2009 swine flu pandemic in Europe, Serbia
Four more cases were confirmed on 1 July, one of the patients is a 73-year-old US citizen, while two patients arrived from abroad, from Australia and the USA. On 2 July, an Australian sportsman was diagnosed with flu. On 6 July, the total number of infected patients rose to 26 with two more cases among the Universiade athletes, one from Uganda and one from Argentina. On 7 July, four more cases were confirmed with a total number of 30 cases in Serbia. On 8 July four more cases were confirmed with a total number of 34 cases.


2009 swine flu pandemic in Europe, Serbia
International events held in Serbia, 2009 Summer Universiade sport competition and EXIT music festival, led to a sudden increase to over 100 cases of flu in mid-July.


2009 swine flu pandemic in Europe, Serbia
On 21 October 2009 the first fatality related to the H1N1 in Serbia. The 46-year-old woman died in hospital in Kragujevac.


2009 swine flu pandemic in Europe, Serbia
As of 10 November, there are 258 people infected, and 7 death cases.


2009 swine flu pandemic in Europe, Serbia
On 16 November, there are 295 officially confirmed cases, with 11 people died as consequence of swine flu infection.


2009 swine flu pandemic in Europe, Slovenia
First confirmed infection was confirmed on 19 June; a female who flew from New York to Venice and then drove by car to Slovenia. 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 week. As of 28 January 2010, there were 2091 people tested positive.


2009 swine flu pandemic in Europe, Spain
On 27 April the Spanish Ministry of Health and Social Policy announced that a man in Castilla-La Mancha, Spain who had recently returned from Mexico had contracted the disease. The man, aged 23, had returned from Mexico on 22 April and had been quarantined on the 25th. This was the first confirmed case in Europe.


2009 swine flu pandemic in Europe, Spain
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.


2009 swine flu pandemic in Europe, Spain
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. Three patients who had just returned from Mexico were under observation in multiple regions of Spain.


2009 swine flu pandemic in Europe, Sweden
On 28 April, at least eighteen Swedish people were tested for swine flu after returning from trips in Mexico and the United States, but the results were negative. On 29 April two people, recently returned from Mexico with flu like symptoms were tested.


2009 swine flu pandemic in Europe, Sweden
On 6 May, the Swedish Institute for Infectious Disease Control confirmed one case of influenza A(H1N1). 186 negative test results have been reported. No suspected cases remain to be analysed.


2009 swine flu pandemic in Europe, Sweden
The number of confirmed cases had reached two in Sweden, with 435 negative cases reported as of 15 May.


2009 swine flu pandemic in Europe, Sweden
A third case was confirmed on Friday, 15 May, and reported on the following Saturday, where the patient, a woman in her sixties, had recovered. In all of the three cases the influenza was contracted in the United States.


2009 swine flu pandemic in Europe, Sweden
A fourth case was confirmed 28 May, influenza was contracted in the United States.


2009 swine flu pandemic in Europe, Sweden
On 19 July 274 cases had been confirmed. On 20 July, the number had risen to 322 confirmed cases and to 340 on 21 July. 362 cases had been reported on 22 July 390 on 23 July and 408 as of 24 July.


2009 swine flu pandemic in Europe, Sweden
Three regions reported more than 20 cases; Stockholm County with 144, Skåne County with 78 and Västra Götaland County with 71.


2009 swine flu pandemic in Europe, Sweden
A 22-year-old man in Norrköping was hospitalised with a life-threatening condition, requiring extracorporeal membrane oxygenation.


2009 swine flu pandemic in Europe, Sweden
In August, a 37-year-old man in Uppsala was the first to die of H1N1 influenza in Sweden. The second case was in September, a 55-year-old man in Västerås. On 31 October, a three-year-old boy died in a hospital after first being turned down treatment even though he suffered several of the obvious symptoms.


2009 swine flu pandemic in Europe, Switzerland
The first suspicious case in Switzerland was officially confirmed on 27 April. 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.


2009 swine flu pandemic in Europe, Switzerland
Switzerland has confirmed its first case of swine flu in a 19-year-old student who returned from Mexico on 30 April. The state hospital in Baden said in a statement that the National Influenza Centre in Geneva confirmed the disease shortly after the student was mistakenly released from hospital day before.


2009 swine flu pandemic in Europe, Switzerland
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.


2009 swine flu pandemic in Europe, Switzerland
On 24 May, a third case of swine flu has been announced in a woman who came back from Washington and is resident in Basel.


2009 swine flu pandemic in Europe, Switzerland
As of 26 June, there are 49 confirmed cases in ten cantons, with five cases having been community-transmitted.


2009 swine flu pandemic in Europe, Switzerland
As of 19 November a total of three persons have been reported to die from swine flu, a baby and two women, all of them with pre-existing health problems of other origin.


2009 swine flu pandemic in Europe, United Kingdom and Crown Dependencies
Samples from suspected cases in the United Kingdom 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.


2009 swine flu pandemic in Europe, United Kingdom and Crown Dependencies
On 25 April 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.


2009 swine flu pandemic in Europe, United Kingdom and Crown Dependencies
The first cases were confirmed on 27 April in passengers returning from Mexico.


2009 swine flu pandemic in Europe, United Kingdom and Crown Dependencies
On 1 May 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.


2009 swine flu pandemic in Europe, United Kingdom and Crown Dependencies
It was reported on 26 May that a man who has been confirmed with swine flu was critically ill.


2009 swine flu pandemic in Europe, United Kingdom and Crown Dependencies
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 reality, 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.


2009 swine flu pandemic in Europe, United Kingdom and Crown Dependencies
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.


2009 swine flu pandemic in Europe, United Kingdom and Crown Dependencies
As of 11 June 2009, 822 cases of swine flu were clinically confirmed.


2009 swine flu pandemic in Europe, United Kingdom and Crown Dependencies
On 13 June, the total of swine flu cases hit 1,122 with 4 people in intensive care in hospital. The following day, the first death from swine flu in the United Kingdom was reported from Scotland, making the first death from Europe.


2009 swine flu pandemic in Europe, United Kingdom and Crown Dependencies
By 9 July there were over 9,718 cases of swine flu and the rate of cases was going up increasingly.


2009 swine flu pandemic in Europe, United Kingdom and Crown Dependencies
By 16 July, over 10000 cases of Swine flu were confirmed, with the British government suggesting a possible 55000 new cases in the week leading up to the 16. There were 29 deaths confirmed, although the majority of these had 'underlying health issues'. (26 in England and 3 in Scotland)


2009 swine flu pandemic in Europe, United Kingdom and Crown Dependencies, Gibraltar
Gibraltar has reported its first confirmed case of swine flu on 24 July.


2009 swine flu pandemic in France
The 2009 flu pandemic, involving an outbreak of a new strain of influenza commonly known as swine flu (usually referred as grippe A or grippe porcine in French), reached France in early May 2009.


2009 swine flu pandemic in France
In order to respond to flu epidemics in France, the government has a "national plan", which is also applied for this flu pandemic. In this plan, the different phases of the flu, which are slightly different from the World Health Organization phases, are detailed.


