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2009 swine flu pandemic in the United States

January 31, 2023

Further information: 2009 swine flu pandemic, 2009 swine flu pandemic by country, and 2009 swine flu pandemic in the United States by state

Reported cases by state/territory
State or territory State-reported confirmed cases[1] State-reported hospital- izations[1] Confirmed deaths
Total 115,318 27,632 3,433
Alabama 2,453/NLU[2] NR 19[2]
Alaska 1,563[3][4] 18[3]wave 1 13[5] (11)[6]
Arizona 8,726[7] 1,897[7] 152[7]
Arkansas 154/NLU[8] NR 53[9]
California 10,545[10] 8,589[10] 657
Colorado 1,321[11] 578[12] 70[12]
Connecticut 5,491[13] 766[13] 35[13]
Delaware 381[14][15] NR 7[16]
District of Columbia 54[14] NR 1[17]
Florida 3,676[18] 1,227[18] 230[19][20]
Georgia 1,012[21] 860[21] 81[22]
Hawaii 2,221[23] NR 13[24]
Idaho 1,171[25] 389[25]wave 2 23[25]wave 2
Illinois 3,387[26] 3,042[27] 111[27]
Indiana 782[28] NR 39[28]
Iowa 929[29] 700[30] 41[31]
Kansas 1,201[32] NR 29[33]
Kentucky 2,092[34] NR 39[34]
Louisiana 1,876[35] NR 52[36]
Maine 2,232[37] 230[37] 21[38]
Maryland 1,772[39] 996[40] 45[41]
Massachusetts 1,979[42] 397[42] 33[43]
Michigan 655/NLU[44] NR 88[45]
Minnesota 2,220[14] 1,813[46] 61[47]
Mississippi 1,292[48] NR 26[49]
Missouri 1,523[50] NR 17[51]
Montana 961[52] 9[52] 19[53]
Nebraska 430[54] 40[54] 15[55]
Nevada 5,516[56][57] NR 44[56][58]
New Hampshire 722[59] NR 10[60]
New Jersey 1,006/NLU[61] 512[62] 42[63]
New Mexico 1,007[64] 1,007[65] 58[66]
New York 2,738[14][67] 909[68] 206
North Carolina 638[69] 267[69] 107[70]
North Dakota 650[71] 60[71] 2[72]
Ohio 227/NLU[73] NR 52[74]
Oklahoma 237/NLU[75] 7[75] 44[76]
Oregon 1,833[77] 1,419[77] 79[78]
Pennsylvania 10,940[79] NR 78[79]
Rhode Island 203[80] 76[81] 13[82][83]
South Carolina 1,634[84] NR 49[85]
South Dakota 2,081[86] 422[86] 23[86]
Tennessee 1,163[87] NR 57[88]
Texas 6,128[89] 1,994[90] 231[91]
Utah 988[14] 302[92] 48[93]
Vermont 404[94] 149[94] 3[95]
Virginia 327[14][96] NR 37[97]
Washington 1,882[14][98] 1,561[99] 99[99]
West Virginia 1,214[100] 853[101] 22[102]
Wisconsin 9,579[103] 1,317[103] 55[103]
Wyoming 725[104] NR 10[105]
American Samoa 90[106] NR 1[107]
Guam 338[108] NR 2[109]
Northern Mariana Islands 71[110] NR 0
Puerto Rico 908[111] NR 60[112]
U.S. Virgin Islands 80[113] NR 1[113]
NR: Not Reported - NLU: No Longer Updated

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.[114] While the 2009 H1N1 virus strain was commonly referred to as "swine flu", there is no evidence that it is endemic to pigs (i.e. actually a swine flu) or of transmission from pigs to people; instead, the virus spreads from person to person.[115] On April 25, the World Health Organization declared a public health emergency, followed concurringly by the Obama administration on April 26.[114]

The U.S. Centers for Disease Control and Prevention (CDC) reported that during the outbreak about half of all influenza viruses being reported were 2009 H1N1 viruses, with the other half being those of the regular seasonal influenza. Unique to this particular strain, about 60% of the 2009 H1N1 influenza cases were occurring among people between 5 years and 24 years of age, and 40% of the hospitalizations were occurring among children and young adults. About 80% of the deaths were in people younger than 65 years of age. The CDC noted that this differed greatly from typical seasonal influenza epidemics, during which about 70% to 90% of deaths are estimated to occur in people 65 years and older. Antibody studies showed that children had no existing cross-reactive antibody to the 2009 H1N1 influenza virus, while about one-third of adults older than 60 years of age had cross-reactive antibody.[116]

By April 21, 2009, CDC had begun working to develop a virus that could be used to make a vaccine to protect against the new virus. Following preparation for distribution beginning in June, the first doses were administered in October 2009.[117]

On August 10, 2010, WHO declared an end to the global 2009 H1N1 influenza pandemic. However, the virus continues to circulate as a seasonal flu virus, and cause illness, hospitalization, and deaths worldwide every year.[118]

From April 12, 2009, to April 10, 2010, the CDC estimates there were 60.8 million cases (range: 43.3 - 89.3 million), 274,304 hospitalizations (range: 195,086 - 402,719), and 12,469 deaths (range: 8868 - 18,306) in the United States due to the virus.[119]

A follow-up study done in September 2010 showed that the risk of serious illness resulting from the 2009 H1N1 flu was no higher than that of the yearly seasonal flu.[120] For comparison, the CDC estimates the global H1N1 death toll at 284,000 and the WHO estimates that 250,000 to 500,000 people die of seasonal flu annually.[121]

History

The earliest reported cases in the US began appearing in early April 2009, in California.[122][123] In late April, the Centers for Disease Control and Prevention (CDC) activated its Emergency Operations Center and declared a public health emergency.[124] On April 25, the World Health Organization (WHO) declared a public health emergency of international concern. WHO declared H1N1 a pandemic on June 11.[citation needed]

By the end of May, the flu had infected people in all 50 states. As of June 16, the total number of confirmed cases was 27,717[125] and on June 25, the CDC said there were over one million (1,000,000) cases, most of which had not been reported or diagnosed.[126][127] Deaths relating to influenza began appearing in the US in late April, and by early June, 15 states had reported fatalities related to or directly occurring from the virus.

By October 5, the first doses of an H1N1 vaccine were given in the U.S. The CDC distributed vaccines for the flu[128] using mechanisms already in place for its Vaccines for Children (VFC) program.[129]

On October 24, and the CDC said more than 1,000 had died from the flu. President Obama declared a national emergency.[130][114][131] On December 10, 2009, the CDC reported an estimated 50 million Americans or 1 in 6 had been infected and 10,000 had died.[132] On December 23, 2009, the CDC reported a reduction of the disease by 59% percent. On February 12, the CDC reported 57 million Americans had been sickened, 257,000 had been hospitalized and 11,690 people had died (including 1,180 children) due to flu from April through to mid-January.[133][134]

Initial cases

The Centers for Disease Control and Prevention (CDC) identified the first two A/09(H1N1) swine flu cases in California on April 17, 2009, via the Border Infectious Disease Program,[135] for a San Diego County child, and a naval research facility studying a special diagnostic test, where influenza sample from the child from Imperial County was tested.[136] By April 21, enhanced surveillance was established to search for additional cases in both California and Texas and the CDC determined that the virus strain was genetically similar to the previously known A(H1N1) swine flu circulating among pigs in the United States since about 1999.[citation needed]

It was established that the virus was a combination of human, North American swine, and Eurasian swine influenza viruses; the viruses from the initial two Californian cases were also noted to be resistant to amantadine and rimantadine, two common influenza antiviral drugs.[137] No contact with pigs was found for any of the seven Californian nor either of the two Texas cases, suggesting human-to-human transmission of the virus.[citation needed]

On April 28, 2009, the director of the Centers for Disease Control and Prevention confirmed the first official US death of swine flu. Tests confirmed that a 23-month-old toddler from Mexico, who was probably infected there, died on April 27 from the flu while visiting Texas.[138]

Outbreak across the US

 
CDC report for the 2008–2009 flu season week 18 (May 17), subtypes and percent positive tests

Cases of H1N1 spread rapidly across the United States, with particularly severe outbreaks in Texas, New York, Utah, and California. Early cases were associated with recent travel to Mexico; many were students who had traveled to Mexico for spring break.[139] On May 4, 2009, the CDC reported one death, 286 confirmed cases of H1N1 flu across 36 states, 35 hospitalizations, and expected H1N1 to eventually spread to all states. A large number of cases, according to medics, have happened in the days that preceded the launch of the alert and came out only in these days due to a massive backlog.[140] By May 5, 2009, the number had risen to 403[125] and a second death was reported in Texas.[141] The CDC and government officials had expressed cautious optimism about the severity and spread of H1N1.[142][143]

