80% of people who become infected never have symptoms. The symptoms are mild – when they appear at all – and usually require only rest, nourishment and other supportive care.

In those who do exhibit symptoms, according to the World Health Organization (WHO) they commonly include:

• Fever, usually low grade and less than 38.5 degrees celsius
• Rashes
• Mild headaches, body and joint pains, sometimes swelling (especially the smaller joints in the hands and feet)
• Red eyes or Conjunctivitis

Symptoms generally clear up within two to seven days

Most at risk are unborn babies should their mothers become infected with the Zika virus.  Between 1 per cent and 10 per cent of women infected during pregnancy give birth to babies with defects. The most common defect is microcephaly, where the baby is born with a much smaller head, sloping forehead and damaged brain.

They are similar in that the patient experiences fever, headaches and muscle aches. However, dengue tends to be more severe with intense bone pain and pain behind the eyes. Compared to dengue, Zika tends to be milder and unlikely to be life-threatening.

List of Countries with Zika Virus Outbreak/ Ongoing Local Transmission
(As of 2 Sep 2016 from MOH Website)

*Areas with “ongoing outbreaks” refer to areas that are reporting a higher number of cases (more than 10 cases), widespread transmission or with transmission for more than 8 weeks.

**Areas with “ongoing local transmission/exported cases” refers to areas reporting 10 or fewer local cases in a single area within 8 weeks as well as areas reporting exported cases.

As Singapore is one of the Asian countries which is under the list of “Zika ongoing local transmission/ exported cases”, our Ministry of Health (MOH) has been closely monitoring the Zika virus situation, and has introduced measures to enhance the surveillance of the disease.

It has been reported that the Singapore areas of concern are limited mainly to the North Eastern and Eastern regions (as of 1st Sep 16) which are not located near to the premises of our hospitals (South Central region).

We have also take extra precautions to enhance the surveillance of the disease and implemented several measures to ensure the protection of all patients and control the spread of Zika virus infections. These include:

• Minimise possible exposure to mosquitos for patients and visitors at our hospital premises
• Active screening for suspect Zika cases among patients/staff (e.g. health declaration forms, personal monitoring)
• Facilitation of Zika testing for patients with exposure risk and symptoms
• Designated ward for isolation of suspect and/or confirmed cases
• Weekly hospital-wide pest control activities

These Zika posters are available for download, to raise awareness about Zika and share on social media. Click on the images to open in full size.

1) Can a person get Zika many times, or will he be immune after getting infected once?

Professor Leo Yee Sin, a senior infectious diseases consultant at the Communicable Disease Centre stated that one infection of Zika should confer life-time immunity against the disease.

2) Where can I get tested for Zika?

There are currently no home kits that can be used to diagnose Zika. Both urine and blood have to be tested in a laboratory. Those who have no symptoms but still wish to get tested can get it done at hospitals under the Parkway Group in Singapore, Gleneagles Hospital, Mount Elizabeth Hospital, Mount Elizabeth Novena Hospital and Parkway East Hospital. The test costs about S$500 and takes between 24 and 72 hours.

3) How does Zika affect pregnant women?

The real danger comes when a pregnant woman is infected with Zika. The virus will circulate in the blood stream, go through the placenta and pass on to the baby. This, unfortunately, causes microcephaly.

4) What is microcephaly and how does it affect the child?

A recent study suggests that the estimated risk of microcephaly associated with infection during pregnancy is less than 13%. The majority of pregnant women who have been infected with Zika give birth to perfectly normal babies.

It is a condition in which the infant’s circumference of the head is significantly smaller than the heads of other babies of the same age and sex, usually due to incomplete brain development. Microcephaly may be present at birth, or could develop during the first few years of life. According to Ministry of Health (MOH) Singapore, a positive Zika test does not mean that the foetus is harmed or infected.

5) Should all pregnant women check to see if they have been infected with Zika, even if they do not get symptoms?

No, because currently, the only reliable test available for Zika is the reverse transcriptase-polymerase chain reaction (RT-PCR) test which looks for genetic material of the virus in blood or urine. However, RT-PCR test is only able to detect Zika infection in blood within 5-7 days of onset of symptoms and in urine within 14 days of onset. Therefore, the time window in which a pregnant woman can be tested using RT-PCR is very short.

At present, there is no reliable serological test (which looks for antibodies in the blood) for Zika.

6) What can I do to prevent Zika infection?

The following precaution measures can be taken to prevent mosquito bites:

• Cover arms and legs by wearing long-sleeved shirts / pants when heading outdoors
• Sleep under mosquito nets or in rooms with mesh wire nets
• Apply insect repellent
• Prevent Aedes mosquito breeding

References

• Ministry of Health. FAQ on Zika Virus. Last modified August 30, 2016. www.moh.gov.sg/zika 
• Ministry of Communications and Information Singapore. Zika Virus. Last modified August 28, 2016. https://www.gov.sg/microsites/zika 
• Singapore Tourism Board. STB statement on the Zika infection in Singapore. Last modified September 1, 2016. http://www.yoursingapore.com/en_my/travel-guide-tips/zika-health-advisory.html 
• World Health Organization. Zika Virus. Last modified June 2, 2016. http://www.who.int/mediacentre/factsheets/zika/en/ 

Related Media Articles

• The Straits Times. All you need to know about the Zika virus and the threat it poses. Last modified September 3, 2016. http://www.straitstimes.com/singapore/health/all-you-need-to-know-about-the-zika-virus-and-the-threat-it-poses
• The Straits Times. First case of pregnant woman with Zika in Singapore; potential new cluster at Bedok North Ave 3. Last modified September 1, 2016. http://www.straitstimes.com/singapore/first-case-of-pregnant-woman-with-zika-in-singapore-bedok-north-ave-3-potential-new
• The Straits Times. Why free testing for mums-to-be islandwide who show symptoms. Last modified September 1, 2016. http://www.straitstimes.com/singapore/health/why-free-testing-for-mums-to-be-islandwide-who-show-symptoms 
• The Straits Times. Isolation of zika cases  to end; MOH to subsidise Zika testing for all S'poreans with symptoms. Last modified September 5, 2016. http://www.straitstimes.com/singapore/isolation-of-zika-cases-to-end-moh-to-subsidise-zika-testing-for-all-sporeans-with