2009 flu pandemic in the United States

Further information: 2009 flu pandemic, 2009 flu pandemic by country, and 2009 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  2453[2] NR 52[3]
Alaska 460[4] 18[4] 13[5]
Arizona   8592[6] 1818[6] 151[6]
Arkansas 154/NLU[7] NR 32[8]
California   10,545[9] 8589[9] 657[10]
Colorado  1321[11] 578[12] 70[13]
Connecticut   5382[14] 734[14] 35[14]
Delaware  381[15][16] NR 7[17]
District of Columbia  54[15] NR 1[18]
Florida  3676[19] 1227[19] 230[20][21]
Georgia  1012[22] 860[22] 81[23]
Hawaii   2221[24] NR 13[25]
Idaho  1165[26] NR 23[27]
Illinois    4649[28] 2931[28] 111[28]
Indiana   782[29] NR 39[29]
Iowa  929[30] 700[31] 41[32]
Kansas  1201[33] NR 29[34]
Kentucky   2092[35] NR 39[35]
Louisiana  1876[36] NR 52[37]
Maine  2232[38] 230[38] 21[39]
Maryland   1772[40] 996[41] 45[42]
Massachusetts    1979[43] 397[43] 33[44]
Michigan   655/NLU[45] NR 88[46][47]
Minnesota   2220[15] 1813[48] 61[49]
Mississippi  1292[50] NR 26[51]
Missouri  1523[52] NR 17[53]
Montana  961[54] 9[54] 19[55]
Nebraska  430[56] 40[56] 15[57]
Nevada   5516[58][59] NR 44[58][60]
New Hampshire   722[61] NR 10[62]
New Jersey   1006/NLU[63] 512[64] 42[65]
New Mexico   1007[66] 1007[67] 58[68]
New York    2738[15][69] 909[70] 206[10]
North Carolina  638[71] 267[71] 107[72]
North Dakota  650[73] 60[73] 2[74]
Ohio  227/NLU[75] NR 52[76]
Oklahoma  237/NLU[77] 7[77] 44[78]
Oregon   1833[79] 1419[79] 79[80]
Pennsylvania   10,940[81] NR 78[81]
Rhode Island  203[82] 76[83] 13[84][85]
South Carolina  1634[86] NR 49[87]
South Dakota  2081[88] 422[88] 23[88]
Tennessee   1163[89] NR 57[90]
Texas    6128[91] 1994[92] 231[93]
Utah   988[15] 302[94] 48[95]
Vermont  404[96] 149[96] 3[97]
Virginia  327[15][98] NR 37[99]
Washington 1882[15][100] 1561[101] 99[102]
West Virginia  1214[103] 853[104] 22[105]
Wisconsin    9579[106] 1317[106] 55[106]
Wyoming  725[107] NR 10[108]
-   -  -  -
American Samoa 90[109] NR 1[110]
Guam  338[111] NR 2[112]
Northern Mariana Islands 71[113] NR 0
Puerto Rico 908[114] NR 60[115]
U.S. Virgin Islands 80[116] NR 1[116]
NR: Not Reported - NLU: No Longer Updated

The 2009 flu pandemic in the United States was a pandemic experienced in the United States of a novel strain of the Influenza A/H1N1 virus, commonly referred to as 'swine flu', that began in the spring of 2009. The virus had spread to the US from an outbreak in Mexico.[117]

As of mid-March 2010, the U.S. Centers for Disease Control and Prevention (CDC) estimated that about 59 million Americans contracted the H1N1 virus, 265,000 were hospitalized as a result, and 12,000 died.[118]

Contents

History

The earliest reported cases in the US began appearing in late March 2009, in California,[119][120] then spread to infect people in Texas, New York, and assorted other states by mid-April. This spread continued across the country's population and by the end of May had infected citizens in all 50 states. The pattern continued through June of the same year. The total number of confirmed cases varied from 27,717[121] (Centers for Disease Control and Prevention (CDC) confirmed and probable cases) and 25,453[122] (total of all state confirmed cases) as of June 26, 2009.

Towards the middle of June 2009, the number of US cases surpassed those of Mexico, which had been the previous leader in diagnosed cases of the disease. Toward the end of June 2009, the number of deaths related to the virus in the US surpassed those of all other countries as well.

On June 25, the CDC released information revealing that there were more than likely over one million (1,000,000) cases of the disease in the US, most of which had not been reported or diagnosed.[123][124]

Deaths relating to this new strain of 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. These deaths totaled at 4,000 as of November 15, 2009.[122]

The CDC is distributing vaccine for the novel flu strain[125] using mechanisms already in place for its Vaccines for Children (VFC) program.[126]

On October 24, 2009, President Barack Obama declared Swine Flu a national emergency in the United States.

On November 12, 2009, the CDC reported an estimated 22 million Americans had been infected with 2009 A H1N1 and 4,000 Americans have died.[127]

On December 10, 2009, the CDC reported an estimated 50 million Americans or 1-6 people had been infected with the 2009 A H1N1 Virus and 10,000 American have died, by which time the vaccine was beginning to be widely distributed to the general public by several states.[128]

On December 23 , 2009 the CDC reported the Reduction of The Disease by 59% percent and only 3 states reporting widespread and the disease is expected to end in The United States in January 2010.

On January 15, 2010, the CDC released new estimate figures for swine flu, saying it has sickened about 55 million Americans and killed about 11,160 from April through mid-December.[129]

On February 12, 2010, the CDC released updated estimate figures for swine flu, reporting that, in total, 57 million Americans had been sickened, 257,000 had been hospitalised and 11,690 people had died (including 1,180 children) due to swine flu from April through to mid-January.[130]

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,[131] for the 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.[132] 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.

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.[133] 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.

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.[134]

Outbreak across the US

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.[135] On May 4, 2009, the CDC reported one death, 286 confirmed cases of H1N1 flu across 36 states, 35 hospitalizations, and expects 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.[136] By May 5, 2009, the number had risen to 403[137] and a second death was reported in Texas.[138] The CDC and government officials had expressed cautious optimism about the severity and spread of H1N1.[139][140]

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.[141]

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.

