
2009 flu pandemic timeline
Encyclopedia

H1N1
'Influenza A virus is a subtype of influenza A virus and was the most common cause of human influenza in 2009. Some strains of H1N1 are endemic in humans and cause a small fraction of all influenza-like illness and a small fraction of all seasonal influenza. H1N1 strains caused a few percent of...
) pandemic. Flag icons denote the first announcements of confirmed cases by the respective nation-states, their first deaths (and other major events such as their first intergenerational cases, cases of zoonosis
Zoonosis
A zoonosis or zoonoseis any infectious disease that can be transmitted from non-human animals to humans or from humans to non-human animals . In a study of 1415 pathogens known to affect humans, 61% were zoonotic...
, and the start of national vaccination campaigns), and relevant sessions and announcements of the World Health Organization
World Health Organization
The World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health. Established on 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health...
(WHO), the European Union
European Union
The European Union is an economic and political union of 27 independent member states which are located primarily in Europe. The EU traces its origins from the European Coal and Steel Community and the European Economic Community , formed by six countries in 1958...
(and its agency the European Centre for Disease Prevention and Control
European Centre for Disease Prevention and Control
The European Centre for Disease Prevention and Control is an independent agency of the European Union aimed at strengthening Europe's defences against infectious diseases. It was established in 2005 and is located in Solna, Sweden....
),
and the U.S. Centers for Disease Control
Centers for Disease Control and Prevention
The Centers for Disease Control and Prevention are a United States federal agency under the Department of Health and Human Services headquartered in Druid Hills, unincorporated DeKalb County, Georgia, in Greater Atlanta...
(CDC).
Unless otherwise noted, references to terms like S-OIV, H1N1 and such, all refer to this new A(H1N1) strain and not to sundry other strains of H1N1 which are endemic in humans, birds and pigs.
Timeline
Take note that the date of the first confirmations of the disease or any event in a country may be before or after the date of the events in local time because of the International Dateline
March 2009

In La Gloria, Veracruz
La Gloria, Veracruz
La Gloria is a town in the municipality of Perote in the Mexican state of Veracruz. As of the 2005 population survey, it had a population of 2,243 ....
60% of the town's population is sickened by a respiratory illness of unknown provenance. The government of Mexico believes it to be caused by h3n2
H3N2
Influenza A virus subtype H3N2 is a subtype of viruses that cause influenza . H3N2 Viruses can infect birds and mammals. In birds, humans, and pigs, the virus has mutated into many strains...
influenza, though at least one patient in La Gloria tested positive for A/H1N1. Two babies died in the outbreak but both were buried without testing.
March 7

March 14

March 17

Earliest known onset of a case that is later to be confirmed as Swine-Origin Influenza A (H1N1) Virus Infection.
March 21

March 28


Earliest known onset of a USA case later confirmed as swine flu, that of a nine-year-old girl residing in Imperial County, California
Imperial County, California
Imperial County is a county located in the Imperial Valley, in the far southeast of the U.S. state of California, bordering both Arizona and Mexico. It is part of the El Centro Metropolitan Area, which encompasses all of Imperial County. The population as of 2000 was 142,361. The county seat is the...
. Thirteen states reported widespread influenza activity and 19 reported regional activity on the CDC's FluView, Week 12.
March 30

A sample is collected from a nine-year-old female patient which is later confirmed to contain the novel virus strain (genetically sequenced as A/California/05/2009(H1N1)).

Onset of illness for a ten-year-old boy residing in San Diego County, California
San Diego County, California
San Diego County is a large county located in the southwestern corner of the US state of California. Hence, San Diego County is also located in the southwestern corner of the 48 contiguous United States. Its county seat and largest city is San Diego. Its population was about 2,813,835 in the 2000...
; his case is eventually the first to be confirmed as swine flu in the USA .
April 1

A nasopharyngeal
Nasopharynx
The nasopharynx is the uppermost part of the pharynx. It extends from the base of the skull to the upper surface of the soft palate; it differs from the oral and laryngeal parts of the pharynx in that its cavity always remains patent .-Lateral:On its lateral wall is the pharyngeal ostium of the...
swab is collected from a ten-year-old male patient in San Diego County, later confirmed as containing the novel virus and the first organism of that strain to be completely sequenced
Genetic sequencing
Genetic Sequencing may refer to:* DNA sequencing* Full genome sequencing...
(A/California/04/2009(H1N1)).
April 2

In La Gloria, Veracruz
La Gloria, Veracruz
La Gloria is a town in the municipality of Perote in the Mexican state of Veracruz. As of the 2005 population survey, it had a population of 2,243 ....
, a four-year-old boy falls ill at the end of the outbreak. Only his sample, which was eventually sent abroad, tested positive for A(H1N1). Veracruz officials state that there were no plans to exhume the bodies of two infants who died in the outbreak.
April 4

April 5

The media monitoring website MedISys reports on a Mexican article about the epidemiological alert.
April 6

Public health authorities begin investigating unusual cases of pneumonia
Pneumonia
Pneumonia is an inflammatory condition of the lung—especially affecting the microscopic air sacs —associated with fever, chest symptoms, and a lack of air space on a chest X-ray. Pneumonia is typically caused by an infection but there are a number of other causes...
. 400 people had reportedly sought treatment for pneumonia/influenza-like illness
Influenza-like illness
Influenza-like illness , also known as acute respiratory infection and flu-like syndrome, is a medical diagnosis of possible influenza or other illness causing a set of common symptoms, with SARI referring to Severe Acute Respiratory Infection.Symptoms commonly include fever, shivering, chills,...
(ILI) in La Gloria the preceding week.

