It has been brought to my attention that certain remarks which I had copied to The Star, regarding undocumented migrant (workers) vis-à-vis the management of novel infectious outbreaks, have been misinterpreted (Expert warns of Zika threat from illegal migrants, The Star, Sept 11, 2016).

My statement that “the management of novel infectious outbreaks (e.g. Sars, MERS) is made more difficult when undocumented migrants have a strong incentive to avoid contact with government agencies. We need to address the drivers and policy options for the persistently large pool of undocumented migrant (workers) in Malaysia (despite repeated rounds of amnesty)” was not made in reference to the ongoing Zika outbreak.

The statement I did make vis-à-vis Zika (a mosquito-borne pathogen, unlike the Sars and MERS coronaviruses) was as follows: Zika may not be our most serious challenge (as far as novel infectious outbreaks).

If an effective vaccine is not rolled out double quick, most of us will eventually be naturally ‘vaccinated’ by Zika-bearing Aedes, with mild or even asymptomatic infections (the pandemic will eventually burn itself out in this initial outbreak, very sadly at the cost of numbers of micro-cephalic newborns, and other afflictions, until a critical mass of immunologically naive among the next generation(s) builds up, and sets the stage for a cyclically re-emergent outbreak).

Indeed there may be a subtle trade-off from a population health perspective, between the benefits of (long lasting?) natural immunity from a mild/asymptomatic infection (males and pre-pubertal females), versus the risks for women of child-bearing age who may conceive in the years before a (fast-tracked) development of an efficacious anti-Zika vaccine becomes available to be deployed on a priority needs basis.

Thank you for your attention, and I hope this letter will appear as a corrective to an unfortunate misinterpretation of my remarks.

CHAN CHEE KHOON, ScD (Epidemiology), is a senior research fellow (health & social policy), Centre for Poverty & Development Studies, Faculty of Economics & Administration,
Universiti Malaya.