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Disease Outbreak News

Sunday, June 7, 2009

15th Confirmed Case of Influenza A (H1N1-2009)

Singapore has confirmed one more case of Influenza A (H1N1-2009). She is the first close contact of an earlier confirmed case to be infected. The patient has relatively mild symptoms and is in stable condition. To date, 6 patients (1st - 5th and 9th cases) have been discharged already and 9 still remain in hospital.

The 15th Confirmed Case

2. The patient is a 39-year-old Indonesian female, who is the aunt of the 11th case. She went to Changi Airport to fetch her niece when the latter arrived from New York via Frankfurt on SQ25 to Singapore at 0618 hours on 1 Jun 09. They took a taxi to the 15th case's residence. The niece developed symptoms in the afternoon of 2 Jun 09. The aunt accompanied her niece to seek medical attention at Raffles Hospital's Emergency Department in the evening by taxi. Her niece was confirmed positive at 1500 hours on 3 Jun 09.

3. The aunt was subsequently placed on HQO until 10 June and given chemoprophylaxis. Laboratory results confirmed infection of the aunt at 1600 hours on 6 Jun 09. Three of her (the 15th case) household members have already been placed on HQO.

Update on the 13th and 14th Confirmed Cases

4. Contact tracing of all the close contacts of the 13th and 14th confirmed cases have been completed. For the 13th case, a 23-year-old Singaporean male who had a travel history to Melbourne from 27 May - 3 June, MOH has identified 44 close contacts on the flight. We have managed to contact 18 out of the 19 passengers with entry records into Singapore. They comprise 11 Singaporeans and 7 foreigners, and they have been placed under HQOs. Their period of quarantine ends on 11 June 09. One foreigner is uncontactable. We have alerted ICA to inform us if he should turn up at our checkpoints. We have also informed WHO and our IHR counterparts of the 25 passengers who are out of Singapore.

5. For the 14th case, a 22-year-old Singaporean air-stewardess with Singapore Airlines, as she developed onset of symptoms more than 24 hours after disembarkation, no contact tracing of flight passengers was undertaken on the basis that the confirmed case is unlikely to have been infectious onboard the plane. MOH has identified 4 close local contacts and they have been placed under HQOs. Her period of quarantine is from 5 Jun to 11 Jun 09.

Advice from MOH

6. Although the 15th case was started on chemoprophylaxis when she was served the HQO, it should be noted that she could already have been infected through close contact with her niece prior to the administration of the chemoprophylaxis. While chemoprophylaxis can significantly reduce the risk of infection, it does not completely eliminate it. As such, MOH reiterates its advice 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). For those returning from affected areas, they should seek medical attention promptly and call 993 for an ambulance if they become unwell within 7 days of their return. 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.

7. 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.

8. MOH also advises travellers to see a doctor as soon as possible if they feel unwell overseas and refrain from travelling until certified fit by the doctor. This is in line with the World Health Organisation’s recommendations for people who are ill to delay international travel and for people who develop symptoms following travel to seek medical attention.

9. 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

6 June 09


Travel Notices - CDC Travelers' Health