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[142]
First Death Inside the US April 27, 2009[134]
First Death of US Citizen May 5, 2009[143]
Number of People Hospitalized 9,079 (as of September 3) [144]
Fatalities 593 (as of September 3) [144]

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.

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.

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.[145]

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.[146]

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, 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. 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.

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.[147] 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 do 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,an major increase from 2% of patients treated by West Virginia health care providers having influenza like illness in November.

Flu strain severity

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. The World Health Organization (WHO) and the U.S. Centers for Disease Control and Prevention (CDC) have expressed serious concerns that the new strain has the potential to become an influenza pandemic.[148] It is reported that, because the virus is already widespread, containment will be impossible.[149]

In addition, the flu death toll in Mexico could be lower than first thought, Dr. Gregory 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:[150]

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.

Moreover, another Canadian expert, Dr. Neil Rau, criticized the WHO's decision to raise its Pandemic alert to level 5, saying:[151]

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 stated on April 28, 2009 that there were at least 800 deaths in the U.S. due to normal influenza in each individual week between January 1 and April 18, which is higher than the combined worldwide death toll for the swine flu.[152]

As of November 19, 2009, the official death toll attributed directly to the novel H1N1 and seasonal influenza was 877.[153] This total exceeds the 849 deaths directly attributed to seasonal influenza in 2006.[154] 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)[154][155]

Response

The Federal response remains at US Pandemic Stage 0, congruent with the World Health Organization (WHO) Pandemic Phases 1, 2 and 3;[156][157] however, the WHO's Pandemic Phase was raised to 4 on April 27, which is congruent with US Pandemic Stage 2.[158] On April 29, the WHO raised the pandemic alert level to phase 5.[159]

The United States federal government declared a public health emergency, and several U.S. states have indicated 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.[160]

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.[161]

White House

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."[162] 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".[163] President Obama suggested that U.S. schools should consider shutting down, as a future possibility, if their students were to become infected.[164] White House Press Secretary, Robert Gibbs said the effort to get a team in place to respond to the health scare has 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.[165] The president's nominee, Kansas Gov. Kathleen Sebelius, was still awaiting confirmation from the U.S. Senate until passing on April 28. The President has 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.[165] The current acting Surgeon General, Steven K. Galson, is also currently serving as the Acting Assistant Secretary for Health.[166]

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 Barack Obama's trip to Mexico.[167] However, the White House stated that the President is not at risk of obtaining the flu.[167] 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.[168][169]

On October 24, President Obama declared the 2009 H1N1 swine flu a national emergency.[170] The declaration will make 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)

Activation of Emergency Operations Center

During the week of April 19, the CDC activated its Emergency Operations Center (EOC) to augment the ongoing investigation of human cases of swine influenza A (H1N1). More than 250 CDC professionals are working from the CDC EOC as part of the agency's response.[171] 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.[137]

Swine Flu Test Kits

As of April 29, only the CDC could confirm U.S. swine flu cases.[172] Dr. 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.[173] On May 6, the CDC announced that testing kits were now available for all states. This is expected to generate an increase in the number of confirmed cases as more states begin doing their own tests.[174]

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.

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.[175] The new strain responsible for this outbreak was one such virus.

CDC 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.[176] Some school districts closed all schools if a single child was classified as probable.[135] 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.[177] By that time at least 726 schools nationwide serving more than 480,000 students had closed for at least some period of time.[176] The CDC amended its advice citing, new information on disease severity and the limiting effectiveness of school closure as a control measure.[177] 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."[177]

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.)[178] The FDA stated it is also responding to this threat by:

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.[180] The FDA also issued a warning for consumers to be wary of products claiming to cure or prevent swine flu.[181]

Other federal agencies

Department of Homeland Security

Secretary Napolitano stated that DHS is the principal federal office for incidents such as the current H1N1 flu outbreak, and “Under that role, we have been leading a true collaborative effort.”[182] The Department of Homeland Security has a document, dated NOV 1, 2005, entitled "National Strategy for Pandemic Influenza", detailing planning for potential pandemics. http://www.pandemicflu.gov/plan/federal/pandemic-influenza.pdf

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.[183] However, the State Department did recommend US citizens avoid non-essential travel to Mexico.[184]

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.[185]

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.[186]

Department of Defense

The Department of Defense (DOD) is monitoring the swine flu situation and has contingency plans to deal with such outbreaks.[187] As of May 7, 2009, the DOD reports 104 confirmed cases among Armed Forces personnel and their families. DOD maintains a daily summary and map.[188]

Department of Education

The Department of Education is providing guidance to schools in the US affected by swine flu, as well as precautions to take.[189]

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.[190] On May 4, 2009, about 533 schools in 24 states in the U.S. were closed, affecting about 330,000 students.[191] On September 25, 2009, forty-two schools were closed in eight states as the second wave of the pandemic began.[192]

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 parents keep their child home if he or she displays an influenza-like illness.[193]

Travel industry

Several airlines are waiving fees for cancellations and flight changes.[194] At least one cruise line changed itinerary to avoid Mexican ports of call.[195]

Summary

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.
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 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.

