On May 21, 2016, the Central Epidemic Command Center (CECC) for Zika Virus announced the second imported case of Zika virus infection identified in Taiwan. The case is a Thai male who was stopped by the quarantine officer at the fever screening station upon his arrival in Taiwan Taoyuan International Airport. Infection with Zika virus was confirmed in the case through testing his blood samples by the Taiwan for Centers for Disease Control (Taiwan CDC) laboratory today. As a result, Taiwan CDC has implemented various prevention and control measures and notified the World Health Organization (WHO) and the Thai health authority about the case.

The case is a 34-year-old Thai male who is visiting Taiwan the second time for work. When he boarded the airplane in Thailand on May 19, he already experienced chill. After he arrived in Taiwan Taoyuan International Airport and his blood samples were collected by the airport quarantine officer, he sought medical attention at a hospital with the help of his labor agency. As of now, the case is no longer experiencing any symptoms. In the evening of May 20, he returned to the factory dormitory in central Taiwan. His male companion who visited Taiwan with him has not experienced any symptoms.

Taiwan CDC and the local health authority visited the factory to conduct an epidemiological investigation and provide relevant health education to the communities adjacent to the factory. Specifically, they implemented cleaning of vector breeding sites, investigated the mosquito population density around the factory, distributed mosquito nets and mosquito repellents, and instructed the communities there the proper ways to control mosquito populations and prevent mosquito bites.

Since the first case was identified on January 19, this is the second case of Zika virus infection detected among over 2,000 samples collected by the Taiwan CDC laboratory this year. Both imported cases came from the same region in Thailand. Therefore, Taiwan CDC has scaled up the travel notice level for Thailand to Level 2: Alert for Zika virus. In addition, pregnant women 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. When suspected of Zika virus infection, please seek prompt medical attention after arrival in Taiwan and proactively notify the physician of the relevant travel history.

Thus far, at least 60 countries, areas and/or territories worldwide, primarily in Latin America, the Caribbean region and Asia (Maldives and Thailand), 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. Although sporadic cases have been reported in 6 countries, including Cambodia, Indonesia, Malaysia, Laos, Bangladesh, and Gabon in Africa, no direct evidence has shown local transmission has occurred in any of the 6 countries.

CECC for Zika Virus will continue to implement relevant national efforts for Zika virus infection control, primarily the 4 major strategies that include healthcare system preparedness planning, prevention of Zika virus importation, border quarantine and vector control, will be implemented. 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 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. 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 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).