2009 flu pandemic in Europe

The 2009 flu pandemic in Europe, part of a pandemic in 2009 of a new strain of influenza A virus subtype H1N1 causing what has been commonly called swine flu, has afflicted at least 125,550 people in Europe, with 458 confirmed deaths in Turkey, 438 confirmed deaths in Russia, and 299 confirmed deaths in the United Kingdom.

Contents

European Union

On 27 April, the European Union health commissioner advised Europeans not to travel to the United States or Mexico unless urgent. This followed the discovery of the first confirmed case in Spain.[8]

EU Foreign relations commissioner Benita Ferrero-Waldner said on 27 April the halt of all travel to Mexico and disinfecting all airports due to the global flu outbreak is being considered.[9]

Albania

On 20 July, authorities in Albania reported the first positive case of the swine flu. The infected person was a student from Gjirokastra, whose tests resulted positive.[10] However, the student was later reported to have been fully recovered from the flu, and he was healthy again. A few day later, three other cases of the flu were confirmed. The infected people were two sailors from the Philippines and one from Romania. They are now recovering on the Durrës city hospital. As of July 24, there were four cases of the swine flu confirmed in Albania.

On 3 December, A First Death Was confirmed in Albania.

As of 10 January 2010, A/H1N1 has caused 12 victims in Albania and there are 426 confirmed cases, only patients with a severe form of the virus are being tested for its presence. 2 pregnant women, one 18 years old from Kuçovë and the other 25 years old from Kukës are among the 12 A/H1N1 victims in Albania.

Austria

Several possible cases in Austria turned out to be negative, whereas one test, that of a 28-year-old woman from Vienna, had a positive result. Therefore Austria is the 9th country affected by a confirmed case of swine flu.[11] There are still two suspected cases being tested.[12] As of 22 July 2009 64 cases of the virus have been confirmed in the country.

On 2 November 2009, an 11-year-old girl from Bozen, died in the hospital of Innsbruck. This is the first time, the Flu caused the death of a human in Austria.

Azerbaijan

Belgium

Six suspected cases of swine flu in Belgium ultimately tested negative.[13]

The Belgian interior ministry announced the first case of A/H1N1 flu in Belgium on 13 May 2009. The infected person is a 28-year-old man who lives in Ghent and returned from a holiday in the United States.[14]

Also a second person tested positive for Mexican flu in Belgium on 14 May 2009.

Two new persons tested positive for A/H1N1 flu on 15 May 2009.[15]

A sixth[16] and seventh[17] case of swine flu was discovered on 21 May 2009. An eighth[18] infection was reported on 26 May 2009.

By 22 July, a total of 126 have been confirmed.

On 30 July, a woman from Hoogstraten became the first patient in Belgium to die because of swine flu.[19]

By 16 August, a total of 2353 cases have been confirmed.

As of 18 October, 5 people have died as consequence of swine flu infection and it has been estimated that at least 20100 have been infected by it in Belgium.

By 29 October, a total of 76964 cases have been confirmed and 7 people have died.[20]

By 25 March, a total of 214531 cases have been confirmed[21] and 19 people have died.[22]

Bosnia and Herzegovina

First case was confirmed in Bosnia and Herzegovina on 29 June.[23] On November 16, 2009 the first fatality related to the H1N1 in Bosnia and Herzegovina. The 40-year-old man died in hospital in Mostar.[24]

Bulgaria

The first case of swine flu in Bulgaria was a person from New York to Sofia on 27 May. The person developed respiratory problems, cough and high fever on 29 May.[25]

On September 30, 2009 the first fatality related to the H1N1 in Sofia. The 30-year-old man died in hospital in the Bulgarian capital.[26]

Croatia

On 29 April it was announced that a 22-year-old traveller from Florida had been held in quarantine in Osijek, Croatia under suspicion of swine flu.[27] However, later that day director of infectious disease epidemiology agency, Dr. Ira Gjenero Margan, stated results of the testing were negative "with 99% certainty".[28] On 30 April, a child was held in quarantine in Zagreb but the results were negative.[29] On 15 June health minister Darko Milinovic confirmed the first case of swine flu in Croatia; however few hours later he said that laboratory in London had cross-contaminated the samples and thus created a false positive result, meaning that there were no affected in Croatia.[30] The first case was Laboratory confirmed on 3 July. The patient was a 60-year-old woman, who came from Australia.[31] On 31 October, a 61-year-old man from Split became the first patient in Croatia to die because of swine flu.[32]

Cyprus

Cyprus identified its first case of H1N1 on May 30 in a 39-year-old woman from Moldova, living in Cyprus, who returned from the United States on May 28. As of July 11, 250 cases have been confirmed in Cyprus. In the north part of Cyprus all the schools, universities and government offices were shut down for ten days. People were told not to leave their houses unless there was an emergency or something urgent.

Czech Republic

The Czech Republic confirmed its first case of swine flu May 25. The 29-year-old man working as a pilot returned from New York. He was held in quarantine in the hospital Bulovka in Prague.

On August 5, 135 Czechs tested positive for swine flu.

Denmark

Authorities confirmed on 1 May that a Danish citizen had tested positive for swine flu, making it the first reported case in Scandinavia.

By 11 June, a total of 11 cases is confirmed, including a six year old boy.[33][34]

On 29 June, the first case of Oseltamivir (Tamiflu) resistance in the world was announced.[35]

On August 28, 2009 A truckdriver from Pandrup, Denmark, did die on duty in Norway. This was discovered by the driver of the truck. They both had flu-symptoms, and when the living man from Pandrup arrived at Aalborg Sygehus, he was tested positive on H1N1. Although, it is still not known, if the passenger died caused the flu.

In the moment, 600ish Danes is tested positive for swine flu. Among them, two in isolation in Indonesia and the first known resistant case against tamiflu.

Estonia

The first case in Estonia was laboratory confirmed on 29 May. The patient was a 29-year-old man who returned from the United States.[36]

On 3 June, two new cases have been laboratory confirmed.[37]

On 7 June, fourth case was confirmed. The patient was a person who also returned from the United States on 4 June.

Seven new cases were confirmed on June 26. Two of the infected people came back from a trip to Mexico. The others are Americans, who were on a trip to Estonia.

On 12 July, six new cases were confirmed.