2009 swine flu pandemic in France, Government reaction to the flu
A governmental web site has been created to inform the population of the dangers and good practices to avoid the spread of the disease.


2009 swine flu pandemic in France, Government reaction to the flu
The French government lags behind the decision of the World Health Organization to upgrade to phase 6. It is currently in phase 5A in France.


2009 swine flu pandemic in France, Government reaction to the flu
A mandatory mass vaccination plan has been discussed. This vaccination plan is currently implemented, it is free and not mandatory.


2009 swine flu pandemic in France, Government reaction to the flu
In July 2010, France initially ordered 1,46 doses per inhabitant, the third largest amount among members of the Global Health Security Initiative (GHSI), behind the United Kingdom and Canada. In January, 50 million of the initial 94 million doses were cancelled.


2009 swine flu pandemic in France, Timeline, April
The French government asks Europe to decide to cancel all flights to Mexico.


2009 swine flu pandemic in France, Timeline, May
On 1 May, the French Health Minister confirmed, during the 8 p.m. TF1 news, that 2 cases of A(H1N1) flu have been detected in France.


2009 swine flu pandemic in France, Timeline, May
The government discusses the possibility of ordering 100 million vaccine doses against the flu from three companies (GlaxoSmithKline, Sanofi and Novartis).


2009 swine flu pandemic in France, Timeline, May
The French government plans to vaccinate the entire French population (65 million inhabitants)


2009 swine flu pandemic in France, France, by region
The detailed situation by region is updated by the National Institute of Health


2009 swine flu pandemic in Germany
The 2009 flu pandemic, involving an outbreak of a new strain of influenza commonly known as swine flu, reached Germany in April 2009.


2009 swine flu pandemic in Germany
Two men and a woman from Bielefeld who had been firstly suspected of having the virus tested negative on influenza type A.


2009 swine flu pandemic in Germany
On 29 April, the first case of swine flu in Germany was confirmed by the Robert Koch Institute in the area of Regensburg. A 22-year-old woman from Hamburg is also confirmed to have been infected by swine flu during a trip to Mexico. A 37-year-old woman from Kulmbach is also confirmed to have become infected during a similar trip.


2009 swine flu pandemic in Germany
On 1 May, the Robert Koch Institute confirmed the first case of human-to-human transmission of swine flu in Munich. A nurse who had contact with one of the infected people was infected with the virus. At approximately 10:00 she was claimed to be already healed. At 13:00 one additional infection in Bavaria was confirmed, but the patient was also claimed to be healthy again.


2009 swine flu pandemic in Germany
On 2 May, 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.


2009 swine flu pandemic in Germany
On 3 May, two further cases of swine flu in Brandenburg were reported. Two people from the same flight as patient in Hamburg were also infected.


2009 swine flu pandemic in Germany
On 5 May, one new case in Saxony-Anhalt has been confirmed bringing to 9 the total number of people infected.


2009 swine flu pandemic in Germany
On 7 May, another new case in Saxony-Anhalt is reported.


2009 swine flu pandemic in Germany
On 8 May, an adult male living in Bavaria who had recently been to United States.


2009 swine flu pandemic in Germany
On 11 May, the case of a 27-year-old Bavarian woman, who stayed for some weeks in Mexico and medicated patients in a hospital, is reported.


2009 swine flu pandemic in Germany
On 15 May, two more cases were reported, a female and her son from Saxony-Anhalt were obviously infected by her husband / his father, who returned from Mexico.


2009 swine flu pandemic in Germany
On 21 May, a case was found in a 43-year-old woman from Düsseldorf in North Rhine-Westphalia who returned from New York. One day later, Robert Koch Institute confirmed that her husband has been tested positive with swine influenza too. Furthermore, their six-year-old daughter, who did not stay in New York, has been infected by her parents, bringing the total to 17.


2009 swine flu pandemic in Germany
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.


2009 swine flu pandemic in Germany
As of 6 November 2009, the number of infections increased to 29,900 with nine deaths caused by the flu.


2009 swine flu pandemic in Hong Kong
The 2009 flu pandemic in Hong Kong was part of the worldwide pandemic that started with the city's first reported case of influenza A virus subtype H1N1 infection, commonly called swine flu, on 1 May 2009, in a Mexican national who had travelled to Hong Kong via Shanghai. It was also the first reported case of in Asia. As of 25 November 2009, there have been 32,301 confirmed cases of swine flu in the city.


2009 swine flu pandemic in Hong Kong, Initial response
Following news of the flu outbreak in Mexico and the United States, on 26 April, Secretary for Food and Health York Chow announced that Hong Kong had raised its influenza pandemic alertness level to "serious", out of three possible alertness levels: alert, serious, and emergency. Hong Kong also became one of the first jurisdictions to declare swine flu as a notifiable disease, and much of the procedures against the spread of the swine flu were learned from the 2003 SARS outbreak, of which Hong Kong was the center.


2009 swine flu pandemic in Hong Kong, Initial response
Chow advised Hong Kong residents to avoid travelling to cities facing an outbreak of the flu, and stated that swine flu has been added to the list of notifiable disease, which required cases of the flu to be reported to the government. Residents were also advised to take precautionary measures against infection if travel to affected areas was necessary. Surveillance measures at boundary control points were boosted to detect travellers with fever and respiratory symptoms, and travellers who were suspected of being infected would be quarantined and monitored.


2009 swine flu pandemic in Hong Kong, First case
On 1 May, Hong Kong Chief Executive Donald Tsang told reporters that tests performed by the Department of Health and the University of Hong Kong confirmed that a 25-year-old Mexican citizen who had traveled to the city via Shanghai on a China Eastern Airlines flight was infected with swine flu. In light of this, Tsang raised Hong Kong's influenza pandemic alertness level to "emergency" from "serious". This first confirmed case of swine flu in Hong Kong was also the first confirmed case in Asia.


2009 swine flu pandemic in Hong Kong, First case
The man had developed a fever after arriving in Hong Kong, and was then isolated in Princess Margaret Hospital, the hospital designated to handle swine flu cases. The hotel where the traveller had stayed, the Metropark Hotel in Wanchai, was quarantined and about 200 guests and 100 staff were instructed to remain in the hotel for seven days regardless of whether or not they had come into contact with the traveller. Authorities also made an effort to track down anybody who had made contact with the traveller, with Chow appealing to those who were on the same flight as the traveller to contact health officials.


2009 swine flu pandemic in Hong Kong, First case
The guests and staff were released on 8 May, when the quarantine expired. Tsang was at the hotel for the release, speaking to reporters and with those who had been quarantined. To compensate for the quarantine, the government offered guests two free nights of accommodation at other hotels in Hong Kong. The Mexican traveller was also discharged after treatment with the antiviral drug Tamiflu and the Centre for Health Protection confirmed that he was no longer carrying the virus.


2009 swine flu pandemic in Hong Kong, School closure
Following the finding that 12 students at St. Paul's Convent School contracted the swine flu virus, Chief Executive Donald Tsang ordered the closure of all primary schools, kindergartens, and special schools for two weeks starting from 12 June. The 12 cases of infection were confirmed to be the first known cluster of local transmission of the virus. According to the Education Bureau, the school closure affected about 500,000 students from 964 kindergartens, 601 primary schools and 61 special schools.


