On February 14, 2016, the Taiwan Centers for Disease Control (Taiwan CDC) updated the Zika travel advisory, which became in line with the latest development of the ongoing outbreaks announced by the World Health Organization (WHO), the European Centre for Disease Prevention and Control (ECDC), andthe U.S. Centers for Disease Control and Prevention (US CDC). In view of the fact that WHO included Thailand as one of the countries and territories with autochthonous transmission of Zika virus for the first  time on February 12, Taiwan CDC stepped up the travel notice level for Thailand to Level 2: Alert for Zika virus. In addition, pregnant women and women planning their pregnancy are advised to postpone their trips to areas where Zika virus is active, travelers are advisedto 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. As the Chinese Lunar New Year holiday has come to an end, travelers returning from Zika-affected areas are urged to proactively contact thequarantine officer at the fever screening station at the airport when suspected symptoms develop, seek immediate medical attention and inform the physician of their travel history in order to ensure timely diagnosis and prompt treatment when they experience symptoms within two weeks of their return.

Since the Zika outbreak was first reported in Brazil in 2015, the virus has continued to spread worldwide. According to the surveillance data compiled by Taiwan CDC, at least 36 countries, areas and/or territories worldwide, primarily in Latin America and the Caribbean region, have reported local outbreaks of Zika virus infection. On top of that, 6 countries, areas and/or territories, including Brazil, have observed a significant increase in the numbers of microcephaly cases and Guillaine-Barre syndrome (GBS)after Zika outbreaks occurred. As the evidence connecting maternal Zika virus infections to microcephaly in babies has been mounting and findings about the connection between Zika virus infection and GBS have also been reported, further evidence is needed to confirn the claims.

During 2015 and 2016, a total of 18 countries have reported a few imported Zika cases from the Americas, Thailand, Tonga, and Samoa, including 14countries in Europe, the U.S. , Canada, Israel, New Zealand, Australia, and China. As of now, only one imported case of Zika virus infection in a Thai national detected at the airport in Taiwan on January 10, 2016, no other casesof Zika virus infection have been identified in Taiwan. In light of the ongoing Zika transmission, Taiwan CDC has issued a travel notice of Level 2: Alert forZika virus for 36 countries and territories in Latin America, the Caribbeanregion and Asia (Maldives and Thailand), and a travel notice of Level 1: Watch for Zika virus for four countries in Asia,including Cambodia, Indonesia, Malaysia, and the Philippines.

Zika virus is transmitted by the same type of mosquitoes that transmit dengue virus, Aedes mosquitoes, including Aedes aegypti and Aedes albopictus. Typical symptoms include fever accompanied by a maculopapular rash, joint pain, or conjunctivitis. Other symptoms include headache, musclepain and pain behind the eyes. Although the disease is usually mild, there havebeen reports of congenital microcephaly and even deaths in babies of mothers who were infected with Zika virus while pregnant. Hence, Taiwan CDC will continue to closely monitor the numbers of microcephaly and GBS cases in Taiwan and urges physicians to heighten vigilance for microcephaly cases.

Taiwan CDC advises pregnant women to postponetheir trips to areas affected by Zika virus. Travelers visiting affected areas are urged to take precautions against mosquito bites suchas 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 toproactively contact the quarantine officer at the fever screening station atthe 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 orcall the toll-free Communicable Disease Reporting and Consultation Hotline,1922 (or 0800-001922).