Changes in surveillance of cases of influenza-like illness, including new guidelines for identifying cases to test, increased laboratory testing, and new test kits able to distinguish this novel strain, resulted in a spike in the percent of cases tested positive for influenza. Of the positive cases, about a third were due to the novel strain. Also found were a substantial number of cases where the strain could not be subtyped.[144]

 
Pneumonia and influenza deaths in 122 US cities, 5 years through October 2009

The proportion of US deaths due to pneumonia and influenza climbed above the epidemic threshold in the 2007–2008 winter flu season but not in the 2008–2009 season. Although the 2009 H1N1 outbreak reached epidemic levels of infection early in 2009, it did not contribute to epidemic levels of pneumonia and influenza related deaths until October 2009.[citation needed]

2009 US Swine Flu Summary
Number of Confirmed Cases/Deaths See Table Above
Number of States/Territories
with Reported Cases 		56
Number of States/Territories
with Confirmed Deaths 		55
Earliest Confirmed Infection in US March 28, 2009[145]
First Death Inside the US April 27, 2009[138]
First Death of US Citizen May 5, 2009[146]
Number of People Hospitalized 9,079 (as of September 3)[147]
Fatalities 593 (as of September 3)[147]

The second wave

In early October 2009, the Centers for Disease Control and Prevention announced that swine flu was widespread across the country. It also said there was significant flu activity in virtually all states, which was considered to be quite unusual for this time of year. There was particular worry about pregnant women. As of late August, 100 had been hospitalized in intensive care units and 28 had died since the beginning of the outbreak in April. On October 1, it was acknowledged that a recruit in basic training in Fort Jackson, South Carolina, was the Army's first swine flu death. The recruit fell ill on September 1 and died of pneumonia on September 10.[citation needed]

Dell Children's Medical Center in Austin, Texas, erected two tents in its parking lot to handle emergency room visits, and hospitals around Colorado Springs recorded a 30 percent spike in flu visits. As pediatric cases were increasing, the Dept. of Health and Human Services released 300,000 courses of children's liquid Tamiflu from the national pandemic stockpile in late September, with the first batches sent to Texas and Colorado.[citation needed]

In late September, the disease centers reported that 936 had died of flu symptoms or of flu-associated pneumonia since August 30, when it began a new count of deaths, including some without laboratory-confirmed swine flu.[148]

The Agriculture Department reported on October 16 that three pigs at the Minnesota State Fair, in St. Paul, were tested positive in late August for H1N1 virus, which were the first cases in the country, although infected pigs had been found in eight other countries. There were 103 pigs tested at the Fair, including the three infected, though all appeared healthy. Scientists said the virus was already spreading widely among people, and, in fact, was more common in humans than in pigs, so humans were more likely to catch it from others than from pigs.[149]

In mid-October, it was reported that flu caused by the H1N1 virus was widespread in 41 states, and flu-like illnesses accounted for 6.1 percent of all doctor visits, which was considered high[citation needed], particularly for October. Forty-three children had died from H1N1 since August 30, which is approximately the number that usually dies in an entire flu season. Nineteen of the forty-three were teenagers while sixteen were between ages five to eleven. The rest were under five.[citation needed] It is reported that the severity of the disease was not increasing. About fifteen to twenty percent of the patients hospitalized for the flu were placed in the intensive care unit, a level similar to that for seasonal flu.[citation needed]

 
High-risk groups line up at a defunct Kmart on October 24, 2009, for the first H1N1 vaccines publicly available in Boise, Idaho.

Projections of the supply of H1N1 vaccine had decreased significantly from a level of 120 million doses ready in October, estimated during the summer, to an estimate of 28 to 30 million doses by the end of the month. On October 14, 11.4 million doses of the H1N1 vaccine were said to be available. As of November 20, 2009, the CDC reported sharp declines in H1N1 activity throughout the United States, with influenza-like illness (which may also include meningitis, pneumonia, strep pharyngitis, gastroenteritis, and the common cold) accounting for 5.5% of doctors visits, down sharply from 8% in late October, the peak of the second wave. However, taking the vaccine is still urged by the CDC, as a third wave of the disease may sweep across the US, possibly in January/February 2010.[150][needs update] As of December 24, the second wave of H1N1 has clearly peaked, with pneumonia and influenza deaths falling below the epidemic threshold for the first time in 11 weeks, and the proportion of doctors visits due to influenza-like illness falling to baseline (2.3%), down from 5.5% 1 month before, on November 20. However, it was reported that influenza activity was beginning to increase in West Virginia, with 5.2% of patients treated by West Virginia health care providers having influenza-like illness, a major increase from 2% of patients treated by West Virginia health care providers having influenza-like illness in November.[citation needed]

On August 10, 2010, WHO declared an end to the global 2009 H1N1 influenza pandemic. However, the virus continues to circulate as a seasonal flu virus, and cause illness, hospitalization, and deaths worldwide every year.[151]

H1N1 characteristics and severity

 
Influenza-associated pediatric deaths reported to CDC, from 2005–06 to start of 2009–2010

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 (see human influenza) and in pigs (see swine influenza). The strain transmits between humans and was initially reported to have a relatively high mortality rate in Mexico. In April 2009 the World Health Organization (WHO) and the U.S. Centers for Disease Control and Prevention (CDC) expressed serious concerns that the new strain had the potential to become an influenza pandemic.[152] On April 25 it was reported that, because the virus was already widespread, containment would be "nearly impossible."[153]

By this time, there had also been speculation that the flu death toll in Mexico could be lower than first thought. Gerald Evans, head of the Association of Medical Microbiology and Infectious Disease Canada and a member of a federal pandemic-planning committee, said on April 29:[154]

There was a lot of speculation and what seemed to be evidence there were dozens and dozens of deaths. Careful analysis showed these people likely died of something else, and not influenza. That's really good news, and that would fit with what we've seen outside of Mexico.

Another Canadian expert, Neil Rau, criticized the WHO's decision to raise its pandemic alert to level 5, saying:[155]

I don't agree with (the WHO) because I think it's a panic metre, not a pandemic metre. [...] If that flu-like illness is not deadly, I don't know what the cause for alarm is for people who are not really sickened by this virus. [...] I'm really eager to know how much worse this is than seasonal flu. So far it's looking like it's not that serious.

CNN noted on April 28, 2009, that in any individual week between January 1 and April 18, there had been at least 800 deaths in the U.S. due to normal influenza, which is higher than the 150 total deaths worldwide from the swine flu up to that time.[156]

As of May 28, 2010, the official U.S. death toll attributed directly to the novel H1N1 and seasonal influenza was 2,117.[157] This total exceeds the 849 U.S. deaths directly attributed to seasonal influenza in 2006.[158] Many of the other deaths commonly attributed to influenza are caused by complicated influenza, where a second infection causes death, usually pneumonia (of which 48,657 of 55,477 official deaths in 2006 occurred in people aged 65 years and older).[158][159] The final estimate was of over 12,000 deaths over the course of the pandemic (April 2009 – April 2010).[119]

H1N1 unique characteristics

The CDC reported that during the outbreak about half of all influenza viruses being detected through laboratory reports were 2009 H1N1 viruses, with the other half being those of the regular seasonal influenza viruses. Surveillance reports indicated that about 57% of the 2009 H1N1 influenza confirmed and probable cases were occurring among people between 5 years and 24 years of age, and 41% of the hospitalizations were occurring among older children and young adults. The highest rates of hospitalization were among children younger than 5 years of age; the next highest hospitalization rate was in people 5 years to 24 years of age. Antibody studies showed that children had no existing cross-reactive antibody to the 2009 H1N1 influenza virus, while about one-third of adults older than 60 years of age had cross-reactive antibody. One possible explanation for this pre-existing antibody in older adults was that they may have had previous exposure, either through infection or vaccination, to an influenza A H1N1 virus that was more closely related to the 2009 H1N1 flu virus.[160]

Based on data from previous influenza pandemics and seasonal influenza, pregnant women had been recognized as a high-risk group early in the outbreak. People with other previously recognized medical conditions that placed them at high risk of complications from seasonal influenza also appeared to be at increased risk of complications from 2009 H1N1 influenza. One report found that seventy-one percent of hospitalized patients had one or more underlying chronic medical conditions and reported deaths had occurred in people ranging in age from 22 months old to 57 years old. Also, only 13% of hospitalizations had occurred in people 50 years and older, and there were few cases and no deaths in people older than 65 years, which was unusual when compared with seasonal flu. [161]

Response

 
Congruent U.S. Government and WHO Pandemic Response Charts.

