Annex 1

SENARAI NEGARA YANG MELAPORKAN JANGKITAN VIRUS ZIKA

BAGI JANUARI 2016

Sehingga Januari 2016, sebanyak 24 negara melaporkan kes virus Zika.

Lampiran 1

1. CASE DEFINITION FOR ZIKA VIRUS INFECTION

Suspected case:
Patient with rash or fever (>37.5C) with one or more of the following symptoms (not
explained by other medical conditions):
- Arthralgia or myalgia
- Non-purulent conjunctivitis or conjunctival hyperemia
- Headache or malaise
- Presented with **Guillain-Barre Syndrome or microcephaly (age less than 1 year)
AND
Recent history of travelling to the country affected with Zika infection (within 7 days after
arrival) or history of *contact with confirm Zika case.

Confirmed case:
A suspected case with laboratory positive result for the specific detection of Zika virus (see
algorithm for laboratory diagnosis)

2. CASE DEFINITION FOR MICROCEPHALY

Diagnosed in utero or postnatally as microcephaly using standard growth chart by medical
profession

This case definition is developed based on the outbreak situation in Americas in 2015 -2016 that was reported to WHO.
(Available at http://www.who.int/mediacentre/news/statements/2016/emergency-committee-zika/en/). The case definition
has been adapted from Pan American Health Organization; Epidemiological Update, Zika Virus Infection, 16 October
2015 (Available at:
http://www.paho.org/hq/index.php?option=com_docman&task=doc_view&Itemid=270&gid=32021&lang=en), WHO; Zika
virus Fact sheet , Updated January 2016 . (Available at http://www.who.int/mediacentre/factsheets/zika/en/) and CDC,
Morbidity and Mortality Weekly Reports, 29 January 2016 / Vol. 65(3);5962. ( Available at
http://www.cdc.gov/mmwr/volumes/65/wr/mm6503e2.htm) and may be subject to further modifications as new
knowledge and information on the disease and the etiological agent is available.
*person who live in the same locality with the Suspected case or history of sexual intercourse with person who
had travelled to affected countries.
**Signs and symptoms of Guillain-Barre syndrome may include:

Prickling, "pins and needles" sensations in your fingers, toes, ankles or wrists
Weakness in your legs that spreads to your upper body

Unsteady walking or inability to walk or climb stairs

Difficulty with eye or facial movements, including speaking, chewing or swallowing
Severe pain that may feel achy or cramp-like and may be worse at night
Difficulty with bladder control or bowel function
Rapid heart rate

Low or high blood pressure

Difficulty breathing
People with Guillain-Barre syndrome usually experience their most significant weakness within two to four
weeks after symptoms begin. Recovery usually begins two to four weeks after weakness plateaus.
Reference:
(http://www.mayoclinic.org/diseases-conditions/guillain-barre-syndrome/basics/symptoms/con-20025832)

Lampiran 2A

CARTA ALIR UJIAN PENGESAHAN VIRUS ZIKA UNTUK SAMPEL DARI HOSPITAL

Suspected case or not explained by other medical conditions

(refer Case Definition; Lampiran 1)

Suitable samples for Zika Virus Investigation

(Serum, CSF, Plasma, Umbilical cord blood on its own in sterile containers;
Tissue samples in VTM/ saline) Send on Ice with Request Forms

Suspected case
(Serum, plasma)

Microcephaly case:
- Baby (Serum, plasma, CSF, Umbilical
cord blood)
- Mother (Serum, plasma)

Virology Unit
Infectious Diseases Research Centre
Institute for Medical Research
(Refer to IMR call list Lampiran 11)
Real Time RT-PCR for Zika Virus

Zika Virus RNA

Detected

(1) Report Results to

CPRC and hospitals

Viral
Isolation

Zika Virus RNA Not

Detected

Report Results to CPRC

and hospitals

(2) Further
characterization of virus
through genetic
sequencing

#Infants

with microcephaly- Please collect blood from

umbilical cord or directly from infant within 2 days of birth; or
placenta at delivery and maternal serum.
Ref: Center for Diseases Control MMWR Interim Guidelines
for the evaluation and testing of infants with possible
congenital Zika Virus Infection; 29 Jan 2016/65(3); 63-67

Virology Unit, IMR; 29 Jan 2016

Lampiran 2B
CARTA ALIR UJIAN PENGESAHAN VIRUS ZIKA UNTUK SAMPEL DARI KLINIK
KESIHATAN
A person with suspected Zika virus infection
Walk in patients
Referral from general practitioner/ other MOH Primary Healthcare facilities
Patient with Health Alert Card from Point of Entry

Primary triage
History taking
Travel history to Zika affected countries (Annex 1), AND
Symptoms (Lampiran1)

