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2009 swine flu pandemic timeline

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This article covers the chronology of the 2009 H1N1 Swine Influenza Epidemic. The flag icons denote the first publically announced confirmed cases per nation-state, plus major announcements by international agencies such as the EU and the WHO. Template:2009 swine flu outbreak table

See the following articles for more information:

Main article: 2009 swine flu outbreak
See also: 2009 swine flu outbreak by country
See also: Influenza A virus subtype H1N1

Timeline: alerts, confirmed cases and deaths

February 2009

MexicoMexico In La Gloria, Veracruz, 60% of the town's population starts to fall ill from a mysterious respiratory illness. Only one sample from a later-infected four-year-old boy was tested internationally after the novel flu was reported (with a positive result), but Veracruz officials said that there were no plans to exhume the bodies of two infants who died in the outbreak. One infant was reported to have died from the February outbreak and one on March 21.[1]

March 2009

Probable and confirmed Mexican cases by date of illness onset, March 15 – April 26. —CDC

March 15

MexicoMexico Onset of the first cases of what would later be classed as probable swine flu A(H1N1).[2]

March 17

MexicoMexico Earliest known onset of a case later confirmed as S-OIV.[2]

March 28

Confirmed USA cases with known dates of illness onset (April 27, 2009). —CDC


United StatesUnited States Earliest known onset of a USA case later confirmed as swine flu, being a nine-year-old girl residing in Imperial County, California.[3][4]

March 30

United StatesUnited States Biosurveillance firm Veratect begins tracking the unusual respiratory illness in Mexico.[5][6]

United StatesUnited States A sample is collected from a nine-year-old female patient, later confirmed as also containing the novel virus strain (organism sequenced as A/California/05/2009(H1N1)).[7][8]

United StatesUnited States Onset of illness for a ten-year-old boy residing in San Diego County, California, the case later being the first confirmed as swine flu, .[4]

April 2009

April 1

United StatesUnited States A nasopharyngeal 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 (A/California/04/2009(H1N1)).[4][7][9]

April 6

MexicoMexico Public health authorities begin investigating unusual cases of pneumonia.[10] 400 people had reportedly sought treatment for pneumonia/influenza-like illness (ILI) in La Gloria the preceding week.[10]

United StatesUnited States Veratect publishes the alert "La Gloria: 'Strange' Respiratory Affects 60% of Local Population; Three Pediatric Deaths May be Associated with the Outbreak."[5][10]

April 12

MexicoMexico The General Directorate of Epidemiology (DGE) reports the outbreak of an ILI in a small community in Veracruz to the Pan American Health Organization (PAHO), which is the Regional Office of the World Health Organization (WHO).[2]

MexicoMexico A 39-year-old woman dies of severe viral pneumonia in the city of San Luis Potosí, and is later believed to be the earliest known fatality related to the outbreak.[11]

April 13

MexicoMexico First death in Oaxaca due to what would later be identified as swine flu.[12]

United StatesUnited States The Centers for Disease Control (CDC) is advised of a ten-year-old boy with a respiratory illness in San Diego County, California. Test results had revealed an Influenza A virus, but were negative for standard human sub-types. The San Diego County Health Department is notified.[4]

April 14

United StatesUnited States The CDC receives its first sample from California (ten-year-old boy in San Diego County), and identifies the virus as a strain of swine influenza A (H1N1).[4]

April 16

MexicoMexico Authorities notify the PAHO of the atypical pneumonia.[10]

United StatesUnited States Veratect publishes the alert "Atypical Pneumonia Cases Reported at Hospital" regarding the Oaxaca cases.[5][10]

April 17

United StatesUnited States The CDC receives a second sample from Southern California (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 is notified.[4]

MexicoMexico A case of atypical pneumonia in Oaxaca prompts enhanced national surveillance. A field investigation is started.[2]. Mexico contacts Canada to request more specialized testing.[13]

April 18

MexicoMexico Mexico sends 14 mucous samples to the CDC, and health teams are dispatched to hospitals to look for patients showing severe influenza or pnuemonia-like symptoms.[14]

