SINGAPORE/JAKARTA — More than 300 people have been diagnosed with the Zika virus in Singapore this year, while the figure for Thailand has reached 200. Though the numbers of Zika cases in other Asian countries remain in the single digits, outbreaks in these two trade and tourism hubs could take a heavy economic toll.
Such impacts are already being felt in Latin America. The spread of Zika there has resulted in around 1,800 cases of microcephaly, and the World Bank estimates that Zika could result in losses of around $3.5 billion to Latin American economies, or 1% of gross domestic product in tourism-dependent ones.
MUTED SO FAR
In Asia, the main impact is likely to be felt in Singapore, which will host a Formula One Grand Prix race from Sept. 16-18. The event attracts not only regional motor sports fans but also corporate guests attending business meetings during the race week. The current Zika outbreak is the first ever in the city-state. Though it has not sparked any panic yet, the rapid spread of infection has reminded many residents of the SARS crisis of 2003, which saw economic activity contract 4.2% in the second quarter of that year.
China, Singapore’s biggest source of tourists, issued an alert on Sept. 7 urging visitors to Zika-affected countries to take precautions against mosquito bites.
Zika is mainly a mosquito-borne virus, though it can also be spread through sexual contact. It usually causes only mild fever, rash and red eyes in adults, but if a pregnant woman is infected, it may lead to microcephaly in the baby. Microcephaly is a condition in which a baby’s head is much smaller than average and the brain develops abnormally.
So far, tourism numbers in Singapore have not dropped, although the U.S., the U.K., Australia, Taiwan and South Korea have advised pregnant women to postpone visiting the city-state.
“There has been no perceivable impact of Zika on Singapore tourism thus far, with only a handful of cancellations,” Oliver Chong, executive director for communications and marketing at the Singapore Tourism Board, told the Nikkei Asian Review.
Thailand’s crucial tourism sector, which employs an estimated 5 million people, directly or indirectly, has not yet been affected either. The head of the Tourism Authority of Thailand, Yuthasak Supasorn, brushed aside concerns, given that the number of Zika cases in Thailand is lower than in Singapore. “I think Thailand is credible as a country. We are doing everything according to international procedures. We are not hiding anything so I don’t think it should raise any concern,” he said in early September.
But the tally has since spiked. Health ministry spokesman Suwannachai Wattanayingcharoen confirmed to the Nikkei Asian Review that 200 cases have been found this year, double the ministry’s previous update more than two months ago.
He attributed the sharp spike — Thailand has averaged just five cases of Zika infection annually in recent years — to increased awareness of the virus prompting more people to have blood or urine tests.
Thai tourism has been battered before: The 2003 SARS outbreak in the region hit the country with a 7% year-on-year drop in foreign arrivals.
Malaysia has reported six cases of Zika so far, though that number includes one pregnant woman. In most years, Malaysia vies with Thailand as the leading tourist destination in Southeast Asia, and its comparatively low number of Zika cases could give it an extra edge this year.
The Philippine health department confirmed the first case of locally transmitted Zika in the country on Sept. 5, followed by two more on Sept. 13. This brings the total number of cases in the Philippines to eight, including five foreigners who had come from Zika-affected countries.
Authorities in India are also starting to worry. Though the country has not yet seen any Zika cases, 13 Indian nationals were being treated for the Zika virus in Singapore as of the end of August, according to the Indian foreign ministry. Airports and ports in India have posted signs providing information on Zika and advising travelers returning from affected countries and experiencing fever symptoms to report to authorities.
Meenakshi Makkar, a 38-year-old New Delhi lawyer who is due to give birth in November, said she prefers to spend most of her time at home to avoid contracting an infection. “I have read about a possible outbreak of Zika,” she said. “Already there’s a spike in dengue and chikungunya cases, which has left me deeply worried. In the midst of all this, it’s so scary to even think of Zika.”
The Zika strains observed in Asia have not yet been linked to any microcephaly cases, and at least eight Thai women have reportedly given birth to healthy babies after contracting Zika. But Raymond Lin, head of Singapore’s National Public Health Laboratory, said doctors cannot guarantee no such link exists. “We do not have the answer,” he said.