Clinical
assessment and
examination

Mild
Facilities without
doctors and
suspected Zika
infection

Facilities with doctor/ Family Medicine

Specialist

Severe
e.g. signs of
Guillain Barre
Syndrome

Based on clinical
judgement
Severity?
Mild

Take blood for zika virus and send to MKAK / MKA

Treat symptomatically
Notify nearest Direct Health Office
Self monitoring at home

Severe
e.g. signs of Guillain
Barre Syndrome

Refer to hospital

Lampiran 3

Zika1 /case/2016
NOTIFICATION FORM
FOR ZIKA VIRUS

Disease Control Division

Ministry Of Health Malaysia
1.Reporting Centre

Name of Hospital / Clinic:

Phone:

State:

Fax:

2. Information of Patient

E-mail:

Name:

Age:___yr ___mth

Address:

Phone (Home):
Ethnicity:

Nationality:
Malaysian

Non Malaysian
:

Occupation

3. Signs and Symptoms

Malay

Chinese

Indian

IC No:

Country of Origin:

Passport No:

Health Care Worker

Others, please state:

Fever
Rash

Conjuctivitis
Myalgia

Date of symptom onset

[dd/mm/yy] :

Malaise
Athralgia
Other symptoms, specify :

4. Is there any alternative diagnosis that can fully explain patient's illness?

Yes

Was patient hospitalised?

Clinical status at
time of report

Ward:

Yes

No

No

Progress:

Isolation ward
General ward
ICU

Yes, date: _________

Brought In Dead (BID)
Date:

If patient died: Was past mortem performed?

Male
Female

RN No:

Other, specify:

Temperature on admission: ____C

Gender:

On treatment, specify: _____

Died
Date :

Pending

Has the patient travelled to areas reporting confirmed cases of Zika virus prior to onset of symptoms
Yes

No

6. Exposure History
If yes, please specify:
Country visited:
Country/State/province visited

Duration of stay
From [dd/mm/yr]

Name of Airline & Flight No/Cruise/Other mode of transportation

To [dd/mm/yr]

1.
2.
3.
Date of return to Malaysia:

7. Similar illness
8. Diagnostic Evaluation

Entry point :

Anybody in the neighbourhood having similar illness?

Date taken

Date send to lab

Yes

No

Name of laboratory

Result

Virology
9. Working diagnosis: (please state)
10. Reporting Officer:

Signature:

Designation:

Date:

H/phone No:

For District Health Office use only

11. Active case finding

Has active case finding been initiated?

Number of people with similar illness:

Yes

No

12. Investigating Officer:

Designation:

No. of cases referred to hospital:

Number of cases isolated:
Signature:

Date:

H/Phone No:

For Disease Control Division use only

COMMENTS:

Lampiran 4
Zika 2/ microcephaly/ 2016
NOTIFICATION FORM
FOR MICROCEPHALY

Disease Control Division

Ministry Of Health Malaysia
1.Reporting Centre

Name of Hospital

Phone:

State:
Fax:

2. Information Mothers

E-mail:
Age:___yr ___mth

Name:

Address:

Phone (Home):
Ethnicity:

Nationality:
Malaysian

Non Malaysian

Chinese

Indian

Other, specify:

Postnatal Parity:

Occupation

Malay

Health Care Worker

RN No:
IC No:

State:

Passport No:
Date of delivery
[dd/mm/yy] :

Others, please state:

LSCS
3. Mode of delivery

SVD

4.Mother relevant medical history:

Baby weight:

5. Congenital abnormalities diagnosed by:

Name:

6. Congenital abnormalities (ICD10) codes

(based on ICD10 ) and diagnosis

Was baby hospitalised?

7.

Ward:

Progress:

Isolation ward
General ward
ICU

Yes, date: _________

Brought In Dead (BID)
Date:

Clinical status at
time of reporting

1.
2.
3.
4.
5.

If patient died: Was post mortem performed?

Yes

No

On treatment, specify: _____

Died
Date :

Pending

Has the mother travelled to areas reporting confirmed cases of Zika virus during her antenatal
Yes
8.. Exposure History

No

Date of travelling: From_________________ to _______________

If yes, please specify:
Country visited:

Country/State/province visited

Duration of stay
From [dd/mm/yr]

Name of Airline & Flight No/Cruise/Other mode of transportation

To [dd/mm/yr]

1.
2.
3.
Date of return to Malaysia:
9. Diagnostic Evaluation

Entry point :
Date taken

Date send to lab

Name of laboratory

Result

Virology
10. Working diagnosis: (please state)
11. Reporting Officer:
Designation:

Signature:
Date:

H/phone No:

For District Health Office use only

12. Investigating Officer:
Designation:

Signature:
Date:

H/Phone No:

For Disease Control Division use only

COMMENTS:

