On March 8, 2016, the Taiwan Centers for Disease Control (Taiwan CDC) scaled up the travelnotice level for the Philippines to Level 2: Alert for Zika virus based on thelatest updates on recent local transmission of Zika virus provided by theEuropean Centre for Disease Prevention and Control (ECDC). Pregnant women are advised to postpone their trips to areas where Zika virus is active, travelersare 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.

An American woman was recently confirmed with Zika virus infection following her trip to Luzon, the Philippines. The woman developed symptoms prior to returning to the U.S. Although no local cases have been reported in the Philippines, the risk of local transmission remains. 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 a travel 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 4countries. 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 Zika transmission, 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.

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 and control 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 hospital referrals. 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 Zikavirus. Besides one imported case of Zika virus infection in a Thai national detected at the airport in Taiwan, no local cases of Zika virus infection havebeen identified in Taiwan. In addition, no significant increase in the number of microcephaly cases in Taiwan has been observed.

Although the disease isusually mild, there have been reports of congenital microcephaly and evendeaths in babies of mothers who were infected with Zika virus while pregnant. 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 andlong pants, applying officially approved mosquito repellent to exposed parts ofthe body, staying at accommodations installed with window screens, screen doorsor air conditioners. People returning from Zika-affected areas are advised touse 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).