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- W2562123605 abstract "Purpose: Zika virus (ZIKV) is a zoonotic disease transmitted by the Aedes mosquito. Singapore reported its first case of locally transmitted ZIKV on 27 August 2016 and the cases surged to 384 by mid-September. This abstract presents a summary of Zika testing at a tertiary hospital during the first three weeks of the Zika outbreak in Singapore. Methods & Materials: An observational study of patients presenting to NUH, a 1,250 bed academic hospital in Singapore, was conducted. All patients tested from 29 August to 18 September 2016 were included. The initial testing strategy from 29 August to 6 September 2016 was aimed at identifying positive cases and isolating them in order to contain the outbreak. Free testing was provided based on Singapore Ministry of Health (SG-MOH) case definitions with links to known geographical clusters. From 7 September onwards, the SG-MOH definition for suspect cases was not limited to specific geographic locales, and clinicians were given greater leeway when ordering ZIKV tests especially for pregnant women. The costs of tests were henceforth charged to patients but at a subsidized rate for Singapore residents. We reviewed the impact of these changes on test positivity rates. Positive ZIKV Real time Polymerase Chain Reaction (RT-PCR) of the blood and/or urine was used to define a confirmed case. Results: A total of 370 patients were tested during the study period, overall 38 (10%) (25 blood, 34 urine and 21 blood and urine) were ZIKV positive. Patients were more likely to be positive during the initial containment period (Odds Ratio 16.1, 95% CI 3.1-68.1, p <0.0001) when 36/211 (17%) were positive compared with 2/159 (1%) when tests were charged and freely available to all including those who did not meet any case definition. Conclusion: A system of free testing using geographic and clinical criteria had a much higher yield than a looser testing criterion which incorporated user fees. Countries trying to get an accurate epidemiologic understanding of their emerging Zika outbreaks should consider using a wider net of free testing to identify cases for targeted vector control to avoid catering primarily to the “worried well”." @default.
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- W2562123605 date "2016-12-01" @default.
- W2562123605 modified "2023-10-18" @default.
- W2562123605 title "The Zika outbreak: An overview of suspected Zika cases presenting at a tertiary hospital in Singapore" @default.
- W2562123605 doi "https://doi.org/10.1016/j.ijid.2016.11.305" @default.
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