Sunset over Borneo rainforest with mosquito silhouette symbolizing Zika virus.

Zika Virus in Borneo: What You Need to Know About the Outbreak

Theo Raines in Health & Wellness December 2025 • 4 min read.

"Understanding the autochthonous outbreak of Zika virus in Sabah, Malaysia and its implications for public health."

Zika virus (ZIKV) is a mosquito-borne virus that has gained international attention due to its association with microcephaly in infants born to infected mothers. While many ZIKV infections are asymptomatic, the potential consequences for pregnant women and their babies have made it a significant public health concern.

In 2014, the presence of ZIKV antibodies was first noted in a traveler returning from Sabah, Malaysia, raising concerns about the virus's presence in the region. Further investigations revealed the presence of antibodies in both humans and orangutans, suggesting an ongoing cycle of transmission.

This article delves into the details of the first confirmed autochthonous (locally acquired) Zika virus outbreak in Sabah, Malaysia. We will explore the investigations undertaken to determine the extent of the outbreak, identify potential sources of the virus, and understand the implications for public health in the region.

Unveiling the Sabah Zika Virus Outbreak: Key Findings

Sunset over Borneo rainforest with mosquito silhouette symbolizing Zika virus.

In September 2016, the first autochthonous case of ZIKV infection in Malaysia was detected in Kota Kinabalu, Sabah. This discovery prompted a collaborative investigation to understand the scope of the outbreak and identify potential sources of the virus.

The investigation focused on identifying individuals with ZIKV infection in the Damai area, as well as those with recent travel history to areas known to have ZIKV transmission. Researchers looked for ZIKV RNA in serum samples collected between September and October 2016. Cases were identified through record reviews at health facilities, surveillance systems, and active case-finding activities. Clinical records were reviewed to determine common exposures.

Mosquitoes: Mosquitoes, primarily female Aedes albopictus, were collected from 30 locations where patients resided or visited.
Sample Analysis: Nucleic acid was extracted from collected mosquitoes using the QIAamp Viral RNA Mini Kit.
Animal Samples: Serum samples were also collected from 4 wild M. Fascicularis (long-tailed macaques) by a veterinarian.
Genetic Sequencing: Nucleotide sequences were determined by BigDye terminator v3.1 cycle sequencing kit.
Phylogenetic Analysis: A phylogenetic tree was constructed using Mega 5.05 using the neighbour-joining method.

The results of the investigation identified two cases of ZIKV infection in Damai residents and one Taiwanese traveler. One of the infected individuals unfortunately passed away. Both local cases resided within one kilometer of each other, and only the first case had a history of travel to Southern Peninsular Malaysia. Further testing revealed that all household members of the local cases and volunteers living within a 400-meter radius of the two cases were negative for ZIKV. Additionally, serum samples from M. Fascicularis and mosquitoes collected from different locations were also negative for ZIKV.

Moving Forward: Understanding and Preventing Zika Virus in Sabah

The investigation concluded that ZIKV infection in Sabah is sporadic, potentially due to limited transmission of the virus. However, ongoing surveillance is crucial to monitor the situation and prevent future outbreaks.

To gain a comprehensive understanding of ZIKV epidemiology in Sabah, it is essential to implement a prospective surveillance program that encompasses humans, animals, and vectors (mosquitoes). This will help to identify potential sources of the virus, understand transmission patterns, and develop effective control strategies.

The findings of this investigation highlight the importance of vigilance and preparedness in the face of emerging infectious diseases. By continuing to monitor and study ZIKV in Sabah, we can better protect the health of the population and prevent future outbreaks.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1016/j.ijid.2018.04.3899, Alternate LINK

Title: The First Outbreak Of Autochthonous Zika Virus In Sabah, Malaysian Borneo

Subject: Infectious Diseases

Journal: International Journal of Infectious Diseases

Publisher: Elsevier BV

Authors: S.M. Jeffree, J. Julian Frederick Dony, K. Ahmed

Published: 2018-08-01

Everything You Need To Know

What exactly is Zika virus (ZIKV), and why is it such a concern?

Zika virus (ZIKV) is a mosquito-borne virus that has gained international attention due to its association with microcephaly in infants born to infected mothers. The virus can cause severe health complications, especially for pregnant women and their unborn children. While many ZIKV infections are asymptomatic, the potential for severe birth defects highlights the importance of understanding and controlling its spread.

What does it mean that the Zika virus outbreak was 'autochthonous' in Sabah?

The first autochthonous case of ZIKV infection in Malaysia was detected in Kota Kinabalu, Sabah. Autochthonous means the infection was locally acquired, indicating the virus was transmitted within the region rather than brought in by a traveler. This discovery was a critical event because it confirmed that ZIKV was actively circulating within Sabah, necessitating further investigation and public health measures to contain the outbreak.

What were the main steps taken to investigate the Zika virus outbreak in Sabah?

The investigation into the ZIKV outbreak in Sabah involved several key steps. Researchers identified individuals with ZIKV infection in the Damai area, and those with recent travel history to known ZIKV transmission locations. They collected and analyzed serum samples, focusing on record reviews at health facilities, surveillance systems, and active case-finding activities. Mosquitoes, primarily female Aedes albopictus, were collected, and genetic sequencing was conducted. Samples from wild M. Fascicularis were also analyzed. These diverse methods aimed to understand the extent of the outbreak, identify potential sources, and trace the virus's spread.

What were the key findings of the Zika virus outbreak investigation?

The investigation identified two cases of ZIKV infection in Damai residents and one Taiwanese traveler. These cases confirmed the presence and transmission of the virus within Sabah. Notably, one of the infected individuals passed away. The geographic proximity of the local cases and the travel history analysis helped to narrow down potential sources of infection and understand the pattern of spread within the community. These findings emphasized the need for ongoing surveillance to monitor the situation and prevent future outbreaks.

What are the implications of the Zika virus outbreak for the people of Sabah?

The investigation concluded that ZIKV infection in Sabah is sporadic, likely due to limited transmission. The presence of autochthonous cases, however, indicates the virus is still a public health concern. Ongoing surveillance is therefore crucial to monitor for future outbreaks and prevent potential harm, particularly to pregnant women and their babies. This includes monitoring mosquito populations, tracking new infections, and implementing public health interventions to control the spread of ZIKV within the region.