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- In 1991 an unusually large cluster of
anencephalic births occurred in Brownsville, Texas (Cameron County) - In one hospital six affected deliveries occurred in six weeks - A Texas Department of Health-CDC joint investigation of this cluster revealed that NTDs were endemic among the entire Texas-Mexico border population - This recognition of an NTD problem along the border prompted long-term active surveillance of NTDs, a case-control study, and a primary prevention program |