2009 swine flu pandemic in India
2009 flu pandemic in India was the outbreak of swine flu in various parts of India. Soon after the outbreak of H1N1 virus in the United States and Mexico in March, the Government of India started screening people coming from the affected countries at airports for swine flu symptoms. The first case of the flu in India was found on the Hyderabad airport on 13 May, when a man traveling from US to India was found H1N1 positive.


2009 swine flu pandemic in India
Subsequently, more confirmed cases were reported and as the rate of transmission of the flu increased in the beginning of August, with the first death due to swine flu in India in Pune, panic began to spread. As of 24 May 2010, 10193 cases of swine flu have been confirmed with 1035 deaths.


2009 swine flu pandemic in India
The only known drug to work against H1N1 (Tamiflu) was not sold in general medical stores, to prevent the virus from developing antibiotic resistance due to excessive use. The government feared that people would pop in pills for no reason, thereby making the virus resistant to its only known cure. The problem facing the state machinery was the fact that flu infected cases were coming from across the country.


2009 swine flu pandemic in India
Generic version of Tamiflu (Oseltamivir) was made available in Indian market, after several months of swine flu attack. Natco Pharma and Strides Arcolabs have launched their generic version of Oseltamivir, Natflu and Starflu. These drugs were made available to the customers directly under prescription.


2009 swine flu pandemic in India
On 8 August 2010 the Indian government reported there had been 1833 deaths from swine flu in the country.


2009 swine flu pandemic in India
On 18 October 2010 a biotechnology firm announced the launch of India's first indigenously developed cell culture H1N1 Swine Flu Vaccine under the brand name HNVAC.


2009 swine flu pandemic in India, Background
A new strain of influenza virus, officially named the "new H1N1", first identified in April 2009, and commonly called "Swine flu" initially spread in Mexico and then globally by transmission. It is thought to be a mutation of four known strains of the influenza A virus, subtype H1N1: one endemic in (normally infecting) humans, one endemic in birds, and two endemic in pigs (swine). Experts assume the virus "most likely" emerged from pigs in Asia, and was carried to North America by infected persons. The virus typically spreads from coughs and sneezes or by touching contaminated surfaces and then touching the nose or mouth. Symptoms, which can last up to a week, are similar to those of seasonal flu, and may include fever, sneezes, sore throat, coughs, headache, and muscle or joint pains.


2009 swine flu pandemic in India, Deaths
The first death was a 14-year-old girl in Pune, Maharashtra. On 8 and 9 August a 43-year-old man in Ahmedabad, Gujarat, a 42-year-old teacher in Pune and a 53-year-old woman in Mumbai died. On 10 August a 53-year-old doctor in Pune and a 4-year-old in Chennai died. On 11 August a 7-year-old girl in Vadodara, Gujarat died. On 13 August, a 26-year-old woman became Bangalore's first victim of swine flu.


2009 swine flu pandemic in India, Deaths
An eleven-month-old boy, a 75-year-old woman and a 37-year-old woman died taking the toll in Pune, severely hit by the virus, to 15 and across the country, to 24.A lady having a young daughter of 5 yrs died near Mumbai in Khopoli on 14 August. On 13 August, three people died at different hospitals in Bangalore, according to the reports.


2009 swine flu pandemic in India, Deaths
Swine flu death toll crosses 500 in India. New Delhi, 10 November—The death toll of the H1N1 flu in India is rising in leaps and bounds with 18 new fatalities reported Monday. Within the short space of a little over three months, the mortality figure has shot up to 503.


2009 swine flu pandemic in India, Deaths, Influenza A H1N1 status
As of 8 August 2010 there had been 1833 deaths from H1N1 swine influenza reported.


2009 swine flu pandemic in India, Deaths, Influenza A H1N1 status
As of 31 January the death toll of A/H1N1 influenza was 1229, and the number of laboratory confirmed cases of A/H1N1 (including uncomplicated cases) was 28,810.


2009 swine flu pandemic in India, Deaths, Influenza A H1N1 status
As of 8 February, the number of confirmed deaths due to A/H1N1 in India had risen to 1270.


2009 swine flu pandemic in India, Deaths, Influenza A H1N1 status
As of 12 February, the number of confirmed deaths from A/H1N1 pandemic influenza had risen to 1302.


2009 swine flu pandemic in India, Deaths, Influenza A H1N1 status
As of 24 February 1357 confirmed deaths from H1N1 have been reported in India, and 29,583 confirmed cases of H1N1 have been reported.


2009 swine flu pandemic in India, Deaths, Influenza A H1N1 status
As of 12 March 2010, 1404 confirmed deaths from H1N1 influenza have been reported, and at least 29,904 laboratory-confirmed cases of H1N1 have been reported.


2009 swine flu pandemic in India, Deaths, Influenza A H1N1 status
Consolidated Status of Influenza A H1N1 : 2 January 2011


2009 swine flu pandemic in Japan
The 2009 Japan flu pandemic was an outbreak of the H1N1 and the Influenza A viruses across Japan. The World Health Organization raised the pandemic alert for influenza to level 4 in April 2009 following a worldwide outbreak of the H1N1 influenza strain. The first Japanese infections of H1N1 and Influenza A were both recorded early in May 2009. In August 2009, the government estimated that the virus strains had infected about 760,000 people.


2009 swine flu pandemic in Japan
At the height of the pandemic in October 2009, it was estimated that 20% of the Japanese population had been infected and that there were on average more than 20 infected people in each Japanese medical facility. The Ministry of Health, Labor and Welfare reported 198 Deaths as of March 30, 2010. Japan put several measures in place to attempt to control the spread of infection including quarantining air travellers entering Japan who were suspected of having the virus and closing schools in areas of Japan with high numbers of infection. The pandemic ended in August 2010 when the World Health Organization announced that worldwide influenza infection number were back to the seasonal average before the outbreak occurred.


2009 swine flu pandemic in Japan, Government reaction
In April, Japan's Ministry of Agriculture, Forestry and Fisheries instructed animal quarantine offices across the country to examine any live pigs being brought into the country to double-check for infection by the H1N1 strain of influenza. Japanese Agriculture Minister Shigeru Ishiba appeared on TV to reassure consumers regarding the safety of pork. The Japanese farm ministry said that it would not ask for restrictions on pork imports because pork was unlikely to be contaminated with the virus, and any virus would be killed in the cooking process anyway.


2009 swine flu pandemic in Japan, Timeline, April, December
151 young flu patients have exhibited abnormal behavior such as depression and uttering gibberish.


2009 swine flu pandemic in Malaysia
The 2009 flu outbreak in Malaysia is part of a larger flu pandemic involving a new type of influenza A virus subtype H1N1 (A (H1N1)) virus. As of 11 August 2009, the country has over 2,253 cases, beginning with "imported" cases from affected countries, including the United States and Australia from 15 May 2009 onwards, and the first identified local transmission on 17 June 2009. From 12 August, the Malaysian Health Ministry said that it had discontinue officially updating the total number of H1N1 cases within Malaysia in line with guidelines issued by the World Health Organization.


