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• W2589732450 abstract "We read with great interest the Comment from Yee-Sin Leo and Angela Chow1Leo Y-S Chow A Zika virus has arrived in Singapore.Lancet Infect Dis. 2016; 16: 1317-1319Summary Full Text Full Text PDF PubMed Scopus (15) Google Scholar about the emergence of Zika virus in Singapore. The recent history of Zika virus began in 2013–14 in French Polynesia where it caused a large outbreak and the first severe complications. Zika virus then spread across the Pacific and the Americas.2Musso D Gubler DJ Zika virus.Clin Microbiol Rev. 2016; 29: 487-524Crossref PubMed Scopus (958) Google Scholar The Zika virus strains that emerged in these areas were closely related to the French Polynesian strain and belonged to the Asian lineage of Zika virus.2Musso D Gubler DJ Zika virus.Clin Microbiol Rev. 2016; 29: 487-524Crossref PubMed Scopus (958) Google Scholar It was hypothesised that mutations might have occurred in Zika virus resulting in an increased epidemicity and virulence.2Musso D Gubler DJ Zika virus.Clin Microbiol Rev. 2016; 29: 487-524Crossref PubMed Scopus (958) Google Scholar The detection of aminoacid substitutions in the Zika virus M protein, coinciding with the emergence of Zika virus in French Polynesia, reinforced this hypothesis.3Pettersson JH Eldholm V Seligman SJ et al.How did Zika virus emerge in the Pacific islands and Latin America.MBio. 2016; 7: e01239-e01316Crossref PubMed Scopus (105) Google Scholar The hypothesis of increased epidemicity and virulence associated with the new emerging strains was reinforced by reports of microcephaly cases and Zika virus circulation in Guinea-Bissau (Africa) in 2016.4WHOZika situation report. Zika virus microcephaly Guillain-Barré syndrome 1 September 2016.http://www.who.int/emergencies/zika-virus/situation-report/1-september-2016/en/Google Scholar However, genetic studies showed that, while the Zika virus strain that emerged in Cape Verde (Africa) in 2015 belonged to the Asian lineage and could have been imported from Brazil, the strain isolated in Guinea-Bissau belonged to the African lineage.4WHOZika situation report. Zika virus microcephaly Guillain-Barré syndrome 1 September 2016.http://www.who.int/emergencies/zika-virus/situation-report/1-september-2016/en/Google Scholar An imported case of Zika virus infection in Singapore in May, 2016, was suspected to have been introduced from Brazil.5Sadarangani SP Hsu LY The 2016 outbreak of Zika in Singapore.Ann Acad Med Singapore. 2016; 45: 381-382PubMed Google Scholar However, the strain currently spreading in Singapore, causing the first Zika virus outbreak ever reported in southeast Asia, is closely related to a strain that previously circulated in Asia before 2007 and is not the consequence of a new introduction of the so-called emerging strains circulating in the Americas and Pacific.1Leo Y-S Chow A Zika virus has arrived in Singapore.Lancet Infect Dis. 2016; 16: 1317-1319Summary Full Text Full Text PDF PubMed Scopus (15) Google Scholar This is puzzling because it suggests that old Zika virus strains from the Asian and the African lineages have the potential for outbreaks and perhaps for severe disease outcomes. Nevertheless, reports of microcephaly in Guinea-Bissau and re-emergence of an old Zika virus strain in Singapore might simply reflect the increased awareness and therefore testing for Zika virus after Zika virus emerged in other parts of the world and was declared an international public health emergency. The reason for the concurrent emergence or re-emergence of different Asian strains in different geographical locations and at different periods in time (Yap 2007, French Polynesia 2013–14, Singapore 2016) is unknown. The potential for theses strains to cause severe complications is also unknown and challenging in countries with other disease burden and limited resources and therefore interest. Careful monitoring, including genetic investigations, of all new emergences, would be valuable to understand the risk associated with different Zika virus strains. We declare no competing interests. Zika virus has arrived in SingaporeIn 1954, less than a decade after the discovery of the Zika virus in Uganda, mosquitoes and human sera from long-time residents of Malaya and Borneo were reported to show evidence of Zika virus infection.1 Singapore, an island city-state located at the southern tip of the Malaysian peninsula and near Borneo, has battled with dengue—a related virus—for decades. The question in the minds of many in Singapore: was Zika virus already present and if not, when will it arrive on Singapore's shores? Full-Text PDF" @default.
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• W2589732450 title "Emergence of Zika virus: where does it come from and where is it going to?" @default.
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• W2589732450 doi "https://doi.org/10.1016/s1473-3099(17)30070-1" @default.
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