April 20

United StatesUnited States Veratect advises the CDC of the Mexican events.[5][10] The CDC is already investigating the California and Texas cases.[5][10][15]

April 21

United StatesUnited States The CDC alerts doctors to a similar novel strain of swine influenza A(H1N1) in two cases from Southern California. Local investigations including Texas are underway, and enhanced surveillance for possible additional cases is being implemented in the areas.[4] The Associated Press covers the alert.[15] [16]

April 22

CanadaCanada Canada receives samples from Mexico for testing.[13]

April 23

MexicoMexico The Public Health Agency of Canada confirms Mexico cases of swine-origin influenza A (H1N1) virus (S-OIV) infection.[2] Sequence analysis reveals that the Mexico patients were infected with the same S-OIV strain detected in two children residing in California.[2] The PAHO is informed that a cluster in Mexico of severe respiratory illnesses has been laboratory-confirmed as S-OIV infection.[2]

April 24

World Health OrganizationThe WHO issues its first Disease Outbreak Notice on the matter, confirming the infection of a number of people in Mexico and the United States by "Swine Influenza A/H1N1 viruses… not… previously detected in pigs or humans."[17]

United StatesUnited StatesUnited States The CDC tells a press conference that seven of the 14 Mexico samples were found to contain the same virus strain as the known USA cases in California and Texas, and that indicators suggest that containment in the USA is "not very likely".[18]

MexicoMexico The Minister of Health confirmed Mexican cases of human infection by swine influenza and that it was believed that some of those cases had resulted in death.[18]

MexicoMexico Health authorities implement public health measures for all airport passengers and vaccination of health-care workers with seasonal influenza vaccine.[2]

April 25

The PAHO Vaccination Week In The Americas starts.[19] The 2009 Week was planned to emphasize the vaccination of entire families, and health worker immunization.[19]

Under the International Health Regulations (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".[20][21]

April 26

CanadaCanada Four cases confirmed in Nova Scotia and two in British Columbia[citation needed].

April 27

World Health Organization Regions.

World Health OrganizationThe Emergency Committee meets for the second time, and the WHO Director-General issues a statement that containment of the outbreak is not feasible, and elevates its pandemic alert from Phase 3 to Phase 4.[22]

SpainSpain First confirmed case of swine flu in Almansa, Spain and thus the first case in Europe; A(H1N1) has spread from the WHO Region of the Americas to the WHO European Region.

United KingdomUnited Kingdom First two confirmed cases, in Scotland[citation needed].

European UnionEuropean Union (EU) Health Commissioner advises Europeans not to travel to the United States or Mexico unless the need is urgent. This follows the first confirmed case in Spain.[23]

April 28

World Health OrganizationWHO Confirmed cases are now extant in four of six WHO regions (see map). As of 19:15 GMT seven countries have officially reported cases of swine influenza A(H1N1) infection.[24]

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

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

CanadaCanada Confirmed: two cases and another four in Alberta and Ontario, respectively[citation needed].

Spain The second confirmed case in Spain is located in Valencia[citation needed].

Costa Rica Second confirmed case in Costa Rica and in Central America and Caribbean[citation needed].

April 29

World Health OrganizationWHO The Emergency Committee meets for the third time,[25] and the WHO raises its pandemic alert level from Phase 4 to Phase 5, its second highest.[26]As of 18:00 GMT, nine countries have officially reported 148 cases of swine influenza A(H1N1) infection.[27]

European UnionEU Foreign Relations Commissioner Benita Ferrero-Waldner announces that the halt of all travel to Mexico and disinfecting all airports due to the global flu outbreak is being considered.[28]

GermanyGermany Three confirmed cases, two in Bavaria and one in Hamburg. [29]

AustriaAustria First confirmed case[citation needed].

United StatesUnited States First death caused by the swine flu, a 23-month old Mexican child hospitalized in Texas[citation needed]. Ninety-one cases confirmed cases worldwide to date.

CanadaCanada Nineteen confirmed cases[citation needed].