On 17 July, a young Estonian football player was infected, he returned from Finland after participating in U-19 European Championships. As of 17 July, there were 22 confirmed cases of A(H1N1).

On 28 July, Ivi Normet, Deputy Secretary General on Health of Ministry of Social Affairs of Estonia, speculated that in the worst-case scenario the swine flu could infect 500,000 Estonians in ten weeks. That's about 30% of Estonian population.[38]

As of 9 November 2009 (2009 -11-09), there were 130 cases confirmed.

As of 11 November 2009 (2009 -11-11), there were 172 cases of influenza A (H1N1) confirmed, in Harjumaa, Tartumaa, Viljandimaa, Võrumaa, Ida-Virumaa and Lääne-Virumaa.[39]

Since November 11, Estonian Health Protection Inspectorate no longer recommends laboratory tests for all suspected cases of A(H1N1).[40]

As of 13 November 2009 (2009 -11-13), there were 79 new cases confirmed in one week. Total: 217 cases.

As of 20 November 2009 (2009 -11-20), there were 269 cases of influenza A (H1N1) confirmed, in 10 counties: Harjumaa, Tartumaa, Viljandimaa, Võrumaa, Ida-Virumaa, Lääne-Virumaa, Jõgevamaa, Põlvamaa, Valgamaa and Pärnumaa.[41]

On November 23 the first death of swine influenza occurred. The victim was a 13-year-old boy, living in Harjumaa region.[42]

On November 29 the second death of swine influenza occurred. The victim was a 50-year-old male. The total number of confirmed cases has reached 302.[43]

On December 4, another two deaths were confirmed; the number of confirmed infections has reached 456.[44]

As of 6 January 2010, the number of cases was 808 and 13 deaths.[45]

As of 4 March 2010, there were 881 cases confirmed and 20 deaths.[46]

Finland

On October 16, 2009, the national broadcasting company YLE reported that the first epidemic wave of swine flu was hitting Finland. The National Institute for Health and Welfare (THL) said that the H1N1 outbreaks in northern Finland were reaching epidemic proportions.[47] THL also reported that by 16 October there were 377 confirmed cases in Finland.[48]

The H1N1 strain of influenza was added to the official list of infectious diseases dangerous to public ("yleisvaarallinen tartuntatauti"),[49] which guarantees free-of-charge treatment to all residents and allows for involuntary quarantine, effective from May 1, 2009. From the beginning of August it was removed from the list, so free-of-charge treatment is not available to residents any more.[50] Finland's first two H1N1 cases were confirmed on May 12, 2009 in Helsinki metropolitan area. The first confirmed cases were traveling together in Mexico and came to Finland via Amsterdam on May 6, 2009.[51]

According to a Finnish site tracking H1N1 cases, there are currently 1,425 confirmed cases (November 9),[52] laboratory testing of every suspected case having stopped by August.[53] Two serious cases were reported in Finland by September 2.[54] Thousands were infected in Lapland, northern Finland by October 21.[55]

On October 24, a 25-year-old woman from Northern Ostrobothnia also suffering a chronic disease died from H1N1 influenza.[56] On November 2, an 8-year-old previously healthy girl died from the disease. The girl and her parents had visited doctor earlier, but were sent back home where the girl later died.[57] According to some estimates, the total number of cases in Finland is probably 10,000-100,000.[58]

A two-year-old girl died from the disease (November 13, 2009).[59] After publicity of the death of the two-year-old child, Finnish National Institute for Health and Welfare, THL, (November 13, 2009) said they will no longer report deaths caused by H1N1.[60]

France

As of 28 April there were twenty suspected cases of swine flu being investigated in France. Since 25 April, over 100 cases of Influenza-like illness have been reported, of which 30 were identified as possible cases. 10 of those cases have since been excluded.[61] On 30 April, the number of suspected cases was revised to 50 (including 4 probable cases).[62]

On 1 May, the French Health Minister has confirmed, during the 8 p.m. TF1 news, that 2 cases of A(H1N1) flu have been detected in France.[63]

On 4 May, two new cases have been confirmed bringing to 4[64] the total number of people infected.

6 May, a fifth case is confirmed in Paris region.[65] Two new cases are also confirmed at the end of the afternoon by the INVS (National Institute for Sanitary Watch),[66] 7 are probable and 32 are suspected.[67]

On 7 May, three new cases were announced by the National Institute for Sanitary Watch.[68]

In November 2009, 351 cases has been detected for each 100.000 inhabitants. Since August, it has been estimated that 1 980 000 persons have been infected by the flu in metropolitan France. 43 of them died (70 including overseas territories)[69]

Germany

Two men and a woman from Bielefeld, Germany who had been firstly suspected of having the virus tested negative on influenza type A.[70]

On 29 April, the first case of swine flu in Germany was confirmed by the Robert Koch Institute in the area of Regensburg.[71][72][73] A 22-year-old woman from Hamburg is also confirmed to have been infected by swine flu during a trip to Mexico.[73] A 37-year-old woman from Kulmbach is also confirmed to have become infected during a similar trip.[73]

On 1 May, Robert Koch Institute confirmed the first case of human-to-human spreading of swine flu in Munich. Infected was the nurse who had contact with one of the infected people. At approx. 10:00 she was claimed to be already healed.[74] At the time of 13:00 one further infection in Bavaria was confirmed, but the patient is also claimed to be healthy again.[75]

On 2 May, a new human-to-human infection, in the same hospital in Munich, was confirmed. The new patient, who was in the same room with the original infected German that came from Mexico, is currently being reported to show no signs of the new influenza strain anymore.[76]

On 3 May, two further cases of swine flu in Brandenburg were reported. Two people from the same flight as patient in Hamburg were also infected.[77]

On 5 May, one new case in Saxony-Anhalt has been confirmed bringing to 9[78] the total number of people infected.

On 7 May, another new case in Saxony-Anhalt is reported.[79]

On 8 May an adult male living in Bavaria who had recently been to USA.[80]

On 11 May the case of a 27-year-old Bavarian woman, who stayed for some weeks in Mexico and medicated patients in a hospital, is reported.[81]

On 15 May two more cases were reported, a female human and her son from Saxony-Anhalt have been infected obviously by her husband / his father, who returned from Mexico.[82]

On 21 May a case was found in a 43-year-old woman from Düsseldorf in North Rhine-Westphalia who returned from New York.[83] One day later, Robert Koch Institute confirmed that that her husband has been tested positive with swine influenza too. Furthermore their six-year-old daughter who did not stay in New York has been infected by her parents, bringing the total to 17.[84]

Until 5 June 2009, the total number of confirmed cases increased to 49. Most of them have been recent travellers to Mexico, the US or the UK. However, there was also a single-digit number of (isolated) in-country-transmissions.

