Abstract

Zika Alert!

Timothy Barkham, Doctor, Tan Tock Seng Hospital

Zika has been on the horizon for many years, as are a list of other pathogens, and the outbreak in Singapore was long anticipated. Laboratory diagnostic confirmation relied on a PCR described in 2008. Sequence analysis showed several mismatches with the Singapore Asian strain. Updated primers gave improved detection but the utility of PCR is restricted to early disease. The dramatic outbreak was followed by an equally dramatic fall in numbers of cases, such that there are few samples available for evaluating assays. Serological assays are pouring onto the market but suffer from cross reactions with other flaviviruses; few are substantiated with well characterized sera. Data on the threat this Asian strain poses to unborn children is lacking but the pregnant mother may be the main focus of future test requests. If Zika becomes endemic in Singapore it will join a growing list of causes of fever. This list is interesting as causes of fever are targets for diagnosis simply so we can distinguish them from the cause of the next outbreak, which may be more significant.