• 1.

    Petersen LR , Jamieson DJ , Powers AM , Honein MA , 2016. Zika virus. N Engl J Med 374: 15521563.

  • 2.

    Cao-Lormeau VM , Roche C , Teissier A , Robin E , Berry AL , Mallet HP , Sall AA , Musso D , 2014. Zika virus, French Polynesia, South Pacific, 2013. Emerg Infect Dis 20: 10851086.

    • Search Google Scholar
    • Export Citation
  • 3.

    Duffy MR et al., 2009. Zika virus outbreak on Yap Island, Federated States of Micronesia. N Engl J Med 360: 25362543.

  • 4.

    Campos GS , Bandeira AC , Sardi SI , 2015. Zika virus outbreak, Bahia, Brazil. Emerg Infect Dis 21: 18851886.

  • 5.

    Lourenço J , de Lourdes Monteiro M , Valdez T , Monteiro Rodrigues J , Pybus O , Rodrigues Faria N , 2018. Epidemiology of the Zika virus outbreak in the Cabo Verde Islands, West Africa. PLoS Curr 10: ecurrents.outbreaks.19433b1e4d007451c691f138e1e67e8c.

    • Search Google Scholar
    • Export Citation
  • 6.

    Schuler-Faccini L et al., 2016. Possible association between Zika virus infection and microcephaly: Brazil, 2015. MMWR Morb Mortal Wkly Rep 65: 5962.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 7.

    World Health Organization , 2019. Zika Epidemiology Update. Available at: https://www.who.int/emergencies/diseases/zika/zika-epidemiology-update-july-2019.pdf. Accessed January 13, 2021.

  • 8.

    Musso D , Ko AI , Baud D , 2019. Zika virus infection: after the pandemic. N Engl J Med 381: 14441457.

  • 9.

    Marchette NJ , Garcia R , Rudnick A , 1969. Isolation of Zika virus from Aedes aegypti mosquitoes in Malaysia. Am J Trop Med Hyg 18: 411415.

  • 10.

    Malaysia Ministry of Health , 2019. Updated Zika Alert. Putrajaya, Malaysia: Malaysia Ministry of Health.

  • 11.

    Mudin RN , 2015. Dengue incidence and the prevention and control program in Malaysia. IIUM Med J Malaysia 14: 59.

  • 12.

    Lam SK , Chua KB , Hooi PS , Rahimah MA , Kumari S , Tharmaratnam M , Chuah SK , Smith DW , Sampson IA , 2001. Chikungunya infection: an emerging disease in Malaysia. Southeast Asian J Trop Med Public Health 32: 447451.

    • Search Google Scholar
    • Export Citation
  • 13.

    Buathong R et al., 2015. Detection of Zika virus infection in Thailand, 2012–2014. Am J Trop Med Hyg 93: 380383.

  • 14.

    Singapore Zika Study Group , 2017. Outbreak of Zika virus infection in Singapore: an epidemiological, entomological, virological, and clinical analysis. Lancet Infect Dis 17: 813821.

    • Search Google Scholar
    • Export Citation
  • 15.

    Woon YL , Lim MF , Tg Abd Rashid TR , Thayan R , Chidambaram SK , Syed Abdul Rahim SS , Mudin RN , Sivasampu S , 2019. Zika virus infection in Malaysia: an epidemiological, clinical and virological analysis. BMC Infect Dis 19: 152.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 16.

    Gallian P , Cabié A , Richard P , Paturel L , Charrel RN , Pastorino B , Leparc-Goffart I , Tiberghien P , de Lamballerie X , 2017. Zika virus in asymptomatic blood donors in Martinique. Blood 129: 263266.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 17.

    Ngwe Tun MM et al., 2018. Detection of Zika virus infection in Myanmar. Am J Trop Med Hyg 98: 868871.

  • 18.

    Reiter D , 2019. Zika Virus Returns to Malaysia. Zika News. Available at: https://www.zikanews.com/malaysian-perak-health-department-confirmed-man-has-been-infected-zika-virus. Accessed March 13, 2021.

  • 19.

    Whiteman A et al., 2020. Do socioeconomic factors drive Aedes mosquito vectors and their arboviral diseases? A systematic review of dengue, chikungunya, yellow fever, and Zika virus. One Health 11: 100188.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 20.