Biosurveillance firm Veratect reports the unusual respiratory illness in Mexico. Veratect publishes the alert "La Gloria: 'Strange' Respiratory Affects 60% of Local Population; Three Pediatric Deaths May be Associated with the Outbreak."
April 11

April 12

The General Directorate of Epidemiology (DGE) reports the outbreak of an ILI in a small community in Veracruz to the Pan American Health Organization
Pan American Health Organization
The Pan American Health Organization is an international public health agency with over 100 years of experience working to improve health and living standards of the people of the Americas...
(PAHO), which is the Regional Office of the World Health Organization
World Health Organization
The World Health Organization is a specialized agency of the United Nations that acts as a coordinating authority on international public health. Established on 7 April 1948, with headquarters in Geneva, Switzerland, the agency inherited the mandate and resources of its predecessor, the Health...
(WHO). Furthermore, a 39-year-old woman dies of severe viral pneumonia
Viral pneumonia
Viral pneumonia is a pneumonia caused by a virus.Viruses are one of the two major causes of pneumonia, the other being bacteria; less common causes are fungi and parasites...
in the city of San Luis Potosí
San Luis Potosí, San Luis Potosí
San Luis Potosí, commonly called SLP or simply San Luis, is the capital of, and most populous city in the Mexican state of the same name. The city lies at an elevation of 1,850 meters...
; this is later believed to be the earliest known fatality related to the outbreak.
April 13

First death in Oaxaca
Oaxaca
Oaxaca , , officially Estado Libre y Soberano de Oaxaca is one of the 31 states which, along with the Federal District, comprise the 32 federative entities of Mexico. It is divided into 571 municipalities; of which 418 are governed by the system of customs and traditions...
due to what would later be identified as swine flu.

The U.S. Centers for Disease Control
Centers for Disease Control and Prevention
The Centers for Disease Control and Prevention are a United States federal agency under the Department of Health and Human Services headquartered in Druid Hills, unincorporated DeKalb County, Georgia, in Greater Atlanta...
(CDC) is advised of a ten-year-old boy with a respiratory illness in San Diego County, California. Test results revealed an Influenza A virus but were negative for standard human strains. The San Diego County Health Department is notified.
April 14

The CDC receives its first sample from California (from the ten-year-old boy in San Diego County), and identifies the virus as a strain of swine influenza A(H1N1).
April 16

Authorities notify the PAHO of the atypical pneumonia
Atypical pneumonia
Atypical pneumonia aka "walking pneumonia" is a pneumonia not caused by one of the more traditional pathogens, and with a clinical presentation inconsistent with typical pneumonia. It can be caused by a variety of microorganisms...
.

Veratect publishes the alert "Atypical Pneumonia Cases Reported at Hospital" regarding the Oaxaca cases.
April 17

A case of atypical pneumonia in Oaxaca prompts enhanced national surveillance. A field investigation is started.
Mexico contacts Canada to request more specialized testing.

The CDC receives a second sample from Southern California (taken from the nine-year-old girl in Imperial County), and again identifies the virus as a strain of swine influenza A(H1N1). The California Department of Public Health
California Department of Public Health
The California Department of Public Health is the state department responsible for public health in California. It is a subdivision of the California Health and Human Services Agency...
is notified.
April 18

Mexico sends 14 mucus samples to the CDC and dispatches health teams hospitals to look for patients showing severe influenza- or pneumonia-like symptoms.

April 20

Veratect advises the CDC of the Mexican events.
The CDC is already investigating the California and Texas
Texas
Texas is the second largest U.S. state by both area and population, and the largest state by area in the contiguous United States.The name, based on the Caddo word "Tejas" meaning "friends" or "allies", was applied by the Spanish to the Caddo themselves and to the region of their settlement in...
cases.
April 21

The CDC alerts physicians to a similar novel strain of swine influenza A(H1N1) in two cases from Southern California in an Morbidity and Mortality Weekly Report
Morbidity and Mortality Weekly Report
The Morbidity and Mortality Weekly Report is a weekly epidemiological digest for the United States published by the Centers for Disease Control and Prevention...
Early Release on its website. Local investigations, including investigations in Texas, are already underway, and overall surveillance is enhanced. The Associated Press
Associated Press
The Associated Press is an American news agency. The AP is a cooperative owned by its contributing newspapers, radio and television stations in the United States, which both contribute stories to the AP and use material written by its staff journalists...
covers the alert, the first mention of the A(H1N1) outbreak in English-language news media.
April 22

Canada receives the samples from Mexico for testing.
April 23

The Public Health Agency of Canada
Public Health Agency of Canada
The Public Health Agency of Canada is an agency of the Government of Canada that is responsible for public health, emergency preparedness, and response and infectious and chronic disease control and prevention...
confirms Mexico cases of swine-origin influenza A (H1N1) virus (S-OIV) infection.
Genetic sequence analysis reveals that the Mexican patients were infected with the same S-OIV strain detected in two California children.
The PAHO is informed that a cluster in Mexico of severe respiratory illnesses has been laboratory-confirmed as S-OIV infection.
April 24


The Minister of Health confirms the Mexican cases of human infection by swine influenza and states that it believes that some of these cases had resulted in death.
Health authorities implement public health measures for all airport passengers and the vaccination of health care workers with seasonal
Flu season
Flu season is a annually-recurring time period characterized by the prevalence of outbreaks of influenza . The season occurs during the cold half of the year in each hemisphere. Influenza activity can sometimes be predicted and even tracked geographically...
influenza vaccine.

The CDC tells a press conference that seven of the 14 Mexican samples contained the same virus strain as the known in California and Texas, and that indications suggested that containment in the USA was "not very likely".
The novel strain had already been reported on the CDC's Morbidity and Mortality Weekly Report
Morbidity and Mortality Weekly Report
The Morbidity and Mortality Weekly Report is a weekly epidemiological digest for the United States published by the Centers for Disease Control and Prevention...
website.
April 25

International Health Regulations
The International Health Regulations 2005 are legally binding regulations that aim to a) assist countries to work together to save lives and livelihoods endangered by the spread of diseases and other health risks, and b) avoid unnecessary interference with international trade and travel.The...
(IHR), the newly convened Emergency Committee meets for the first time, resulting in the WHO Director-General declaring a formal "public health emergency of international concern".

Vaccination Week In The Americas
Vaccination Week In The Americas is an annual effort by the member countries of the Pan American Health Organization to vaccinate millions of people in the region. It was first held in 2003, and was prompted by a measles outbreak in Venezuela and Colombia and proposed as an annual event by the...
starts.
The 2009 Week was planned to emphasize the vaccination of entire families, and health worker immunization
Immunization
Immunization, or immunisation, is the process by which an individual's immune system becomes fortified against an agent ....
.

