Situation report on identified cases and responses in Japan-1
May 9, 2009
Minister of Health, Labour and Welfare, Mr. Masuzoe announced just after
8:30 a.m. this morning that three travelers returned yesterday evening
from Ontario, Canada through Detroit, USA tested positive to current epidemic
influenza A (H1N1) infection. These are the first three positive cases
reported from Japan.
As of 0:00 UTC/GMT, 9th May 2009, three Japanese reported fever and/or cough, sneeze have tested positive for novel influenza A(H1N1) virus infection. All are male belonging to the same group of travelers from one high school in the region. One teacher in 40s and two are teenager students. No death or critically ill case has reported. The group was in Oakville for cultural exchange since 24th April and traveled around the region. They took a flight from Toronto, transited at Detroit, and arrived in Narita by Northwest 025 on 8th May evening.
Contacts, 33 of those from same group, 14 passengers on the same aircraft
seated at close proximity to the three, and 2 crew members are under medical
surveillance and will be in quarantine for 10 days in accordance with the
pandemic planning. Further 7 cases were reported unwell in the same 9th
evening and are waiting for the test results. The Japanese government is
also contact tracing for those in transit at Narita as well as those already
passed immigration by the time of detection.
The Minister also announced that the case of second student was identified
only after he passed onboard quarantine which illustrates the limitation
of entry screening. He stated that Japan will continue the entry screening
but also needs to consider ways to strengthen domestic surveillance for
early detection. He also touched on the issue that medical community and
regions need to be prepared for cases from the community.
Since this first report was detected at the
border and there is no apparent evidence for human to human transmission in the
community, no major changes on response plan or medical treatments are
recommended. Good personal hygiene is strongly recommended for individual protection,
including masks in the crowd, hand washing, and gargling.
Report from National surveillance
The national case-based early reporting surveillance received 14 cases (9 May, +1:00 UTC/GMT). Result of laboratory diagnostic tests at either Regional Public Health Laboratories or the National Institute of Infectious Diseases (NIID) were all negative except the first case which has no result reported yet. These cases are excluding those identified at the port of entry Quarantine Stations. Under Japanese regulations, cases prior to the immigration are reported separately through the quarantine system.
Successful detection at the entry point by Quarantine
Station, proved the effectiveness of current measures in place and provided
early warning to the nation for a blinks of time to prepare.
However, if the cases rise from now as seen in North Americas and Europe,
it is just a matter of time to face multiple communitywide infection throughout
Above situation only pose heavy stress to
the quarantine activity and increase risk of mild case or latent phase cases
Looking toward seasonal flu season to come
in few months time, now is time to consider to shift towards early detection
with effective rapid test and early mitigation by personal protection and