2009 swine flu pandemic in the United States

Main article: 2009 swine flu outbreak

Further information: 2009 swine flu outbreak by country

Reported cases by state/territory

State or territory	State-reported confirmed cases	State-reported hospital- izations	Confirmed deaths
Total	115,318	27,632	3,433
Alabama	2,453/NLU	NR	19
Alaska	1,563	18wave 1	13 (11)
Arizona	8,726	1,897	152
Arkansas	154/NLU	NR	53
California	10,545	8,589	657
Colorado	1,321	578	70
Connecticut	5,491	766	35
Delaware	381	NR	7
District of Columbia	54	NR	1
Florida	3,676	1,227	230
Georgia	1,012	860	81
Hawaii	2,221	NR	13
Idaho	1,171	389wave 2	23wave 2
Illinois	3,387	3,042	111
Indiana	782	NR	39
Iowa	929	700	41
Kansas	1,201	NR	29
Kentucky	2,092	NR	39
Louisiana	1,876	NR	52
Maine	2,232	230	21
Maryland	1,772	996	45
Massachusetts	1,979	397	33
Michigan	655/NLU	NR	88
Minnesota	2,220	1,813	61
Mississippi	1,292	NR	26
Missouri	1,523	NR	17
Montana	961	9	19
Nebraska	430	40	15
Nevada	5,516	NR	44
New Hampshire	722	NR	10
New Jersey	1,006/NLU	512	42
New Mexico	1,007	1,007	58
New York	2,738	909	206
North Carolina	638	267	107
North Dakota	650	60	2
Ohio	227/NLU	NR	52
Oklahoma	237/NLU	7	44
Oregon	1,833	1,419	79
Pennsylvania	10,940	NR	78
Rhode Island	203	76	13
South Carolina	1,634	NR	49
South Dakota	2,081	422	23
Tennessee	1,163	NR	57
Texas	6,128	1,994	231
Utah	988	302	48
Vermont	404	149	3
Virginia	327	NR	37
Washington	1,882	1,561	99
West Virginia	1,214	853	22
Wisconsin	9,579	1,317	55
Wyoming	725	NR	10
American Samoa	90	NR	1
Guam	338	NR	2
Northern Mariana Islands	71	NR	0
Puerto Rico	908	NR	60
U.S. Virgin Islands	80	NR	1
NR: Not Reported - NLU: No Longer Updated

The United States (US) experienced an outbreak of Influenza A virus subtype H1N1, commonly known as the swine flu, in the spring of 2009. The outbreak apparently spread from an earlier outbreak in Mexico. Initial US infections occurred in late March 2009 in California, and by mid-April had spread to scores of people across several states. Public health officials in the United States and the World Health Organization (WHO) expressed serious concern because the initial outbreak was suspected in over 100 deaths in Mexico, transmitted easily from person to person, and no vaccine was available, prompting President Obama to declare a public health emergency.

By the end of April, hundreds of people were confirmed or suspected as infected, one person had died, and hundreds of schools were closed, keeping over 161,000 students at home. Experts were puzzled by the fact that nearly all the deaths were in Mexico, even though the flu had spread to thousands of others across the world, and that it disproportionately infected young people. By early May, however, public health officials expressed cautious optimism that the infection was relatively mild and was not spreading as quickly as initially feared. The Centers for Disease Control and Prevention (CDC) issued new guidance, and most schools across the country quickly reopened. Even so, officials cautioned that the flu might mutate and return with more severe consequences during the fall flu season. The CDC is continuously monitoring the ongoing outbreak, and the US Food and Drug Administration (FDA) is currently working on a vaccine for the fall flu season.

As of May 25, the CDC reports that there have been a total of 6,764 human cases of H1N1 infection in the United States. Tallies of cases reported by other public health agencies result in higher figures, and the head of flu epidemiology for the CDC has postulated that the actual number of cases is "upwards of 100,000" as patients with mild cases are not likely to be tested.

As of May 21 the outbreak had spread to 47 states and the District of Columbia, however with over 5000 confirmed or probable cases, only 10 deaths have been confirmed. In a press briefing on May 20, Dr. Daniel Jernigan of the CDC stated, that 247 individuals had been hospitalized and over 70% of those patients had underlying chronic medical conditions, including pregnancy, asthma and heart disease.

Initial cases

The Centers for Disease Control and Prevention (CDC) identified the first two A/09(H1N1) swine flu cases in California on April 17, 2009 via the Border Infectious Disease Program, for the San Diego County child, and a naval research facility studying a special diagnostic test, where influenza sample from the child from Imperial County was tested. By April 21, enhanced surveillance was established to search for additional cases in both California and Texas and the CDC determined that the virus strain was genetically similar to the previously known A(H1N1) swine flu circulating among pigs in the United States since about 1999.

It was established that the virus was a combination of human, North American swine, and Eurasian swine influenza viruses; the viruses from the initial two Californian cases were also noted to be resistant to amantadine and rimantadine, two common influenza antiviral drugs. No contact with pigs was found for any of the seven Californian nor either of the two Texas cases, suggesting human-to-human transmission of the virus.

On April 28, 2009, the director of the Centers for Disease Control and Prevention confirmed the first official US death of swine flu. Tests confirmed that a 23-month old toddler from Mexico, who was probably infected there, died on April 27 from the flu while visiting Texas.

Outbreak across the US

Cases of H1N1 spread rapidly across the United States, with particularly severe outbreaks in Texas, New York, and California. Early cases were associated with recent travel to Mexico, many were students who had traveled to Mexico for Spring Break. As of May 4, 2009, the CDC reported one death, 286 confirmed cases of H1N1 flu across 36 states, 35 hospitalizations, and expects H1N1 to eventually spread to all states. A large number of cases, according to medics, have happened in the days that preceded the launch of the alert and came out only in these days due to a massive backlog. By May 5, 2009, the number has risen to 403 and a second death was reported in Texas, although it's not clear the flu was the cause of her death. The CDC and government officials have recently expressed cautious optimism about the severity and spread of H1N1.

CDC report for the 2008-2009 flu season week 18, subtypes and percent positive tests

Changes in surveillance of cases of influenza-like illness, including new guidelines for identifying cases to test, increased laboratory testing, and new test kits able to distinguish this novel strain, resulted in a spike in the percent of cases tested that were positive for influenza. Of the positive cases, about a third were due to the novel strain. Also found were a substantial number of cases where the strain could not be subtyped. Some have claimed that illegal immigrants were significantly contributing to the spread of the swine flu.