Texas
Texas is the second largest U.S. state by both area and population, and the largest state by area in the contiguous United States.The name, based on the Caddo word "Tejas" meaning "friends" or "allies", was applied by the Spanish to the Caddo themselves and to the region of their settlement in...
.
April 27



First six cases confirmed, four in Nova Scotia and two in British Columbia.


First confirmed case of swine flu, in Almansa
Almansa
Almansa is a Spanish town and municipality in the province of Albacete, part of the autonomous community of Castile-La Mancha. The municipality borders with Alicante, Valencia and Murcia...
, and thus the first case in Europe; A(H1N1) has spread from the WHO Region of the Americas to the WHO European Region.
(

First two confirmed cases, in Scotland.
April 28


Confirmed: two cases and another four in Alberta
Alberta
Alberta is a province of Canada. It had an estimated population of 3.7 million in 2010 making it the most populous of Canada's three prairie provinces...
and Ontario
Ontario
Ontario is a province of Canada, located in east-central Canada. It is Canada's most populous province and second largest in total area. It is home to the nation's most populous city, Toronto, and the nation's capital, Ottawa....
, respectively.

First confirmed case in Israel and thus the WHO Eastern Mediterranean Region (color-coded yellow), the third region to be affected.

First three confirmed cases in New Zealand and thus the WHO Western Pacific Region (color-coded red), the fourth region to be affected.

The second confirmed case in Spain, in Valencia
Valencia (province)
Valencia or València is a province of Spain, in the central part of the Valencian Community.It is bordered by the provinces of Alicante, Albacete, Cuenca, Teruel, Castellón, and the Mediterranean Sea...
.
April 29

The Emergency Committee meets for the third time,
and the WHO raises its pandemic alert level from Phase 4 to Phase 5, its second highest. As of 1800 GMT, nine countries have officially reported 148 cases of swine influenza A(H1N1) infection.
ASEAN ASEAN officials are looking at coordinating measures to address the potential pandemic.

Benita Ferrero-Waldner
Dr. Benita Ferrero-Waldner is an Austrian diplomat and politician, and a member of the conservative Austrian People's Party . Ferrero-Waldner served as the Foreign Minister of Austria 2000–2004 and was the candidate of the Austrian People's Party in the Austrian presidential election, 2004, which...
announces that the halt of all travel to Mexico and disinfecting all airports due to the global flu outbreak is being considered.

First confirmed case.

First three confirmed cases, two in Bavaria
Bavaria
Bavaria, formally the Free State of Bavaria is a state of Germany, located in the southeast of Germany. With an area of , it is the largest state by area, forming almost 20% of the total land area of Germany...
and one in Hamburg
Hamburg
-History:The first historic name for the city was, according to Claudius Ptolemy's reports, Treva.But the city takes its modern name, Hamburg, from the first permanent building on the site, a castle whose construction was ordered by the Emperor Charlemagne in AD 808...
.

Eight more cases raises the total in Spain to 10, including the first human-to-human intergenerational transmission (in which the patient had not recently been to Mexico but was infected by another patient who had just visited Mexico, namely his girlfriend). This is the first intergenerational transmission to be documented in Europe.

First death outside Mexico, a 23-month old Mexican child hospitalized in Texas. Ninety-one confirmed cases in the USA to date.
April 30

Confirmed: One more case in Toronto
Toronto
Toronto is the provincial capital of Ontario and the largest city in Canada. It is located in Southern Ontario on the northwestern shore of Lake Ontario. A relatively modern city, Toronto's history dates back to the late-18th century, when its land was first purchased by the British monarchy from...
, and eight more cases in Nova Scotia
Nova Scotia
Nova Scotia is one of Canada's three Maritime provinces and is the most populous province in Atlantic Canada. The name of the province is Latin for "New Scotland," but "Nova Scotia" is the recognized, English-language name of the province. The provincial capital is Halifax. Nova Scotia is the...
, and Alberta
Alberta
Alberta is a province of Canada. It had an estimated population of 3.7 million in 2010 making it the most populous of Canada's three prairie provinces...
bringing total to 28.

First confirmed case.

First confirmed case, a three-year-old child. The child returned from Mexico to the Netherlands on April 27, 2009. The parents test negative for A(H1N1).

First confirmed case.

Four cases are confirmed in an outbreak at the University of Delaware
University of Delaware
The university is organized into seven colleges:* College of Agriculture and Natural Resources* College of Arts and Sciences* Alfred Lerner College of Business and Economics* College of Earth, Ocean and Environment* College of Education and Human Development...
; another 12 cases are deemed "probable". One of the confirmed cases is a baseball player, which results in the university cancelling sporting events, a concert by rapper Young Jeezy
Young Jeezy
Jay Wayne Jenkins , better known by his stage name Young Jeezy, is an American rapper. He is the member of the hip hop group United Streets Dopeboyz of America and a former member of BMF...
, and other school activities.
United Kingdom
Three further confirmed cases of swine flu, giving a total of eight confirmed cases.
May 1


51 confirmed cases.

- 300 people are placed under quarantine at a hotel for seven days due to Hong KongHong KongHong Kong is one of two Special Administrative Regions of the People's Republic of China , the other being Macau. A city-state situated on China's south coast and enclosed by the Pearl River Delta and South China Sea, it is renowned for its expansive skyline and deep natural harbour...
's first confirmed case there. - Chief Executive Donald TsangDonald TsangSir Donald Tsang Yam-kuen, GBM, KBE is the current Chief Executive and President of the Executive Council of the Government of Hong Kong....
raises Hong Kong's response level from "serious" to "emergency". - The Director of Health, Dr. PY Lam, orders Metropark Hotel in Wan ChaiWan ChaiWan Chai is a metropolitan area situated at the western part of the Wan Chai District on the northern shore of Hong Kong Island, in Hong Kong. Its other boundaries are Canal Road to the east, Arsenal Street to the west and Bowen Road to the south. The area north of Gloucester Road is often called...
to be isolated for seven days.

First confirmed case (in Hvidovre).

First two confirmed cases.

United Kingdom
First and second case of human to human (or intergenerational) transmission within the UK confirmed.

