On May 6, 2016, the Taiwan Centers for Disease Control (Taiwan CDC) scaled up the travel notice level for Peru and Saint Barthelemy to Level 2: Alert for Zika virus based on the latest updates on recent local transmission of Zika virus provided by the World Health Organization (WHO). Pregnant women are advised to postpone their trips to areas where Zika virus is active, travelers are advised to avoid mosquito bites, and people returning from Zika-affected areas are advised to use condoms when having sex for at least 28 days to prevent Zika transmission.　　

Thus far, at least 57 countries, areas and/or territories worldwide, primarily in Latin America, the Caribbean region and Asia (Maldives and Thailand), have reported local outbreaks of Zika virus infection. Taiwan CDC has issued a travel notice of Level 2: Alert for Zika virus for the 51 countries and territories. Although sporadic cases have been reported in 6 countries, including Cambodia, Indonesia, Malaysia, Laos, Bangladesh, and Gabon in Africa, no direct evidence has shown local transmission has occurred in any of the 6 countries. Therefore, Taiwan CDC has issued a travel notice of Level 1: Watch for Zika virus for these 6 countries. 13 countries have observed an increase in the number of Guillain-Barré syndrome (GBS) cases reported, including Brazil, Colombia, Dominican Republic, and Honduras. The available clinical and epidemiological data has suggested a strong link between Zika infection and neurological disorders such as microcephaly and GBS.

Zika virus is transmitted by the same type of mosquitoes that transmit dengue virus, Aedes mosquitoes, including Aedes aegypti and Aedes albopictus. Typical symptoms include fever accompanied by a maculopapular rash, joint pain, or conjunctivitis. Other symptoms include headache, muscle pain and pain behind the eyes. Although the disease is usually mild, there have been reports of congenital microcephaly and even deaths in babies of mothers who were infected with Zika virus while pregnant. Hence, Taiwan CDC will continue to closely monitor the numbers of microcephaly and GBS cases in Taiwan and urges physicians to heighten vigilance for microcephaly cases.　　

Taiwan CDC advises pregnant women to postpone all unnecessary travels to Zika-affected areas. If visits to affected areas are necessary, travelers are advised to conduct self-health management for at least two weeks after returning from affected areas, and follow the doctor’s instructions for all follow-ups. Travelers visiting 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. People returning from Zika-affected areas are advised to use condoms when having sex for at least 28 days to prevent Zika transmission. Further, Taiwan CDC urges travelers returning from affected areas to proactively contact the quarantine officer at the fever screening station at the airport when suspected symptoms develop. If symptoms develop within two weeks of their return, please seek immediate medical attention and inform the physician of their travel history. 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).