Greece

On 19 May 2009 the authorities confirmed the first case of the new flu in Greece. The infected person is a 19-year-old Greek student who studies in New York and who flew to Greece a few days ago. He is hospitalised at Sismanogleion[85] but is not gravely ill. The authorities have contacted many of the passengers who sat near this patient on the plane and are examining them for suspicious symptoms. At this point in time Greece has enough antivirals to cover 12% of the population[86] (at least 10% is the amount proposed by the EU directives). The 19-year-old is now out of the hospital and none of the passengers in his flight are infected.

On 29 May 2009 the fourth case was announced.[87]

On 14 June 2009 the total number of cases have reached 20[88] and on 17 June 2009 reached 25.[89] On 9 July 2009 the total number of cases have reached 216 out of whom 93 have fully recovered.[90]

On 13 July 2009 the total number of cases have reached 290 of which 128 have fully recovered[91]

On July 14, 2009 the total number of cases have reached 323 of which 200 have fully recovered[92]

On September 16, 2009 the total number of cases have reached 2.149.[93]

Hungary

According to the MTI as of 29 April six suspected cases have been reported in Hungary, none of them confirmed to be the swine flu. Samples of the virus from the US health authorities are due to arrive to Hungary in a few days enabling the start of vaccine production.[94]

On 29 May, a case has been confirmed.[95] The infected person, a Brazilian man has since recovered and left the country. On June 18 three new cases of swine flu were confirmed in Hungary, a married couple who returned from New York, and a man who came back from London were new infected.[96]

Iceland

The first case of A(H1N1) in Iceland was reported on 23 May 2009. The infected person came to the country from New York and got sick shortly after he arrived in Iceland. The second case was announced on 9 June. The infected was a male in the Greater Reykjavík area who also had arrived from the United states. As of 6 August there are 54 cases of H1N1 in Iceland.[97][98][99] [100]

Iceland is currently being briefed by the WHO and is cooperating closely with ECDC, CDC and the EU in terms of monitoring and response. Initially the directorate of health warned people traveling to Mexico and the United States (especially California and Texas) to exercise caution and to contact a doctor immediately if they started showing symptoms of swine flu but on April 28 people travelling to Mexico were advised to cancel their trip unless its very urgent.[101][102]

On 28 April, it was announced that passengers arriving in Iceland from the United States or Mexico would be monitored and will undergo medical examination even if the slightest signs of influenza are detected.[103]

Iceland has stocks of Tamiflu and Relenza for one-third of its population.[103]

In a risk assessment made by the Icelandic government in 2008 in case of a influenza pandemic two scenarios are envisioned:

Ireland

Latest details on cases of A(H1N1) flu in Ireland are to be found on the Health Service Executive website.[105] As of 29 June 2009 there were 39 cases in Ireland.[106]

Ireland has over two million doses of anti-virals and a pandemic plan in place.

On 2 May 2009 the Department of Health's (HSE) announced the first confirmed case in Ireland, an adult male living in Dublin who had recently been to Mexico.

From 25 May to 31 May three more cases were confirmed.[107][108][109]

On 2 June, 3 new cases were confirmed by the HSE on people who returned recently from New York,[110] The total number of cases as of this date was 7.

On 19 June, a case of human swine flu was discovered in a seven-year-old, who was attending a primary school in Co. Mayo and had been abroad. 28 children in the school were treated with Tamiflu. The total number of cases as of this date was 18.[111]

On 21 June a child believed to have recently returned from the United States of America and presenting flu-like symptoms was treated in Kerry General Hospital in Tralee, Co. Kerry, but tests later proved negative.[112]

Saturday 4 July 2009

A free swine flu vaccination is to be offered to the general population in the coming months, as part of a major plan to avoid the worst affects of a global pandemic.

The HSE plans to acquire over 7,500,000 doses of the vaccine, at a cost of almost €90 million.

The jabs would be administered by GPs or through a network of over a hundred swine flu clinics and will be ready by the autumn.

12 new cases of swine flu were confirmed here yesterday, bringing the total number in Ireland to 63.[113]

Friday 10 July 2009

Total number of laboratory confirmed cases in Ireland exceed 100. 9 of these cases are believed to have been in-country transmissions of the virus

Tuesday 21 July

11 new cases of the H1N1 virus have been identified in Ireland bringing the total number of confirmed cases to 164 including 17 cases which are believed to have been in-country transmissions of the virus.

As of July 28, 2009, there are reportedly 276 confirmed cases in Ireland, according to the HSE.[114] A man in his 30s is critically ill in St James's Hospital in Dublin with human swine flu (H1N1). The man, who is originally from Bratislava in Slovakia, was admitted to hospital late last week. He has been working in Ireland for several years.

Around 1,500 people visited GPs last week with suspected swine flu, three times more than the most recent figures released.

Director of the Health Protection Surveillance Centre Dr Darina O'Flanagan said the figure was included in the latest data from the Irish College of General Practitioners.

It represents 37 people per 100,000 and is three times more than figures released yesterday by the Department of Health.

Advertisement The Department said laboratory tests have confirmed 278 cases of the H1N1 virus have been reported but the actual number exceeds that total as family doctors report an increase in the number of cases they have been diagnosing in recent weeks.

Two patients who contracted human swine flu (H1N1) are still being treated in intensive care units.

Chief medical officer at the Department of Health Dr Tony Holohan said yesterday that the HSE expects some deaths from the virus, and further hospitalisations, over the coming weeks and months.

Dr Holohan said 12 people have been hospitalised so far.

A man in his 30s, who was admitted to St James's Hospital last week, remains 'critically ill' with the virus.

It is believed the man, who is originally from Bratislava in Slovakia, contracted the virus abroad. He has been living in Ireland for several years.

The hospital said that all necessary precautions were being taken and that the Health Service Executive and the Department of Health were being fully informed.[115]

Friday, 7 August 2009 18:00 A young Irish woman has died from human swine flu today at Tallaght Hospital in Dublin.

She is the first person to die from the virus here since the first cases emerged in this country in May.

