2009 swine flu pandemic in North America: Difference between revisions
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{{2009 flu pandemic in North America table}} |
{{2009 flu pandemic in North America table}} |
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The '''2009 flu pandemic in North America''', part of an [[epidemic]] in 2009 of a new strain of [[influenza A virus subtype H1N1]] causing what has been commonly called [[swine influenza|swine flu]], has (as of 9 June 2009) afflicted at least 23,544 [[human|people]] in [[North America]], with at least 162 confirmed [[death]]s. The majority of cases and deaths worldwide have been in North America: while the [[United States]] has the highest number of confirmed cases worldwide, [[Mexico]] has had a majority of deaths worldwide; [[Canada]] has the highest number of confirmed cases per capita continent-wide. |
The '''2009 flu pandemic in North America''', part of an [[epidemic]] in 2009 of a new strain of [[influenza A virus subtype H1N1]] causing what has been commonly called [[swine influenza|swine flu]], has (as of 9 June 2009) afflicted at least 23,544 [[human|people]] in [[North America]], with at least 162 confirmed [[death]]s. The majority of cases and deaths worldwide have been in North America: while the [[United States]] has the highest number of confirmed cases worldwide, [[Mexico]] has had a majority of deaths worldwide; [[Canada]] has the highest number of confirmed cases per capita continent-wide. |
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{{double image|left|H1N1 North America Map.svg|150|H1N1 North America map by confirmed cases.svg|150|Outbreak evolution in North America: {{legend|#000000|Deaths}}{{legend|#FF0000|Confirmed cases}}{{legend|#FFA900|Unconfirmed or suspected cases}}|Outbreak evolution in North America: {{legend|#550000|2000+ cases}}{{legend|#aa0000|500+ cases}}{{legend|#d40000|100+ cases}}{{legend|#ff5555|1+ cases}} |
{{double image|left|H1N1 North America Map.svg|150|H1N1 North America map by confirmed cases.svg|150|Outbreak evolution in North America: {{legend|#000000|Deaths}}{{legend|#FF0000|Confirmed cases}}{{legend|#FFA900|Unconfirmed or suspected cases}}|Outbreak evolution in North America: {{legend|#550000|2000+ cases}}{{legend|#aa0000|500+ cases}}{{legend|#d40000|100+ cases}}{{legend|#ff5555|1+ cases}} |
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[[File:Influenza-2009-cases-logarithmic.png|thumb|300px|left|A [[Semi-log graph|semi-logarithmic]] chart of laboratory-confirmed A(H1N1) influenza cases by date according to [[World Health Organization|WHO]] reports.<ref name="who-situation-updates">{{cite web | title=Situation updates - Influenza A(H1N1) | url=http://www.who.int/csr/disease/swineflu/updates/en/index.html | work=Epidemic and Pandemic Alert and Response | publisher=WHO | date= | accessdate=2009-05-13}}</ref> Mexico, USA, and Canada are shown as a breakdown of the total.]] |
[[File:Influenza-2009-cases-logarithmic.png|thumb|300px|left|A [[Semi-log graph|semi-logarithmic]] chart of laboratory-confirmed A(H1N1) influenza cases by date according to [[World Health Organization|WHO]] reports.<ref name="who-situation-updates">{{cite web | title=Situation updates - Influenza A(H1N1) | url=http://www.who.int/csr/disease/swineflu/updates/en/index.html | work=Epidemic and Pandemic Alert and Response | publisher=WHO | date= | accessdate=2009-05-13}}</ref> Mexico, USA, and Canada are shown as a breakdown of the total.]] |
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Revision as of 10:31, 25 July 2009
Template:2009 flu pandemic in North America table
The 2009 flu pandemic in North America, part of an epidemic in 2009 of a new strain of influenza A virus subtype H1N1 causing what has been commonly called swine flu, has (as of 9 June 2009) afflicted at least 23,544 people in North America, with at least 162 confirmed deaths. The majority of cases and deaths worldwide have been in North America: while the United States has the highest number of confirmed cases worldwide, Mexico has had a majority of deaths worldwide; Canada has the highest number of confirmed cases per capita continent-wide.
