 | This article needs to be updated.(November 2010) |
The 2009 swine flu pandemic in North America, part of a pandemic in 2009 of a new strain of influenza A virus subtype H1N1 causing what has been commonly called swine flu, began in the United States or Mexico.
Roughly 10% of Canadians had been infected with the virus as of mid-late November [2] with 416 confirmed deaths as of January 7; there were over 10,000 confirmed cases when Health Canada stopped counting in July 2009. [3] Canada began its vaccination campaign in October [4] [5] and 40% of the populace has since been immunized against H1N1. [6]
The widespread effect of H1N1 in Canada were a concern for the XXI Olympic Winter Games, which took place in Vancouver in February 2010. [7]
Dr. José Ángel Córdova Villalobos, Mexico's Secretariat of Health, stated that since March 2009, there have been over 1,995 suspected cases and 149 deaths, with 20 confirmed to be linked to a new swine influenza strain of Influenza A virus subtype H1N1. [8] [9] As of April 26 there had been 1,614 cases, with 103 deaths and about 400 patients in hospital; approximately two-thirds of the sick patients had recovered. [10] "'As many as 23,000 Mexicans were likely infected with the swine flu virus,' Neil Ferguson of Imperial College London and colleagues reported in the journal Science." [11]
Soldiers mobilized by the government have handed out six million surgical masks to citizens in and around Mexico City. [12] On April 24, 2009, schools (from pre-school to university level) as well as libraries, museums, concerts and any public gathering place, were shut down by the government in Mexico City and the neighboring State of Mexico to prevent the disease from spreading further; the schools in Mexico City, the State of Mexico, and the state of San Luis Potosí will remain closed until at least May 5. [13] Marcelo Ebrard, Mexico City's mayor, has also asked all night-life operators to shut down their places of business for ten days to prevent further infections. [14] José Ángel Córdova, federal Secretary of Health, said on April 24 that schools will probably be suspended for at least the following week then, and that it will take around ten days to see the evolution of the virus' behavior, and to consider other measures after such. [15] On April 25, President Felipe Calderón declared an emergency which granted him the power to suspend public events and order quarantines. [16] Hours later, Córdova announced that classes in Mexico City would be officially suspended through May 6. [17] On April 26, Natividad González Parás, governor of the northeastern State of Nuevo León, announced that statewide schools will remain closed until 6 May, and established a quarantine system in airports, central bus stations and the creation of observation points mainly in the southern part of the state at the nearest highways to the borders with other states, in order to realize tests conducted on people arriving from other states. However, as for April 27, there are no confirmed reported cases of infection in this state. [18]
On April 26, the World Bank announced US$ 25 million in immediate aid loans to Mexico, an additional US$180 million for long-term assistance to address the outbreak, and advice on how other nations have responded to similar crises. [12]
On April 27, the Secretariat of Public Education announced that all schools in Mexico will remain closed at least until May 6. [19]
On April 28, the Mexico City government closed all restaurants and cinemas. The National History and Anthropology Institute also closed all its archaeological sites and museums, including the most famous Mayan and Aztec ruins, until further notice.
Initial reports of atypical flu in two individuals in southern California led to the discovery of the novel swine flu virus by the CDC in mid-April. More than a hundred cases were confirmed in the next two weeks, spread through a dozen states. [20] Outside of California and Texas, initial cases were all tied to recent travel to Mexico or close contact with those who had recently visited Mexico. St. Francis Preparatory School, a private school in New York, was the center of a large cluster of cases after a Spring Break trip by several students, and perforce one of the first U.S. schools to be closed as a public health measure during the early outbreak. [21] Most of the cases in California and Texas are not linked and may reflect localized outbreaks of this virus in those areas. [22] As of April 30, the disease was not as virulent outside of Mexico as within Mexico, for reasons not fully understood.
The United States of America declared a state of Public Health Emergency but this was said to be standard procedure in cases as divergent as the recent inauguration and flooding. [23] According to The New York Times, "the emergency declaration frees resources to be used toward diagnosing or preventing additional cases and releases money for more antiviral drugs," including the transfer of approximately 12 million influenza medications from a federal stockpile to states. [12] [24] The U.S. plans followed a guidebook developed over the past five years to fight a pandemic flu such as H5N1. The situation developed rapidly with the White House initially looking into the matter on April 24 according to press releases, but rapidly adopting a serious stance as the WHO and CDC issued stronger recommendations.