New Zealand Three confirmed cases[citation needed].

Spain Eight more cases raises the total in Spain to 10, including the first human-to-human intergenerational transmission[30] (in which the patient had not recently been to Mexico but was infected by another patient who had just visited Mexico, namely his girlfriend).[31] This is the first intergenerational transmission to be documented in Europe.

United KingdomUnited Kingdom Three more confirmed cases of swine flu, giving a total of five confirmed cases[citation needed].

April 30

NetherlandsNetherlands First confirmed case, a three-year-old child.[32] The child returned from Mexico to the Netherlands on April 27, 2009. The parents test negative for A(H1N1).

SwitzerlandSwitzerland First confirmed case[citation needed].

Republic of IrelandIreland First confirmed case[33].

United StatesUnited States Four cases are confirmed in an outbreak at the University of Delaware; 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, and other school activities. [34]

CanadaCanada Confirmed: One more case in Toronto, and eight more cases in Nova Scotia, and Alberta bringing total to 28. [35]

United KingdomUnited Kingdom Three further confirmed cases of swine flu, giving a total of eight confirmed cases. [36]

May 2009

May 1

World Health OrganizationWHO As of 06:00 GMT, 11 countries have officially reported 331 cases of influenza A(H1N1) infection.[37]

ChinaHong Kong, China 300 people are placed under quarantine at a hotel for seven days due to Hong Kong's first confirmed case there. [38]

  • Chief Executive Donald Tsang raises Hong Kong's response level from "serious" to "emergency".[39]
  • The Director of Health, Dr. PY Lam, orders Metropark Hotel in Wan Chai to be isolated for 7 days.[40]

DenmarkHvidovre, Denmark First confirmed case.[41]

FranceFrance First two confirmed cases. [42]

CanadaCanada Confirmed: 51 Confirmed Cases

United KingdomUnited Kingdom First and second case of human to human transmission within the UK confirmed.[43]

United StatesUnited States 155 confirmed cases.

MexicoMexico begins five-day shutdown to fight flu spread.[44]

May 2

World Health Organization WHO As of 06:00 GMT 15 countries have officially reported 615 cases of influenza A(H1N1) infection.

ItalyItaly First confirmed case.

South KoreaSouth Korea First confirmed case.[45]

CanadaCanada

United StatesUnited States 189 confirmed cases, also start of school closers.

MexicoMexico The death and confirmed case are corrected to 101 and 397 respectively.

ChinaChina suspended flights from Mexico to Shanghai with a case confirmed in a flight from Mexico[47]

May 3

World Health OrganizationWHO As of May 3, 2009, 18 countries have reported 745 cases of H1N1 (swine flu).

  • Mexico
    The first cases were reported as ILI starting on March 18, but were not then suspected of being due to a new strain of flu. The first case where the person died of this new strain was on April 13, the news of which was first broadcast live in Mexico on April 23.
    • Laboratory confirmed cases: 358
    • Suspected cases: 2500+
    • Confirmed deaths: 15
    • Unconfirmed deaths: 168
As of 29 April 2009, per Mexican Health Ministry
  • United States
    The first cases in the United States were reported on March 28 and 30 in San Diego County and Imperial County, California. It has spread to numerous states including Texas, Kansas (April 25), Ohio (April 26) and New York (April 24). On April 25, in Minnesota, a television news station reported a suspected case. On April 28, there were many hundreds of suspected cases in a school in New York and an outbreak reported at the University of Delaware which was later confirmed by laboratory testing on April 30[48]. On April 29, the first confirmed death from Swine Flu, that of a young infant, occurred in Texas. That child was a Mexican national and was receiving medical treatment in the U.S.
    • Laboratory confirmed cases: 155[49]
    • Suspected cases: 767+
    • Confirmed deaths: 1
    • Unconfirmed deaths: 0
As of 1 May 2009, per CDC and state health departments

Countries with confirmed cases

See also: 2009 swine flu outbreak by country

World Health Organization

  • Confirmed Deaths: 16
  • Confirmed Cases: 611

[As of May 1, 2009]