155 confirmed cases, including two at George Washington University's Thurston Hall.
May 2

Who
Who may refer to:* Who , an English-language pronoun* who , a Unix command* Who?, one of the Five Ws in journalism- Art and entertainment :* Who? , a 1958 novel by Algis Budrys...
As of 0600 GMT 15 countries have officially reported 615 cases of influenza A(H1N1) infection.

Canada
Canada is a North American country consisting of ten provinces and three territories. Located in the northern part of the continent, it extends from the Atlantic Ocean in the east to the Pacific Ocean in the west, and northward into the Arctic Ocean...
The Canadian Food Inspection Agency
Canadian Food Inspection Agency
The Canadian Food Inspection Agency is a science based regulatory agency that is dedicated to the safeguarding of food, animals, and plants, which enhance the health and well-being of Canada's people, environment and economy...
confirms the first human-to-animal transmission of the virus after an Albertan returns from Mexico and infects a pig farm, the first known case of (reverse) zoonosis
Zoonosis
A zoonosis or zoonoseis any infectious disease that can be transmitted from non-human animals to humans or from humans to non-human animals . In a study of 1415 pathogens known to affect humans, 61% were zoonotic...
.

China
Chinese civilization may refer to:* China for more general discussion of the country.* Chinese culture* Greater China, the transnational community of ethnic Chinese.* History of China* Sinosphere, the area historically affected by Chinese culture...
suspends flights from Mexico to Shanghai
Shanghai
Shanghai is the largest city by population in China and the largest city proper in the world. It is one of the four province-level municipalities in the People's Republic of China, with a total population of over 23 million as of 2010...
when a case is confirmed on a flight from Mexico
South Korea
South Korea
The Republic of Korea , , is a sovereign state in East Asia, located on the southern portion of the Korean Peninsula. It is neighbored by the People's Republic of China to the west, Japan to the east, North Korea to the north, and the East China Sea and Republic of China to the south...
First confirmed case.

United States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...
There are more than 430 school closures in 18 states. CDC FluView Week 17: Widespread activity in seven states, regional activity in 12.
May 3



101 confirmed cases after seven cases in British Columbia
British Columbia
British Columbia is the westernmost of Canada's provinces and is known for its natural beauty, as reflected in its Latin motto, Splendor sine occasu . Its name was chosen by Queen Victoria in 1858...
, three in Alberta
Alberta
Alberta is a province of Canada. It had an estimated population of 3.7 million in 2010 making it the most populous of Canada's three prairie provinces...
, two in Nova Scotia
Nova Scotia
Nova Scotia is one of Canada's three Maritime provinces and is the most populous province in Atlantic Canada. The name of the province is Latin for "New Scotland," but "Nova Scotia" is the recognized, English-language name of the province. The provincial capital is Halifax. Nova Scotia is the...
and Ontario
Ontario
Ontario is a province of Canada, located in east-central Canada. It is Canada's most populous province and second largest in total area. It is home to the nation's most populous city, Toronto, and the nation's capital, Ottawa....
, and one in Quebec
Quebec
Quebec or is a province in east-central Canada. It is the only Canadian province with a predominantly French-speaking population and the only one whose sole official language is French at the provincial level....
were confirmed.

First confirmed case in South America
South America
South America is a continent situated in the Western Hemisphere, mostly in the Southern Hemisphere, with a relatively small portion in the Northern Hemisphere. The continent is also considered a subcontinent of the Americas. It is bordered on the west by the Pacific Ocean and on the north and east...
.
May 4


Edmonton
Edmonton is the capital of the Canadian province of Alberta and is the province's second-largest city. Edmonton is located on the North Saskatchewan River and is the centre of the Edmonton Capital Region, which is surrounded by the central region of the province.The city and its census...
, Alberta
Alberta
Alberta is a province of Canada. It had an estimated population of 3.7 million in 2010 making it the most populous of Canada's three prairie provinces...
was diagnosed with a severe case of the H1N1 virus.
May 5

As of 06:00 GMT, 21 countries have officially reported 1,124 cases of influenza A (H1N1) infection.

- Second confirmed death, the first of a U.S. resident, a pregnant special education teacher in Texas: Judy Trunnell. The 33-year-old gives birth to her second child via Caesarian section during her eighth month of pregnancy, in a comaComaIn medicine, a coma is a state of unconsciousness, lasting more than 6 hours in which a person cannot be awakened, fails to respond normally to painful stimuli, light or sound, lacks a normal sleep-wake cycle and does not initiate voluntary actions. A person in a state of coma is described as...
whilst on life supportLife supportLife support, in medicine is a broad term that applies to any therapy used to sustain a patient's life while they are critically ill or injured. There are many therapies and techniques that may be used by clinicians to achieve the goal of sustaining life...
. Judy Trunnell had several underlying medical conditions, most notably asthmaAsthmaAsthma is the common chronic inflammatory disease of the airways characterized by variable and recurring symptoms, reversible airflow obstruction, and bronchospasm. Symptoms include wheezing, coughing, chest tightness, and shortness of breath...
.
- Several sailors in San Diego, California fall ill (including a sailor on the USS DubuqueUSS Dubuque (LPD-8)USS Dubuque , an Austin-class amphibious transport dock, is the second ship of the United States Navy to be named for the city of Dubuque, Iowa....
, which results in the cancellation of its deployment). These are the first cases in the U.S. Navy.
- As the low level of virulence of novel A(H1N1) in the U.S. becomes established, the CDC issues revised criteria for school closures, effectively ending widespread shutdowns.
May 6

As of 06:00 GMT, 22 countries have officially reported 1,516 cases of influenza A (H1N1) infection.
ASEAN A special regional summit to fight possible swine flu pandemic was held in Bangkok and was attended by senior ASEAN health officials along with those from China, Japan and South Korea.



May 7

As of 18:00 GMT, 24 countries have officially reported 2,371 cases of influenza A (H1N1) infection.

First confirmed case.


Reports suggest that an elderly woman who had swine flu has died in northern Alberta, marking the first death in Canada related to swine flu. Furthermore, an unusual case of zoonosis occurred when a swine flu inspector in improper gear caught the virus from an infected pig.

Second case confirmed, a 53-year-old woman who had recently travelled to Mexico.