Department of Health officials said this evening that the woman had an underlying medical condition.[116]

Monday, 17 August 2009.

The second death due to the swine flu virus has been reported. The victim is believed to have been living in the east of the country. The death toll currently stands at nine.

On October 1, two further deaths were announced, bringing the total fatalities to four.[117]

As of 5 January 2010 (2010 -01-05) there have been 3189 cases and 22 deaths in Ireland from Influenza A.[118]

Italy

Italy's agriculture lobby, Coldiretti, warned against panic reaction, noting that farmers lost hundreds of millions of Euros due to consumer boycotts during the 2001 mad cow scare and the 2005 bird flu outbreak.[119]

A woman who returned from San Diego was hospitalised in Venice for suspected swine flu.[120]

As of 30 April, about 20 suspected cases of swine flu are monitored in Italy.[121]

On 2 May, Reuters confirmed that Italy had a case of the swine flu. It was recorded in a 50-year-old man in Massa after he returned from Mexico City. However, he had very mild symptoms (i.e. aches, coughing, but no fever) and is recovering well.

As of 26 July the amount of swine flu cases is 618 with community outbreaks contributing to the number.

On 4 September the first death was confirmed in Italy. On 19 September the second death was confirmed in Italy.

Kosovo

On July 24, the authorities in Kosovo[note 1] announced that the samples of three suspected cases had been sent to the laboratory for analysis.[122] According to the authorities, the three cases had had contact with other people who were infected by the A/H1N1 virus. Two of them had previously been visited Switzerland and Sweden, and one of them was in the United Kingdom.

On July 28, the results of these three suspected cases showed that only the person, who recently was in the United Kingdom was infected with the swine flu.[123] This person was a 9-year-old child, living in the United Kingdom, who along with the family came to spend their vacation in Kosovo. The family arrived to the Pristina Airport from London, and during the flight, health inspectors recommended the child to see a doctor, once they arrived to Pristina.

On November 14, A First Death Was Confirmed In Kosovo.

On December 28 there were 14 A/H1N1 confirmed victims in Kosovo.

Latvia

On June 21, a woman, who had just returned from North America, was hospitalised in Latvia. Symptoms were observed already when she was still in the plane. It was later confirmed that she has the swine flu. It was the first registered case in Latvia.[124]

In early November, after severe outbreak in Russia and Ukraine, the people suffering from the flu increased. On November 5, there were alone 10 new cases registered, increasing the total amount of cases to 63.[125] Just four days later, on November 9, the number reached 89 cases and the first death of H1N1 in Latvia was confirmed.[126][127] As more people got precautious and the pharmacies weren't supplied enough, already the next day for a moment they ran out of any profilactic drugs against influenza.[128] On November 11 the number of registered cases reached 132.[129] The next day, with another 33 new cases, the total amount reached already 165 people.[126]

Lithuania

On 26 June Lithuania confirmed country's first influenza A (H1N1) in Tauragė (diagnosed by Lithuanian AIDS Centre).

On 2 July Lithuania confirmed two more cases of influenza A (H1N1), in Tauragė and Vilnius.Total number of cases - 3

On 7 July Lithuania confirmed two more cases of influenza A (H1N1), in Vilnius region.Total number of cases - 5

As of 11 July 2009 (2009 -07-11), there was 25 possible cases. All of 25 cases was not confirmed.[130]

On 16 July Lithuania confirmed two more cases of influenza A (H1N1), in Vilnius region.Total number of cases - 7

On 23 July Lithuania confirmed three more cases of influenza A (H1N1), in Vilnius, Marijampolė and Kaunas region.Total number of cases - 10

On 27 July Lithuania confirmed two more cases of influenza A (H1N1), in Vilnius region.Total number of cases - 12

On 29 July Lithuania confirmed three more cases of influenza A (H1N1).Total number of cases - 15

On 31 July Lithuania confirmed seven more cases of influenza A (H1N1), in Vilnius, Panevėžys, Klaipėda, Kaunas, Prienai region.Total number of cases - 22.

As of 8 August 2009 (2009 -08-08), there was 29 cases. Lithuania confirmed eight more cases of influenza, from Kaunas, Vilnius, Ukmergė rajono and Utena region. One of the infected — Israeli citizen, comed to Lithuania.

On 11 August, Lithuania confirmed six more cases of influenza A (H1N1), in Vilnius, Panevėžys, Pasvalys, Prienai region.Total number of cases - 35.

On 13 August, Lithuania confirmed five more cases of influenza A (H1N1), in Akmenė and Šiauliai. Total number of cases - 40.

On days 14–22 August, Lithuania confirmed seven more cases of influenza A (H1N1). Total number of cases - 47

As of 30 August 2009 (2009 -08-30), there were 48 cases. Lithuania confirmed one more case of influenza.

As of 7 September 2009 (2009 -09-07), there were 51 cases. Lithuania confirmed three more cases of influenza.

As of 3 November 2009 (2009 -11-03), there was 57 cases. Lithuania confirmed six more cases of influenza.

As of mid-November there was 68 cases. Lithuania confirmed eleven more cases of influenza.

As of 15 of November. Currently 127 confirmed cases of influenza.

As of 18 of November. First death of swine influenza. Victim is 14-year-old boy, living in Kaunas region.

As of 23 of November. Second death of swine influenza. Victim is 40-year-old male, living in Visaginas.

On November 24, epidemic is announced in whole Lithuania.

As of 28 of November. Third death of swine influenza. Victim is 30-year-old female, living in Šiauliai.

As of 30 of November. Fourth death of swine influenza. Victim is 45-year-old female, living in Varėna.

As of 1 of December. Fifth death of swine influenza. Victim is 46-year-old male, living in Vilnius.

As of 2 of December. Sixth death of swine influenza. Victim is 40-year-old male, living in Kaunas.

Luxembourg

On 2 June, the first case of swine flu was detected in Luxembourg.

On 17 September, the first death relative to swine flu was reported in Luxembourg.

On 18 October, 785 people were confirmed to have the swine flu.

On 16 November, a second person died of swine flu.[131]

Macedonia

On 27 April 2009, the government of the Republic of Macedonia prohibited all exports and imports of live pigs. Even though Macedonia is not affected from the Swine Flu, the government ordered a ten days health monitoring period for everybody that comes from an affected country.