2009 US Swine Flu Summary
Number of Confirmed Cases/Deaths	See Table Above
Number of States/Territories with Confirmed Cases	49
Earliest Confirmed Infection in US	March 28, 2009
First Death Inside the US	April 27, 2009
First Death of US Citizen	May 5, 2009
Number of People Hospitalized	247

Flu strain severity

The new strain was identified as a combination of several different strains of Influenzavirus A, subtype H1N1, including separate strains of this subtype circulating in humans (see human influenza) and in pigs (see swine influenza). The strain transmits between humans and has been reported to have a relatively high mortality rate in Mexico. The World Health Organization (WHO) and the U.S. Centers for Disease Control and Prevention (CDC) have expressed serious concerns that the new strain has the potential to become an influenza pandemic. It is reported that, because the virus is already widespread, containment will be impossible.

In addition, the flu death toll in Mexico could be lower than first thought, Dr. Gregory Evans, head of the Association of Medical Microbiology and Infectious Disease Canada and a member of a federal pandemic-planning committee, said on April 29:

There was a lot of speculation and what seemed to be evidence there were dozens and dozens of deaths. Careful analysis showed these people likely died of something else, and not influenza. That's really good news, and that would fit with what we've seen outside of Mexico.

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

I don't agree with (the WHO) because I think it's a panic metre, not a pandemic metre. [...] If that flu-like illness is not deadly, I don't know what the cause for alarm is for people who are not really sickened by this virus. [...] I'm really eager to know how much worse this is than seasonal flu. So far it's looking like it's not that serious.

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

Response

Congruent U.S. Government and WHO Pandemic Response Charts.

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

The United States federal government declared a public health emergency, and several U.S. states have indicated they may follow suit. Secretary of Homeland Security Janet Napolitano noted that this declaration was standard operating procedure, which was also done for the 2009 presidential inauguration and for flooding.

White House

An official for the White House said on April 24 that "the White House is taking the situation seriously and monitoring for any new developments. The president has been fully briefed." President Barack Obama stated that "We are closely monitoring the emerging cases of swine flu". He also noted, "This is obviously a cause for concern ... but it is not a cause for alarm". President Obama suggested U.S. schools should consider shutting down as a future possibility if students are infected. White House Press Secretary, Robert Gibbs said the effort to get a team in place to respond to the health scare has not been hindered by the lack of a secretary of Health and Human Services or appointees in any of the department’s 19 key posts. The president's nominee, Kansas Gov. Kathleen Sebelius, was still awaiting confirmation from the U.S. Senate until passing on April 28. The President has not yet made appointments to either the Commissioner of the Food and Drug Administration, the Surgeon General, or the Director of the Centers for Disease Control and Prevention. The current acting Surgeon General, Steven K. Galson, is also currently serving as the Acting Assistant Secretary for Health.

Health and Human Services Secretary Kathleen Sebelius in a meeting in the Situation Room of the White House regarding the H1N1 virus.

On April 30, it was reported that an aide to Steven Chu, the US Energy Secretary, had fallen ill from the virus after helping arrange President Barack Obama's trip to Mexico. However, the White House stated that the President is not at risk of obtaining the flu. Kathleen Sebelius was confirmed as the Secretary of Health and Human Services by the Senate on April 28, 2009 with a vote of 65-31.

Centers for Disease Control and Prevention (CDC)

In this video, Dr. Joe Bresee, with CDC's Influenza Division, describes the symptoms of swine flu and warning signs to look for that indicate the need for urgent medical attention.
See also: See this video with subtitles in YouTube

Activation of Emergency Operations Center During the week of April 19, the CDC activated its Emergency Operations Center (EOC) to augment the ongoing investigation of human cases of swine influenza A (H1N1). More than 250 CDC professionals are working from the CDC EOC as part of the agency's response. As of May 4, 2009, the CDC reported that it had deployed 25% of the supplies and medicines in the Strategic National Stockpile to the various states.

Swine Flu Test Kits As of April 29, only the CDC could confirm U.S. swine flu cases. Dr. Besser stated during an April 30 press briefing that California and New York had diagnostic test kits, and that the kits would be sent to all states starting the following day. On May 6, the CDC announced that testing kits were now available for all states. This is expected to generate an increase in the number of confirmed cases as more states begin doing their own tests.

Influenza Reporting Requirements In the United States, the majority of the 70 National Respiratory and Enteric Virus Surveillance System (NREVSS) laboratories do not report the influenza A subtype. However, in 2007 human infection with a novel influenzavirus A became a nationally notifiable condition. Novel influenza A virus infections include all human infections with influenza A viruses that are different from currently circulating human influenza H1 and H3 viruses. These viruses include those that are subtyped as nonhuman in origin and those that are unsubtypable with standard methods and reagents. The new strain responsible for this outbreak was one such virus.

CDC Recommendations for Schools Initially the CDC had issued a recommendation that schools close for as long as two weeks if a student catches swine flu. Some school districts closed all schools if a single child was classified as probable. On May 5 the CDC retracted its advice stating that schools that were closed based on previous CDC guidance related to this outbreak may reopen. By that time at least 726 schools nationwide serving more than 480,000 students had closed for at least some period of time. The CDC amended its advice citing, new information on disease severity and the limiting effectiveness of school closure as a control measure. The new advice given stated, "Decisions about school closure should be at the discretion of local authorities based on local considerations, including public concern and the impact of school absenteeism and staffing shortages."

Food and Drug Administration

The Food and Drug Administration (FDA) authorized emergency use of medicines and diagnostic tests for flu. (FDA is part of Department of Health and Human Services.) The FDA stated it is also responding to this threat by:

• working with other government agencies and manufacturers on a series of issues related to antiviral medications.
• growing the 2009 H1N1 flu virus and preparing to make vaccine seed lots, which may be used eventually to produce a safe and effective vaccine.
• helping to prepare reagents needed for vaccine production and coordinating closely with other public health agencies for clinical development and testing.
• accelerating access to new diagnostic tools for this 2009 H1N1 flu virus

On May 6, 2009, the FDA announced that it had approved a new manufacturing facility for seasonal flu vaccine, owned by Sanofi Pasteur, which could also be used for manufacturing a vaccine for the new H1N1 flu strain. The FDA also issued a warning for consumers to be wary of products claiming to cure or prevent swine flu.

Other Federal Agencies

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

State Department The State Department suggested travelers to Mexico stay alert and comply with guidance from Mexican public health officials, but did not impose any travel restrictions on US citizens to Mexico. However, the State Department did recommend US citizens avoid non-essential travel to Mexico.

Department of Agriculture The Department of Agriculture (USDA) reported no swine in the US have been infected so far, but the USDA is monitoring swine across the US for signs of infection.

Department of Commerce The Department of Commerce sent a letter to Russia and China requesting that those countries lift their ban on American pork products.

