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2009 swine flu pandemic in Europe

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Template:2009 flu pandemic table

The 2009 flu pandemic in Europe, part of a pandemic in 2009 of a new strain of influenza A virus subtype H1N1 causing what has been commonly called swine flu, has (as of 9 June 2009) afflicted at least 1,082 people in Europe, with no confirmed deaths. The majority of confirmed cases and the highest incidence in Europe have occurred in the United Kingdom.

Outbreak evolution in Europe:
  Confirmed cases followed by death
  Confirmed cases
  Unconfirmed or suspected cases
Outbreak evolution in Europe:
  500+ cases
  50+ cases
  5+ cases
  1+ cases

On April 27, the European Union health commissioner advised Europeans not to travel to the United States or Mexico unless urgent. This followed the discovery of the first confirmed case in Spain.[1]

EU Foreign relations commissioner Benita Ferrero-Waldner said on April 29 the halt of all travel to Mexico and disinfecting all airports due to the global flu outbreak is being considered.[2]

Outbreak evolution in Austria
  Confirmed cases
  Unconfirmed or suspected cases

Several possible cases in Austria turned out to be negative, whereas one test, that of a 28-year-old woman from Vienna, had a positive result. Therefore Austria is the 9th country affected by a confirmed case of swine flu.[3] There are still two suspected cases being tested.[4]

Six suspected cases of swine flu in Belgium ultimately tested negative.[5]

The Belgian interior ministry announced the first case of A/H1N1 flu in Belgium on 13 May 2009. The infected person is a 28-year old man who lives in Ghent and returned from a holiday in the United States.[6]

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

Two new persons tested positive for A/H1N1 flu on 15 May 2009.[7]

A sixth[8] and seventh [9] case of swine flu was discovered on 21 May 2009. An eighth[10] infection was reported on 26 May2009.

The first case of swine flu was a person from New York to Sofia on the 27th May. The person developed respiratory problems, cough and high fever on the 29th May.[11]

On April 29 it was announced that a 22-year old traveller from Florida had been held in quarantine in Osijek under suspicion of swine flu.[12] However, later that day director of infectious disease epidemiology agency, Dr. Ira Gjenero Margan, stated results of the testing were negative "with 99% certainty".[13] On April 30, a child was held in quarantine in Zagreb but the results were negative.[14]

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

By June 11, a total of 11 cases is confirmed, including a six year old boy[15][16]

The first case was Laboratory confirmed on May 29. The patient was a 29-year-old man, who returned from the United States.[17] On June 3, two new cases have been Laboratory confirmed. [18]

The H1N1 strain of influeza has been added to the official list of infectious diseases dangerous to public ("yleisvaarallinen tartuntatauti"), which guarantees free-of-charge treatment to all residents and allows for involuntary quarantine, effective from May 1 2009.[19] Finland's first two H1N1-cases confirmed 12.5.2009 in Helsinki metropolitan area. They were together in Mexico and came to Finland via Amsterdam 6.5.2009 [20]

Outbreak evolution in France
  Confirmed cases
  Unconfirmed or suspected cases

As of April 28 there were twenty suspected cases of swine flu being investigated in France. Since April 25, over 100 cases of Influenza-like illness have been reported, of which 30 were identified as possible cases. 10 of those cases have since been excluded.[21] On April 30, the number of suspected cases was revised to 50 (including 4 probable cases).[22]

On May 1, the French Health Minister has confirmed, during the 8 p.m. TF1 news, that 2 cases of A(H1N1) flu have been detected in France.[23]

On May 4, two new cases have been confirmed bringing to 4[24] the total number of people infected.