Countries and territories
North America
As of June 9, there has been 4 deaths and a further 2,446 confirmed cases of swine flu, most of which was contracted in-country, have been confirmed in the country; 68 in Nova Scotia, 114 in British Columbia, 86 in Alberta, 284 in Ontario, 106 in Quebec, 2 in New Brunswick, 6 in Manitoba, 3 in Prince Edward Island, 49 in Saskatchewan, and 1 in Yukon Territory.[2][3][4][5] Nova Scotia's chief medical officer, Dr. Robert Strang, said on April 26 that the National Microbiology Laboratory in Winnipeg confirmed late the previous day, that four young people in the province were recovering from "relatively mild" cases of the disease. The four all attended King's-Edgehill preparatory school in Windsor; and one of the four infected students had been on a recent school trip to the Yucatán Peninsula.[2][6] There is evidence that the disease is spreading beyond the first 4 Nova Scotia cases, as friends and relatives are starting to show symptoms. Dr. Robert Strang indicated that he expects the disease to spread to the rest of Nova Scotia within a few weeks.[7] On April 30, the first case of swine flu affecting someone who had not travelled to Mexico was confirmed in Nova Scotia.[8]
Dr. Michael Gardam, director of infectious disease prevention and control at Ontario's public health agency, said in an interview with the CBC that an outbreak of swine flu in Ontario, Canada's most populous province, would not be as serious as the 2003 SARS epidemic.[9] In preparing for and dealing with an influenza pandemic, the Public Health Agency of Canada follows the WHO's categories, but has expanded them somewhat.[10] Despite initial reports of two swine influenza cases in a Montreal hospital, an official on the Montreal regional health board confirmed negative results for all quarantined patients at the hospital and that no quarantines were currently in effect at the hospital.[11]
Canada's Chief Public Health Officer, Dr. David Butler-Jones, stated that the six affected Canadians suffered from only mild symptoms and have already started to recover. Butler-Jones warned against complacency though, stating that the fact that only mild cases have been reported so far "doesn’t mean we won’t see either some more severe illness or potentially deaths."[12] In both provinces, the cases either involved people who had recently returned from Mexico or those in close contact with them.[13] On May 4, it was announced that a girl from Alberta was diagnosed with a severe case of the H1N1 virus, the first severe one in Canada. The girl was hospitalized on April 30 and the case is still being researched.[14] On May 8, the first confirmed death from the H1N1 virus was reported in Alberta.[15] On may 25th Ontario Health Minister David Caplan confirmed that a Toronto man in his 40s has died of the H1N1 swine flu virus.[16]
The first incidence of the flu in pigs was discovered on a farm in Alberta, it is accounted as the first instance of reverse-zoonosis passing the flu from humans to pigs in this epidemic.[17] It is suspected that an infected farmhand who recently returned from Mexico infected the animals.[18]
Dr. José Ángel Córdova Villalobos, Mexico's Secretariat of Health, stated that since March 2009, there have been over 1,995 suspected cases and 149 deaths, with 20 confirmed to be linked to a new swine influenza strain of Influenza A virus subtype H1N1.[19][20] As of April 26 there had been 1,614 cases, with 103 deaths and about 400 patients in hospital; approximately two-thirds of the sick patients had recovered.[21] "'As many as 23,000 Mexicans were likely infected with the swine flu virus,' Neil Ferguson of Imperial College London and colleagues reported in the journal Science."[22]
Soldiers mobilized by the government have handed out six million surgical masks to citizens in and around Mexico City.[23] On April 24, 2009, schools (from pre-school to university level) as well as libraries, museums, concerts and any public gathering place, were shut down by the government in Mexico City and the neighboring State of Mexico to prevent the disease from spreading further; the schools in Mexico City, the State of Mexico, and the state of San Luis Potosí will remain closed until at least May 5.[24] Marcelo Ebrard, Mexico City's mayor, has also asked all night-life operators to shut down their places of business for ten days to prevent further infections.[25] José Ángel Córdova, federal Secretary of Health, said on April 24 that schools will probably be suspended for at least the following week then, and that it will take around ten days to see the evolution of the virus' behavior, and to consider other measures after such.