Notes

  1. ^ 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. 2009-04-30. http://www.cdc.gov/h1n1flu/casedef_swineflu.htm. Retrieved 2009-05-01. 
  2. ^ "Swine Influenza Updates". Alabama - Department of Public Health. 2009-07-30. http://www.adph.org/H1N1Flu/index.asp?id=3571. 
  3. ^ Epi - Influenza
  4. ^ a b "Swine Flu Information". Alaska - Department of Health and Social Services. 2009-08-05. http://www.epi.alaska.gov/id/influenza/swineflu.htm. 
  5. ^ Homer woman who died at 44 tested positive for swine flu: Swine flu (H1N1) | Alaska news at adn.com
  6. ^ a b c Update each Wednesday "New 2009 Influenza A H1N1 Strain in the US". Arizona - Department of Health Services. 2009-07-29. http://www.azdhs.gov/flu/h1n1/index.htm. 
  7. ^ "H1N1 Flu (Swine Flu) Resources". Arkansas - Department of Health. 2009-07-29. http://www.healthyarkansas.com/news/swineflu-resources.html. 
  8. ^ http://arkansasmatters.com/content/news/fulltext?cid=302082
  9. ^ a b "Novel Influenza A (H1N1) Virus (Swine Flu) - Latest News". California - Department of Public Health. 2007-08-25. http://www.cdph.ca.gov/HealthInfo/discond/Pages/SwineInfluenza.aspx. Retrieved 2009-08-27. 
  10. ^ a b 2009 flu pandemic in the United States by state
  11. ^ "Influenza-Associated Hospitalizations by County by Diagnosis Date". Colorado - Department of Public Health and Environment. 2009-08-30. http://www.cdphe.state.co.us/dc/Influenza/09_10%20Hospitalizations%20by%20County.pdf. Retrieved 2009-11-09. 
  12. ^ http://www.cdphe.state.co.us/dc/Influenza/09_10%20Hospitalizations%20by%20County.pdf
  13. ^ http://www.cdphe.state.co.us/dc/Influenza/09-10_Deaths_Linelist.pdf
  14. ^ a b c "CTFLUWATCH". Connecticut Department of Public Health. 2009-07-29. http://www.ct.gov/ctfluwatch/cwp/view.asp?a=2533&q=439218. Retrieved 2009-07-30. 
  15. ^ a b c d e f g "PAHO Influenza A(H1N1) Surveillance". PAHO. 2009-08-26. http://new.paho.org/hq/images/atlas/en/atlas.html. Retrieved 2009-08-26. 
  16. ^ No longer updating "H1N1 UPDATE - JUNE 18". Delaware - Department of Health and Social Services. 2009-06-18. http://dhss.delaware.gov/dhss/pressreleases/2009/swineflu-061809.html. Retrieved 2009-06-19. 
  17. ^ 7th death in DE from H1N1 influenza - WGMD.COM
  18. ^ Drug-resistant swine flu reported in Va., Md
  19. ^ a b Update each Wednesday "Swine Flu Information". Florida - Department of Health. 2009-07-21. http://www.doh.state.fl.us/Disease_ctrl/epi/swineflu/index.html. Retrieved 2009-07-30. 
  20. ^ H1N1 Media Releases
  21. ^ http://www.doh.state.fl.us/Disease_ctrl/epi/htopics/flu/2010/Week-20-2009-2010.pdf
  22. ^ a b "H1N1". Georgia - Division of Public Health. 2009-09-24. http://dch.georgia.gov/00/channel_title/0,2094,31446711_148304655,00.html. Retrieved 2009-09-24. 
  23. ^ georgia.gov - Seasonal Flu
  24. ^ "Influenza Surveillance Report". July 19–August 1, 2009. HAWAI‘I STATE DEPARTMENT OF HEALTH DISEASE OUTBREAK CONTROL DIVISION. 2009-08-06. http://hawaii.gov/health/family-child-health/contagious-disease/influenza/Influenza%20Reports/Influenza%20Surveillance%20Weeks%2029-30%202009.pdf. Retrieved 2009-08-26. 
  25. ^ Delawareonline - Levi Johnston wants to be mayor; has no platform
  26. ^ "Idaho Case Counts". Idaho - Department of Health & Welfare. 2009-10-06. http://healthandwelfare.idaho.gov/Health/PanFluHome/IdahoCaseCounts/tabid/890/Default.aspx. 
  27. ^ Idaho Case Counts
  28. ^ a b c Update each Friday "Illinois Department of Public Health Swine Flu Statistics". Illinois - Department of Public Health. 2009-07-24. http://www.idph.state.il.us/swine_flu. Retrieved 2009-07-30. 
  29. ^ a b "ISDH Press releases". Indiana - State Department of Health. 2009-08-20. http://www.in.gov/flu/2442.htm. Retrieved 2009-08-27. 
  30. ^ "Influenza and Other Respiratory Virus Weekly Activity Report". Iowa - Department of Public Health. 2009-08-01. http://www.idph.state.ia.us/adper/common/pdf/flu/flu_report_47.pdf. Retrieved 2009-08-26. 
  31. ^ newtondailynews.com | H1N1 vaccine plentiful in Iowa
  32. ^ Iowa Influenza Surveillance Network (IISN) Reports
  33. ^ update at Monday"Kansas H1N1 Flu Virus Information". Kansas - Department of Health and Environment. 2009-08-24. http://www.kdheks.gov/H1N1/H1N1_Epi_Reports.htm. 
  34. ^ Kansan dies from H1N1 - Pratt, KS - Pratt Tribune
  35. ^ a b "Flu Activity". Commonwealth of Kentucky. 2009-10-29. http://healthalerts.ky.gov/Pages/FluActivity.aspx. 
  36. ^ "DHH Updates Status of Fight the Flu Campaign". Louisiana - Department of Health & Hospitals. 2009-11-09. http://www.dhh.louisiana.gov/news.asp?Detail=1560. Retrieved 2009-11-09. 
  37. ^ Department of Health & Hospitals | State of Louisiana
  38. ^ a b update weekly "Maine - H1N1 Influenza (“Swine Flu”) Update". Maine - Center for Disease Control and Prevention. 2009-08-26. http://www.maine.gov/dhhs/boh/swine-flu-2009.shtml. Retrieved 2009-08-27. 
  39. ^ Flu News - CDC; DHHS Maine
  40. ^ "Maryland weekly flu report". The Baltimore Sun. 2009-07-02. http://www.marylandfluwatch.org/weekly-report/2008-2009-weekly-reports-1. Retrieved 2009-07-02. 
  41. ^ Maryland Flu Watch
  42. ^ Department of Health and Mental Hygiene Seasonal Influenza Preparedness Guide
  43. ^ a b "Confirmed H1N1 Influenza (swine flu)". Massachusetts - Department of Public Health. 2009-08-27 ]. http://publichealth.blog.state.ma.us/h1n1-swine-flu/. 
  44. ^ Weekly Flu Report: April 15, 2010 - Commonwealth Conversations: Public Health
  45. ^ Daily Update of fatalities "MDCH-Influenza A (H1N1)". Michigan - Department of Community Health. 2009-06-13. http://www.michigan.gov/mdch/0,1607,7-132-2940_2955_22779_53388-213600--,00.html. Retrieved 2009-07-30. 
  46. ^ [1]