North America

[As of May 1, 2009]

Europe

  • Austria: Confirmed cases
    • Laboratory confirmed cases: 1
    • Suspected cases: 2
    • Confirmed deaths: 0
    • Unconfirmed deaths: 0
[As of May 3, 2009]
  • Germany: Confirmed cases
    • Laboratory confirmed cases: 6
    • Suspected cases: 30
    • Confirmed deaths: 0
    • Unconfirmed deaths: 0
[As of May 3, 2009]
  • Spain Confirmed cases
    • Laboratory confirmed cases: 21
    • Suspected cases: 103
    • Confirmed deaths: 0
    • Unconfirmed deaths: 0
[As of May 3, 2009]
  • United Kingdom Confirmed cases
    • Laboratory confirmed cases: 15
    • Suspected cases: 631+
    • Confirmed deaths: 0
    • Unconfirmed deaths: 0
[As of May 3, 2009]
  • France: Confirmed cases
    • Laboratory confirmed cases: 2
    • Suspected cases: 33
    • Confirmed deaths: 0
    • Unconfirmed deaths: 0
[As of May 3, 2009]
  • Netherlands: Confirmed cases
    • Laboratory confirmed cases: 1
    • Suspected cases: 0
    • Confirmed deaths: 0
    • Unconfirmed deaths: 0
[As of May 1, 2009]
  • Italy: Confirmed cases
    • Laboratory confirmed cases: 1
    • Suspected cases: 13
    • Confirmed deaths: 0
    • Unconfirmed deaths: 0
[As of May 3, 2009]

Asia

  • Israel
    On April 25, medics were testing a 26-year-old man, and a 47-year-old man who had been taken to hospital with flu-like symptoms after returning from a trip to Mexico, independently. On April 28, the 26-year-old man tested positive, making the first outbreak of the swine flu in Israel and Asia. Later that day the 47-year-old man was confirmed to be the second case in Israel and Asia.
    • Laboratory confirmed cases: 3
    • Suspected cases: 1
    • Confirmed deaths: 0
    • Unconfirmed deaths: 0
[As of May 3, 2009]
  • South Korea
    A 51-year-old female is believed to have contracted the disease after contact with a local driver during a Mexico trip in late April. Upon her arrival at Incheon International Airport, on Sunday, she felt light flu symptoms and reported her illness to a local health center. On April 28, she was found to have tested positive for the A/H1N1 virus.
    • Laboratory confirmed cases: 1
    • Suspected cases: 99
    • Confirmed deaths: 0
    • Unconfirmed deaths: 0
[As of May 3, 2009]
  • Hong Kong
    One Mexican, who travelled from Mexico to Hong Kong via Shanghai, arrived Hong Kong on April 30, was tested positive by the University of Hong Kong and Department of Health of Hong Kong on May 1, becoming the first confirmed case of swine influenza A (H1N1) infections in Hong Kong and also in Asia.
    • Laboratory confirmed cases: 1[50]
    • Suspected cases: 5[51]
    • Confirmed deaths: 0
    • Unconfirmed deaths: 0
[As of May 3, 2009 HKT 20:00]

Oceania

  • New Zealand
    On April 26, a group of students who have arrived from Mexico has tested positive for Influenza A; however, further testing is needed to confirm A/09 (H1N1) infection. On April 28, tests made to the students were positive, making the first outbreak of swine flu in New Zealand and in Oceania.
    • Laboratory confirmed cases: 4
    • Suspected cases: 101+
    • Confirmed deaths: 0
    • Unconfirmed deaths: 0
[As of May 3, 2009]

Central America and Caribbean

  • Costa Rica
    On April 28, the first case of the swine flu outbreak was confirmed, being the first case confirmed in Costa Rica and Central America and Caribbean. By the end of April 28 the second case has been already confirmed.
    • Laboratory confirmed cases: 2
    • Suspected cases: 51+ (2 probable cases)
    • Confirmed deaths: 0
    • Unconfirmed deaths: 0
[As of May 3, 2009]