[26] On April 25, President Felipe Calderón declared an emergency which granted him the power to suspend public events and order quarantines.[27] Hours later, Córdova announced that classes in Mexico City would be officially suspended through May 6.[28] On April 26, Natividad González Parás, governor of the northeastern State of Nuevo León, announced that state-wide schools will remain closed until 6 May, and established a quarantine system in airports, central bus stations and the creation of observation points mainly in the southern part of the state at the nearest highways to the borders with other states, in order to realize tests conducted on people arriving from other states. However, as for April 27, there are no confirmed reported cases of infection in this state.[29]
On April 26, the World Bank announced US$ 25 million in immediate aid loans to Mexico, an additional US$ 180 million for long-term assistance to address the outbreak, and advice on how other nations have responded to similar crises.[23]
On April 27, the Secretariat of Public Education announced that all schools in Mexico will remain closed at least until May 6.[30]
On April 28, the Mexico City government closed all restaurants and cinemas. The National History and Anthroplogy Institute also closed all its archaeological sites and museums, including the most famous Mayan and Aztec ruins, until further notice.
Initial reports of atypical flu in two individuals in southern California led to the discovery of the novel swine flu virus by the CDC in mid-April. More than a hundred cases were confirmed in the next two weeks, spread through a dozen states.[31] Outside of California and Texas, initial cases were all tied to recent travel to Mexico or close contact with those who had recently visited Mexico. St. Francis Preparatory School, a private school in New York, was the center of a large cluster of cases after a Spring Break trip by several students, and perforce one of the first U.S. schools to be closed as a public health measure during the early outbreak.[32] Most of the cases in California and Texas are not linked and may reflect localized outbreaks of this virus in those areas.[33] As of April 30, the disease was not as virulent outside of Mexico as within Mexico, for reasons not fully understood.
The United States of America declared a state of Public Health Emergency but this was said to be standard procedure in cases as divergent as the recent inauguration and flooding.[34] According to the New York Times, "the emergency declaration frees resources to be used toward diagnosing or preventing additional cases and releases money for more antiviral drugs," including the transfer of approximately 12 million influenza medications from a federal stockpile to states.[23][35] The U.S. plans followed a guidebook developed over the past five years to fight a pandemic flu such as H5N1. The situation developed rapidly with the White House initially looking into the matter on April 24 according to press releases, but rapidly adopting a serious stance as the WHO and CDC issued stronger recommendations.
On April 29, the US suffered its first confirmed death of swine flu. On April 28, the Centers for Disease Control and Prevention had officially confirmed through tests that a 23-month old child was infected with the flu. When the sickness continued to worsen the next day, he was transferred to Texas Children's Hospital in Houston, where he died.[36][37][38]
On May 5, Judy Trunnell, a woman in her 30's suffering from "chronic underlying health conditions" died of swine flu in Cameron County, near the US-Mexico border. She was the first US citizen to die from the disease.[39] The woman, a special education teacher, had recently given birth to an eight-month-term healthy baby, delivered by caesarian section.[40] She had been in a coma after being admitted to the hospital with breathing problems on April 19.[40] The woman had also suffered from asthma, rheumatoid arthritis and a skin condition.
On May 10, a 30-year-old man with underlying health problems died in Washington from H1N1, the first fatality in that state. [41]
On May 17, 55-year old Mitchell Wiener, an assistant principal at Intermediate School 238 in Hollis, Queens died from H1N1, making it the first H1N1 related fatality in the state of New York. Wiener suffered from many other underlying health problems, weakening his resistance to the disease.[42]
On May 19, 2009, a St. Louis County man became the first death in Missouri due to the Swine Flu.
