Epidemiology of travel-associated pandemic (H1N1) 2009 infection in 116 patients, Singapore.
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.
Mukherjee
Pratik
P
Tan Tock Seng Hospital, Singapore.
Lim
Poh Lian
PL
Chow
Angela
A
Barkham
Timothy
T
Seow
Eillyne
E
Win
Mar Kyaw
MK
Chua
Arlene
A
Leo
Yee Sin
YS
Cheng Chen
Mark I
MI
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