2009 swine flu pandemic in Malaysia
As of 21 August 2009 the unofficial number of cases reported in the media is 5,876 so far. The first death related to the A(H1N1) virus was reported on 23 July 2009 and so far there have been 78 deaths reported. On 6 July 2009 Malaysia announced that it was shifting from containment to mitigation to tackle the spread of the virus. The federal government has declared a national health emergency in Malaysia because of the A(H1N1) outbreak and is considering imposing a health curfew similar to the week-long shutdown of non-essential services and industries in Mexico.


2009 swine flu pandemic in Malaysia, Government measures
Since the Nipah virus outbreak in 1999, the Malaysian Health Ministry have put in place processes to be better prepared to protect the Malaysian population from the threat of infectious diseases. Malaysia was fully prepared during the Severe Acute Respiratory Syndrome (SARS) situation (Malaysia was not a SARS affected country) and the episode of the H5N1 (bird flu) outbreak in 2004.


2009 swine flu pandemic in Malaysia, Government measures
The Malaysian government has developed a  which serves as a time bound guide for preparedness and response plan for influenza pandemic. It provides a policy and strategic framework for a multisectoral response and contains specific advice and actions to be undertaken by the Ministry of Health at the different levels, other governmental departments and agencies and non-governmental organisations to ensure that resources are mobilised and used most efficiently before, during and after a pandemic episode.


2009 swine flu pandemic in Malaysia, Government measures
According to the Malaysian Ministry of Health, headed by Liow Tiong Lai, health screenings were carried out on passengers travelling to and from Mexico via sea, air and land beginning 17 April 2009. The Health Ministry's disease control division has activated its operations room to monitor the swine flu situation and informed medical practitioners who are treating cases with symptoms of influenza-like illness or severe pneumonia and persons who had visited Mexico, California or Texas to inform the district health office immediately for preventive and control measures.


2009 swine flu pandemic in Malaysia, Government measures
As has several Asian countries, thermal scanners had been installed at entry points at the Kuala Lumpur International Airport (KLIA) following the start of the global alert on the flu. Screenings were imposed in Pengkalan Hulu, at the border with Thailand, in late April. Quarantine rooms had been allocated in 28 hospitals, and the country has stockpiled more than 2 million doses of Tamiflu, as of May 2009.


2009 swine flu pandemic in Malaysia, Government measures
The Malaysian Health Ministry has warned Malaysians not to withhold health information to the authorities saying that those doing so could be fined RM10,000 or jailed two years or both if they are found guilty under the Disease Prevention Act 1988. On 18 June 2009 Malaysian Deputy Prime Minister Tan Sri Muhyiddin Yassin declared that all visitors and Malaysians returning from abroad will be required to fill the health declaration form following the influenza A (H1N1) pandemic around the world.


2009 swine flu pandemic in Malaysia, Government measures, Mitigation of the Virus
On 17 August, The Government said that will consider declaring a health curfew if the mortality rate of Influenza A(H1N1) is above 0.4% from the current 0.1%-0.3%. Health Minister Datuk Seri Liow Tiong Lai said that they are currently treating the flu as a "health emergency".


2009 swine flu pandemic in Malaysia, Government measures, Mask use
Health Minister Datuk Seri Liow Tiong Lai urged the public to wear a mask if showing symptoms of the flu.


2009 swine flu pandemic in Malaysia, School closures
In response to the country's first case of A (H1N1), the health ministry urged calm among the populace "as the situation is under control" and "the ministry has taken all the possible precautionary measures to control and contain the disease after the WHO issued a level-five alert." In addition, schools were issued strict hygiene procedures on 16 May to contain any H1N1 outbreak among students and teachers.


2009 swine flu pandemic in Malaysia, School closures
Sekolah Rendah Kebangsaan Assunta 1 in Petaling Jaya became the fourth school to be closed in a week.


2009 swine flu pandemic in Malaysia, A (H1N1) cases
The country had reported no suspected cases before 4 May 2009, but all cases tested negative between 4 and 15 May. The 2009 FOBISSEA primary tournament in Kuala Lumpur was cancelled due to an unidentified student who was found to have contracted the virus whilst at the airport. Teams from British International Schools throughout South-East Asia were immediately sent home and quarantined.


2009 swine flu pandemic in Malaysia, A (H1N1) cases, 15 May – 10 June
On 15 May, the Health Ministry confirmed Malaysia's first case of A (H1N1) infection of a 21-year-old male student who had arrived at the KLIA on 13 May via a Malaysia Airlines flight (MH091) from Newark and on transit at Stockholm-Arlanda Airport, followed by a second case on 16 May of a female student in Penang who shared the same flight as the first patient and boarded an AirAsia flight (AK5358) from KLIA to Penang International Airport. This makes Malaysia the 36th country to detect A (H1N1) within its borders.


2009 swine flu pandemic in Malaysia, A (H1N1) cases, 15 May – 10 June
The first patient has been hospitalised at the Sungai Buloh Hospital, while house quarantines were undertaken on two of the second patient's friends who boarded the same flight, along with their family members. All passengers of the flights were also asked to contact the Health Ministry or head to any hospital, clinic or health office or further action, and crew members of MH091 and AK5358 were located and grounded. As the first patient has indicated, the use of thermal scanners is revealed not to be entirely effective as symptoms of his flu had yet to manifest; the Health Ministry resumes the use of the scanners nevertheless.


2009 swine flu pandemic in Malaysia, A (H1N1) cases, 15 May – 10 June
On 4 June, three additional inbound airline passengers were reported to be carrying the virus. The earliest of the three is a 23-year-old male student who returned from United States on 1 June via the same Malaysian Airlines flight (MH091) that the first cases of A (H1N1) were detected.


2009 swine flu pandemic in Malaysia, A (H1N1) cases, 15 May – 10 June
On the same day, two German tourists and friends (aged 30 and 32) who were holidaying in Southeast Asia and arrived in Malaysia were confirmed to be infected with the virus; both had flown into the country on 3 June via an Air Asia flight (AK702) after transferring from a Singapore Airlines flight (SQ45) from Germany to Singapore on 1 June. The third reported victim developed symptoms on 3 June and was hospitalised in Tunku Jaafar Hospital, while the two tourists developed symptoms while in Kuala Lumpur on 3 June and were given similar medical treatment.


2009 swine flu pandemic in Malaysia, A (H1N1) cases, 15 May – 10 June
All three victims were reported to be stable. As it has been for the last two cases, passengers sharing both the Malaysian Airlines and Air Asia flights are being traced. On 5 June, sixth case were reported from a student who took the same flight with the fourth patient. On the next day, a girl from Australia was confirmed to be infected with Influenza A (H1N1) when the airport scanner detected severe fever making her the 7th confirmed case overall in Malaysia.


