The 2009 swine flu pandemic in North America, part of a pandemic in 2009 of a new strain of influenza A virus subtype H1N1 causing what has been commonly called swine flu, began in the United States or Mexico.
Countries and territories
North America
Canada
Roughly 10% of Canadians had been infected with the virus as of mid-late November "Roughly 10 per cent of Canadians have been infected, and another 25 per cent have been immunized." with 416 confirmed deaths as of January 7; there were over 10,000 confirmed cases when Health Canada stopped counting in July 2009.Government of Canada - Health Canada: Update bulletins for influenza A H1N1 2009 (human swine influenza) Canada began its vaccination campaign in OctoberCBC - The Road to Rollout, Nov. 6, 2009 and 40% of the populace has since been immunized against H1N1.
The widespread effect of H1N1 in Canada was a serious concern for the XXI Olympic Winter Games, which took place in Vancouver in February 2010.
Mexico
Dr. José Ángel Córdova Villalobos, Mexico's Secretariat of Health, stated that since March 2009, there have been over 1,995 suspected cases and 149 deaths, with 20 confirmed to be linked to a new swine influenza strain of Influenza A virus subtype H1N1. As of April 26 there had been 1,614 cases, with 103 deaths and about 400 patients in hospital; approximately two-thirds of the sick patients had recovered. "'As many as 23,000 Mexicans were likely infected with the swine flu virus,' Neil Ferguson of Imperial College London and colleagues reported in the journal Science."
Soldiers mobilized by the government have handed out six million surgical masks to citizens in and around Mexico City. On April 24, 2009, schools (from pre-school to university level) as well as libraries, museums, concerts and any public gathering place, were shut down by the government in Mexico City and the neighboring State of Mexico to prevent the disease from spreading further; the schools in Mexico City, the State of Mexico, and the state of San Luis Potosí will remain closed until at least May 5. Marcelo Ebrard, Mexico City's mayor, has also asked all night-life operators to shut down their places of business for ten days to prevent further infections. José Ángel Córdova, federal Secretary of Health, said on April 24 that schools will probably be suspended for at least the following week then, and that it will take around ten days to see the evolution of the virus' behavior, and to consider other measures after such. On April 25, President Felipe Calderón declared an emergency which granted him the power to suspend public events and order quarantines. Hours later, Córdova announced that classes in Mexico City would be officially suspended through May 6. On April 26, Natividad González Parás, governor of the northeastern State of Nuevo León, announced that statewide schools will remain closed until 6 May, and established a quarantine system in airports, central bus stations and the creation of observation points mainly in the southern part of the state at the nearest highways to the borders with other states, in order to realize tests conducted on people arriving from other states. However, as for April 27, there are no confirmed reported cases of infection in this state.
On April 26, the World Bank announced US$ 25 million in immediate aid loans to Mexico, an additional US$180 million for long-term assistance to address the outbreak, and advice on how other nations have responded to similar crises.
On April 27, the Secretariat of Public Education announced that all schools in Mexico will remain closed at least until May 6.
On April 28, the Mexico City government closed all restaurants and cinemas. The National History and Anthropology Institute also closed all its archaeological sites and museums, including the most famous Mayan and Aztec ruins, until further notice.
United States
Initial reports of atypical flu in two individuals in southern California led to the discovery of the novel swine flu virus by the CDC in mid-April. More than a hundred cases were confirmed in the next two weeks, spread through a dozen states. Outside of California and Texas, initial cases were all tied to recent travel to Mexico or close contact with those who had recently visited Mexico. St. Francis Preparatory School, a private school in New York, was the center of a large cluster of cases after a Spring Break trip by several students, and perforce one of the first U.S. schools to be closed as a public health measure during the early outbreak. Most of the cases in California and Texas are not linked and may reflect localized outbreaks of this virus in those areas. As of April 30, the disease was not as virulent outside of Mexico as within Mexico, for reasons not fully understood.
The United States of America declared a state of Public Health Emergency but this was said to be standard procedure in cases as divergent as the recent inauguration and flooding. According to The New York Times, "the emergency declaration frees resources to be used toward diagnosing or preventing additional cases and releases money for more antiviral drugs," including the transfer of approximately 12 million influenza medications from a federal stockpile to states. The U.S. plans followed a guidebook developed over the past five years to fight a pandemic flu such as H5N1. The situation developed rapidly with the White House initially looking into the matter on April 24 according to press releases, but rapidly adopting a serious stance as the WHO and CDC issued stronger recommendations.