  47. ^ http://www.michigan.gov/documents/mdch/20090623_5pm_FLI_283516_7.pdf
  48. ^ "Weekly Influenza Activity: Statistics". Minnesota - Department of Health. 2009-08-17. http://www.health.state.mn.us/divs/idepc/diseases/flu/stats/index.html. 
  49. ^ Weekly Influenza Activity - Minnesota Dept. of Health
  50. ^ "Mississippi H1N1 Swine Flu Cases by County, 2009". Mississippi - State Department of Health. 2009-09-23. http://www.msdh.state.ms.us/msdhsite/_static/14,0,334,82.html. 
  51. ^ http://www.clarionledger.com/article/20100319/NEWS/100319021/Mississippi+child+dies+of+flu
  52. ^ "Special Weekly Influenza Surveillance 2009-2010 Pre-Season Report, Missouri". Missouri - Department of Health and Senior Services. 2009-08-22. http://www.dhss.mo.gov/Influenza/Week500910.pdf. Retrieved 2009-08-27. 
  53. ^ http://www.kmox.com/Missouri-health-officials-add-up-the-H1N1-numbers/6795716
  54. ^ a b "Confirmed Novel Influenza A/H1N1 (Swine Flu)". Billings Gazette. 2009-08-06. http://mt.gov.cdc.nicusa.com/search?q=cache:eE-W161tnBwJ:www.dphhs.mt.gov/PHSD/Lab/documents/InfluenzaVolumes2009-10.xls+influenza+week+43&access=p&output=xml_no_dtd&ie=UTF-8&client=DPHHS&site=DPHHS&proxystylesheet=DPHHS&oe=ISO-8859-1. Retrieved 2009-08-06. 
  55. ^ Flathead County man dies of swine flu; 19th such death in Montana
  56. ^ a b "Influenza Report". Week 34 (August, 29). Nebraska - Department of Health & Human Services. 2009-08-21. http://www.hhs.state.ne.us/flu/WeeklyReport.pdf. Retrieved 2009-08-27. 
  57. ^ AP Health News Online Breaking News & Headlines from Associated Press - pennlive.com
  58. ^ a b "Nevada State Health Division Weekly Influenza Report". Nevada - State Health Division. 2009-08-21. http://flu.nv.gov/FluSurveillanceReports.htm. 
  59. ^ Woman, 29, first H1N1 death in new year - Wednesday, Jan. 6, 2010 | 1:31 p.m. - Las Vegas Sun
  60. ^ Boy, 10, dies from swine flu - News - ReviewJournal.com
  61. ^ "WEEKLY INFLUENZA SURVEILLANCE REPORT". New Hampshire - Department of Health & Human Services. 2009-08-29. http://www.dhhs.nh.gov/NR/rdonlyres/ekhk5hht2nqcy3svcotpqibj54rwxiroebx6zhnqhl7vy574mwp4eh25xemrr3cchl5fojz7g7ojvipf6l4nnpuynvc/weeklyflu.pdf. Retrieved 2009-09-16. 
  62. ^ NH reports 10th H1N1-related death » New Hampshire » EagleTribune.com, North Andover, MA
  63. ^ [http://www.state.nj.us/health/flu/documents/stats08/flummwr_34.pdf "New Jersey Department of Health and Senior Services UCommunicable Disease Service Influenza Brief"]. Week Ending August 29, 2009 (MMWR Week 34). http://www.state.nj.us/health/flu/documents/stats08/flummwr_34.pdf. Retrieved 2009-09-23. 
  64. ^ "H1N1 Flu Hospitalizations and Deaths in NJ". New Jersey DHSS. 2009-08-26. http://www.state.nj.us/health/flu/h1n1.shtml. Retrieved 2009-08-27. 
  65. ^ Two New H1N1-Related Deaths Reported | njtoday.net – Everything New Jersey
  66. ^ Flu in New Mexico - Influenza Information
  67. ^ New Mexico Analyzes Swine Flu | KDBC.com
  68. ^ NM Department of Health Seasonal & H1N1Flu Information
  69. ^ "H1N1 Flu (Swine Flu)". New York State - Department of Health. 2009-06-19. http://www.health.state.ny.us/diseases/communicable/influenza/h1n1/. Retrieved 2009-06-19. 
  70. ^ "Health Alert #27". New York City DHMH. 2009-07-08. http://www.nyc.gov/html/doh/downloads/pdf/cd/2009/09md27.pdf. Retrieved 2009-09-02. 
  71. ^ a b Update each Wednesday "NCPH: Influenza in N.C.". North Carolina - Public Health. 2009-07-29. http://www.epi.state.nc.us/epi/gcdc/flu.html. Retrieved 2009-07-30. 
  72. ^ North Carolina Influenza Sentinel Surveillance Program
  73. ^ a b ND Flu
  74. ^ Few flu cases reported this year
  75. ^ "Swine flu". Ohio - Department of Health. 2009-07-30. http://www.odh.ohio.gov/ASSETS/4FF646242E8142DFAB49FAEF13925F76/h1n1cases.pdf. Retrieved 2009-07-30. 
  76. ^ Daily Standard Stories
  77. ^ a b updated on Mondays and Thursdays "Novel Influenza A H1N1 (Swine Flu) Daily Updates & Alerts". Oklahoma - State Department of Health. 2009-07-29. http://www.ok.gov/health/2009_H1N1_Flu_Updates_and_Alerts.html. 
  78. ^ Swine flu death is 44th in Oklahoma | Tulsa World
  79. ^ a b Update each Friday "H1N1 Influenza Update". Oregon - Department of Human Services. 2009-07-24. http://www.oregon.gov/DHS/ph/acd/swineflu_investigation.shtml. Retrieved 2009-07-30. 
  80. ^ http://www.flu.oregon.gov/articles/Pages/FluStats.aspx
  81. ^ a b H1N1 in PA › PA Situation Update
  82. ^ "Rhode Island Department of Health Swine Flu". Rhode Island - Department of Health. 2009-07-30. http://www.health.ri.gov/pandemicflu/swineflu/swineflu.php. Retrieved 2009-06-17. 
  83. ^ http://www.health.ri.gov/pandemicflu/swineflu/dailybriefing.php
  84. ^ Third swine flu death reported in RI | Turn to 10
  85. ^ RI sees 10th H1N1 death; vaccine to be offered broadly - Projo 7 to 7 News Blog | Rhode Island news | The Providence Journal
  86. ^ "South Carolina Influenza Activity and Surveillance: 2008-2009 Season". South Carolina - Department of Health and Environmental Control. 2009-06-13. http://www.scdhec.gov/health/disease/acute/docs/200947SCFluWatch.pdf. Retrieved 2009-06-19. 
  87. ^ http://www.scdhec.gov/health/disease/acute/docs/201031SCFluWatch_a.pdf
  88. ^ a b c "South Dakota (A)H1N1 Surveillance". South Dakota - Department of Health. 2009-05-28. http://doh.sd.gov/H1N1/Surveillance.aspx. Retrieved 2009-06-05. 
  89. ^ "Sentinel Provider Influenza-Like Illness (ILI) Surveillance Summary". Tennessee - Department of Health. 2009-11-21. http://health.state.tn.us/Downloads/week50ILI_spnreport_2009.pdf. Retrieved 2009-11-27. 
  90. ^ ttp://www.volunteertv.com/home/headlines/83837562.html
