T

he Zika virus has suddenly caught everybody'€™s attention. The virus has spread to at least 29 countries worldwide. Recently, the Indonesian government, following in the footsteps of other countries, issued a travel advisory for Indonesians leaving for countries where Zika has been reported.

This alert follows reports in Brazil of microcephaly and other birth defects following mothers becoming infected with the Zika virus during pregnancy.

No cure, no vaccine and poor diagnostics have put Zika on the spot. Until more is known, the WHO has decided to declare Zika a '€œpublic health emergency of international concern'€.

The Zika virus is transmitted by the Aedes aegypti mosquito, the same insect that spreads dengue and chikungunya. Regional governments in Indonesia are reporting dengue outbreaks, therefore there is the fear that the country could face a Zika outbreak too.

Indonesia is also on the WHO list since a positive case of Zika infection was detected during a dengue outbreak in Jambi last year.

Zika is definitely less well known than dengue and chikungunya. Additional studies are needed to further characterize the risks of Zika virus infection during pregnancy.

It is hard to detect Zika because of the limitations of current diagnostic tests. The most accurate tests '€”which detect viral RNA in a patient'€™s blood '€” only work within a week of the first symptoms.

Antibody detection sometimes gives false results because it cross-reacts with dengue antibodies.

Furthermore, there is no drug available to heal Zika. And if there is an antiviral drug, physicians would be hesitant to give one because the majority of those infected have very few symptoms or none at all. A vaccine may offer hope, but it could take at least five to seven years to be commercially available. A dengue vaccine for example has taken at least 20 years to develop.

So what can we do about it? As there is currently no drug or vaccine for Zika, containing the virus will have to be in the form of controlling the mosquito population and protecting expectant mothers.

Neighboring Singapore, with previous successful dengue control programs, recently released a joint statement between the Ministry of Health (MoH) and the National Environment Agency (NEA). While the NEA is intensifying search-and-destroy efforts to control the Aedes aegypti mosquito population, the MoH has been closely monitoring the Zika virus situation, and will be introducing several measures to enhance the surveillance of the disease and the protection of Singaporeans.

Since 2013, NEA has been conducting surveillance of the Zika virus. Together the two institutions are implementing a set of control measures to reduce the risk of the Zika virus. These include: reducing the risk of importation of the Zika virus, facilitating early detection of cases and containing the spread of Zika virus infection.

The key NEA dengue strategy is to tackle the root of the problem, which is to deny Aedes aegypti mosquitoes a place to breed. This approach has been endorsed by the WHO.

The NEA works with various land agencies as well as private organizations and associations to ensure that there is a coordinated approach to keeping the mosquito population and dengue cases low. The agencies are part of the Inter-Agency Dengue Task Force (IADTF).

The IADTF has enhanced the communication and coordination on dengue control efforts among various agencies. The chief executive officer of the NEA chairs the IADTF, overseeing 27 government agencies and private associations.

Each agency puts in place a tighter and more comprehensive source reduction regime in their mosquito-control contracts with pest control operators.

Furthermore, permanent solutions to eliminating potential sources of stagnant water, like repairs to infrastructure, sealing up of cracks, backfilling of land and the clearing of roof-gutters are conducted on a regular basis.

It seems there is a better way to control mosquitoes, doesn'€™t it? A British biotech called Oxitec has developed Aedes aegypti mosquitoes containing a gene construct that will kill their offspring before they reach adulthood. When released in the wild, male individuals will mate with local females, producing offspring that are not viable.

Other scientists are infecting Aedes aegypti with a bacterium named wolbachia. This infection reduces mosquitoes'€™ ability to transmit diseases.

These approaches were for dengue, but Zika'€™s surge would be a good reason to attempt similar strategies. However, it will also take several years before they are ready.

By then, declaring Zika a public health emergency, or we should say declaring dengue-chikungunya-Zika altogether as a public health emergency, in Indonesia seem to be a logical way to go.

This declaration will allow coordinated national action.

It will also raise public awareness. An integrated dengue-chikungunya-Zika task force should be formed immediately. Indonesia should adopt a multi-pronged approach to controlling these Aedes aegypti-transmitted diseases that have been lingering in our country for too long a time.

Central and regional governments, multilateral institutions and other stakeholders need to build and strengthen interconnected systems for outbreak prevention, preparedness, detection and response. We need to work together and draw resources into tackling the emergency before it becomes a larger crisis.
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The writer, who obtained a PhD in biochemistry, cellular and molecular biology in 2002 from the University of Tennessee, Knoxville, USA, is a researcher and member of the National Consortium of Vaccines and Medicine (Dengue and Hepatitis B).