As of mid-May 2009 many states had abandoned testing for likely influenza cases unless serious illness and/or hospitalization were present.[43] Because reported numbers represent only confirmed cases, they are a "very great understatement" of the total number of cases of infection, according to the CDC.[44]
The real number of swine flu cases in the United States could be “upwards of 100,000,” a top public health official estimated on Friday — far higher than the official count of 7,415 cases confirmed by laboratories.[45]
Central America and Carribean
Trevor van Gellecum, the Director of the Aruban Department of Health, announced that all passengers arriving by airplane or cruise ship will have to fill out a health questionaire beginning on April 27, 2009.[46] Hotels and resorts are required to report to authorities if any tourists are showing flu-like symptoms.[46] The government of Aruba also ordered antiviral medication and other supplies from the Netherlands and the United States.[46] No swine flu cases have been reported.[46]
Ten students and teachers who arrived from Mexico in the last week of April are in quarantine.[47]
The Minister Of Health, Donville Inniss has confirmed that two samples have been sent off to the Caribbean Epidemiology Centre (CAREC) in Trinidad and Tobago to be tested for the virus.[47]
There are two suspected cases of swine flu currently under investigation in Belize. As a result, all major public events have been cancelled. This includes the National Agriculture and Trade Show. People have been asked to be very careful and use preventative measures.[47]
A 21 year old woman was confirmed as carrying the swine flu virus on April 28. The woman came back from Mexico by airplane.[48] A second case was confirmed on the same day, a 30-year old man who traveled to Mexico the week before.[49] On May 2 the Costa Rican Ministry of Health confirmed two more cases.[50] Four more cases were confirmed on May 4.[51] All of these patients have recently traveled to Mexico. Since April 29 the Ministry of Health recommended to avoid travel to Mexico, Canada, and the U.S.[51]
A 53 year-old man became the first confirmed death from the disease in the country, as reported by the Minister of Health on May 9.[52][53][54] Out of the seven remaining cases confirmed by the US Center for Disease Control, three are children infected by the patient who died, and their condition is not critical.[55] This is the first death outside of a North American country and the fourth country in the world to present a mortal case.[54] The deceased man was suffering other chronic diseases. The Minister of Health informed he had diabetes and also was suffering from chronic obstructive pulmonary disease (COPD). She also informed the man was infected inside Costa Rica because he had not traveled to Mexico.[56]
On May 12 the Minister of Health announced that an alert was received from U.S. authorities informing that three members from a Boston chorus that traveled to several places in Costa Rica in April, showed symptoms of AH1N1 flu after returning to the U.S.[57] On May 13 Costa Rican health authorities announced four new probable cases, three of which had contact with the Boston chorus.[58] A local English language newspaper questioned whether the chorus members had infected locals, or rather the Boston youngsters picked up the disease in Costa Rica.[59]
By June 5 the Costa Rican Ministry of Health had 83 confirmed cases[60] of influenza A (H1N1) leading to one fatality,[52][53][54] two probable cases pending confirmation, 107 suspected cases, and 1,506 already discarded.[60]
Cuba's Health Ministry is adopting precautionary measures to prevent the illness from coming into the country. The government has advised citizens to go to seek medical treatment if experiencing flu-like symptoms.[61] Cuba has also banned flights to and from Mexico for 48 hours.[62]
Cuba has reported its first case of Influenza A H1N1 as a Mexican student who travelled to Cuba on April 25 for study
The ministry statement said that in all of Cuba, authorities have tested 84 possible cases in people of eight nationalities for the virus. Only one case was positive - the Mexican student.[63]