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

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

State and local

Schools closed in many states in response to local flu outbreaks. By April 30, 2009, 300 U.S. schools and school districts had announced closures in response to the outbreak, giving 169,000 students time off. On May 4, 2009, about 533 schools in 24 states in the U.S. were closed, affecting about 330,000 students.

On May 5, Kathleen Sebelius stated in a CDC news conference that school closures for single confirmed cases of H1N1 influenza were unnecessary, but that parents keep their child home if he or she displays an influenza-like illness.

Travel industry

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

Affected states

Alabama

On May 2, 2009, the Alabama Department of Public Health confirmed the first case of H1N1 (swine flu) in Madison, Alabama, one of two probable cases previously identified at an elementary school in Madison. As a result, all public schools and most private schools and daycare centers in Madison County, Alabama, including the cities of Huntsville and Madison, closed for two days. After meeting with the state public health officer on May 3, 2009, all Madison city elementary schools were to be closed through May 13, 2009, but were reopened after the CDC updated its guidance to schools.

As of May 8, 2009, the Alabama Department of Public Health reports 4 confirmed and 27 probable cases of swine flu.

Alaska

On May 10, 2009, the Alaska state Division of Public Health reported the state's first probable case of swine flu in a crew member of a Royal Caribbean cruise ship traveling in Alaska waters. On May 12, they confirmed that the individual had been infected with swine flu but they do not consider it to be Alaska's first case because she became ill before entering state waters.

Arizona

As of May 26, 2009:

  Death(s) confirmed

  Case(s) confirmed

As of May 28, the CDC has reported a total of 532 confirmed cases and 3 deaths in the state of Arizona. The Arizona Department of Health Services reported a total of 534 confirmed cases in 12 of the state's 15 counties, with 4 deaths attributed to the illness. To date, deaths have been reported in Maricopa, Pima and Pinal counties, the state's most populous counties, while the largely rural counties of Gila, Greenlee and Navajo lacked confirmed cases.

On April 28, Arizona's Department of Health submitted samples from four patients to the CDC for testing. Those four samples were confirmed to be H1N1 swine flu virus, and were all from elementary-school students in the Phoenix metropolitan area. Following recommendations from the CDC, local health authorities ordered the 3 area schools where the studends attended to be closed for a period of 7 days beginning on May 1. After only 3 days, however, the order was rescinded and the schools reopened ahead of schedule on May 5 when it appeared the H1N1 flu would be no more deadly than the seasonal flu.

State health officials informed that they had 58, 000 anti-viral treatment courses on hand, and that they had received over 200, 000 doses from the Strategic National Stockpile.

The first death in the state due to H1N1 swine flu complications was reported by the Maricopa County Department of Public Health on May 14. The woman, in her late 40's, had died the previous week at an undisclosed location in the county. The report indicated that the woman had suffered from an underlying respiratory ailment but did not elaborate on her condition. Subsequent victims were a 57 year old resident of the Gila River Indian Community, a 13 year old boy from Tucson and a preteen girl from Pima County.

Arkansas

As of May 8, 2009, the Arkansas Department of Health reported 5 confirmed cases of swine flu. Four of the cases were from Camp Robinson, a US Army National Guard base located in North Little Rock in Pulaski County.

California

As of May 28, 2009:

  Death(s) confirmed

  Case(s) confirmed

  Case(s) unconfirmed (both suspected and probable cases)

CDC conference with the media on the swine flu outbreak on April 25, 2009

The first two cases detected in the US were two children living in San Diego County and Imperial County (a county in which 18% of their residents are not U.S. citizens), who became ill on March 28 and 30 respectively. A CDC alert concerning these two isolated cases was reported in the media on April 21. As of April 24 eight human cases were known in the US, including six in Southern California. The patients have recovered. The acting director of the US Centers for Disease Control (CDC) said that preliminary tests on seven out of fourteen samples from patients in Mexico had matched the virus found in the US, which experts say is a new strain of swine flu. None of the US patients had any contact with pigs, leading CDC officials to believe that human-to-human transmission has been occurring.

Gov. Arnold Schwarzenegger and the state of California activated the Joint Emergency Operations Center of the Department of Public Health, and are coordinating with the California Emergency Management Agency, the CDC, and the Mexican government. They have additionally stepped up other preparations to lessen the flu's threat. On April 28, Gov. Schwarzenegger declared a state of emergency which allows the state to deploy additional resources to the Department of Public Health and more quickly and easily purchase equipment and materials.

St. Mels Catholic School in Fair Oaks was closed after Sacramento County Health Department notified the school that a 7th grade student who reportedly recently returned from a family vacation in Mexico tested positive for an unidentified strain of Influenzavirus A. On April 27, CDC officials confirmed that the student tested positive for swine flu. In Marin County, a grandmother and her 20-month-old granddaughter have been confirmed to have the flu. By April 28, the CDC had confirmed 10 cases of swine flu in California.

California State University, Long Beach reported on April 29 that a student had returned a "probable positive" test result for swine influenza. The student showed symptoms on Sunday April 26 and went to the campus health services office the following day. The test results were received by the school on April 28 and distributed to all students and faculty. The affected student had not attended any classes since falling ill and has an apparently mild case of the disease that does not appear life threatening. Three high schools in Riverside County were closed April 29 after two teenage girls, from Corona and Indio respectively, were confirmed to have contracted the virus. Branham High School in San Jose was closed that day for a week after one teenage girl was confirmed to be a probable case. Rucker Elementary School in Gilroy is set to be closed on Friday, May 1 after at least one student was being tested after exhibiting flu-like symptoms. Three students at the Grizzly Youth Academy in San Luis Obispo are confirmed cases of swine influenza. As many as 73 students are exhibiting flu-like symptoms at The Academy and are assumed to have the virus. All are being isolated. The Academy is set to stay open. More recently, on May 3, 2009, parent of students attending King Middle School in Berkeley were notified that their school would be closed down due to a swine flu outbreak involving students at the school.

Colorado

On April 30 two cases of the flu virus were confirmed in the state of Colorado. The confirmed cases were a woman from Arapahoe County who recently returned from a cruise to Mexico and a Denver International Airport baggage handler. Two more were confirmed on May 2, both in Jefferson County, Colorado. One case is a middle school student, which has caused his school to close for a week. The tally increased to seven on May 4 when The University of Colorado at Boulder (CU) confirmed three of its students contracted the virus.