2009 swine flu pandemic in Malaysia, A (H1N1) cases, 10–20 June
On 10 June, two new Influenza A(H1N1) cases had been detected in Malaysia. The eighth case involved a 17-year-old American student who accompanied her parents for a holiday in the country. The ninth case was a New Zealand national who arrived in the country at 7.30am on 5 June on an Air Asia flight DX7 2723. Malaysia recently registered two more cases of the disease, bringing the total to 11 cases. The 10th patient in the country was a 17-year-old girl who had just returned from a holiday in Melbourne, Australia on 9 June. The 11th patient was a 41-year-old woman who had returned from Manila to Penang on 6 June.


2009 swine flu pandemic in Malaysia, A (H1N1) cases, 10–20 June
A 12th case was reported on 13 June 2009 whereby a 19-year-old medical student was returning to Malaysia after a 17-day holiday in Melbourne.


2009 swine flu pandemic in Malaysia, A (H1N1) cases, 10–20 June
As of 15 June 2009, the total number of cases have increased to 17, with an addition of 5 new cases. The 13th case was a 12-year-old student who returned from a holiday in Manila. The 14th case was a British tourist, hospitalised in Kuantan after showing symptoms in Pulau Tioman. The 15th and 17th cases involved Malaysians who recently came back from Melbourne, both being currently hospitalised in Sungai Buloh Hospital. The 16th case involved an American resident, currently hospitalised in Queen Elizabeth Hospital in Kota Kinabalu, Sabah. A Filipino man was confirmed as the 18th victim of influenza A (H1N1) in Malaysia, after being detected as having a fever and cough during the screening process when he arrived at the KL International Airport from Manila.


2009 swine flu pandemic in Malaysia, A (H1N1) cases, 10–20 June
Malaysia recorded its first local infection of influenza A(H1N1) on 17 June 2009 involving the 19th case as that person had no history of having travelled to a country that had the flu.


2009 swine flu pandemic in Malaysia, A (H1N1) cases, 10–20 June
A 20th case was reported whereby a 23-year-old local public university male student who made a seven-day study visit together with 12 students and lecturers to Melbourne, returned from Melbourne aboard Air Asia X D7 2723 and landed at the Low Cost Carrier Terminal on 17 June. The 21st case came about with a 20-year-old medical student of a Melbourne university who returned to holiday in Malaysia aboard MH 128 and arrived at the KLIA on 16 June.


2009 swine flu pandemic in Malaysia, A (H1N1) cases, 10–20 June
The 22nd case showed that a 54-year-old man who had travelled to Manila on business on 9 June and arrived at KLIA on 12 June. It was reported that the 23rd case was a 22-year-old female Malaysian student who arrived from Melbourne by Air Asia at the LCCT on 14 June.


2009 swine flu pandemic in Malaysia, A (H1N1) cases, 10–20 June
On 18 June 2009 the Crisis Preparedness and Response Centre in Malaysia reported there were four imported cases of Influenza A(H1N1), bringing to total of 27 cases overall.


2009 swine flu pandemic in Malaysia, A (H1N1) cases, 10–20 June
On 19 June 2009 Director-General of Health Tan Sri Dr Mohd Ismail Merican said that eight new Influenza A(H1N1) cases were detected bringing the total number of cases of the disease in Malaysia to 35. The 35th case is a 20-year-old male Malaysian student who is studying in a university in Melbourne and has been there since January who came back to Malaysia for a holiday.


2009 swine flu pandemic in Malaysia, A (H1N1) cases, 20–30 June
On 20 June 2009 7 new cases of A(H1N1) were reported bringing the total number of confirmed cases so far to 42. One of the new cases included a local transmission of the virus whereby an 11-year-old student of Sekolah Jenis Kebangsaan Cina (SJKC) Davidson, Kuala Lumpur, contracted the virus from her grandmother who was 31st case confirmed.


2009 swine flu pandemic in Malaysia, A (H1N1) cases, 20–30 June
On 21 June 2009, eight more cases confirmed. Three of them were students from SJK(C) Jalan Davidson who contracted the virus from the 31st patient, which brought the total of confirmed cases in the country soaring to 50. SJK(C) Jalan Davidson had also been closed and more than one thousand people in the school had been quarantined.


2009 swine flu pandemic in Malaysia, A (H1N1) cases, 20–30 June
On 22 June 2009 it was reported that there were 8 new cases of A(H1N1) in Malaysia bringing the total number of confirmed cases to 58 overall. The 51st case is a three-year-old girl who returned from a week-long holiday in Melbourne on 19 June with her parents on MH 148. The 52nd case is a 35-year-old MAS air steward who was on duty on MH1 Delta from London and arrived in KLIA on 18 June. The 53rd case is a 27-year-old woman who returned from a holiday in Sydney with her husband on 16 June on MH 122. She is in Kuala Lumpur Hospital. The 54th case is a 25-year-old woman who had contact with the 48th case and was confirmed with the flu 21 June in Hospital Sultanah Bahiyah, Alor Star. She is the 5th local transmission.


2009 swine flu pandemic in Malaysia, A (H1N1) cases, 1–10 July
On 9 July 61 new cases of Influenza A(H1N1) were confirmed, consisting of 37 imported cases and 24 locally transmitted which makes the number of cases in Malaysia soared to 574. Among the 574 cases, 415 cases were reported to have been imported while 159 cases were locally transmitted. One of the visitors who visited a company in Cyberjaya were confirmed to have contracted the virus, which caused 12 workers to be put under home quarantine.


2009 swine flu pandemic in Malaysia, A (H1N1) cases, 11–31 July
On  23, 18 July new cases were confirmed in Malaysia consisting 17 local transmission and 1 imported case.


2009 swine flu pandemic in Malaysia, A (H1N1) cases, 1 August onwards
According to the Health Ministry another 39 cases of A(H1N1) were reported on 2 August.


2009 swine flu pandemic in Malaysia, A (H1N1) cases, 1 August onwards
16 new cases of H1N1 were discovered on 5 August 2009 bringing the total number of cases to 1,492.


2009 swine flu pandemic in Malaysia, A (H1N1) cases, 1 August onwards
33 new cases were reported on 6 August 2009, bringing the total cases in Malaysia to 1525. It was reported on the same day that an immigration detainee from Togo was found dead at the Sepang detention centre. According to the guard, the prisoner did not complain of fever or cough. Autopsy were conducted on 4 August 2009 in Selayang Hospital and discovered that the patient was suffering from Influenza A(H1N1). However, they were still unable to determine if the flu was the direct cause of the patient's fatality.


2009 swine flu pandemic in Malaysia, A (H1N1) cases, 1 August onwards
On 8 August 2009, 53 more cases were confirmed and brought the number of cases in Malaysia to 1578. Among the 1578 cases, 574(36%) were imported cases and 1004(64%) were local transmission.


2009 swine flu pandemic in Malaysia, A (H1N1) cases, 1 August onwards
A record of more than 200 cases were confirmed on 9 August 2009. 202 new local transmitted cases were confirmed which brought the number of flu cases soared to 1780. 13 patients were still in ICU, and four of them were still in critical condition. 270 new local cases were confirmed on 11 August 2009, bringing the total cases in Malaysia to 2,253.


2009 swine flu pandemic in Malaysia, Deaths, July
On 23 July 2009 first A(H1N1) related death was confirmed. The patient is a 30-year-old Indonesian man who suffered from multiple medical condition, including obesity and enlarged heart. However, Health Minister Datuk Liow Tiong Lai revealed that the flu was not the direct cause of the patient's fatality.