On April 29, the US suffered its first confirmed death of swine flu. On April 28, the Centers for Disease Control and Prevention had officially confirmed through tests that a 23-month-old child was infected with the flu. When the sickness continued to worsen the next day, he was transferred to Texas Children's Hospital in Houston, where he died.First U.S. swine flu death confirmed , CNN, April 29, 2009US reports first swine flu death, BBC, April 29, 2009
On May 5, Judy Trunnell, a woman in her 30s 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.
On May 10, a 30-year-old man with underlying health problems died in Washington from H1N1, the first fatality in that state.
On May 17, 55-year-old Mitchell Wiener, an assistant principal at Intermediate School 238 in Hollis, Queens died from H1N1, making it the first H1N1 related fatality in the state of New York. Wiener suffered from many other underlying health problems, weakening his resistance to the disease.
On May 19, 2009, a St. Louis County man became the first death in Missouri due to the Swine Flu.
As of mid-May 2009 many states had abandoned testing for likely influenza cases unless serious illness and/or hospitalization were present. Because reported numbers represent only confirmed cases, they are a "very great understatement" of the total number of cases of infection, according to the CDC.With limited resources, some states are placing a priority on testing hospitalized patients, which may create a false impression that the virus is becoming more lethal, Richard Besser, MD, the CDC's acting director, said at a media briefing yesterday.
However, he added that scaled-back testing is also in line with how public health officials handle testing for seasonal influenza. Given that the swine flu outbreak seems to resemble seasonal flu, expect the CDC to revise some of its recommendations and change some of its reporting practices, he said.
As the disease becomes more widespread, tallies of individual cases won't be as meaningful, but health authorities will want to know what regions of the country are affected and to what extent, Besser said. For reporting on the swine flu outbreak, the CDC will likely use the surveillance and reporting model it uses for seasonal flu.
Minnesota is among states that have announced a cutback in influenza testing. In a May 4 press release, the Minnesota Department of Health (MDH) said it was asking healthcare providers to submit lab specimens only when a patient has been hospitalized for flu-like symptoms. It will also continue to accept specimens from the state's 29 sentinel influenza surveillance sites and for ill healthcare workers.
May 9, 2009 — The confirmed numbers of influenza A (H1N1) cases reported are likely to fall far short of the actual numbers occurring within the community, according to a US Centers for Disease Control and Prevention (CDC) spokesperson.
"The individual numbers are likely a very great underestimate of how much virus is circulating or how many people are becoming ill from it," said Anne Schuchat, MD, the Director of the CDC's National Center for Immunization and Respiratory Diseases, speaking at a media briefing today.
...
The real number of swine flu cases in the United States could be “upwards of 100,000,” a top public health official estimated on Friday — far higher than the official count of 7,415 cases confirmed by laboratories.
On September 1, 2009, several new virus isolates were tested for neuraminidase inhibitor resistance. These included one seasonal influenza A (H1N1), 13 influenza A (H3N2), 23 Influenza B, and 1, 855 2009 influenza A (H1n1) virus isolates.
Central America and Caribbean
Aruba Trevor van Gellecum, the Director of the Aruban Department of Health, announced that all passengers arriving by airplane or cruise ship will have to fill out a health questionnaire beginning on April 27, 2009. Hotels and resorts are required to report to authorities if any tourists are showing flu-like symptoms. The government of Aruba also ordered antiviral medication and other supplies from the Netherlands and the United States. No swine flu cases have been reported.
The Bahamas Ten students and teachers who arrived from Mexico in the last week of April are in quarantine.
Barbados The Minister Of Health, Donville Inniss has confirmed that two samples have been sent off to the Caribbean Epidemiology Centre (CAREC) in Trinidad and Tobago to be tested for the virus.
Belize There are two suspected cases of swine flu currently under investigation in Belize. As a result, all major public events have been cancelled. This includes the National Agriculture and Trade Show. People have been asked to be very careful and use preventative measures.
Costa Rica
A 21-year-old woman was confirmed as carrying the swine flu virus on April 28. The woman came back from Mexico by airplane. A second case was confirmed on the same day, a 30-year-old man who traveled to Mexico the week before. On May 2 the Costa Rican Ministry of Health confirmed two more cases. Four more cases were confirmed on May 4.
A 53-year-old man became the first confirmed death from the disease in the country, as reported by the Minister of Health on May 9. This was the first death outside of a North American country and the fourth country in the world to present a mortal case. The deceased man was suffering other chronic diseases. The Minister of Health informed he had diabetes and also was suffering from chronic obstructive pulmonary disease (COPD). She also informed the man was infected inside Costa Rica because he had not traveled to Mexico.
On August 11 was confirmed that Costa Rica's president, Óscar Arias Sánchez, was infected with the A(H1N1) virus, becoming the first head of state sick with the A(H1N1) virus President Arias returned to his normal activities after one week of isolation at his home.