Guideline by MOH, Malaysia

1. DR LEE OI WAH
PEGAWAI PERUBATAN UD 54

2. EPIDEMIOLOGY OF ZIKA VIRAL
INFECTION
MALAYSIA :
7/9/2016

3. ZIKA VIRUS

6. ACUTE ZIKA VIRAL INFECTION

7. LABORATORY DIAGNOSIS
 RT-PCR is the recommended diagnostic
test
 ≤ 7 days : blood and urine
 8-14 days : urine
 ≥ 14 days : no role
 Serology not useful ; cross-reactivity
with other Flavivirus eg Dengue

8. COMPLICATIONS OF ZIKA
INFECTION

10. PREVENTION OF ZIKA VIRUS
TRANSMISSION
 Prevention of mosquito bite : advice
against travel to Zika endemic region ;
proper clothing, use of mosquito net
(DEET) , use of repellent
 Prevention of sexual transmission : use
barrier contraception (females – 28 days ,
malen -6 months)
 Prevention of transmission via blood or
blood-products : use screened Zika
negative blood for antenatal mother who
required blood transfusion

11. GUILLAIN-BARRE SYNDROME

12. GUILLAIN-BARRE SYNDROME

13. GUILLAIN-BARRE SYNDROME- BRIGHTON
CRITERIA

15. MICROCEPHALY

16. MICROCEPHALY

17. CONGENITAL ZIKA SYNDROME
 Microcephaly + other manifestation such as :
a) carniofacial disproportion
b) neurological : spasticity , seizures,
irritability, swallowing difficulty,
contractures
c) hearing abnormalities
d) ocular abnormalities
e) brain anomalies
in neonates with in-utero exposure to Zika
virus

19. PRE & POST-TEST COUNSELLING

22. CLINICAL EVALUATION & MANAGEMENT OF
INFANTS WITH LABORATORY EVIDENCE OF ZIKA
VIRUS INFECTION
NO SPECIALTY EVALUATION REQUIRED
1. Neurology • Neuroimaging (CT-scan , MRI or
Cranium ultrasound)
• Neurological assessment
2. Infectious disease • Screening for TORCHES
3. Opthalmology • Comprehensive eye examination
prior to discharge or within 1/12
old.
4. Audiology • Before discharge then at 3/12 ,
then every 3 -6 monthly
5. Endocrinology • Hypothalamic or pituitary
dysfunction assessment

23. CLINICAL EVALUATION & MANAGEMENT OF
INFANTS WITH LABORATORY EVIDENCE OF ZIKA
VIRUS INFECTION
NO SPECIALTY EVALUATION REQUIRED
6. Clinical geneticist • Rule out other causes of
microcephaly
7. Orthopedics • Manage club foot , hypertonia
and arthrogrypotic-like conditions
8. Pulmologist /ENT • Address concern of aspiration
9. Lactation specialist • Manage feeding issues
10. Nutritionist • Manage feeding issues

24. CLINICAL EVALUATION & MANAGEMENT OF
INFANTS WITH LABORATORY EVIDENCE OF ZIKA
VIRUS INFECTION
NO SPECIALTY EVALUATION REQUIRED
11. Gastroenterologist • Manage feeding issues
12. Speech/Occupational therapist • Manage feeding issues
13. Developmental Specialist • Early interventional services
14. Medical Social Support
Service
• Psychosocial support