May 6, a fifth case is confirmed in Paris region.[25] Two new cases are also confirmed at the end of the afternoon by the INVS (National Institute for Sanitary Watch [26]), 7 are probable and 32 are suspected ([27])

On May 7, three new cases were announced by the National Institute for Sanitary Watch. There are now 10 confirmed cases, 5 probable, and 27 are suspected.[28]

Confirmed cases in Germany by states[29]
State Confirmed cases
North Rhine-Westfalia 79
Bavaria 25
Baden-Württemberg 18
Hesse 13
Thuringia 8
Saxony-Anhalt 6
Hamburg 5
Lower Saxony 4
Brandenburg 3
Saxony 3
Rhineland-Palatinate 2
Mecklenburg-Vorpommern 1
Schleswig-Holstein 1
Total 168
File:H1N1 Germany Map-2009-29-04.svg
Outbreak evolution in Germany:
  Confirmed cases followed by death
  Confirmed cases
  Unconfirmed or suspected cases
Outbreak evolution in Germany:
  50+ cases
  5+ cases
  1+ cases

Two men and a woman from Bielefeld who had been firstly suspected of having the virus tested negative on influenza type A.[30]

On April 29, the first case of swine flu in Germany was confirmed by the Robert Koch Institute in the area of Regensburg.[31][32][33] A 22-year-old woman from Hamburg is also confirmed to have been infected by swine flu during a trip to Mexico.[33] A 37-year-old woman from Kulmbach is also confirmed to have become infected during a similar trip.[33]

On May 1, Robert Koch Institute confirmed the first case of human-to-human spreading of swine flu in Munich. Infected was the nurse who had contact with one of the infected people. At approx. 10:00 she was claimed to be already healed.[34] At the time of 13:00 one further infection in Bavaria was confirmed, but the patient is also claimed to be healthy again.[35]

On May 2, a new human-to-human infection, in the same hospital in Munich, was confirmed. The new patient, who was in the same room with the original infected German that came from Mexico, is currently being reported to show no signs of the new influenza strain anymore.[36]

On May 3, two further cases of swine flu in Brandenburg were reported.Two people from the same flight as patient in Hamburg. were also infected [37]

On May 5, one new case in Saxony-Anhalt has been confirmed bringing to 9[38] the total number of people infected.

On May 7, another new case in Saxony-Anhalt is reported.[39]

On May 8 an adult male living in Bavaria who had recently been to USA.[40]

On May 11 the case of a 27 years old Bavarian woman, who stayed for some weeks in Mexico and medicated patients in a hospital, is reported.[41]

On May 15 two more cases were reported, a female human and her son from Saxony-Anhalt have been infected obviously by her husband / his father, who returned from Mexico.[42]

On May 21 a case was found in a 43 year old woman from Düsseldorf in North Rhine-Westphalia who returned from New York.[43] One day later, Robert Koch Institute confirmed that that her husband has been tested positive with swine influenza too. Furthermore their six years old daughter who did not stay in New York has been infected by her parents, bringing the total to 17.[44]

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

On 19 May 2009[citation needed] the authorities confirmed the first case of the new flu in Greece. The infected person is a 19 year old Greek student who studies in New York and who flew to Greece a few days ago. He is hospitalised at Sismanogleion[45] but is not gravely ill. The authorities have contacted many of the passengers who sat near this patient on the plane and are examining them for suspicious symptoms. At this point in time Greece has enough antivirals to cover 12% of the population[46] (at least 10% is the amount proposed by the EU directives). The 19-year-old is now out of the hospital and none of the passengers in his flight are infected.

On 29 May 2009 the fourth case was announced.[47]

On 14 Jun 2009 the total number of cases have reached 20.[48]

According to the MTI as of April 29 six suspected cases have been reported in Hungary, none of them confirmed to be the swine flu. Samples of the virus from the US health authorities are due to arrive to Hungary in a few days enabling the start of vaccine production.[49]

On May 29, a case has been confirmed.[50] The infected person, a brasilian man has since recovered and left the country.