Connecticut

On April 28, it was announced that there were suspected cases of swine flu in three Connecticut towns. Schools were closed due to suspected cases in East Haddam and Wethersfield, though tests on these patients later came back negative. On April 30, two students at Fairfield University were announced as having "probable" swine flu, in addition to another person in Glastonbury, bringing the total number of likely cases to 6. On May 1, the first confirmed case of swine flu was reported in Connecticut in Stratford. On May 2, the second confirmed case was reported in a child from Middlefield that had recently returned from a family trip to Mexico. On May 5, Fairfield University announced that two "probable" cases had tested positive for the H1N1 flu, with five other "probable" cases awaiting test results. One May 8, Fairfield announced that those five students had also tested positive, although the students by that time were nearly recovered, and there remained one "probable" case remained to be confirmed.

Delaware

The first probable cases of swine flu in Delaware were reported on Monday, April 27. Four probable cases of swine flu were reported on the University of Delaware campus after the students were experiencing flu like symptoms. Tests were sent to the CDC to see if the students had the swine flu. All four cases were confirmed by the CDC on April 28. The students were reported to be recovering, and the campus set up a temporary Public Health clinic. The Delaware Division of Public Health reported on May 1 a further 17 probable cases, all from the University.

District of Columbia

As of May 10, 2009, the DC Department of Health reported 4 confirmed and 6 probable cases of swine flu.

Florida

As of May 23, 2009:

  Death(s) confirmed

  Case(s) confirmed

  Case(s) unconfirmed (both suspected and probable cases)

On April 28, it was reported that an individual in Florida had tested positive for influenza type A, of which swine flu is a subtype. A culture from that person has been sent to Jacksonville to be tested for swine flu, with results expected within 48 hours. Governor Crist announced the first two confirmed cases in Florida on May 1. The cases are both children and in Lee and Broward counties.

On May 3, the Hillsborough County Health Department announced 5 possible cases of H1N1, 4 of the persons are students, and the other is a relative who has recently traveled to Mexico. Three public schools (Wilson Middle School, Freedom High School, and Liberty Middle School) where the students attended have been closed till May 11.

On May 7, Alachua County announced its first case of H1N1 (Swine Flu). The person is a University of Florida student and has since recovered.

On May 8, a 7 year old boy tested positive of swine influenza in Rockledge, Brevard County, Florida . Two other children tested positive for influenza. It caused Golfview Elementary School in Rockledge to close on May 11.

Georgia

The first case of laboratory confirmed swine flu was reported on April 30. A Kentucky woman was hospitalized in LaGrange while visiting family in Georgia; she had recently returned from a trip to Mexico. While Georgia health officials reported this as a confirmed case for the state, the CDC and the Kentucky health department reported it as a case in Kentucky. In relation to this case, state officials said they had no plans to close schools or other public institutions.

On May 4, the Georgia Department of Human Resources announced that all classes have been temporarily suspended at Eagle's Landing Christian Academy in Henry County until the CDC confirms the status of a student who became ill. The Georgia Public Health Laboratory sent three probable cases to the CDC over the weekend for confirmation. On May 5, the Georgia Division of Public Health confirmed three cases of H1N1 located in Cobb, DeKalb and Henry Counties.

Hawaii

On May 4, 2009, the Hawaii Department of Health announced that there were three suspected cases of swine flu in the state. Governor Linda Lingle announced that the cases were mild and that the patients were recovering at home. On May 5, 2009, all three cases were confirmed on the island of Oahu by the CDC. All three cases involve recent travel to the mainland United States. One case is a school-age child, who recently traveled to California. The two other cases are a military member, and his or her spouse. The military member traveled to Texas, and has exposed their spouse.

Two more cases were confirmed on May 6. Another four were confirmed on May 13, with two identified at Anuenue School, a Hawaiian language immersion school. In response to the outbreak, the University of Hawaii at Manoa announced that it will not be shaking graduates' hands at its commencement.

Idaho

On Sunday, May 3, 2009, The Centers for Disease Control and Prevention confirmed the state's first swine flu infection for a Kootenai County woman in her 60s. As of Tuesday, May 6, 2009, an infant from Ada County was being tested for a probable case.

Illinois

The state's first probable case of swine flu was reported on Wednesday, April 29. An elementary school in Chicago's Rogers Park neighborhood, on the city's Far North Side, was closed because a 12-year-old student was presumed to have the disease. The student reportedly was recovering at home. By April 30, over 40 probable cases had been identified by state and local health officials. In addition to 16 cases in the city of Chicago, and 11 in surrounding Cook County, cases were reported in Kane, Lake, DuPage, McHenry, and Will counties. Several schools in the affected areas were temporarily closed. Many other flu cases happened during or even before the launch of the alert were then confirmed, principally in the urban area of Chicago. By May 20, the following 17 counties had confirmed cases: Boone, Cook, DeKalb, DuPage, Franklin, Kane, Kankakee, Kendall, Knox, Lake, McDonough, McHenry, Ogle, Sangamon, Will, Williamson, and Winnebago. Total confirmed cases in Illinois were 794, up from 707 the previous day.

Cases in Illinois throughout May 2009 continued to climb and by May 31, 2009 the published CDC numbers had reached 1002 confirmed cases with 2 deaths. A third confirmed death - the first outside of the Chicago metropolitan area - was reported by state health authorities on May 28th, 2009 but this was not reflected in the CDC official numbers by the end of the month.

Indiana

On April 28, an unidentified Notre Dame student was confirmed as the first case of swine flu in this state. The patient had not recently traveled to Mexico or been in contact with anyone who has traveled to Mexico. The student was in voluntarily quarantine, and was doing well, according to Judy Monroe, Indiana's state health commissioner. Two other cases in the state which occurred in two Indianapolis elementary schools were confirmed by the CDC shortly thereafter. Additional cases later surfaced in the counties of Hendricks, Lake, Marion, Putnam, St. Joseph, and Tippecanoe.

Iowa

On April 29, two probable case of swine flu were reported in Des Moines County and Clinton County. One was a woman from California, the other one was a man from Mexico. On May 3, another case was found in Marshall County causing schools to close. On the week of February 28, 2009, a three year old caught the swine flu due to close contact with ill pigs, but not the same dangerous strain that came from Mexico. In early May, cases climbed up to 43. A few were in Polk County, where Des Moines is.

Kansas

Health officials in Kansas announced April 25 that two new cases of swine flu had been confirmed in Dickinson County, after both were isolated. The week prior, one patient had traveled to Mexico by plane to attend a professional conference; both he and his wife experienced minor influenza symptoms.

Kentucky

• • Please see 2009 Swine Flu Outbreak in Kentucky.**

Louisiana

As of May 26, 2009:

  Death(s) confirmed

  Case(s) confirmed

On May 29, there are a total of 125 swine flu cases confirmed by The Louisiana Department of Health and Hospitals. Up from 114 reported on May 28.