The New England Journal of Medicine
New England Journal of Medicine
The New England Journal of Medicine is an English-language peer-reviewed medical journal published by the Massachusetts Medical Society. It describes itself as the oldest continuously published medical journal in the world.-History:...
establishes its H1N1 Influenza Center on its website.
May 8

As of 16:00 GMT, 25 countries have officially reported 2,500 cases of influenza A (H1N1) infection.


May 9

As of 06:00 GMT, 29 countries have officially reported 3,440 cases of influenza A(H1N1) infection.






May 10

As of 07:30 GMT, 29 countries have officially reported 4,379 cases of influenza A(H1N1) infection.

May 11

As of 06:00 GMT, 30 countries have officially reported 4,694 cases of influenza A(H1N1) infection.
May 12



May 13



May 14



May 15




May 16



Kobe
, pronounced , is the fifth-largest city in Japan and is the capital city of Hyōgo Prefecture on the southern side of the main island of Honshū, approximately west of Osaka...
, a male high school student with no history of travel abroad. The Kobe Festival, planned for May 16 and 17, is cancelled.




May 17


May 18

As of 06:00 GMT, 40 countries have officially reported 8,829 cases of influenza A(H1N1) infection, including 74 deaths.



May 19



Hyogo Prefecture
is a prefecture of Japan located in the Kansai region on Honshū island. The capital is Kobe.The prefecture's name was previously alternately spelled as Hiogo.- History :...
has the most at 111.



May 20



Shiga Prefecture
is a prefecture of Japan, which forms part of the Kansai region on Honshu Island. The capital is the city of Ōtsu.- History :Shiga was known as Ōmi Province or Gōshū before the prefectural system was established...
,
and the cities of Hachiōji
Hachioji, Tokyo
is a city located in Tokyo, Japan, about 40 kilometers west of the center of the special wards of Tokyo.As of January 1, 2010, the city has an estimated population of 551,901 and a population density of 2,962.27/km². The total area is 186.31 km². It is the eighth largest city in the...
and Kawasaki
Kawasaki, Kanagawa
is a city located in Kanagawa Prefecture, Japan, between Tokyo and Yokohama. It is the 9th most populated city in Japan and one of the main cities forming the Greater Tokyo Area and Keihin Industrial Area....
in the Greater Tokyo Area
Greater Tokyo Area
The Greater Tokyo Area is a large metropolitan area in Kantō region, Japan, consisting of most of the prefectures of Chiba, Kanagawa, Saitama, and Tokyo . In Japanese, it is referred to by various terms, including the , , and others....
. Two female high school students from Tokyo who had recently attended a Model United Nations
Model United Nations
Model United Nations is an academic simulation of the United Nations that aims to educate participants about current events, topics in international relations, diplomacy and the United Nations agenda....
conference in New York are presumed to have become infected abroad.

May 21


May 22


Saitama Prefecture
is a prefecture of Japan located in the Kantō region of the island of Honshu. The capital is the city of Saitama.This prefecture is part of the Greater Tokyo Area, and most of Saitama's cities can be described as suburbs of Tokyo, to which a large amount of residents commute each day.- History...
.
Third confirmed in Tokyo, a 25-year-old man who visited Osaka from May 14-20th.

May 23

Iceland First confirmed case. 4 more cases suspected.

May 24


May 25



May 26




May 27


Dominican Republic First two confirmed cases.



United Kingdom Two new cases confirmed. Total: 186

May 28





May 29

United Kingdom 14 confirmed cases. Total: 217




May 30


May 31
Dominican Republic Nine more cases confirmed, for a total of 11 cases nationwide.June 1


June 2




June 3


June 4



June 5



Dominican Republic First fatality, a 17-year-old pregnant girl. Total amount of confirmed cases rises to 44.

June 6


June 7



June 8



June 10




June 11





June 12



June 13



June 15

United Kingdom First death confirmed
June 17


June 19




June 22

June 24




June 27

June 29





June 30

July 2

New South Wales
New South Wales is a state of :Australia, located in the east of the country. It is bordered by Queensland, Victoria and South Australia to the north, south and west respectively. To the east, the state is bordered by the Tasman Sea, which forms part of the Pacific Ocean. New South Wales...
. National total: 10

July 4



July 11

July 12



July 13


July 14



July 16


July 17

July 18



male who also suffered from diabetes, hypertension and high cholesterol, from a heart attack caused by severe pneumonia.
July 19


July 20



July 21

Quebec
Quebec or is a province in east-central Canada. It is the only Canadian province with a predominantly French-speaking population and the only one whose sole official language is French at the provincial level....
, Canada
Canada
Canada is a North American country consisting of ten provinces and three territories. Located in the northern part of the continent, it extends from the Atlantic Ocean in the east to the Pacific Ocean in the west, and northward into the Arctic Ocean...
.


July 22

disease.

July 23


Hajj
The Hajj is the pilgrimage to Mecca, Saudi Arabia. It is one of the largest pilgrimages in the world, and is the fifth pillar of Islam, a religious duty that must be carried out at least once in their lifetime by every able-bodied Muslim who can afford to do so...
. New regulations were promulgated for the Hajj: anyone younger than 12 or older than 65 or who have "chronic health problems" shall not be allowed to undertake the pilgrimage to Mecca.


July 24


July 25


July 26

shut down after fifty Norwegian participants catch H1N1.

July 27


Robert Koch Institute
The Robert Koch Institute is the German federal institution responsible for disease control and prevention. It is located in Berlin and Wernigerode and is part of the Federal Ministry of Health.-History:...
, states there were 3,810 confirmed cases of H1N1 in the country; nearly all of the cases are mild.




July 28


Vertical transmission
Vertical transmission, also known as mother-to-child transmission, is the transmission of an infection or other disease from mother to child immediately before and after birth during the perinatal period. A pathogen's transmissibility refers to its capacity for vertical transmission...
of A(H1N1), a baby is born infected.
July 29



July 30



Brest, France
Brest is a city in the Finistère department in Brittany in northwestern France. Located in a sheltered position not far from the western tip of the Breton peninsula, and the western extremity of metropolitan France, Brest is an important harbour and the second French military port after Toulon...
.