The first case of A(H1N1) in Iceland was reported on May 23 2009. The infected person came to the country from New York and got sick shortly after he arrived in Iceland. The second case was announced on June 9. The infected was a male in the Greater Reykjavík area who also had arrived from the United states.[51][52][53] [54]

Iceland is currently being briefed by the WHO and is cooperating closely with ECDC, CDC and the EU in terms of monitoring and response. Initially the directorate of health warned people traveling to Mexico and the United States (especially California and Texas) to exercise caution and to contact a doctor immediately if they started showing symptoms of swine flu but on April 28 people traveling to Mexico were advised to cancel their trip unless its very urgent.[55][56]

On April 28, it was announced that passengers arriving in Iceland from the United States or Mexico would be monitored and will undergo medical examination even if the slightest signs of influenza are detected.[57]

Iceland has stocks of Tamiflu and Relenza for one-third of its population.[57]

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

  • A worst-case scenario where 50% of the Icelandic population are infected and 3% of the infected population die.
  • A milder scenario where precautionary measures prevent infection, 25% of the Icelandic population are infected and 1% die.[58]

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

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

From 25 May to 31 May, three more cases were confirmed.[59][60][61]

On 2 June, 3 new cases were confirmed by the HSE on people who returned recently from New York. [62]. This brings the total of people in Ireland with Swine Flu to 7.

Outbreak evolution in Italy
  Confirmed cases
  Unconfirmed or suspected cases

Italy's agriculture lobby, Coldiretti, warned against panic reaction, noting that farmers lost hundreds of millions of euros due to consumer boycotts during the 2001 mad cow scare and the 2005 bird flu outbreak.[63]

A woman who returned from San Diego was hospitalised in Venice for suspected swine flu.[64]

As of April 30, about 20 suspected cases of swine flu are monitored in Italy.[65]

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

As of April 29, one possible case (tourist returned from Mexico) in Lithuania is currently under investigation. The institutions already confirmed that it is the A type influenza, but the details as to whether it is H1N1 are still not known.[66] For further investigation sample was sent to the laboratory located in London.[67]

On April 27 2009, the government of the Republic of Macedonia prohibited all exports and imports of live pigs. Even though Macedonia is not affected from the Swine Flu, the government ordered a ten days health monitoring period for everybody that comes from an affected country.[68]

The Netherlands National Institute for Public Health and the Environment advised any traveller who returned from Mexico since April 17 and developed a fever of 38.5 degrees Celsius (101.3 degrees Fahrenheit) within four days of arriving in the Netherlands to stay at home.[69] On April 30, 2009 a three year old child tested positive for the swine flu. The child returned from Mexico to the Netherlands on April 27, 2009. The parents tested negative to the swine flu.[70] The girl was very ill at first according to her parents,[71] but made a full recovery.[72] On 7 May a second case and a day later a third case of swine flu in the Netherlands were announced, concerning a 53 year old woman and a 52 year old man, respectively.[73] Both of them had returned from Mexico recently and are being treated with Tamiflu. The woman made a full recovery,[72] the man is doing well. There are no connections between each of the three cases. People who were seated close to the infected people in the plane were contacted and are being treated with Tamiflu as a precautionary measure. On 10 June, there are 30 confirmed cases in the Netherlands.

Outbreak evolution in Poland
  Confirmed cases
  Suspected cases

As of June 13, Poland has seven confirmed cases - one of which a 58 year old woman from Mielec, who came back from the USA. She was already released from the hospital, because all of her symptoms had been successfully cured . As of May 8, eight cases are under investigation, according to the National Institute of Public Health and news channel TVN 24.[74][75] At least 19 other patients had been previously investigated but tests turned out negative.[76][77] The Polish Foreign Ministry issued a statement on April 25 or earlier recommending that citizens avoid travel to affected areas until the outbreak is totally contained.[69]

Outbreak evolution in Norway
  Confirmed cases
  Suspected cases
Outbreak evolution in Norway:
  500+ cases
  50+ cases
  5+ cases
  1+ cases

The Norwegian Institute of Public Health (FHI) updates their homepage with information about the swine flu outbreak in Norway every day at 10:00 (UTC). [78]

On May 9, two Norwegian students from Oslo and Telemark, were confirmed to be infected with swine flu after they came home from studies in Mexico. None of them became seriously ill and they are recovering quickly. A member of one of their families is suspected of being infected as well.[79] One of them (the 20 year-old man from Oslo) have been confirmed completely recovered. [80] These are the first two cases of swine influenza in Norway.

