In February 2016, a total of 13 tour groups consisting of 254 travelers, including the tour guides, visited Latin America. As of now, all the 254 travelers have returned to Taiwan. Only one of the returned travelers was detected with fever at the fever screening station at the airport upon arrival, and both Zika virus infection and dengue fever have been ruledout in the individual. All the other returned  travelers are in good health. Asthe Zika virus continues to spread worldwide, pregnant women and women planning pregnancy 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 43 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 atravel notice of Level 2: Alert for Zika virus for the aforementioned 43 countries and territories. Although sporadic cases have been reported in 4 countries, including Cambodia, Indonesia, Malaysia, and Gabon in Africa, no direct evidence has shown local transmission has occurred in any of the 4 countries. Taiwan CDC has issued a travel notice of Level 1: Watch for Zika virus for these 4 countries.

As of now, two countries with ongoing Zikatransmission, including Brazil and French Polynesia, have experienced sustained outbreaks of microcephaly. On the other hand, 9 countries have observed an increase in the number of Guillain-Barré syndrome (GBS) cases reported, including French Polynesia, Brazil, Colombia, Suriname, El Salvador, Venezuela, Martinique, Puerto Rico and Panama. More and more clinical and epidemiological data suggest a link between Zika infection and microcephaly/GBS. According to the second meeting of the Emergency Committee (EC) convened by the World HealthOrganization (WHO) Director-General under the International Health Regulations(2005) (IHR 2005) regarding clusters of microcephaly cases and other neurological disorders in some areas affected by Zika virus on March 8, 2016, thereis increasing evidence on the possible causal association between Zika virus infection and other neurological disorders such as microcephaly and GBS, and the clusters of microcephaly cases and other neurological disorders and their possible association with the Zika virus continue to constitute a Public Health Emergency of International Concern (PHEIC).

The Taiwan CDC’s Command Center for Zika Virus points out that the current prevention and control efforts focus on offshore and border control. Taiwan CDC has been implementing 6 major prevention andcontrol measures, including mosquito control for aircrafts, health education for arriving and departing passengers, fever screening of all inbound travelers, traveler’s health declaration, blood tests at ports, and hospitalreferrals. The Command Center for Zika Virus will continue to closely monitor the development of the ongoing Zika outbreaks and implement measures that are in line with the international community. The public is urged to cooperate with government policies to help ward off the Zika virus.

Taiwan CDC advises pregnant women and women planning pregnancy 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, applyin gofficially 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 toproactively 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 theTaiwan CDC website at http://www.cdc.gov.tw or call the toll-free Communicable Disease Reporting and Consultation Hotline,1922 (or 0800-001922).