Countries with suspected cases

Africa

  • South Africa:
    • Laboratory confirmed cases: 0
    • Suspected cases: 2
    • Confirmed deaths: 0
    • Unconfirmed deaths: 0

Oceania

  • Australia:
    On April 25, two people in Queensland, Australia, are being tested after developing flu-like symptoms on returning from Mexico.
    • Laboratory confirmed cases: 0
    • Suspected cases: 80
    • Confirmed deaths: 0
    • Unconfirmed deaths: 0
[As of May 3, 2009]
  • Fiji:
    On April 30, the first suspected case was reported in Fiji.
    • Laboratory confirmed cases: 0
    • Suspected cases: 1+
    • Confirmed deaths: 0
    • Unconfirmed deaths: 0
[As of April 30, 2009]

Europe

  • Iceland:
    • Laboratory confirmed cases: 0
    • Suspected cases: 0
    • Confirmed deaths: 0
    • Unconfirmed deaths: 0
[As of April 28, 2009]
  • Norway:
    • Laboratory confirmed cases: 0
    • Suspected cases: 1+
    • Confirmed deaths: 0
    • Unconfirmed deaths: 0
[As of May 3, 2009]
  • Poland:
    • Laboratory confirmed cases: 0
    • Suspected cases: 9
    • Confirmed deaths: 0
    • Unconfirmed deaths: 0
[As of May 1, 2009]
  • Sweden:
    • Laboratory confirmed cases: 0
    • Suspected cases: 5[52]
    • Confirmed deaths: 0
    • Unconfirmed deaths: 0
[As of April 29, 2009]
  • Finland:
    • Laboratory confirmed cases: 0
    • Suspected cases: 2
    • Confirmed deaths: 0
    • Unconfirmed deaths: 0
[As of April 29, 2009]

Central America and Caribbean

  • Guatemala:
    • Laboratory confirmed cases: 0
    • Suspected cases: 3
    • Confirmed deaths: 0
    • Unconfirmed deaths: 0
[As of May 3, 2009]
  • Honduras:
    • Laboratory confirmed cases: 0
    • Suspected cases: 9+
    • Confirmed deaths: 0
    • Unconfirmed deaths: 0
[As of April 28, 2009]

South America

  • Colombia:
    • Laboratory confirmed cases: 0
    • Suspected cases: 2
    • Confirmed deaths: 0
    • Unconfirmed deaths: 0
[As of May 3, 2009]
  • Venezuela:
    • Laboratory confirmed cases: 0
    • Suspected cases: 3
    • Confirmed deaths: 0
    • Unconfirmed deaths: 0
[As of May 3, 2009]
  • Brazil:
    • Laboratory confirmed cases: 0
    • Suspected cases: 14 (7)
    • Confirmed deaths: 0
    • Unconfirmed deaths: 0
[As of May 3, 2009]
  • Argentina:
    • Laboratory confirmed cases: 0
    • Suspected cases: 17
    • Confirmed deaths: 0
    • Unconfirmed deaths: 0
[As of May 3, 2009]
  • Chile:
    • Laboratory confirmed cases: 0
    • Suspected cases: 5
    • Confirmed deaths: 0
    • Unconfirmed deaths: 0
[As of May 3, 2009]
  • Uruguay:
    • Laboratory confirmed cases: 0
    • Suspected cases: 1
    • Confirmed deaths: 0
    • Unconfirmed deaths: 0
[As of May 3, 2009]
  • Peru:
    • Laboratory confirmed cases: 0
    • Suspected cases: 7
    • Confirmed deaths: 0
    • Unconfirmed deaths: 0
[As of May 3, 2009]