On 4 July, Macedonia confirmed the first two cases of virus A/H1N1.[132][133] As of 8 December 2009, 9 death cases due to complications from the swine flu have been recorded in Macedonia.[134]

As of 29 December 2009 (2009 -12-29), 18 death cases have been confirmed in Macedonia.

Malta

On 2 July 2009, two men were diagnosed with swine flu after a holiday in Girona, Spain. Malta had so far been the only country in European Union without swine flu cases. On 3 July 2009, 14 more cases were reported, bringing the total to 16. Most cases of swine flu in Malta have been mild, with only two hospital admissions as of 6 July 2009, when there were 24 confirmed cases. Ironically the largest number of cases have occurred in Għarb, Gozo; one of the smallest villages on the islands. On Tuesday 18 August the first death was reported; by then the total cases had increased to 244. On the 3rd of September the 2nd death flu was confirmed. The first death, an 82 year-old-woman, was suffering from a chronic disease whereas the second victim, a 63 year-old-man, had chronic health problems. The third victim, a 32 year-old-woman from Spain, that died at San Pawl il-Baħar area. In December 2010 died a 70-year-old British woman while she was in Malta for a holiday.

Moldova

As of 10 November 2009, there are 132 confirmed cases, and 3 confirmed deaths in Moldova.

Monaco

Monaco has reported its first confirmed case of swine flu on 17 June. The victim is a young Monegasque who returned from the United States. He was put in the isolation unit of L'archet Hospital.[135]

Montenegro

On December 1, 2009, the first case of death due to swine flu was confirmed in Montenegro. Since then, there were a total of 4 fatalities. On December 17, the Government of Montenegro declared a swine flu epidemic for the whole territory of the country. The only municipalities without any confirmed cases are Žabljak, Šavnik and Rožaje.

Netherlands

The Netherlands National Institute for Public Health and the Environment advised any traveller who returned from Mexico since 17 April and developed a fever of 38.5 degrees Celsius (101.3 degrees Fahrenheit) within four days of arriving in the Netherlands to stay at home.[136] On 30 April 2009 a three year old child tested positive for the swine flu. The child returned from Mexico to the Netherlands on 27 April 2009. The parents tested negative to the swine flu.[137] The girl was very ill at first according to her parents,[138] but made a full recovery.[139] On 7 May a second case and a day later a third case of swine flu in the Netherlands were announced, concerning a 53-year-old woman and a 52-year-old man, respectively.[140] Both of them had returned from Mexico recently and are being treated with Tamiflu. The woman made a full recovery,[139] the man is doing well. There are no connections between each of the three cases. People who were seated close to the infected people in the plane were contacted and are being treated with Tamiflu as a precautionary measure. On 3 July, there were 134 confirmed cases in the Netherlands. The number rose to 273 on 24 July[141] and to 517 on 31 July. On 4 August the first person died (after being sick already), and the number of infected people rose to 912 on 7 August.[142] Only 20% of the patients have contracted the flu within the Netherlands. Many of the sick are people who fell ill during or after their holidays in countries like Spain, Greece and the United Kingdom. On November 6 the Netherlands National Institute for Public Health and the Environment reported there are 5 more cases of death (this brings the total on 17) and that there is an epidemic, which means more than 51 per 100,000 inhabitants contracted the flu, more than 2 weeks in a row. On the 4th December the number of fatalities rose to 42. On 4 January 2011, it was confirmed that another 2 children died of swine flu. One of them would be a 4-year-old girl. They both lived in the region of Nijmegen, Gelderland. They died on 20 December and 27 December 2010. There would be no link between the deaths.[143]

Norway

The Norwegian Institute of Public Health (FHI) updates their homepage with information about the swine flu outbreak in Norway every day at 10:00 (UTC).[144]

On 9 May, two Norwegian students from Oslo and Telemark, were confirmed to be infected with swine flu after they came home from studies in Mexico. None of them became seriously ill and they are recovering quickly. A member of one of their families is suspected of being infected as well.[145] One of them (the 20 year-old man from Oslo) have been confirmed completely recovered.[146] These are the first two cases of swine influenza in Norway. By the end of May, there were a total number of 7 infected in Norway.

On 4 June, a Norwegian woman from Vest-Agder who recently had been to the United States was confirmed with the swine influenza. The infected woman is recovering well. This is the ninth confirmed case of swine influenza.[144] By the end of June, the total number of infected by influenza A H1N1 rose to 33.

As of 20 July, The Norwegian Institute of Public Health (FHI) reports a total of 133 infected. 115 were infected abroad and 18 in Norway. Influenza A H1N1 has now reached 16 out of 19 fylker (counties). Most cases are found in Oslo (42), and in Sør-Trøndelag (30). So far, swine flu has not been registered in Finnmark, Nord-Trøndelag and in Hedmark

As of 24 July, 197 cases in 18 out of 19 fylker (counties). Most cases are found in Oslo (60), and in Sør-Trøndelag (36). So far, swine flu has not been registered in Hedmark.

As of 19 November, 23 deaths were reported in Norway.

On 22 October, it was confirmed by authorities that over 100,000 people in Norway had been infected with swine flu. 14 people are reported dead by October 29.

Poland

Polish Chief Sanitary Inspectorate (PIS) maintains a webpage[147] on the epidemic situation in Poland which includes weekly updates on influenza A/H1N1 outbreak. As of 4 November, it confirmed 187 cases, but there were no death cases.

The Polish Foreign Ministry issued a statement on 25 April recommending that citizens avoid travel to affected areas until the outbreak is totally contained.

On 13 November, a 37-year-old man died in Gdańsk. It was first death of patient with A/H1N1 in Poland.[148]

As of 9 December, there were 1,525 cases and 67 deaths. Number of patients with A/H1N1 could be underestimated because it shows only laboratory confirmed cases.

Portugal

As of 4 May, there has been one confirmed case in Lisbon, Portugal, but it did not represent any concern, because the risk of transmission was no longer present at that time.[149]

On 1 June, Ana Jorge, the Portuguese Health Minister, has confirmed the second case in Portugal, a 33-year-old man who travelled from the United States, first landing in Frankfurt, Germany. The case was reported at São João Hospital, Oporto.[150] On 30 June, five new cases were announced in Portugal elevating the total number of cases to 18.[151]

As of 2 July there have been 27 confirmed cases in Portugal.

