Border quarantine is the first line of defense against the importation of communicable diseases. To help all walks of life to understand the significant role border quarantine plays in preventing international spread of diseases and Taiwan’s history of quarantine policies and practices in the past 120 years, the Taiwan Centers for Disease Control (Taiwan CDC) specially invited esteemed researchers who specialize in Taiwanese history at Academia Sinica as well as retired and current quarantine officers to jointly publish the book, “Power of Perseverance-Taiwan’s History of Quarantine in 2 Cycles of 60 Years”. In addition, on January 23, 2018, Taiwan CDC invited Academia Sinica Academician Liu Shi-yung (劉士永) and senior quarantine officer Kang Chi-zhang (康啟彰) to attend the book launch event and discuss the publication of the book and the joys and pains of implementing quarantine efforts.
The book details the development of Taiwan’s quarantine practices during the past 120 years from 1896 to 2016. During the Japanese occupation period, the public health infrastructure was built and the quarantine mechanism was established. As the standards of living in Taiwan improved, the practices of vessel fumigation and cholera testing of seafood were gradually lifted. In addition, since the 2003 SARS outbreak, Taiwan established fever screening stations at points of entry. Until now, the four major quarantine practices in Taiwan include: proactive surveillance and following-up of all inbound passengers with symptoms (traveler quarantine), vector surveillance and control at points of entry (point of entry hygiene and sanitation), inspection and review of hygiene and sanitation on vessels and issuance of vessel sanitation certificates (vessel hygiene and sanitation), and prevention of importing communicable diseases through transportation (port quarantine). All of these efforts are carried out tirelessly by the front-line quarantine officers day and night, safeguarding the health and wellbeing of the people in Taiwan.
In line with the scope and spirit of the International Health Regulations 2005 (IHR 2005), Taiwan has been formulating and adopting various prevention measures without interfering international transportation and trade. Under the guidance and full support of the Executive Yuan, Taiwan developed the IHR core capacity requirements at 7 designated points of entry that cover more than 95% of the total visitor arrivals/departures and cargo throughput, which have been demonstrated in the numerous past battles against infectious diseases. For instance, during the Ebola outbreak in West Africa in 2014-15 and the MERS-CoV outbreak in Korea in 2015, our quarantine teams at designated points of entry worked closely with other agencies to reinforce health education among departing travelers, strengthen inbound quarantine efforts, activate the implementation of on-board quarantine measures, and implement emergency referral. All of the aforementioned efforts show the smooth operation of the communication mechanism in place and the capacity to respond to emergency events. On the other hand, since the Zika outbreaks that occurred in 2016, Taiwan has successfully detected several imported Zika cases, effectively buying time for epidemic preparedness. Simultaneously, Taiwan has also been proactively monitoring Zika activity in neighboring countries, contributing to the prevention of international spread of the disease. All of these achievements rely on the establishment of the border quarantine capacity and its continuous operation and maintenance.
According to the statistics compiled by Taiwan CDC, a total of 154 dengue cases, 8 chikungunya cases and 2 Zika cases were detected through border screening in 2017. Early detection of diseases does not only promptly identify cases, but also facilitates the implementation of necessary prevention measures in the community, which will help effectively prevent the occurrence of outbreaks. Nevertheless, along with frequent international exchange and diversification in tourism, border quarantine has been facing multi-faceted challenges. As a result, beginning this year, Taiwan is implementing “Reinforced Border Quarantine and Cross-Border Collaboration for Disease Prevention– Phase I Project” to continuously improve our capacity to tackle infectious diseases through four major strategies, including the establishment of intelligent quarantine network, improving the quality and quantity of quarantine personnel, reinforcing the concept of travel medicine and strengthening international exchange of experiences, in order to ensure the health and wellbeing of the public.