2009 swine flu pandemic in Malaysia, Deaths, August
On 6 August 2009, in Putrajaya another death was confirmed involving a 57-year-old pensioner who was a diabetic and suffered from hypertension. On 7 August 2009, a 40-year-old obese man who was admitted to Kuala Lumpur Hospital died of acute coronary syndrome and cardiogenic shock. The man was suffering from fever and had been coughing since 28 July 2009. His autopsy result confirmed that he is the nation's fifteen Influenza A(H1N1) death.


2009 swine flu pandemic in Malaysia, Deaths, August
On 8 August 2009, three more deaths were recorded, which brought the death cases in Malaysia to 18. The sixteenth death was a 5-year-old boy who had upper respiratory tract infection and sought treatment in a private clinic on 3 August. He was then had a seizure and was sent to Tengku Ampuan Afzan Hospital and confirmed to have the H1N1 virus. He died on 7 August 2009 due to acute encephalitis secondary to Influenza A(H1N1). The seventeenth death was a one-year-old toddler who had history of hyperthyroidism and was under treatment for it.


2009 swine flu pandemic in Malaysia, Deaths, August
He had symptoms of the flu but did not seek for treatment. He was then sent to Sultanah Amanah Hospital, Johor Bahru. He was confirmed to have the flu on 4 August 2009. However, after five days of treatment, his condition deteriorated with symptoms of drowsiness, lethargy and altered consciousness and was sent to ICU. On 7 August 2009, he died due to pneumonia with underlying H1N1 infection. The eighteenth death was a 63-year-old man who was suffering from asthma and tuberculosis. He was admitted to Selayang Hospital and died on 6 August due to severe pneumonia with positive Influenza A(H1N1) and underlying pulmonary tuberculosis.


2009 swine flu pandemic in Malaysia, Deaths, August
Eight more deaths were confirmed on 9 August 2009. Among the eight patient who died, three died on 3 August, two on 5 August, four on 7 August and one on 8 August. All of them were in the high-risk group except a 20-year-old college student who was found dead at her hostel about a week after obtaining outpatient treatment.


2009 swine flu pandemic in Malaysia, Deaths, August
Among the dead were two Sabahans, one of them was a 24-year-old obese woman from Ranau who died of pulmonary oedema after a bout of flu while the other one was a 74-year-old man who had a history of heart problem who died of pneumonia and pulmonary oedema. The other deaths were a 47-year-old patient with asthma in Sarawak and a 37-year-old obese man who died of broncho-pneumonia at the hospital in Johor Bahru.


2009 swine flu pandemic in Malaysia, Deaths, August
Six more deaths were confirmed on 10 August 2009, bringing the total death cases in Malaysia skyrocketed to 32. Of the six cases, four of them had underlying medical cases. Another six deaths were recorded on 11 August 2009. Among the six death cases, four of them had been diagnosed with asthma, hypertension and diabetes.


2009 swine flu pandemic in Malaysia, Deaths, August
As at 12 August 2009 the total of deaths reported raised to 44 with six more cases confirmed. A 60-year-old man who had histories of diabetes, hypertension and heart problems was hospitalised on 6 August after showing symptoms of the flu. Throat swab and antiviral drugs were prescribed. However, he died on the next day due to severe pneumonia. Lab result confirmed the man as an Influenza A(H1N1) patient on 9 August. A 62-year-old man who was a diabetic was hospitalised on 6 August. He was then later dehydrated and given antiviral drug for precaution against the flu.


2009 swine flu pandemic in Malaysia, Deaths, August
Throat swab was taken on 7 August. However, he died on the same day due to pneumonia and possible cancer. A 20-year-old whom didn't have any history of underlying medical condition suffered from fever, coughing and sore throat. He sought for treatment at a hospital on 6 August and was later hospitalised due to suffocation. Antiviral drugs were later prescribed by the doctor. On the next day, he died due to severe pneumonia and septicaemia. A 10-year-old baby was among the death cases confirmed on 12 August. She showed symptoms but was hospitalised six days later due to suffocation.


2009 swine flu pandemic in Malaysia, Deaths, August
Antiviral drugs were not given. On the next day, she died due to bronchopneumonia. An 18-year-old woman who was 26 weeks pregnant, and was also obese, showed symptoms on 3 August. Her condition deteriorated and was then later sent to ICU, where a throat swab was performed. She died due to severe pneumonia. A 1-year-old toddler who had congenital heart disease had a seizure and fever on 7 August. Antiviral drugs were not given to the toddler and he died on 9 August 2009 while undergoing a surgery.


2009 swine flu pandemic in Malaysia, Deaths, August
Seven more deaths were confirmed on 13 August 2009, bringing the total number of death cases in Malaysia rose to 51. All of the seven fatalities were in high-risk group. A 4-month-old baby who had an extremely low immunity was hospitalised on 8 August 2009 after he showed symptoms of fever, breathing difficulty, vomiting, coughing and diarrhoea. A throat swab was conducted, but he died on 10 August due to severe pneumonia. Lab result confirmed he had Influenza A(H1N1) on the next day, making him one of the victims of the flu.


2009 swine flu pandemic in Malaysia, Deaths, August
A 37-year-old diabetic woman was hospitalised after showing symptoms. She was later given antiviral drugs but died on 10 August. A 69-year-old woman who had history of hypertension was found to have been coughing. Throat swab was conducted after she was transferred to ICU due to suffocation. On 11 August 2009, she died due to acute myocarditis. A woman in her 20s, who also had a history of congenital disease, started to have fever and coughing on 6 August. She was later admitted and given antiviral drugs on 8 August. However, she died on 10 August due to severe bronchopneumonia.


2009 swine flu pandemic in Malaysia, Deaths, August
A 4-year-old boy who had congenital disease was treated on 2 August after exhibiting symptoms of the flu. He was later confirmed to have the flu after a throat swab was taken; however, he died before the confirmation was received. A 92-year-old lady who had asthma and a 43-year-old man who had diabetes, hypertension and heart diseases died on 11 August 2009 due to severe pneumonia.


2009 swine flu pandemic in Malaysia, Deaths, August
Five more cases were confirmed on 14 August. A two-month-old baby who was born prematurely was admitted to the hospital after suffering from fever, coughing, sneezing and difficulty in breathing. He was given antiviral drugs and was placed on mechanical ventilation as his condition deteriorated, but he died on 12 August due to pneumonia. Another two-month-old baby was rushed to the hospital when he was found unconscious. His condition was critical and was sent to ICU. He tested positive for the flu on 8 August, but died on 10 August due to myocarditis, hepatitis and renal impairment associated with H1N1.


2009 swine flu pandemic in Malaysia, Deaths, August
A 49-year-old diabetic woman, who was also obese and having tuberculosis was confirmed to have the virus on 11 August. A 57-year-old diabetic man sought for treatment on 2 August after showing symptoms of the flu. On 3 August, he returned to the clinic after experiencing fever, vomiting and diarrhoea. He was then sent to hospital and given antiviral drugs. Despite given antiviral drugs, he died on 12 August due to sepsis. A 19-year-old teenager was admitted to the hospital after complaining having fever and coughing. He was then suffocated and died on 11 August due to pneumonia.