    Khor GL , Shariff ZM , 2019. Do not neglect the indigenous peoples when reporting health and nutrition issues of the socio-economically disadvantaged populations in Malaysia. BMC Public Health 19: 1685.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 21.

    Tay ST , Mohamed Zan HA , Lim YAL , Ngui R , 2013. Antibody prevalence and factors associated with exposure to Orientia tsutsugamushi in different aboriginal subgroups in west Malaysia. PLoS Negl Trop Dis 7: e2341.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 22.

    Dick GW , Kitchen SF , Haddow AJ , 1952. Zika virus: I. Isolations and serological specificity. Trans R Soc Trop Med Hyg 46: 509520.

  • 23.

    Wolfe ND , Kilbourn AM , Karesh WB , Rahman HA , Bosi EJ , Cropp BC , Andau M , Spielman A , Gubler DJ , 2001. Sylvatic transmission of arboviruses among Bornean orangutans. Am J Trop Med Hyg 64: 310316.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 24.

    Khor CS et al., 2019. Serological evidences of DENV, JEV and ZIKV among the indigenous people (Orang Asli) of Peninsular Malaysia. J Med Virol 92: 956965.

    • Search Google Scholar
    • Export Citation
  • 25.

    Dhanoa A et al., 2018. Seroprevalence of dengue among healthy adults in a rural community in southern Malaysia: a pilot study. Infect Dis Poverty 7: 1.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 26.

    Tiong V , Abd-Jamil J , Mohamed Zan HA , Abu-Bakar RS , Ew CL , Jafar FL , Nellis S , Fauzi R , AbuBakar S , 2015. Evaluation of land cover and prevalence of dengue in Malaysia. Trop Biomed 32: 587597.

    • Search Google Scholar
    • Export Citation
  • 27.

    Abd-Jamil J , Ngui R , Nellis S , Fauzi R , Lim ALY , Chinna K , Khor C-S , AbuBakar S , 2020. Possible factors influencing the seroprevalence of dengue among residents of the forest fringe areas of Peninsular Malaysia. J Trop Med 2020: 1019238.

    • Search Google Scholar
    • Export Citation
  • 28.

    Rabe IB , Staples JE , Villanueva J , Hummel KB , Johnson JA , Rose L , Hills S , Wasley A , Fischer M , Powers AM , 2016. Interim guidance for interpretation of Zika virus antibody test results. MMWR Morb Mortal Wkly Rep 65: 543546.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 29.

    World Health Organization , 2016. WHO Statement on the First Meeting of the International Health Regulations (2005) (IHR 2005) Emergency Committee on Zika Virus and Observed Increase in Neurological Disorders and Neonatal Malformations. Available at: http://www.who.int/mediacentre/news/statements/2016/1st-emergency-committee-zika/en/. Accessed June 22, 2020.

  • 30.

    Sam IC , Montoya M , Chua CL , Chan YF , Pastor A , Harris E , 2019. Low seroprevalence rates of Zika virus in Kuala Lumpur, Malaysia. Trans R Soc Trop Med Hyg 113: 678684.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 31.

    Teoh B-T , Sam S-S , Tan K-K , Johari J , Shu M-H , Danlami MB , Abd-Jamil J , MatRahim N , Mahadi NM , AbuBakar S , 2013. Dengue virus type 1 clade replacement in recurring homotypic outbreaks. BMC Evol Biol 13: 213.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 32.

    Tan KK , Nellis S , Zulkifle NI , Sulaiman S , AbuBakar S , 2018. Autochthonous spread of DENV-3 genotype III in Malaysia mitigated by pre-existing homotypic and heterotypic immunity. Epidemiol Infect 146: 16351641.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 33.

    Wong S-S , Abd-Jamil J , Abubakar S , 2007. Antibody neutralization and viral virulence in recurring Dengue virus type 2 outbreaks. Viral Immunol 20: 359368.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 34.

    World Health Organization , 2016. Zika Virus Disease: Interim Case Definition. Available at: https://apps.who.int/iris/handle/10665/204381. Accessed April 9, 2020.

  • 35.

    World Health Organization , Institut Pasteur , 2016. Standardized Protocol: Cross-sectional Seroprevalence Study of Zika Virus Infection in the General Population. Available at: https://www.who.int/publications/i/item/WHO-ZIKV-PHR-16.1. Accessed January 22, 2020.

  • 36.