According to the Dominican Republic Government[64] there were two people confirmed to be infected with the AH1N1 flu on May 27. One has been a 58 year-old woman from Santiago de los Caballeros and the other one has been a 20 year-old woman from Santo Domingo Province. Each of them visited the United States (Orlando and Seattle, respectively) before being diagnosed.[citation needed] On May 30, nine more cases were confirmed, all from the Carol Morgan school.[65]
On June 5, a 17 year old pregnant girl infected with the AH1N1 virus died. 44 cases where confirmed to this date.[66]
A 29-year-old, who had recently visited Mexico, was being tested for a suspected case of swine flu.[67]
Guatemala is checking all travelers arriving from Mexico for signs of flu and stopping anyone with symptoms of the virus at border crossings.[67]
On May 5, in a meeting with Health Minister and the Vicepresident, it was announced that an 11-year-old girl was infected with the AH1N1 virus. It was told that the family of the girl came from Mexico a few days ago, but no one else in the family it is infected.[68]
On the same press meeting, Rafael Espada said: "We've to prepare ourselves for the worst, and just hope for the best".[69]
The government has stated that they're prepared for a first wave of AH1N1. Nevertheless, other institutions have started to help population by giving them masks and information about the virus. University of San Carlos de Guatemala by the Faculty of Farmacy and Pharmaceutics has started to prevent the virus among the students population, as the Rector Estuardo Gálvez said: "This people are prepared to counteratack the virus inside and outside this campus".[70]
Honduras reported its first confirmed case of swine flu(H1N1) on 27 May, 2009. On the 22nd June it reported it's first death of swine flu.
As of 07 July 2009, there has been 33 confirmed cases of swine flu in Jamaica. On the 6th of July, Jamaica recorded its first human mortality from the virus. Health Minister Ruddy Spencer told Parliament that the country has been placed on high alert. There has been heightened surveillance at health care facilities and port entry's.[71]
As on July 9, 480 confirmed cases had been reported by Panamanian health authorities:[72]
- 188 male and 169 female
- 66% of the cases are teens(12-15) and the 34% are adults(20-49)
No deaths reported.
Schools with positive cases are being disinfected.
Thermal cameras had been deployed in Tocument Int´l Airpot to identify sickness in arriving passengers.
The members of the Under 17 Trinidad and Tobago football team have taken Flu tests after returning from a World Cup qualifying football match in Mexico City.[73] One female was this week confirmed as having contracted the H1N1 influenza. Her identity is being withheld. At the moment, people who travelled on the same air craft as the infected woman are being asked to contact the relevant health authorities.[74]
Timeline
| 2009 | A(H1N1) Outbreak and Pandemic Milestones in North America |
|---|---|
| 17 March |  First case in the world of what would later be identified as swine flu.
|
| 28 March |  First case in the US of what would later be identified as swine flu.
|
| 12 April | First known death due to what would later be identified as swine flu.
|
| 25 April | Community outbreaks comfirmed in United States.
|
| Community outbreaks confirmed in Mexico.
| |
| 27 April |  First case confirmed in Canada.
|
| 29 April | First death confirmed in the United States.
|
| 2 May |  First case confirmed in Costa Rica.
|
| 3 May | First cases confirmed of infections in pigs, also first cases of reverse zoonosis.
|
| 4 May |  First case confirmed in El Salvador.
|
| 5 May |  First case confirmed in Guatemala.
|
| 7 May | First death confirmed in Canada.
|
| 8 May |  First case confirmed in Panama.
|
| Community outbreaks confirmed in Canada.
| |
| 9 May | First death confirmed in Costa Rica.
|
| 12 May |  First case confirmed in Cuba.
|
| 13 May | Community outbreaks confirmed in Costa Rica.
|
| 22 May |  First case confirmed in Honduras.
|
| 26 May |  First case confirmed in Puerto Rico.
|
| 27 May |  First case confirmed in Dominican Republic.
|
| 31 May |  First case confirmed in Bahamas.
|
| 2 June |  First case confirmed in Nicaragua.