  91. ^ Update each Wednesday "Surveillance". Texas - Department of State Health Services. http://www.dshs.state.tx.us/idcu/disease/influenza/surveillance/2010/. Retrieved 2009-10-24. 
  92. ^ http://www.dshs.state.tx.us/txflu/TX-cumulative-age.pdf
  93. ^ Texas Department of State Health Services, Infectious Disease Control Unit > Surveillance
  94. ^ "Utah Pandemic A (H1N1) 2009 Hospitalized Case Surveillance". Utah - Department of Health. 2009-07-29. http://health.utah.gov/epi/h1n1flu/UT_update.html. Retrieved 2009-07-31. 
  95. ^ http://www.sltrib.com/news/ci_14686756?source=rss
  96. ^ a b "Novel H1N1 Flu (Swine Flu): Status Update". Vermont - Department of Health. 2009-06-24. http://healthvermont.gov/prevent/flu/flusurveillance.aspx#sentinel. Retrieved 2009-06-26. 
  97. ^ Vt. Reports Third Swine Flu Death - WCAX.COM Local Vermont News, Weather and Sports
  98. ^ "Confirmed Influenza A (H1N1) Case Counts". Virginia - Department of Health. 2009-07-10. http://www.vdh.state.va.us/news/Alerts/SwineFlu/ConfirmedCases.htm. Retrieved 2009-07-11. 
  99. ^ http://www.vdh.virginia.gov/epidemiology/DiseasePrevention/H1N1/pdf/071010Tracking.pdf
  100. ^ "Swine flu (H1N1) monitoring changes in Washington". WSDOH. 2009-05-26. http://www.doh.wa.gov/Publicat/2009_news/09-093.htm. Retrieved 2009-06-25. 
  101. ^ "Swine Flu Information". Washington - Department of Health and Human Resources. 2009-10-16. http://www.doh.wa.gov/h1n1/h1n1_newsroom.htm. Retrieved 2009-10-20. 
  102. ^ http://www.doh.wa.gov/h1n1/h1n1_newsroom.htm
  103. ^ Updated each Wednesday "Influenza Surveillance Data 2008-2009". West Virginia - Department of Health and Human Resources. 6/18/2009 12:45 PM ET. http://www.wvidep.org/AZIndexofInfectiousDiseases/Influenza/InfluenzaSeason0809/tabid/1747/Default.aspx. Retrieved 2009-06-18. 
  104. ^ The Record Delta Woman with H1N1 dies
  105. ^ Archived Influenza Season Data 2009-10
  106. ^ a b c "Current H1N1 Situation in Wisconsin". Wisconsin - Department of Health Services. 2009-07-29. http://pandemic.wisconsin.gov/category.asp?linkcatid=3191&linkid=1567&locid=106. Retrieved 2009-07-29. 
  107. ^ "Swine Influenza (Swine Flu)". Wyoming - Department of Health. 2009-08-05. http://wdh.state.wy.us/phsd/epiid/swineflu.html. 
  108. ^ More deaths as flu season continues in Wyoming
  109. ^ pandemic influenza A/H1N1 2009 surveillance
  110. ^ American Samoa News - Topix
  111. ^ pandemic influenza A/H1N1 2009 suveillance report as of 27 October 2009
  112. ^ Saipan Tribune
  113. ^ Saipan Tribune
  114. ^ :::** Diario La Verdad **:::
  115. ^ Noticias de Prensa Latina
  116. ^ a b AP National News Online Breaking News & Headlines from Associated Press - oregonlive.com
  117. ^ "Outbreak of Swine-Origin Influenza A (H1n1) Virus Infection". CDC. April 30, 2009. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm58d0430a2.htm. Retrieved June 11, 2009. 
  118. ^ Thomas H. Maugh II (March 19, 2010). "Swine flu danger appears to be ebbing". Los Angeles Times. http://articles.latimes.com/2010/mar/19/science/la-sci-swine-flu20-2010mar20. Retrieved March 20, 2010. 
  119. ^ "Swine Influenza A (H1N1) Infection in Two Children --- Southern California, March--April 2009". Morbidity and Mortality Weekly Report. Centers for Disease Control. 2009-04-24. pp. 400–402. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5815a5.htm. Retrieved 2009-10-04. 
  120. ^ "CDC Press Briefing Transcripts April 23, 2009". CDC. April 23, 2009. http://www.cdc.gov/media/transcripts/2009/t090423.htm. Retrieved June 11, 2009. 
  121. ^ "H1N1 Flu (Swine Flu)". H1N1 Flu. Centers for Disease Control and Prevention. 2009-05-06 (11:00 EDT). Archived from the original on 2009-09-10. http://www.cdc.gov/h1n1flu/. Retrieved 2009-05-06. 
  122. ^ a b "Template:2009 US swine flu otbreak table". Wikipedia. http://en.wikipedia.org/wiki/Template:2009_US_swine_flu_outbreak_table. Retrieved June 11, 2009. 
  123. ^ "1 Million Americans Likely Stricken by Swine Flu: CDC". Forbes. June 25, 2009. http://www.forbes.com/feeds/hscout/2009/06/25/hscout628467.html. Retrieved June 25, 2009. 
  124. ^ "US Swine Flu Cases May Have Hit 1 Million". Associated Press. June 25, 2009. http://www.google.com/hostednews/ap/article/ALeqM5hjdCHrP82YTFser5vD6CzTK1az6wD991UK9O1. Retrieved June 25, 2009. 
  125. ^ http://www.cdc.gov/h1n1flu/vaccination/vaccinesupply.htm
  126. ^ http://www.cdc.gov/H1N1flu/vaccination/statelocal/centralized_distribution_qa.htm
  127. ^ http://www.cdc.gov/media/transcripts/2009/t091112.htm
  128. ^ "Swine flu has killed 10,000 Americans since April". Reuters. 2009-12-10. http://www.reuters.com/article/idUSTRE5AO3Z420091210. 
  129. ^ http://www.msnbc.msn.com/id/34880176/ns/health-cold_and_flu
  130. ^ http://www.msnbc.msn.com/id/35367744/ns/health-cold_and_flu/
  131. ^ "Border Disease Program Helped Sound Alarm on Swine Flu". KPBS San Diego. http://www.kpbs.org/news/2009/may/07/border-disease-program-helped-sound-alarm-swine-fl/. Retrieved 2010-09-02. 
  132. ^ "CDC Briefing on Public Health Investigation of Human Cases of Swine Influenza". CDC. 2009-04-23. http://www.cdc.gov/media/transcripts/2009/t090423.htm. Retrieved April 26, 2009. 
  133. ^ CDC (April 21, 2009). "Swine Influenza A (H1N1) Infection in Two Children --- Southern California, March--April 2009". Morbidity and Mortality Weekly Report. http://www.cdc.gov/mmWR/preview/mmwrhtml/mm5815a5.htm. Retrieved April 26, 2009. 
  134. ^ a b "Swine flu fatality in Texas likely infected in Mexico, official says". CNN. http://cnnwire.blogs.cnn.com/2009/04/29/swine-flu-fatality-in-texas-likely-infected-in-mexico-official-says/. 
  135. ^ a b "Queens School At Flu Epicenter Reopens". CBS News. May 4, 2009. http://www.cbsnews.com/stories/2009/05/04/health/main4988673.shtml. Retrieved 2009-05-08. 
