On October 1, 2016, the Central Epidemic Command Center for Zika Virus (CECC for Zika Virus) announced the tenth imported Zika case identified in Taiwan. The case is a 50-year-old Taiwanese female who resides in Taoyuan City. During September 23 and 27, the case traveled to Sabah, Malaysia with a tour group. On October 5, when she developed symptoms, including headache, rashes on parts of her body and muscle ache, she did not seek medical attention. On the next day, when her rash spread to the entire body and she developed a slight fever, she sought medical attention at a hospital and was hospitalized. Infection with Zika virus was laboratory confirmed in the case on October 9 after the hospital reported her to the health authority. Based on the case’s activity history during her incubation period, it was determined that she became infected in Malaysia. As of now, the case has been discharged and resting at home. The case has been asked to prevent mosquito bites and isolate herself till October 16, 2016 and follow the “1+6 Principle”. During the viremic period, besides seeking medical attention, her primary areas of activities include places around her house and workplace. Currently, none of her contacts, including family members who reside in the same household with her and her colleagues, have developed suspected symptoms. The local health authority has implemented various prevention measures and will continue to monitor and follow up on the health of the other 71 members of the same tour group till October 10. In addition, the health authority has provided the tour group members with relevant health education, and asked them to prevent mosquito bites for at least 3 weeks and follow the “1+6 Principle”.

Since September 2016, a cumulative total of 7 cases of Zika virus infection in Malaysia, including 2 pregnant women, have been reported in Sarawak, Sabah, and Johor Bahru that neighbors Singapore. Thus far this year, a total of 10 imported Zika cases have been identified in Taiwan and they respectively became infected in Thailand (2), Vietnam (2), Indonesia (1), Singapore (1), Malaysia (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 67 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 63 countries and territories with ongoing outbreaks or possible local transmission of Zika virus, including 7 countries in Asia: Malaysia, Thailand, the Philippines, Vietnam, Indonesia, Singapore, and Maldives, and 4 counties in Florida: Broward, Miami-Dade, Pinellas and Palm Beach counties. Moreover, about 4 countries, including Laos, have previously reported Zika outbreaks. Nonetheless, thus far in 2016, no Zika cases have been reported in those 4 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 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).