|
 First case confirmed in Bermuda.
| |
| 3 June |  First case confirmed in Barbados.
|
 First case confirmed in Jamaica.
| |
| 4 June |  First case confirmed in Trinidad and Tobago.
|
| 5 June | First death confirmed in Dominican Republic.
|
 First case confirmed in Cayman Islands.
| |
| 7 June |  First confirmed case in Martinique.
|
| 8 June |  First case confirmed in Dominica.
|
| 10 June | First death confirmed in Guatemala.
|
| Community outbreaks confirmed in Guatemala.
| |
| 11 June |  First case confirmed in British Virgin Islands.
|
| 17 June |  First confirmed case in U.S. Virgin Islands.
|
 First confirmed case in the island of Sint Maarten, Netherlands Antilles.
| |
| 19 June |  First confirmed case in Antigua and Barbuda.
|
| 22 June | First death confirmed in Honduras.
|
| 30 June |  First confirmed case in Saint Lucia.
|
| 2 July | First death confirmed in El Salvador.
|
| 2 July |  First confirmed case in Saint Vincent and the Grenadines.
|
| 6 July | First death confirmed in Jamaica.
|
| 7 July | First death confirmed in Puerto Rico.
|
 First case confirmed in Belize.
| |
| 9 July | Community outbreaks confirmed in Panama.
|
| 14 July |  First case confirmed in Haiti.
|
 First case confirmed in Saint Kitts and Nevis.
| |
| 19 July | First death confirmed in Panama.
|
| 22 July | First case of Oseltamivir (Tamiflu) resistance found in Canada.[1]
|
Resources
References
- ^ "Situation updates - Influenza A(H1N1)". Epidemic and Pandemic Alert and Response. WHO. Retrieved 2009-05-13.
- ^ a b "4 cases of swine flu confirmed in Nova Scotia, 2 in B.C." Canadian Broadcasting Corporation. 2009-04-26.
- ^ "Alberta confirms 2 cases of swine flu". Canadian Broadcasting Corporation. 2009-04-28.
- ^ "Six more Canadians diagnosed with swine flu". CTV. 2009-04-29.
- ^ "New 'swine flu' cases bring Canadian total to 34". CTV. 2009-04-30.
- ^ "Flu Update" (Press release). King's-Edgehill School. April 26, 2009. Retrieved April 26, 2009.
- ^ "4 cases of swine flu confirmed in Nova Scotia, 2 in B.C." Canadian Broadcasting Corporation. 2009-04-26.
- ^ "N.S. has first Canadian person-to-person flu case". Toronto Star. 2009-04-30.
- ^ "Swine flu not as serious as SARS: Canada's Ontario". Reuters. April 24 2009.
{{cite news}}: Check date values in:|date=(help) - ^ "Public Health Agency of Canada: The Canadian Pandemic Influenza Plan for the Health Sector". Phac-aspc.gc.ca. 2009-01-06. Retrieved 2009-04-27.
- ^ "Swine-flu fears at Lakeshore General unfounded". The Gazette (Montreal). 2009-04-25. Retrieved 2009-04-25.
- ^ Richard J. Brennan (April 26 2009). "Swine flu confirmed in Canada, Unlike deadly outbreak in Mexico, the cases in Nova Scotia and B.C. were mild and didn't require hospitalization". Toronto Star. Retrieved 2009-04-27.
{{cite news}}: Check date values in:|date=(help) - ^ "Six swine flu cases confirmed in Canada". CTV News. April 26, 2009.
- ^ "Canada identifies first severe flu case". brisbanetimes. May 5, 2009: Australia. Retrieved 2009-05-05.
{{cite web}}: Check date values in:|date=(help) - ^ "Alberta confirms woman with H1N1 flu and underlying health problems dies". The Canadian Press. 8 May 2009. Retrieved 8 May 2009.