Lampiran 5

CARTA ALIR BAGI NOTIFIKASI PENYAKIT ZIKA

Notifikasi virus Zika dari

makmal swasta/makmal
universiti

notifikasi
Hospital
/ klinik
( kerajaan dan swasta)

Pejabat Kesihatan Daerah

MKAK
Sungai Buloh

Jabatan Kesihatan Negeri

Bilik Gerakan Vektor(Zika)di CPRC
Negeri
(Ketua Penolong Pengarah (Vektor)
Setiap Hari

Crisis Preparedness and

Response Centre, KKM
Pegawai Petugas CPRC
(03-88810700)(HP: 0136699700)(email:cprc@moh.gov.my)

Sektor Penyakit Bawaan Vektor, KKM

Dr Zailiza Binti Suli
(hp:0192745122 ;email: drzailiza@moh.gov.my)
Dr Izwan Effendy Bin Zainudin
(hp:0137798897;email:jdrizwan@moh.gov.my)
En Zuraime Bin Mohd Daud /
En Kamarulzaman Bin Daniel
email:bgvektor@moh.gov.my
( 03-88834340/ 4339)

Lampiran 6

PANDUAN PENJAGAAN PESAKIT ZIKA SEBAGAI PESAKIT LUAR

1. Kes yang menunjukkan gejala klinikal

Sekiranya berlaku satu kes Zika dan pesakit tidak dimasukkan ke dalam
wad, pegawai perubatan perlu memberi nasihat kepada pesakit iaitu
seperti berikut ;
Menghadkan pergerakan dan berada di rumah sehingga tanda-tanda
dan gejala telah tiada.
Menggunakan repellent, memakai baju berlengan panjang dan
berseluar panjang atau menggunakan kelambu untuk mengelakkan
daripada gigitan nyamuk.
Sekiranya pesakit mengidap gejala-gejala dan tanda-tanda GuillainBarre Syndrome yang dikaitkan dengan masalah sistem saraf,
dapatkan rawatan di hospital dengan kadar segera.
Makan ubat demam seperti paracetamol mengikut nasihat doktor.
Sponge atau lap badan dengan kain basah bagi mengurangkan suhu
badan.
Berehat secukupnya.
Minum banyak cecair seperti susu, jus buah-buahan, minuman
isotonik dan air barli ( minum melebihi 5 gelas). Meminum air kosong
sahaja tidak mencukupi.
Melakukan langkah pencegahan di rumah seperti aktiviti cari dan
musnah tempat-tempat pembiakan Aedes di dalam dan luar rumah
setiap minggu.
Menggunakan semburan aerosol, penghalau nyamuk seperti
lingkaran nyamuk, kepingan pengewapan cecair dan sebagainya.

Memasang jejaring pada tingkap untuk mengelakkan nyamuk masuk

ke dalam rumah.

2. Pelancong yang sihat tetapi mempunyai sejarah perjalanan ke negara

terlibat.

Bagi mereka yang tidak mempunyai gejala tetapi mempunyai sejarah

perjalanan ke negara yang terlibat dan datang untuk mendapat khidmat
nasihat, hendaklah diberi layanan dan nasihat yang sama seperti di
atas.
Walaupun masih banyak perkara yang tidak diketahui mengenai
penyakit Zika ini, tempoh viraemia dijangka adalah sama dengan
jangkitan denggi. Oleh itu tempoh lebih dari 4 minggu selepas kembali
ke tanah air dijangka tidak lagi berada dalam keadaan viraemia dan
tidak berisiko untuk menularkan jangkitan tersebut kepada orang lain.
Nasihat khusus hendaklah diberikan agar menangguhkan rancangan
untuk mendapatkan anak dan mengandung dalam tempoh sebulan dari
tarikh kepulangan dari negara terbabit. Jika masih ingin berbuat
demikian dalam tempoh tersebut, risiko dari keputusan tersebut
hendaklah dijelaskan sepenuhnya, memandangkan 80% mereka yang
dijangkiti tidak menunjukkan sebarang gejala dan terdapatnya laporan
bahawa jangkitan Zika boleh berlaku melalui hubingan seks. Ujian
pengesahan Zika disaran dilakukan dan sekalipun negatif, ia tidak
menolak risiko berlakunya komplikasi seperti microcpehaly

PREPAREDNESS AND RESPONSE AT POINTS OF ENTRY AGAINST ZIKA VIRUS

INFECTION

A. On board Announcements:
i.

All international flights arriving at Malaysian entry points, are required to conduct
an onboard health announcement on Zika virus infection. The script for the
announcement is attached as Annex 3.

ii.

The health announcement seeks cooperation from the passengers and crew who
have history of travel to the affected countries since the last seven (7) days to
present themselves to the Health Personnel at the Health screening area after
disembarking the aircraft.

B.

