The first Zika cluster of 2017 was reported in Simon Place, near Kovan, involving two locally transmitted cases from the same household. There have also been six other isolated Zika cases detected in Singapore this year.
Last year, ever since the first case of Zika was detected in Singapore, the infection spread like wildfire.
This time, to prevent a serious outbreak, the National Environment Agency (NEA) has conducted vector control operations and outreach activities in the cluster, including inspecting about 120 out of 400 premises in the cluster for mosquito breeding, ground checks in the vicinity and more.
The Zika virus is a virus infection transmitted by the bite of an infected Aedes mosquito, which also carries the dengue and chikungunya viruses.
Worried? Here’s everything you need to know about Zika.
What are the symptoms?
They include a fever, an itchy rash, body aches, headache, conjunctivitis (red eyes) and occasionally, nausea and vomiting, which usually develop within three to 12 days after the mosquito bite and often last between four and seven days.
However, four in five people who become infected with Zika do not show any symptoms, but could be infectious – which is what makes the outbreak even more worrying.
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Is there a cure?
At the moment, there is no cure or vaccine. Only the symptoms can be treated.
To avoid getting infected, use insect repellent and wear clothing that covers the body, arms and legs.
The public are also encouraged to do the five-step mozzie wipeout to prevent mosquitoes from breeding at home: change water in vases and bowls and remove water from flower pot plates on alternate days, clear blockages and put insecticide in roof utters monthly, and cover or turn over all water stoage containers when not in use.
Will there ever be a cure?
About 40 potential vaccines for the Zika virus are being tested. Although there’s progress towards prevention, the World Health Organisation reported in February this year that none is likely to be available for women of childbearing age before 2020.
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Who is at greatest risk?
Unborn babies are the most at risk 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.
The risk of microcephaly from a Zika virus infection is still unknown, although some studies have put it at between 1 per cent and 13 per cent. Research is still ongoing.
That being said, scientists found that the Zika virus in Singapore likely evolved from a strain which was already circulating in South-east Asia, rather than the microcephaly-causing strain from South America. If this is the case, the likelihood of microcephaly here will be more distant.
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Are pregnant women at higher risk of getting infected by Zika?
There is currently no evidence that this is so, says the Ministry of Health (MOH).
Is the baby at risk throughout the pregnancy?
The risk is highest during the first trimester and the early part of the second trimester of pregnancy.
Though the risk is lower in the third trimester, the virus could still cause fatal outcomes such as stillbirth.
Are there any tests that can be done to determine if a pregnant woman is infected with Zika?
Currently, the only reliable test is the reverse transcriptase-polymerase chain reaction (RT-PCR) test, which looks for genetic material of the virus in blood or urine.
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If a pregnant woman has Zika, what can be done to prevent its effects on the baby?
Dr Derrick Heng, group director for public health at the Health Ministry, says: “Once the mother is infected, there is nothing much that can be done to prevent the effect on the baby.”
However, more than nine in 10 pregnant women infected with Zika will deliver normal babies. In Singapore, the Ministry of Health said that as of 27 December 2016, 17 pregnant women were known to have had Zika. Four of them have given birth, and their babies show no signs of microcephaly.
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At what point can microcephaly be detected in unborn babies?
According to the United States Centres for Disease Control and Prevention, microcephaly can be diagnosed through an ultrasound starting from late in the second trimester of pregnancy.
However, the accuracy of using ultrasound to detect microcephaly in a baby whose mother has Zika is still unknown. It can depend on many factors, including when the mother was infected and how serious the microcephaly is.
The World Health Organisation (WHO) recommends an ultrasound between 28 and 30 weeks.
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If a woman is pregnant and asymptomatic, but worried about a possible Zika infection, where should she go to get tested?
The WHO’s May 2016 guidelines and MOH’s August 2016 clinical guidelines on Zika virus infection and pregnancy do not recommend routine Zika testing for asymptomatic pregnant women. Regular blood/ urine tests are not necessary.
If a pregnant women has recently visited or live/work a Zika-affected area in Singapore, consult a doctor to get tested immediately if she shows symptoms.
Otherwise, there is no need to see a doctor if she is well. She should nonetheless continue to take strict precautions against mosquito bites.
If they are concerned, they should discuss this further with their doctor.
NEXT: Precautionary measures for pregnant women →
Is it safe for pregnant women to use insect repellent?
Yes, insect repellents sold in Singapore are safe for use by pregnant women.
They can also prevent mosquito bites by wearing long-sleeved clothing and long trousers, and sleeping under mosquito nets or in rooms with wire-mesh screens or in air-conditioned rooms to keep out mosquitoes.
If a pregnant woman tests positive for Zika virus infection, should she consider termination of pregnancy?
Serial ultrasounds and amniotic fluid testing may be considered after the potential risks and interpretation of results are discussed.
Currently, even if a pregnant woman is confirmed to be infected with the Zika virus, there is no test that will predict the future occurrence of microcephaly.
The termination of pregnancy is a personal choice that should be made carefully by the parents in consultation with their doctor.
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Can mothers with Zika infection breastfeed their baby?
The Zika virus has been detected in breast milk, but there is currently no evidence that it is transmitted to babies through breastfeeding.
Following infection with the Zika virus, will a woman’s future pregnancies be at risk?
The Zika virus infection does not pose a risk of birth defects for future pregnancies.
But if the woman tests positive for Zika, she should practise safer sex or abstain from sexual intercourse for at least eight weeks after recovery, before trying to conceive.
If the man shows symptoms, he should seek medical attention promptly. If he is found to have the Zika virus, he should practise safer sex through the use of condoms or abstain from sexual intercourse for at least six months after recovery.
If you have been infected with Zika once, you should have lifetime immunity. However, it is not advisable to try and get infected with so you have immunity when you want to start a family – not enough is known about Zika to warrant this.
NEXT: Zika and Dengue→
Is it true that a Zika infection strikes harder when one has previously contracted dengue?
Laboratory experiments showed that having a Zika infection after contracting dengue is worse compared with just having a Zika infection on its own.
While there hasn’t been any conclusive results – an answer is expected only in one to two years’ time – the worry is that it may. While the symptoms of Zika infections are generally milder compared with dengue’s, the enhancement of Zika infection with a pre-existing dengue immunity also leads to a more severe disease, such as microcephaly and related congenital abnormalities in infants, or Guillain-Barre syndrome in adults.
Find out more about the study here.
NEXT: Symptoms →
By The Straits Times, last updated March 2017
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