Mosquito silhouette against a Borneo rainforest backdrop, symbolizing the Zika virus outbreak in Sabah, Malaysia.

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

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

"Uncover the facts about the first autochthonous Zika virus outbreak in Sabah, Malaysian Borneo, and understand its potential impact on public health."

Zika virus (ZIKV) has been a global health concern since its association with microcephaly in infants born to infected mothers came to light. While often asymptomatic, ZIKV infection can have serious consequences, especially for pregnant women. The virus, transmitted primarily through mosquito bites, has been detected in various parts of the world, prompting investigations and preventive measures.

In 2016, the first autochthonous (locally acquired) case of ZIKV infection was identified in Kota Kinabalu, Sabah, Malaysia. This discovery triggered a collaborative investigation to determine the extent of the outbreak and identify potential sources of the virus within the region. Understanding the specifics of this outbreak is crucial for public health officials and residents alike.

This article delves into the details of the Zika virus outbreak in Sabah, Malaysian Borneo, examining how it was detected, the measures taken to investigate it, and the potential implications for the region's public health. By understanding the dynamics of this outbreak, we can better prepare for and respond to future public health challenges.

Unraveling the Sabah Zika Virus Outbreak: Detection and Investigation

Mosquito silhouette against a Borneo rainforest backdrop, symbolizing the Zika virus outbreak in Sabah, Malaysia.

The identification of the first autochthonous Zika virus case in Sabah prompted immediate action. A collaborative investigation was launched to understand the scope of the outbreak and identify potential sources of the virus. This involved defining cases as ZIKV occurrence in individuals residing in the Damai area or with recent travel to affected regions with known ZIKV transmission.

The investigation involved several key steps:

Record Reviews: Health facilities were reviewed to identify potential cases.
Surveillance System: Existing surveillance systems were utilized to track and monitor the spread of the virus.
Active Case Finding: Proactive efforts were made to identify new cases through targeted investigations.
Clinical Record Review: Detailed reviews of patient clinical records were conducted to identify common exposures and potential risk factors.
Mosquito Collection: Mosquitoes, primarily female Aedes albopictus, were collected from 30 locations where patients resided or visited. These mosquitoes were then transported to a laboratory for analysis.
Sample Analysis: Nucleic acid was extracted from mosquito and patient serum samples using the QIAamp Viral RNA Mini Kit. The nucleotide sequences were determined using the BigDye terminator v3.1 cycle sequencing kit. Phylogenetic analysis was performed using Mega 5.05 to understand the virus's evolutionary relationships.

The investigation identified two cases of ZIKV infection in Damai residents and one Taiwanese traveler. Notably, 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 household members of local cases and volunteers within a 400-meter radius of the two cases were negative for ZIKV. Serum samples from wild M. Fascicularis (long-tailed macaque) and mosquitoes collected from different locations were also negative for ZIKV.

Implications and Future Directions for Zika Virus in Sabah

The Sabah Zika virus outbreak appears to be sporadic, potentially due to limited virus transmission. However, continued vigilance and proactive measures are crucial to prevent future outbreaks and protect public health.

A prospective surveillance program encompassing human, animal, and vector populations is needed to comprehensively understand ZIKV epidemiology in Sabah. This would involve ongoing monitoring of mosquito populations, screening of animals for ZIKV, and surveillance of human populations for potential infections.

Understanding the factors that contribute to ZIKV transmission in Sabah, including mosquito breeding habits, human behavior, and environmental conditions, is essential for developing targeted prevention strategies. By implementing comprehensive surveillance and prevention programs, Sabah can minimize the risk of future Zika virus outbreaks and safeguard the health of its residents.

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.

Everything You Need To Know

What steps were taken to investigate the Zika virus outbreak in Sabah after the first case was identified?

The initial investigation of the Zika virus outbreak in Sabah involved several key steps to understand the scope and source of the virus. These included record reviews at health facilities, utilizing existing surveillance systems to track the spread, active case finding to identify new cases, detailed clinical record reviews to identify common exposures, mosquito collection (primarily female Aedes albopictus) from locations where patients resided or visited, and sample analysis using the QIAamp Viral RNA Mini Kit and BigDye terminator v3.1 cycle sequencing kit to determine nucleotide sequences and perform phylogenetic analysis.

What were the key findings of the investigation into the Zika virus outbreak among Damai residents and travelers?

The investigation into the Zika virus outbreak in Sabah identified two cases of ZIKV infection in Damai residents and one Taiwanese traveler. Both local cases lived within one kilometer of each other, and only the first case had a history of travel to Southern Peninsular Malaysia. Further testing revealed that household members of local cases and volunteers within a 400-meter radius of the two cases were negative for ZIKV. Serum samples from wild M. Fascicularis (long-tailed macaque) and mosquitoes collected from different locations were also negative for ZIKV.

Although the Zika virus outbreak in Sabah was contained, what are the broader implications for public health and future preparedness?

While the Zika virus outbreak in Sabah appears to be sporadic, potentially due to limited virus transmission, the broader implications involve the need for continuous monitoring and proactive public health measures to prevent future outbreaks. If Zika were to become more widespread, it could lead to significant public health concerns, particularly regarding the risk of microcephaly in infants born to infected mothers. The risk extends to other regions through travel. Further research and improved diagnostic capabilities are essential for managing potential future cases.

How was phylogenetic analysis used during the Zika virus outbreak investigation in Sabah, and what information did it provide?

Phylogenetic analysis, performed using Mega 5.05, played a crucial role in understanding the virus's evolutionary relationships during the Sabah Zika virus outbreak investigation. By analyzing the nucleotide sequences of the virus samples, scientists could determine the origin and potential pathways of transmission of the Zika virus. However, the investigation did not discuss how the analysis results were interpreted, and how the results have been compared to sequences from other geographical regions to understand the source of the virus. This understanding helps in formulating effective control measures and preventing future outbreaks.

What specific laboratory methods were used to analyze samples during the Sabah Zika virus investigation, and what are their limitations?

The article mentions the use of the QIAamp Viral RNA Mini Kit for nucleic acid extraction from mosquito and patient serum samples, and the BigDye terminator v3.1 cycle sequencing kit for determining nucleotide sequences. While these are essential tools for molecular analysis, the specifics of their application and limitations are not detailed. The accuracy and sensitivity of these methods directly impact the reliability of the investigation's findings. For example, the detection limit of the QIAamp kit and the coverage depth of the sequencing could influence the ability to detect low-level infections or mixed infections.