Malaysia: First Zika patient getting better

LOH FOON FONG, WANI MUTHIAH, JOSEPH KAOS, THO XIN YI, SHAZNI ONG, CHRISTOPHER TAN, NEVILLE SPYKERMAN, DINA MURAD, VICTORIA BROWN, MOHD FARHAAN SHAH, NORBAITI PHAHARORADZI, NABILA AHMAD, REBECCA RAJAENDRAM, andEDWARD RAJENDRA
The Star 2 Sep 16;

PETALING JAYA: The first Zika patient in the country is recuperating well at the Sungai Buloh Hospital.

The hospital’s infectious disease head Datuk Dr Christopher Lee said the symptoms that the 58-year-old woman suffered from, including rashes, had also cleared up.

“We will be doing a blood test on her today and if it turns out to be negative, we can let her go home in a few days’ time,” he said yesterday.

He said her mild rashes cleared up in two or three days and the last blood test was negative but the hospital decided to keep her for a little longer just to ensure there would be no transmission to other people.

The blood test today was to reconfirm that she was free of Zika, he said.

The woman and her husband had visited their daughter in Singapore on Aug 19 and returned on Aug 21.

A week later, the woman developed rashes and fever, and sought medical attention at a private clinic in Klang.

She was referred to the Sungai Buloh Hospital, and on Aug 31, her urine sample tested positive for the Zika virus.

Her daughter, who works and lives in Paya Lebar, Singapore, has also been infected.

The woman’s husband and other family members who lived in the same house in Ambang Botanic have yet to show any symptoms of the infection.

Dr Lee said the most common symptoms of Zika were fever, body aches, rashes and red eyes which would normally clear up within a few days.

He said that if a woman was infected by Zika, the vaginal fluids might contain the virus for up to two months after she had recovered.

“So, if she has sex with a man within the two months, the man can be infected with Zika.

“The virus can also stay in a man’s semen for up to six months after he has recovered.”

Infected pregnant women face the risk of delivering a child with microcephaly, while others might suffer from Guillain-Barre syndrome, a neurological condition.

According to the American National Institute of Neurological Disorder’s fact sheet, Guillain-Barre syndrome is a disorder in which the body’s immune system attacks part of the peripheral nervous system.

These symptoms can increase in intensity until certain muscles cannot be used at all and, when severe, the person is almost totally paralysed.

Dr Lee recommended that pregnant women who have travelled to affected countries like Brazil and Singapore go for check-ups at nearby hospitals.


Klang woman is first Zika case
The Star 1 Sep 16;

PETALING JAYA: Malaysia recorded its first case of Zika infection after a 58-year-old woman in Bandar Botanic in Klang was suspected to have been infected on Wednesday.

She and her husband had visited their daughter in Singapore on Aug 19 and returned to Malaysia on Aug 21. He daughter was confirmed as being infected on Aug 30.


The Health Ministry said the woman started exhibiting symptom of rash on Aug 28 and sought medical attention at a private clinic in Klang on Aug 30.

“As the patient had travelling history to Singapore and her daughter was confirmed to have Zika virus infection on Aug 30, the private general practitioner had diagnosed her as "suspected case of Zika".

“On the same day, the patient was refered to Sungai Buloh Hospital and the result of the urine PCR (Polymerase Chain Reaction) test on Aug 31 found positive for Zika virus.

“However, the patient’s blood test result is still pending,” the ministry said in a statement.

It said the source of infection “is suspected to occur in Singapore since the patient had started experiencing signs of Zika infection on the same day with her daughter in Singapore.” Her husband showed no signs of being infected.