The Federal response remained at US Pandemic Stage 0, congruent with the World Health Organization (WHO) Pandemic Phases 1, 2 and 3;[162][163] however, the WHO's Pandemic Phase was raised to 4 on April 27, which is congruent with US Pandemic Stage 2.[164] On April 29, the WHO raised the pandemic alert level to phase 5.[165]

The United States federal government declared a public health emergency, and several U.S. states then indicated that they may follow suit. Secretary of Homeland Security Janet Napolitano noted that this declaration was standard operating procedure, which was also done for the 2009 presidential inauguration and for flooding.[166]

After many days of deliberation the WHO declared that the current influenza had become a true pandemic, raising the Pandemic Alert level to Phase 6, the highest on the WHO scale and congruent with U.S. Federal Government Response Stages 3–6.[167]

Obama Administration reactions

 
Barack Obama being vaccinated on Dec. 20, 2009.

An official for the White House said on April 24 that "the White House is taking the situation seriously and monitoring for any new developments. The president has been fully briefed."[168] President Barack Obama stated that "We are closely monitoring the emerging cases of swine flu". He also noted, "This is obviously a cause for concern ... but it is not a cause for alarm".[169] Obama suggested that U.S. schools should consider shutting down, as a future possibility, if their students were to become infected.[170] White House Press Secretary Robert Gibbs said the effort to get a team in place to respond to the health scare had not been hindered by the lack of a secretary of Health and Human Services or appointees in any of the department's 19 key posts.[171] The president's nominee, Kansas Gov. Kathleen Sebelius, was still awaiting confirmation from the U.S. Senate until passing on April 28. The President had not yet made appointments to either the Commissioner of the Food and Drug Administration, the Surgeon General, or the Director of the Centers for Disease Control and Prevention.[171] The current acting Surgeon General, Steven K. Galson, was also currently serving as the Acting Assistant Secretary for Health.[172]

 
Health and Human Services Secretary Kathleen Sebelius in a meeting in the Situation Room of the White House regarding the H1N1 virus.

On April 30, it was reported that an aide to Steven Chu, the US Energy Secretary, had fallen ill from the virus after helping arrange President Obama's trip to Mexico.[173] However, the White House stated that the President was not at risk of contracting the flu.[173]Kathleen Sebelius was confirmed as the Secretary of Health and Human Services by the Senate on April 28, 2009, with a vote of 65–31.[174][175]

 
Wikinews has related news:
  • Obama declares swine flu emergency in US

On October 24, President Obama declared the 2009 H1N1 swine flu a national emergency.[176] The declaration made it easier for U.S. medical facilities to handle a surge in flu patients by allowing the waiver of some requirements of Medicare, Medicaid and other federal health insurance programs as needed.

Centers for Disease Control and Prevention (CDC)

In this video, Joe Bresee, with CDC's Influenza Division, describes the symptoms of swine flu and warning signs to look for that indicate the need for urgent medical attention.
See also this video with subtitles: Video on YouTube

Activation of Emergency Operations Center

During the week of April 19, 2009, the CDC activated its Emergency Operations Center (EOC), with RADM Stephen Redd as the Incident Commander, to augment the ongoing investigation of human cases of swine influenza A (H1N1).[177] More than 250 CDC professionals worked from the CDC EOC as part of the agency's response.[178] As of May 4, 2009, the CDC reported that it had deployed 25% of the supplies and medicines in the Strategic National Stockpile to the various states.[179]

Swine flu test kits

As of April 29, only the CDC could confirm U.S. swine flu cases.[180] Besser stated during an April 30 press briefing that California and New York had diagnostic test kits, and that the kits would be sent to all states starting the following day.[181] On May 6, the CDC announced that testing kits were now available for all states. It was expected this would generate an increase in the number of confirmed cases as more states began doing their own tests.[182]

 
President Obama is briefed in the Situation Room about the swine flu outbreak.

Influenza reporting requirements

In the United States, the majority of the 70 National Respiratory and Enteric Virus Surveillance System (NREVSS) laboratories do not report the influenza A subtype.[citation needed]

However, in 2007, human infection with a novel influenzavirus A became a nationally notifiable condition. Novel influenza A virus infections include all human infections with influenza A viruses that are different from currently circulating human influenza H1 and H3 viruses. These viruses include those that are subtyped as nonhuman in origin and those that are unsubtypable with standard methods and reagents.[183] The new strain responsible for this outbreak was one such virus.[citation needed]

Recommendations for schools

Initially the CDC had issued a recommendation that schools close for as long as two weeks if a student catches swine flu.[184] Some school districts closed all schools if a single child was classified as probable.[139] On May 5 the CDC retracted its advice stating that schools that were closed based on previous CDC guidance related to this outbreak may reopen.[185] By that time at least 726 schools nationwide serving more than 480,000 students had closed for at least some period of time.[184] The CDC amended its advice, citing new information on disease severity and the limiting effectiveness of school closure as a control measure.[185] The new advice given stated, "Decisions about school closure should be at the discretion of local authorities based on local considerations, including public concern and the impact of school absenteeism and staffing shortages."[185]

Food and Drug Administration

The Food and Drug Administration (FDA) authorized emergency use of medicines and diagnostic tests for flu. (FDA is part of Department of Health and Human Services.)[186] The FDA stated it was also responding to this threat by:

  • working with other government agencies and manufacturers on a series of issues related to antiviral medications.
  • growing the 2009 H1N1 flu virus and preparing to make vaccine seed lots, which may be used eventually to produce a safe and effective vaccine.
  • helping to prepare reagents needed for vaccine production and coordinating closely with other public health agencies for clinical development and testing.
  • accelerating access to new diagnostic tools for this 2009 H1N1 flu virus[187]

On May 6, 2009, the FDA announced that it had approved a new manufacturing facility for seasonal flu vaccine, owned by Sanofi Pasteur, which could also be used for manufacturing a vaccine for the new H1N1 flu strain.[188] The FDA also issued a warning for consumers to be wary of products claiming to cure or prevent swine flu.[189]

Other federal agencies

Department of Homeland Security

Secretary Napolitano stated that DHS was the principal federal office for incidents such as the H1N1 flu outbreak, and "Under that role, we have been leading a true collaborative effort."[190] The Department of Homeland Security issued a document, dated November 1, 2005, entitled "National Strategy for Pandemic Influenza", detailing planning for potential pandemics.

State Department

The State Department suggested travelers to Mexico stay alert and comply with guidance from Mexican public health officials, but did not impose any travel restrictions on US citizens to Mexico.[191] However, the State Department did recommend US citizens avoid non-essential travel to Mexico.[192]

Department of Agriculture

The Department of Agriculture (USDA) reported no swine in the US have been infected so far, but the USDA is monitoring swine across the US for signs of infection.[193]

Department of Commerce

The Department of Commerce sent a letter to Russia and China requesting that those countries lift their ban on American pork products.[194]

Department of Defense

The Department of Defense (DOD) monitored the swine flu situation and had contingency plans to deal with such outbreaks.[195] As of May 7, 2009, the DOD reported 104 confirmed cases among Armed Forces personnel and their families. DOD maintained a daily summary and map.[196]

Department of Education

The Department of Education provided guidance to schools in the US affected by swine flu, as well as precautions to take.[197]

State and local

Schools closed in many states in response to local flu outbreaks. By April 30, 2009, 300 U.S. schools and school districts had announced closures in response to the outbreak, giving 169,000 students time off.[198] On May 4, 2009, about 533 schools in 24 states in the U.S. were closed, affecting about 330,000 students.[199] On September 25, 2009, 42 schools were closed in eight states as the second wave of the pandemic began.[200]

On May 5, Kathleen Sebelius stated in a CDC news conference that school closures for single confirmed cases of H1N1 influenza were unnecessary, but that children displaying an influenza-like illness should say home.[201]

Travel industry

Several US airlines waived fees for cancellations and flight changes.[202] At least one cruise line changed itinerary to avoid Mexican ports of call.[203]

Summary

[citation needed]

