SINGAPORE (AP) — Singapore said Tuesday it is investigating the severity of its locally transmitted Zika virus, amid a rising number of cases.

Researchers concluded last week that the strain of Zika found in two patients in Singapore was not from South America, but was similar to those found in the region decades ago.

“We cannot tell at this moment whether the viruses found here cause more or less severe disease than those in South America. Further research will be needed to shed light on this,” Health Minister Gan Kim Yong told Parliament.

Singapore announced its first confirmed Zika infection in May, with the virus imported by a 48-year-old man who had traveled to Brazil.

On Monday, the Ministry of Health and National Environment Agency confirmed four more locally transmitted cases, bringing the total to 333, including eight pregnant women.

“It is still early days to ascertain what the long-term trend of Zika infection will be,” Gan said, stopping short of labeling the outbreak an epidemic.

“Even if we can control the present outbreak, we will need to continue to guard against imported cases as the Zika virus is still circulating among many countries, including several in this region,” he said.

Last week, Gan told Channel NewsAsia that Singapore will no longer isolate all Zika patients, except when the infection is “severe or unless they have other conditions that require medical attention.”

The mosquito-borne Zika virus has mild effects on most people, but can be fatal for unborn children. Infection during pregnancy is believed to result in babies with small heads — a condition called microcephaly — and other brain defects.

Every day, about 850 workers in Singapore inspect homes and worksites for possible mosquito breeding grounds. From January to July, 748,000 inspections were conducted and more than 10,000 breeding habitats were destroyed, according to official statistics.

Despite government efforts, the island nation has been included in several travel advisories because of the Zika cases, with experts fearing this will cause a dip in tourism revenue. </s> KUALA LUMPUR/SINGAPORE, Sept 1 (Reuters) - Malaysia reported its first case of Zika on Thursday, a woman who tested positive for the mosquito-borne virus after a visit to neighbouring Singapore, where 115 people have so far been infected, many of them foreigners.

The 58-year-old victim had shown signs of a rash and fever one week after her return from Singapore on August 21, said Malaysian Health Minister Subramaniam Sathasivam.

"We are carrying out control measures against aedes mosquitoes near the woman's home to prevent the spread of the virus," he told a news conference.

The Zika virus, which has spread through the Americas and the Caribbean since late last year, is generally a mild disease but is a particular risk to pregnant women. It has been linked to microcephaly - a severe birth defect in which babies are born with abnormally small heads and underdeveloped brains.

The U.S. Centers for Disease Control and Prevention had said Singapore is the only Asian nation with an active Zika virus transmission. Officials in the city-state, one of the world's largest financial centres and busiest travel hubs, reported the first locally transmitted infection on Saturday and said on Wednesday the number had jumped to 115.

Singapore authorities detected infections in people living outside the initial outbreak area and have identified a potential second cluster. A pregnant woman was among the victims, they said.

"Over time, we expect Zika cases to emerge from more areas," Singapore's Minister for Health Gan Kim Yong said in a statement on Wednesday. "We must work and plan on the basis that there is Zika transmission in other parts of Singapore and extend our vector control efforts beyond the current affected areas."

Five Malaysians in Singapore had tested positive for Zika, including the latest victim's adult daughter, who works in Singapore, the Malaysian minister said.

Twenty-one Chinese nationals, 13 Indians, six Bangladeshis, and an Indonesian are also among the 115 cases of Zika reported in Singapore, foreign officials said.

Many are believed to be overseas workers at building sites in Singapore, although the Singapore government has not given details of the victims by nationality.

The United States, Australia, Taiwan, South Korea and Indonesia have warned pregnant women not to travel to Singapore.

The outbreak and advisories come as the tourism industry in Singapore already faces weak global economic growth. Singapore's Tourism Board said it was premature to consider any impact on the sector, adding it remained a "safe travel destination".

More than 55 million people pass through Singapore's Changi airport every year. In the first half of this year, tourism arrivals topped 8 million, around 1 million more than a year earlier.

Malaysia has asked people visiting Singapore to use repellent and cover up to avoid mosquito bites. Tens of thousands of people travel between the two nations each day, by boat, air and across two land border crossings.