July 31


Voyager of the Seas
MS Voyager of the Seas, is a Voyager-class cruise ship, completed in 1999, for Royal Caribbean International. She is the namesake of Voyager-class ships....
, which had reported dozens of cases of H1N1 flu amongst its 5,000 passengers and crew, docks in France.
August 1


August 4



August 8

August 11

Óscar Arias
Óscar Arias Sánchez is a Costa Rican politician who was President of Costa Rica from 2006 to 2010. He previously served as President from 1986 to 1990 and received the Nobel Peace Prize in 1987 for his efforts to end civil wars then raging in several other Central American countries.He is also a...
is confirmed to have swine flu, the first head of state
Head of State
A head of state is the individual that serves as the chief public representative of a monarchy, republic, federation, commonwealth or other kind of state. His or her role generally includes legitimizing the state and exercising the political powers, functions, and duties granted to the head of...
known to have been infected.
August 15


August 17


August 18

August 20



August 21

Zoonosis
A zoonosis or zoonoseis any infectious disease that can be transmitted from non-human animals to humans or from humans to non-human animals . In a study of 1415 pathogens known to affect humans, 61% were zoonotic...
cluster.



United Kingdom First death confirmed in Northern Ireland, that of woman with underlying health conditions.
August 22


August 23


August 24



August 26





August 27


Zoonosis
A zoonosis or zoonoseis any infectious disease that can be transmitted from non-human animals to humans or from humans to non-human animals . In a study of 1415 pathogens known to affect humans, 61% were zoonotic...
which raises concerns about possible increased genetic reassortment
Reassortment
Reassortment is the mixing of the genetic material of a species into new combinations in different individuals. Several different processes contribute to reassortment, including assortment of chromosomes, and chromosomal crossover. It is particularly used when two similar viruses that are infecting...
of the virus.
August 28


first wave of infections in autumn and winter which stresses hospitals in particular; it is noted, however, that
"the overall interruption of essential services in (well-prepared) countries has been manageable."

August 29



August 30


Álvaro Uribe
Alvaro Uribe Vélez was the 58th President of Colombia, from 2002 to 2010. In August 2010 he was appointed Vice-chairman of the UN panel investigating the Gaza flotilla raid....
is confirmed to have swine flu, the second Head of state
Head of State
A head of state is the individual that serves as the chief public representative of a monarchy, republic, federation, commonwealth or other kind of state. His or her role generally includes legitimizing the state and exercising the political powers, functions, and duties granted to the head of...
known to have been infected.


August 31


underyling medical conditions.

September 2


September 3



Centers for Disease Control and Prevention
The Centers for Disease Control and Prevention are a United States federal agency under the Department of Health and Human Services headquartered in Druid Hills, unincorporated DeKalb County, Georgia, in Greater Atlanta...
in its Morbidity and Mortality Weekly Report
Morbidity and Mortality Weekly Report
The Morbidity and Mortality Weekly Report is a weekly epidemiological digest for the United States published by the Centers for Disease Control and Prevention...
notes that 67% of thirty-six children who have died from H1N1 early in the epidemic had at least one serious chronic medical condition, with neurodevelopmental conditions such as developmental delay, epilepsy, and cerebral palsy being especially prominent. Roughly one in thirteen deaths have been of school-age children. More than 80% of the children who died were five or older, in contrast with the seasonal flu baseline of half or more of the influenza fatalities being four or younger.
September 5

September 7

dies of H1N1 flu
after twenty-eight days at Quito Military Hospital.


September 9


An outbreak is confirmed at the gaming convention PAX
Penny Arcade Expo
The Penny Arcade Expo is a semi-annual gamer festival held in Seattle and Boston. PAX was created by Jerry Holkins and Mike Krahulik, the authors of the Penny Arcade webcomic, because they wanted to attend a show that gave equal attention to console gamers, computer gamers, and tabletop...
in Seattle, Washington.
September 11

September 12

September 14

September 17



September 18

September 19


September 21


September 23

September 25

superinfection
Superinfection
In virology, superinfection is the process by which a cell, that has previously been infected by one virus, gets coinfected with a different strain of the virus, or another virus at a later point in time. Viral superinfections of serious conditions can lead to resistant strains of the virus, which...
which included H1N1.

begins in early autumn.
September 26

September 27


September 30




October 3

October 4



October 5

October 6

Lhasa
Lhasa is the administrative capital of the Tibet Autonomous Region in the People's Republic of China and the second most populous city on the Tibetan Plateau, after Xining. At an altitude of , Lhasa is one of the highest cities in the world...
, Tibet
Tibet
Tibet is a plateau region in Asia, north-east of the Himalayas. It is the traditional homeland of the Tibetan people as well as some other ethnic groups such as Monpas, Qiang, and Lhobas, and is now also inhabited by considerable numbers of Han and Hui people...
.

October 10


October 12





October 15



October 16

October 17


Qinghai
Qinghai ; Oirat Mongolian: ; ; Salar:) is a province of the People's Republic of China, named after Qinghai Lake...
.

October 19

Zoonosis
A zoonosis or zoonoseis any infectious disease that can be transmitted from non-human animals to humans or from humans to non-human animals . In a study of 1415 pathogens known to affect humans, 61% were zoonotic...
in the country.


October 20

H1N1-infected turkeys are confirmed in Ontario, the second such case of zoonosis reported in the world.

First death confirmed.

In a unique case of zoonosis, a pet ferret in Oregon is confirmed to be infected with H1N1.
October 21




October 22


Fears over the H1N1 virus prompts nearly 2,500 school closures.
October 23



Two new deaths reported, that of a 14-year-old girl and 40-year-old man. Total deaths: 6.

Barack Obama
Barack Hussein Obama II is the 44th and current President of the United States. He is the first African American to hold the office. Obama previously served as a United States Senator from Illinois, from January 2005 until he resigned following his victory in the 2008 presidential election.Born in...
declares a national emergency, inasmuch as "The potential exists for the pandemic to overburden health care resources in some localities."
October 24


October 26


October 27



October 28

October 29



October 30

European Free Trade Association
The European Free Trade Association or EFTA is a free trade organisation between four European countries that operates parallel to, and is linked to, the European Union . EFTA was established on 3 May 1960 as a trade bloc-alternative for European states who were either unable to, or chose not to,...
countries are reporting cases of pandemic (H1N1) 2009 influenza.