Passengers and crew who have history of travel to the affected countries are
required to report to Health Personnel at the Health Screening area at entry
point.
i.

At the Health Screening area/Health Quarantine Centre, passengers and crew

will be screened for Zika virus infection through history taking and examination
as detailed in Annex 4.

ii.

Cases suspected of Zika virus infection (Annex 5) will be referred to the nearest
health facilities for further management.

iii.

Cases not suspected of Zika virus infection will be provided with health advice
and issued with a Health Alert Card (HAC) as in Annex 6.

iv.

Passenger and crew details (name, citizenship, passport number/identification

number, contact details and address in Malaysia) will be submitted to the
relevant State Vector Officer for immediate implementation of surveillance and
prevention activities.

C. Suspected Zika virus case on-board flight/vessel/conveyance

i.

Public Health Teams, consisting of a medical doctor, Nurse/Medical Assistant and

Assistant Environmental Health Officer (PPKP) will be stationed at the arrival
gates.

ii. All passengers except cases suspected of Zika virus infection will be allowed to
disembark the aircraft/vessel/conveyance to proceed for fever screening.
Passengers and crew without symptoms will be provided a Health Alert Card
(HAC). The details of passengers and crew will be recorded for follow up actions
as required.
1

iii. The suspected case which have been identified by the crew will be interviewed
and history taking and physical examination will be conducted. Cases that do not
fulfil the case definition of a suspected case of Zika virus infection (Annex 2) will
be provided with health advice and issued with a HAC.
iv. Cases suspected of Zika virus infection will be referred to the nearest health facility
for further management.
v. Passenger and crew details (name, citizenship, passport number/identification
number, contact details and address in Malaysia) will be submitted to the relevant
State Vector Officer for immediate implementation of surveillance and prevention
activities.
vi. All cases of Zika virus infection are to be notified to the National and State CPRC
and the nearest District Health Office.

D.

Public Health Procedures on the aircraft/vessel/conveyance with a case

suspected of Zika virus infection on-board
i. When a case suspected of Zika virus infection is present on-board, an Assistant
Environmental Health Officer (PPKP) will immediately perform an inspection of the
aircraft /conveyance.
ii. Under Annex 5 (6), IHR 2005, a conveyance may be regarded as suspect and
should be inspected for vectors and reservoirs if;
a. it has a possible case of vector-borne disease on board;
b. a possible case of vector-borne disease has occurred on board during an
international voyage; or
c. it has left an affected area within a period of time where on-board vectors could
still carry disease.
iii. Confirming that the aircraft disinsection has been carried out by verifying the
evidence and validity and records of the disinsection procedures (eg. empty spray
can, residual disinsection certificate etc.).
iv. The health part of the Aircraft General Declaration or Ship Sanitation Control
Certificate (SSCC) is to be inspected. The presence of control measures used to
eradicate vectors should be included in the health part of the Aircraft General
Declaration or SSCC for vessel.
v. Instruct

the aircraft/vessel/conveyance to be disinsected by the

groundhandlers/competent officers who has been identified by the company and
to be supervised by the PPKP.

E. Awareness to public, passengers and crew on Zika virus

Heighten awareness on Zika virus, prevention and control measures such as:
i.

Distribution of education materials such as pamphlets, posters and Travel advisory

to passengers, crew, airport workers.

ii. Updated information on social media Website, Facebook (FB)

iii. Distribution of Health Alert Card (HAC) to passengers and crew with history of
visiting to Zika virus affected countries.
iv. Providing talks and briefings about the disease, mode of transmission and
prevention and control measures.
v. Health announcements and messages focused at public and tourist area and
especially at international airports and seaports

F. Vector surveillance, Prevention and control at Points of Entry

i.

Enhanced vector surveillance, and vector prevention and control activities at points
of entry (Please refer to the existing guidelines).

ii. All international flights arriving Malaysian international points of entry are required
to disinsect the aircraft prior to disembarkation of passengers and crew. Evidence
by means of empty spray cans or residual disinsection certificate or any proof of
treatment (approved by MOH, WHO or accredited organisation/agencies) must be
provided to the health authority on arrival.
iii. Aircraft General Declaration of Health or SSCC to be collected and inspected for
any declaration on the presence of vectors and control measures used to eradicate
the vectors (Annex 5 (2), IHR 2005.
iv. Increase awareness among all agencies/stakeholders on the importance of vector
free areas at entry points, as to prevent the spread of vector borne disease such
as Dengue, Yellow fever, Zika virus and others.

G. Collaboration with other Agencies/Ministries

i.

Ministry of Health Malaysia (MoH) is working in close collaboration with other

relevant agencies such as The Immigration Department of Malaysia, Royal
Malaysian Customs, Royal Malaysian Police Force, Department of Civil
Aviation Malaysia, Airport/Port/Ground crossing authorities and agencies,
Airlines, Shipping companies, Ground handlers, Pest Control Operators, etc.

ii.