References

  1. ^ Tuckman, Jo (2009-04-27). "Four-year-old could hold key in search for source of swine flu outbreak". The Guardian. Retrieved 2009-04-28.
  2. ^ a b c d e f g h "Outbreak of Swine-Origin Influenza A (H1N1) Virus Infection --- Mexico, March--April 2009". Morbidity and Mortality (Dispatch). Centers for Disease Control. 2009-04-30. Retrieved 2009-05-01.
  3. ^ Brown, David (2009-04-22). "New Strain of Swine Flu Investigated: Two Children in San Diego Area Had No Contact With Pigs". Washington Post. Archived from the original on 2009-05-01. Retrieved 2009-05-01.
  4. ^ a b c d e f g "Swine influenza A (H1N1) infection in two children --- Southern California, March--April 2009". Morbidity and Mortality Weekly Report. Centers for Disease Control. 2009-04-21. Retrieved 2009-04-30.
  5. ^ a b c d e Blumenthal, Les (2009-05-01). "Company warned officials of flu 18 days before alert was issued". McClatchy Newspapers. Retrieved 2009-05-02.
  6. ^ "Veratect the Company to First Sound Alarm on Swine Influenza Makes Data on the Spread of this Disease Public" (PDF). Corporate press release. Veratect Inc. 2009-04-27. Retrieved 2009-04-30.
  7. ^ a b "GenBank sequences from 2009 H1N1 influenza outbreak". Influenza Virus Resource. NCBI. 2009-05-01. Archived from the original on 2009-05-02. Retrieved 2009-05-02.
  8. ^ "Influenza A virus (A/California/05/2009(H1N1)) segment 1 polymerase PB2 (PB2) gene, complete cds". NCBI. Retrieved 2009-05-02.
  9. ^ "Influenza A virus (A/California/04/2009(H1N1)) segment 1 polymerase PB2 (PB2) gene, complete cds". NCBI. Retrieved 2009-05-02.
  10. ^ a b c d e f g Brown, David (2009-04-30). "Reporting Health Threats: System Set Up After SARS Epidemic Was Slow to Alert Global Authorities". Washington Post. Archived from the original on 2009-05-01. Retrieved 2009-04-30.
  11. ^ Brown, David (2009-04-26). "U.S. Slow to Learn of Mexico Flu: Canadian Officials Knew of Rare Strain Before Americans Did". Washington Post. Retrieved 2009-05-02. The earliest case found in Mexico was a 39-year-old woman who died April 12 of severe viral pneumonia in San Luis Potosi, a city of about 700,000 in central Mexico. "That attracted the attention of the epidemiologist there," said Mauricio Hernández, deputy minister for disease prevention and health promotion in Mexico's Federal Department of Health.
  12. ^ Orsi, Peter (2009-04-27). "Mexico says suspected swine flu deaths now at 149". Google News. Associated Press. Archived from the original on 2009-04-28. Retrieved 2009-04-30.
  13. ^ a b "Human Swine Influenza Outbreak. Message from the Minister of Health and the Chief Public Health Officer on Human Swine Flu". Advisories. Public Health Agency of Canada. 2009-04-24. Archived from the original on 2009-05-01. Retrieved 2009-05-01.
  14. ^ Stevenson, Mark (2009-04-26). "U.S., Mexico battle deadly flu outbreak". KomoNews.com. Fisher Communications, Inc. AP. Retrieved 2009-05-02.
  15. ^ a b Stobbe, Mike (2009-04-21). "Officials alert doctors after 2 California children infected with unusual swine flu". Star Tribune. AP. Retrieved 2009-04-30.
  16. ^ Stobbe, Mike (2009-04-21). "Swine flu cases in Calif. worry health officials". FoxNews.com. Fox News. AP. Archived from the original on 2009-05-02. Retrieved 2009-05-02.
  17. ^ "(Update 1) Influenza-Like Illness in the United States and Mexico". World Health Organization. 2009-04-24. Retrieved 2009-05-01.
  18. ^ a b "CDC Briefing on Public Health Investigation of Human Cases of Swine Influenza (April 24, 2009)". Press Briefing Transcripts. CDC. 2009-04-24. Retrieved 2009-05-02.
