Zika Virus Infection - Proposed Management Strategies - 

Comment on  “Zika virus: a Review from the Virus Basics to Proposed Management Strategies”  (Mediterr J Hematol Infect Dis 2016)

Viroj Wiwanitkit

Visiting professor, Hainan Medical University, China; professor, senior expert, Surindra Rajabhat University, Thailand

Corresponding author: Professor Viroj Wiwanitkit, Wiwanitkit House, Bangkhae, Bangkok Thailand. E-mail: 

Published: March 1, 2017
Received: November 24, 2016
Accepted: January 20, 2017
Mediterr J Hematol Infect Dis 2017, 9(1): e2017016 DOI 10.4084/MJHID.2017.016
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Dear Editor,
I read the recent publication on Zika virus infection with great interest.  As noted by Zammarchi et al.[1] “it is advisable that the healthcare professionals working in non-endemic areas maintain full awareness on this issue in order to practice proper management of the imported cases of Zika virus infection”. There are many interesting issues for discussion. First, the importation of disease from one to the other setting is very complex. For Zika virus infection, the newly discovered methods of transmission make it more difficult in disease control. Sometimes, it might be hard to find the origin of the newly emerging infection in a new setting. In fact, the disease can be imported from any countries where there is the circulation of the virus and presence of competent vectors. It is not necessary that the disease has to be imported from the country already included in the list of endemic area. In Taiwan, the first imported case was from Thailand and Thailand was not in the list of the endemic area at that time.[2] Furthermore, the imported case can be asymptomatic and further silent transmission might occur. Second, not only awareness of the problem, the practitioner has to update the knowledge on the problem. Of interest, in the endemic area, it is still observed that the local medical personnel including to nurse, public health worker, and physician still have poor knowledge on the disease.[3] The continuous education system and regular competency check against any new emerging public health problem are required.


  1. Zammarchi L, Spinicci M, Bartoloni A. Zika Virus: a Review from the Virus Basics to Proposed Management Strategies. Mediterr J Hematol Infect Dis. 2016 Nov 1;8(1):e2016056. PMid:27872736  PMCid:PMC5111539    
  2. Wiwanitkit S, Wiwanitkit V. J Imported Thai patient with Zika virus to Taiwan: What else should be known and discussed? Formos Med Assoc. 2016 Sep;115(9):822. doi: 10.1016/j.jfma.2016.06.003.            
  3. Wiwanitkit S, Wiwanitkit V. Zika virus infection, do medical personnel know about the situation?. Ann Trop Med Public Health 2016;9:361-2.