According to the Louisiana Department of Health and Hospitals, the confirmed cases are broken down by parish as follows:

• 3 Ascension
• 14 East Baton Rouge
• 2 Evangeline
• 3 Iberia
• 56 Lafayette
• 3 Lafourche
• 3 LaSalle
• 1 Orleans
• 12 Plaquemines
• 5 St. Charles
• 2 St. Landry
• 2 St. Martin
• 1 St. Tammany
• 1 Tangipahoa
• 2 Terrebonne
• 3 Vermillion
• 1 Vernon

Maine

On April 29 three cases of H1N1 (swine flu) were confirmed in Maine, according to the Maine Center for Disease Control. The three adults, two from Kennebec County and one from York County, were reported to be recovering at home. Dr. Dora Anne Mills, director of Maine's CDC, said on April 28 that at least 12 suspected cases were being tested.

Late on April 29, Maine Governor John Baldacci declared a "civil emergency" and ordered a school and daycare facility in York County to close for 7 days.

Maryland

By May 1, 2009, eleven probable cases had been identified in Maryland, in Anne Arundel, Baltimore, Charles, Prince Georges, and Montgomery Counties. One of these cases, that of a high school student in Rockville, resulted in the closing of Rockville High School, the first Maryland school closing due to the outbreak. On May 1, three other schools in the state were closed. As of May 5, Rockville High School has reopened. Four of Maryland's probable cases were confirmed on May 4, including two adults and one child in Baltimore County as well as one young child in Anne Arundel county.

Massachusetts

As of 6:00 EDT, May 21, 2009:

  Death(s) confirmed

  Case(s) confirmed

  Case(s) unconfirmed (both suspected and probable cases)

There are 529 confirmed cases in Massachusetts, 6.0% of which have led to hospitalizations. Confirmed cases by county

• 4 Barnstable
• 6 Bristol
• 18 Essex
• 1 Franklin
• 1 Hampden
• 4 Hampshire
• 217 Middlesex
• 62Norfolk
• 6 Plymouth
• 178 Suffolk
• 32 Worcester

By County

• Barnstable County
  • A member of the U.S. Coast Guard stationed on Cape Cod, acquired the virus while training in California, but reportedly recovered.

• Bristol County
  • The Health Agent for the town of Easton stated that there are "a couple of suspected cases in town."
  • The Mass. Dept. of Public Health announced that they had 1 confirmed case of the virus in the city of Fall River in southeastern Massachusetts.

• Franklin County
  • There is at least 1 confirmed case reported in the county.

• Hampshire County
  • Two students at Amherst College in Amherst had confirmed cases of the virus and 13 other students are 'suspected' cases. All 15 students are being isolated on campus. A third student at the school contracted the H1N1 virus. Also, there has been 1 'suspected' case each at Mount Holyoke College (in South Hadley) and Smith College (in Northampton).

• Middlesex County
  • The Massachusetts Department of Public Health informed the Ashland school superintendent that two Ashland High School students have "probable" cases of H1N1 flu.
  • The CDC confirmed that an elementary school student in Chelmsford tested positive for acquiring the virus.
  • In Cambridge, there are 2 students (at the Massachusetts Institute of Technology) that are "probable" cases of having acquired the virus.
  • Eight residents of Framingham are being tested for being "probable" cases.
  • The Lincoln Public Schools Superintendent had confirmed a Lincoln middle school student been diagnosed with the H1N1 virus.
  • Two middle school students in Lowell have tested positive for swine flu as of April 29, 2009. The two had gone on a family trip to Mexico, and became mildly sick on returning home. The local health department said that the boys had not returned to school since coming back from Mexico, and there were no concerns that the illness had been spread.
  • In Tyngsboro, there had been 1 probable case reported at the Academy of Notre Dame.
  • There is 1 suspected case of the virus in the city of Waltham.
  • Winchester Hospital in Winchester reported having received a possible case (of the virus) within the town.
  • There had been two additional confirmed cases, 1 of each located in the municipalities of Bedford and Weston.
  • In Wayland there has been one confirmed case at the elementary school level and one possible case at the high school level.

• Norfolk County
  • The health inspector of Quincy confirmed that a New York resident who checked into Quincy Medical Center on May 1, 2009, and tested positive for the H1N1 flu.
  • The CDC confirmed that a resident of the Wellesley College campus tested positive for the virus.
  • The Dana Hall School in Wellesley was closed after nearly 100 students called in sick.

• Plymouth County
  • The CDC had announced 4 additional confirmed cases, from 2 adults and 2 school-age residents (of the state), from the following counties: (3) Middlesex County and (1) Plymouth County.

• Suffolk County
  • Massachusetts' Secretary of Health and Human Services announced that 'some' of the 34 confirmed cases in the state are from the Harvard School of Dental Medicine campus (at the Longwood Medical Area in Boston), which is temporarily closed. Later, it was reported that 3 of the 9 reported cases of influenza at the school, resulted positive for the H1N1 virus.
  • On May 1, 2009, a United Airlines Flight 903 from Munich to Washington D.C., was diverted to Logan International Airport in Boston. A 53-year old passenger complained of flu-like symptoms, that led him to be admitted to Massachusetts General Hospital.
  • A male passenger in his 40's complained of flu-like symptoms upon landing at Logan International Airport in Boston May 2, 2009. He was flying aboard American Airlines Flight 155, from London to Boston, that had originated from Malaysia. He, too, was admitted to Massachusetts General Hospital in Boston.
  • The Boston University Goldman School of Dental Medicine reported a single resident that has a confirmed case of the virus. They claim that he has had no contact with anybody on the school's main campus, and those he has been in contact with have been notified.
  • Both Boston Latin, where 250 called in sick, and the Winsor School, where 34 called in sick, and were closed.

• Worcester County
  • There is at least 1 confirmed case reported in the county.

• Other
  • In Spencer, two students who also had recently returned from Mexico were tested for possible swine flu infection. The results of those tests were both negative.

Michigan

As of 14:00 EDT, May 22, 2009:

  Death(s) confirmed

  Case(s) confirmed

On April 29, a 34-year-old woman from Livingston County was Michigan's first reported case of swine flu. On April 30, another 34-year-old woman from Ottawa County was confirmed as Michigan's second case. As of May 29, Michigan reports 273 confirmed flu cases.

