Malaysia confirms first case of Zika, launches measures to contain spread of virus

KUALA LUMPUR, Sept 1 (Reuters) - Malaysia confirmed on Thursday its first case of Zika after a woman tested positive for the virus following a three-day visit to neighbouring Singapore on August 19.

The 58-year-old woman had showed signs of a rash and fever one week after returning from Singapore, according to Health Minister Subramaniam Sathasivam.

"We are carrying out control measures against aedes mosquitoes near the woman's home to prevent the spread of the virus," he said at a news conference on Thursday, adding that the virus was discovered in the woman's urine sample.

Subramaniam initially said the woman's "child" had also tested positive for Zika in Singapore. He later clarified that the child was in fact an adult daughter who is working in Singapore and has not returned to Malaysia.

Subramaniam said they have already intensified vector control activities in Taman Botani in Klang, where the infected woman's home is located, and urged residents to allow officers despatched to the area to enter their homes and carry out fogging and larvicidal spraying.

Singapore announced the first locally contracted case of Zika late on Saturday, and the number of diagnosed infections has grown steadily this week.

A pregnant woman was among those diagnosed with Zika infections in Singapore, as the number of confirmed cases of the mosquito-borne virus in the city-state rose to 115.

Subramaniam said on Thursday that a total of five Malaysians have so far been identified as having tested positive for Zika in Singapore.

U.S. health officials have concluded that Zika infections in pregnant women can cause microcephaly, a birth defect marked by small head size that can lead to severe developmental problems in babies.

The World Health Organization has said there is strong scientific consensus that Zika can also cause Guillain-Barre, a rare neurological syndrome that causes temporary paralysis in adults.

The connection between Zika and microcephaly first came to light last fall in Brazil, which has now confirmed more than 1,600 cases of microcephaly that it considers to be related to Zika infections in the mothers.</s>The 58-year-old woman had showed signs of a rash and fever one week after returning from Singapore, according to Health Minister Subramaniam Sathasivam.

"We are carrying out control measures against aedes mosquitoes near the woman's home to prevent the spread of the virus," he said at a news conference on Thursday, adding that the virus was discovered in the woman's urine sample.

Subramaniam initially said the woman's "child" had also tested positive for Zika in Singapore. He later clarified that the child was in fact an adult daughter who is working in Singapore and has not returned to Malaysia.

Subramaniam said they have already intensified vector control activities in Taman Botani in Klang, where the infected woman's home is located, and urged residents to allow officers despatched to the area to enter their homes and carry out fogging and larvicidal spraying.

Singapore announced the first locally contracted case of Zika late on Saturday, and the number of diagnosed infections has grown steadily this week.

A pregnant woman was among those diagnosed with Zika infections in Singapore, as the number of confirmed cases of the mosquito-borne virus in the city-state rose to 115.

Subramaniam said on Thursday that a total of five Malaysians have so far been identified as having tested positive for Zika in Singapore.

U.S. health officials have concluded that Zika infections in pregnant women can cause microcephaly, a birth defect marked by small head size that can lead to severe developmental problems in babies.

The World Health Organization has said there is strong scientific consensus that Zika can also cause Guillain-Barre, a rare neurological syndrome that causes temporary paralysis in adults.

The connection between Zika and microcephaly first came to light last fall in Brazil, which has now confirmed more than 1,600 cases of microcephaly that it considers to be related to Zika infections in the mothers.</s>KUALA LUMPUR/SINGAPORE, Sept 1 (Reuters) - Malaysia reported its first case of Zika on Thursday, a woman who tested positive for the mosquito-borne virus after a visit to neighbouring Singapore, where 115 people have so far been infected, many of them foreigners.

The 58-year-old victim had shown signs of a rash and fever one week after her return from Singapore on August 21, said Malaysian Health Minister Subramaniam Sathasivam.

"We are carrying out control measures against aedes mosquitoes near the woman's home to prevent the spread of the virus," he told a news conference.

The Zika virus, which has spread through the Americas and the Caribbean since late last year, is generally a mild disease but is a particular risk to pregnant women. It has been linked to microcephaly - a severe birth defect in which babies are born with abnormally small heads and underdeveloped brains.

