On August 1, 2016, officials from the Florida Department of Health (Florida Health) confirmed 10 new cases of local Zika infection. In addition, the US Centers for Disease Control and Prevention (US CDC) has issued travel guidance to the neighborhood with active Zika spread. Due to the potential risk of Zika transmission, the Taiwan Centers for Disease Control (Taiwan CDC) scaled up the travel notice level for Broward and Miami-Dade counties, Florida to Level 2: Alert for Zika virus on August 2, 2016 and urges pregnant women and women planning pregnancy to postpone all travels to the two counties. If visits to the affected areas are necessary, travelers are advised to follow the “2226 Principle” after leaving Zika-affected areas to prevent Zika transmission. The “2226 Principle” specifies that female travelers are urged to 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.　

So far, a total of 14 Zika cases spread by local mosquitoes have been confirmed in Florida. Among them, 10 cases were found in Broward and Miami-Dade counties through door-to-door surveillance conducted by Florida Health. Although the two counties are not very close to Walt Disney World in Orlando, which is located in Central Florida and frequented by Taiwanese travelers, it is possible more cases might be reported in Florida in the future. Therefore, the Central Epidemic Command Center (CECC) for Zika Virus urges travelers to follow the “2226 Principle” in order to ward off Zika.

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. In addition, pregnant women during their first trimester (3 months) are at higher risk of contracting the virus. Therefore, pregnant women and women planning pregnancy are advised to postpone all unnecessary travels to Zika-affected areas.　

Since January 2016, 3 imported Zika cases have been identified in Taiwan and all of them are foreign workers. Thus far, no indigenous cases have been reported in Taiwan. Taiwan CDC has been implementing 6 major prevention and control measures that focus on offshore and border control to ward off Zika transmission, 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.

Thus far, at least 64 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 54 countries and territories, including 4 countries in Asia: Thailand, the Philippines, Vietnam and Indonesia. 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).