On April 29, the US suffered its first confirmed death of swine flu. On April 28, the Centers for Disease Control and Prevention had officially confirmed through tests that a 23-month-old child was infected with the flu. When the sickness continued to worsen the next day, he was transferred to Texas Children's Hospital in Houston, where he died. [25] [26] [27]
On May 5, Judy Trunnell, a woman in her 30s suffering from "chronic underlying health conditions" died of swine flu in Cameron County, near the US-Mexico border. She was the first US citizen to die from the disease. [28] The woman, a special education teacher, had recently given birth to an eight-month-term healthy baby, delivered by caesarian section. [29] She had been in a coma after being admitted to the hospital with breathing problems on April 19. [29] The woman had also suffered from asthma, rheumatoid arthritis and a skin condition.
On May 10, a 30-year-old man with underlying health problems died in Washington from H1N1, the first fatality in that state. [30]
On May 17, 55-year-old Mitchell Wiener, an assistant principal at Intermediate School 238 in Hollis, Queens died from H1N1, making it the first H1N1 related fatality in the state of New York. Wiener suffered from many other underlying health problems, weakening his resistance to the disease. [31]
On May 19, 2009, a St. Louis County man became the first death in Missouri due to the Swine Flu.
As of mid-May 2009 many states had abandoned testing for likely influenza cases unless serious illness and/or hospitalization were present. [32] Because reported numbers represent only confirmed cases, they are a "very great understatement" of the total number of cases of infection, according to the CDC. [33]
The real number of swine flu cases in the United States could be “upwards of 100,000,” a top public health official estimated on Friday — far higher than the official count of 7,415 cases confirmed by laboratories. [34]
On September 1, 2009, several new virus isolates were tested for neuraminidase inhibitor resistance. These included one seasonal influenza A (H1N1), 13 influenza A (H3N2), 23 Influenza B, and 1, 855 2009 influenza A (H1n1) virus isolates. [35]
Trevor van Gellecum, the Director of the Aruban Department of Health, announced that all passengers arriving by airplane or cruise ship will have to fill out a health questionnaire beginning on April 27, 2009. [36] Hotels and resorts are required to report to authorities if any tourists are showing flu-like symptoms. [36] The government of Aruba also ordered antiviral medication and other supplies from the Netherlands and the United States. [36] No swine flu cases have been reported. [36]
Ten students and teachers who arrived from Mexico in the last week of April are in quarantine. [37]
The Minister Of Health, Donville Inniss has confirmed that two samples have been sent off to the Caribbean Epidemiology Centre (CAREC) in Trinidad and Tobago to be tested for the virus. [37]
There are two suspected cases of swine flu currently under investigation in Belize. As a result, all major public events have been cancelled. This includes the National Agriculture and Trade Show. People have been asked to be very careful and use preventative measures. [37]
A 21-year-old woman was confirmed as carrying the swine flu virus on April 28. The woman came back from Mexico by airplane. [38] A second case was confirmed on the same day, a 30-year-old man who traveled to Mexico the week before. [39] On May 2 the Costa Rican Ministry of Health confirmed two more cases. [40] Four more cases were confirmed on May 4. [41]
A 53-year-old man became the first confirmed death from the disease in the country, as reported by the Minister of Health on May 9. [42] [43] [44] This was the first death outside of a North American country and the fourth country in the world to present a mortal case. [44] The deceased man was suffering other chronic diseases. The Minister of Health informed he had diabetes and also was suffering from chronic obstructive pulmonary disease (COPD). She also informed the man was infected inside Costa Rica because he had not traveled to Mexico. [45]