The U.S. Centers for Disease Control and Prevention had said Singapore is the only Asian nation with an active Zika virus transmission. Officials in the city-state, one of the world's largest financial centres and busiest travel hubs, reported the first locally transmitted infection on Saturday and said on Wednesday the number had jumped to 115.

Singapore authorities detected infections in people living outside the initial outbreak area and have identified a potential second cluster. A pregnant woman was among the victims, they said.

"Over time, we expect Zika cases to emerge from more areas," Singapore's Minister for Health Gan Kim Yong said in a statement on Wednesday. "We must work and plan on the basis that there is Zika transmission in other parts of Singapore and extend our vector control efforts beyond the current affected areas."

Five Malaysians in Singapore had tested positive for Zika, including the latest victim's adult daughter, who works in Singapore, the Malaysian minister said.

Twenty-one Chinese nationals, 13 Indians, six Bangladeshis, and an Indonesian are also among the 115 cases of Zika reported in Singapore, foreign officials said.

Many are believed to be overseas workers at building sites in Singapore, although the Singapore government has not given details of the victims by nationality.

The United States, Australia, Taiwan, South Korea and Indonesia have warned pregnant women not to travel to Singapore.

The outbreak and advisories come as the tourism industry in Singapore already faces weak global economic growth. Singapore's Tourism Board said it was premature to consider any impact on the sector, adding it remained a "safe travel destination".

More than 55 million people pass through Singapore's Changi airport every year. In the first half of this year, tourism arrivals topped 8 million, around 1 million more than a year earlier.

Malaysia has asked people visiting Singapore to use repellent and cover up to avoid mosquito bites. Tens of thousands of people travel between the two nations each day, by boat, air and across two land border crossings.

Both Malaysia and neighbouring Indonesia have stepped up protective measures following the Singapore outbreak, intensifying checks on people arriving from Singapore, introducing thermal scanners and posting paramedics at airports and border checkpoints.

Zika is carried by mosquitoes, which transmit the virus to humans, but a small number of cases of sexual transmission have been reported in the United States and elsewhere. A case of suspected transmission through a blood transfusion in Brazil has raised questions about other ways Zika may spread.

There is no vaccine or treatment for Zika, which is a close cousin of dengue and chikungunya and causes mild fever, rash and red eyes. An estimated 80 percent of people infected have no symptoms, however.</s>India confirms 13 of its nationals test positive for Zika in Singapore

NEW DELHI, Sept 1 (Reuters) - India's foreign ministry confirmed on Thursday that 13 of its nationals had tested positive for the Zika virus in Singapore, after an outbreak of the mosquito-borne disease that at first affected three dozen workers on a construction site.

"According to our mission in Singapore 13 Indian nationals have tested positive for Zika in Singapore," Vikas Swarup, spokesman for the Ministry of External Affairs, said in response to a Reuters inquiry.

U.S. health officials have concluded that Zika infections in pregnant women can cause microcephaly, a birth defect marked by small head size that can lead to severe developmental problems in babies. (Reporting by Douglas Busvine; Editing by Michael Perry)</s>Risk that Zika will spread further in U.S, elsewhere - WHO

GENEVA, Sept 2 (Reuters) - Singapore has handled its Zika outbreak in a textbook fashion so far, while the United States could see the disease spread beyond Florida despite mosquito-control measures, officials at the World Health Organization said on Friday.

Speaking after a meeting of the WHO's emergency committee on Zika, its chairman David Heymann said the disease continued to constitute an international health emergency although the risk to people attending the Paralympics in Rio de Janeiro this month was low.

"This extraordinary event is rapidly becoming, unfortunately, an ordinary event. And Zika is beginning to spread, continuing to cause outbreaks in many countries around the world," Heymann told a news conference.

Singapore, with a "very technologically advanced health system", was able to identify the disease "very early", Heymann said. "But in other countries where it might enter at some time, that might not be the case."

Peter Salama, head of disease emergencies and outbreaks at the WHO, said the virus was likely to keep spreading.

Florida officials on Thursday said they have trapped the first mosquitoes that tested positive for the Zika virus in the Miami area, further confirming reports of local U.S. transmission of the illness. There have been 49 cases of Zika in people believed to have contracted the virus in a small area of Miami

Salama, asked about Florida and the risk of spread elsewhere in the United States, said: "In terms of further spread, yes, a risk. As we said, the U.S. is no exception. Wherever there is a competent vector, in this case the Aedes aegypti (mosquito), there is a risk that the virus will spread."