On June 4, a Norwegian woman from Vest-Agder who recently had been to the United States was confirmed with the swine influenza. The infected woman is recovering well. This is the ninth confirmed case of swine influenza.[81]

Outbreak evolution in Portugal
  Confirmed cases
  Suspected cases

As of May 4, there has been one confirmed case in Lisbon, Portugal, but it did not represent any preocupation, because the risk of transmission was no longer present at that time[82].

On June 1, Ana Jorge, the Portuguese minister of health, has confirmed the second case in Portugal. A 33 year old man who travelled from the United States, first landing in Frankfurt, Germany, the case was reported at São João Hospital, Oporto[83].

Outbreak evolution in Romania
  Confirmed cases
  Suspected cases

In Sâmbăteni, Arad County, a child of a year and six months and his mother who recently returned from a trip to Portugal and Spain were suspected of having contracted influenza A(H1N1). Tests returned negative.[84][85] On Wednesday, 27 May a woman returning from America was confirmed with swine flu in Bucharest. [86]

Russia has banned the import of pork meat from Guatemala, Honduras, Dominican Republic, Colombia, Costa Rica, Cuba, Nicaragua, Panama, El Salvador, 9 US States (Alabama, Arizona, Arkansas, Georgia, Kansas, Louisiana, New Mexico, Oklahoma and Florida) and all types of meat and meat products from Mexico and 5 US States (California, Texas, Kansas, New York and Ohio).[87][88][89]

The President instructed the regional governors to take urgent steps to prevent swine flu from spreading to Russia. Dmitry Medvedev also instructed the presidential plenipotentiary envoys in the federal districts to personally supervise the preventive measures to ensure the disease did not spread [in Russia] and stipulated monthly reports on the situation.[90]

On May 1 officials confirmed that two women who came from USA trip were suspected to have swine flu. Currently both are in hospital for further treatment.[91] As on May 2, both tourists are reported not to be infected with new strain.[92]

According to Deputy Health Minister Svetlana Mijatović, Serbia will adhere to all WHO recommendations for monitoring the swine flu epidemic.[93] "A sanitary inspection, together with Serbian Ministry of Internal Affairs (MUP), is checking travelers, [...] while the media and all the agencies throughout the world, as well as our own, are constantly informing the public that if anyone feels ill, or is coming from a contaminated area, to consult the authorities at any airport in the world [...]," Mijatović said.[93] Serbia's Health Minister stated on May 8, 2009 that there have been no registered cases of swine flu, and that Serbia has stockpiles of anti-viral medicine, although he admitted it would not stop a pandemic of swine flu in that country.[94]

Flights and holidays to Mexico and the U.S. have yet to be canceled, and the advice to citizens traveling to infected countries is to take precautions in terms of immunity and to maintain personal hygiene.[93]

A 71 year old tourist from Texas asked to be tested for swine flu at the Provincial hospital in Novi Sad, on April 30. Results were negative.[95]

Institute of Public Health of the Republic of Slovenia has established a web site with information about H1N1 induced influenza. Status of this webpage is updated once a day. As of May 25, there were 17 people tested, all negative.[96]

Outbreak evolution in Spain
  Confirmed cases
  Suspected cases

On April 27 the Spanish Ministry of Health and Social Policy announced that a man in Castilla-La Mancha who had recently returned from Mexico had contracted the disease. The man, aged 23, had returned from Mexico on April 22 and had been quarantined on the 25th. This was the first confirmed case in Europe.[97]

The Spanish government is also observing other 35 possible swine flu cases in the Basque Country, Catalonia, the Balearic Islands, Andalusia, Murcia, Madrid and the Valencian Community.[98]

AENA, the Spanish state owned company who manages all Spanish airports and Air Traffic Control established a protocol for the flights coming from and to Spain from the affected areas.[99] Three patients who had just returned from Mexico were under observation in multiple regions of Spain.[63]