The fact that Zika cases so far have been concentrated in Singapore and Thailand suggests the region has not seen the worst. The Lancet medical journal recently published a study suggesting that 2.6 billion people, mostly in Asia and Africa, could be vulnerable to the spread of Zika.
“If competent mosquito vectors become infected from these travelers in areas where environmental conditions are conducive to the virus’s spread, new epidemics could occur, subject to the presence of an immunologically susceptible human population,” the report said.
Eloi Yao, a Manila-based public relations officer for the World Health Organization, gave a similar warning. “Zika is anticipated to spread further in the region. We advise countries to be vigilant.” He also indicated there may be more cases than is currently known. “The problem of Zika is the similarity with other diseases, like chikungunya, yellow fever and dengue. It requires good testing [to tell them apart],” he said.
Speaking at a summit of the Association of Southeast Asian Nations in Laos in early September, Singapore Prime Minister Lee Hsien Loong said Zika could become “endemic” in Southeast Asia as it is carried by the same mosquito that transmits malaria and dengue — the latter a greater concern than Zika in Indonesia and Malaysia, according to health officials in both countries.
Lee said governments should prepare for a long fight against Zika and called for increased cooperation among Southeast Asian neighbors. “We should prepare ourselves for a possibly extended campaign against Zika but ensure that the region remains open and connected for business and trade,” he said.
Indonesia, the most populous country in Southeast Asia, has not seen any Zika cases recently, but Oscar Primadi, an Indonesian health ministry spokesman, said airports and seaports are screening arrivals from affected countries. “We’ve installed thermal scanners at airports and seaports through which passengers from these countries commonly enter Indonesia, such as the airports in Jakarta, Denpasar and Surabaya, as well as the port in Batam [an Indonesian island south of Singapore],” he said.
Zika remains an enigmatic virus, which makes it difficult to predict its likely economic impact. Scientists and medical professionals are still assessing Zika amid new data about how long it can survive in an infected adult who may show no symptoms.
“A good estimate of the situation is very challenging, as the disease is asymptomatic or mild for most cases and will tend not to trigger a visit to the doctor,” said Herve Zeller of the European Centre for Disease Prevention and Control, a European Union agency.
On Sept. 6, the WHO said that “mounting evidence has shown that sexual transmission of Zika virus is possible and more common than previously assumed.”
There have not yet been any confirmed cases of sexual transmissions of Zika in Asia, but the spread of cases and new information about the virus are worrying the public. An Indonesian woman in her late 20s, who asked not to be identified, said she is not planning to have a child soon but is worried that the virus could affect her later in life. “I wonder if it’s a kind of virus that can stay dormant and then reawaken after years,” she said.
There is also ongoing research into possible complications from interaction between the Zika virus and dengue.
Just as the WHO said that assumptions about how Zika spreads need to be revised, assumptions about any economic fallout need to be regarded as tentative. Ravi Menon, managing director of the Monetary Authority of Singapore, said on Sept. 6 that Zika could have “some small impact” on the local economy. But he added, “It’s too early to tell.”
And while worries persist that Asian economies, especially tourism-dependent ones, could take a hit, Zika’s spread could boost some businesses, such as hospitals and rubber glove manufacturers.
“Whenever there’s any outbreak, hospitals will get higher traffic,” said Montes Rattayapas, an analyst at Capital Nomura Securities in Bangkok.
“Zika has the effect of raising the awareness of the people,” said Lee Kim Meow, managing director of Top Glove, a Malaysian company that is one of the world’s biggest rubber glove makers. “That will thrust our business to the front line,” he said.
With reporting by Nikkei staff writers Mayuko Tani in Singapore, Yukako Ono in Bangkok, Kim Dung Tong in Ho Chi Minh City, Kiran Sharma in New Delhi, Mikhail Flores in Manila, Erwida Maulia in Jakarta and CK Tan in Kuala Lumpur