Singapore has confirmed seven more cases of Influenza A (H1N1-2009), bringing the total number of confirmed cases here to 34.

All of the 34 cases, except one who was a close contact of a confirmed case, are imported cases with a travel history.

So far, 17 patients have been discharged.

The remaining 17 patients are still in the hospital and their conditions remain stable.

The Ministry of Health said the 28th to 31st confirmed cases cases are related to the 26th and 27th cases, a mother and son, who had returned to Singapore on June 9, 2009 after attending a wedding in Melbourne.

The latest cases had all attended the same wedding in Melbourne but had returned to Singapore on separate flights.

The 28th and 29th case are a couple - a 52-year-old Singaporean father and his 42-year-old wife. They had returned to Singapore from Melbourne on Singapore Airlines SQ228 at 2140 hours on June 9. They were seated at row 37.

The father had symptoms before he boarded the plane and the mother developed symptoms while on the plane.

The 30th case is a 16-year-old female, who is the daughter of the couple, also had symptoms on June 9 before she boarded the plane, and returned to Singapore from Melbourne on Emirates EK405 at 2350 hours on June 9. She was seated at row 49.

All three were not picked up by the thermal scanner as they did not have fever then. All three were fetched home by another daughter of the family who did not go to Melbourne.

On June 10 and 11, the 16-year-old went to her secondary school, Bedok North Secondary School, to attend some activities.

On June 11, the father went out for work for almost the whole day while the mother remained largely at home.

On the night of June 12, they called the 993 ambulance and all three were admitted to CDC.

The 31st case is a 17-year-old Singaporean female who had returned to Singapore from Melbourne on Singapore Airlines SQ228 at 2140 hours on June 9.

She had attended the same wedding in Melbourne. She was seated at row 62, and developed symptoms while on the plane. She was not picked up by the thermal scanner as she did not have fever then.

On June 10, she stayed at home for the whole day. On June 11, she was out with some friends. On the morning of June 12, she went to her Junior College, Raffles Junior College, to attend lessons.

That night, a 993 ambulance was called and she was admitted to CDC.

Laboratory results confirmed infection of H1N1 of the 28th to 31st cases at 1200 hours on June 13.

The 32nd case is a 28-year-old Singaporean male who returned to Singapore from Montreal via New York and Tokyo on Japanese Airlines JL711 at 0030 hours on June 11.

He was on the same flight as the 25th case. He was brought home from the airport by his parents in a taxi. He developed symptoms on the morning of June 13, and went to a polyclinic with his mother by bus. He was then referred to CDC via a 993 ambulance. Laboratory results confirmed his infection at 1545 hours on June 13.

No contact tracing for flight passengers is needed as case developed symptoms more than 24 hours after disembarkation.

The 33rd case is a 32-year-old Singaporean female who returned to Singapore from Phuket on Tiger Airways TR155 at 2300 hours on June 5.

On the morning of June 9, she developed symptoms and went out for work. On the morning of June 10, she sought medical attention at a GP clinic and was given medical leave for 2 days - from June 10 to June 11. She returned home and did not go out for the rest of the day and on June 11. On the morning of June 12, she went to TTSH ED where she was given treatment.

A throat swab was taken from her for testing. She was discharged from ED on the afternoon of June 12 with 4 days of medical leave - from June 12 to June 15 - as Thailand is not on the list of affected countries. Laboratory results confirmed her infection at 2000 hours on June 13, and she was admitted to CDC2 at night. No contact tracing for flight passengers is needed as case developed symptoms more than 24 hours after disembarkation.

The 34th case is a 6-year-old Australian female who came to Singapore from Melbourne with her mother on Emirates EK405 at 2350 hours on June 12 for a holiday. She was seated at row 28. She developed symptoms on June 11 while in Melbourne. She was brought to see a GP by her uncle on morning of June 13. She was referred to KKH via a 993 ambulance. Laboratory results confirmed her infection at 2115 hours on June 13.

Contact tracing

Contact tracing has been initiated for the seven new confirmed cases.

Passengers seated within the following rows who have not been contacted by MOH yet should call the MOH hotline at 1800-333 9999 to enable us to check on their health condition expeditiously:
- 31 - 38 and 61 - 64 on Singapore Airlines SQ228 at 2140 hours on June 9
- 47 - 51 on Emirates Airlines EK405 at 2350 hours on June 9
- 26 - 30 on Emirates Airlines EK405 at 2350 hours on June 12

All close contacts identified will be quarantined and provided with antiviral prophylaxis.

MOH advisory to all travellers

Given these recent cases, MOH would like to again remind travellers from infected areas to consult a doctor there as soon as possible if they feel unwell and to refrain from travelling if they have symptoms within 24 hours of their planned departure. This is to avoid infecting other passengers and putting them to great inconvenience if they have to be quarantined. This advisory is in line with the WHO's recommendations for people who are ill to delay international travel and for people who develop symptoms following travel to seek medical attention.

MOH has on its website a list of countries most affected by H1N1 in terms of numbers of cases, death and known exported cases. This is updated regularly.

Travellers are encouraged to review the information when making their travel plans. Where travel is unavoidable to countries considered by WHO to have sustained community transmission or to be in transition towards community transmission (USA, Mexico, Canada, UK, Spain, Chile, Australia, Japan), they should take the necessary precautionary measures, and call 993 for an ambulance should they become unwell within 7 days of their return.

If unwell, they should stay at home and not go about their usual activities such as going to school, shopping or work. Such behaviour will significantly increase the risk of causing a community spread in Singapore.

For more information on Influenza A (H1N1-2009), please access MOH'?s website at www.moh.gov.sg, call our hotline at 1800-333 9999, or visit www.flu.gov.sg.