[Comment on article: “Zika, afebrile disease?”].

We read with great interest the publication entitled “Zika, afebrile disease?” from del Carpio-Orantes and González-Clemente,1 who mentioned that afebrile illness might be seen in Zika virus infection and concluded that “…we point out that symptoms such as nonpurulent conjunctivitis or rash could be reliable criteria in the absence of fever for the probable diagnosis of Zika, which invariably requires serological confirmation, even though the latter is not always available.” We would like to share ideas and experience on this issue. In our setting, Indochina, the Zika virus infection is also endemic. Nevertheless, most of the cases are asymptomatic.2 The high incidence of asymptomatic infection among local people in Cambodia is reported.3 The afebrile illness is common.4 Regarding the non-purulent conjunctivitis or rash, the clinical problem might be seen, but it is less common than the asymptomatic presentation.5 Diagnosing the Zika virus in an asymptomatic case is usually difficult and requires the laboratory test.