The Central Epidemic Command Center (CECC) announced a newly confirmed imported case of influenza A (H1N1) in Taiwan, which is the 17th confirmed case in Taiwan. The seventeenth case is a 4-year-old, Taiwan-born boy who traveled to the Philippines on May 15, 2009. In the afternoon of May 30, 2009, the case returned to Taiwan with his parents from Manila and arrived at Taiwan Taoyuan International Airport at 19:30 on the same day.After landing, the case and his parents took a bus and then a cab home.According to the case’s mother, the case developed symptoms such as fever and cough on May 31, 2009 and then running nose on June 1, 2009.On June 4, 2009, the case was brought to the hospital for medical attention by his family.After being examined by the physician, he was listed as a person under investigation and specimen was collected from the case.At noon of June 5, 2009, influenza A (H1N1) infection was confirmed in the case, and the case was then sent to the isolation ward for treatment.

The case’s mother also indicated that the case has not come into contact with family members or friends with influenza-like symptoms while in the Philippines besides attending a wedding party in Manila on May 16, 2009. Further, during the trip to the Philippines, the case visited SM mall.Further, since the case developed symptoms after arriving in Taiwan for less than 24 hours, it is thus likely that the case became infected with influenza A (H1N1) in the Philippines.However, the case did not wear a facemask during his trip to the Philippines and on his way to Taiwan.In addition, even though the case had stayed at home most of the time after returning to Taiwan, he had dined with his grandparents, aunt and uncle-in-law.The case’s parents have been given antiviral prophylaxis because they have spent a lot of time with the case.The case’s grandparents, aunt and uncle-in-law have not been given antiviral prophylaxis because further investigation is needed to determine if such a precaution is necessary.On the other hand, the passengers sitting in the same row and in the 3 rows in front and behind the case are required 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.Moreover, the risk of infecting the bus and cab drivers is fairly low.Therefore, they will not be investigated.At the time of writing, all the close contacts that have been reached have not experienced any symptoms, and the passengers sitting close to the case on the plane and the medical personnel that have come into close contact with the case are still under investigation.CECC has reported the case to the World Health Organization (WHO).

According to international outbreak surveillance data, besides the 4th and 6th cases of influenza A (H1N1) confirmed in Taiwan were imported from the Philippines, Korea has confirmed a case of influenza A (H1N1) infection in a female tour guide from Manila.Furthermore, Japan, Singapore and Saudi Arabia have respectively confirmed an imported case from the Philippines.Hence, it is speculated that besides the 29 confirmed cases of influenza A (H1N1) reported to WHO by the Philippines, there are probably other cases in the community.CECC urges people planning to visit the Philippines to pay attention to disease prevention and physicians to take the Philippines into account when considering a case’s travel history.