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Singapore Primed for Large-scale Zika Virus Outbreak

Health officials in Singapore have reported a significant increase in the incidence of Zika virus infection in the country in recent weeks.

Health officials in Singapore have reported a significant increase in the incidence of Zika virus infection in the country in recent weeks.

Although the virus is hardly anything new for the Asian nation, there are concerns that the rapid increase in cases—there have been nearly 400 since the start of mosquito season—could signal a large-scale outbreak.

“Zika has been around since the 1960s. The laboratories in Ministry of Health and Ministry of Environment have been doing surveillance on this illness for several years, and we have not isolated Zika in patients or in mosquitoes [until now],” said Hoe Nam Leong, MBBS, an infectious disease specialist at Mount Elizabeth Novena Hospital in Singapore told the Center for Infectious Disease Research and Policy at the University of Minnesota. “We suspect a significant mutation occurred that conferred [the virus] an advantage in spreading from person to mosquito to person. Previously, reports of Zika [here] are far and few in between.”

Singapore officials had reported an initial case of travel-related Zika virus infection in May, in a man who had visited Brazil. According to Leong, the strain currently circulating in Singapore, is not the same French Polynesian strain behind the Zika cases in Brazil, the United States, and the rest of the Americas, though it is closely related. The Singapore strain, he said, is related to one that caused an outbreak on nearby Yap Island in 2007 and that has been circulating in Thailand since 2012.

Speaking of Thailand, last week, officials there announced plans to criminally charge homeowners who fail to remove mosquito breeding grounds on their property, effectively re-instituting a 1992 law that enables authorities to order the removal of areas with still water where mosquitoes can breed. Those failing to comply with the directive could face fines or even jail time. To date, there have been 279 Zika cases in Thailand since the start of the year.

Because of the ongoing Zika outbreaks in Singapore and Thailand, officials from all of the Association of Southeast Asian Nations (ASEAN) have agreed to cooperate in Zika prevention efforts, including “increasing monitoring efforts in each member country, improving information exchange, and improving surveillance and countermeasures to new viral diseases,” according to a statement from the Thai health ministry. They also agreed to coordinate efforts to control mosquito populations and better manage larvae breeding grounds.

Brian P. Dunleavy is a medical writer and editor based in New York. His work has appeared in numerous healthcare-related publications. He is the former editor of Infectious Disease Special Edition.