On May 31, 2017, the Taiwan Centers for Disease Control (Taiwan CDC) scaled up the travel notice level for India to Level 1: Watch for Zika virus according to the Zika virus classification table published by the World Health Organization (WHO) on May 24. Based on the results of retrospective investigations, Zika cases have been identified in India. Pregnant women and women planning pregnancy are advised to postpone all unnecessary travels to India. Travelers visiting Zika-affected areas are urged to take precautions against mosquito bites such as wearing light-colored clothing, long sleeves and long pants, applying officially approved mosquito repellent to exposed parts of the body, staying at accommodations installed with window screens, screen doors or air conditioners. In addition, travelers leaving Zika-affected areas are urged to follow the “1+6 Principle” to prevent Zika transmission. The “1+6 Principle” specifies that people who have recently traveled to Zika-affected areas should monitor their own health and take precautions against mosquito bites for at least 3 weeks, postpone blood donation for at least 1 month, and regardless whether they develop suspected Zika symptoms, they should practice safe sex for at least 6 months to prevent Zika transmission. Further, female travelers should postpone pregnancy for at least 6 months. On the other hand, the outbreak in Brazil has slowed and the transmission in Saint Barts (Saint Barthélemy) has been interrupted. Therefore, Taiwan CDC has lowered the travel notice level for Brazil to Level 1: Watch for Zika virus and removed the travel notice for Saint Barts (Saint Barthélemy).

Since 2015, 78 countries, areas and/or territories worldwide have reported local outbreaks of Zika virus infection. Some countries, including Belize, Turks and Caicos Islands, Argentina, Ecuador and Peru, have observed an increase in the number of cases while outbreaks in other countries have remained at a plateau or declined. On May 11, 2017, Brazil declared an end to its public health emergency for Zika virus due to the significant decrease in the numbers of Zika cases and congenital microcephaly reported this year. Singapore and Ho Chi Minh City, Vietnam have recently reported sporadic cases.  This year’s investigations have confirmed the first three Zika cases in India. Travelers planning to visit India are urged to heighten vigilance for the virus. Taiwan CDC has issued a travel notice of Level 2: Alert for Zika virus for 58 countries and territories with ongoing outbreaks or possible local transmission of Zika virus, including Singapore, Maldives and Angola. Moreover, 20 countries, including Indonesia, Thailand, Bangladesh, Cambodia, Laos, Malaysia, the Philippines, Vietnam and India, had previously reported Zika outbreaks. Although no Zika cases have been recently reported in those countries, no evidence has suggested that the local transmission of the virus has been interrupted. Hence, Taiwan CDC has issued a travel notice of Level 1: Watch for Zika virus for those countries.

As outbreaks in neighboring Southeast Asian countries continue to persist and the mosquito season has arrived,  the risk of imported and indigenous epidemic is elevated.　 Travelers returning to Taiwan from Zika-affected areas are urged to proactively contact the quarantine officer at the fever screening station at the airport when experiencing symptoms. If symptoms develop within two weeks of their return, please seek immediate medical attention and inform the physician of their travel history in order to facilitate diagnosis and treatment. For more information, please visit the Taiwan CDC website at http://www.cdc.gov.tw or call the toll-free Communicable Disease Reporting and Consultation Hotline, 1922 (or 0800-001922).