On August 17, 2016, the Central Epidemic Command Center for Zika Virus (CECC for Zika Virus) announced the sixth imported Zika case identified in Taiwan.　The case is a 44-year-old female who resides in New Taipei City and visited Miami, Florida, US during July 31 and August 11, 2016 for business. After she returned to Taiwan, she sought medical attention after developing rash on her legs and abdomen. Infection with Zika virus was confirmed in the case by the Taiwan for Centers for Disease Control (Taiwan CDC) laboratory.

The case is not pregnant and all her symptoms have subsided. She is currently in good health.　The case has been asked to stay home, prevent mosquito bites, and isolate herself till August 23 and follow the “2226 Principle” to prevent further spread of the virus. None of the other two colleagues who went on the business trip with her to Miami and her family members who reside in the same household have developed symptoms. The local health authority has promptly implemented various prevention measures, including cleaning of vector breeding sites, investigating the mosquito population density around the case’s residence, and providing the case’s family members with relevant health education.

According to the epidemiological investigation, after the case returned to Taiwan on August 12, she developed sore in her distal phalanges on her right hand. On the following day, she sought medical attention after developing rash. During the incubation period, the case was in the U.S. and visited Broward and Miami-Dade counties, Florida, both of which Taiwan CDC has issued a travel notice of Level 2: Alert for Zika virus for. Hence, it is determined that the case contracted Zika virus in the U.S. As of August 15, 2016, a cumulative total of 30 non-travel related Zika cases have been confirmed in Florida, U.S. and Texas has reported one Zika case who traveled to Miami.

CECC for Zika virus pointed out that the U.S. and Taiwan have been working closely together to jointly tackle global public health issues. Previously, the U.S. Centers for Disease Control and Prevention (US CDC) has shared an isolate of Zika virus with Taiwan.　In addition, during April 13 and 15, 2016, under the US-Taiwan Global Cooperation Training Framework (GCTF), the U.S. and Taiwan co-organized the International Training Workshop on Molecular Diagnosis for Zika, which was participated by 24 laboratory professionals from 12 countries. On top of that, Taiwan CDC has sent a medical officer to US CDC to attend relevant training and participate in actual investigation concerning Zika virus. Communication regarding the prevention and control of infectious diseases between the two countries has been smooth. Taiwan has notified the U.S. and the World Health Organization (WHO) concerning this latest imported Zika case through the National IHR Focal Point.

Thus far, at least 66 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 56 countries and territories with ongoing outbreaks or possible local transmission of Zika virus, including 4 countries in Asia: Thailand, the Philippines, Vietnam and Indonesia, as well as Broward and Miami-Dade counties, Florida. Moreover, during 2007 and 2015, about 10 countries, including Cambodia, Malaysia, Laos, Bangladesh, Maldives and Gabon, reported Zika outbreaks. Nonetheless, thus far in 2016, no Zika cases have been reported in those 10 countries. Hence, Taiwan CDC has issued a travel notice of Level 1: Watch for Zika virus for those countries.　

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. CECC for Zika Virus urges travelers returning to Taiwan from Zika-affected areas to follow the “2226 Principle” to prevent Zika transmission. The “2226 Principle” specifies that female travelers are urged to seek immediate medical attention if they develop suspected Zika symptoms within 2 weeks of their return from an affected-area and postpone pregnancy 2 months after their return regardless whether they develop suspected Zika symptoms, and male travelers, if they do not develop suspected Zika symptoms, are urged to avoid sex or use condoms correctly for 2 months after their return from an affected-area and if they develop suspected Zika symptoms, they are urged to avoid sex or use condoms correctly for 6 months after their return. Travelers visiting 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. Further, Taiwan CDC urges travelers returning from 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. 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).