Zika infections in pregnant women have been shown to cause microcephaly - a severe birth defect in which the head and brain are undersized - as well as other brain abnormalities. Brazil has confirmed more than 1,800 cases of microcephaly in the past year.

Although there is no vaccine and scientists don't yet know how to stop Zika, they foresaw a low risk of the virus spreading at the Olympic Games last month in Brazil, the country hardest hit by the virus, during the winter season there.

Nobody returning from the Games, neither travellers nor athletes, has reported Zika symptoms, although most cases of the disease are asymptomatic, Salama said.

"Certainly we feel fairly confident that the risk assessment that there would be no significant increased transmission due to the Olympics is very much on track," he said.

Singapore, now with 189 known cases, has had a textbook response with transparency and quick reporting, Salama said.

"The way the government of Singapore has handled the outbreak in Singapore really represents in many cases a role model...remembering that the first case was only confirmed really just a little over a week ago," he said.

Heymann said Singapore was expected to complete genetic sequencing of the virus by next week, which would show which strain was causing the outbreak there. (Reporting by Stephanie Nebehay, editing by Tom Miles and Mark Trevelyan)</s>JAKARTA, Indonesia (AP) — Indonesia is screening travelers from neighboring Singapore for the mosquito-borne Zika virus as the city-state reports a growing number of infections and its first case of a pregnant woman testing positive.

Indonesian Health Ministry spokesman Oscar Primadi said Thursday that health officials are recommending that the Foreign Ministry issue an advisory against nonessential travel to Singapore, particularly for pregnant women.

Singapore issued a statement on Wednesday evening saying it had identified 22 new Zika cases in one particular area of the city and its first case involving a pregnant woman.

Zika has mild effects for most people but doctors believe infection during pregnancy can result in babies with small heads, which is known as microcephaly, and other serious developmental disorders. Singapore had 155 cases as of Wednesday.

The U.S. Centers for Disease Control and Prevention is advising travelers to Singapore to take precautions such as protecting themselves against mosquito bites, and because the virus can also be sexually transmitted, to use condoms or not have sex.

Primadi said thermal imaging equipment to detect abnormal body temperatures was installed at eight Indonesian ports with routes serving Singapore, including the capital Jakarta's airport.

He said travelers will also be given a health questionnaire so they will recognize symptoms and know to immediately report to health authorities.

On Thursday, Malaysia's Health Ministry said a 58-year-old woman who traveled to Singapore had become that country's first Zika case.

Health Minister S. Subramaniam said the woman and her husband visited Singapore for three days from Aug. 19. The woman developed a rash a week after her return and later tested positive for Zika in her urine, he said. Her daughter in Singapore tested positive for Zika on Tuesday.

"We can conclude that it is rather easy to get infected by the virus when visiting places that has outbreak, including Singapore," he said. "Proactive action from the community can help stop the spread of Zika virus in Malaysia."

Subramaniam said the virus was believed to be imported from Singapore because the woman started experiencing symptoms on the same day as her daughter.

The ministry has started control activities such as eliminating mosquito breeding sites and fog spraying in her residential area and other places that the patient had visited.

Indonesia has not yet reported any local Zika infections but an Indonesian woman in Singapore is among those infected there.

Associated Press writer Eileen Ng in Kuala Lumpur, Malaysia contributed to this story.</s>Laurie Garrett is a Senior Fellow for Global Health at the Council on Foreign Relations, and a Pulitzer Prize-winning writer. The opinions expressed in this commentary are hers.

(CNN) Thirty-five years ago, alert physicians in the United States spotted a new disease, caused by a virus that had been in circulation, unnoticed, for decades in people, and millennia in monkeys.

The virus had hit pay dirt, racing through the gay sexual revolution where one man might have sex with 30 other men a year, giving the virus exponential rates of infection

Over time, the virus' transmission shifted, especially in Africa, from rare cases of monkey-to-human transmission to general heterosexual spread, with women today five times more likely to be newly infected compared to men, thanks to sexual cultures that favor male promiscuity.

That was HIV, the virus that causes AIDS, which currently infects more than 37 million people living all over the world.

