On October 1, 2016, the Central Epidemic Command Center for Zika Virus (CECC for Zika Virus) announced the ninth imported Zika case identified in Taiwan.The case is a 51-year-old Taiwanese male who resides in New Taipei City. During September 10 and 23, 2016, he traveled to Ho Chi Minh City and Bac Lieu Province, Vietnam with his wife. On September 23, he developed symptoms, including fever, cough, sore throat, conjunctivitis and joint pain. On September 25, he sought medical attention at a clinic after developing rash on his trunk and limbs. On September 28, he sought further medical attention at another clinic when his symptoms persisted and was transferred to a hospital. Infection with Zika virus was laboratory confirmed in the case on October 1 after the hospital reported him to the health authority. At the time of writing, the case is resting at home. The case has been asked to prevent mosquito bites and isolate himself till October 4, 2016 and follow the “1+6 Principle”. During the viremic period, besides seeking medical attention, his primary areas of activities include places around his house and workplace. Currently, none of his contacts, including family members (his mother and wife) who reside in the same household with him and his colleagues, have developed suspected symptoms. The local health authority has implemented various prevention measures.

Since April 2016, at least 3 cases of locally transmitted Zika virus infection in Vietnam have been reported in Khanh Hoa Province, Ho Chi Minh City, and Phu Yen Province.　　　So far, Korea, Australia and Israel have reported imported Zika cases from Vietnam this year. In light of the recent rapid geographic expansion of Zika virus, the increase in Zika activity in neighboring Southeast Asian countries, and the increased activity of the mosquito vector, the risks of importing Zika cases into Taiwan and having a local outbreak are thus elevated.　

Thus far this year, a total of 9 imported Zika cases have been identified in Taiwan and they respectively became infected in Thailand (2), Vietnam (2), Indonesia (1), Singapore (1), St. Lucia (1), St. Vincent and the Grenadines (1), and Florida, the U.S. (1).　　Current scientific evidence has proved that Zika virus infection is usually mild in adults and suggested the occurrence of congenital microcephaly and even deaths in babies of mothers who were infected with Zika virus while pregnant. Therefore, pregnant women and women planning pregnancy are advised to postpone all unnecessary travels to Zika-affected areas. 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. CECC for Zika Virus urges travelers leaving Zika-affected areas 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 three 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. In addition, female travelers should postpone pregnancy for at least 6 months.

Since 2015, at least 70 countries, areas and/or territories worldwide, primarily in Latin America and the Caribbean region, have reported local outbreaks of Zika virus infection.　　Taiwan CDC has issued a travel notice of Level 2: Alert for Zika virus for 62 countries and territories with ongoing outbreaks or possible local transmission of Zika virus, including 7 countries in Asia: Thailand, the Philippines, Vietnam, Indonesia, Singapore, Malaysia and Maldives, and 4 counties in Florida: Broward, Miami-Dade, Pinellas and Palm Beach counties. Moreover, during 2007 and 2015, about 8 countries, including Cambodia, Laos, and Bangladesh, reported Zika outbreaks. Nonetheless, thus far in 2016, no Zika cases have been reported in those 8 countries. Hence, Taiwan CDC has issued a travel notice of Level 1: Watch for Zika virus for those countries.

Taiwan CDC urges travelers returning to Taiwan from Zika-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. At the same time, physicians are urged to heighten vigilance for suspected cases, inquire patients of their travel history when necessary and report suspected cases to the competent health authority as soon as possible. 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).