A Sabah man has died from heart complications after being diagnosed as Malaysia's first locally transmitted case of the Zika virus.
A resident of Kota Kinabalu, the capital of the East Malaysian state, the 61-year-old man was the second confirmed infection after a woman in Klang, Selangor, contracted the virus following a trip to Singapore in mid-August. She is recovering in hospital.
The dead man was already suffering from a string of illnesses before he contracted Zika, including high blood pressure, heart disease, chronic kidney disease and gout.
He was in a serious condition with high fever, diarrhoea and muscle aches when he first sought medical treatment on Aug 30, according to the health ministry. Blood and urine tests at the Queen Elizabeth Hospital 2 were positive for Zika.
The ministry said he died from a "complication of his underlying heart disease", adding that the full results of investigations on the cause of death were still pending.
"He was scheduled for heart surgery next month. The death is not due to Zika," said Director-General of Health Noor Hisham Abdullah.
The ministry has initiated vector control, such as larvaciding and fogging, in areas the patient recently visited.
"Since the Zika virus has been detected in this country, Zika cases are expected to increase further, especially if prevention activities for Aedes mosquitoes are not seriously taken up," said Dr Noor Hisham.
He also disclosed that the Sabah man did not travel abroad recently.
Confirmation of Malaysia's second Zika case coincided with news that three women in a family in Malacca had been quarantined over fears they had also succumbed to the virus after returning ill from Singapore last week, although blood tests have so far been negative.
Health Minister S. Subramaniam, in providing details of the first case, told a news briefing on Thursday that the 58-year-old woman contracted Zika after visiting her infected daughter in Paya Lebar last month.
The ministry also said that its Singapore counterpart had confirmed that 11 Malaysians were infected with the virus, all of them working and living in Singapore except for one commuter from Johor.
Meanwhile, Indonesia has begun monitoring travellers from Singapore arriving at major points-of-entry, namely in Jakarta, Batam, Bali and Medan, following confirmation that an Indonesian woman was being treated in Singapore for the virus. Thermal scanners have been set up at the four locations - popular with travellers from the Republic, who will now also need to fill up health alert cards upon entry.
Indonesia's Health Ministry has also deployed paramedics at eight seaports across Batam, Bintan and Karimun in the Riau islands, due to their proximity to Singapore.
However, Vice-President Jusuf Kalla said on Friday it was "not necessary yet" for Indonesia to issue a travel warning for Indonesians travelling to Singapore.
"Singapore has not announced the Zika virus (outbreak) as an extraordinary event," he said.