Yulia Tymoshenko
Yulia Volodymyrivna Tymoshenko , née Grigyan , born 27 November 1960, is a Ukrainian politician. She was the Prime Minister of Ukraine from 24 January to 8 September 2005, and again from 18 December 2007 to 4 March 2010. She placed third in Forbes Magazine's List of The World's 100 Most Powerful...
ordered a massive and for Ukraine unprecedented disease-control programme to go into effect immediately in an attempt to prevent the spread of the disease. A 'full quarantine' will be imposed in seven provinces of Western Ukraine
Ukraine
Ukraine is a country in Eastern Europe. It has an area of 603,628 km², making it the second largest contiguous country on the European continent, after Russia...
, with police monitoring the entrance and exit of all persons. It will block those lacking justification for travel
October 31


November 1



November 3






Zoonosis
A zoonosis or zoonoseis any infectious disease that can be transmitted from non-human animals to humans or from humans to non-human animals . In a study of 1415 pathogens known to affect humans, 61% were zoonotic...
in commercial swine, in a herd in Indiana.
November 4



Zoonosis
A zoonosis or zoonoseis any infectious disease that can be transmitted from non-human animals to humans or from humans to non-human animals . In a study of 1415 pathogens known to affect humans, 61% were zoonotic...
in a cat is confirmed, in Iowa.
November 6


November 7




November 8


November 9


November 11


November 12


November 13



November 14



"The proportion of outpatient visits for influenza-like illness (ILI) was 5.5% which is above the national baseline of 2.3%. All 10 regions reported ILI above region-specific baseline levels."
November 16


Bosnia & Herzegovina First death confirmed.



November 18




November 20



UK The first person-to-person transmission of Tamiflu-resistant H1N1 in the world is confirmed at the University Hospital of Wales
University Hospital of Wales
University Hospital of Wales , opened in November 1971, is a major 1000-bed hospital situated in the inner city district of Heath in Cardiff, Wales...
in Cardiff
Cardiff
Cardiff is the capital, largest city and most populous county of Wales and the 10th largest city in the United Kingdom. The city is Wales' chief commercial centre, the base for most national cultural and sporting institutions, the Welsh national media, and the seat of the National Assembly for...
. Five patients are so infected, with three apparently having been infected in hospital in a case of iatrogenic transmission.

November 21

November 23

November 24


November 27



November 28

Zoonosis
A zoonosis or zoonoseis any infectious disease that can be transmitted from non-human animals to humans or from humans to non-human animals . In a study of 1415 pathogens known to affect humans, 61% were zoonotic...
in the world.


"The proportion of outpatient visits for influenza-like illness (ILI) was 3.7% which is above the national baseline of 2.3%. Eight of the 10 regions reported ILI at or above region-specific baseline levels. Regions 6 and 10 reported ILI below their region specific baselines."
November 30



December 1

Háj
Háj may refer to:* Háj in Turčianske Teplice District, Slovakia* Háj in Košice-okolie District, Slovakia...
.
December 2
United Kingdom First case of reverse zoonosis in pigs is discovered, in NorfolkNorfolk
Norfolk is a low-lying county in the East of England. It has borders with Lincolnshire to the west, Cambridgeshire to the west and southwest and Suffolk to the south. Its northern and eastern boundaries are the North Sea coast and to the north-west the county is bordered by The Wash. The county...
.
December 5

December 6
Gaza Strip First five cases are confirmed in the blockaded Gaza StripGaza Strip
thumb|Gaza city skylineThe Gaza Strip lies on the Eastern coast of the Mediterranean Sea. The Strip borders Egypt on the southwest and Israel on the south, east and north. It is about long, and between 6 and 12 kilometres wide, with a total area of...
.


With one in six Americans infected, or 15% of the country, nearly 10,000 have died to date, including 1,100 children and 7,500 younger adults. More than 200,000 Americans had been hospitalized to date —roughly the same number who are so affected by the regular seasonal flu variant in an entire year. Furthermore, with 12 million additional doses of H1N1 vaccine being released this week, several states begin to distribute the vaccine to the general public.
December 7


December 9

December 12

Gaza The eighth fatality is reported, that of a child with underlying kidney failure, within a week of the first H1N1 case in the Gaza Strip.

December 13


December 16

December 17

December 19

Centers for Disease Control and Prevention
The Centers for Disease Control and Prevention are a United States federal agency under the Department of Health and Human Services headquartered in Druid Hills, unincorporated DeKalb County, Georgia, in Greater Atlanta...
reports that levels of influenza are declining steadily, with only seven states reporting widespread influenza activity and 18 reporting reginoal activity; furthermore, the proportion of deaths attributed to pneumonia and influenza (P&I) is below the epidemic threshold. The CDC also notes that almost all isolates of H1N1 remain sensitive to oseltamivir
Oseltamivir
Oseltamivir INN , an antiviral drug, slows the spread of influenza virus between cells in the body by stopping the virus from chemically cutting ties with its host cell; median time to symptom alleviation is reduced by 0.5–1 day. The drug is sold under the trade name Tamiflu, and is taken orally...
. "The proportion of outpatient visits for influenza-like illness (ILI) was 2.3% which is at the national baseline of 2.3%."
December 21

December 23


New England Journal of Medicine
The New England Journal of Medicine is an English-language peer-reviewed medical journal published by the Massachusetts Medical Society. It describes itself as the oldest continuously published medical journal in the world.-History:...
shows that "Pediatric 2009 H1N1 influenza was associated with pediatric death rates that were 10 times the rates for seasonal influenza than in previous years," and that the elevated risk for pregnant women extends for as long as two weeks after they give birth.
December 26

