dallas 2 11 13
Denton 1 1
El Paso 3 3 6
Fort Bend 2 2
Galveston 1 1
Gregg 1 1
Guadalupe 1 1
Harris 4 18 22
Hidalgo 1 1 2
Hunt 1 1
Lubbock 1 3 4
Montgomery 3 7 10
Orange 1 1
Randall 1 1
Roberts   1 1
Smith 1 2 3
Tarrant 5 6 11
Travis 1 2 3
Walker 1 1
Webb 1 1
Wharton 1 1
Total 28 70 98
Figure 3: West Nile Case Counts by County in Texas, 2018

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Cyclospora – Oct. 9, 2018

This is the final update on the May-August 2018 cluster of illnesses caused by the Cyclospora parasite. There were 339 cases reported among Texas residents, and DSHS and local public health departments investigated three sub-clusters in the state, but no specific source of illness was identified. CDC has information on multiple outbreaks in the United States at No reported Texas cases were linked to outbreaks in other states.

Cyclosporiasis is an intestinal illness caused by consuming food or water contaminated with the microscopic Cyclospora parasite. The main symptom is watery diarrhea lasting a few days to a few months. Additional symptoms may include loss of appetite, fatigue, weight loss, abdominal cramps, bloating, increased gas, nausea, vomiting and a low fever. Symptoms may come and go multiple times over a period of weeks or months. People with symptoms that could be related to Cyclospora should contact their health care provider for treatment.

*data is provisional and subject to change

Reported 2018 Cases by County

Reported Cyclosporiasis Case Counts* by County in Texas, 2018
County Count
Archer 1
Bastrop 2
Bell 4
Bexar 49
Brazoria 2
Brazos 3
Caldwell 3
Cameron 8
Clay 1
Collin 15
Cooke 1
Dallas 34
Deaf Smith 2
Denton 3
El Paso 5
Ellis 3
Fort Bend 7
Galveston 4
Gillespie 2
Grayson 4
Grimes 1
Guadalupe 3
Harris 26
Hays 3
Hidalgo 19
Hockley 1
Houston 2
Hunt 4
Irion 1
Jackson 4
Jefferson 1
Kaufman 1
Kendall 1
Kerr 2
Llano 1
Lubbock 3
Maverick 1
McLennan 4
Medina 1
Montgomery 9
Orange 1
Parker 2
Smith 3
Somervell 1
Starr 4
Tarrant 10
Travis 52
Val Verde 1
Van Zandt 1
Victoria 3
Waller 1
Washington 1
Webb 1
Wichita 2
Wilbarger 1
Williamson 12
Unknown or pending 2
TOTAL 339 
Figure 4: Reported Cyclosporiasis Case Counts* by County in Texas, 2018

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Zika Virus – Oct. 23, 2018

DSHS provides updates every Tuesday on the number of Zika virus disease cases in Texas by the patient’s county of residence. DSHS has confirmed three Zika cases for all of 2018, all acquired outside the United States. Full data for previous years is available at

2018 Zika cases by county

Collin - 1 
Williamson - 2

All 2018 cases are associated with travel.

Zika is a mosquito-borne virus that can cause fever, rash, muscle and joint aches and red eyes (conjunctivitis). Symptoms are usually mild, and most people exposed to Zika virus won’t develop any symptoms at all. Zika has also been linked to a birth defect called microcephaly and other poor pregnancy outcomes in babies of mothers who were infected with the virus while pregnant.

Because the virus spreads from place to place through human travel, DSHS encourages people to follow travel precautions for countries and regions where Zika virus transmission is ongoing. That generally includes Latin America, the Caribbean and some Pacific islands. DSHS recommends travelers avoid mosquito bites while abroad and for 21 days after returning, in case they have been exposed to the virus.

People everywhere can protect themselves from mosquito bites and the threat of Zika by taking a few simple steps:

  • Apply EPA-registered insect repellents.
  • Wear pants and long-sleeved shirts that cover exposed skin.
  • Use screens or close windows and doors to keep mosquitoes out of your home. 
  • Remove standing water in and around your home.
  • Cover trash cans or containers where water can collect.

Additional information at

Texas Zika Campaign Materials

DSHS Zika News Releases

Zika Virus at CDC

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Last updated October 23, 2018