2009 A(H1N1) Outbreak and pandemic milestones
28 March   First case in the US of what would later be identified as swine flu origin.
21 April   First case confirmed in California.
23 April   First case confirmed in Texas.
25 April   First case confirmed in Kansas.
  Community outbreaks confirmed in the United States.
26 April   First case confirmed in New York.
  First case confirmed in Ohio.
Acting HHS Secretary Charles E. Johnson declares 2009 H1N1 a public health emergency[204][205]
28 April   First case confirmed in Indiana.
29 April   First non-US citizen death confirmed in Texas.
  First case confirmed in Nevada.
  First case confirmed in Arizona.
  First case confirmed in Maine.
  First case confirmed in Massachusetts.
  First case confirmed in Michigan.
30 April   First case confirmed in Nebraska.
  First case confirmed in South Carolina.
  First case confirmed in Minnesota.
  First case confirmed in Colorado.
  First case confirmed in Virginia.
  First case confirmed in Kentucky.
  First case confirmed in New Jersey.
1 May   First case confirmed in Florida.
  First case confirmed in Missouri.
  First case confirmed in Connecticut.
  First case confirmed in Delaware.
2 May   First case confirmed in New Mexico.
  First case confirmed in Utah.
  First case confirmed in New Hampshire.
  First case confirmed in Rhode Island.
  First case confirmed in Iowa.
  First case confirmed in Wisconsin.
  First case confirmed in Alabama.
3 May   First case confirmed in Idaho.
  First case confirmed in Pennsylvania.
  First case confirmed in Louisiana.
  First case confirmed in North Carolina.
  First case confirmed in Tennessee.
4 May   First case confirmed in Oregon.
  First case confirmed in Georgia.
  First case confirmed in Maryland.
5 May   First case confirmed in Washington.
  First case confirmed in Oklahoma.
  First case confirmed in Hawaii.
  First US citizen death confirmed in Texas.
6 May   First case confirmed in District of Columbia.
7 May   First case confirmed in South Dakota.
8 May   First case confirmed in Vermont.
  First case confirmed in Arkansas.
9 May   First death confirmed in Washington.
11 May   First case confirmed in Montana.
13 May   First case confirmed in North Dakota.
14 May   First death confirmed in Arizona.
15 May   First case confirmed in Mississippi.
17 May   First death confirmed in New York.
19 May   First death confirmed in Missouri.
20 May   First death confirmed in Utah.
25 May   First death confirmed in Illinois.
26 May   First case confirmed in Puerto Rico.
27 May   First case confirmed in Wyoming.
  First case confirmed in Alaska.
2 June   First case confirmed in West Virginia. All 50 states have confirmed H1N1.
  First death confirmed in Virginia.
3 June   First death confirmed in Michigan.
  First death confirmed in Connecticut.
4 June   First death confirmed in California.
5 June   First death confirmed in Pennsylvania.
  First death confirmed in Wisconsin.
8 June   First death confirmed in Oregon.
  First death confirmed in Oklahoma.
15 June   First death confirmed in New Jersey.
  First death confirmed in Massachusetts.
  First death confirmed in Minnesota.
16 June   First death confirmed in Florida.
  First death confirmed in Rhode Island.
  First case confirmed in US Virgin Islands.
23 June   First death confirmed in Maryland.
24 June   First death confirmed in North Carolina.
26 June   First case confirmed in American Samoa.
29 June   First death confirmed in Hawaii.
1 July   First case confirmed in Guam.
6 July   First death confirmed in Ohio.
  First death confirmed in Nevada.
10 July   First death confirmed in Indiana.
  First death confirmed in Georgia.
15 July   First death confirmed in Nebraska.
  First death confirmed in Tennessee.
20 July   First death confirmed in Guam.
21 July   First case confirmed in Northern Mariana Islands.
27 July   First death confirmed in Alaska.
29 July   First death confirmed in Alabama.
  First death confirmed in Colorado.
3 August   First death confirmed in Iowa.
6 August   First death confirmed in Kansas.
  First death confirmed in Montana.
  First death confirmed in Mississippi.
8 August   First death confirmed in Arkansas.
10 August   First death confirmed in New Mexico.
13 August   First death confirmed in Maine.
  First death confirmed in Louisiana.
14 August   First case of Oseltamivir (Tamiflu) resistance confirmed.
17 August   First death confirmed in New Hampshire.
19 August   First death confirmed in Wyoming.
28 August   First death confirmed in South Carolina.
2 September   First death confirmed in US Virgin Islands.
3 September   First death confirmed in Kentucky.
4 September   First death confirmed in West Virginia.
10 September   First Oseltamivir (Tamiflu) resistance spread from person to person confirmed.
28 September   First death confirmed in Idaho.
2 October   First death confirmed in South Dakota.
22 October   First death confirmed in Delaware.
26 October   First death confirmed in North Dakota.
28 October President Obama declares H1N1 a National Emergency.[205]
  First death confirmed in Vermont. All 50 states have confirmed H1N1 deaths.
4 November   First feline zoonosis confirmed in Iowa.
19 November   First death confirmed in American Samoa.
  First feline death confirmed in Oregon.
24 November   First double infection case confirmed in West Virginia.

See also

References

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External links

 
Wikimedia Commons has media related to 2009 swine flu outbreak in the United States.
 
Wikinews has related news:
  • US declares public health emergency over spread of swine flu

U.S. federal government

  • PandemicFlu.gov – Access to U.S. Government swine, avian and pandemic flu information.
  • U.S. Centers For Disease Control (CDC) H1N1 Flu – Updates periodically as the CDC releases new information
  • Medical Encyclopedia Medline Plus: Swine Flu Encyclopic Information from the National Institutes of Health

International organizations

  • – Updates periodically and links to archived WHO releases

Other websites

  • H1N1 Swine Flu in the Neonatal Intensive Care Unit
  • Get Pandemic Ready
  • Influenza Research Database – Database of influenza genomic sequences and related information.
  • , Fox News, Associated Press reference, May 20, 2009.
  • USA Today – State-by-state preparations
  • Medical Encyclopedia WebMD: Swine Flu Center
  • Worldwide Confirmed and Suspected Cases