    Tappe D , Nachtigall S , Kapaun A , Schnitzler P , Günther S , Schmidt-Chanasit J , 2015. Acute Zika virus infection after travel to Malaysian Borneo, September 2014. Emerg Infect Dis 21: 911913.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 37.

    Nguyen CT et al., 2020. Prevalence of Zika virus neutralizing antibodies in healthy adults in Vietnam during and after the Zika virus epidemic season: a longitudinal population-based survey. BMC Infect Dis 20: 332.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 38.

    Pastorino B , Sengvilaipaseuth O , Chanthongthip A , Vongsouvath M , Souksakhone C , Mayxay M , Thirion L , Newton PN , de Lamballerie X , Dubot-Pérès A , 2019. Low Zika virus seroprevalence in Vientiane, Laos, 2003–2015. Am J Trop Med Hyg 100: 639642.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 39.

    Chien YW , Ho TC , Huang PW , Ko NY , Ko WC , Perng GC , 2019. Low seroprevalence of Zika virus infection among adults in southern Taiwan. BMC Infect Dis 19: 884.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 40.

    Kisuya B , Masika MM , Bahizire E , Oyugi JO , 2019. Seroprevalence of Zika virus in selected regions in Kenya. Trans R Soc Trop Med Hyg 113: 735739.

  • 41.

    Netto EM et al., 2017. High Zika virus seroprevalence in Salvador, northeastern Brazil limits the potential for further outbreaks. MBio 8: 6.

  • 42.

    Langerak T et al., 2019. Zika virus seroprevalence in urban and rural areas of Suriname, 2017. J Infect Dis 220: 2831.

  • 43.

    Lee BY , Alfaro-Murillo JA , Parpia AS , Asti L , Wedlock PT , Hotez PJ , Galvani AP , 2017. The potential economic burden of Zika in the continental United States. PLoS Negl Trop Dis 11: e0005531.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 44.

    Malaysia Ministry of Health , 2021. Current Situation for Dengue, Zika and Chikungunya in Malaysia for 2021. Putrajaya, Malaysia: Malaysia Ministry of Health.

    • Search Google Scholar
    • Export Citation
  • 45.

    Haby MM , Pinart M , Elias V , Reveiz L , 2018. Prevalence of asymptomatic Zika virus infection: a systematic review. Bull World Health Organ 96: 402413D.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 46.

    Dejnirattisai W et al., 2016. Dengue virus sero-cross-reactivity drives antibody-dependent enhancement of infection with Zika virus. Nat Immunol 17: 11021108.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 47.

    Robbiani DF et al., 2017. Recurrent potent human neutralizing antibodies to Zika virus in Brazil and Mexico. Cell 169: 597609.e11.

  • 48.

    Collins MH , McGowan E , Jadi R , Young E , Lopez CA , Baric RS , Lazear HM , de Silva AM , 2017. Lack of durable cross-neutralizing antibodies against Zika virus from Dengue virus infection. Emerg Infect Dis 23: 773781.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 49.

    Chew CH et al., 2016. Rural–urban comparisons of dengue seroprevalence in Malaysia. BMC Public Health 16: 824.

  • 50.

    Roehrig JT , Hombach J , Barrett ADT , 2008. Guidelines for plaque-reduction neutralization testing of human antibodies to dengue viruses. Viral Immunol 21: 123132.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 51.

    Saba Villarroel PM et al., 2018. Zika virus epidemiology in Bolivia: a seroprevalence study in volunteer blood donors. PLoS Negl Trop Dis 12: e0006239.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 52.

    Gake B , Vernet MA , Leparc-Goffart I , Drexler JF , Gould EA , Gallian P , de Lamballerie X , 2017. Low seroprevalence of Zika virus in Cameroonian blood donors. Braz J Infect Dis 21: 481483.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 53.

    Nurtop E et al., 2018. Combination of ELISA screening and seroneutralisation tests to expedite Zika virus seroprevalence studies. Virol J 15: 192.

  • 54.

    Pond WL , 1963. Arthropod-borne virus antibodies in sera from residents of South-East Asia. Trans R Soc Trop Med Hyg 57: 364371.

  • 55.

    Johnson BK , Chanas AC , Gardner P , Simpson DI , Shortridge KF , 1979. Arbovirus antibodies in the human population of Hong Kong. Trans R Soc Trop Med Hyg 73: 594596.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 56.

    Counotte MJ , Althaus CL , Low N , Riou J , 2019. Impact of age-specific immunity on the timing and burden of the next Zika virus outbreak. PLoS Negl Trop Dis 13: e0007978.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 57.

