Molecular and Serological Detection of Zika Virus and Zika–Dengue Virus Coinfections in Febrile Patients in Sabah, Malaysia, 2019–2020

Zika virus (ZIKV) infection is a mosquito-borne disease produced by a virus of the Flaviviridae family. It can either be asymptomatic or cause mild febrile illness similar to dengue fever. This study collected 188 serum samples from acute febrile patients in Kota Kinabalu and Lahad Datu, Sabah, Malaysia. The ZIKV genome was detected in 13 (6.9%) patients, and among these, dengue virus (DENV) was detected by quantitative reverse transcription polymerase chain reaction in 6 (3.2%) patients. Thirty-seven patients (19.7%) tested positive for IgM against ZIKV, and 11 patients (5.9%) showed positive neutralization against ZIKV. The positive rate included 7 (3.7%) individuals with coinfection of ZIKV-DENV, 12 (6.4%) individuals with confirmed ZIKV, and 3 (1.6%) individuals with probable ZIKV. Our study concludes that ZIKV infection and DENV-ZIKV coinfection were detected among febrile patients in Kota Kinabalu, Sabah during 2019-2020. Therefore, a serosurveillance system is essential to determine the circulation of ZIKV in this area.