New York City

    January 31, 2023
    2009, swine, pandemic, united, states, further, information, 2009, swine, pandemic, 2009, swine, pandemic, country, state, reported, cases, state, territory, state, territory, state, reported, confirmed, cases, state, reported, hospital, izations, confirmed, d. Further information 2009 swine flu pandemic 2009 swine flu pandemic by country and 2009 swine flu pandemic in the United States by state Reported cases by state territory State or territory State reported confirmed cases 1 State reported hospital izations 1 Confirmed deathsTotal 115 318 27 632 3 433Alabama 2 453 NLU 2 NR 19 2 Alaska 1 563 3 4 18 3 wave 1 13 5 11 6 Arizona 8 726 7 1 897 7 152 7 Arkansas 154 NLU 8 NR 53 9 California 10 545 10 8 589 10 657Colorado 1 321 11 578 12 70 12 Connecticut 5 491 13 766 13 35 13 Delaware 381 14 15 NR 7 16 District of Columbia 54 14 NR 1 17 Florida 3 676 18 1 227 18 230 19 20 Georgia 1 012 21 860 21 81 22 Hawaii 2 221 23 NR 13 24 Idaho 1 171 25 389 25 wave 2 23 25 wave 2Illinois 3 387 26 3 042 27 111 27 Indiana 782 28 NR 39 28 Iowa 929 29 700 30 41 31 Kansas 1 201 32 NR 29 33 Kentucky 2 092 34 NR 39 34 Louisiana 1 876 35 NR 52 36 Maine 2 232 37 230 37 21 38 Maryland 1 772 39 996 40 45 41 Massachusetts 1 979 42 397 42 33 43 Michigan 655 NLU 44 NR 88 45 Minnesota 2 220 14 1 813 46 61 47 Mississippi 1 292 48 NR 26 49 Missouri 1 523 50 NR 17 51 Montana 961 52 9 52 19 53 Nebraska 430 54 40 54 15 55 Nevada 5 516 56 57 NR 44 56 58 New Hampshire 722 59 NR 10 60 New Jersey 1 006 NLU 61 512 62 42 63 New Mexico 1 007 64 1 007 65 58 66 New York 2 738 14 67 909 68 206North Carolina 638 69 267 69 107 70 North Dakota 650 71 60 71 2 72 Ohio 227 NLU 73 NR 52 74 Oklahoma 237 NLU 75 7 75 44 76 Oregon 1 833 77 1 419 77 79 78 Pennsylvania 10 940 79 NR 78 79 Rhode Island 203 80 76 81 13 82 83 South Carolina 1 634 84 NR 49 85 South Dakota 2 081 86 422 86 23 86 Tennessee 1 163 87 NR 57 88 Texas 6 128 89 1 994 90 231 91 Utah 988 14 302 92 48 93 Vermont 404 94 149 94 3 95 Virginia 327 14 96 NR 37 97 Washington 1 882 14 98 1 561 99 99 99 West Virginia 1 214 100 853 101 22 102 Wisconsin 9 579 103 1 317 103 55 103 Wyoming 725 104 NR 10 105 American Samoa 90 106 NR 1 107 Guam 338 108 NR 2 109 Northern Mariana Islands 71 110 NR 0Puerto Rico 908 111 NR 60 112 U S Virgin Islands 80 113 NR 1 113 NR Not Reported NLU No Longer UpdatedvteThe 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 114 While the 2009 H1N1 virus strain was commonly referred to as swine flu there is no evidence that it is endemic to pigs i e actually a swine flu or of transmission from pigs to people instead the virus spreads from person to person 115 On April 25 the World Health Organization declared a public health emergency followed concurringly by the Obama administration on April 26 114 The U S Centers for Disease Control and Prevention CDC reported that during the outbreak about half of all influenza viruses being reported were 2009 H1N1 viruses with the other half being those of the regular seasonal influenza Unique to this particular strain about 60 of the 2009 H1N1 influenza cases were occurring among people between 5 years and 24 years of age and 40 of the hospitalizations were occurring among children and young adults About 80 of the deaths were in people younger than 65 years of age The CDC noted that this differed greatly from typical seasonal influenza epidemics during which about 70 to 90 of deaths are estimated to occur in people 65 years and older Antibody studies showed that children had no existing cross reactive antibody to the 2009 H1N1 influenza virus while about one third of adults older than 60 years of age had cross reactive antibody 116 By April 21 2009 CDC had begun working to develop a virus that could be used to make a vaccine to protect against the new virus Following preparation for distribution beginning in June the first doses were administered in October 2009 117 On August 10 2010 WHO declared an end to the global 2009 H1N1 influenza pandemic However the virus continues to circulate as a seasonal flu virus and cause illness hospitalization and deaths worldwide every year 118 From April 12 2009 to April 10 2010 the CDC estimates there were 60 8 million cases range 43 3 89 3 million 274 304 hospitalizations range 195 086 402 719 and 12 469 deaths range 8868 18 306 in the United States due to the virus 119 A follow up study done in September 2010 showed that the risk of serious illness resulting from the 2009 H1N1 flu was no higher than that of the yearly seasonal flu 120 For comparison the CDC estimates the global H1N1 death toll at 284 000 and the WHO estimates that 250 000 to 500 000 people die of seasonal flu annually 121 Contents 1 History 2 Initial cases 3 Outbreak across the US 3 1 The second wave 4 H1N1 characteristics and severity 4 1 H1N1 unique characteristics 5 Response 5 1 Obama Administration reactions 5 2 Centers for Disease Control and Prevention CDC 5 2 1 Activation of Emergency Operations Center 5 2 2 Swine flu test kits 5 2 3 Influenza reporting requirements 5 2 4 Recommendations for schools 5 3 Food and Drug Administration 5 4 Other federal agencies 5 4 1 Department of Homeland Security 5 4 2 State Department 5 4 3 Department of Agriculture 5 4 4 Department of Commerce 5 4 5 Department of Defense 5 4 6 Department of Education 5 5 State and local 5 6 Travel industry 6 Summary 7 See also 8 References 9 External links 9 1 U S federal government 9 2 International organizations 9 3 Other websites 9 3 1 New York CityHistory EditThe earliest reported cases in the US began appearing in early April 2009 in California 122 123 In late April the Centers for Disease Control and Prevention CDC activated its Emergency Operations Center and declared a public health emergency 124 On April 25 the World Health Organization WHO declared a public health emergency of international concern WHO declared H1N1 a pandemic on June 11 citation needed By the end of May the flu had infected people in all 50 states As of June 16 the total number of confirmed cases was 27 717 125 and on June 25 the CDC said there were over one million 1 000 000 cases most of which had not been reported or diagnosed 126 127 Deaths relating to influenza began appearing in the US in late April and by early June 15 states had reported fatalities related to or directly occurring from the virus By October 5 the first doses of an H1N1 vaccine were given in the U S The CDC distributed vaccines for the flu 128 using mechanisms already in place for its Vaccines for Children VFC program 129 On October 24 and the CDC said more than 1 000 had died from the flu President Obama declared a national emergency 130 114 131 On December 10 2009 the CDC reported an estimated 50 million Americans or 1 in 6 had been infected and 10 000 had died 132 On December 23 2009 the CDC reported a reduction of the disease by 59 percent On February 12 the CDC reported 57 million Americans had been sickened 257 000 had been hospitalized and 11 690 people had died including 1 180 children due to flu from April through to mid January 133 134 Initial cases EditThe Centers for Disease Control and Prevention CDC identified the first two A 09 H1N1 swine flu cases in California on April 17 2009 via the Border Infectious Disease Program 135 for a San Diego County child and a naval research facility studying a special diagnostic test where influenza sample from the child from Imperial County was tested 136 By April 21 enhanced surveillance was established to search for additional cases in both California and Texas and the CDC determined that the virus strain was genetically similar to the previously known A H1N1 swine flu circulating among pigs in the United States since about 1999 citation needed It was established that the virus was a combination of human North American swine and Eurasian swine influenza viruses the viruses from the initial two Californian cases were also noted to be resistant to amantadine and rimantadine two common influenza antiviral drugs 137 No contact with pigs was found for any of the seven Californian nor either of the two Texas cases suggesting human to human transmission of the virus citation needed On April 28 2009 the director of the Centers for Disease Control and Prevention confirmed the first official US death of swine flu Tests confirmed that a 23 month old toddler from Mexico who was probably infected there died on April 27 from the flu while visiting Texas 138 Outbreak across the US Edit CDC report for the 2008 2009 flu season week 18 May 17 subtypes and percent positive tests Cases of H1N1 spread rapidly across the United States with particularly severe outbreaks in Texas New York Utah and California Early cases were associated with recent travel to Mexico many were students who had traveled to Mexico for spring break 139 On May 4 2009 the CDC reported one death 286 confirmed cases of H1N1 flu across 36 states 35 hospitalizations and expected H1N1 to eventually spread to all states A large number of cases according to medics have happened in the days that preceded the launch of the alert and came out only in these days due to a massive backlog 140 By May 5 2009 the number had risen to 403 125 and a second death was reported in Texas 141 The CDC and government officials had expressed cautious optimism about the severity and spread of H1N1 142 143 Changes in surveillance of cases of influenza like illness including new guidelines for identifying cases to test increased laboratory testing and new test kits able to distinguish this novel strain resulted in a spike in the percent of cases tested positive for influenza Of the positive cases about a third were due to the novel strain Also found were a substantial number of cases where the strain could not be subtyped 144 Pneumonia and influenza deaths in 122 US cities 5 years through October 2009 The proportion of US deaths due to pneumonia and influenza climbed above the epidemic threshold in the 2007 2008 winter flu season but not in the 2008 2009 season Although the 2009 H1N1 outbreak reached epidemic levels of infection early in 2009 it did not contribute to epidemic levels of pneumonia and influenza related deaths until October 2009 citation needed 2009 US Swine Flu SummaryNumber of Confirmed Cases Deaths See Table AboveNumber of States Territorieswith Reported Cases 56Number of States Territorieswith Confirmed Deaths 55Earliest Confirmed Infection in US March 28 2009 145 First Death Inside the US April 27 2009 138 First Death of US Citizen May 5 2009 146 Number of People Hospitalized 9 079 as of September 3 147 Fatalities 593 as of September 3 147 The second wave Edit In early October 2009 