No significant increase in microcephaly cases in Malaysia

PETALING JAYA: There has been no indication of an increase in microcephaly cases in Malaysia so far, but testing may be considered for pregnant women with fever, says Asia-Pacific Paediatric Association secretary-general Datuk Dr Zulkifli Ismail.

He said that it was not a huge concern currently because microcephaly cases were still very rare in the country and the cause of it in Brazil had not been established.

"Until there is a reason to start testing, then only we will test," he said in a telephone interview.

He said the link between microcephaly and Zika virus had only been found in Brazil and not in other countries thus far.

"For now, our main concern is still dengue," he added.

In Malaysia, the Zika virus was isolated from mosquitoes in 1969 in Bentong, Pahang.

But since then, no one had followed up on the study and its origin was not known.

Dr Zulkifli said microcephaly, where a baby is born with a smaller than usual brain and skull, was still very rare here.

They can be due to genetic causes, congenital rubella syndrome, toxoplasmosis (a parasite from cats) and effect from certain drugs, he added.

In October, a marked increase in the number of infants with microcephaly was reported in Brazil. It had been associated with the Zika virus but was not conclusive.

Asked on the possibility of contaminated tetanus, diptheria and pertusis (Tdap) vaccine that could have affected the pregnant mothers and babies, Dr Zulkifli said the vaccine had been given to adolescents and adults in the United States for years, and there was no increased reporting of microcephaly there, where hundreds of thousands of doses were given.

"I don't think the uptake of the Tdap vaccine in Brazil is high and will definitely not coincide with this rise in microcephaly," he said.

Dr Zulkifli said there had not been much research on the Zika virus except that it caused fever and pains similar to a mild dengue infection.

"Information on the neurotropism or viscerotropism of the virus on the unborn child is unknown," he said.

"In the next few months, we should get a clearer picture regarding this virus and its association with foetal brain development as well as other modes of transmission other than the Aedes mosquito."

Dr Zulkifli also said that with the current uncertainty, a pregnant woman with fever should get examined and appropriate blood tests done.

"Foetal ultrasound examination can track the feral brain and skull growth.

Pregnant mothers should not miss the regular antenatal checkups," he said, adding that they should also avoid unnecessary outdoor exposure when the Aedes mosquitoes were out at dawn and dusk.