On April 28, at least eighteen Swedish people were tested for swine flu after returning from trips in Mexico and the USA, but the results were negative.[100][101] On April 29 two people, recently returned from Mexico with flu like symptoms were tested.[102]

As of May 6, the Swedish Institute for Infectious Disease Control confirms 1 case of influenza A(H1N1). 186 negative test results have been reported. No suspected cases remain to be analysed. [103]

The number of confirmed cases has reached 2 in Sweden, with 435 negative cases reported as of May 15. [104]

A third case was confirmed on Friday 15, and reported on the following Saturday, where the patient, a woman in her sixties, has recovered. In all of the 3 cases the influenza was contracted in the USA. [105]

A fourth case was confirmed 28 May, influenza contracted in USA. [106]

As of June 13, 30 cases has been confirmed. Of those, 22 in the area of Stockholm County, 7 in Västra Götaland County and 1 in Skåne County. 9 cases were contracted domestically. [107]

File:H1N1 Switzerland Map-2.svg
Outbreak evolution in Switzerland
  Confirmed cases
  Suspected cases

The first suspicious case was officially confirmed on April 27. A young man returning from holiday in Mexico informed his family doctor about fever and flu-like symptoms. He was immediately put under quarantine in a hospital. 8 more people are under observation. A container of inactive swine flu virus samples packed in dry ice exploded on a Swiss train, injuring one person but posing no other risks to humans.[108]

Switzerland has confirmed its first case of swine flu in a 19-year-old student who returned from Mexico on April 30. The state hospital in Baden said in a statement that the National Influenza Center in Geneva confirmed the disease shortly after the student was mistakenly released from hospital day before.[109]

Switzerland has confirmed its second case of swine flu in a young woman of 24. She was returning from a trip to Mexico and USA. She is now in the Hospital in Bern.[110]

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

As of June 5, there are 14 confirmed cases in seven cantons.

The first case of A(H1N1) in Turkey was reported on May 16, 2009.[111] A U.S. citizen, flying from the United States via Amsterdam was found to be suffering from the swine flu after arriving Istanbul's Atatürk International Airport.[112] Turkey is the 36th country in the world to report an incident of swine flu. The Turkish Government has taken measures at the international airports, using thermal imaging cameras to check passengers coming from international destinations.[113] On June 11, 2009 The Turkish Health Ministry declared that there were a total of 13 cases in Turkey.[114]

Outbreak evolution in the United Kingdom
  Confirmed cases
  Suspected cases
Outbreak evolution in the United Kingdom:
  500+ cases
  50+ cases
  5+ cases
  1+ cases

Samples from suspected cases have been analysed by the National Institute for Medical Research in London, which is also examining samples of the U.S. strain of the disease.[115]

On April 25, 2009, a member of British Airways cabin crew was taken to Northwick Park Hospital in Harrow and quarantined after falling ill with flu-like symptoms on a flight from Mexico City though he was later found not to have swine flu.[116]

The first cases were confirmed on 27 April in passengers returning from Mexico. The first case of person to person transmission within the UK was announced on 1 May.[117]

On May 1 the first UK person to person transmission was confirmed. Graeme Pacitti, 24, of Falkirk, picked up the virus after contact with the UK's first cases Iain and Dawn Askham.[118]

It was reported on 26 May that a man who has been confirmed of swine flu is critically ill, since then 4 more people have become criticly ill due to swine flu in the U.K. all in Scotland.[119]

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

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

As of 11th June, 822 Cases of swine flu have been clinically confirmed.[120]

On 13 june, the total of swine flu cases hit 1,122 with 4 people in intensive care in hospital

Imports of pork and live pigs from all affected countries have been banned. The ban also applies to all shipments after April 21.[121] On June 5, 2009 the first case of the virus was officially confirmed in Ukraine. The patient concerned, a 24-year-old Ukrainian citizen, had arrived from New York via Paris at Kyiv's Boryspil Airport on May 29, 2009.[122]

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