There are some inherent limitations in certain data collection methods employed in this study. Self-reporting has potential inaccuracy and bias unless followed up with careful questioning and assessment. Newspaper reports Gefitinib can be notoriously biased and inaccurate and great care must be taken in interpretation of these and supporting evidence gathered where possible. Calls to DAN for advice are much more likely to be assessed objectively and yield more credible reports. We would like

to acknowledge the efforts of Andrew Jones, whose young son was badly stung while on holiday in Thailand. In response to the sting, Mr Jones has personally spent much time and effort trying to make tropical beaches safer. Sincere thanks to all of those who submitted marine sting reports to DAN to facilitate this research. J. L. is the Executive Director of Divers Alert Network Asia-Pacific. P. F. was the Marine Stinger Advisor with Surf Life Saving Queensland from 1985 to 2005: the National Medical Officer, Surf Life Saving Australia 1995–2005. He was a co-author on the textbook3 and is a member of the Marine Stinger Advisory Group to the

Queensland Government. K. W. is the Director of the Australian Venom Research Unit, and Senior Research Fellow, at the University of Melbourne. He is also a member of the Marine Stinger Advisory Group to the Queensland Government and is a consultant to CSL Limited, the manufacturer of Australia’s antivenoms. K. W. is funded by the Australian Government Department of Health. L.-A. G. was the National see more Marine

Stinger Advisor with Surf Life Saving Australia from 2005 to 2007. Since 2007, she has been on the Medical Advisory Panel for St John Ambulance Australia and the Director of the Australian Marine Stinger Advisory Services. “
“Background. From the beginning of the influenza pandemic until the time the outbreak described here was detected, 77,201 cases of pandemic influenza A(H1N1) with 332 deaths had been reported worldwide, mostly in the United States and Mexico. All of the cases Thiamine-diphosphate kinase reported in Spain until then had a recent history of travel to Mexico, the Dominican Republic, or Chile. We describe an outbreak of influenza among medical students who traveled from Spain to the Dominican Republic in June 2009. Methods. We collected diagnostic samples and clinical histories from consenting medical students who had traveled to the Dominican Republic and from their household contacts after their return to Spain. Results. Of 113 students on the trip, 62 (55%) developed symptoms; 39 (45%) of 86 students tested had laboratory evidence of influenza A(H1N1) infection. Most students developed symptoms either just before departure from the Dominican Republic or within days of returning to Spain. The estimated secondary attack rate of influenza-like illness among residential contacts of ill students after return to Spain was 2.1%. Conclusions.