The Texas Department of State Health Services (DSHS) issued 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.

The Rio Grande Valley is considered to be at higher risk for Zika transmission because of a previous outbreak of dengue, a similar virus spread by the same type of mosquito.

Health officials urge all Texas residents to take the steps to protect themselves even with the cooler temperatures that have arrived in parts of the state.

“So as always the word to the wise if you’re outside, even as we are experiencing a bit of a cool off, wear repellant, wear long sleeves and long pants and do everything you can to protect yourself from bites,” Chris Van Deusen, a Texas DSHS official, said in an interview with the Texas Farm Bureau Radio Network.

He said the four symptoms of Zika are: fever, rash, joint pain and conjunctivitis or redness of the eyes.

The current health department requirements are to test those who have traveled to areas where Zika is being transmitted, such as Latin America or the Caribbean.

But Van Deusen says they also want those who haven’t traveled to be tested.

“We also want to test people who haven’t necessarily traveled, so anywhere in the state if you have three of those four symptoms…. We encourage you to go to a doctor and for that doctor to do a test for Zika, so that we’ll know what we are dealing with,” Van Deusen said.

Pregnant women should take extra measures to protect themselves because of the risk of birth defects associated with Zika. DSHS recommends testing pregnant women who live in the area who have at least two of the Zika symptoms, regardless of their travel history or other risk factors.

“In the Rio Grande Valley, it’s a little bit different for pregnant women, because of the association Zika has with birth defects,” Van Deusen said. “We are also recommending that they be tested if they have any two of those four symptoms.”

There have been no reported cases of Zika transmitted in Texas.

“We are on guard for the possible local transmission of Zika by mosquitos in Texas,” Van Deusen said. “We haven’t seen that yet, but if it doesn’t happen this year, of course there’s a chance it will happen next year. So it’s not something that is going to go away.”

Texas has had 218 reported Zika cases, all related to travel, including two cases transmitted via sexual contact with someone infected overseas and two infants who were infected before birth.