Both Malaysia and neighbouring Indonesia have stepped up protective measures following the Singapore outbreak, intensifying checks on people arriving from Singapore, introducing thermal scanners and posting paramedics at airports and border checkpoints.

Zika is carried by mosquitoes, which transmit the virus to humans, but a small number of cases of sexual transmission have been reported in the United States and elsewhere. A case of suspected transmission through a blood transfusion in Brazil has raised questions about other ways Zika may spread.

There is no vaccine or treatment for Zika, which is a close cousin of dengue and chikungunya and causes mild fever, rash and red eyes. An estimated 80 percent of people infected have no symptoms, however. </s> MANILA: The Zika virus is set to spread through Asia, the World Health Organization warned Monday, with hundreds of cases reported in Singapore and two Thai babies diagnosed with Zika-linked microcephaly.

The mosquito-borne virus has been detected in 70 countries worldwide including at least 19 countries in the Asia Pacific region, said WHO director for health security and emergencies Li Ailan.

A WHO report released at the annual regional meeting in Manila said the virus was “highly likely to further spread in the region” which includes China, Japan, Australia, most Southeast Asian nations and the Pacific islands.

“It is highly likely that the region will continue to report new cases and possibly new outbreaks of Zika,” the report added.

WHO director Margaret Chan said leaders in the region had expressed concerns over the outbreak, adding that experts were still grappling with ways to tackle the scourge.

“Unfortunately, scientists do not yet have answers to many critical questions,” she said.

There have been more than 400 Zika cases detected in Singapore, while Vietnam, the Philippines and Malaysia have reported fewer than 20 each, said Chan.

Zika causes only mild symptoms in most, including fever, sore eyes and a rash. But pregnant women with the mosquito-borne virus risk giving birth to babies with microcephaly — a deformation that leads to abnormally small brains and heads.

Li said Zika has been in the region since 1947 but said it was difficult to pinpoint if individuals had been infected overseas, with the region’s tropical weather, large mosquito populations and international travel hubs potential factors. -AFP </s> Image copyright Getty Images Image caption Singaporean authorities have been fumigating areas where mosquitoes breed

Zika infections are "highly likely" to keep spreading in Asia, the World Health Organization (WHO) has warned.

Hundreds of cases of the virus have been reported in Singapore while two cases of Zika-linked microcephaly have already been confirmed in Thailand.

The mosquito-borne virus has been detected in 70 countries worldwide, at least 19 in the Asia Pacific region.

WHO director Margaret Chan said experts were still looking for ways to deal with the virus.

Zika virus: The outbreak in Asia

'New outbreaks'

In a report released on Monday at its annual meeting in Manila, the WHO said it is "highly likely that the region will continue to report new cases and possibly new outbreaks of Zika".

This is because the carrier of the disease - the Aedes mosquito - is widely found in the region, which also sees a high volume of travel.

There is also still uncertainty about the level of immunity in the regional population, the report added.

"Unfortunately, scientists do not yet have answers to many critical questions [about Zika]," Ms Chan said at the meeting.

Though the virus is known to have existed in Asia for decades, she noted that the first sign of its presence in some countries came from travellers whose Zika infections were only confirmed once they returned home.

"Is this weak surveillance, an indication of population-wide immunity, or proof that the virus has somehow acquired greater epidemic potential?" she asked.

Zika generally has mild effects but is more dangerous for pregnant women as it has been linked to severe birth defects, including the brain deformation microcephaly.

The latest large-scale outbreak originated in Brazil. </s> The outbreak and the warnings come as a potential blow to tourism in one of the world's busiest travel hubs, which is already struggling to recover from a slump amid tepid global growth.

Singapore reported its first case of locally-transmitted Zika at the weekend, and the number of reported infections of the mosquito-borne virus has since jumped to 56. At least three dozen of those have since made a full recovery.

The Zika virus was detected in Brazil last year and has since spread across the Americas. It poses a risk to pregnant women because it can cause severe birth defects. It has been linked in Brazil to more than 1,800 cases of microcephaly, a rare birth defect where babies are born with abnormally small heads and brains.

The 56 confirmed cases in Singapore include only one woman.