2009 swine flu pandemic in Malaysia, Deaths, August
3 more deaths were confirmed on 15 August. A 22-year-old obese man was hospitalised on 9 August but died on 12 August due to viral pneumonia. A 29-year-old man who had valvular heart disease was admitted to the hospital after flu symptoms persisted for 2 days. Antiviral drugs were given on 10 August but he died 2 days later due to bronchopneumonia. A 44-year-old woman who had asthma was tested positive for the flu on 10 August but died on 13 August due to pneumonia.


2009 swine flu pandemic in Malaysia, Deaths, August
Another three deaths were confirmed on 16 August, raising the total number of deaths to 62. The 59th death was a 6-year-old child with Down's syndrome who had the flu for 3 days before being confirmed as a H1N1 patient. He died on 13 August due to pneumonia with underlying Down's syndrome with AVSD and pulmonary hypertension. A 3-year-old child was hospitalised on 1 August after having symptoms for 5 days. Confirmed to have contracted the virus on 3 August and antiviral drugs were given on the same day. However, he died on 14 August due to severe pneumonia. A man in his 50s who had symptoms on 28 July was hospitalised. He was also suffering from vomiting and diarrhoea two days before he was admitted. On 13 August, he was confirmed dead due to septicaemia with severe pneumonia.


2009 swine flu pandemic in Malaysia, Deaths, August
On 17 August, two more deaths were announced. A 7-month-old boy who had asthma was transferred to ICU after having fever and coughing for 2 days. Antiviral drugs were given and was confirmed to have the virus on 12 August. However, he was confirmed dead three days later due to severe pneumonia and acute respiratory failure. A 74-year-old diabetic woman, who also had CCF was admitted to the hospital after she was found unconscious in her house. She died on 11 August due to severe pneumonia. Her test results came back on 12 August and confirmed her as a H1N1 patient.


2009 swine flu pandemic in Malaysia, Deaths, August
On 18 August, three more death cases were confirmed and brought the number of death cases in Malaysia to 67. A 33-year-old woman was transferred to ICU after her lungs disease began to deteriorate after 4 days of treatment in a private hospital. She showed symptoms on 31 July and antiviral drugs were started on 7 August. On 12 August, she died due to bronchopneumonia. Her result later came back and was positive for the flu.


2009 swine flu pandemic in Malaysia, Deaths, August
A 10-year-old school girl, who was diagnosed with Systemic lupus erythematosus was sent to ICU after she had breathing difficulty, chest pain and stomach ache. Antiviral drugs were given since 8 July. Despite on medicine, she died on 13 August due to Systemic lupus erythematous with severe pneumonia with renal impairment. A 71-year-old woman with Chronic obstructive pulmonary disease, hypertension, Ischaemic heart disease and Diabetes mellitus type 2, showed symptoms of the flu and was hospitalised on 12 August. However, on 14 August, she died due to Ischaemic dilated cardiomyopathy precipitated by pneumonia.


2009 swine flu pandemic in Malaysia, Deaths, August
On 20 August, one new death was confirmed. The victim was a 34-year-old woman who was in the 34th week of pregnancy. The patient was treated and admitted into a private hospital in Johor Baru on 8 Aug after developing fever and cough for a day. She was subsequently, referred and admitted to the intensive care unit of the Sultanah Aminah Hospital in Johor Baru for breathing difficulties five days later. Tamiflu was administered. However, she died on next day due to severe pneumonia and respiratory failure.


2009 swine flu pandemic in Malaysia, Deaths, August
Another death was confirmed on 24 August, increasing the death toll to 69. The patient, a 38-year-old teacher, who was also obese, tested positive for H1N1 by a private clinic. Tamiflu was not administered but only gave her symptomatic treatment. Five days later, on 18 August, she was admitted to the hospital after suffering from breathing difficulties and cyanosis. She was referred to KL Hospital and Tamiflu was administered. However, the woman died on 19 August due to pneumonia with AVDS. One more death was confirmed on 25 August by the Mortality Review Committee.


2009 swine flu pandemic in Malaysia, Deaths, August
A 3-year-old boy who had febrile convulsion and cough was hospitalised on 12 August. The boy was then transferred to ICU after his condition deteriorate and tamiflu was administered. He tested positive for the flu on 17 August. However, he died on the next day due to H1N1 encephalitis with Cerebral oedema and multiorgan failure.


2009 swine flu pandemic in Malaysia, Deaths, August
The death of a 24-year-old woman brought the number of cases in Malaysia to 71. The patient, having fever, cough and headache was admitted to a private hospital in Kuantan on 10 August and received viral pneumonitis treatment. She was then referred to a government hospital and placed in ICU after her condition worsened. Her condition continued to deteriorate despite the administration of Tamiflu. On 19 August, she was confirmed dead due to H1N1 secondary to ARDS.


2009 swine flu pandemic in Malaysia, Deaths, August
One more death was confirmed on 30 August. A 49-year-old patient with heart problems was brought to Melaka Hospital after suffering from fever, cough and vomiting which persisted for 2 days. He was given antiviral drugs and antibiotics and he was also tested for tuberculosis, typhoid, dengue, Leptospirosis and H1N1 but all of the tests came back negative. The patient's condition deteriorate and was confirmed dead on 19 August due to severe pneumonia with septic shock and H1N1. The post-mortem biopsy report based on lung samples tested positive for Influenza A(H1N1) on 24 Aug.


2009 swine flu pandemic in Malaysia, Deaths, September
On 3 September 2009 the death of a 25-year-old woman was confirmed bringing the total number of deaths related to A(H1N1) to 73. The woman received outpatient treatment after developing flu symptoms. She was then subsequently brought to Sibu Hospital and administered antiviral drugs. However, she died on 1 September due to severe pneumonia with H1N1 infection.


2009 swine flu pandemic in Malaysia, Deaths, September
It was announced that on 11 September, the death of the 19-year-old man brought the total number of death cases to 74. The patient was brought to Gerik Hospital after flu symptoms persisted for 4 days. On 20 August, he was transferred to Ipoh Hospital where he was administered Tamiflu. Despite given antiviral drugs, he died on 23 August due to Acute Pulmonary Oedema with Underlying Influenza A(H1N1) infection.


2009 swine flu pandemic in Malaysia, Deaths, September
Another two death cases were confirmed on 15 September, bringing the total number of cases to 76 in total. The first death, a 45-year-old woman who had hypertension was referred to Tambunan Hospital on 17 August after flu symptoms persisted. She was then sent to Keningau Hospital and antiviral was administered. After 10 days in ICU, she died due to severe bronchopneumonia and Acute respiratory distress syndrome. The second death registered was a 19-year-old teenage girl. She was sent to Kuala Lumpur Hospital and antiviral was administered. Despite given antiviral drugs, she died on 31 August due to severe pneumonia with H1N1 infection.