On August 11 was confirmed that Costa Rica's president, Óscar Arias Sánchez, was infected with the A(H1N1) virus, becoming the first head of state sick with the A(H1N1) virus [46] [47] President Arias returned to his normal activities after one week of isolation at his home. [48]
As of September 8 the Costa Rican Ministry of Health had 1,246 confirmed cases, 1,257 pending cases, 6,337 already discarded, and 33 deaths. [49] The mortality rate is 0.73 deaths by 100,000 people, and the fatality rate is 2.96%. [49] From all deceased patients, 48.5% occurred among San José residents, and only the Guanacaste Province has not had any deaths related to the virus. The age of the deceased varies between 20 and 79 years, with an average age of 41 years. [49]
Cuba's Health Ministry is adopting precautionary measures to prevent the illness from coming into the country. The government has advised citizens to go to seek medical treatment if experiencing flu-like symptoms. [50] Cuba has also banned flights to and from Mexico for 48 hours. [51]
Cuba has reported its first case of Influenza A H1N1 as a Mexican student who travelled to Cuba on April 25 for study
The ministry statement said that in all of Cuba, authorities have tested 84 possible cases in people of eight nationalities for the virus. Only one case was positive - the Mexican student. [52]
According to the Dominican Republic Government, two people were confirmed to be infected with the AH1N1 flu on May 27. [53] One was a 58-year-old woman from Santiago de los Caballeros and the other was a 20-year-old woman from Santo Domingo Province. Each of them had visited the United States (Orlando and Seattle, respectively) before being diagnosed. [53] On May 30, nine more cases were confirmed, all from the Carol Morgan school. [54]
On June 5, a 17-year-old pregnant girl infected with the AH1N1 virus died. 44 cases were confirmed to this date. [55]
A 29-year-old, who had recently visited Mexico, was being tested for a suspected case of swine flu. [56]
Guatemala is checking all travelers arriving from Mexico for signs of flu and stopping anyone with symptoms of the virus at border crossings. [56]
On May 5, in a meeting with Health Minister and the Vicepresident, it was announced that an 11-year-old girl was infected with the AH1N1 virus. It was told that the family of the girl came from Mexico a few days ago, but no one else in the family it is infected. [57]
On the same press meeting, Rafael Espada said: "We've to prepare ourselves for the worst, and just hope for the best". [58]
The government has stated that they're prepared for a first wave of AH1N1. Nevertheless, other institutions have started to help population by giving them masks and information about the virus. University of San Carlos de Guatemala by the Faculty of Pharmacy and Pharmaceutics has started to prevent the virus among the students population, as the Rector Estuardo Gálvez said: "This people are prepared to counteratack the virus inside and outside this campus". [59]
Honduras reported its first confirmed case of swine flu(H1N1) on 27 May 2009. On 22 June it reported its first death of swine flu.
As of 7 July 2009, there has been 33 confirmed cases of swine flu in Jamaica. On the 6th of July, Jamaica recorded its first human mortality from the virus. Health Minister Ruddy Spencer told Parliament that the country has been placed on high alert. There has been heightened surveillance at health care facilities and port entry's. [60]
As of July 23, 553 confirmed cases had been reported by Panamanian health authorities: [61]
66% of the cases are teens (12–15) and the 34% are adults(20-49). Only one death has been reported. Schools with positive cases are being disinfected and thermographic cameras have been deployed at Tocumen International Airport to identify sickness in arriving passengers.