Taiwan, Australia and South Korea advised pregnant women and those planning pregnancy to postpone trips to Singapore. Those returning from the country should avoid pregnancy for two months. South Korean travelers will receive text messages with the warning when they arrive in Singapore.

Malaysia and Indonesia, Singapore's closest neighbors, have stepped up protective measures following the outbreak, introducing thermal scanners at airports and border checkpoints.

Singapore's Tourism Board said it was monitoring developments, adding the city state remained a "safe travel destination", and it was premature to consider any impact.

More than 55 million people pass through Singapore's Changi airport every year. In the first half of this year, tourism arrivals reached almost 8.2 million, compared with around 7.3 million in the same period of last year.

Online retailer Lazada Singapore said on Tuesday it has seen sales of mosquito repellent and other deterrent products rise fivefold over the past three days compared to a week ago.

Authorities continued to inspect thousands of homes in seven parts of Singapore, including five foreign worker dormitories, on Tuesday. Officials sprayed insecticide and removed potential mosquito breeding habitats such as stagnant water and moist dirt from drains.

The majority of those infected with Zika in Singapore were foreign workers, but the government has not disclosed their nationalities. The High Commission of Bangladesh, which represents the largest community of foreign workers, said none of the workers were Bangladeshis.

The Chinese and Myanmar embassies in Singapore said they had not been notified by Singapore whether their citizens were among those infected. The Thai embassy did not immediately return a call seeking comment.

Foreign workers in Singapore, employed mostly in the construction and marine industries, can earn as little as S$2 ($1.47) an hour, often work 12-14 hours a day and take few days off. They are unlikely to travel often.

The GuocoLand construction site, where the infected workers were found, remained closed on Tuesday morning, according to a Reuters photographer at the scene. It was ordered on Sunday to halt work and rectify the conditions that allowed mosquitoes to breed.

Regional health experts said the Zika virus is likely to be significantly under-reported across tropical Southeast Asia as local health authorities fail to conduct adequate screening. </s> SINGAPORE, Aug 30 (Reuters) - The number of confirmed cases of Zika virus in Singapore rose to 82 on Tuesday, with some of the latest infections detected beyond the area of the initial outbreak.

Several countries advised pregnant women or those trying to conceive to avoid travelling to the city-state.

The mosquito-borne Zika virus was detected in Brazil last year and has since spread across the Americas. It poses a risk to pregnant women as it can cause severe birth defects. It has been linked in Brazil to more than 1,800 cases of microcephaly, a rare birth defect where babies are born with abnormally small heads and brains.

At least five of 26 new cases confirmed late on Tuesday were detected outside the initial cluster in the Aljunied area in the southeast of Singapore, the health ministry and National Environment Agency (NEA) said in a joint statement.

Australia, Taiwan and South Korea issued travel warnings, and Singapore advised pregnant women to take a free Zika test if they showed any symptoms or if their partners tested positive.

"This is regardless of whether they have been to Zika-affected areas," the statement said.

The outbreak and advisories come as the tourism industry in one of the world's busiest travel hubs already faces weak global economic growth. Singapore's Tourism Board said it was premature to consider any impact on the sector, adding it remained a "safe travel destination".

More than 55 million people pass through Singapore's Changi airport every year. In the first half of this year, tourism arrivals topped 8 million, around 1 million more than a year earlier.

Singapore reported its first case of locally-transmitted Zika at the weekend, and the number of confirmed infections has risen steadily since then. At least three dozen patients have made a full recovery.

Neighbouring Malaysia and Indonesia have stepped up protective measures, introducing thermal scanners at airports and border checkpoints with the island state.

Singapore residents responded to government calls to be vigilant and to take precautions against mosquito bites.

Online retailer Lazada Singapore said sales of insect repellents jumped fivefold in the past three days. FairPrice supermarkets and Watsons pharmacies said their sales of such products had doubled.

Most of the early infections were among foreign workers, hundreds of thousands of whom, mainly from the Asian sub-continent, work on Singapore's construction sites and in the marine sector.

The Singapore government has not said where the infected foreign workers are from. The foreign ministry directed queries to the health ministry, which did not respond to Reuters questions on the issue. The Ministry of Manpower also did not respond to a request for comment made outside working hours.

