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Disease Outbreak News

Saturday, June 6, 2009

13th and 14th Confirmed Cases of Influenza A (H1N1-2009)

Singapore has confirmed two more cases of Influenza A (H1N1-2009). Both of them have relatively mild symptoms and are in stable condition

The 13th Confirmed Case

2. The patient is a 23-year-old Singaporean male who went to Melbourne on 27 May and developed symptoms in the early hours of 3 Jun while he was still there. He returned to Singapore on Singapore Airlines SQ238 (Row 40) on 4 Jun at 1611 hours. His fever was detected by the thermal scanner at Changi Airport and was sent to TTSH via a 993 ambulance. He was subsequently admitted to CDC for further assessment that night. Laboratory results confirmed his infection at 1530 hours on 5 Jun.

The 14th Confirmed Case

3. The patient is a 22-year-old Singaporean female who is a cabin crew with Singapore Airlines and went to New York on 24 May. She was on the same flight (SQ25) from New York to Frankfurt as three of the earlier confirmed cases; the 7th confirmed case involving a 30-year-old Australian male tourist who was seated at row 54; the 10th confirmed case involving a 33-year-old Singapore female who was seated at row 19; and the 11th confirmed case involving an 18-year-old American female visitor who was seated at row 57. While these three earlier confirmed cases arrived in Singapore on 1 Jun, she had stopped over at Frankfurt and returned to Singapore one day later on 2 Jun at 0630 hours.

4. Upon arrival, she went home by taxi from the airport. She developed symptoms in the afternoon of 3 Jun. The next day, she consulted a GP in the evening. She was referred to TTSH via a 993 ambulance and admitted to CDC for further assessment that night. Laboratory results confirmed her infection at 1530 hours on 5 Jun.

5. Malaysian MOH has also informed us of two confirmed cases arising from SQ25 on 1 Jun. The two were foreign passengers arrived in Singapore on 1 Jun and left for Malaysia KL on 3 Jun.

Contact Tracing

6. Contact tracing has been initiated for the 13th and 14th confirmed cases. Passengers within rows 38 to 42 on SQ238 on 4 Jun 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.

7. In view of that there are six confirmed cases related to SQ25 on 1 Jun, passengers on board SQ25 on 1 Jun (New York to Singapore via Frankfurt) are advised to monitor their health closely till 8 Jun. Should they be unwell, they are advised to go to CDC immediately for an assessment using the 993 ambulance.

Update on the 12th Confirmed Case

8. Contact tracing for close contacts of the 12th case involving the 18-year-old Singaporean male who returned from Melbourne on Emirates EK405 (row 18) at 2350 hours on 1 Jun, have been accounted for. We have established a total of 43 close contacts comprising of 40 flight passengers and 3 local contacts. All 3 local contacts will be issued HQOs. We will also issue 21 HQOs to the 24 flight passengers who are in Singapore. We have provided ICA with the details of the 3 remaining passengers who are uncontactable. 16 flight passengers are out of Singapore.

9. The case had developed symptoms on 30 May while he was in Melbourne. He was not picked up by the thermal scanner at Changi Airport as he did not have fever then. He was met by his friend at the airport who drove him to a hotel for an overnight stay as he wanted to isolate himself from his family. On 2 Jun, he took a taxi to a GP clinic in the morning and then went back to the hotel. He later checked out from the hotel and took a taxi to his sister's residence where he remained for the whole day. On 3 Jun, he went to the same GP clinic with a family member by MRT in the morning. He then returned to his sister's residence, and stayed there the whole day. On 4 Jun, a 993 ambulance was called to send him to TTSH ED at about 12 noon. Laboratory results confirmed his infection at 1925 hours on 4 June, and he was admitted to CDC.

Advice from MOH

10. MOH advises the public to avoid non-essential travel to these affected areas (Melbourne and the State of Victoria in Australia, Kobe and Osaka in Japan and Chile, USA, Canada and Mexico). Should they become unwell within 7 days of their return from affected areas, they should seek medical attention promptly and call 993 for an ambulance. They should avoid taking public transport or taxi to minimise exposure. To help in contact tracing, the public may find it helpful to keep records of their movements for 7 days (for example by keeping taxi receipts) after their return from the affected countries.

11. For people who are unable to avoid travelling to affected areas, they should:

• Avoid crowded areas and contact with anyone who appears unwell.

• Maintain high standards of personal hygiene at all times.
- Wash hands regularly and thoroughly with soap and water, especially before touching the eyes, nose or mouth.
- Turn quickly away from anyone near if they are about to cough or sneeze.
- Cover the nose and mouth with a piece of tissue when coughing or sneezing. Dispose of the tissue paper properly in the dust bin after use.

• MOH also advised travellers to see a doctor as soon as possible if they feel unwell overseas and refrain from travelling until certified fit by the doctor.

8. MOH is monitoring the situation closely and will update the public on any new developments. For more information on Influenza A (H1N1-2009), please access MOH’s website at, call our hotline at 1800-333 9999, or visit

5 Jun 09

Travel Notices - CDC Travelers' Health