the Centers for Disease Control and Prevention announced that swine flu was widespread across the country It also said there was significant flu activity in virtually all states which was considered to be quite unusual for this time of year There was particular worry about pregnant women As of late August 100 had been hospitalized in intensive care units and 28 had died since the beginning of the outbreak in April On October 1 it was acknowledged that a recruit in basic training in Fort Jackson South Carolina was the Army s first swine flu death The recruit fell ill on September 1 and died of pneumonia on September 10 citation needed Dell Children s Medical Center in Austin Texas erected two tents in its parking lot to handle emergency room visits and hospitals around Colorado Springs recorded a 30 percent spike in flu visits As pediatric cases were increasing the Dept of Health and Human Services released 300 000 courses of children s liquid Tamiflu from the national pandemic stockpile in late September with the first batches sent to Texas and Colorado citation needed In late September the disease centers reported that 936 had died of flu symptoms or of flu associated pneumonia since August 30 when it began a new count of deaths including some without laboratory confirmed swine flu 148 The Agriculture Department reported on October 16 that three pigs at the Minnesota State Fair in St Paul were tested positive in late August for H1N1 virus which were the first cases in the country although infected pigs had been found in eight other countries There were 103 pigs tested at the Fair including the three infected though all appeared healthy Scientists said the virus was already spreading widely among people and in fact was more common in humans than in pigs so humans were more likely to catch it from others than from pigs 149 In mid October it was reported that flu caused by the H1N1 virus was widespread in 41 states and flu like illnesses accounted for 6 1 percent of all doctor visits which was considered high citation needed particularly for October Forty three children had died from H1N1 since August 30 which is approximately the number that usually dies in an entire flu season Nineteen of the forty three were teenagers while sixteen were between ages five to eleven The rest were under five citation needed It is reported that the severity of the disease was not increasing About fifteen to twenty percent of the patients hospitalized for the flu were placed in the intensive care unit a level similar to that for seasonal flu citation needed High risk groups line up at a defunct Kmart on October 24 2009 for the first H1N1 vaccines publicly available in Boise Idaho Projections of the supply of H1N1 vaccine had decreased significantly from a level of 120 million doses ready in October estimated during the summer to an estimate of 28 to 30 million doses by the end of the month On October 14 11 4 million doses of the H1N1 vaccine were said to be available As of November 20 2009 the CDC reported sharp declines in H1N1 activity throughout the United States with influenza like illness which may also include meningitis pneumonia strep pharyngitis gastroenteritis and the common cold accounting for 5 5 of doctors visits down sharply from 8 in late October the peak of the second wave However taking the vaccine is still urged by the CDC as a third wave of the disease may sweep across the US possibly in January February 2010 150 needs update As of December 24 the second wave of H1N1 has clearly peaked with pneumonia and influenza deaths falling below the epidemic threshold for the first time in 11 weeks and the proportion of doctors visits due to influenza like illness falling to baseline 2 3 down from 5 5 1 month before on November 20 However it was reported that influenza activity was beginning to increase in West Virginia with 5 2 of patients treated by West Virginia health care providers having influenza like illness a major increase from 2 of patients treated by West Virginia health care providers having influenza like illness in November citation needed On August 10 2010 WHO declared an end to the global 2009 H1N1 influenza pandemic However the virus continues to circulate as a seasonal flu virus and cause illness hospitalization and deaths worldwide every year 151 H1N1 characteristics and severity Edit Influenza associated pediatric deaths reported to CDC from 2005 06 to start of 2009 2010 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 see human influenza and in pigs see swine influenza The strain transmits between humans and was initially reported to have a relatively high mortality rate in Mexico In April 2009 the World Health Organization WHO and the U S Centers for Disease Control and Prevention CDC expressed serious concerns that the new strain had the potential to become an influenza pandemic 152 On April 25 it was reported that because the virus was already widespread containment would be nearly impossible 153 By this time there had also been speculation that the flu death toll in Mexico could be lower than first thought Gerald Evans head of the Association of Medical Microbiology and Infectious Disease Canada and a member of a federal pandemic planning committee said on April 29 154 There was a lot of speculation and what seemed to be evidence there were dozens and dozens of deaths Careful analysis showed these people likely died of something else and not influenza That s really good news and that would fit with what we ve seen outside of Mexico Another Canadian expert Neil Rau criticized the WHO s decision to raise its pandemic alert to level 5 saying 155 I don t agree with the WHO because I think it s a panic metre not a pandemic metre If that flu like illness is not deadly I don t know what the cause for alarm is for people who are not really sickened by this virus I m really eager to know how much worse this is than seasonal flu So far it s looking like it s not that serious CNN noted on April 28 2009 that in any individual week between January 1 and April 18 there had been at least 800 deaths in the U S due to normal influenza which is higher than the 150 total deaths worldwide from the swine flu up to that time 156 As of May 28 2010 the official U S death toll attributed directly to the novel H1N1 and seasonal influenza was 2 117 157 This total exceeds the 849 U S deaths directly attributed to seasonal influenza in 2006 158 Many of the other deaths commonly attributed to influenza are caused by complicated influenza where a second infection causes death usually pneumonia of which 48 657 of 55 477 official deaths in 2006 occurred in people aged 65 years and older 158 159 The final estimate was of over 12 000 deaths over the course of the pandemic April 2009 April 2010 119 H1N1 unique characteristics Edit The CDC reported that during the outbreak about half of all influenza viruses being detected through laboratory reports were 2009 H1N1 viruses with the other half being those of the regular seasonal influenza viruses Surveillance reports indicated that about 57 of the 2009 H1N1 influenza confirmed and probable cases were occurring among people between 5 years and 24 years of age and 41 of the hospitalizations were occurring among older children and young adults The highest rates of hospitalization were among children younger than 5 years of age the next highest hospitalization rate was in people 5 years to 24 years of age Antibody studies showed that children had no existing cross reactive antibody to the 2009 H1N1 influenza virus while about one third of adults older than 60 years of age had cross reactive antibody One possible explanation for this pre existing antibody in older adults was that they may have had previous exposure either through infection or vaccination to an influenza A H1N1 virus that was more closely related to the 2009 H1N1 flu virus 160 Based on data from previous influenza pandemics and seasonal influenza pregnant women had been recognized as a high risk group early in the outbreak People with other previously recognized medical conditions that placed them at high risk of complications from seasonal influenza also appeared to be at increased risk of complications from 2009 H1N1 influenza One report found that seventy one percent of hospitalized patients had one or more underlying chronic medical conditions and reported deaths had occurred in people ranging in age from 22 months old to 57 years old Also only 13 of hospitalizations had occurred in people 50 years and older and there were few cases and no deaths in people older than 65 years which was unusual when compared with seasonal flu 161 Response Edit Congruent U S Government and WHO Pandemic Response Charts The Federal response remained at US Pandemic Stage 0 congruent with the World Health Organization WHO Pandemic Phases 1 2 and 3 162 163 however the WHO s Pandemic Phase was raised to 4 on April 27 which is congruent with US Pandemic Stage 2 164 On April 29 the WHO raised the pandemic alert level to phase 5 165 The United States federal government declared a public health emergency and several U S states then indicated that they may follow suit Secretary of Homeland Security Janet Napolitano noted that this declaration was standard operating procedure which was also done for the 2009 presidential inauguration and for flooding 166 After many days of deliberation the WHO declared that the current influenza had become a true pandemic raising the Pandemic Alert level to Phase 6 the highest on the WHO scale and congruent with U S Federal Government Response Stages 3 6 167 Obama Administration reactions Edit Barack Obama being vaccinated on Dec 20 2009 An official for the White House said on April 24 that the White House is taking the situation seriously and monitoring for any new developments The president has been fully briefed 168 President Barack Obama stated that We are closely monitoring the emerging cases of swine flu He also noted This is obviously a cause for concern but it is not a cause for alarm 169 Obama suggested that U S schools should consider shutting down as a future possibility if their students were to become infected 170 White House Press Secretary Robert Gibbs said the effort to get a team in place to respond to the health scare had not been hindered by the lack of a secretary of Health and Human Services or appointees in any of the department s 19 key posts 171 The president s nominee Kansas Gov Kathleen Sebelius was still awaiting confirmation from the U S Senate until passing on April 28 The President had not yet made appointments to either the Commissioner of the Food and Drug Administration the Surgeon