The members of the Under 17 Trinidad and Tobago football team have taken Flu tests after returning from a World Cup qualifying football match in Mexico City. [62] One female was confirmed as having contracted the H1N1 influenza. Her identity is being withheld. At the moment, people who travelled on the same aircraft as the infected woman are being asked to contact the relevant health authorities. [63]
| 2009 | A(H1N1) Outbreak and Pandemic Milestones in North America |
|---|---|
| 17 March |  First case in the world of what would later be identified as swine flu. |
| 28 March |  First case in the US of what would later be identified as swine flu. |
| 12 April | First known death due to what would later be identified as swine flu. |
| 25 April | Community outbreaks confirmed in United States. |
| Community outbreaks confirmed in Mexico. | |
| 27 April |  First case confirmed in Canada. |
| 29 April | First death confirmed in the United States. |
| 2 May |  First case confirmed in Costa Rica. |
| 3 May | First cases confirmed of infections in pigs, also first cases of reverse zoonosis. |
| 4 May |  First case confirmed in El Salvador. |
| 5 May |  First case confirmed in Guatemala. |
| 7 May | First death confirmed in Canada. |
| First case of zoonosis in Canada, where an infected pig infects a human. | |
| 8 May |  First case confirmed in Panama. |
| Community outbreaks confirmed in Canada. | |
| 9 May | First death confirmed in Costa Rica. |
| 12 May |  First case confirmed in Cuba. |
| 13 May | Community outbreaks confirmed in Costa Rica. |
| 22 May |  First case confirmed in Honduras. |
| 26 May |  First case confirmed in Puerto Rico. |
| 27 May |  First case confirmed in Dominican Republic. |
| 31 May |  First case confirmed in Bahamas. |
| 2 June |  First case confirmed in Nicaragua. |
 First case confirmed in Bermuda. | |
| 3 June |  First case confirmed in Barbados. |
 First case confirmed in Jamaica. | |
| 4 June |  First case confirmed in Trinidad and Tobago. |
| 5 June | First death confirmed in Dominican Republic. |
 First case confirmed in Cayman Islands. | |
| 7 June |  First case confirmed in Martinique. |
| 8 June |  First case confirmed in Dominica. |
| 10 June | First death confirmed in Guatemala. |
| Community outbreaks confirmed in Guatemala. | |
| 11 June |  First case confirmed in British Virgin Islands. |
| 17 June |  First case confirmed in U.S. Virgin Islands. |
 First case confirmed in Netherlands Antilles. | |
| 19 June |  First case confirmed in Antigua and Barbuda. |
| 22 June | First death confirmed in Honduras. |
| 30 June |  First case confirmed in Saint Lucia. |
| 2 July |  First case confirmed in Saint Vincent and the Grenadines. |
| 3 July |  First case confirmed in Aruba. |
| First death confirmed in El Salvador. | |
| 6 July |  First case confirmed in Guadeloupe. |
| First case confirmed in Saint Martin. | |
| First death confirmed in Jamaica. | |
| 7 July | First death confirmed in Puerto Rico. |
 First case confirmed in Belize. | |
| 9 July | Community outbreaks confirmed in Panama. |
| 14 July |  First case confirmed in Haiti. |
 First case confirmed in Saint Kitts and Nevis. | |
| 19 July | First death confirmed in Panama. |
| 22 July | First case of Oseltamivir (Tamiflu) resistance found in Canada. [64] |
| 23 July |  First case confirmed in Turks and Caicos Islands. |
| 24 July |  First case confirmed in Grenada. |
| First death confirmed in Cayman Islands. | |
| 25 July | Community outbreaks confirmed in El Salvador. |
| Community outbreaks confirmed in Nicaragua. | |
| 26 July | Community outbreaks confirmed in Cuba. |
| Community outbreaks confirmed in Honduras. | |
| 27 July | First death confirmed in Saint Kitts and Nevis. |
| 5 August |  First case confirmed in Anguilla. |
| 12 August | First death confirmed in Nicaragua. |
| 14 August | First case of Oseltamivir (Tamiflu) resistance found in United States. |
| 3 September | First death confirmed in U.S. Virgin Islands. |
| 18 September | First death confirmed in Martinique. |
| 19 September | First death confirmed in Bahamas. |
| 30 September | First death confirmed in Barbados. |
| 1 October | First case confirmed in Saint Barthélemy. |
| 10 October | First death confirmed in Cuba. |
| 14 October | First death confirmed in Trinidad & Tobago. |
| 22 October | First death confirmed in Guadeloupe. |
| 11 November |  First case confirmed in Greenland. |
| 24 November | First country to have double case, following by South Korea. |
Swine influenza is an infection caused by any of several types of swine influenza viruses. Swine influenza virus (SIV) or swine-origin influenza virus (S-OIV) refers to any strain of the influenza family of viruses that is endemic in pigs. As of 2009, identified SIV strains include influenza C and the subtypes of influenza A known as H1N1, H1N2, H2N1, H3N1, H3N2, and H2N3.
In virology, influenza A virus subtype H1N1 (A/H1N1) is a subtype of influenza A virus. Major outbreaks of H1N1 strains in humans include the Spanish flu, the 1977 Russian flu pandemic and the 2009 swine flu pandemic. It is an orthomyxovirus that contains the glycoproteins hemagglutinin and neuraminidase. For this reason, they are described as H1N1, H1N2 etc., depending on the type of H or N antigens they express with metabolic synergy. Hemagglutinin causes red blood cells to clump together and binds the virus to the infected cell. Neuraminidase is a type of glycoside hydrolase enzyme which helps to move the virus particles through the infected cell and assist in budding from the host cells.
