11 confirmed new cases of influenza A H1N1 (18 June 2009)

11 confirmed new cases of influenza A H1N1 (18 June 2009)

Singapore has confirmed another 11 new cases (67th to 77th cases) of
Influenza A (H1N1), including one who appeared to have acquired his infection in Singapore. The remaining 10 cases involve travellers returning from countries with known community transmission of H1N1. This brings the total number of confirmed cases here to 77.

The 73rd case is a 26-year-old Malaysian male who is a PR in Singapore. He departed from Singapore to Kuala Lumpur for work on SQ108 at 1000 hours on 14 June. Later that evening, he developed symptoms while he was having dinner at a restaurant. On 15 June, he attended a conference in the morning and went out in the evening. On 16 June, he sought medical attention at a GP clinic in the early hours and was prescribed antibiotics and paracetamol. He then went back to the hotel and remained there for the rest of the day. He returned to Singapore from Kuala Lumpur on SilkAir MI335 at 1514 hours on 17 June. He was seated at row 19. When he arrived at Changi Airport, he immediately approached the airport staff and a 993 ambulance was called to send him to TTSH. Prior to his travel to KL, his last travel out of Sing pore was to Hong Kong from 28 May to 1 June 09. He remained well after his trip to Hong Kong.

While investigations continue, our tentative assessment is that he may be our first unlinked local case as he has no travel history to a known infected area. He could have come into contact with one of the earlier confirmed cases here, since the virus is not native here. Unless further investigations turn up evidence otherwise, and if more such unlinked cases emerge over the next few days, this would signal the beginning of community spread in Singapore. We have not reached such a stage yet. We must press on with our containment efforts and everyone must play his part. This is especially so for recent travellers from infected areas. They must not engage in community activities and come forward immediately for screening and isolation as soon as flu-like symptoms develop.

Meanwhile, we have alerted our Malaysian counterparts about this case and his activities in KL.

Details of new imported cases

The nationalities of the 10 imported cases are:
· 6 Singaporeans
· 1 Singapore PR (Filipino)
· 3 foreigners (1 Filipino, 1 Australian, 1 Canadian)

Of the 10 cases, one was unwell before boarding the flight, while three developed symptoms during the flight. The remaining six cases, who developed symptoms after arrival in Singapore, sought medical treatment or called 993 soon after onset of symptoms. All six stayed home between onset of symptoms and seeking treatment.

Contact tracing

Contact tracing is ongoing for all new cases, including for close contacts for the following flights:
· SQ919 (Manila to Singapore) on 16 June 2200 hrs rows 54-58
· SQ11 (LA to Singapore via Tokyo) on 17 June 0115 hrs rows 40-44
· SQ351 (Copenhagen to Singapore) on 17 June 0530 hrs rows 33-37
· SQ238 (Melbourne to Singapore) on 17 June 1610 hrs 37-41

Passengers who have not been contacted by MOH yet should call the MOH hotline at 1800-333 9999 to enable us to check on their health condition expeditiously. All close contacts identified will be quarantined and provided with antiviral prophylaxis.

The breakdown of the 77* cases is as follows:

Country of Origin of Travel of Confirmed Cases (as of 18 June 2009)
Countries Number of cases
Australia 33
United States 20
Philippines 15
Thailand 1
Canada 2
UK 2
Chile 1
Cruise# 1
Total 75
*75 cases were imported while one appeared to have acquired his infection in Singapore, and another one was a close contact of a confirmed case.

# The 68th case is a 33-year-old Singaporean woman who went for a holiday in Europe from 28 May to 17 June. She was on a cruise from 4 June to 16 June. She developed symptoms while on the cruise. She was treated on the ship and returned to Singapore on 17 June.

So far, 27 patients have been discharged. The remaining 50 patients (22nd – 23rd, 25th – 28th, 31st – 32nd, 34th, 36th – 37th, 39th – 77th cases) are still in the hospital and their conditions remain stable.

Advisory to all travellers

For people who are planning to travel, they should check the MOH website for the latest update on the list of countries with confirmed cases of

H1N1 so that they can make considered decisions on whether to proceed with their travel plans. 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.

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