On June 9, 2009, the Central Epidemic Command Center (CECC) announced three newly confirmed cases of influenza A (H1N1) imported from Thailand in Taiwan, which are the 22nd, 23rd and 24th confirmed cases in Taiwan.

The twenty-second case is a 24-year-old, Taiwan-born male student who went on a graduation trip to Thailand from June 1 to June 7, 2009 with a tour group of 57 people, including the tour guide. In the afternoon of June 7, 2009, the case arrived at Taiwan Taoyuan International Airport and was detected with a temperature of 38.4℃ by the fever screening station in the airport.He was immediately driven to the hospital by his parents for medical assistance.After the case was reported to the health authority, he was isolated for treatment.At night of June 8, 2009, influenza A (H1N1) infection was confirmed in the case.According to the case, he and 6 other classmates experienced symptoms such as sore throat and dizziness on June 5, 2009.The local guide took them to scraping therapy and got them fever reducers.On June 6, 2009, the case developed symptoms such as fever, cough, and muscle pain.In the morning of June 7, 2009, prior to returning to Taiwan, the case took a fever reducer and vomited.Throughout the flight back to Taiwan, the case and six other students who experienced influenza-like symptoms wore a facemask.Those 6 students have been listed as a person under investigation, specimen has been collected from each of them, and they have all been isolated for treatment.On the other hand, the case’s parents have both been asked to conduct self-health management.At noon of June 9, 2009, influenza A (H1N1) infection was confirmed in one of the 6 other students, which is the twenty-forth confirmed case in Taiwan.

The twenty-third case is a 23-year-old, Taiwan-born female student who went on a graduation trip to Thailand from June 1 to June 7, 2009. At night of June 7, 2009, the case arrived at Taiwan Taoyuan International Airport and was detected with a temperature of 38.4℃ by the fever screening station in the airport.She was immediately rushed to the hospital for isolation treatment.According to the case, she developed dry cough on June 6, 2009, and then running nose, itchy throat, fever and chills on June 7, 2009.Nevertheless, throughout the flight back to Taiwan, the case and 16 other people in the case’s tour group, including the tour guide, wore a facemask. CECC indicated that two other students in the tour group were detected with a body temperature of above 38℃ and specimen has been collected from both students.

CECC has reported the three cases to the World Health Organization and the Thai government.Simultaneously, the Field Epidemiology Training Program (FETP) in Taiwan has contacted the FETP in Thailand to work on the epidemiological investigation of the cases together.Further, it is possible that more members of those two aforementioned tour groups might be confirmed cases of influenza A (H1N1).However, no signs of community transmission have been noted.

CECC urges students to pay attention to disease prevention when planning and taking graduation trips, and advises tour guides to take care of students who experience influenza-like symptoms and to notify airline companies or quarantine personnel about the students with symptoms.Additionally, people are advised against taking fever reducers to avoid possible quarantine.