Singapore has confirmed six more cases of Influenza A (H1N1-2009), bringing the total number of confirmed cases here to 40.

All of the 40 cases, except one who was a close contact of a confirmed case, are imported cases with a travel history.

Travellers who returned from Australia form the majority with 19 cases followed by the US with 14 cases.

19 cases were reported in the last three days. So far, 17 patients have been discharged. The remaining 23 patients (18th ? 40th cases) are still in the hospital and their conditions remain stable.

35th - 36th confirmed cases

The 35th case is a 19-year-old Singaporean male who went to Melbourne for holiday on June 7. He developed symptoms the next day while still in Melbourne.

He returned to Singapore from Melbourne on Singapore Airlines SQ238 (Row 43) at 4pm on June 12.

He was not picked up by the thermal scanner at Changi Airport as he was not feverish then. He went home by taxi and stayed at home from June 12-13. On the night of June 13,  he was sent via a 993 ambulance to CDC2 and was admitted near midnight.

The 36th case is a 24-year-old Singaporean female cabin crew who was off duty when she travelled on flight SQ25 (Row 38) from Frankfurt on June 12 as a passenger.

She had earlier developed symptoms on June 12 while she was in Frankfurt, and sought medical attention at a hospital there.

The doctor assessed that she was fit for travel. Upon arrival in Singapore, she was not picked up by the airport's thermal scanner as she was not feverish then. She sought medical attention at a GP clinic in the airport, and was sent to TTSH via a 993 ambulance. She was admitted to CDC2 in the morning of June 14.

37th - 40th confirmed cases

The 37th case, a 41-year-old Singapore PR female and the 38th case, an 8-year-old Singapore PR female, are mother and daughter who went to the Philippines on May 30 for a family visit.

The mother developed symptoms on June 13 before she boarded the plane, while the daughter had symptoms while on the plane. They returned to Singapore from Manila on Singapore Airlines SQ915 at 1132 hours on June 13.

The mother was seated at row 38 while the daughter was seated at row 39. Upon arrival in Singapore, they were picked up by the airport's thermal scanner as they were both feverish, and were sent to KKH via a 993 ambulance. They were admitted in the afternoon of June 13.

The 39th case is a 7-year-old Australian girl who was in Singapore for a holiday. She developed symptoms on June 12 while in Australia.

She came to Singapore from Melbourne on Singapore Airlines SQ228 (Row 60) at 2132 hours on June 13. Her fever was detected by the airport's thermal scanner and she was sent to KKH via a 993 ambulance. She was admitted for further assessment on June 14.

The 40th case is a 9-year-old Malaysian boy who went to Sydney and Melbourne, and later arrived in Singapore with his parents for a holiday.

He came to Singapore from Melbourne on Jetstar JQ61 (Row 17) via Darwin at 2149 hours on June 13. He developed symptoms while on the plane. His fever was detected by the airport's thermal scanner and he was sent to KKH via a 993 ambulance. He was admitted on June 14.

Laboratory results have confirmed infection of H1N1 for all the above cases.

Contact tracing

Contact trace mapping for the 28th - 31st confirmed cases is still ongoing. Similar to the 26th and 27th cases (mother and son), these cases had all attended the same wedding in Melbourne but had returned to Singapore on separate flights.

The Ministry of Health (MOE) has informed the schools of the 30th case, a 16-year-old Singaporean female, and the 31st case, a 17-year-old Singaporean female, both of whom had returned to Singapore from Melbourne on different flights on June 9.

The two schools have traced and contacted all 65 students and staff who were in contact with the confirmed cases. These students and staff have been advised to stay at home and to monitor their well-being for the next seven days. Affected classrooms will be disinfected.

Ministry of Health 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.

MOH has on its website a list of countries most affected by H1N1 in terms of numbers of cases, death and known exported cases. 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 seven 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. Socially irresponsible 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 it's hotline at 1800-333 9999, or visit www.flu.gov.sg.