December 27


December 29

Margaret Chan
Margaret Chan Fung Fu-chun, OBE JP is the Director-General of the World Health Organization . Chan was elected by the Executive Board of the WHO on 8 November 2006, and was endorsed in a special meeting of the World Health Assembly on the following day...
, Director-General of the WHO, remarks in the context of the H5N1
H5N1
Influenza A virus subtype H5N1, also known as "bird flu", A or simply H5N1, is a subtype of the influenza A virus which can cause illness in humans and many other animal species...
bird flu virus that "The fact that the long overdue influenza pandemic is so moderate in its impact is probably the best health news of the decade" but that "No, the world is not ready for a pandemic to be caused by H5N1." Given that H1N1 could still mutate, however, the WHO shall continue to monitor the pandemic for six months to a year. She also said that it would take at least two years before a true death total is established. (Approximately 11,500 people are believed to have died in more than 200 countries.)
December 30

December 31

January 2

January 8

January 15

January 29


February 5

Centers for Disease Control and Prevention
The Centers for Disease Control and Prevention are a United States federal agency under the Department of Health and Human Services headquartered in Druid Hills, unincorporated DeKalb County, Georgia, in Greater Atlanta...
states that H1N1 activity has either remained stable or decreased over the past week in nine out of the ten regions of the United States. Furthermore, the proportion of deaths attributed to pneumonia and influenza, which technically remains above the epidemic threshold, has declined over the past week.
February 19

March 5

March 12

March 19

March 26

March 31

Morbidity and Mortality Weekly Report
The Morbidity and Mortality Weekly Report is a weekly epidemiological digest for the United States published by the Centers for Disease Control and Prevention...
states that inoculation rates varied, with the highest rates in New England and the lowest in the South. (E.g., roughly 39% of the population of Rhode Island is immunized vis-à-vis 13% that of Mississippi.) Among children Georgia had the lowest vaccination rate, with 21%; the state currently has the highest level of H1N1 flu activity.
April 2


April 9

April 14

April 17

April 19

Margaret Chan
Margaret Chan Fung Fu-chun, OBE JP is the Director-General of the World Health Organization . Chan was elected by the Executive Board of the WHO on 8 November 2006, and was endorsed in a special meeting of the World Health Assembly on the following day...
states that "It is still premature and too early for us to say we have come to an end of the pandemic influenza worldwide. It would be prudent and appropriate... to continue to monitor the evolution of this pandemic for the next six to 12 months," i.e. possibly into 2011. She also remarked that although the United States, Britain and Canada have passed through a second wave of H1N1, outbreaks in India, Egypt and elsewhere are intensifying, and reiterates that countries remain ill-prepared for a bird flu
H5N1
Influenza A virus subtype H5N1, also known as "bird flu", A or simply H5N1, is a subtype of the influenza A virus which can cause illness in humans and many other animal species...
(H5N1) pandemic. More than 200 countries have now been affected by H1N1 with almost 12,000 confirmed deaths worldwide, although the vast majority of those infected recovered without special treatment.
May 15

May 16

Margaret Chan
Margaret Chan Fung Fu-chun, OBE JP is the Director-General of the World Health Organization . Chan was elected by the Executive Board of the WHO on 8 November 2006, and was endorsed in a special meeting of the World Health Assembly on the following day...
states at the U.N.'s World Health Assembly
World Health Assembly
The World Health Assembly is the forum through which the World Health Organization is governed by its 194 member states. It is the world's highest health policy setting body and is composed of health ministers from member states....
that "We are just plain lucky ... This has been the case with the A/ H1N1 influenza pandemic... The virus did not mutate to a more lethal form. Cases of resistance to oseltamivir remained few and isolated. The vaccine closely matched circulating viruses and showed an excellent safety record," Chan said. "Emergency wards and intensive care units were often strained, few health systems were overwhelmed ... Schools closed, but borders remained open, and disruptions to travel and trade were far less severe than feared," she told delegates from the agency's 193 member states. "Had things gone wrong in any of these areas, we would have a very different agenda before us today," she added."
August 6

August 10

Margaret Chan
Margaret Chan Fung Fu-chun, OBE JP is the Director-General of the World Health Organization . Chan was elected by the Executive Board of the WHO on 8 November 2006, and was endorsed in a special meeting of the World Health Assembly on the following day...
officially declares the H1N1 pandemic over as countries are now seeing a mix of H1N1, H3N2, and B viruses, with some populaces displaying community-level immunity to H1N1 of 20% to 40%. Nevertheless WHO urged health officials worldwide to prepare for the possibility that a new strain of flu will emerge in the near future. "Pandemics are unpredictable and prone to deliver surprises," Dr. Chan noted.
Summary
2009 | A(H1N1) Outbreak and Pandemic Milestones |
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1 October | First case confirmed in Saint-Barthélemy. |
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21 October | ![]() |
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Mass vaccinations in the United Kingdom begins. | |
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22 October | ![]() |
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23 October | ![]() |
24 October | ![]() |
25 October | ![]() |
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26 October | ![]() |
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27 October | ![]() |
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29 October | ![]() |
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30 October | ![]() |
31 October | ![]() |
1 November | ![]() |
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2 November | ![]() |
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3 November | ![]() |
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4 November | ![]() |
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5 November | ![]() |
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6 November | ![]() |
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7 November | ![]() |
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8 November | ![]() |
9 November | ![]() |
11 November | ![]() |
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12 November | ![]() |
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13 November | ![]() |
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14 November | ![]() |
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16 November | ![]() |
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17 November | ![]() |
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18 November | ![]() |
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19 November | ![]() |
20 November | ![]() |
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23 November | ![]() |
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24 November | ![]() |
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27 November | ![]() |
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28 November | ![]() |
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30 November | ![]() |
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1 December | ![]() |
2 December | First human-to-animal transmission of the virus in the United Kingdom. |
3 December | ![]() |
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4 December | ![]() |
7 December | ![]() |
9 December | ![]() |
13 December | ![]() |
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14 December | ![]() |
15 December | ![]() |
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17 December | ![]() |
20 December | ![]() |
21 December | ![]() |
27 December | ![]() |
2010 | A(H1N1) Outbreak and Pandemic Milestones |
1 January | ![]() |
5 January | ![]() |
11 January | ![]() |
15 January | ![]() |
19 January | ![]() |
20 January | ![]() |
29 January | ![]() |
3 February | ![]() |
9 February | ![]() |
25 February | ![]() |
27 March | ![]() |
2 April | ![]() |
12 April | ![]() |
26 April | ![]() |
10 August | ![]() |