title: Assessment of border control measures and community containment measures used in Japan during the early stages of Pandemic (H1N1) 2009.
abstract: BACKGROUND
  In the early stages of Pandemic (H1N1) 2009, border control measures were taken by quarantine stations to block the entry of infected individuals into Japan and community containment measures were implemented to prevent the spreading. The objectives of this study were to describe these measures and the characteristics of infected individuals, and to assess the measures' effectiveness.
  
  
  RESULTS
  Border control and community containment measures implemented from April to June (Period I: April 28-May 21, Period II: May 22-June 18) 2009 were described. Number of individuals identified and disease characteristics were analyzed. For entry screening, a health declaration form and an infrared thermoscanner were used to detect symptomatic passengers. Passengers indicated for the rapid influenza test underwent the test followed by RT-PCR. Patients positive for H1N1 were isolated, and close contacts were quarantined. Entry cards were handed out to all asymptomatic passengers informing them about how to contact a health center in case they developed symptoms. Nine individuals were identified by entry screening and 1 during quarantine to have Pandemic (H1N1) 2009. Health monitoring by health centers was performed in period I for passengers arriving from affected countries and in period II for those who had come into contact with the individuals identified by entry screening. Health monitoring identified 3 infected individuals among 129,546 in Period I and 5 among 746 in Period II. Enhanced surveillance, which included mandatory reporting of details of the infected individuals, identified 812 individuals, 141 (18%) of whom had a history of international travel. Twenty-four of these 141 passengers picked up by enhanced surveillance had been developing symptoms on entry and were missed at screening.
  
  
  CONCLUSIONS
  Symptomatic passengers were detected by the various entry screening measures put in place. Enhanced surveillance provided data for the improvement of public health measures in future pandemics.
authors.affiliation: Department of Occupational Health, Graduate School of Medical Sciences, Kitasato University, Sagamihara, Kanagawa, Japan.
authors.forename: Hiroko
authors.initials: H
authors.lastname: Sakaguchi
authors.forename: Masashi
authors.initials: M
authors.lastname: Tsunoda
authors.forename: Koji
authors.initials: K
authors.lastname: Wada
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ohta
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Kawashima
authors.forename: Yae
authors.initials: Y
authors.lastname: Yoshino
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Aizawa
mesh_terms: D000293:Adolescent; D000328:Adult; D002675:Child, Preschool; D003140:Communicable Disease Control / Q000458:organization & administration*; D004279:DNA, Viral / Q000235:genetics; D004196:Disease Outbreaks / Q000517:prevention & control*; D004641:Emigration and Immigration; D005260:Female; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype / Q000235:genetics / Q000302:isolation & purification / Q000472:pathogenicity*; D007252:Influenza Vaccines; D007251:Influenza, Human / Q000175:diagnosis* / Q000453:epidemiology / Q000635:transmission*; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D058873:Pandemics; D011159:Population Surveillance; D011634:Public Health; D011790:Quarantine; D014195:Travel; D055815:Young Adult
chemical_list: D004279:DNA, Viral; D007252:Influenza Vaccines