A key lesson of AIDS is that a virus—in HIV's case, infecting African monkeys—might pass rarely, but repeatedly, to human beings for decades before arriving in a context of epidemic potential.

Adapting to new modes of transmission and targeting novel species, the microbe can exist for thousands of years before beginning to achieve previously unimaginable feats, with devastating impact.

Now the world is facing a virus that seems poised to make a similar leap: the Zika virus.

Like HIV, Zika originated in central Africa, very rarely infecting human beings, and circulating among rainforest primates. Unlike HIV, Zika had the ability to fly, carried by Aedes aegypti mosquitoes from one monkey or human, to another.

Since reaching Brazil in 2013, where it has spread explosively over the last 12 months, Zika has demonstrated capabilities not seen, or extremely rarely noted, with any other insect-carried microbes.

If Zika finds its way into an especially sexually active community, it could well become a threat not only in America's southern, mosquito-infested states, but anywhere in the world.

Like HIV, the Zika virus would likely find its way into populations that feel discriminated against by the general population, and take its toll disproportionately among teenage girls and young women.

Meanwhile, in all tiers of public health across America, scientists and officials are scrambling to rob other budgets in order to finance research and mosquito control measures. At local levels, this ironically means things like sexually-transmitted diseases (STDs) programs are losing money, so that counties can hire mosquito abatement experts.

Vital questions about Zika, especially as a sexually transmitted disease linked to birth defects, are going unanswered, thanks to the research funding gap.

Instead, 90% more Zika cases were registered among women, compared to the female rates for dengue.

Neighboring Colombia has also seen far more Zika in females, with young women accounting for two-thirds of the 65,726 cases diagnosed by mid-April 2016.

Critics charge that both the Brazilian and Colombian studies may simply reflect the greater fear women have about exposure to Zika during pregnancy, prompting more of them to seek medical care. The researchers disagree, insisting that the higher rates of diagnosed Zika are seen in young women, whether or not they are pregnant or are trying to conceive.

When microbes gain capacity to be sexually transmitted, they rarely disappear from the human population group in which they emerged.

Fewer still—less than half—were aware that Zika could be passed sexually. In the absence of such knowledge, sexually active Americans are unlikely to use condoms.

Around the world, intriguing puzzles abound. Jacqueline Silva de Oliveira lives in Santos, Brazil, where she contracted Zika during her pregnancy—either via a mosquito or sexually, it is not known—and gave birth to twins in February.

Today, Lucas is a healthy, happy infant, but his twin sister, Laura, suffers in agonizing pain thanks to Zika microcephaly -- which slaughters brain cells and results in complete remodeling of the brain in development.

The couple took a holiday in the Caribbean nation of Martinique, returned to France, and underwent more tests. The man's blood was free of Zika, but about a month after they were back in France, the woman became infected. Examination of her partner's semen revealed Zika. Neither of them ever had symptoms of illness, nor felt any reason to avoid sex or use condoms, as they were a married couple trying to have a baby.

Here at home, time is running out. Researchers desperately need funding to provide the tools required to forestall a sexually transmitted Zika epidemic in the United States.

In the absence of those tools, women will make difficult choices, deferring pregnancies for months, perhaps years, and seeking abortions.

The stalemate on Capitol Hill may actually increase the likelihood that more American babies will be born with terrible malformations and neurological deficits. And, equally horribly, that hundreds, perhaps thousands, of couples will seek abortions based on suspicion of Zika infection, possibly terminating some healthy pregnancies.</s>Of the 26 new cases, 24 were linked to existing clusters while two cases have no known links to any existing cluster, they said.

The sequencing analysis of the Zika virus found in two patients from an existing cluster in Aljunied Crescent/Sims Drive, showed that the virus was not imported from South America, the Ministry of Health (MOH) and NEA said.

"The analysis found that the virus belongs to the Asian lineage and likely evolved from the strain that was already circulating in Southeast Asia. The virus from these two patients was not imported from South America."

The MOH and NEA said a research team that conducted the analysis would release more details shortly.

The Malaysian health ministry said earlier on Saturday that it had detected the first case of a locally transmitted Zika infection in Malaysia, in a 61-year-old man in the state of Sabah.

