Six New Confirmed Cases of Influenza A (H1N1-2009)(1)

14 Jun 2009

Singapore has confirmed six more cases of Influenza A (H1N1-2009), bringing the total number of confirmed cases here to 40. All of the 40 cases, except one who was a close contact of a confirmed case, are imported cases with a travel history.  The breakdown is as follows:

Country of Origin of Travel

3. In the last three days, a total of 19 cases were reported. 13 of the imported cases had arrived in Singapore from Australia, two from the US, two from the Philippines, one from Thailand, and one from Canada

4. So far, 17 patients have been discharged. The remaining 23 patients (18th - 40th cases) are still in the hospital and their conditions remain stable. 

35th - 36th Confirmed Cases

5. The 35th case is a 19-year-old Singaporean male who went to Melbourne for holiday on 7 June.  He developed symptoms on 8 June while he was in Melbourne. He returned to Singapore from Melbourne on Singapore Airlines SQ238 (Row 43) at 1600 hours on 12 June. He was not picked up by the thermal scanner at Changi Airport as he was not feverish then. He went home by taxi and stayed at home for the rest of 12 June and 13 June. On 13 June night, he was sent via a 993 ambulance to CDC2 and was admitted near midnight on 13 June.

6. The 36th case is a 24-year-old Singaporean female cabin crew who was off duty when she travelled on flight SQ25 (Row 38) from Frankfurt on 12 June as a passenger. She had earlier developed symptoms on 12 June while she was in Frankfurt, and sought medical attention at a hospital there. The doctor assessed that she was fit for travel.  Upon arrival in Singapore, she was not picked up by the airport's thermal scanner as she was not feverish then. She sought medical attention at a GP clinic in the airport, and was sent to TTSH via a 993 ambulance. She was admitted to CDC2 in the morning of 14 June.

7. Laboratory results confirmed infection of H1N1 of the 35th to 36th cases at 1400 hours on 14 June.

37th - 40th Confirmed Cases

8. The 37th case, a 41-year-old Singapore PR female and the 38th case, an 8-year-old Singapore PR female, are mother and daughter who went to the Philippines on 30 May for a family visit.  The mother developed symptoms on 13 June before she boarded the plane, while the daughter had symptoms while on the plane. They returned to Singapore from Manila on Singapore Airlines SQ915 at 1132 hours on 13 June. The mother was seated at row 38 while the daughter was seated at row 39. Upon arrival in Singapore, they were picked up by the airport's thermal scanner as they were both feverish, and were sent to KKH via a 993 ambulance. They were admitted in the afternoon of 13 June.

9. The 39th case is a 7-year-old Australian girl who was in Singapore for a holiday. She developed symptoms on 12 June while in Australia. She came to Singapore from Melbourne on Singapore Airlines SQ228 (Row 60) at 2132 hours on 13 June.  Her fever was detected by the airport's thermal scanner and she was sent to KKH via a 993 ambulance. She was admitted for further assessment in the early hours of 14 June.

10. The 40th case is a 9-year-old Malaysian boy who went to Sydney and Melbourne, and later arrived in Singapore with his parents for a holiday. He came to Singapore from Melbourne on Jetstar JQ61 (Row 17) via Darwin at 2149 hours on 13 June.  He developed symptoms while on the plane.  His fever was detected by the airport's thermal scanner and he was sent to KKH via a 993 ambulance. He was admitted in the early hours of 14 June.

11. Laboratory results confirmed infection of H1N1 of the 37th to 40th cases at 1745 hours on 14 June.

Contact Tracing for 24th - 27th and 32nd - 34th Confirmed Cases

12. Contact tracing for 24th - 27th and 32nd - 34th confirmed cases have been completed. For the  24th case, a 12-year-old Singaporean male who is studying in Melbourne and returned to Singapore on 8 June 09, MOH has  placed four of his family members under HQOs. Their period of quarantine ends on 19 June. No contact tracing for close contacts on the flight is required as his date of onset of symptoms was more than 24 hours after disembarkation.

13. For the 25th case, a 15-year-old Singaporean male who is studying in USA and returned to Singapore from San Francisco via Tokyo on 11 June 09,  MOH  has identified nine local household close contacts, and 23 close contacts on the flight of whom 17 had entry records into Singapore. The nine local household close contacts have been served HQOs which will end on 19 June. Of the 17 flight passengers with entry records into Singapore, we have contacted 10 of them (comprising eight Singaporeans and two foreigners), and they have been placed under HQOs which will end on 18 June. For the remaining seven passengers who were uncontactable, we have alerted ICA to inform us should they turn up at our checkpoints. We have also informed WHO and our IHR counterparts of the six foreigner passengers who are out of Singapore.