On 3 July, 6 more cases were reported, making a total of 33 cases. As of 4 July, more 5 cases were confirmed, two of them internal transmissions (one in Azores, and the other one in Lisbon).

On 6 July, there have been confirmed 48 cases in Portugal.

As of 7 July, another 12 people infected were confirmed, making a total of 57 cases in the country. On this day, the first school was closed down for prevention, in Lisbon, as well as a kindergarten in Azores.

On 8 July, 4 more cases were confirmed, including the first in Braga district, making the total cases 61.

As of 14 July, there are a total of 96 confirmed cases in Portugal.[152] On this day, it was also announced that Faro's Hospital will join, on 15 July, the set of hospitals in the country capable of receiving patients infected with the A/H1N1 flu virus.[153]

Government officials state the worst case scenario in Portugal is 25% infection with a mortality of 0.1% totaling 8700 casualties in Portugal.[154]

As of August 23 there have been 2244 people infected with the flu in Portugal.[155]

Portugal has the second higher tie of infections in Europe. 20,9 cases per 100,000 persons.[156]

On 13 September 2009, Portugal had 9618 cases officially confirmed.

In total, as of September 24, there were 12709 cases confirmed in Portugal and the first death was confirmed in the same day.[157]

As of 4 December, there were 121,677 cases confirmed and 24 deaths.[158]

Romania

In Sâmbăteni, Arad County, Romania, a child of a year and six months and his mother who recently returned from a trip to Portugal and Spain were suspected of having contracted influenza A(H1N1). Tests returned negative.[159][160]

On Wednesday, 27 May a woman returning from America was confirmed with swine flu in Bucharest.[161]

As of August 11, there were 227 confirmed cases in 22 out of 41 counties of Romania.[162]

By mid-September the number of cases in Romania had risen to 296.

As of November, 2nd 2009 the number of cases was 555. No deaths.

As of November, 10th 2009 the number of cases was 1,001. No deaths.

As of November, 19th 2009 the number of cases was 1,651. No deaths.

The first confirmed case of death came on November, 23rd.[163]

As of December, 04th 2009 the number of cases was 3,660 and 8 deaths.[164]

As of December, 05th 2009 the number of cases was 3,793 and 10 deaths.[165]

As of December, 6th 2009 the number of cases was 3,842 and 12 deaths. Health authorities have decided to suspend classes for 7 days, starting Monday, December 7 needle, these educational units: High School “Sabin Dragoi”, Deva; High School “Miko”, Sfântu Gheorghe and Group School “Avram Iancu”, Târgu Mureş.[166]

As of December, 7th 2009 the number of cases was 3,881 and 12 deaths.[167]

As of December 8, 2009 the number of cases was 3,998 and 14 deaths.[168]

As of December 9, 2009 the number of cases was 4,113 and 14 deaths.[169]

As of December, 15th 2009 the number of cases was 4,885 and 27 deaths.[170]

As of December 24, 2009 the number of cases was 5,421 and 42 deaths.[171] As of December, 29th 2009 the number of cases was 5568 and 52 deaths.

On January 5, 2010, actor Toni Tecuceanu from Cronica Cârcotaşilor died morning at around 3.00, the Hospital "Matei Balş" in Bucharest, following complications from lung after contracted the virus A/H1N1. Prof. dr. Secretary of State for Health, said the actor, aged 37 years and suffering from obesity.[172]

As of January, 08th 2010 the number of cases was 6,061 and 82 deaths.[173]

As of January, 25th 2010 the number of cases was 6,873 and 111 deaths.[174]

As of February, 9th 2010 the number of cases was 6,982 and 120 deaths.[175]

As of February, 26th 2010 the number of cases was 7,003 and 122 deaths.[176]

As of April, 9th 2010 the number of cases was 7,008 and 122 deaths.[177][178]

Russia

Russia has banned the import of pork meat from Guatemala, Honduras, Dominican Republic, Colombia, Costa Rica, Cuba, Nicaragua, Panama, El Salvador, 9 US States (Alabama, Arizona, Arkansas, Georgia, Kansas, Louisiana, New Mexico, Oklahoma and Florida) and all types of meat and meat products from Mexico and 5 US States (California, Texas, Kansas, New York and Ohio).[265][266][267]

The President instructed the regional governors to take urgent steps to prevent swine flu from spreading to Russia. Dmitry Medvedev also instructed the presidential plenipotentiary envoys in the federal districts to personally supervise the preventive measures to ensure the disease did not spread [in Russia] and stipulated monthly reports on the situation.[268]

On 1 May officials confirmed that two women who came from USA trip were suspected to have swine flu. Currently both are in hospital for further treatment.[269] As on 2 May, both tourists are reported not to be infected with new strain.[270]

Serbia

A 71-year-old tourist from Texas asked to be tested for swine flu at the Provincial hospital in Novi Sad, Serbia on 30 April. The results were negative.[271]

The first confirmed case in Serbia was announced on 24 June. The infected person is a 29-year-old male citizen of Montenegro living in Belgrade who came back from a trip to Argentina two days earlier. As he travelled across Croatia and Germany with other people, they were put in semi quarantine.[272] The second case was confirmed on 25 June. The infected person is a 4-year-old female citizen of Australia who was visiting Sombor. She had contact with 13 people whose health is being monitored.[273] On 26 June, three more cases were confirmed, out of which two were independent cases while one patient was infected from contact with the previously diagnosed patient.[274] In total 44 people were put under quarantine surveillance.[275] On 28 June, 6 more cases were confirmed - three were citizens of Canada, a mother and her 2- and 5-year-old daughters, two were tourists returning from Australia and Egypt and one was infected from contact with the first flu case patient in Serbia.[276][277] Four more cases were confirmed on 1 July, one of the patients is a 73-year-old US citizen, while two patients arrived from abroad, from Australia and the USA.[278] On 2 July, an Australian sportsman was diagnosed with flu.[279] On 6 July, the total number of infected patients rose to 26 with two more cases among the Universiade athletes, one from Uganda and one from Argentina.[280][281] On 7 July, four more cases were confirmed with a total number of 30 cases in Serbia.[282] On 8 July four more cases were confirmed with a total number of 34 cases.[283]

International events held in Serbia, 2009 Summer Universiade sport competition and EXIT music festival, led to a sudden increase to over 100 cases of flu in mid-July.[284]

On October 21, 2009 the first fatality related to the H1N1 in Serbia. The 46-year-old woman died in hospital in Kragujevac.