Below is the press statement from the Health Ministry:

THE FIRST ZIKA VIRUS CASE IN MALAYSIA 1ST SEPTEMBER 2016

On 29th of August 2016, the Ministry of Health Malaysia (MOH) has made an announcement advising those who have been to any country with reported cases of Zika and experiencing the symptoms of this infection are expected to come forward for a medical attention. Following this, the MOH have received report of a patient suspected with Zika virus infection on the 31st August, 2016. This patient is a 58 years-old woman residing in Bandar Botanic, Klang, Selangor and is the mother of a female confirmed with Zika infection in Singapore. The patient, together with her husband had visited their daughter in Singapore on 19th August 2016 and returned to Malaysia on 21st August 2016.

The patient started exhibiting symptom of rash on 28th August, and she sought medical attention at a private clinic in Klang on the 30th August 2016. As the patient had traveling history to Singapore and her daughter was confirmed to have Zika virus infection on 30th August 2016, the Private General Practitioner had diagnosed her as “suspected case of Zika”. On the same day, the patient was refered to Sungai Buloh Hospital and the result of the urine PCR (Polymerase Chain Reaction) test on 31st August 2016 was found positive for Zika virus. However, the patient’s blood test result is still pending.

The source of infection is suspected to occur in Singapore since the patient had started experiencing signs of Zika infection on the same day with her daughter in Singapore. The patient’s husband and family members who lived in the same house with her, has yet to show any symptoms of Zika infection. For the period from 21st - 28th August 2016 when the patient was returning from Singapore, she had visited several areas in the district of Klang and Kuala Lumpur.

Based on the findings from the investigation, the MOH has already started vector control activities in the residential area of the case and other places that the patient had visited. Control activities carried out include eliminating Aedes breeding sites, larvaciding and fogging. In addition, close contacts to the patient will be examined whether they have any fever or other Zika symptoms.

Information obtained from the Ministry of Health Singapore, revealed that there are 5 Malaysians residing and working in Singapore that has also been confirmed to be infected with Zika virus. For the period from 27th to 31st August 2016, there has been 115 confirmed Zika cases reported in Singapore. Due to the rapid spread of Zika virus infection, Aedes monitoring and preventive activities are continuously performed and intensified in all states, especially in the state of Johor and Selangor.

Malaysians, must focus on cleaning the Aedes breeding places, protect themselves from Aedes mosquito bites and seek early medical attention if they have signs such as fever, rash and conjunctivitis. From the first reported case of Zika, we can conclude that it is rather easy to get infected by the virus when visiting places that has outbreak, including Singapore. The MOH once again call upon any individuals whom had visited countries that reported Zika infection, to come forward to seek immediate medical attention if they are experiencing any symptom as mentioned above. Proactive action from the community can help stop the spread of Zika virus in Malaysia. No Aedes: No Zika, Dengue and Chikungunya.

YB DATUK SERI DR. S.SUBRAMANIAM

MINISTER OF HEALTH MALAYSIA

1st September 2016


Malaysia confirms first Zika case in woman who visited Singapore
Today Online 1 Sep 16;

SINGAPORE — Malaysia confirmed on Thursday (Sept 1) its first case of Zika in a woman who recently travelled to Singapore for three days to visit her daughter.

Malaysia's health minister said the woman tested positive for Zika on Wednesday after she experienced a rash and fever for a week after her return from Singapore.

Health Minister Subramaniam Sathasivam said her daughter, who is in Singapore, had tested positive for Zika on Tuesday.

The woman, 58, from Bandar Botanic in Klang, Selangor, is suspected to have been infected while she and her husband visited their daughter in Singapore from Aug 19 to Aug 21.

She started exhibiting symptoms of rash on Sunday, and she sought medical attention at a private clinic in Klang two days later, said a press release from the Malaysia Ministry of Health.

The health ministry said that the woman's husband and relatives who live with her has yet to show any symptoms of the Zika infection. Before she returned home after her visit to Singapore, she had visited several areas in the district of Klang and Kuala Lumpur.

The ministry said it has already started vector control activities in the residential area of the case and other places that the woman had visited. Such activities include thermal fogging, which aims to prevent mosquito breeding.