14. For the 26th and 27th cases, a 39-year-old Singaporean female and a 3-year-old Singaporean male, mother and son, who went to Melbourne to attend a wedding and returned to Singapore on 9 June, MOH has identified four local contacts (relatives of the cases) and 32 close contacts on the flight. The four local household close contacts have been served HQOs which will end on 17 June. Of the 12 flight passengers with entry records into Singapore, we have contacted nine of them (comprising seven Singaporeans and two foreigners), and they have been placed under HQOs which will end on 17 June. For the remaining three passengers who were uncontactable, we have alerted ICA to inform us should they turn up at our checkpoints. We have also informed WHO and our IHR counterparts of the 20 foreigner passengers who are out of Singapore.

15. For the  32nd case, a 28-year-old Singaporean male who had just completed his studies in Canada and returned to Singapore from Montreal via New York and Tokyo on 11 June 09, we have place three household contacts and a close social contact under HQOs. Their period of quarantine ends on 20 June 09. No contact tracing for close contacts on the flight is required as his date of onset of symptoms was more than 24 hours after disembarkation.

16. For the 33rd case, a 32-year-old Singaporean female who went to Phuket with her husband for holiday and returned to Singapore on 5 June, MOH has placed her husband under HQO and his period of quarantine ends on 21 June. Of the five colleagues who had met with the case, four are currently in Singapore and have been served HQOs which will end on 16 June. We have alerted ICA to inform us should the remaining colleague turn up at our checkpoints. No contact tracing for close contacts on the flight is required as her date of onset of symptoms was more than 24 hours after disembarkation.

17. For the 34th case, a 6-year-old Australian girl who came to Singapore from Melbourne with her mother on 12 June for a holiday, MOH  has identified six local household close contacts, and 26 close contacts on the flight of whom seven had entry records into Singapore. The six local household close contacts have been served HQOs which will end on 20 June. Of the seven flight passengers with entry records into Singapore, we have contacted five of them (comprising one Singaporeans and four foreigners), and they have been placed under HQOs which will end on 20 June. For the remaining two passengers who were uncontactable, we have alerted ICA to inform us should they turn up at our checkpoints. We have also informed WHO and our IHR counterparts of the 19 foreigner passengers who are out of Singapore.

Contact Tracing for 28th - 31st  Confirmed Cases

18. Contact trace mapping for the 28th - 31st confirmed cases is still ongoing. Similar to the 26th and 27th cases (mother and son), these cases had all attended the same wedding in Melbourne but had returned to Singapore on separate flights.

19. The Ministry of Education (MOE) has informed the schools of the 30th case, a 16-year-old Singaporean female, and the 31st case, a 17-year-old Singaporean female, both of whom had returned to Singapore from Melbourne on different flights on 9 June.  The two schools have traced and contacted all 65 students and staff who were in contact with the confirmed cases. These students and staff have been advised to stay at home and to monitor their well-being for the next seven days. The affected classrooms will be disinfected. 

20. MOE has advised schools to step up vigilance in monitoring students who participate in holiday activities in school. Temperature taking will be conducted during these activities. We also seek the cooperation of parents to monitor their children's health carefully and exercise social responsibility.  Parents should not send their children to school if they are unwell, but seek medical attention instead, particularly if they have travelled to affected countries during the school holidays

MOH Advisory to all travellers

21. Given these recent cases, MOH would like to again remind travellers from infected areas to consult a doctor there as soon as possible if they feel unwell and to refrain from travelling if they have symptoms within 24 hours of their planned departure. This is to avoid infecting other passengers and putting them to great inconvenience if they have to be quarantined. This advisory is in line with the WHO's recommendations for people who are ill to delay international travel and for people who develop symptoms following travel to seek medical attention.

22. MOH has on its website a list of countries most affected by H1N1 in terms of numbers of cases, death and known exported cases. This is updated regularly. Travellers are encouraged to review the information when making their travel plans. Where travel is unavoidable to countries considered by WHO to have sustained community transmission or to be in transition towards community transmission (USA, Mexico, Canada, UK, Spain, Chile, Australia, Japan), they should take the necessary precautionary measures, and call 993 for an ambulance should they become unwell within seven days of their return. If unwell, they should stay at home and not go about their usual activities such as going to school, shopping or work.  Socially irresponsible behaviour will significantly increase the risk of causing a community spread in Singapore.  

23. For all other travellers, they should see their nearest doctor when they develop flu-like symptoms after their return. Social responsibility and high standard of personal hygiene from all of us is still the most important and practical measure against H1N1 infection. This will reduce the likelihood of their transmitting any infection to their family members, friends and the community. For more information on Influenza A (H1N1-2009), please access MOH's website at www.moh.gov.sg, call our hotline at 1800-333 9999, or visit www.flu.gov.sg.

MINISTRY OF HEALTH