As of November 10, there are 258 people infected, and 7 death cases.[285]

On November 16, there are 295 officially confirmed cases, with 11 people died as consequence of swine flu infection.[286]

Slovenia

First confirmed infection was confirmed on 19 June; a female who flew from New York to Venice and then drove by car to Slovenia. Institute of Public Health of the Republic of Slovenia has established a web site with information about H1N1 induced influenza. Status of this webpage is updated once a week. As of 28 January 2010, there were 2091 people tested positive.[287][288]

Spain

On 27 April the Spanish Ministry of Health and Social Policy announced that a man in Castilla-La Mancha, Spain who had recently returned from Mexico had contracted the disease. The man, aged 23, had returned from Mexico on 22 April and had been quarantined on the 25th. This was the first confirmed case in Europe.[289]

The Spanish government is also observing other 35 possible swine flu cases in the Basque Country, Catalonia, the Balearic Islands, Andalusia, Murcia, Madrid and the Valencian Community.[290]

AENA, the Spanish state owned company who manages all Spanish airports and Air Traffic Control established a protocol for the flights coming from and to Spain from the affected areas.[291] Three patients who had just returned from Mexico were under observation in multiple regions of Spain.[119]

Sweden

On 28 April, at least eighteen Swedish people were tested for swine flu after returning from trips in Mexico and the USA, but the results were negative.[293][294] On 29 April two people, recently returned from Mexico with flu like symptoms were tested.[295]

As of 6 May, the Swedish Institute for Infectious Disease Control confirms 1 case of influenza A(H1N1). 186 negative test results have been reported. No suspected cases remain to be analysed.[296]

The number of confirmed cases has reached 2 in Sweden, with 435 negative cases reported as of May 15.[297]

A third case was confirmed on Friday, May 15, and reported on the following Saturday, where the patient, a woman in her sixties, has recovered. In all of the 3 cases the influenza was contracted in the USA.[298]

A fourth case was confirmed 28 May, influenza was contracted in the USA.[299]

As of July 19, 274 cases has been confirmed. On July 20, the number had risen to 322 confirmed cases and to 340 on July 21. 362 cases had been reported on July 22, 390 on July 23 and 408 as of July 24.

Three regions have reported more than 20 cases; Stockholm county with 144, Skåne country with 78 and Västra Götaland with 71.

42 of the 408 cases were contracted domestically.[300]

A 22-year-old man in Norrköping is hospitalised with a life threatening condition, requiring extracorporeal membrane oxygenation.[301]

In August, a 37-year-old man in Uppsala was the first to die of H1N1 influenza in Sweden. The second case was in September, a 55-year-old man in Västerås. On October 31, a three-year-old boy died in a hospital after first being turned down treatment even though he suffered several of the obvious symptoms.[302]

Switzerland

The first suspicious case in Switzerland was officially confirmed on 27 April. A young man returning from holiday in Mexico informed his family doctor about fever and flu-like symptoms. He was immediately put under quarantine in a hospital. 8 more people are under observation. A container of inactive swine flu virus samples packed in dry ice exploded on a Swiss train, injuring one person but posing no other risks to humans.[303]

Switzerland has confirmed its first case of swine flu in a 19-year-old student who returned from Mexico on 30 April. The state hospital in Baden said in a statement that the National Influenza Centre in Geneva confirmed the disease shortly after the student was mistakenly released from hospital day before.[304]

Switzerland has confirmed its second case of swine flu in a young woman of 24. She was returning from a trip to Mexico and USA. She is now in the Hospital in Bern.[305]

On 24 May, a third case of swine flu has been announced in a woman who came back from Washington and is resident in Basel.

As of 26 June, there are 49 confirmed cases in ten cantons, with five cases having been community-transmitted.[306]

As of 19 November a total of three persons have been reported to die from swine flu, a baby and two women, all of them with prexisting health problems of other origin.

Turkey

Ukraine

United Kingdom and Crown Dependencies

Samples from suspected cases in the United Kingdom have been analysed by the National Institute for Medical Research in London, which is also examining samples of the U.S. strain of the disease.[308]

On 25 April 2009, a member of British Airways cabin crew was taken to Northwick Park Hospital in Harrow and quarantined after falling ill with flu-like symptoms on a flight from Mexico City though he was later found not to have swine flu.[309]

The first cases were confirmed on 27 April in passengers returning from Mexico.

On 1 May the first UK person to person transmission was confirmed. Graeme Pacitti, 24, of Falkirk, picked up the virus after contact with the UK's first cases Iain and Dawn Askham.[310][311]

It was reported on 26 May that a man who has been confirmed with swine flu was critically ill.[312]

On 28 May, people at a Home Office building in Sheffield were quarantined, it was feared someone had caught swine flu on a recent trip to Canada. In fact, not one, but three people had caught it, the person who had been to Canada, one from someone who recently had stayed in Acapulco, Mexico, and one from someone who recently had stayed in London.

On 6 June, the total of swine flu cases hit 508 with 3 people in intensive care in hospital. On 7 June, the total of swine flu cases hit 541 with 3 people in intensive care and one woman with swine flu gave birth in hospital.

As of 11 June 2009 (2009 -06-11), 822 cases of swine flu were clinically confirmed.[313]

On 13 June, the total of swine flu cases hit 1,122 with 4 people in intensive care in hospital. The following day, the first death from swine flu in the United Kingdom is reported from Scotland, making the first death from swine flu in Europe.

By 9 July there were over 9,718 cases of swine flu and the rate of cases was going up increasingly.