General or the Director of the Centers for Disease Control and Prevention 171 The current acting Surgeon General Steven K Galson was also currently serving as the Acting Assistant Secretary for Health 172 Health and Human Services Secretary Kathleen Sebelius in a meeting in the Situation Room of the White House regarding the H1N1 virus On April 30 it was reported that an aide to Steven Chu the US Energy Secretary had fallen ill from the virus after helping arrange President Obama s trip to Mexico 173 However the White House stated that the President was not at risk of contracting the flu 173 Kathleen Sebelius was confirmed as the Secretary of Health and Human Services by the Senate on April 28 2009 with a vote of 65 31 174 175 Wikinews has related news Obama declares swine flu emergency in US On October 24 President Obama declared the 2009 H1N1 swine flu a national emergency 176 The declaration made it easier for U S medical facilities to handle a surge in flu patients by allowing the waiver of some requirements of Medicare Medicaid and other federal health insurance programs as needed Centers for Disease Control and Prevention CDC Edit source source source source source source In this video Joe Bresee with CDC s Influenza Division describes the symptoms of swine flu and warning signs to look for that indicate the need for urgent medical attention See also this video with subtitles Video on YouTube Activation of Emergency Operations Center Edit During the week of April 19 2009 the CDC activated its Emergency Operations Center EOC with RADM Stephen Redd as the Incident Commander to augment the ongoing investigation of human cases of swine influenza A H1N1 177 More than 250 CDC professionals worked from the CDC EOC as part of the agency s response 178 As of May 4 2009 the CDC reported that it had deployed 25 of the supplies and medicines in the Strategic National Stockpile to the various states 179 Swine flu test kits Edit As of April 29 only the CDC could confirm U S swine flu cases 180 Besser stated during an April 30 press briefing that California and New York had diagnostic test kits and that the kits would be sent to all states starting the following day 181 On May 6 the CDC announced that testing kits were now available for all states It was expected this would generate an increase in the number of confirmed cases as more states began doing their own tests 182 President Obama is briefed in the Situation Room about the swine flu outbreak Influenza reporting requirements Edit In the United States the majority of the 70 National Respiratory and Enteric Virus Surveillance System NREVSS laboratories do not report the influenza A subtype citation needed However in 2007 human infection with a novel influenzavirus A became a nationally notifiable condition Novel influenza A virus infections include all human infections with influenza A viruses that are different from currently circulating human influenza H1 and H3 viruses These viruses include those that are subtyped as nonhuman in origin and those that are unsubtypable with standard methods and reagents 183 The new strain responsible for this outbreak was one such virus citation needed Recommendations for schools Edit Initially the CDC had issued a recommendation that schools close for as long as two weeks if a student catches swine flu 184 Some school districts closed all schools if a single child was classified as probable 139 On May 5 the CDC retracted its advice stating that schools that were closed based on previous CDC guidance related to this outbreak may reopen 185 By that time at least 726 schools nationwide serving more than 480 000 students had closed for at least some period of time 184 The CDC amended its advice citing new information on disease severity and the limiting effectiveness of school closure as a control measure 185 The new advice given stated Decisions about school closure should be at the discretion of local authorities based on local considerations including public concern and the impact of school absenteeism and staffing shortages 185 Food and Drug Administration Edit The Food and Drug Administration FDA authorized emergency use of medicines and diagnostic tests for flu FDA is part of Department of Health and Human Services 186 The FDA stated it was also responding to this threat by working with other government agencies and manufacturers on a series of issues related to antiviral medications growing the 2009 H1N1 flu virus and preparing to make vaccine seed lots which may be used eventually to produce a safe and effective vaccine helping to prepare reagents needed for vaccine production and coordinating closely with other public health agencies for clinical development and testing accelerating access to new diagnostic tools for this 2009 H1N1 flu virus 187 On May 6 2009 the FDA announced that it had approved a new manufacturing facility for seasonal flu vaccine owned by Sanofi Pasteur which could also be used for manufacturing a vaccine for the new H1N1 flu strain 188 The FDA also issued a warning for consumers to be wary of products claiming to cure or prevent swine flu 189 Other federal agencies Edit Department of Homeland Security Edit Secretary Napolitano stated that DHS was the principal federal office for incidents such as the H1N1 flu outbreak and Under that role we have been leading a true collaborative effort 190 The Department of Homeland Security issued a document dated November 1 2005 entitled National Strategy for Pandemic Influenza detailing planning for potential pandemics https web archive org web 20090507013213 http www pandemicflu gov plan federal pandemic influenza pdf State Department Edit The State Department suggested travelers to Mexico stay alert and comply with guidance from Mexican public health officials but did not impose any travel restrictions on US citizens to Mexico 191 However the State Department did recommend US citizens avoid non essential travel to Mexico 192 Department of Agriculture Edit The Department of Agriculture USDA reported no swine in the US have been infected so far but the USDA is monitoring swine across the US for signs of infection 193 Department of Commerce Edit The Department of Commerce sent a letter to Russia and China requesting that those countries lift their ban on American pork products 194 Department of Defense Edit The Department of Defense DOD monitored the swine flu situation and had contingency plans to deal with such outbreaks 195 As of May 7 2009 the DOD reported 104 confirmed cases among Armed Forces personnel and their families DOD maintained a daily summary and map 196 Department of Education Edit The Department of Education provided guidance to schools in the US affected by swine flu as well as precautions to take 197 State and local Edit Schools closed in many states in response to local flu outbreaks By April 30 2009 300 U S schools and school districts had announced closures in response to the outbreak giving 169 000 students time off 198 On May 4 2009 about 533 schools in 24 states in the U S were closed affecting about 330 000 students 199 On September 25 2009 42 schools were closed in eight states as the second wave of the pandemic began 200 On May 5 Kathleen Sebelius stated in a CDC news conference that school closures for single confirmed cases of H1N1 influenza were unnecessary but that children displaying an influenza like illness should say home 201 Travel industry Edit Several US airlines waived fees for cancellations and flight changes 202 At least one cruise line changed itinerary to avoid Mexican ports of call 203 Summary Edit citation needed 2009 A H1N1 Outbreak and pandemic milestones28 March First case in the US of what would later be identified as swine flu origin 21 April First case confirmed in California 23 April First case confirmed in Texas 25 April First case confirmed in Kansas Community outbreaks confirmed in the United States 26 April First case confirmed in New York First case confirmed in Ohio Acting HHS Secretary Charles E Johnson declares 2009 H1N1 a public health emergency 204 205 28 April First case confirmed in Indiana 29 April First non US citizen death confirmed in Texas First case confirmed in Nevada First case confirmed in Arizona First case confirmed in Maine First case confirmed in Massachusetts First case confirmed in Michigan 30 April First case confirmed in Nebraska First case confirmed in South Carolina First case confirmed in Minnesota First case confirmed in Colorado First case confirmed in Virginia First case confirmed in Kentucky First case confirmed in New Jersey 1 May First case confirmed in Florida First case confirmed in Missouri First case confirmed in Connecticut First case confirmed in Delaware 2 May First case confirmed in New Mexico First case confirmed in Utah First case confirmed in New Hampshire First case confirmed in Rhode Island First case confirmed in Iowa First case confirmed in Wisconsin First case confirmed in Alabama 3 May First case confirmed in Idaho First case confirmed in Pennsylvania First case confirmed in Louisiana First case confirmed in North Carolina First case confirmed in Tennessee 4 May First case confirmed in Oregon First case confirmed in Georgia First case confirmed in Maryland 5 May First case confirmed in Washington First case confirmed in Oklahoma First case confirmed in Hawaii First US citizen death confirmed in Texas 6 May First case confirmed in District of Columbia 7 May First case confirmed in South Dakota 8 May First case confirmed in Vermont First case confirmed in Arkansas 9 May First death confirmed in Washington 11 May First case confirmed in Montana 13 May First case confirmed in North Dakota 14 May First death confirmed in Arizona 15 May First case confirmed in Mississippi 17 May First death confirmed in New York 19 May First death confirmed in Missouri 20 May First death confirmed in Utah 25 May First death confirmed in Illinois 26 May First case confirmed in Puerto Rico 27 May First case confirmed in Wyoming First case confirmed in Alaska 2 June First case confirmed in West Virginia All 50 states have confirmed H1N1 First death confirmed in Virginia 3 June First death confirmed in Michigan First death confirmed in Connecticut 4 June First death confirmed in California 5 June First death confirmed in Pennsylvania First death confirmed in Wisconsin 8 June First death confirmed in Oregon First death confirmed in Oklahoma 15 June First death confirmed in New Jersey First death confirmed in Massachusetts First death confirmed in Minnesota 16 June First death confirmed in Florida First death confirmed in Rhode Island First case confirmed in US Virgin Islands 23 June