Singapore has 115 confirmed cases of the mosquito-borne disease, five of whom are Malaysians residing and working here.

Among other foreign nationals in Singapore who have been infected with Zika are 21 Chinese nationals and 13 Indian nationals.

The High Commission of Bangladesh in Singapore said on Thursday that six Bangladeshi nationals are among those with Zika. WITH AGENCIES

It will spread but we must put a stop to it, says minister
The Star 2 Sep 16;

PUTRAJAYA: With the first Zika case confirmed, the number of infections is expected to increase and both the authorities and the public will have to work together to prevent its spread.

Health Minister Datuk Seri Dr S. Subramaniam said they had intensified “anti-Aedes activities”, including in Bandar Botanic in Klang, where the first victim – a 58-year-old woman – stayed.

“Dealing with the Zika virus is done the same way we deal with dengue, which is by controlling the spread of Aedes mosquitoes.

“But to do so, we need the support of all Malaysians. The ministry and local authorities cannot do it alone. The Aedes mosquito breeds in houses, so everyone needs to play a role in preventing the spread of the virus.

“If the vector control people come to your residential area to conduct fogging, allow them to enter your house. Very often, we come across cases where people will not allow this,” said Dr Subramaniam at a press conference here.

Besides focusing on cleaning Aedes breeding places, the minister said Malaysians must protect themselves from Aedes mosquito bites through the use of repellents or by wearing long-sleeved clothing, particularly at dawn and dusk.

His predecessor at the ministry, Datuk Seri Liow Tiong Lai, said Malaysia was more than capable of handling the Zika infection.

Having served as minister during the H1N1 outbreak in 2009, Liow said they had successfully contained the spread of that.

“We have a very good surveillance system and can detect those infected at an early stage,” he said during a meet-and-greet session hosted by the International Malaysian Society of Maritime Law.

As Transport Minister, Liow said his ministry would support the Health Ministry in stepping up screening at all entry points into country, especially at international airports and the Causeway.

A new virus can spread like wildfire, he said, and must be nipped in the bud.


Doc: Clean up your act
The Star 2 Sep 16;

PETALING JAYA: Stop throwing rubbish, clean your homes and surrounding areas, and protect yourself from mosquito bites. That’s the only way Malaysians can prevent a high number of Zika cases and microcephaly, said a paediatrician.

Raja Permaisuri Bainun Hospital’s department head and senior consultant paediatrician Datuk Dr Amar Singh said he had not come across any microcephaly cases related to Zika in newborn babies but with new Zika cases entering the country, it was possible for cases to emerge in about a year’s time.

“We have a window period now. If we do something now, the spread will be less and we can lower the number of babies affected,” he said.

Microcephaly is an abnormal smallness of the head in babies, a congenital condition associated with incomplete brain development.

Dr Amar said Malaysians must change their dirty habits.

“It’s time the authorities come down hard on people who throw rubbish indiscriminately,” he said, referring to rubbish ending up containing rainwater and becoming mosquito breeding grounds.

He said South Korea and Taiwan had cleaned up their countries and Malaysia should do likewise.

People should also reduce the risk of getting bitten by mosquitoes by protecting themselves and their homes by using mosquito repellents and nets, he said.

Pregnant women and men involved in sexual relationships, too, must take precautions as Zika can be transmitted from mother to foetus and through sex, he said.

Universiti Malaya virologist Prof Dr Sazaly Abu Bakar said Zika was difficult to monitor and those working and travelling to Singapore daily and those returning from countries with Zika cases need to be very responsible and protect themselves from being bitten by mosquitoes.

“Do all you can to avoid being bitten by mosquitoes by using repellent, and wear light-coloured clothing especially in the morning or evening so you don’t spread to others, especially if your wife is pregnant,” he said.

Dr Sazaly said while people worried about Zika, they should also be concerned about dengue as it kills.

“It’s the rainy season now and there are lots of mosquito breeding grounds,” he said.

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