On September 10, 2016, the Central Epidemic Command Center for Zika Virus (CECC for Zika Virus) announced the seventh imported Zika case identified in Taiwan.　 The case is a 20-year-old female Singaporean who resides in Aljunied Crescent, Singapore. During August 26 and September 3, she visited Japan with some friends. On September 1, she developed symptoms, including rash, joint pain, headache and conjunctivitis. Her symptoms persisted when she arrived in Taiwan on September 3. She sought medical attention on September 4 and 5. She was reported to the health authority as a suspected case by the hospital. Infection with Zika virus was laboratory confirmed in her after a second sample was collected. Based on the case’s incubation period and activity history, it was determined the case became infected with Zika virus in Singapore. After her arrival in Taiwan, besides seeking medical attention, her primary areas of activities include places around her accommodation. As of now, the case has no symptoms. The case has been asked to prevent mosquito bites and isolate herself till September 12. Currently, none of her contacts have developed suspected symptoms and they have all been tested negative for Zika virus. The local health authority has implemented various prevention measures.

Since the first case of locally transmitted Zika virus infection in Singapore was announced on August 27, 2016, as of September 9, 2016, a cumulative total of 304 locally transmitted Zika cases, including 2 pregnant women, have been confirmed.　 The majority of the cases are linked to the Aljunied Crescent/ Sims Drive/ Kallang Way/ Paya Lebar Way cluster. Some cases reside in Joo Seng Road, Punggol Way, Tagore Avenue, Yishun Street 81, Harvey Crescent, Bishan Street 12, Elite Terrace, and Ubi Crescent. More cases are expected to occur.

According to the updated Zika virus guidance published by the World Health Organization (WHO) on September 6, 2016, CECC for Zika virus has revised the “2226 Principle”, its recommendations to prevent the spread of Zika virus through sexual contact and blood transfusion, to “1+6 Principle”. The “1+6 Principle” specifies that people who have recently traveled to Zika-affected areas should 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 2007, at least 69 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 60 countries and territories with ongoing outbreaks or possible local transmission of Zika virus, including 6 countries in Asia: Thailand, the Philippines, Vietnam, Indonesia, Singapore and Malaysia, and 4 counties in Florida: Broward, Miami-Dade, Pinellas and Palm Beach counties. Moreover, during 2007 and 2015, about 9 countries, including Cambodia, Laos, and Bangladesh, reported Zika outbreaks. Nonetheless, thus far in 2016, no Zika cases have been reported in those 9 countries. Hence, Taiwan CDC has issued a travel notice of Level 1: Watch for Zika virus for those countries.　

CECC for Zika Virus once again urges travelers visiting Zika-affected areas 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. Pregnant women are urged to postpone any unnecessary travels. 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 suspected symptoms develop and follow the “1+6 Principle” to prevent Zika transmission. 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).