On June 6, 2016, the Central Epidemic Command Center (CECC) for Zika Virus announced the third imported case of Zika virus infection identified in Taiwan. The case is an Indonesian fisherman who arrived in Taiwan through Kaohsiung International Airport and was successfully identified by the quarantine officer at the airport. Currently, the case is in good health conditions and is no longer experiencing any symptoms. Taiwan Centers for Disease Control (Taiwan CDC) and the Health Bureau of Kaohsiung City Government has implemented a number of vector control measures around areas where the case worked at. Therefore, the travel notice level for Indonesia is raised to Level 2: Alert for Zika virus beginning today.

On June 1, the 22-year-old Indonesia male already experienced discomfort when he boarded the airplane. Upon his arrival at Kaohsiung International Airport, he was stopped by the quarantine officer at the airport screening station due to his symptoms, including fever and red eye. After his specimens were submitted to the laboratory for testing, infection with Zika virus was confirmed in the case last night. This is this year’s first exported Zika case from Indonesia. As a result, Taiwan CDC has notified Taiwan’s Ministry of Foreign Affairs (MOFA), the Indonesian government and the World Health Organization (WHO) about the case.

The case is currently getting ready for work on a distant water fishing boat. After his entry into Taiwan, he has only been to the fishing boat and the harbor district. The other 5 crew members on the boat are in good health conditions. This morning, Taiwan CDC and the Health Bureau of Kaohsiung City Government completed the epidemiological investigation, vector surveillance and relevant health education as well as distributed condoms. The case will be followed up to ensure his health.

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. CECC for Zika Virus urges the public to follow the “2226 Principle” to prevent Zika, which 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.

Thus far, at least 60 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 55 countries and territories. Although sporadic cases have been reported in 5 countries, including Cambodia, Malaysia, Laos, Bangladesh, and Gabon in Africa, no direct evidence has shown local transmission has occurred in any of the 5 countries. Therefore, Taiwan CDC has issued a travel notice of Level 1: Watch for Zika virus for these 5 countries. Although some countries have reported a decline in the number of Zika virus infection cases, Zika outbreaks continue to persist worldwide. Hence, the outbreaks are expected to spread to other countries with the vector mosquitoes. Pregnant women and women planning pregnancy are advised to postpone their trips to areas where Zika virus is active..

On the other hand, previously Zika infection was suspected in a couple in Kaohsiung City who recently returned from Fiji and the Solomon Islands. A further test eliminated infection with Zika virus in the couple and confirmed that they are infected with chikungunya virus. Moreover, their unborn baby is in good health conditions. Since chikungunya was listed as a notifiable infectious disease in Taiwan since 2007, a cumulative total of 86 chikungunya cases have been confirmed. All of them are imported cases and the majority of them are from Southeast Asia.