  136. ^ "Flu spreads across U.S., officials weigh measures | Top News | Reuters". Uk.reuters.com. 2009-02-09. http://uk.reuters.com/article/topNews/idUKTRE5435R220090504. Retrieved 2009-05-05. 
  137. ^ a b "CDC H1N1 Flu". Cdc.gov. Archived from the original on 2009-09-10. http://www.cdc.gov/h1n1flu/. Retrieved 2009-05-06. 
  138. ^ Christopher Sherman. "The Associated Press: Texas confirms first flu death of US resident". Google.com. http://www.google.com/hostednews/ap/article/ALeqM5hNkUqwzLRY-8nSc_6e5AM0Vf2FIgD9809L7G0. Retrieved 2009-05-05. 
  139. ^ Harris, Gardiner; Malkin, Elisabeth (2009-05-05). "Health Officials Begin to Ease Public Alerts About Swine Flu". The New York Times. http://www.nytimes.com/2009/05/05/health/05flu.html?_r=1&ref=americas. 
  140. ^ Bowman, Michael (2008-07-15). "US Officials 'Cautiously Optimistic' About Swine Flu Spread". VOA News. http://www.voanews.com/english/2009-05-04-voa59.cfm. Retrieved 2009-05-05. 
  141. ^ "2008-2009 Influenza Season Week 18 ending May 9, 2009". FluView: A Weekly Influenza Surveillance Report Prepared by the Influenza Division (Centers for Disease Control and Prevention). 2009-05-15. http://www.cdc.gov/flu/weekly/. Retrieved 2009-05-17. 
  142. ^ David Brown (April 22, 2009). "New Strain of Swine Flu Investigated: Two Children in San Diego Area Had No Contact with Pigs". The Washington Post. http://www.washingtonpost.com/wp-dyn/content/article/2009/04/21/AR2009042103694.html. Retrieved April 24, 2009. 
  143. ^ CHRISTOPHER SHERMAN (May 6, 2009). "Texas woman with flu who died beloved teacher". Dallas Morning News/Associated Press. http://www.dallasnews.com/sharedcontent/APStories/stories/D9811NI00.html. Retrieved May 6, 2009. 
  144. ^ a b "CDC H1N1 Flu | Situation Update". Archived from the original on 2009-09-10. http://www.cdc.gov/h1n1flu/update.htm. Retrieved 2009-08-26. 
  145. ^ Donald G. McNeil Jr. (2009-10-02). "Swine Flu Spread Prompts Move on Vaccine". The New York Times. 
  146. ^ Denise Grady (2009-10-17). "Three Pigs May be the First in the U.S. With Swine Flu". The New York Times. 
  147. ^ "Official warns 'third wave' of H1N1 on the way". Sioux City Journal News. 2008-12-15. http://www.siouxcityjournal.com/news/local/article_a3f8bc1e-7237-58ee-9b46-e1bc6e79579a.html. Retrieved 2009-12-25. 
  148. ^ "CDC Press Briefing Transcripts". CDC. January 23, 2009. http://www.cdc.gov/media/transcripts/2009/t090424.htm. Retrieved April 25, 2009. 
  149. ^ Laura Kennedy (April 25, 2009). "Swine Flu Spreading In The U.S.". WDIO-TV. http://www.wdio.com/article/stories/S899045.shtml?cat=10335. Retrieved April 26, 2009. 
  150. ^ "Flu death toll in Mexico could be lower than first thought". National Post, Canada. http://www.nationalpost.com/news/story.html?id=1547114. Retrieved 2009-04-29. 
  151. ^ "Seasonal flu killing much more than swine flu". CTV, Canada. http://www.ctv.ca/servlet/ArticleNews/story/CTVNews/20090429/WHO_panic_090429/20090429?hub=Health. Retrieved 2009-04-29. 
  152. ^ "Regular flu has killed thousands since January". CNN. 28 April 2009. http://www.cnn.com/2009/HEALTH/04/28/regular.flu/?iref=mpstoryview. 
  153. ^ "2009 H1N1 Flu U.S. Situation Update". CDC. 2009-11-13. http://www.cdc.gov/h1n1flu/updates/us/. Retrieved 2009-11-19. 
  154. ^ a b HHS, CDC, NCHS, NVSS (2009-04-17). "Table 10. Number of deaths from 113 selected causes and Enterocolitis due to Clostridium difficile, by age: United States,2006—Con.". National Vital Statistics Reports: Deaths: Final Data for 2006. CDC. http://www.cdc.gov/nchs/data/nvsr/nvsr57/nvsr57_14.pdf. Retrieved 2009-11-19. 
  155. ^ Boyd, Mark, et. al. (2006-11-20). "Pandemic influenza: clinical issues". Medical Journal of Australia 185 (10 Suppl): S44–7. PMID 17115951. http://www.mja.com.au/public/issues/185_10_201106/boy10858_fm.html. Retrieved 2009-11-22. 
  156. ^ "Federal Response Stages". U.S. Government. http://www.pandemicflu.gov/plan/federal/fedresponsestages.html. Retrieved April 26, 2009. 
  157. ^ "Swine Flu Investigation". U.S. Government. http://www.pandemicflu.gov/. Retrieved April 26, 2009. 
  158. ^ Staff Writer (April 27, 2009). "Mexico suspected flu toll soars". BBC. http://news.bbc.co.uk/2/hi/americas/8021656.stm. Retrieved April 27, 2009. 
  159. ^ "WHO raises pandemic alert level". BBC. April 29, 2009. http://news.bbc.co.uk/2/hi/americas/8025931.stm. Retrieved April 29, 2009. 
  160. ^ "Press Briefing on Swine Influenza". Department of Homeland Security. April 26, 2009. http://www.dhs.gov/ynews/releases/pr_1240773850207.shtm. Retrieved May 2, 2009. 
  161. ^ Dr Margaret Chan (June 11, 2009). "World now at the start of 2009 influenza pandemic". World Health Organization. http://www.who.int/mediacentre/news/statements/2009/h1n1_pandemic_phase6_20090611/en/index.html. Retrieved 2009-06-11. 
  162. ^ Staff Writer (2009-04-24). "White House closely following U.S. swine flu outbreak". Reuters. http://www.reuters.com/article/newsOne/idUSTRE53N44P20090424. Retrieved April 26, 2009. 
  163. ^ Mark Silva (April 27, 2009). "Obama says he has his eye on swine flu threat". Los Angeles Times. http://www.latimes.com/news/nationworld/nation/la-na-obama-science28-2009apr28,0,6958464.story. Retrieved April 27, 2009. 
  164. ^ "The President’s Remarks on H1N1". White House. 2009-04-30. http://www.whitehouse.gov/blog/09/04/30/The-Presidents-Remarks-on-H1N1/. Retrieved 2009-05-02. 
  165. ^ a b "As flu hits, holes in W.H. health team – Carrie Budoff Brown". Politico.Com. http://www.politico.com/news/stories/0409/21719.html. Retrieved 2009-04-28. 
  166. ^ "Office of the Surgeon General (OSG)". Surgeongeneral.gov. http://www.surgeongeneral.gov/. Retrieved 2009-04-28. 
