Epidemiological insights into the co-circulation of Zika and dengue viruses in Yangon, Myanmar (2017-2019)

Zika virus (ZIKV) is a mosquito-borne flavivirus mainly transmitted by Aedes aegypti and Aedes albopictus. While well-studied in the Americas, data from Southeast Asia, especially Myanmar, remain limited. This study assessed ZIKV infection among dengue-suspected patients in Yangon, Myanmar, from 2017 to 2019.

This was a cross-sectional retrospective study that collected serum samples from 1162 clinically dengue-suspected patients. Reverse transcription quantitative polymerase chain reaction (RT-qPCR) was used to detect ZIKV RNA and serological assays were used to identify ZIKV-specific immunoglobulin M (IgM), IgG and neutralizing antibodies. The age, gender, clinical manifestations and coinfections with dengue virus (DENV) were determined.

Of the 1162 samples, 23 (2.0%) were positive for ZIKV by RT-qPCR. Among these, nine samples showed coinfection with DENV: four with DENV-1, two with DENV-3 and three with DENV-4. Of the 111 (9.6%) samples that tested positive for ZIKV IgM, 11 (9.9%) had neutralizing antibodies against ZIKV, with 9 (8.1%) confirmed as ZIKV positive and 2 (1.8%) classified as probable cases.

Our study reported that 32 cases (2.8%) were confirmed as ZIKV infections by molecular and serological detection. The findings underscore the need for improved surveillance, diagnostic accuracy and public health interventions to mitigate the impact of ZIKV.