Dissemination of information regarding Zika virus and travel advisory to

personnel and clients going to / coming from the affected countries thus
increasing their awareness and to prevent the spread of disease into Malaysia.

iii.

Participation with all related agencies/stake holders in ensuring areas around

entry points (inside and outside buildings) at a minimum distance of 400 meters
or with extension of the minimum distance if vectors with a greater range are
present at these areas, are free from vectors.

iv.

Emphasizing the importance of reducing breeding places for mosquitoes by

search and destroy activities. These precautions do not only reduce the risk
of Zika virus infection, Yellow fever and also dengue fever.

v.

Immigration Department of Malaysia to assist in referring travelers from Zika

virus affected countries detected at the international points of entry to Health
Personnel, Health screening area/Health Quarantine Centre for assessment.

vi.

All aircraft / ship / vehicle are required to inform the health authorities at the
points of entry if there are passengers from Zika virus affected countries
showing signs and symptoms of Zika virus infection.

vii.

To obtain assistance and cooperation as and when needed from all

agencies/stake holders in disease prevention and control activities.

Annex 3

FLIGHT ANNOUNCEMENT: ZIKA VIRUS ADVISORY BEFORE DISEMBARKATION

Ladies and gentlemen

We welcome everyone on board. For your health safety, we would appreciate your kind
attention and action on this Health Advisory concerning Zika virus
In relation to the announcement from the World Health Organization (WHO) on the recent
outbreak of Zika Virus and cluster of neurological disorders and neonatal malformations
reported in the Americas region which constitutes a Public Health Emergency of
International Concern. We wish to seek the cooperation of passengers who have history
of travel or originating from the affected countries since the past seven (7) days to present
yourselves to the Health Personnel at the Health screening area after disembarking from
the aircraft.
As to date, The World Health Organization (WHO) has reported affected countries of Zika
virus are as follows: Barbados | Bolivia | Brazil | Colombia | Costa Rica | Curaao |
Dominican Republic | Ecuador | El Salvador | French Guiana | Guadeloupe | Guatemala
| Guyana | Haiti | Honduras | Jamaica | Martinique | Mexico | Nicaragua | Panama |
Paraguay | Puerto Rico | Saint Martin | Suriname | US Virgin Islands | Venezuela (will be
updated from time to time as per WHO report)

We thank you for your attention and action on this Zika virus advisory.
Thank You.

Annex 4

Senarai Semak Saringan Penyakit Virus Zika di Pintu Masuk: ....

Tarikh pemeriksaan :

Masa:

A) Maklumat pesakit
Nama

Email

Umur

No Telefon
(di Malaysia)

Jantina
Sekiranya Wanita LMP

Alamat Tempat
Tinggal di
Malaysia
(catatkan alamat
dengan
lengkap/detail)

No Kad Pengenalan /
Paspport

B) Butiran Lanjut
1. Telah tiba dari negara penyakit Zika dalam masa
7 hari sebelum ini
2. Butiran penerbangan pulang

3.

Sila maklumkan :

Route :
..
No penerbangan : ..
No tempat duduk :
Gejala yang dikesan (Sila pilih YA atau Tidak ()bagi setiap gejala yang disenaraikan ) :

DEMAM
SAKIT OTOT /
SENDI
KONJUNKTIVITIS

YA
YA

TIDAK
TIDAK

RUAM
SAKIT KEPALA

YA
YA

TIDAK
TIDAK

YA

TIDAK

KELESUAN
(MALAISE)

YA

TIDAK

C) Pemeriksaan Fizikal
Suhu Badan - C
Conjunctiva - ..
BP .mmHg
PR . / minit
6

D) Tindakan susulan :
.

---------------------------------------------------------------------------------------------------------------------------------E) Pemeriksaan oleh :

Nama :
Jawatan :
Negara negara jangkitan Virus Zika : Barbados | Bolivia | Brazil | Colombia | Costa Rica | Curaao | Dominican Republic | Ecuador | El
Salvador | French Guiana | Guadeloupe | Guatemala | Guyana | Haiti | Honduras | Jamaica | Martinique | Mexico | Nicaragua | Panama |
Paraguay | Puerto Rico | Saint Martin | Suriname | US Virgin Islands | Venezuela
akan dikemaskini dari berdasarkan laporan WHO.

Annex 5

CASE DEFINITION FOR ZIKA VIRUS INFECTION

i. Suspected case:
Patient with rash or fever (< 38.5 C) with one or more of the following symptoms (not
explained by other medical conditions):
- Arthralgia or myalgia
- Non-purulent conjuntivitis or conjunctival hyperemia
- Headache or malaise

And
Recent history of travelling to the country affected with Zika virus infection seven (7) days
after returning to Malaysia.
ii. Confirmed case:
A suspected case with laboratory positive result for the specific detection of Zika virus.

