Even before the state's first locally transmitted case of the Zika virus in Cameron County was confirmed Monday, border counties have been preparing for the worst-case scenario: an increase in babies born with birth defects related to the mosquito-borne illness.
The Texas Department of State Health Services issued in October a health alert encouraging health care providers in Cameron, Hidalgo, Starr, Webb, Willacy and Zapata counties to consider Zika virus infection in their patients and order testing as medically indicated.
In Hidalgo County, home to the largest number of "colonias," residential areas along the Texas-Mexico border that may lack some of the most basic living necessities, public health officials said they've been in close contact with the DSHS and the Centers for Disease Control and Prevention to ensure local providers have the latest information on the spread of the virus.
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Forty-five percent of Hidalgo County residents have little or no insurance, according to Eddie Olivarez, chief administrative officer of Health and Human Services in Hidalgo County.
"The worst-case scenario is you're going to have a family that totally distraught about their child being born with a major neurological birth defect. When is anybody really prepared for that? You're not," said Olivarez.
He said they've strengthened communication with federally qualified clinics, community agencies and hospital networks.
"We've actually sent old-school mail, where we've actually mailed the letters to all the obstetricians and family doctors that work with them [pregnant females], because we have more than 800 physicians in our county, so our focus has been with those who work with that population," said Olivarez.
He hopes ongoing education about Zika will prevent a potential health crisis, which is why community advocate and colonia resident Lourdes Salinas has spent months spreading awareness about the dangers of the virus in her neighborhood.
"We passed the fliers. We tell them, 'You know what? Protect yourself, get inside the house early, put repellent. Do whatever you need to do because you're not going to have the assistance that you need if a baby comes with birth defects," said Salinas.
South Texas is considered the front line of the virus because local transmission has been reported in neighboring cities across the border in Mexico.
The Rio Grande Valley is dealing with a surge of illegal border crossings.
Plus, many residents go back and forth from Texas to Mexico weekly, even daily.
DSHS said the Rio Grande Valley is considered to be at higher risk for Zika transmission because of previous outbreaks of dengue, a similar virus spread by the same type of mosquito.
A spokesperson for South Texas Health System, the largest health system in Hidalgo County, said Zika education is now a part of childbirth classes.
"Every pregnant woman has an Infectious Disease Screen performed and questions are asked about travel and any signs or symptoms of infection (acute onset of fever, maculopapular rash, arthralgia or conjunctivitis)," said spokesperson Cari Lambrecht in an email to NBC 5.
"Our neonatology team specializes in care of newborn infants, especially those with acute needs, such as premature or underweight infants, those with congenital birth defects and infants with serious illnesses. Any baby born with microcephaly due to Zika virus, would be provided standard NICU care and would have imaging series performed and would involve a consult with a Pediatric Infectious Disease Specialist," said Lambrecht.
As of Nov. 29, 2016, two cases of travel-related Zika have been reported in Hidalgo County.