First death confirmed in Maryland 24 June First death confirmed in North Carolina 26 June First case confirmed in American Samoa 29 June First death confirmed in Hawaii 1 July First case confirmed in Guam 6 July First death confirmed in Ohio First death confirmed in Nevada 10 July First death confirmed in Indiana First death confirmed in Georgia 15 July First death confirmed in Nebraska First death confirmed in Tennessee 20 July First death confirmed in Guam 21 July First case confirmed in Northern Mariana Islands 27 July First death confirmed in Alaska 29 July First death confirmed in Alabama First death confirmed in Colorado 3 August First death confirmed in Iowa 6 August First death confirmed in Kansas First death confirmed in Montana First death confirmed in Mississippi 8 August First death confirmed in Arkansas 10 August First death confirmed in New Mexico 13 August First death confirmed in Maine First death confirmed in Louisiana 14 August First case of Oseltamivir Tamiflu resistance confirmed 17 August First death confirmed in New Hampshire 19 August First death confirmed in Wyoming 28 August First death confirmed in South Carolina 2 September First death confirmed in US Virgin Islands 3 September First death confirmed in Kentucky 4 September First death confirmed in West Virginia 10 September First Oseltamivir Tamiflu resistance spread from person to person confirmed 28 September First death confirmed in Idaho 2 October First death confirmed in South Dakota 22 October First death confirmed in Delaware 26 October First death confirmed in North Dakota 28 October President Obama declares H1N1 a National Emergency 205 First death confirmed in Vermont All 50 states have confirmed H1N1 deaths 4 November First feline zoonosis confirmed in Iowa 19 November First death confirmed in American Samoa First feline death confirmed in Oregon 24 November First double infection case confirmed in West Virginia See also EditCOVID 19 pandemic in the United States Spanish fluReferences Edit a b Interim Guidance on Case Definitions to be Used For Investigations of Swine Origin Influenza A H1N1 Cases Centers for Disease Control and Prevention April 30 2009 Archived from the original on May 2 2009 Retrieved May 1 2009 a b H1N1 Flu archived version of dynamic web page Alabama Department of Public Health October 21 2009 Reporting of aggregate statistics ended between 21 and 28 October 2009 were impractical because of the large number of people infected quote from this page version a b Novel H1N1 Influenza Swine Flu archived version of dynamic webpage Alaska Department of Health and Social Services September 17 2009 updated September 2 2009 at 12 00 PM Alaska Positive Rapid Tests For Influenza Epidemiology Alaska Department of Health and Social Services Archived from the original on June 9 2010 Retrieved March 2 2014 n 1 103 from September 1 2009 through April 6 2010 Armstrong Michael February 15 2010 Homer woman who died at 44 tested positive for swine flu Swine flu H1N1 Anchorage Daily News Associated Press Archived from the original on June 2 2013 Retrieved March 2 2014 Alaska Laboratory Confirmed Influenza Deaths by Week Epidemiology Alaska Department of Health and Social Services Archived from the original on June 9 2010 Retrieved March 2 2014 a b c Arizona Weekly Influenze Summary MMWR Week 25 26 6 20 10 7 03 10 PDF Arizona Department of Health Services 2010 p 4 Archived from the original PDF on October 2 2010 H1N1 Flu Swine Flu Resources Arkansas Department of Health July 29 2009 Archived from the original on November 13 2009 State logs year s first flu death Arkansas Democrat Gazette February 2 2011 Retrieved April 6 2022 a b Novel Influenza A H1N1 Virus Swine Flu Latest News California Department of Public Health August 25 2007 Retrieved August 27 2009 Influenza Associated Hospitalizations by County by Diagnosis Date PDF Colorado Department of Public Health and Environment August 30 2009 Retrieved November 9 2009 a b Department of Public Health and Environment www colorado gov a b c CTFLUWATCH continuously updated webpage Connecticut Department of Public Health October 19 2010 Pandemic H1N1 2009 influenza A information for July 20 2010 a b c d e f g PAHO Influenza A H1N1 Surveillance PAHO August 26 2009 Retrieved August 26 2009 No longer updating H1N1 UPDATE JUNE 18 Delaware Department of Health and Social Services June 18 2009 Retrieved June 19 2009 7th death in DE from H1N1 influenza WGMD COM Drug resistant swine flu reported in Va Md via www washingtonpost com a b Update each Wednesday Swine Flu Information Florida Department of Health July 30 2009 Archived from the original on August 2 2009 H1N1 Media Releases Weekly County Influenza Activity PDF Florida Department of Health Archived from the original PDF on June 8 2010 a b H1N1 Georgia Division of Public Health September 24 2009 Retrieved September 24 2009 Seasonal Flu Georgia Department of Community Health dch georgia gov Influenza Surveillance Report PDF July 19 August 1 2009 HAWAI I STATE DEPARTMENT OF HEALTH DISEASE OUTBREAK CONTROL DIVISION August 6 2009 Retrieved August 26 2009 Delawareonline Levi Johnston wants to be mayor has no platform a b c Idaho Case Counts 2009 H1N1 Flu Surveillance Data Idaho Department of Health amp Welfare Archived from the original on April 22 2012 Statistics archived version of dynamic web page H1N1 flu Illinois Department of Public Health August 12 2009 Retrieved March 2 2014 Illinois Cases of H1N1 Flu by County As of July 31 2009 10 a m a b Statistics archived version of dynamic web page H1N1 flu Illinois Department of Public Health May 8 2010 Retrieved March 2 2014 Confirmed H1N1 2009 Hospitalizations and Deaths As of May 7 2010 10 a m a b ISDH Press releases Indiana State Department of Health August 20 2009 Retrieved August 27 2009 Influenza and Other Respiratory Virus Weekly Activity Report PDF Iowa Department of Public Health August 1 2009 Retrieved August 26 2009 H1N1 vaccine plentiful in Iowa www newtondailynews com Iowa Influenza Surveillance Network IISN Reports update at Monday Kansas H1N1 Flu Virus Information Kansas Department of Health and Environment August 24 2009 Kansan dies from H1N1 Pratt KS Pratt Tribune a b Flu Activity Commonwealth of Kentucky October 29 2009 DHH Updates Status of Fight the Flu Campaign Louisiana Department of Health amp Hospitals November 9 2009 Retrieved November 9 2009 Department of Health amp Hospitals State of Louisiana a b update weekly Maine H1N1 Influenza Swine Flu Update Maine Center for Disease Control and Prevention August 26 2009 Retrieved August 27 2009 Maine Center for Disease Control amp Prevention DHHS Maine www maine gov Maryland weekly flu report The Baltimore Sun July 2 2009 Retrieved July 2 2009 Maryland Flu Watch Department of Health and Mental Hygiene Seasonal Influenza Preparedness Guide a b Confirmed H1N1 Influenza swine flu Massachusetts Department of Public Health August 27 2009 Mass Public Health Blog Promoting public health amp wellness in Massachusetts Daily Update of fatalities MDCH Influenza A H1N1 Michigan Department of Community Health June 13 2009 Retrieved July 30 2009 Reports of flu like illness in Michigan PDF www michigan gov 2010 Retrieved July 14 2019 Weekly Influenza Activity Statistics Minnesota Department of Health August 17 2009 Weekly Influenza and Respiratory Activity Statistics Minnesota Dept of Health www health state mn us Mississippi H1N1 Swine Flu Cases by County 2009 Mississippi State Department of Health September 23 2009 Flu claims life of Lafayette County child WTVA March 19 2009 Archived from the original on March 23 2010 Special Weekly Influenza Surveillance 2009 2010 Pre Season Report Missouri PDF Missouri Department of Health and Senior Services August 22 2009 Retrieved August 27 2009 Missouri health officials add up the H1N1 numbers KMOX TV permanent dead link a b Confirmed Novel Influenza A H1N1 Swine Flu Billings Gazette August 6 2009 Retrieved August 6 2009 Missoulian MICHAEL JAMISON of the Flathead County man dies of swine flu 19th such death in Montana missoulian com a b Influenza Report PDF Week 34 August 29 Nebraska Department of Health amp Human Services August 21 2009 Retrieved August 27 2009 dead link AP Health News Online Breaking News amp Headlines from Associated Press pennlive com a b Nevada State Health Division Weekly Influenza Report Nevada State Health Division August 21 2009 Gibson Tiffany January 6 2010 Woman 29 first H1N1 death in new year Las Vegas Sun Newspaper lasvegassun com Las Vegas News Breaking News amp Headlines Las Vegas Review Journal WEEKLY INFLUENZA SURVEILLANCE REPORT PDF New Hampshire Department of Health amp Human Services August 29 2009 Retrieved September 16 2009 NH reports 10th H1N1 related death New Hampshire EagleTribune com North Andover MA New Jersey 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2009 Flu Forces Cruise Lines to Reroute Ships to San Diego San Diego Business Journal Archived from the original on June 30 2009 Retrieved May 5 2009 2009 H1N1 Pandemic Timeline May 8 2019 Archived from the original on March 5 2020 Retrieved March 12 2020 a b Declaration of a National Emergency with Respect to the 2009 H1N1 Influenza Pandemic whitehouse gov Archived from the original on March 12 2020 Retrieved March 12 2020 via National Archives External links Edit Wikimedia Commons has media related to 2009 swine flu outbreak in the United States Wikinews has related news US declares public health emergency over spread of swine flu U S federal government Edit PandemicFlu gov Access to U S Government swine avian and pandemic flu information U S Centers For Disease Control CDC H1N1 Flu Updates periodically as the CDC releases new information Medical Encyclopedia Medline Plus Swine Flu Encyclopic Information from the National Institutes of HealthInternational organizations Edit World Health Organization WHO Influenza A H1N1 page Updates periodically and links to archived WHO releasesOther websites Edit H1N1 Swine Flu in the Neonatal Intensive Care Unit Students Prep America for High School amp College Students and Families Get Pandemic Ready Influenza Research Database Database of influenza genomic sequences and related information Utah Man 22 With Swine Flu Dies Fox News Associated Press reference May 20 2009 USA Today State by state preparations Medical Encyclopedia WebMD Swine Flu Center Worldwide Confirmed and Suspected CasesNew York City Edit New York City Health Department Retrieved from https en wikipedia org w index php title 2009 swine flu pandemic in the United States amp oldid 1108219409, wikipedia, wiki, book, books, library,

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