Annex 6

MINISTRY OF HEALTH MALAYSIA

HEALTH ALERT CARD

FOR VISITORS AND CREW FROM THE
ZIKA VIRUS AFFECTED COUNTRIES

Keep this card for the next seven (7) days after arriving to Malaysia. Monitor your body
temperature and look out for fever, skin rash (exanthema), muscle or joint pain, malaise, headache
and conjunctivitis (red eye). If these symptoms were to develop and you are not feeling well, seek
medical advice immediately.
Attention to The Attending Doctor:
The person presenting this HEALTH ALERT CARD had recently travelled or returned from a
Zika Affected Country (within the past 7days). If the person presents with fever (low grade fever
less than 38.5C), skin rash (exanthema), muscle or joint pain, malaise, headache and
conjunctivitis (red eye), please refer him/her immediately to the nearest hospital for investigation
and treatment.
*List of countries affected by Zika virus: Barbados, Bolivia, Brazil, Colombia, Dominican
Republic, Ecuador, El Salvador, French Guiana, Guadeloupe, Guatemala, Guyana, Honduras,
Martinique, Mexico, Panama, Paraguay, Puerto Rico, Saint Martin, Suriname, US Virgin
Islands, Venezuela, Haiti, Nicaragua and Samoa.
Note: This list will be updated from time to time as per WHO report.

Date issued:
Name of Entry points:

KEMENTERIAN KESIHATAN MALAYSIA

KAD AMARAN KESIHATAN

KEPADA PELAWAT DAN ANAK KAPAL DARI
NEGARA DIJANGKITI VIRUS ZIKA

Simpan kad ini untuk tujuh ( 7 )hari akan datang selepas kembali ke Malaysia. Pantau
suhu badan untuk demam, ruam kulit (exanthema), sakit otot atau sendi, kelesuan, sakit
kepala dan konjunktivitis (mata merah). Sekiranya anda tidak sihat dan menghidap gejala
tersebut, segeralah berjumpa doktor.
Kepada Pengamal Perubatan Yang Merawat Pesakit Ini
Individu yang membawa KAD AMARAN KESIHATAN ini telah membuat perjalanan atau
kembali dari Negara yang terdapat jangkitan Virus Zika (dalam 7hari lalu). Jika individu
ini mendapat demam (demam yang rendah kurang dari 38.5C), ruam kulit (exanthema),
sakit otot atau sendi, kelesuan, sakit kepala dan konjunktivitis (mata merah), sila rujuk ke
hospital yang berhampiran dengan kadar segera untuk pemeriksaan dan rawatan.
*Senarai negara terlibat dengan jangkitan virus Zika: Barbados, Bolivia, Brazil, Colombia,
Dominican Republic, Ecuador, El Salvador, French Guiana, Guadeloupe, Guatemala, Guyana,
Honduras, Martinique, Mexico, Panama, Paraguay, Puerto Rico, Saint Martin, Suriname, US
Virgin Islands, Venezuela, Haiti, Nicaragua dan Samoa.
Nota: Senarai ini akan dikemaskini dari masa ke masa berdasarkan laporan oleh WHO.

Tarikh dikeluarkan:
Nama Pintu Masuk:

10

Annex 7
TRAVEL ADVISORY FOR TRAVELLERS TO COUNTRIES AFFECTED BY ZIKA VIRUS

Background

Zika virus is a mosquito-borne flavivirus closely related to dengue virus. It was first isolated
from a rhesus monkey in Zika forest, Uganda in 1947, in mosquitoes (Aedes africanus) in the
same forest in 1948 and in humans in Nigeria in 1954.
Prior to 2015, Zika virus outbreaks have occurred in areas of Africa, Southeast Asia, and the
Pacific Islands.
In May 2015, the WHO Pan American Health Organization (PAHO) issued an alert regarding
the first confirmed Zika virus infections in Brazil. In December 2015, the Ministry of Health,
Brazil reported a sharp increase in the number of reported cases of microcephaly of unknown
cause in areas affected by Zika virus outbreak.
As at 29 January 2016, WHO reported outbreaks of Zika virus in 22 countries*: Barbados,
Bolivia, Brazil, Colombia, Dominican Republic, Ecuador, El Salvador, French Guiana,
Guadeloupe, Guatemala, Guyana, Honduras, Martinique, Mexico, Panama, Paraguay,
Puerto Rico, Saint Martin, Suriname, US Virgin Islands, Venezuel, Haiti, Nicaragua and
Samoa.

(Note: The list of countries will be updated from time to time as per WHO report)

Key facts

Zika virus disease is caused by a virus transmitted by Aedes mosquitoes.