  167. ^ a b 5 days ago. "The Associated Press: White House aide's family likely has swine flu". Google.com. http://www.google.com/hostednews/ap/article/ALeqM5hxNSbTBv3oDBbiqGXWiQvAK-0nkQD97SUKBO0. Retrieved 2009-05-05. 
  168. ^ Sebelius wins panel approval as health secretary
  169. ^ Goldstein, David; Klepper, David (2009-04-28). "Sebelius sworn in to Cabinet, Parkinson becomes Kansas governor". The Kansas City Star. http://www.kansascity.com/105/story/1168432.html. Retrieved 2009-04-29. 
  170. ^ "Obama declares swine flu a national emergency". Reuters. 24 October 2009. http://www.reuters.com/article/topNews/idUSTRE59N19E20091024. 
  171. ^ CDC Responds to Swine Flu Outbreak Among Humans, US Centers for Disease Control and Prevention, April 27, 2009. Retrieved 2009-05-02.
  172. ^ "Interim Guidance on Specimen Collection, Processing, and Testing for Patients with Suspected Swine-Origin Influenza A (H1N1) Virus Infection". Centers for Disease Control and Prevention. April 30, 2009. http://www.cdc.gov/h1n1flu/specimencollection.htm. Retrieved April 30, 2009. 
  173. ^ "CDC Briefing on Public Health Investigation of Human Cases of Swine Influenza". CDC. 2009-04-30. http://www.cdc.gov/media/transcripts/2009/t090430.htm. Retrieved 2009-05-01. 
  174. ^ "CDC Press Briefing Transcripts May 6, 2009". Cdc.gov. 2009-05-06. http://www.cdc.gov/media/transcripts/2009/t090506.htm. Retrieved 2009-05-19. 
  175. ^ "Flu Activity & Surveillance". Centers for Disease Control and Prevention. April 17, 2009. http://www.cdc.gov/flu/weekly/fluactivity.htm. Retrieved April 26, 2009. 
  176. ^ a b Stein, Rob (2007-01-15). "Schools Shut by Flu Can Reopen". The Washington Post. http://www.washingtonpost.com/wp-dyn/content/article/2009/05/05/AR2009050500719.html. Retrieved 2009-05-06. 
  177. ^ a b c "CDC H1N1 Flu | Update on School (K – 12) Dismissal and Childcare Facilities". Cdc.gov. http://www.cdc.gov/h1n1flu/K12_dismissal.htm. Retrieved 2009-05-06. 
  178. ^ "FDA Authorizes Emergency Use of Influenza Medicines, Diagnostic Test in Response to Swine Flu Outbreak in Humans". Fda.gov. 2009-04-27. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm149571.htm. Retrieved 2009-07-31. 
  179. ^ "2009 H1N1 (Swine) flu virus". Food and Drug Administration. 2009-05-12. http://www.fda.gov/NewsEvents/PublicHealthFocus/ucm150305.htm. Retrieved 2009-07-31. 
  180. ^ "Welcome to AJC!". ajc.com. 2009-05-06. http://www.ajc.com/health/content/shared-auto/healthnews/cdc-/626829.html. Retrieved 2009-05-19. 
  181. ^ "FDA, FTC Warn Public of Fraudulent 2009 H1N1 Influenza Products". Food and Drug Administration. 2009-05-01. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm149576.htm. Retrieved 2009-07-31. 
  182. ^ "DHS: Testimony by Secretary Napolitano to the Senate Committee on Homeland Security and Governmental Affairs on Federal Coordination in Response to the H1N1 Flu Outbreak". Dhs.gov. 2009-04-29. http://www.dhs.gov/ynews/testimony/testimony_1241017177339.shtm. Retrieved 2009-05-05. 
  183. ^ "Threats of Increased Violence in Ciudad Juarez during the weekend of May 23–25, 2008". Mexico.usembassy.gov. http://mexico.usembassy.gov/eng/eacs_warden_090425update_FluOutbreak.html. Retrieved 2009-05-08. 
  184. ^ "Travel Alert – 2009-H1N1 Influenza". Travel.state.gov. http://www.travel.state.gov/travel/cis_pa_tw/pa/pa_3028.html. Retrieved 2009-05-08. 
  185. ^ "Release No. 0131.09". Usda.gov. http://www.usda.gov/wps/portal/?contentidonly=true&contentid=2009/04/0131.xml. Retrieved 2009-05-08. 
  186. ^ ksullivan (2009-05-01). "Department of Commerce – Press Releases, Fact Sheets and Opinion Editorials – Commerce Secretary Gary Locke Urges China, Russia to End Ban on U.S. Pork". Commerce.gov. http://www.commerce.gov/NewsRoom/PressReleases_FactSheets/PROD01_007941. Retrieved 2009-05-08. 
  187. ^ "DefenseLink News Article: Military Monitors H1N1 Flu With Focus on Protecting Force". Defenselink.mil. http://www.defenselink.mil/news/newsarticle.aspx?id=54088. Retrieved 2009-05-08. 
  188. ^ "DoD Pandemic Influenza Watchboard – U.S. DoD Official Website". Fhp.osd.mil. http://fhp.osd.mil/aiWatchboard/. Retrieved 2009-05-19. 
  189. ^ "Additional Flu Resources for School Leaders Seeking Guidance – ED.gov Blog". Edgovblogs.org. 2009-04-29. http://www.edgovblogs.org/duncan/2009/04/additional-flu-resources-for-school-leaders-seeking-guidance/. Retrieved 2009-05-08. 
  190. ^ "US closes 300 schools amid swine flu scare". AFP. April 30, 2009. http://www.google.com/hostednews/afp/article/ALeqM5iVi40liSCcy6QuawOiik3az8ceiA. Retrieved April 30, 2009. 
  191. ^ "Swine Flu Sickens 1, 490 as Answers Sought in South (Update4)". Bloomberg.com. 2005-05-30. http://www.bloomberg.com/apps/news?pid=20601080&sid=aGmubXeIXSqI&refer=asia. Retrieved 2009-05-05. 
  192. ^ Stein, Rob (2009-09-27). "Swine Flu Surge Closes Schools, Tests Hospitals - washingtonpost.com". The Washington Post. Archived from the original on 2009-09-30. http://www.washingtonpost.com/wp-dyn/content/article/2009/09/26/AR2009092601254.html?hpid=topnews. Retrieved 2009-09-28. 
  193. ^ "CDC Press Briefing Transcripts May 5, 2009". Centers for Disease Control. 2009-05-05. http://www.cdc.gov/h1n1flu/press/. Retrieved 2009-05-05. 
  194. ^ Miles, Kent A. (2009-04-27). "Airlines waiving change fees amid swine flu scare". ajc.com. http://www.ajc.com/business/content/business/delta/stories/2009/04/27/airline_fees_flu.html. Retrieved 2009-05-05. 
  195. ^ Allen, Mike (2009-04-05). "San Diego Business Journal Online – business news for San Diego, California". Sdbj.com. http://www.sdbj.com/industry_article.asp?aID=47999878.5516779.1777724.4325329.569692.256&aID2=136739. Retrieved 2009-05-05. 