By 16 July, over 10000 cases of Swine flu were confirmed, with the British government suggesting a possible 55000 new cases in the week leading up to the 16. There were 29 deaths confirmed, although the majority of these had 'underlying health issues'. (26 in England and 3 in Scotland)

Gibraltar

Gibraltar has reported its first confirmed case of swine flu on 24 July.[314]

Timeline

2009 A(H1N1) outbreak and pandemic milestones in Europe
27 April First case confirmed in the United Kingdom.
First case confirmed in Spain.
29 April First case confirmed in Germany.
First case confirmed in Austria.
30 April First case confirmed in the Netherlands.
First case confirmed in Switzerland.
First case confirmed in Ireland.
1 May First case confirmed in Denmark.
First case confirmed in France.
2 May First case confirmed in Italy.
3 May First case confirmed in Portugal.
6 May First case confirmed in Poland.
First case confirmed in Sweden.
9 May First case confirmed in Norway.
12 May First case confirmed in Finland.
13 May First case confirmed in Belgium.
16 May First case confirmed in Turkey.
18 May First case confirmed in Greece.
22 May First case confirmed in Russia.
23 May First case confirmed in Iceland.
25 May First case confirmed in the Czech Republic.
26 May Community outbreaks confirmed in the United Kingdom.
27 May First case confirmed in Romania.
28 May First case confirmed in Slovakia.
29 May First case confirmed in Hungary.
30 May First case confirmed in Cyprus.
First case confirmed in Estonia.
31 May Community outbreaks confirmed in Germany.
1 June First case confirmed in Bulgaria.
2 June First case confirmed in Luxembourg.
First case confirmed in Ukraine.
5 June Community outbreaks confirmed in Switzerland.
12 June First confirmed case in the Isle of Man.
14 June First death confirmed in the United Kingdom.
17 June First confirmed case in Monaco.
Community outbreaks confirmed in France.
18 June First confirmed case in Jersey.
19 June First case confirmed in Slovenia.
22 June First case confirmed in Montenegro.
23 June First case confirmed in Latvia.
24 June First case confirmed in Serbia.
25 June First human-to-animal transmission of the virus in the United Kingdom.
26 June First case confirmed in Lithuania.
29 June First case confirmed in Bosnia and Herzegovina.
First case of Oseltamivir (Tamiflu) resistance found in Denmark.
Community outbreaks confirmed in Italy.
30 June First death confirmed in Spain.
1 July First case confirmed in Malta.
4 July First case confirmed in Croatia.
First case confirmed in Macedonia.
Community outbreaks confirmed in Spain.
7 July Community outbreaks confirmed in Portugal.
8 July Community outbreaks confirmed in Malta.
11 July First case confirmed in Andorra.
19 July First case confirmed in Georgia.
20 July First case confirmed in Albania.
Community outbreaks confirmed in Norway.
22 July First death confirmed in Hungary.
Community outbreaks confirmed in Ireland.
23 July Community outbreaks confirmed in Sweden.
24 July First case confirmed in Gibraltar.
25 July Community outbreaks confirmed in Greece.
26 July Community outbreaks confirmed in Cyprus.
Community outbreaks confirmed in Turkey.
27 July Community outbreaks confirmed in Denmark.
Community outbreaks confirmed in the Netherlands.
First case confirmed in Kosovo.
30 July First case confirmed in Azerbaijan.
First case confirmed in Moldova.
First death confirmed in Belgium.
First death confirmed in France.
3 August First case confirmed in Akrotiri and Dhekelia.
4 August First death confirmed in the Netherlands.
6 August First case confirmed in Liechtenstein.
7 August First death confirmed in Ireland.
18 August First death confirmed in Malta.
19 August First case confirmed in Belarus.
23 August First death confirmed in Greece.
31 August First death confirmed in Sweden.
3 September First death confirmed in Norway.
4 September First death confirmed in Italy.
17 September First death confirmed in Luxembourg.
Community outbreaks confirmed in Belgium.
24 September First death confirmed in Portugal.
25 September First death confirmed in Germany.
30 September First death confirmed in Bulgaria.
Community outbreaks confirmed in Finland.
20 October First death confirmed in Iceland.
21 October First death confirmed in Serbia.
Mass vaccinations in the United Kingdom begins.
22 October First death confirmed in the Czech Republic.
24 October First death confirmed in Finland.
First death confirmed in Turkey.
26 October First death confirmed in Moldova.
27 October First death confirmed in Russia.
30 October First death confirmed in Ukraine.
31 October First death confirmed in Croatia.
2 November First death confirmed in Austria.
Mass vaccinations in Turkey begins.
3 November First death confirmed in Slovenia.
4 November First death confirmed in Belarus.
First case of Oseltamivir (Tamiflu) resistance found in Belarus.
First case of Oseltamivir (Tamiflu) resistance found in the Netherlands.
5 November First case confirmed in San Marino.
7 November Mass vaccinations in Belgium begins.
9 November First death confirmed in Latvia.
10 November First death confirmed in Slovakia.
11 November First case confirmed in Armenia.
12 November Mass vaccinations in France begins.
13 November First death confirmed in Cyprus.
First death confirmed in Poland.
14 November First death confirmed in Kosovo.
First death confirmed in Switzerland.
16 November First death confirmed in Bosnia and Herzegovina.
Mass vaccinations in Greece begins.
Mass vaccinations in Spain begins.
Mass vaccinations in Cyprus begins.
18 November First death confirmed in Lithuania.
First death confirmed in Macedonia.
First case of Oseltamivir (Tamiflu) resistance found in Finland.
First case of Oseltamivir (Tamiflu) resistance found in Slovenia.
20 November First death confirmed in Denmark.
First case of Oseltamivir (Tamiflu) resistance found in the United Kingdom.
First mutation (D222G) confirmed in Norway.
23 November First death confirmed in Estonia.
First death confirmed in Romania.
Mass vaccinations in the Netherlands begins.
Mass vaccinations in the Czech Republic begins.
First mutation (D222G) confirmed in Ukraine.[315]
27 November First mutation (D222G) confirmed in France.
First case of Oseltamivir (Tamiflu) resistance found in France.
30 November First mutation (D222G) confirmed in Finland.
First mutation (D222G) confirmed in Italy.
1 December First death confirmed in Montenegro.
3 December First mutation (D222G) confirmed in the Netherlands.[316]
First death confirmed in Albania.
4 December First mutation (D222G) confirmed in Spain.
13 December First death confirmed in Georgia.
14 December First death confirmed in Armenia.
15 December First human-to-animal transmission of the virus in France.
First case of Oseltamivir (Tamiflu) resistance found in Germany.
2010 A(H1N1) outbreak and pandemic milestones in Europe
1 January Mass vaccinations in the Malta begins.

Notes

  1. ^ Kosovo is the subject of a territorial dispute between the Republic of Serbia and the self-proclaimed Republic of Kosovo. The latter declared independence on 17 February 2008, while Serbia claims it as part of its own sovereign territory. Its independence is recognised by 86 UN member states.

References

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