It causes low grade fever (less than 38.5C) and rash. Other symptoms include muscle
pain, joint pain, headache, pain behind the eyes and conjunctivitis.
These symptoms normally last for 2-7 days
The disease has similar clinical signs to dengue, and may be misdiagnosed in areas where
dengue is common.
There is no specific treatment or vaccine currently available. Treatment is focused on
relieving the symptoms.
The best form of prevention is protection against mosquito bites.
Prevention and control relies on reducing the breeding of Aedes mosquitoes and
minimizing contact between mosquito vectors and people by using barriers (such as
repellents, insect screens), reducing water-filled habitats supporting mosquito larvae in
and close to dwellings, and reducing the adult mosquito populations around at-risk
communities.
The virus is known to circulate in Africa, the Americas, Asia and the Pacific
11

Health Advisory:
Based on the current available information WHO does not recommend any travel or trade
restrictions to Zika virus affected countries. Given the current global situation of Zika virus
infections, the Ministry of Health, Malaysia would like to advise the public who wish to visit
countries affected by the Zika virus to take the same precautionary measures used to prevent
dengue to minimize risk of infection of Zika virus as follows;
1.

Prevent mosquito bites by;

covering skin with long-sleeve clothing, trousers and hats,

use insect repellents on exposed body surfaces,

sleep protected by mosquito nets,

2.

Avoid doing outdoor activities during peak biting times of the Aedes mosquitoes, i.e. a few
hours after dawn and before dusk.

3.

Individuals travelling in or returning from Zika virus affected countries* presenting with the
following symptoms within 7 days of travel, should seek medical advice immediately and
inform the attending doctor of their travel history;

fever

skin rash (exanthema)

muscle or joint pain

malaise

headache

conjunctivitis (red eye)

As a precautionary measure, the Ministry of Health would like to advise pregnant women,
especially those in the first trimester, to postpone their trip to Brazil until the cause of microcephaly
events associated with Zika virus infection in the country can be identified. MOH would like to
emphasize that the public should continue the search and destroy activities to reduce the
breeding places of Aedes mosquitoes in their homes and surroundings. These precautions do not
only reduce the risk of Zika virus infection but also dengue fever, Yellow fever, Chikungunya and
other vector borne disease.
Prepared by:
Disease Control Division
Ministry of Health Malaysia
29 January 2016
12

Lampiran 8
FLOW CHART FOR SCREENING OF TRAVELLERS AND CREW ARRIVING
FROM ZIKA VIRUS AFFECTED COUNTRIES AT THE
INTERNATIONAL ENTRY POINTS (WITH THERMAL SCANNER)
Arrival of travellers and crew at the international
entry points
From Zika Virus Affected Countries
Self-referral
to Health

Thermal Scanner

Yes

No
Fever
(

Immigration
Counter screening

Not From
Zika Virus
Affected
Countries

Allow to enter
into Malaysia
after Immigration
clearance

From Zika Virus

Affected
Countries

HEALTH SCREENING AT HEALTH

SCREENING AREA/COUNTER
History taking
Clinical examination
To record the passengers and
crew details and immediately
submit to State Vector Officer for
vector surveillance and
prevention activities.

Suspected
Zika Virus
Zik
No

Allow home with

Health Alert Card
(HAC) and advice

Refer to the nearest health

facilities for further
management

Yes

Lampiran 9
FLOW CHART FOR SCREENING OF TRAVELLERS AND
CREW ARRIVING FROM ZIKA VIRUS AFFECTED COUNTRIES AT
THE INTERNATIONAL ENTRY POINTS (WITHOUT THERMAL SCANNER)

Arrival of travellers and crew at the international entry

points

Not From Zika Virus

Affected Countries
Immigration
counter
Allow enter into
Malaysia after
Immigration
clearance

Self-referral
to Health

From Zika Virus

Affected Countries
Refer for Health Screening

HEALTH SCREENING AT HEALTH

SCREENING AREA/COUNTER
History taking
Clinical examination
To record the passengers and crew details
and immediately submit to State Vector
Officer
for
vector
surveillance
and
prevention activities.