The 2009 swine flu pandemic, caused by the H1N1/swine flu/ influenza virus and declared by the World Health Organization (WHO) from June 2009 to August 2010, is the third recent flu pandemic involving the H1N1 virus. The first two cases were discovered independently in the United States in April 2009. The virus appeared to be a new strain of H1N1 that resulted from a previous triple reassortment of bird, swine, and human flu viruses which further combined with a Eurasian pig flu virus, leading to the term "swine flu".
The 2009 flu pandemic in the United States was caused by a novel strain of the Influenza A/H1N1 virus, commonly referred to as "swine flu", that was first detected on 15 April 2009. While the 2009 H1N1 virus strain was commonly referred to as "swine flu", there is no evidence that it is endemic to pigs or of transmission from pigs to people; instead, the virus spreads from person to person. On April 25, the World Health Organization declared a public health emergency, followed concurringly by the Obama administration on April 26.
The 2009 swine flu pandemic in Canada was part of an epidemic in 2009 of a new strain of influenza A virus subtype H1N1 causing what has been commonly called swine flu. In Canada, roughly 10% of the populace has been infected with the virus, with 428 confirmed deaths ; non-fatal individual cases are for the most part no longer being recorded. About 40% of Canadians have been immunized against H1N1 since a national vaccination campaign began in October 2009, with Canada among the countries in the world leading in the percentage of the population that has been vaccinated. The widespread effect of H1N1 in Canada raised concerns during the months leading to the XXI Olympic Winter Games, which took place in Vancouver in February 2010.
This article covers the chronology of the 2009 novel influenza A (H1N1) pandemic. Flag icons denote the first announcements of confirmed cases by the respective nation-states, their first deaths, and relevant sessions and announcements of the World Health Organization (WHO), the European Union , and the U.S. Centers for Disease Control (CDC).
In March and April 2009, an outbreak of a new strain of influenza commonly referred to as "swine flu" infected many people in Mexico and other parts of the world, causing illness ranging from mild to severe. Initial reports suggested that the outbreak had started in February due to farming practices at a pig farm half-owned by Smithfield Foods. Smithfield Foods stated that it had found no clinical signs or symptoms of the presence of swine influenza in the company's swine herd, or among its employees at its joint ventures in Mexico, that it routinely administers influenza virus vaccination to their swine herds and that it conducts monthly testing for the presence of swine influenza. The new strain was identified as a combination of several different strains of Influenzavirus A, subtype H1N1, including separate strains of this subtype circulating in humans and in pigs. The World Health Organization (WHO) and the U.S. Centers for Disease Control and Prevention (CDC) have expressed serious concerns that the new strain, which transmits between humans and has had a relatively high mortality rate in the possible and confirmed Mexican cases, has the potential to become an influenza pandemic. It is reported that, because the virus is already widespread, containment will be impossible.
In March and April 2009, an outbreak of a new strain of influenza commonly referred to as swine flu infected many people in Mexico and parts of the United States causing severe illness in the former. The new strain was identified as a combination of several different strains of Influenzavirus A, subtype H1N1, including separate strains of this subtype circulating in humans and in pigs. Spain was the first country in continental Europe to report cases of swine flu, in late April 2009.
The 2009 flu pandemic was a global outbreak of a new strain of influenza A virus subtype H1N1, first identified in April 2009, termed Pandemic H1N1/09 virus by the World Health Organization (WHO) and colloquially called swine flu. The outbreak was first observed in Mexico, and quickly spread globally. On 11 June 2009, the WHO declared the outbreak to be a pandemic. The overwhelming majority of patients experienced mild symptoms, but some persons were in higher risk groups, such as those with asthma, diabetes, obesity, heart disease, who were pregnant or had a weakened immune system. In the rare severe cases, around 3–5 days after symptoms manifest, the sufferer's condition declines quickly, often to the point of respiratory failure.
This article deals with the status and efforts regarding the 2009 swine flu pandemic by country and continent/region.
