The Central Epidemic Command Center (CECC) confirmed one domestic case and two imported cases of influenza A (H1N1) in Taiwan. The cumulative number of confirmed cases of influenza A (H1N1) in Taiwan is 9. The seventh case is a 40-year-old, Taiwan-born female who is a friend of the forth case.On May 20, 2009, the seventh case and her husband met up with the forth and six cases from noon till after dinner.Both the seventh case and her husband are considered as the close contacts of the forth case.Therefore, the local health unit had administered prophylaxis antivirals to them and requested them to conduct self-health management when influenza A (H1N1) infection was confirmed in the forth case.In the evening of May 22, 2009, the seventh case developed a sore throat.On the following day, May 23, 2009, the case developed a cough and muscle pain and contacted the health authority.After contacting the health authority, specimen was collected from the case.On May 24, 2009, the case was sent to the negative pressure isolation room for medical treatment.In the evening of the same day, influenza A (H1N1) infection was confirmed in the case.The seventh case is the first domestic case that became infected with influenza A (H1N1) through close contact with an imported case.As a result, the current pandemic alert level in Taiwan has been raised to phase 3 (yellow light).As of now, no community spread of the virus has occurred.

The eight and ninth cases are students who returned to Taiwan from studying abroad in the United States.The two cases took flight BR007 from San Francisco on May 23, 2009 and arrived at Taiwan Taoyuan International Airport in the morning of May 24, 2009.Their plane seats were 23K and 23H, respectively.The two cases developed a fever on May 19 and 20, 2009, respectively.The eighth case claimed that she took a fever reducer before boarding the plane.In addition, both cases had worn a facemask throughout the flight.Upon arrival, their fever had subsided.Nevertheless, they still experienced discomfort.Therefore, they took a cab to seek medical attention at Taoyuan General Hospital.After diagnosis, they were reported as suspected cases of influenza A (H1N1) and sent to negative pressure isolation rooms for treatment.Influenza A (H1N1) infection was confirmed in both cases in the evening of May 24, 2009.

CECC indicated that the husband of the seventh case is currently in good health condition, conducting self-health management, and being followed up by the local health unit.On the other hand, CECC has obtained the list of 13 close contacts of the eight and ninth cases, including the passengers sitting in the same row and in the 3 rows in front and behind the cases.Further, the cab driver of the cab the eight and ninth cases took has been contacted by the local health unit in the evening of May 24, 2009 and has been requested to conduct self-health management as a precaution.

All close contacts of the confirmed cases are urged to conduct self-health management: observe their own health, conduct home quarantine, and measure their body temperature twice a day for a period of seven days. 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 contact the local health unit first and refrain from seeking medical attention on his/her own.If any question, please call the Communicable Disease Reporting and Consultation Hotline, 1922, for more information.Public health personnel will visit close contacts to administer antiviral prophylaxis and request them to conduct self-health management.CECC stated that as long as the outbreaks in the United States and Canada persist, and as the summer vacation approaches and more students who study abroad will be retuning to Taiwan during the summer, the number of imported case is bound to increase and the outbreak control measures implemented will have to be adjusted accordingly.