Confirmed cases by county

• 2 Allegan
• 2 Bay
• 4 Berrien
• 1 Branch
• 4 Calhoun
• 2 Chippewa
• 1 Clare
• 1 Eaton
• 5 Genessee
• 1 Hillsdale
• 3 Ingham
• 1 Ionia
• 2 Isabella
• 8 Kalamazoo
• 52 Kent
• 12 Livingston
• 20 Macomb
• 5 Missaukee
• 7 Monroe
• 2 Montcalm
• 3 Muskegon
• 1 Newaygo
• 54 Oakland
• 1 Oceana
• 16 Ottawa
• 1 Roscommon
• 1 Saginaw
• 1 St. Clair
• 3 Van Buren
• 124 Washtenaw
• 30 Wayne

Minnesota

On April 30, 2009, the Minnesota Department of Health announced that the first case of "H1N1 novel influenza virus" in the state was confirmed by the CDC. The infected individual is an unidentified resident of Cold Spring, Minnesota. Two schools in the affected city will remain closed until May 6, 2009.

On May 4, 2009 the second case of H1N1 was confirmed in Minnesota by the Minnesota Department of Health. The case was reported in a teen boy attending a Minneapolis Public School. As of May 6, 2009 three more cases of swine flu are suspected in kids attending multiple Minneapolis Public Schools.

Another case of H1N1 was confirmed in a worker who was taking pigs to Texas and brought it back up to the small town of Mountain Lake.

Mississippi

On May 15, 2009 Mississippi State officials reported three cases in Harrison County, Mississippi.

Missouri

(source)

  Death(s) confirmed

  Case(s) confirmed

In Missouri, Gov. Jay Nixon announced in a written statement that a probable case had been discovered in a Platte County man, and that a sample had been sent to the CDC for confirmation.

As of May 8, 2009, the Missouri Department of Health and Senior Services (DHSS) reported 10 confirmed and 4 probable cases of swine flu.

On May 19, 2009, a St. Louis County man became the first death in Missouri due to the Swine Flu.

On May 21, 2009, St. Louis Public School District announced one of its students had the Swine Flu but has not been in class since May 15.

Montana

As of May 11, 2009, the Montana Department of Public Health and Human Services (DPHHH) reported the state's first confirmed case of swine flu.

Nebraska

There are 29 confirmed cases of swine flu in Nebraska, with six probable cases.

Nevada

The first confirmed case of the virus was reported in Nevada on April 29. A two year-old girl from Reno contracted the virus, but it is unclear how as the case did not appear to be linked to any previously affected areas. As of recent the virus has spread to Clark County, where the city of Las Vegas lies. It has also resulted in the closing of Mendive Middle School in Sparks, Reno's neighboring city, where ten students were confirmed to have contracted the virus.

New Hampshire

The New Hampshire Department of Health and Human Services announced the state's first confirmed case of the H1N1 flu May 2, 2009. The confirmed case involves an employee of Concord Hospital in Concord, New Hampshire.

New Jersey

As of May 29, 2009, the New Jersey Government has confirmed 75 cases of swine flu and 6 probable cases, most of them within a range of 30 minutes of New York or Philadelphia. More swine flu cases are being reported daily, which has caused a widespread in the state. Counties currently confirmed with swine flu: Bergen (7), Burlington (8), Camden (8), Essex (5), Hudson (12), Mercer (5), Middlesex (3), Monmouth (11), Morris (7), Ocean (2), Passaic (2), Somerset (1), Sussex (1), Union (1), Warren (2), which indicates that currently 15 counties have confirmed cases of swine flu.

New Mexico

On April 29, 2009, Gov. Bill Richardson announced that there are two very probable cases in New Mexico. The suspected cases were a 1 year old boy from Santa Fe County and an 18 year old man from Valencia County. The 1 year old tested negative for H1N1, but the 18 year old man tested positive. More cases were raised in the intervening days, and by May 1 the probable case number was increased to nine. In addition to the cases above, a 17 year old girl from Eddy County, a 22 year old woman also from Eddy County, a 15 year old girl from Valencia County, a 17 Year old boy from Hidalgo County, and a 27 year old man from Bernalillo County are also likely to be infected.

As of May 19, 2009 the New Mexico Department of Health has confirmed 76 total cases of the H1N1 virus among humans in various counties. 8 new were confirmed on May 19 itself.

New York

On April 24, New York City Department of Health and Mental Hygiene dispatched a team of investigators to the private St. Francis Preparatory School in Queens after 150 students complained of symptoms consistent with the disease. Several of the students had recently traveled to Mexico City. New York City Health Commissioner Dr. Thomas Frieden reported on April 25 that eight of the New York school cases were "probable" swine flu.

On April 26 the Centers for Disease Control and Prevention (CDC) confirmed that the Queens cases are indeed associated with the H1N1 virus. The students suffered only mild symptoms, and some have since recovered.

On April 27 federal officials confirmed 20 new U.S. cases at the same school in New York in which eight cases were confirmed earlier.

As of April 29, one undergraduate commuter student on the Queens Campus of St. John's University had contracted the Swine Flu (A/H1N1) virus. The student was treated and recovered.

On May 14, three New York City public schools were closed due to the flu symptoms of hundreds of students.

On May 17, Mitchell Wiener, the assistant principal at a Queens school was confirmed as New York State's first death due to the disease.

On May 24, a woman in her 50s died because of the disease and had other health problems. She is New York State's second death and the 11th in the country.

North Carolina

The state health director, Dr. Jeffrey Engel, announced that there had been two probable cases of swine flu in the state. The first case was a man traveling through Wake County, where the capital is located, on business. The other case was an Onslow County resident who had recently traveled to Texas. On a related note, North Carolina is one of 29 states that have deemed to have not stockpiled enough flu medicines by federal guidelines. However, Dr. Engel dismissed these concerns, saying, "I think the commercial supply will keep up at the present time."

Ohio

On April 26, the Ohio Department of Health reported that a nine-year-old boy attending Elyria City Schools in Elyria, Lorain County, had been diagnosed with a mild case of the new strain of swine influenza and that his immediate family was undergoing testing. After the confirmed case in Ohio and eight in New York occurred Federal officials declared a public health emergency. The Cleveland health department received numerous calls from concerned residents the first week of the outbreak, although it has been difficult to tell whether or not the cases are swine flu, since it is regular flu season. On April 29, a probable case was reported in Columbus, and two new cases were confirmed in Columbus on May 2, one of them being an employee of The Ohio State University Medical Center.

Oklahoma

In Muskogee, Oklahoma a man who recently visited Mexico had been admitted into a hospital after having H1N1 flu symptoms, but test results on May 1 returned negative. On May 5, a woman from Pontotoc County was confirmed to have H1N1 flu, On May 7, Oklahoma State Department of Health confirmed three new cases of the H1N1 virus: a child from Oklahoma County, and one adult and a teenage female in Cleveland County. All have recovered.