In March and April 2009, an outbreak of a new strain of flu, popularly known as swine flu was discovered to have infected several people in Mexico and the states of California and Texas in the United States. On April 28 Costa Rica became the first Central American country to report the outbreak of the virus, with a confirmed infection. As of November 4 the Costa Rican Ministry of Health had 1,596 confirmed cases, 1,275 pending cases, 8,000 already discarded, and 38 deaths.
The pandemic H1N1/09 virus is a swine origin influenza A virus subtype H1N1 strain that was responsible for the 2009 swine flu pandemic. This strain is often called swine flu by the public media. For other names, see the Nomenclature section below.
The 2009 swine flu pandemic in Brazil began on April 25, 2009, with two people, spreading to 34 over the first two weeks. CDC calculate that Africa and Southeast Asia, which have 38% of the world's population, accounted for a disproportionate 51% of the deaths.
The 2009 flu pandemic in South America was part of a global epidemic in 2009 of a new strain of influenza A virus subtype H1N1, causing what has been commonly called swine flu. As of 9 June 2009, the virus had affected at least 2,000 people in South America, with at least 4 confirmed deaths. On 3 May 2009, the first case of the flu in South America was confirmed in a Colombian man who recently travelled from Mexico – since then, it has spread throughout the continent. By far, the most affected country has been Chile, with more than 12,000 confirmed cases, 104 deaths, and the highest per capita incidence in the world.
The 2009 flu pandemic in Asia, part of an epidemic in 2009 of a new strain of influenza A virus subtype H1N1 causing what has been commonly called swine flu, afflicted at least 394,133 people in Asia with 2,137 confirmed deaths: there were 1,035 deaths confirmed in India, 737 deaths in China, 415 deaths in Turkey, 192 deaths in Thailand, and 170 deaths in South Korea. Among the Asian countries, South Korea had the most confirmed cases, followed by China, Hong Kong, and Thailand.
The 2009 flu pandemic in Oceania, part of an epidemic in 2009 of a new strain of influenza A virus subtype H1N1 causing what has been commonly called swine flu, has afflicted at over 22,000 people in Oceania, with 56 confirmed deaths. Almost all of the cases in Oceania have been in Australia, where the majority of cases have resulted from internal community spread of the virus. In addition, the government of New Zealand, where most of the remainder of cases in Oceania have occurred, is on high alert for any people travelling into the country with flu-like symptoms.
The 2009 flu pandemic in Europe was part of a pandemic involving a new strain of influenza, subtype H1N1. H1N1 is commonly called swine flu. The pandemic infected at least 125,550 people in Europe. There were 458 confirmed deaths in Turkey, 438 confirmed deaths in Russia, and 457 confirmed deaths in the United Kingdom.
The 2009 flu pandemic hit Africa two months later than other continents with the first case reported in Egypt on June 2, 2009. As of December 1, 30 countries in Africa had reported cases and 7 countries in Africa had reported a total of 108 deaths. It was the least affected continent.
The United States experienced the beginnings of a pandemic of a novel strain of the influenza A/H1N1 virus, commonly referred to as "swine flu", in the spring of 2009. The earliest reported cases in the US began appearing in late March 2009 in California, then spreading to infect people in Texas, New York, and other states by mid-April. Early cases were associated with recent travel to Mexico; many were students who had traveled to Mexico for Spring Break. This spread continued across the country's population and by the end of May there were approximately 0 confirmed cases throughout all 50 states.
The 2009 flu pandemic was a global outbreak of a new strain of influenza A virus subtype H1N1, first identified in April 2009, termed Pandemic H1N1/09 virus by the World Health Organization (WHO) and colloquially called swine flu. The outbreak was first observed in Mexico, and quickly spread globally. On 11 June 2009, WHO declared the outbreak to be a pandemic. The overwhelming majority of patients experience mild symptoms", but some persons are in higher risk groups, such as those with asthma, diabetes, obesity, heart disease, or who are pregnant or have a weakened immune system. In the rare severe cases, around 3–5 days after symptoms manifest, the person's condition declines quickly, often to the point respiratory failure.
The official, Dr. Daniel Jernigan, head of flu epidemiology for the Centers for Disease Control and Prevention, said at a news conference that the official number gave an inaccurate picture of the outbreak because so few mildly sick people were being tested.
