had contact with the 48th case and was confirmed with the flu 21 june in hospital sultanah bahiyah, alor star. she is the 5th local transmission. 1–10 july on 9 july 61 new cases of influenza a(h1n1) were confirmed, consisting of 37 imported cases and 24 locally transmitted which makes the number of cases in malaysia soared to 574. among the 574 cases, 415 cases were reported to have been imported while 159 cases were locally transmitted. one of the visitors who visited a company in cyberjaya were confirmed to have contracted the virus, which caused 12 workers to be put under home quarantine. 11–31 july on 23, 18 july new cases were confirmed in malaysia consisting 17 local transmission and 1 imported case. 1 august onwards according to the health ministry another 39 cases of a(h1n1) were reported on 2 august. 16 new cases of h1n1 were discovered on 5 august 2009 bringing the total number of cases to 1,492. 33 new cases were reported on 6 august 2009, bringing the total cases in malaysia to 1525. it was reported on the same day that an immigration detainee from togo was found dead at the sepang detention centre. according to the guard, the prisoner did not complain of fever or cough. autopsy were conducted on 4 august 2009 in selayang hospital and discovered that the patient had influenza a(h1n1). however, they were still unable to determine if the flu was the direct cause of the patient's fatality. on 8 august 2009, 53 more cases were confirmed and brought the number of cases in malaysia to 1578. among the 1578 cases, 574(36%) were imported cases and 1004(64%) were local transmission. a record of more than 200 cases were confirmed on 9 august 2009. 202 new local transmitted cases were confirmed which brought the number of flu cases soared to 1780. 13 patients were still in icu, and four of them were still in critical condition. 270 new local cases were confirmed on 11 august 2009, bringing the total cases in malaysia to 2,253. deaths reported death as of 15 october 2009 july on 23 july 2009 first a(h1n1) related death was confirmed. the patient is a 30-year-old indonesian man who had multiple medical condition, including obesity and enlarged heart. however, health minister datuk liow tiong lai revealed that the flu was not the direct cause of the patient's fatality. august on 6 august 2009, in putrajaya another death was confirmed involving a 57-year-old pensioner who was a diabetic and had hypertension. on 7 august 2009, a 40-year-old obese man who was admitted to kuala lumpur hospital died of acute coronary syndrome and cardiogenic shock. the man had developed a fever and had been coughing since 28 july 2009. his autopsy result confirmed that he is the nation's fifteen influenza a(h1n1) death. on 8 august 2009, three more deaths were recorded, which brought the death cases in malaysia to 18. the sixteenth death was a 5-year-old boy who had upper respiratory tract infection and sought treatment in a private clinic on 3 august. he was then had a seizure and was sent to tengku ampuan afzan hospital and confirmed to have the h1n1 virus. he died on 7 august 2009 due to acute encephalitis secondary to influenza a(h1n1). the seventeenth death was a one-year-old toddler who had history of hyperthyroidism and was under treatment for it. he had symptoms of the flu but did not seek for treatment. he was then sent to sultanah amanah hospital, johor bahru. he was confirmed to have the flu on 4 august 2009. however, after five days of treatment, his condition deteriorated with symptoms of drowsiness, lethargy and altered consciousness and was sent to icu. on 7 august 2009, he died due to pneumonia with underlying h1n1 infection. the eighteenth death was a 63-year-old man who had asthma and tuberculosis. he was admitted to selayang hospital and died on 6 august due to severe pneumonia with positive influenza a(h1n1) and underlying pulmonary tuberculosis. eight more deaths were confirmed on 9 august 2009. among the eight patient who died, three died on 3 august, two on 5 august, four on 7 august and one on 8 august. all of them were in the high-risk group except a 20-year-old college student who was found dead at her hostel about a week after obtaining outpatient treatment. among the dead were two sabahans, one of them was a 24-year-old obese woman from ranau who died of pulmonary oedema after a bout of flu while the other one was a 74-year-old man who had a history of heart problem who died of pneumonia and pulmonary oedema. the other deaths were a 47-year-old patient with asthma in sarawak and a 37-year-old obese man who died of broncho-pneumonia at the hospital in johor bahru. six more deaths were confirmed on 10 august 2009, bringing the total death cases in malaysia skyrocketed to 32. of the six cases, four of them had underlying medical cases. another six deaths were recorded on 11 august 2009. among the six death cases, four of them had been diagnosed with asthma, hypertension and diabetes. as at 12 august 2009 the total of deaths reported raised to 44 with six more cases confirmed. a 60-year-old man who had histories of diabetes, hypertension and heart problems was hospitalised on 6 august after showing symptoms of the flu. throat swab and antiviral drugs were prescribed. however, he died on the next day due to severe pneumonia. lab result confirmed the man as an influenza a(h1n1) patient on 9 august. a 62-year-old man who was a diabetic was hospitalised on 6 august. he was then later dehydrated and given antiviral drug for precaution against the flu. throat swab was taken on 7 august. however, he died on the same day due to pneumonia and possible cancer. a 20-year-old who didn't have any history of underlying medical condition experienced fever, coughing and sore throat. he sought for treatment at a hospital on 6 august and was later hospitalised due to suffocation. antiviral drugs were later prescribed by the doctor. on the next day, he died due