Low seroprevalence rates of Zika virus in Kuala Lumpur, Malaysia

Sam, I-Ching and Montoya, Magelda and Chua, Chong Long and Chan, Yoke Fun and Pastor, Andrew and Harris, Eva (2019) Low seroprevalence rates of Zika virus in Kuala Lumpur, Malaysia. Transactions of The Royal Society of Tropical Medicine and Hygiene, 113 (11). pp. 678-684. ISSN 0035-9203, DOI https://doi.org/10.1093/trstmh/trz056.

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Official URL: https://doi.org/10.1093/trstmh/trz056


Background: Zika virus (ZIKV) is believed to be endemic in Southeast Asia. However, there have been few Zika cases reported to date in Malaysia, which could be due to high pre-existing levels of population immunity. Methods: To determine Zika virus (ZIKV) seroprevalence in Kuala Lumpur, Malaysia, 1085 serum samples from 2012, 2014-2015 and 2017 were screened for anti-ZIKV antibodies using a ZIKV NS1 blockade-of-binding assay. Reactive samples were confirmed using neutralization assays against ZIKV and the four dengue virus (DENV) serotypes. A sample was possible ZIKV seropositive with a ZIKV 50% neutralization (NT50) titre ≥20. A sample was probable ZIKV seropositive if, in addition, all DENV NT50 titres were <20 or the ZIKV NT50 titre was >4-fold greater than the highest DENV NT50 titre. Results: We found low rates of possible ZIKV seropositivity (3.3% [95% confidence interval {CI} 2.4 to 4.6]) and probable ZIKV seropositivity (0.6% [95% CI 0.3 to 1.4]). Possible ZIKV seropositivity was independently associated with increasing age (odds ratio [OR] 1.04 [95% CI 1.02 to 1.06], p<0.0001) and male gender (OR 3.5 [95% CI 1.5 to 8.6], p=0.005). Conclusions: The low ZIKV seroprevalence rate, a proxy for population immunity, does not explain the low incidence of Zika in dengue-hyperendemic Kuala Lumpur. Other factors, such as the possible protective effects of pre-existing flavivirus antibodies or reduced transmission by local mosquito vectors, should be explored. Kuala Lumpur is at high risk of a large-scale Zika epidemic. © 2019 The Author(s) 2019. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved.

Item Type: Article
Funders: National Institute of Allergy and Infectious Diseases/National Institutes of Health grant (P01 AI106695), A grant from the Malaysia One Health University Network and the US Agency for International Development (to I-CS)
Uncontrolled Keywords: dengue virus; Malaysia; neutralization test; NS1 blockade-of-binding ELISA; seroprevalence; Zika virus
Subjects: Q Science > QR Microbiology
R Medicine
Divisions: Faculty of Medicine
Depositing User: Ms. Juhaida Abd Rahim
Date Deposited: 23 Jan 2020 07:23
Last Modified: 23 Jan 2020 07:23
URI: http://eprints.um.edu.my/id/eprint/23542

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