title: Epidemiology of travel-associated pandemic (H1N1) 2009 infection in 116 patients, Singapore.
abstract: In June 2009, during Singapore's pandemic influenza plan containment phase, pandemic (H1N1) 2009 was introduced into the country through imported cases. To understand how travel patterns affected the initial outbreak, we examined epidemiologic and travel data for the first 116 case-patients admitted to Tan Tock Seng Hospital, Singapore, with travel-associated infection. Sixty-one percent and 54% of patients, respectively, met US Centers for Disease Control and Prevention and World Health Organization temperature criteria for influenza-like illness. One fourth of the case-patients traveled after illness onset, and 15% became ill while traveling. Regions of exposure for imported infections changed rapidly; case-patients initially arrived from North America, followed by Australasia and Southeast Asia. Case-patients on longer flights were more likely to become ill before arrival; those with shorter flights tended to become ill after arrival. Thermal scanners detected fevers in 12% of the arriving case-patients, resulting in a shorter time to isolation.
authors.affiliation: Tan Tock Seng Hospital, Singapore.
authors.forename: Pratik
authors.initials: P
authors.lastname: Mukherjee
authors.forename: Poh Lian
authors.initials: PL
authors.lastname: Lim
authors.forename: Angela
authors.initials: A
authors.lastname: Chow
authors.forename: Timothy
authors.initials: T
authors.lastname: Barkham
authors.forename: Eillyne
authors.initials: E
authors.lastname: Seow
authors.forename: Mar Kyaw
authors.initials: MK
authors.lastname: Win
authors.forename: Arlene
authors.initials: A
authors.lastname: Chua
authors.forename: Yee Sin
authors.initials: YS
authors.lastname: Leo
authors.forename: Mark I
authors.initials: MI
authors.lastname: Cheng Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D000401:Aircraft; D004196:Disease Outbreaks / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000453:epidemiology* / Q000635:transmission; D008297:Male; D008875:Middle Aged; D012846:Singapore / Q000453:epidemiology; D013997:Time Factors; D014195:Travel; D055815:Young Adult