- ^ http://www.cbc.ca/canada/toronto/story/2009/05/25/swine-flu.html.
{{cite news}}: Missing or empty|title=(help) - ^ Lauren Etter (3 May 2009). "Pigs in Canada Contract Flu Virus". Wall Street Journal. Retrieved 2009-05-03.
- ^ "Canada farm worker 'infects pigs'". BBC News. 3 May 2009. Retrieved 2009-05-03.
- ^ "Mexico closes schools nationwide due to swine flu". Associated Press.
- ^ "Influenza-Like Illness in the United States and Mexico". World Health Organization.
- ^ "Reuters AlertNet - Swine flu death toll in Mexico rises to 103". Alertnet.org. Retrieved 2009-04-27.
- ^ Mexican H1N1 flu spreads easily: study Mon May 11, 2009 7:45pm EDT http://www.reuters.com/article/GCA-SwineFlu/idUSTRE54A59O20090511?sp=true By Maggie Fox, Health and Science Editor
- ^ a b c Neergaard, Lauran (2009-04-26). "World govts race to contain swine flu outbreak". Associated Press. Retrieved 2009-04-26.
- ^ "AP Top News at 9:11 p.m. EDT". Associated Press. 2009-04-25. Retrieved 2009-04-25.
- ^ [Pide Ebrard parar 10 días vida nocturna "Estima SSA 10 dias de alerta por influenza"]. Reforma. 2009-04-25.
{{cite web}}: Check|url=value (help) - ^ "Estima SSA 10 dias de alerta por influenza". El Universal. 2009-04-25.
- ^ "Mexico's Calderon Declares Emergency Amid Swine Flu Outbreak". Bloomberg. 2009-04-25.
- ^ "Se suspenden clases hasta el 6 de mayo" (in Spanish). Excélsior. 2009-04-25.
- ^ "Nuevo Leon schools to be closed down until 6 May" (in Spanish). El Universal. 2009-04-26.
- ^ "All schools closed in Mexico". CNN. 2009-04-27.
- ^ "Human Swine Influenza Investigation". US Centers for Disease Control (CDC).
- ^ "Mayor Says City Confirms 20 More Cases Of Swine Flu". New York 1. April 27, 2009.
- ^ Thomas H. Maugh II (April 24, 2009). "Eight swine flu cases identified in U.S.: All victims, six of them in California, have recovered. Officials say the new virus is easily passed, but does not appear to be especially virulent. Researchers plan to go to Mexico, where the viruses in 12 cases match six in the U.S.". Los Angeles Times.
{{cite news}}:|access-date=requires|url=(help) - ^ "US Declares Public Health Emergency for Swine Flu". Associated Press.
- ^ Healy Jack, Stolberg, Sheryl Gay (April 26 2009). "U.S. declares public health emergency over swine flu". New York Times.
{{cite news}}: Check date values in:|date=(help)CS1 maint: multiple names: authors list (link) - ^ First U.S. swine flu death confirmed, CNN, April 29, 2009
- ^ US reports first swine flu death, BBC, April 29, 2009
- ^ "Brownsville Hospital Officials speak out". Valleycentral.com. Retrieved 2009-05-02.
- ^ "US resident dies from swine flu". BBC. 2009-05-05.
- ^ a b "Flu suspected in US teacher's death". Smh.com.au. 2009-04-23. Retrieved 2009-05-08.
- ^ "Homem no Estado de Washington morre por conta da nova gripe". O Globo. 2009-05-10.
- ^ "Assistant principal Mitchell Wiener dies from complications of swine flu". New York Daily News. 2009-05-17.
- ^ "Demand, flu patterns lead states to reduce testing". University of Minnesota. 8 May 2009.
- ^ Emma Hitt, PhD (9 May 2009). "CDC: H1N1 Flu Numbers Represent a "Very Great Underestimate"".
With limited resources, some states are placing a priority on testing hospitalized patients, which may create a false impression that the virus is becoming more lethal, Richard Besser, MD, the CDC's acting director, said at a media briefing yesterday.
