On June 1, 2009, the Central Epidemic Command Center (CECC) confirmed the thirteen imported case of influenza A (H1N1) in an 8-year-old Canadian-born Chinese girl who traveled to Camboida from Montreal, Canada through Vancouver and Taipei. The case developed symptoms such as vomit, fever and cough at Vancouver International Airport. The case and her family members put on a facemask after boarding the plane and informed the cabin crew about the case’s symptoms.Therefore, necessary precautious measures were immediately implemented.

The case took a flight from Vancouver on May 30, 2009 and arrived at Taoyuan International Airport at 05:30 on May 31, 2009.After being examined by the quarantine physician, the case was reported to the health authority as a person under investigation and sent to thehospital for specimen collection and isolation treatment.In the evening of May 31, 2009 influenza A (H1N1) infection was confirmed in the case.Currently, the case is in fair health condition (cough with no fever). On the other hand, the case’s mother was also reported to the health authority as a person under investigation because she also experienced cough.Nevertheless, the mother was tested negative for influenza A (H1N1) virus.

According to the epidemiological investigation, the case developed symptoms in Vancouver before boarding the plane.Therefore it is highly likely that the case became infected with influenza A (H1N1) in Montreal, Canada.Further, the case and the rest of her family members wore a facemask throughout their flight back to Taiwan.As a result, the risk of infecting the close contacts, particularly the passengers sitting in the same row and in the 3 rows in front and behind the case, is fairly low.Hence, all the close contacts have been asked to conduct self-health management. If any of the close contacts develop influenza-like symptoms such as fever and cough during the next 2-7 days, please be sure to call 1922 or contact the local health unit first and refrain from seeking medical attention on his/her own.CECC indicated that a total of 54 passengers sat close to the case on the plane.Of the passengers, 24 have entered Taiwan and 30 have transferred to other countries. Those that entered Taiwan have been reached for further investigation.In addition, CECC has reported the case to the World Health Organization and contact points in other countries through the IHR Focal Point. Since the case is a foreign national, her consular mission has been notified for relevant matters.

As the case was identified through incident reporting on the airplane, proper control measures were implemented promptly.CECC once again urges all the airline companies to advise any travelers with influenza-like symptoms to delay their flights or ask them to obtain a certificate that proves he/she is cleared of influenza A (H1N1) infection before boarding the plane. If a traveler on plane develops influenza-like symptoms, he/she should put on a facemask immediately and be arranged to sit as far from the other passengers as possible.Prior to landing, the airline company is required to inform the aviation unit about such passenger to facilitate on-board quarantine inspection operations due to incident reporting.