The Zika virus was detected in Brazil last year and has since spread across the Americas. It poses a risk to pregnant women because it can cause severe birth defects.</s>Six Bangladesh nationals have been tested positive with the mosquito-borne Zika virus in Singapore, the High Commission of Bangladesh said on Thursday.

 ‘We have been informed yesterday by MOH (the ministry of health) that of those tested positive, as of 12 noon on 30 August, 6 are Bangladeshi nationals,’ Mahbub Uz Zaman, high commissioner of Bangladesh to Singapore told Reuters by email.

 ‘We have also been informed that the patients are presented with mild symptoms and have either recovered or recovering. We are in touch with the ministry of health in this regard.’</s>Nearly half of Americans polled say they are wary of traveling to places in the U.S. where people have been infected with the Zika virus by mosquitoes, such as parts of Florida.

A poll released on Americans' health care attitudes by the Kaiser Family Foundation found 48 percent would be uncomfortable traveling to Zika infection areas within the U.S., and up to 61 percent felt uneasy about traveling to Puerto Rico or non-U.S. Zika zones.

More than two-and-a-half billion people are at risk of developing the Zika virus, scientists have warned. It comes as the World Health Organisation declared the outbreak of Zika remains an international health emergency and noted the virus is continuing to infect new countries. Malaysia has also confirmed its first case of the virus after authorities in Singapore confirmed they have detected more than 150 people with the virus. New analysis of travel, climate and mosquito patterns in parts of Asia and Africa found people in these regions were particularly at risk.

Most Zika cases contacted directly through mosquito bites in Florida are in the Miami area, not the tourist mecca of Orlando which is home to the Walt Disney World, Universal and SeaWorld theme parks.

'There are no non-travel related cases in Orange County or central Florida,' Gov. Rick Scott said earlier this week at an appearance in the Orlando area.

But Miami is a major tourism draw, with more than 15.5 million people making overnight visits to the city and its nearby beaches last year.

And overall, Florida set a new record for tourism with more than 105 million people from out of state and other countries visiting the state in 2015.

As of Wednesday, the state Department of Health has reported 47 non-travel related Zika cases in Florida.

The arts district of Wynwood north of downtown Miami and a section of Miami Beach have been singled out as mosquito transmission areas.

The Kaiser poll also found that a third of those interviewed believe Congress should make it a top priority to pass legislation increasing money to combat the virus.

President Barack Obama proposed $1.9 billion in emergency funding for Zika in February, but Congress has been unable to agree on a final bill.

Poll respondents identifying as Democrats were more likely than Republicans or independents to view Zika funding as a top priority for Congress, according to the poll.

Scott, a Republican, has repeatedly called on Congress to send the president a Zika funding bill, calling the issue one of urgent international importance.

'We still need the federal government to show up,' Scott told reporters recently in Miami.

'It's not just a Florida issue.'

The poll of 1,211 adults conducted Aug. 18-24 has a margin of error of plus or minus 3 percentage points.

WHAT YOU NEED TO KNOW ABOUT ZIKA The Zika (ZEE'-ka) virus was first discovered in monkey in Uganda in 1947 - its name comes from the Zika forest where it was first discovered. It is typically transmitted through bites from the Aedes species of mosquitoes. They are aggressive feeders, commonly biting multiple people in quick succession, fueling the spread of the virus. They are most active during mid-morning and then again between late afternoon and nightfall. Scientists have found Zika can be transmitted sexually - from both men and women. Couples should abstain or wear condoms for eight weeks if either partner has traveled to a country with a Zika outbreak, regardless of whether they have symptoms. A mother can pass the virus to her unborn baby during pregnancy. There are two ways this can happen: through the placenta, and through the amniotic sac. Since the virus can live in the womb lining, there is a chance the baby can become infected during birth. The majority of people infected with Zika virus will not experience symptoms. Those that do, usually develop mild symptoms - fever, rash, joint pain, and red eyes - for no more than a week. There is no specific treatment for the virus and there is currently no vaccine. CAN THE SPREAD BE STOPPED? Individuals can protect themselves from mosquito bites by using insect repellents. They could also wear long sleeves and long pants - especially during daylight, when the mosquitoes tend to be most active, health officials say. Eliminating breeding spots and controlling mosquito populations can help prevent the spread of the virus.
A pregnant woman is discovered to be infected by the Zika virus after cases jump to over 100 in Singapore.