Oregon

As of May 28, 2009:

  Death(s) confirmed

  Case(s) confirmed

  Case(s) unconfirmed (both suspected and probable cases)

On Apr 29, 2009 at 9:50 PM at 4:30 PM PDT, there were 14 flu samples awaiting testing in Oregon. This was confirmed during a press conference held by state health officials. "I do expect that at some point, perhaps this week, perhaps next week, we are going to have a case, and probably more, here in Oregon," Dr. Mel Kohn, the state’s director of public health. The first probable case was identified that evening and announced 12:30 PM the following day.

By May 2, 2009 at 4:00 PM PDT Oregon had identified eleven possible cases of H1N1 influenza in seven counties, including Lane County, Marion County, Multnomah County, Polk County, Umatilla County, Wallowa County, and Washington County. Three of them were confirmed the following day. By May 6, Wallowa County was the only county in the suspected list which was confirmed negative, but Clackamas County was added to the confirmed list.

As of May 22, 2009 at 10:00 AM PDT, the Oregon Department of Human Services has identified 120 confirmed cases of H1N1 flu in 11 Oregon counties. Baker County, Clatsop County, Columbia County, and Yamhill County have been added, and no deaths anywhere in the state have been reported.

Pennsylvania

On May 3, The Pennsylvania Department of Health said that a 31-year-old male in Montgomery County had the H1N1 flu. Another resident from Montgomery County was also confirmed to have the virus on May 5. There are also confirmed cases in the following counties: Allegheny (1), Berks (16), Bucks (2), Chester (1), Luzerne (1), Lycoming(1), Montgomery (2), and Philadelphia (15). More cases are currently being tested. Several probable cases are also located in the following counties: ten in Philadelphia, two in Bucks, two in Chester, as well as one each in Allegheny, Cambria, Franklin, Lehigh, Luzerne, Lycoming, Montgomery, and York.

Rhode Island

On May 2, 2009, Rhode Island confirmed its first case of H1N1 Flu in a Westerly woman. As of May 8, 2009, the Rhode Island Department of Health reported 7 confirmed and 1 probable case of swine flu.

South Carolina

13 cases of the flu virus were confirmed in South Carolina on April 30. All 13 were students or parents from the private Newberry Academy in Newberry, South Carolina; many had traveled to Mexico earlier in the month. All nearby public schools were closed for May 1. The S.C. Department of Health said there were nine more probable cases, and a further 22 cases still under investigation throughout the state.

South Dakota

Test results for two suspected cases of swine flu in South Dakota came back negative. The University of Nebraska Medical Center looked into suspicious specimens to determine if a Nebraska resident had the flu. However the test turned up negative, but the Medical center is currently testing more than a dozen other specimens for the strain.

Tennessee

Officials announced Wednesday in Williamson County that a child in Middle Tennessee is believed to have swine flu. The child's school, Harding Academy in Davidson County, has been closed. A second possible case of swine flu in Collierville has been reported in Tennessee. Medical tests at St. Jude Children's Research Hospital indicate the child has swine flu. Incarnation Catholic School the second child's school, has also been closed for the next week, per CDC guidelines. Another possible case has been identified in Knox County for a student who attends West Valley Middle School.

Texas

As of CDT 23:35, May 29, 2009: (source)

  Death(s) confirmed

  Case(s) confirmed

  Case(s) probable

Of the first 5 deaths and 1,293 cases confirmed in Texas, one was a Mexican citizen.

Two students attending Byron P. Steele II High School in Cibolo were confirmed to have the A/H1N1 swine flu; the patients recovered. A third possible case in a student who attends the same high school as the two other cases in Texas has been identified and the school is closed temporarily. On April 25, the Texas Department of State Health Services (DSHS) decided to close Byron P. Steele II High School for the following week. Following the discovery of more possible swine flu illnesses, the DSHS ordered that all schools and district facilities in the Schertz-Cibolo-Universal City Independent School District be closed for the week.

On April 27, a 7-year-old, a 24-year-old, and a 3-month-old in Dallas County were confirmed to have swine flu. All recovering and were not hospitalized. That same day, the Richardson Independent School District in the northern Dallas suburb of Richardson shut down Canyon Creek Elementary School due to a confirmed and two suspected cases of swine flu. All schools in New Braunfels—private schools and all campuses of the Comal and New Braunfels Independent School Districts—announced closures through May 10 on the recommendation of the Medical Authority of Comal County. On May 6, the New Braunfels Herald-Zeitung reported that all schools in Guadalupe and Comal counties would reopen on Thursday, May 7, four days earlier than had previously been announced.

Due to the swine flu, the University Interscholastic League (UIL) suspended all athletic, musical, and academic competitions and games for primary and secondary public education in the state of Texas until May 11.

On April 28, the City of Houston Health Department and Texas Children's Hospital sent samples in to the CDC. There are also possible cases at the Baylor College of Medicine outpatient clinic, Memorial Hermann Hospital, and St. Luke's Hospital.

A 23-month-old Mexican toddler who had been brought to Houston from Brownsville died on April 27, making the child the first US death due to the outbreak. The child had traveled with his family from Mexico to Brownsville to visit relatives. The infant was admitted to a Brownsville hospital after becoming ill, then transferred to Texas Children's Hospital the next day. The toddler suffered from chronic muscle weakness, a heart defect, a swallowing problem and lack of oxygen.

Texas Governor Rick Perry issued a disaster declaration.

On April 29, it was confirmed by Harris County that a 17-year-old girl from Fort Bend County attending Episcopal High School in Bellaire had contracted and recovered from the A/H1N1 swine flu. In compliance with the directives of the Harris County Public Health and Environmental Services Department, the school has been closed until further notice. Also in Fort Worth, a rising number of possible and confirmed cases in the district made school officials close all schools starting the next day, April 30. Schools in FWISD remained closed until May 8. The district was the biggest in the nation to close resulting in 80,000 students out of school and 11,000 staff members out of their jobs for that time. During the next week 6 school districts in Dallas-Fort Worth shut down. Including Cleburne, Lewisville, Decatur, Denton, Fort Worth, and Ponder. Other schools in Plano, Dallas, and Richardson were also closed, but did npt result in a district wide shut down. Other smaller districts also shut down. Also that day, a probable case caused the closure of Lucy Read Pre-Kindergarten Demonstration School in north Austin.

Denton County reported its first confirmed swine flu case April 30, in a child in Plano; the student attended Wilson Middle School in the Plano Independent School District, and the district decided to close the Collin County school until May 11. Navo Middle School and Lee Elementary School, of Denton Independent School District were also closed after three students at both schools respectively were diagnosed with type A influenza. As of May 2, the rest of Denton ISD officially closed for the following week, but as of May 5, all schools are officially reopening on May 7.