No

Suspected
Zika Virus
Zik

Yes

Allow home with

Health Alert Card
(HAC) and advice

Refer to the nearest health facilities for

further management

Lampiran 10

LIST OF HOSPITALS AND PUBLIC HEALTH LABORATORY

PROVIDING SERVICES FOR REAL TIME PCR
List of hospital providing Real Time PCR confirmation test for Zika
virus
1. Hospital Umum Sarawak
2. Hospital Tuanku Jaafar Negeri.Sembilan
3. Hospital Raja Perempuan Zainab II
4. Hospital Sultanah Bahiyah Kedah
5. Hospital Kuala Lumpur
6. Hospital Sungai Buloh
7. Hospital Sultanah Aminah Johor
8. Hospital Raja Permaisuri Bainun Perak
9. Hospital Pulau Pinang
10. Hospital Sultanah Nur Zahirah Terengganu
11. Hospital Tengku Ampuan Afzan Pahang
12. Hospital Melaka

Public Health Laboratory Providing Real Time PCR confirmation

test for Zika virus
1. MKAK Sg Buloh
2. MKA Kota Kinabalu
3. MKA Kota Bahru
4. MKA Ipoh
5. MKA Johor Bahru

Jadual Mingguan Pegawai Bertugas Untuk Kes-Kes Urgent & Wabak (03
Jan -31 Disember 2016)
Tarikh
03.01.16 - 09.01.16
10.01.16 - 16.01.16
17.01.16 - 23.01.16
24.01.16 - 30.01.16
31.01.16 -06.02.16
07.02.16 - 13.02.16
14.02.16 - 20.02.16
21.02.16 - 27.02.16
28.02.16 - 05.03.16
06.03.16 - 12.03.16
13.03.16 - 19.03.16
20.03.16 - 26.03.16
27.03.16 - 02.04.16
03.04.16 - 09.04.16
10.04.16 - 16.04.16
17.04.16 - 23.04.16
24.04.16 - 30.04.16
01.05.16 - 07.05.16
08.05.16 - 14.05.16
15.05.16 - 21.05.16
22.05.16 - 28.05.16
29.05.16 - 04.06.16
05.06.16 - 11.06.16
12.06.16 - 18.06.16
19.06.16 - 25.06.16
26.06.16 - 02.07.16
03.07.16 - 09.07.16
10.07.16 - 16.07.16
17.07.16 - 23.07.16
24.07.16 - 30.07.16
31.07.16 - 06.08.16
07.08.16 - 13.08.16
14.08.16 - 20.08.16
21.08.16 - 27.08.16
28.08.16 - 03.09.16
04.09.16 - 10.09.16
11.09.16 - 17.09.16
18.09.16 - 24.09.16
25.09.16 - 01.10.16
02.10.16 - 08.10.16
09.10.16 - 15.10.16
16.10.16 - 22.10.16
23.10.16 - 29.10.16
30.10.16 - 05.11.16
06.11.16 - 12.11.16
13.11.16 - 19.11.16
20.11.16 - 26.11.16
27.11.16 - 03.12.16
04.12.16 - 10.12.16
11.12.16 - 17.12.16
18.12.16 - 24.12.16
25.12.16 - 31.12.16

NAMA PEGAWAI
FAUZIAH MD. KASSIM
DR RAVINDRAN THAYAN
DR ROZAINANEE MOHD ZAIN
MOHD APANDI YUSOF
TS SARASWATHY
FAUZIAH MD. KASSIM
DR RAVINDRAN THAYAN
DR ROZAINANEE MOHD ZAIN
MOHD APANDI YUSOF
TS SARASWATHY
FAUZIAH MD. KASSIM
DR RAVINDRAN THAYAN
DR ROZAINANEE MOHD ZAIN
MOHD APANDI YUSOF
TS SARASWATHY
FAUZIAH MD. KASSIM
DR RAVINDRAN THAYAN
DR ROZAINANEE MOHD ZAIN
MOHD APANDI YUSOF
TS SARASWATHY
FAUZIAH MD. KASSIM
DR RAVINDRAN THAYAN
DR ROZAINANEE MOHD ZAIN
MOHD APANDI YUSOF
TS SARASWATHY
FAUZIAH MD. KASSIM
DR RAVINDRAN THAYAN
DR ROZAINANEE MOHD ZAIN
MOHD APANDI YUSOF
TG ROGAYAH TG ABD RASHID
FAUZIAH MD. KASSIM
DR RAVINDRAN THAYAN
DR ROZAINANEE MOHD ZAIN
MOHD APANDI YUSOF
TG ROGAYAH TG ABD RASHID
FAUZIAH MD. KASSIM
DR RAVINDRAN THAYAN
DR ROZAINANEE MOHD ZAIN
MOHD APANDI YUSOF
TG ROGAYAH TG ABD RASHID
FAUZIAH MD. KASSIM
DR RAVINDRAN THAYAN
DR ROZAINANEE MOHD ZAIN
MOHD APANDI YUSOF
TG ROGAYAH TG ABD RASHID
FAUZIAH MD. KASSIM
DR RAVINDRAN THAYAN
DR ROZAINANEE MOHD ZAIN
MOHD APANDI YUSOF
TG ROGAYAH TG ABD RASHID
FAUZIAH MD. KASSIM
DR RAVINDRAN THAYAN

NOMBOR TALIPON H/P

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