However, he added that scaled-back testing is also in line with how public health officials handle testing for seasonal influenza. Given that the swine flu outbreak seems to resemble seasonal flu, expect the CDC to revise some of its recommendations and change some of its reporting practices, he said.
As the disease becomes more widespread, tallies of individual cases won't be as meaningful, but health authorities will want to know what regions of the country are affected and to what extent, Besser said. For reporting on the swine flu outbreak, the CDC will likely use the surveillance and reporting model it uses for seasonal flu.
Minnesota is among states that have announced a cutback in influenza testing. In a May 4 press release, the Minnesota Department of Health (MDH) said it was asking healthcare providers to submit lab specimens only when a patient has been hospitalized for flu-like like symptoms. It will also continue to accept specimens from the state's 29 sentinel influenza surveillance sites and for ill healthcare workers.
- May 9, 2009 — The confirmed numbers of influenza A (H1N1) cases reported are likely to fall far short of the actual numbers occurring within the community, according to a US Centers for Disease Control and Prevention (CDC) spokesperson.
- "The individual numbers are likely a very great underestimate of how much virus is circulating or how many people are becoming ill from it," said Anne Schuchat, MD, the Director of the CDC's National Center for Immunization and Respiratory Diseases, speaking at a media briefing today.
- ^ Donald G. McNeill Jr. (15 May 2009). "Mild U.S. Flu Cases May Exceed Official Tally". New York Times.
The official, Dr. Daniel Jernigan, head of flu epidemiology for the Centers for Disease Control and Prevention, said at a news conference that the official number gave an inaccurate picture of the outbreak because so few mildly sick people were being tested.
- ^ a b c d "Aruba checks disembarking passengers: Precautionary measures regarding swine influenza". Amigoe. 2009-04-27. Retrieved 2009-04-29.
- ^ a b c "Suspected swine flu cases in Caribbean as WHO raises alert level". Caribbean360.com. 2009-04-30.
- ^ "Confirmada primera tica con fiebre porcina" (in Spanish). La Nación. Retrieved 2009-04-28.
- ^ "Confirmado segundo tico con fiebre porcina" (in Spanish). La Nación. 2009-04-28. Retrieved 2009-04-28.
- ^ "Salud reporta dos nuevos casos de gripe porcina en el país" (in Spanish). La Nación. 2009-04-30. Retrieved 2009-05-02.
- ^ a b "Sube a ocho cifra de ticos infectados con gripe pandémica" (in Spanish). La Nación. 2009-05-04. Retrieved 2009-05-04.
- ^ a b "Gripe porcina: Costa Rica confirmó la muerte de un hombre a causa de la enfermedad" (in Spanish). Clarín. 2009-05-09. Retrieved 2009-05-09.
- ^ a b "Muere primer tico contagiado de gripe AH1N1" (in Spanish). La Nación. 2009-05-09. Retrieved 2009-05-09.
- ^ a b c "Costa Rica Sees 1st Swine Flu Death". ABC News. 2009-05-09. Retrieved 2009-05-09.
- ^ "Tres niños con gripe AH1N1 fueron contagiados por tico que falleció esta madrugada" (in Spanish). La Nación. 2009-05-09. Retrieved 2009-05-09.
- ^ "Tico fallecido por gripe AH1N1 empeoró por enfermedades crónicas" (in Spanish). La Nación. 2009-05-09. Retrieved 2009-05-11.
- ^ "Coro de Boston viajó por todo el país con la gripe AH1N1" (in Spanish). La Nación. 2009-05-12. Retrieved 2009-05-14.
- ^ "Salud reporta cuatro nuevos casos probables de gripe" (in Spanish). La Nación. 2009-05-13. Retrieved 2009-05-14.
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- ^ Trinidad Express - http://www.trinidadexpress.com/index.pl/article_news?id=161487721