The Superintendent of Keller Independent School District in Keller reported 3 possible cases, one in each of three schools; .

On April 30, 8 suspected cases were recognized in El Paso County. Lab samples have been sent to CDC. No further information has been provided at this time until cases are confirmed. At this time, international borders will remain open. The El Paso Dept. of Public Health identified 11 more suspect cases of H1N1 flu in El Paso County on Friday, May 1, to bring the total number of suspect cases to 19. Lamar Consolidated ISD closed Lamar Junior High School due to a suspected (probable) case. Weslaco ISD closed all campuses for 7 days after a student was confirmed to have contracted type A influenza.

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. The woman, a special education teacher, had recently given birth to an eight-month-term healthy baby, delivered by caesarian section. She had been in a coma after being admitted to the hospital with breathing problems on April 19. The woman had also suffered from asthma, rheumatoid arthritis and a skin condition.

Utah

File:2009 Swine Flu outbreak in Utah.png

As of 17:45 MST, May 8, 2009:

  Death(s) confirmed

  Case(s) confirmed

* Cases from the Southeaster and Central Health department not specified by county.

On April 28, 2009, one student in Park City, Utah was suspected to have Swine Flu. Two more students in the school district began showing similar symptoms making three probable cases. All 8 schools in the Park City School District closed the following day. On May 1 the number of probable cases was increased to 9; 6 in Summit County (Park City), 2 in Salt Lake County and 1 in the Morgan-Weber Health District and about 80 suspected cases. May 2 at around 11 o'clock the first confirmation came back for the original case, 7 more were confirmed by the 6th. On May 6 the probable case count was at 30.[citation needed] The first confirmed death from swine flu in Utah, of a 21 year old man, was reported on May 20, 2009.

Vermont

The Vermont Department of Health announced a probable case of the H1N1 virus in rural Orleans County. A second case of the flu was confirmed involving an adult in Windsor County.

Virginia

The Virginia Department of Health had confirmed 14 cases in the state by May 7, and a total of 23 by May 21. The VDH reports cases by Health district, often without narrowing down a specific county, citing HIPAA privacy laws, as well as a desire to avoid creating a "false sense of security". 12 of the cases have been reported for the district containing Lexington, Virginia, following an early outbreak on the campus of Washington and Lee University. Additionally, there have been three cases in Fairfax, two each in the Chesterfield, Arlington and Peninsula Health districts, and one each in the Norfolk and Three Rivers Health districts.

Washington

As of the evening of May 22, 2009, Washington state has reported 574 confirmed cases, one probable case, and one death due to Swine Flu. So far, confirmed cases have been identified in seventeen Washington state counties, with public facilities closed as a precaution in those counties and several others. On May 3, Seattle-King County officials announced that, due to the virus' widespread presence in the community and low rates of severity, schools would no longer be closing due to suspect or probable cases.

A majority of confirmed cases (384) so far have occurred in King County. 115 confirmed cases, one probable case, and one death have been reported in Snohomish County. Thirty-one confirmed cases have also been identified in Pierce County. While seven cases of swine flu have been confirmed in Clark County, bordering the city of Portland, Oregon.

Thurston County and Yakima County have reported five cases. Spokane County and Whatcom County have reported four cases each. Kitsap County and Mason County have reported three cases. Two cases have been reported in Island County and Skagit County. One case each has been reported in Douglas County, Grays Harbor County, Jefferson County, Kittitas and Lewis County. An additional case, that of a cruise ship worker, is counted at the state level only.

On May 9, it was announced that a man from Snohomish County, in his thirties with a pre-existing heart condition and active viral pneumonia, became the third confirmed U.S. death from Swine Flu-involved complications.

Wisconsin

  Death(s) confirmed

  Case(s) confirmed

  Case(s) unconfirmed (probable)

As of May 22, 2009, Wisconsin has 1130 confirmed cases, most of which are in the southern and south-eastern region of the state. So far, cases have been confirmed in 24 counties, however Milwaukee, Dane, Waukesha, and Columbia have the majority of the cases, with 706, 90, 54, and 52 respectively. As of May 24, 2009, Wisconsin currently has the most confirmed cases of swine flu in the United States.

Wyoming

As of May 27, there have been two confirmed cases of swine flu in Wyoming.

See also

• 1918 flu pandemic
• 2009 swine flu outbreak
• 2009 swine flu outbreak in Canada
• 2009 swine flu outbreak in Mexico
• Avian influenza
• Pandemic Preparedness and Response Act
• Severe acute respiratory syndrome (SARS)
• Swine influenza 1976 U.S. outbreak

External links

U.S. federal government

• PandemicFlu.gov - Access to U.S. Government swine, avian and pandemic flu information.
• U.S. Centers For Disease Control (CDC) H1N1 Flu – Updates periodically as the CDC releases new information
• Medical Encyclopedia Medline Plus: Swine Flu Encyclopic Information from the National Institutes of Health

State governments

• Alabama Department of Public Health homepage on Novel A/09(H1N1)
• Arizona Department of Health Services daily updates
• California Department of Public Health provides updates on Swine Flu
• Georgia Department of Human Services - Division of Public Health
• Louisiana Department of Health and Hospitals - A/H1N1 (2009 Swine Flu) updates and links
• Michigan Dept of Community Health updates with county breakdowns posted daily at 4:30pm EDT
• Missouri Department of Health and Senior Services Swine Flu Updates
• Nebraska Department of Health and Human Services
• New York State Department of Public Health provides updates on Swine Flu
• North Carolina Department of Health and Human Services
• Ohio Department of Health
• South Carolina Department of Health and Environmental Control
• South Dakota Department of Health
• Tennessee Department of Health
• Texas Department of State Health Services provides updates on Swine Flu and a county breakdown of confirmed cases
• Utah Bureau of Epidemology Swine Flu
• Vermont Department of Health Swine Flu Outbreak
• Washington, DC Department of Health
• Washington State Department of Health Swine Flu Information
• West Virginia Bureau for Public Health Swine Influenza
• Wisconsin Pandemic Flu Resource

International organizations

• World Health Organization (WHO) Influenza A(H1N1) page – Updates periodically and links to archived WHO releases

Other websites

• Utah Man, 22, With Swine Flu Dies, Fox News, Associated Press reference, May 20, 2009.
• New York City public schools attendance tracking
• BioHealthBase Bioinformatics Resource Center – Database of influenza genomic sequences and related information.
• USA Today – State-by-state preparations
• Medical Encyclopedia WebMD: Swine Flu Center
• Worldwide Confirmed and Suspected Cases

New York City

• New York City Health Department
• New York City Department of Education