Zika is spreading in southeast Asia, but with minimal screening and reporting, the number of official cases remains unusually low. The region is beginning to confront the reality that the disease is making its presence known after an outbreak in Singapore, which is ramping up its screening efforts and reported 56 confirmed cases.
Thailand has recorded 100 cases, and other countries in the region have reported cases as well, but the numbers of far below what would be expected in an area where the mosquito-borne virus is endemic. Case in point: Indonesia. The country with a population nearing 250 million has tested just 1,000 people for Zika with one confirmed positive.
The spike in cases in Singapore is forcing its neighbors to take the threat seriously. Indonesia’s foreign minister said that the country will “strengthen alertness” to prevent the spread of Zika. The office is working with the health ministry and its embassy in Singapore to prepare. Malaysia’s health ministry took similar steps, announcing it would monitor its two main crossing points in the city of Johor, bordering Singapore.
“For visitors coming from countries that have the Zika virus, a Health Alert card will be given as a guide detailing what should be done if the person exhibits signs and symptoms of Zika,” said Malaysian Health Director General Noor Hisham Abdullah, in a statement Sunday. “We have also examined over 784 blood samples of those showing an active possibility of the infection and found that the results were all negative for the virus.”
The cases in Singapore are isolated in the Aljunied area toward the southeast. Most were foreign workers at a nearby construction site. The virus has spread domestically, but the fact that many are foreigners adds a layer of risk that it could travel to other countries.
Zika has existed in southeast Asia for decades. It is believed that people have built up immunity against the virus, but the World Health Organization is unable to confirm whether the current outbreak is the same as existing strains in the region, or a new form.
One of the main challenges with Zika is the fact that it does not always make someone noticeably ill. Many cases go unreported because infected people don’t need medical attention. This makes it incredibly hard to track all cases and allows it to spread from country to country as seen with the emergence of Zika in Miami.
It is believed that a man who traveled to Brazil brought Zika to Singapore in May. Some have accused the government of covering up cases of Zika when the number of reported cases jumped from one to 41 over the weekend. Singapore’s National Environment Agency said it has inspected dormitories where infected foreign workers live and are distributing insect repellent.
Despite the cases, public-health officials have bigger concerns, notably dengue, also known as “breakbone fever.”
“What we can do as a country comes down to how well we control our vectors, and at this point of time, dengue is still a bigger problem than Zika because people can die from dengue,” Malaysian Health Minister Subramaniam Sathasivam told Reuters.