The High Commission of Bangladesh, which represents the largest community of foreign workers, said none of those infected were Bangladeshis, and the Thai foreign ministry said none were from Thailand. The embassies of China, India, Sri Lanka and Myanmar said they had not been notified by Singapore whether their citizens were among those infected.

Authorities inspected thousands of homes in seven parts of Singapore, including five foreign worker dormitories, spraying insecticide and removing potential mosquito breeding habitats.

The NEA has inspected about 5,000 premises in and around the initial outbreak area, issuing 400 notices to owners of buildings they could not access. The NEA can force entry into those premises if needed. </s> Both Zika, which is of particular risk to pregnant women, and the dengue virus are spread by the Aedes aegypti mosquito, which is common in tropical Malaysia, Southeast Asia's third largest economy, and across the region.

Neighboring Singapore has reported more than 200 cases of Zika.

Three days ago, Malaysia reported its first Zika infection - a woman living near Kuala Lumpur who contracted the virus during a visit to Singapore.

On Saturday, Malaysian authorities said they had detected the first local infection: a 61-year-old man in the city of Kota Kinabalu, in the Malaysian part of Borneo island.

"The confirmation of the second case of Zika in Kota Kinabalu suggests that the virus is already present within our communities," Health Minister Subramaniam Sathasivam said.

"Zika is present in our country. New cases will continue to emerge," he posted on his Facebook page.

Zika infections in pregnant women have been shown to cause microcephaly - a severe birth defect in which the head and brain are undersized - as well as other brain abnormalities.

The connection between Zika and microcephaly first came to light last fall in Brazil, which has since confirmed more than 1,800 cases of microcephaly.

In adults, Zika infections have also been linked to a rare neurological syndrome known as Guillain-Barre, as well as other neurological disorders.

Since reporting its first Zika infection, Malaysia has increased insecticide spraying to kill mosquitoes. It has also stepped up health checks at its main border with Singapore, through which 200,000 people pass daily.

Malaysia, with a population of almost 30 million and a size 46 times bigger than Singapore, faces a much more challenging fight against Zika, doctors say.

"Zika will spread even faster in Malaysia than Singapore because our Aedes volume is so much higher and the breeding grounds are enormous," said Amar Singh, head of the paediatric department at Hospital Raja Permaisuri Bainun in the Malaysian town of Ipoh.

The World Health Organisation (WHO) ranks Malaysia's healthcare system as the world's 49th most developed. Singapore figures in the top 10.

There is no vaccine or treatment for Zika, which is a close cousin of dengue and chikungunya and causes mild fever, rash and red eyes. An estimated 80 percent of people infected have no symptoms, making it difficult for pregnant women to know whether they have been infected.

The WHO has declared the Zika outbreak an international health emergency, and if Malaysia's fight against dengue is any indication, it will struggle with Zika.

Malaysia recorded a total of 120,836 dengue cases last year, including 336 fatalities - the most since 1995, according to government data. This year, there have been 75,000 dengue cases and 166 fatalities.

Malaysian authorities say dengue is a bigger problem than Zika.

But regional health experts believe Zika is significantly under-reported in Southeast Asia as authorities fail to conduct adequate screening and also because of its usually mild symptoms.

The WHO lists Indonesia, Thailand, the Philippines and Vietnam as countries with "possible endemic transmission or evidence of local mosquito-borne Zika infections in 2016".

The virus was first identified in Uganda in 1947 and was unknown in the Americas until 2014. </s> Hong Kong (CNN) The Zika virus is on a rampage in Singapore, with 82 locally-transmitted cases confirmed late Tuesday by the country's Ministry of Health (MOH).

The MOH warns that the figures are likely set to rise, but why is Zika spreading so fast in the city state?

"The proportion of our population that are immune to the Zika virus is likely to be low in Singapore and if you don't have the immunity to provide the roadblocks, then it's likely that the virus will spread fast," Ooi Eng Eong, the deputy director of the Emerging Infectious Disease program at Duke-NUS Medical School in Singapore, told CNN.

Everything you need to know about Zika

Everything you need to know about Zika 01:42

Everything you need to know about Zika

The majority of reported cases are among foreign construction workers based in the residential Aljunied Crescent neighborhood in Singapore. Though cases were limited to this area on Monday, by late Tuesday the MOH reported 26 new cases that showed how the Zika virus had spread to nearby residential areas, raising concerns that the virus could travel even further afield.

