Preventive Measures and Treatment Options for Zika Virus Infection in Taiwan
The most effective preventive measures against Zika virus infection in Taiwan include avoiding mosquito bites, using mosquito repellents, wearing protective clothing, and practicing safe sex, while treatment remains supportive care as there is no specific antiviral therapy currently available. 1
Epidemiology and Transmission in Taiwan
- Taiwan reported its first imported case of Zika virus infection in January 2016 through airport fever screening, with the virus identified as Asian lineage closely related to virus from Cambodia 1
- No autochthonous (local) transmission of Zika virus has been documented in Taiwan to date 1
- The Taiwan Centers for Disease Control has implemented comprehensive surveillance and prevention strategies to prevent Zika from establishing within the country 1
Transmission Routes
- Zika virus is primarily transmitted through the bite of infected Aedes species mosquitoes 2
- Other documented transmission routes include:
Clinical Manifestations
- Most Zika virus infections (up to 80%) are asymptomatic 4
- When symptomatic, the most common signs and symptoms include:
- Symptoms typically last for several days to a week 5
Preventive Measures
Vector Control
- Implement comprehensive mosquito control programs targeting Aedes mosquitoes 1
- Community mobilization and education about mosquito breeding sites elimination 1
- Use of mosquito repellents containing DEET, picaridin, IR3535, or oil of lemon eucalyptus on exposed skin 5
- Wear long-sleeved shirts and long pants when outdoors 5
- Use air conditioning or window/door screens to keep mosquitoes outside 1
- Empty standing water from containers around homes and workplaces 1
Travel Precautions
- Pregnant women should avoid travel to areas with ongoing Zika virus transmission 2
- Travelers to areas with Zika transmission should take enhanced precautions against mosquito bites 5
- Healthcare providers should educate patients, particularly pregnant women, about risks and preventive measures 5
Sexual Transmission Prevention
- Men who have traveled to areas with active Zika transmission and have pregnant partners should:
- Abstain from sexual activity OR
- Consistently and correctly use condoms during sex for the duration of the pregnancy 3
- Similar precautions are recommended for non-pregnant partners until more is known about duration of potential sexual transmission 3
Diagnostic Approaches
- Zika virus should be considered in patients with acute onset of fever, rash, arthralgia, or conjunctivitis who have:
- Traveled to areas with ongoing Zika virus transmission, or
- Had unprotected sex with someone who traveled to these areas and developed compatible symptoms within 2 weeks of returning 5
Laboratory Testing
- Molecular methods (RT-PCR) are the most reliable tool to confirm Zika virus infection 4
- Zika virus RNA is typically detectable in serum from approximately 2 days before to 1 week after illness onset 6
- IgM antibody testing may yield false positives due to cross-reactivity with other flaviviruses (e.g., dengue) 6
- Confirmatory neutralization tests are required for inconclusive or positive serology results 4
Treatment Options
- No specific antiviral treatment is currently available for Zika virus infection 1
- Treatment is supportive and includes:
- Rest
- Hydration
- Acetaminophen for fever and pain
- Avoiding aspirin and NSAIDs until dengue has been ruled out (due to risk of bleeding) 5
Special Considerations for Pregnant Women
- Pregnant women with possible exposure to Zika virus should be tested for Zika virus infection 4
- Prenatal ultrasound monitoring is essential for detecting potential fetal abnormalities 4
- Congenital Zika syndrome can occur in 5-10% of infected pregnancies, with higher risk in first-trimester infections 2
- Long-term follow-up of infants born to mothers with Zika virus infection during pregnancy is recommended 4
Taiwan's Public Health Response
- Taiwan CDC has implemented several measures to prevent Zika spread:
- No significant increase in microcephaly or Guillain-Barré Syndrome has been observed in Taiwan 1