    Shahar S , Vanoh D , Mat Ludin AF , Singh DKA , Hamid TA , 2019. Factors associated with poor socioeconomic status among Malaysian older adults: an analysis according to urban and rural settings. BMC Public Health 19: 549.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 58.

    Khor GL , Mohd Shariff Z , 2008. The Ecology of health and nutrition of “Orang Asli” (indigenous people) women and children in Peninsular Malaysia. Tribes Tribals 2: 6777.

    • Search Google Scholar
    • Export Citation
  • 59.

    Loong SK , Khor CS , Chen HW , Chao CC , Ling ISC , Abdul Rahim NF , Hassan HS , Nellis S , Ching WM , AbuBakar S , 2018. Serological evidence of high Leptospira exposure among indigenous people (Orang Asli) in Peninsular Malaysia using a recombinant antigen-based ELISA. Trop Biomed 35: 19.

    • Search Google Scholar
    • Export Citation
  • 60.

    Yong M-Y , Lee S-C , Ngui R , Lim YA-L , Phipps ME , Chang L-Y , 2020. Seroprevalence of Nipah virus infection in Peninsular Malaysia. J Infect Dis 221: S370S374.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 61.

    Ngui R , Lim YAL , Amir NFH , Nissapatorn V , Mahmud R , 2011. Seroprevalence and sources of toxoplasmosis among Orang Asli (indigenous) communities in Peninsular Malaysia. Am J Trop Med Hyg 85: 660666.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 62.

    Vellymalay SKN , 2013. Relationship between Malay parents’ socioeconomic status and their involvement in their children’s education at home. J Soc Sci Hum 8: 90108.

    • Search Google Scholar
    • Export Citation
  • 63.

    Gregorio ER Jr , Medina JRC , Lomboy M , Talaga ADP , Hernandez PMR , Kodama M , Kobayashi J , 2019. Knowledge, attitudes, and practices of public secondary school teachers on Zika virus disease: a basis for the development of evidence-based Zika educational materials for schools in the Philippines. PLoS One 14: e0214515.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 64.

    Ratanawong P , Kittayapong P , Olanratmanee P , Wilder-Smith A , Byass P , Tozan Y , Dambach P , Quiñonez CAM , Louis VR , 2016. Spatial variations in dengue transmission in schools in Thailand. PLoS One 11: e0161895.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 65.

    Wilder-Smith A et al., 2012. DengueTools: innovative tools and strategies for the surveillance and control of dengue. Glob Health Action 5: 17273.

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Seroprevalence of Zika Virus among Forest Fringe Communities in Peninsular Malaysia and Sabah: General Population-Based Study

Hooi-Yuen KhooTropical Infectious Diseases Research & Education Centre, Higher Institution Centre of Excellence, University Malaya, Kuala Lumpur, Malaysia;

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Hai-Yen LeeTropical Infectious Diseases Research & Education Centre, Higher Institution Centre of Excellence, University Malaya, Kuala Lumpur, Malaysia;

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Chee-Sieng KhorTropical Infectious Diseases Research & Education Centre, Higher Institution Centre of Excellence, University Malaya, Kuala Lumpur, Malaysia;

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Kim-Kee TanTropical Infectious Diseases Research & Education Centre, Higher Institution Centre of Excellence, University Malaya, Kuala Lumpur, Malaysia;

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Mohd Rohaizat bin HassanDepartment of Community Health, Faculty of Medicine, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia;

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Chin Mun WongDepartment of Community Health, Faculty of Medicine, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia;

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Hani Kartini AgustarDepartment of Earth Sciences and Environment, Faculty of Science & Technology, University Kebangsaan Malaysia, Selangor, Malaysia;

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Nadia Aqilla SamsusahDepartment of Earth Sciences and Environment, Faculty of Science & Technology, University Kebangsaan Malaysia, Selangor, Malaysia;

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Syed Sharizman Syed Abdul RahimFaculty of Medicine and Health Sciences, University Malaysia Sabah, Sabah, Malaysia;

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Mohd Saffree bin JeffreeFaculty of Medicine and Health Sciences, University Malaysia Sabah, Sabah, Malaysia;

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Nur Athirah YusofBiotechnology Research Institute, University Malaysia Sabah, Sabah, Malaysia;

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Noor Ain HaronBiotechnology Research Institute, University Malaysia Sabah, Sabah, Malaysia;

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Zarina binti AminBiotechnology Research Institute, University Malaysia Sabah, Sabah, Malaysia;

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Rozita HodDepartment of Community Health, Faculty of Medicine, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia;

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Sazaly AbuBakarTropical Infectious Diseases Research & Education Centre, Higher Institution Centre of Excellence, University Malaya, Kuala Lumpur, Malaysia;
Department of Medical Microbiology, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia

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ABSTRACT.

