On August 19, 2016, the U.S. Centers for Disease Control and Prevention (US CDC) identified Miami Beach in Miami Dade County, Florida as another area of active Zika transmission. It is the second active Zika transmission area identified near Wynwood.

Since non-travel related Zika cases have been reported in Florida beginning the end of July 2016, as of August 19, 2016 a total of 36 locally acquired Zika cases have been reported in the state. The majority of these cases have traveled to the one-square-mile transmission area in Wynwood, which is north of downtown Miami. Among them, 5 cases are linked to the Miami Beach transmission area and 1 of them is a 44-year-old female traveler from Taiwan, which is the 6^th imported Zika case announced in Taiwan on August 17, 2016. The case visited Miami, Florida, US during July 31 and August 11, 2016 for business. She developed suspected symptoms after returning to Taiwan on August 12, 2016 and her infection with Zika virus was laboratory confirmed. As of now, the case’s symptoms have all subsided and she is in good health. The case has been asked to stay home, prevent mosquito bites, and isolate herself till August 23, 2016 and follow the “2226 Principle” to prevent further spread of the virus. Additionally, the local health authority has promptly implemented various prevention measures, including cleaning of vector breeding sites, investigating the mosquito population density around the case’s residence, and providing the case’s family members with relevant health education.

The Central Epidemic Command Center for Zika Virus (CECC for Zika Virus) pointed out that Miami-Dade County, Florida, U.S. is a popular travel destination. Moreover, US CDC stated that as Miami County is in the midst of mosquito season and more Zika infections are expected to occur in the coming months, pregnant women and women planning pregnancy are advised to avoid visiting the areas with ongoing Zika transmission. People visiting Zika-affected areas are urged to take precautions against mosquito bites. Further, those who have traveled to the Miami Beach transmission area since July 14, 2016 should be aware of active Zika virus transmission, and pregnant women should see their doctor about getting tested for Zika as well as take measures against sexual transmission of Zika virus.

The World Health Organization (WHO) announced on August 18, 2016 that since 2007, at least 67 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 57 countries and territories with ongoing outbreaks or possible local transmission of Zika virus, including 4 countries in Asia: Thailand, the Philippines, Vietnam and Indonesia, as well as Broward and Miami-Dade counties, Florida. Moreover, during 2007 and 2015, about 10 countries, including Cambodia, Indonesia, Malaysia, Laos, and Bangladesh, reported Zika outbreaks. Nonetheless, thus far in 2016, no Zika cases have been reported in those 10 countries. Hence, Taiwan CDC has issued a travel notice of Level 1: Watch for Zika virus for those countries.    

Although the disease is usually mild in adults, there have been reports of congenital microcephaly and even deaths in babies of mothers who were infected with Zika virus while pregnant. Taiwan CDC advises pregnant women and women planning pregnancy to postpone all unnecessary travels to Zika-affected areas. In addition, travelers are advised to follow the “2226 Principle” after leaving the affected areas to prevent Zika transmission, which 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. 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. 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).