  19. ^ a b "Vaccination Week In The Americas (2009 portal)". Pan American Health Organization. 2009. Retrieved 2009-04-29.
  20. ^ "Statement by WHO Director-General, Dr Margaret Chan (25 April 2009): Swine influenza". World Health Organization. 2009-04-25. Retrieved 2009-05-01.
  21. ^ http://www.who.int/csr/don/2009_04_26/en/index.html
  22. ^ "Statement by WHO Director-General, Dr Margaret Chan (27 April 2009): Swine influenza". World Health Organization. 2009-04-27. Retrieved 2009-05-01.
  23. ^ "Europeans urged to avoid Mexico and US as swine flu death toll exceeds 100". Guardian. 27 April 2009. Retrieved 2009-04-27.
  24. ^ http://www.who.int/csr/don/2009_04_28/en/index.html
  25. ^ Jordans, Frank (2009-04-29). "WHO calls emergency meeting; eyes pandemic level". Google News. Associated Press. Archived from the original on 2009-04-30. Retrieved 2009-04-30. {{cite news}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
  26. ^ "Statement by WHO Director-General, Dr Margaret Chan (29 April 2009): Swine influenza". World Health Organization. 2009-04-27. Retrieved 2009-05-01.
  27. ^ http://www.who.int/csr/don/2009_04_29/en/index.html
  28. ^ EU considers halting all Mexico travel- commissioner
  29. ^ "SWINE FLU: GERMANY CONFIRMS THREE CASES". AGI. 2009-04-29. Archived from the original on 2009-05-02. Retrieved 2009-05-02.
  30. ^ http://www.ctv.ca/servlet/ArticleNews/story/CTVNews/20090428/swineflu_WHO_090428/20090428?hub=Health&s_name=
  31. ^ http://dailynews.muzi.com/news/ll/english/10089979.shtml?q=&cc=10314&a=on
  32. ^ "Dutch confirm swine flu case in three year-old". Reuters. 2009-04-30. Retrieved 2009-04-30.
  33. ^ "Irish man treated for swine flu". BBC. 2009-04-30. Retrieved 2009-05-02.
  34. ^ http://www.delawareonline.com/article/20090430/HEALTH/904300351
  35. ^ Tanya Talaga, Joanna Smith. "Spike in cases of swine flu" Toronto Star 30 April 2009
  36. ^ "Three new cases of swine flu confirmed in Britain" China View 1 May 2009
  37. ^ http://www.who.int/csr/don/2009_05_01/en/index.html
  38. ^ http://news.bbc.co.uk/2/hi/asia-pacific/8029871.stm
  39. ^ "1st H1N1 case confirmed in HK". Hong Kong SAR. 2009-05-01. Retrieved 2009-05-03.
  40. ^ "Director of Health issues isolation order to control human swine flu". Centre for Health Protection, Hong Kong SAR. 2009-05-31.
  41. ^ http://www.bt.dk/article/20090501/nyheder/90501055
  42. ^ http://www.invs.sante.fr/derniere_minute/fichiers/10.bilan01052009_19h00.pdf)
  43. ^ HPA. "First case of onward human to human swine flu transmission in England confirmed".
  44. ^ "Mexico To Close Down Most Businesses For Five Days As 331 Cases Of Swine Flu Reported". AHN. 2009-05-01. Retrieved 2009-05-03.
  45. ^ http://www.who.int/csr/don/2009_05_02/en/index.html 1st South Korea case.
  46. ^ "Worker may have passed H1N1 to Alberta pigs". CTV. 2009-05-02. Retrieved 2009-05-02. {{cite news}}: Check date values in: |accessdate= and |date= (help)
  47. ^ "China halts Mexico flights". The Straits Times. 2009-05-02. Retrieved 2009-05-03.
  48. ^ http://www.delawareonline.com/article/20090430/NEWS/90430029
  49. ^ http://cdc.gov/h1n1flu/
  50. ^ "Hong Kong reports first confirmed swine flu press conference on May 1". Hong Kong SAR. 2009-05-02. Retrieved 2009-05-02.
  51. ^ "Update on Swine Influenza Infection in Humans" (PDF) (PDF). Centre for Health Protection, Hong Kong SAR. 2009-05-02. Retrieved 2009-05-02.
  52. ^ http://www.thelocal.se/19112/20090427/
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