On October 2, 2018, Taiwan Centers for Disease Control (Taiwan CDC) announced one new imported Zika case identified in Taiwan. The case is an over 30-year-old Taiwanese male who resides in northern Taiwan. During June 24 and September 23, he was in Vietnam for work. On September 20, he developed pain below the ears, pain behind the eyes and rash, so he took over-the-counter drugs to relieve the symptoms. On September 22, his rash gradually subsided. On the following day, he took a flight from Vietnam to return to Taipei. On September 26, he sought medical attention, and blood specimen was collected from the case. On September 30, infection with Zika virus was confirmed in the case. As of now, the case’s symptoms have improved, and he is not experiencing any discomfort. Hence, he has returned to work in Vietnam.

Since 2016, a total of 19 imported Zika cases, including 2 in 2018, 4 in 2017, and 13 in 2016, have been identified in Taiwan. The majority of them acquired the infection in Southeast Asia and they respectively became infected in Indonesia (1), Malaysia (2), the Philippines (2), Singapore (1), Thailand (4), Vietnam (5).The others became infected in Africa and the Americas, including Angola (1), Florida, the U.S. (1), St. Lucia (1), St. Vincent and the Grenadines (1).

Taiwan CDC scaled up the travel notice level for Vietnam to Level 2: Alert for Zika virus in view of the newly imported case and the potential risk of local transmission of Zika virus in the country. Travelers returning to Taiwan from Zika-affected areas are urged to proactively contact the quarantine officer at the fever screening station at the airport when experiencing symptoms. If symptoms develop within two weeks of their return, please seek immediate medical attention and inform the physician of their travel history. Simultaneously, healthcare facilities are urged to heighten vigilance for suspected cases, inquire patients of their travel history when necessary, and report suspected cases to the competent health authority as required by the law in order to lower the risk of transmission.

According to the Zika virus classification table published by the World Health Organization (WHO) on March 9, 2018, 71 countries, areas and/or territories worldwide have reported local outbreaks of Zika virus infection since 2015. Taiwan CDC has issued a travel notice of Level 2: Alert for Zika virus for 3 affected Asian countries with ongoing outbreaks or possible local transmission of Zika virus, including the Philippines, Singapore, and Vietnam. For countries with evidence of virus circulation before 2015 or ongoing transmission that is no longer in the new or re-introduction phase, but where there is no evidence of interruption, Taiwan CDC has issued a travel notice of Level 1: Watch for Zika virus; these countries include Bangladesh, Cambodia, India, Indonesia, Laos, Malaysia, Maldivesand Myanmar, Thailand.

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. Travelers visiting Zika-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. In addition, travelers leaving Zika-affected areas are urged to follow the “1+6 Principle” to prevent Zika transmission. The “1+6 Principle” specifies that people who have recently traveled to Zika-affected areas should monitor their own health and take precautions against mosquito bites for at least 3 weeks, postpone blood donation for at least 1 month, and regardless whether they develop suspected Zika symptoms, they should practice safe sex for at least 6 months to prevent Zika transmission. Further, female travelers should postpone pregnancy for at least 6 months. 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).