While Malaysia and Indonesia announced they would be implementing additional passenger screening procedures at its airports, foreign ministries in the US, Australia, Taiwan and South Korea have all issued alerts, advising pregnant women against traveling to Singapore.

Singapore is known to suffer widely from dengue virus, a mosquito-borne tropical disease that triggers high fevers, headaches, vomiting and skin rashes in those infected.

In 2016, the MOH announced that it expected as many as 30,000 cases in the country.

Ooi explained that the Zika virus' rapid spread in Singapore was likely down to its similarities with the dengue virus.

"Zika is very closely related to dengue. It has all the genetic traits that would allow it to spread where dengue thrives -- the virus can infect and spread through the same Aedes aegypti mosquitoes that spread dengue virus," said Ooi.

With its 5.7 million-strong population packed mostly in crowded urban areas, containing Zika's spread in Singapore is a challenge.

"In Singapore, many people live in densely packed apartment blocks so it's easy for high numbers of people to get infected even if there are only a few mosquitoes flying around," explained Ooi.

As of August 29, Singapore's MOH had screened roughly 5,000 premises out of an estimated 6,000 in the Aljunied Crescent neighborhood to check for mosquito breeding grounds. So far, the agency has detected and destroyed 39 breeding habitats.

The MOH is also urging local residents to play an active role in stopping Zika's spread by distributing information leaflets and advising residents to apply repellent as a precaution.

Jaspar Fuk-Woo Chan, an infectious disease specialist and assistant professor at the University of Hong Kong, supported the MOH's efforts to reduce Zika's spread in Singapore.

"The government are making information on the Zika virus' spread readily available. They've also reacted very quickly to the first local cases by collecting information on the infected people," Chan told CNN.

He added, however, that it would take several weeks to grasp the extent of the outbreak. In the meantime, efforts to curb Zika's spread in the city state, he said, hinged on all citizens using insect repellent and making sure there were no potential mosquito breeding areas around their residential areas.

'Repellents are flying off the shelves'

In a joint statement released Wednesday, Singapore's MOH and the the Clinical Advisory Group (CAG) advised all pregnant women with symptoms of Zika, or with Zika-positive male partners to be tested for the infection.

But not every woman is letting the recent outbreak get to them.

"I'm conscious that I have to be more careful now," Su San, a 30-year-old mother trying for a second child, told CNN. "I'm applying ointments so that I don't get bitten, but I haven't put my plans to have another child on hold."

Rather than locking herself indoors, San said she would avoid areas like parks where mosquitoes were likely to be, and spend recreational time in libraries and museums instead.

For others, the Zika outbreak in Singapore has become an unlikely boon.

Theodore Khng, CEO of mosquito repellent startup Theo10, told CNN that sales of his natural deet-free product had tripled in the last three days.

Khng initially manufactured his product to combat mosquitoes carrying the dengue virus, but admitted that the recent Zika scare had boosted sales.

"People who have used the products before have been buying in bulk for others," said Khng. "The repellents are flying off the shelves." </s> Singapore has so far detected more than 280 Zika infections since reporting its first case on Aug. 27.

Zika infections in pregnant women have been shown to cause microcephaly - a severe birth defect in which the head and brain are undersized - as well as other brain abnormalities. The connection between Zika and microcephaly first came to light last fall in Brazil, which has since confirmed more than 1,800 cases of the birth defect.

In adults, Zika infections have also been linked to a rare neurological syndrome known as Guillain-Barre, as well as other neurological disorders.

An analysis of two locally infected patients showed the Zika strain in Singapore likely evolved from a strain already circulating in Southeast Asia since the 1960s, the Straits Times newspaper said on its website.

The analysis will be made available for the benefit of the global scientific community, including the World Health Organization (WHO), the newspaper said.

On Wednesday, the WHO updated its assessment of the Zika virus as a cause of congenital brain abnormalities in babies and the Guillian-Barre syndrome, after considering months of research into the mosquito-borne disease.
The Zika virus outbreak in Singapore which has infected over 200 people likely evolved from Southeast Asia.