to severe pneumonia and septicaemia. a 10-year-old baby was among the death cases confirmed on 12 august. she showed symptoms but was hospitalised six days later due to suffocation. antiviral drugs were not given. on the next day, she died due to bronchopneumonia. an 18-year-old woman who was 26 weeks pregnant, and was also obese, showed symptoms on 3 august. her condition deteriorated and was then later sent to icu, where a throat swab was performed. she died due to severe pneumonia. a 1-year-old toddler who had congenital heart disease had a seizure and fever on 7 august. antiviral drugs were not given to the toddler and he died on 9 august 2009 while undergoing a surgery. seven more deaths were confirmed on 13 august 2009, bringing the total number of death cases in malaysia rose to 51. all of the seven fatalities were in high-risk group. a 4-month-old baby who had an extremely low immunity was hospitalised on 8 august 2009 after he showed symptoms of fever, breathing difficulty, vomiting, coughing and diarrhoea. a throat swab was conducted, but he died on 10 august due to severe pneumonia. lab result confirmed he had influenza a(h1n1) on the next day, making him one of the victims of the flu. a 37-year-old diabetic woman was hospitalised after showing symptoms. she was later given antiviral drugs but died on 10 august. a 69-year-old woman who had history of hypertension was found to have been coughing. throat swab was conducted after she was transferred to icu due to suffocation. on 11 august 2009, she died due to acute myocarditis. a woman in her 20s, who also had a history of congenital disease, started to have fever and coughing on 6 august. she was later admitted and given antiviral drugs on 8 august. however, she died on 10 august due to severe bronchopneumonia. a 4-year-old boy who had congenital disease was treated on 2 august after exhibiting symptoms of the flu. he was later confirmed to have the flu after a throat swab was taken; however, he died before the confirmation was received. a 92-year-old lady who had asthma and a 43-year-old man who had diabetes, hypertension and heart diseases died on 11 august 2009 due to severe pneumonia. five more cases were confirmed on 14 august. a two-month-old baby who was born prematurely was admitted to the hospital following fever, coughing, sneezing and difficulty in breathing. he was given antiviral drugs and was placed on mechanical ventilation as his condition deteriorated, but he died on 12 august due to pneumonia. another two-month-old baby was rushed to the hospital when he was found unconscious. his condition was critical and was sent to icu. he tested positive for the flu on 8 august, but died on 10 august due to myocarditis, hepatitis and renal impairment associated with h1n1. a 49-year-old diabetic woman, who was also obese and having tuberculosis was confirmed to have the virus on 11 august. a 57-year-old diabetic man sought for treatment on 2 august after showing symptoms of the flu. on 3 august, he returned to the clinic after experiencing fever, vomiting and diarrhoea. he was then sent to hospital and given antiviral drugs. despite given antiviral drugs, he died on 12 august due to sepsis. a 19-year-old teenager was admitted to the hospital after complaining having fever and coughing. he was then suffocated and died on 11 august due to pneumonia. 3 more deaths were confirmed on 15 august. a 22-year-old obese man was hospitalised on 9 august but died on 12 august due to viral pneumonia. a 29-year-old man who had valvular heart disease was admitted to the hospital after flu symptoms persisted for 2 days. antiviral drugs were given on 10 august but he died 2 days later due to bronchopneumonia. a 44-year-old woman who had asthma was tested positive for the flu on 10 august but died on 13 august due to pneumonia. another three deaths were confirmed on 16 august, raising the total number of deaths to 62. the 59th death was a 6-year-old child with down's syndrome who had the flu for 3 days before being confirmed as a h1n1 patient. he died on 13 august due to pneumonia with underlying down's syndrome with avsd and pulmonary hypertension. a 3-year-old child was hospitalised on 1 august after having symptoms for 5 days. confirmed to have contracted the virus on 3 august and antiviral drugs were given on the same day. however, he died on 14 august due to severe pneumonia. a man in his 50s who had symptoms on 28 july was hospitalised. he also had been vomiting and had had diarrhoea two days before he was admitted. on 13 august, he was confirmed dead due to septicaemia with severe pneumonia. on 17 august, two more deaths were announced. a 7-month-old boy who had asthma was transferred to icu after having fever and coughing for 2 days. antiviral drugs were given and was confirmed to have the virus on 12 august. however, he was confirmed dead three days later due to severe pneumonia and acute respiratory failure. a 74-year-old diabetic woman, who also had ccf was admitted to the hospital after she was found unconscious in her house. she died on 11 august due to severe pneumonia. her test results came back on 12 august and confirmed her as a h1n1 patient. on 18 august, three more death cases were confirmed and brought the number of death cases in malaysia to 67. a 33-year-old woman was transferred to icu after her lungs disease began to deteriorate after 4 days of treatment in a private hospital. she showed symptoms on 31 july and antiviral drugs were started on 7 august. on 12 august, she died due to bronchopneumonia. her result later came back and was positive for the flu. a 10-year-old school girl, who was diagnosed with systemic lupus erythematosus was sent to icu after she had breathing difficulty, chest pain and stomach ache. antiviral drugs were given since 8 july. despite on medicine, she died on 13 august due to systemic lupus erythematous with severe pneumonia with renal impairment.