External links

U.S. federal government

International organizations

Other websites

New York City

Location
Africa
Algeria  · Benin · Egypt · Ethiopia  · Ghana  · Kenya  · Libya  · Morocco · Namibia · Nigeria · South Africa · Tunisia · Zambia
Asia
Europe
North America
Aruba · Belize · Canada · Costa Rica · Cuba · Dominican Republic · Guatemala · Honduras · Jamaica · Mexico · Panama · Trinidad and Tobago · United States (by state)
South America
Oceania
Related
General topics
Influenza viruses
Influenza A virus
subtypes
H1N1 - H1N2 - H2N2 - H2N3 - H3N1 - H3N2 - H3N8 - H5N1 - H5N2 - H5N3 - H5N8 - H5N9 - H7N1 - H7N2 - H7N3 - H7N4 - H7N7 - H9N2 - H10N7
H1N1
       Pandemics
1918 flu pandemic (Spanish flu) - 2009 flu pandemic (Swine flu)
Science
H5N1
        Outbreaks
Science
Treatments
Antiviral drug
Flu vaccines
Influenza epidemics
and pandemics
       Pandemics
Epidemics
Russian flu (1977–1978) - Fujian flu (H3N2)
Non-human
Mammals
Non-mammals
Related

M: VIR

virs(prot)/clss

cutn/syst (hppv/hiva, infl/zost/zoon)/epon

drugJ(dnaa, rnaa, rtva, vacc)