Zika virus (ZIKV) has had a history in Malaysia since its first isolation in 1966. However, it is believed that the immunity status among forest fringe communities has been underreported. We conducted cross-sectional surveillance of forest fringe communities from 10 Orang Asli villages and their peripheral communities in Perak, Pahang, and Sabah in Malaysia. A total of 706 samples were collected from 2019 to 2020 and screened for ZIKV exposure using an anti-ZIKV IgG ELISA kit. A neutralization assay against ZIKV was used to confirm the reactive samples. The seroprevalence results reported from the study of this population in Malaysia were 21.0% (n = 148, 95% CI, 0.183–0.273) after confirmation with a foci reduction neutralization test. The presence of neutralizing antibodies provides evidence that the studied forest fringe communities in Malaysia have been exposed to ZIKV. Multivariate analysis showed that those older than 44 years and those with an education below the university level had been exposed significantly to ZIKV. In addition, higher seropositivity rates to ZIKV were also reported among secondary school students from Bentong (Pahang) and residents from Segaliud (Sabah). No associations were identified between Zika seropositivity and gender, household size, house radius to the jungle, and income level. The presence of neutralizing antibodies against ZIKV among the study population might indicate that the causative pathogen had already circulated widely in forest fringe regions. Intervention for vector control, protection from mosquito bites, and awareness improvement should be encouraged in this population.

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Author Notes

Address correspondence to Hai-Yen Lee or Sazaly AbuBakar Tropical Infectious Diseases Research & Education Centre (TIDREC), Level 2, High Impact Research Building, Universiti Malaya, 50603, Kuala Lumpur, Malaysia. E-mails: leehaiyen@um.edu.my or sazaly@um.edu.my

These authors contributed equally to this work.

Financial support: This research received funding from the Long-Term Research Grant Scheme (LRGS MRUN/F1/01/2018), the Higher Institution Centre of Excellent program (MO002-2019) from the Ministry of Education Malaysia, and University Malaya Graduate Research Assistant Scheme (GRAS).

Authors’ addresses: Hooi-Yuen Khoo, Hai-Yen Lee, Chee-Sieng Khor, and Kim-Kee Tan, Tropical Infectious Diseases Research & Education Centre, Higher Institution Centre of Excellence, University Malaya, Kuala Lumpur, Malaysia, E-mails: hooiyuenkhoo@um.edu.my, leehaiyen@um.edu.my, khor_cs@um.edu.my, and kimkee@um.edu.my. Mohd Rohaizat bin Hassan, Chin Mun Wong, and Rozita Hod, Department of Community Health, Faculty of Medicine, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia, E-mail: rohaizat@ppukm.ukm.edu.my, chinmun@yahoo.com, and rozita.hod@ppukm.ukm.edu.my. Hani Kartini Agustar and Nadia Aqilla Samsusah, Department of Earth Sciences and Environment, Faculty of Science & Technology, University Kebangsaan Malaysia, Selangor, Malaysia, E-mails: hani_ag@ukm.edu.my and nadiaaqilla94@gmail.com. Syed Sharizman Syed Abdul Rahim and Mohd Saffree bin Jeffree, Faculty of Medicine and Health Sciences, University Malaysia Sabah, Sabah, Malaysia, E-mails: syedsharizman@ums.edu.my and saffree@ums.edu.my. Nur Athirah Yusof, Noor Ain Haron, and Zarina binti Amin, Biotechnology Research Institute, University Malaysia Sabah, Sabah, Malaysia, E-mails: ym.ude.smu@fosuy.harihtarn, noorainharon@yahoo.com, and zamin@ums.edu.my. Sazaly AbuBakar, Tropical Infectious Diseases Research & Education Centre, Higher Institution Centre of Excellence, University Malaya, Kuala Lumpur, Malaysia, and Department of Medical Microbiology, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia, E-mail: sazaly@um.edu.my.

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