2009 swine flu pandemic in Malaysia, Terminology
The flu virus is officially designated by the WHO as "Influenza A (H1N1)", following a name change from "swine flu" to avoid suggestions that eating pork products carried a risk of infection, and is referred as such by Malaysia's Health Minister.


2009 swine flu pandemic in Malaysia, Terminology
However, Information Communication and Culture Minister Rais Yatim suggested on 25 June that the local media use "swine flu" (Malay: selsema babi) instead, justifying that the dangers of the flu would be better understood by the public, and that the flu would be easily described in Malay, a language which is officially used in news programmers of government-owned television and radio channels.


2009 swine flu pandemic in Mexico
In March and April 2009, an outbreak of a new strain of influenza commonly referred to as "swine flu" infected many people in Mexico and other parts of the world, causing illness ranging from mild to severe. Initial reports suggested that the outbreak had started in February due to farming practices at a pig farm half-owned by Smithfield Foods.


2009 swine flu pandemic in Mexico
Smithfield Foods stated that it had found no clinical signs or symptoms of the presence of swine influenza in the company's swine herd, or among its employees at its joint ventures in Mexico, that it routinely administers influenza virus vaccination to their swine herds and that it conducts monthly testing for the presence of swine influenza. 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 and in pigs.


2009 swine flu pandemic 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, which transmits between humans and has had a relatively high mortality rate in the possible and confirmed Mexican cases, has the potential to become an influenza pandemic. It is reported that, because the virus is already widespread, containment will be impossible.


2009 swine flu pandemic in Mexico
As of April 27, 2009, all schools nationwide remained closed until at least May 6. Health Minister Córdova noted that the number of new cases had declined during the three days: from 141 on Saturday to 119 on Sunday and 110 on Monday. It is unclear why there were more deaths in Mexico than in other areas, as there were multiple potential variables, such as a stronger strain of the virus or more exposure to it. No definite conclusion had been reached, however the CDC reported that swine flu viruses in the US and Mexico matched.


2009 swine flu pandemic in Mexico, Outbreak
The first infected was registered in San Diego, California, on April 2, 2009, but it was misclassified as an H2N3 case. It was not until April 13, with the first death in Oaxaca, that further research was carried out, officially detecting the new type of virus on April 16. The pandemic outbreak was first detected in the Federal District, where surveillance began picking up a surge in cases of influenza-like illness starting on March 18.


2009 swine flu pandemic in Mexico, Outbreak
The surge was assumed by authorities to be "late-season flu" (which usually coincides with a mild Influenzavirus B peak) until April 21, when a CDC alert concerning two isolated cases of a novel swine flu was reported in the media (see 2009 swine flu outbreak in the United States). Both cases were in US counties on the Mexico – United States border, adjacent to one state in Mexico where the influenza surge had been detected. This was the missing link that connected the surge and the new strain, and established the high suspicion of an outbreak.


2009 swine flu pandemic in Mexico, Outbreak
One study estimated that by the end of April, at least 113,000 to 375,000 people in Mexico had been infected. Then, in early May, influenza activity began to decline, likely due to the shutdown of most public places in response to the outbreak. However, H1N1 remains present in Mexico, and as of December, was classified by WHO as widespread.


2009 swine flu pandemic in Mexico, Confirmed cases
Dr. José Ángel Córdova Villalobos, the federal Secretary of Health, stated on April 25, 2009 that since March, there had been over 1300 reported cases and put the death toll at 83, with 20 confirmed to be linked to a new swine influenza strain of Influenza A virus subtype H1N1. As of April 26 there have been 1,614 cases, with 103 deaths and about 400 patients in hospitals. Around two-thirds of the sick patients had recovered.


2009 swine flu pandemic in Mexico, Confirmed cases
However, flu death toll in Mexico could be lower than first thought, said Dr. Gerald Evans, head of the Association of Medical Microbiology and Infectious Disease Canada and a member of a federal pandemic-planning committee, on April 29:


2009 swine flu pandemic in Mexico, Confirmed cases
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 flu. That's really good news, and that would fit with what we've seen outside of Mexico.as of October 7, it is reported that more new cases of A/H1N1 were recorded in the month of September then in any other month-there were 9,231 new confirmed cases of A/H1N1 influenza in Mexico in September.


2009 swine flu pandemic in Mexico, Confirmed cases
It is important to remember that that number represents only confirmed cases, far more people infected with A/H1N1 influenza became only mildly ill, and recovered without seeing a doctor, and thus never had their cases confirmed or counted. Widespread closures of schools are unlikely, however, as it is known that the virus has a low mortality rate. "We know that the situation is not as serious as officials feared last spring" said health secretary Jose Angel Cordava.


2009 swine flu pandemic in Mexico, Response
Both the World Health Organization and the U.S. Centers for Disease Control and Prevention have praised the response by the Mexican government, calling it "a model of rapid and transparent reporting, aggressive control measures, and generous sharing of data and samples" in addition to labeling it "courageous and impressive".


2009 swine flu pandemic in Mexico, Response
After a month since the first atypical pneumonia cases were detected, the Mexican government responded and established some measures in Mexico City, the State of Mexico and the State of San Luis Potosí, where the swine flu had spread, to decrease the risk of more infections. Hundreds of soldiers and police officers mobilized by the government have handed out six million surgical masks to citizens in and around Mexico City.


2009 swine flu pandemic in Mexico, Response
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; schools in Mexico City, the State of Mexico, and the state of San Luis Potosí will remain closed through at least May 5. Marcelo Ebrard, Mexico City's mayor, has also asked all night-life facilities operators to shut down their places for ten days to prevent further infections.


2009 swine flu pandemic in Mexico, Response
Health Secretary José Ángel Córdova 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 thereafter. 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 classes will be officially suspended through May. 6


2009 swine flu pandemic in Mexico, Response
On April 26, Natividad González Parás, governor of the northeastern state of Nuevo León, announced that statewide schools will remain closed until May 6, 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, to realize tests conducted on people arriving from other states. Classes in Coahuila were cancelled on April 27 and 28, with the possibility of cancelling the rest of the week. On April 27, Health Secretary José Ángel Córdova announced that schools of all levels throughout the nation will be suspended until May 6 to prevent the spread of the flu.


2009 swine flu pandemic in Mexico, Response
As part of a marketing strategy, a mascot for the outbreak was released in Mexico City on April 29 depicting a blue plush virus with black eyes in reference of H1N1; but it was discontinued two days later.


2009 swine flu pandemic in Mexico, Economic impact
The outbreak increased the strain on an economy already under pressure from the current economic crisis. Although the World Bank said it would extend Mexico $25 million in loans for immediate aid and $180 million in long-term assistance, it wasn't enough to restore customer investor confidence leading to the peso’s biggest tumble in six months. It seems likely now that Mexico will have to draw on a $47 billion credit line from the International Monetary Fund.


2009 swine flu pandemic in Mexico, Economic impact
It has been reported that the food services sector within Mexico City is experiencing losses of over US$4.5 million per day. It has been reported that pork meat price has dropped 30% within Mexico; combined with several export bans, this will inflict severe damage to the industry. Although the virus hasn't spread throughout the whole country, as a precaution all mass gatherings were prohibited, affecting the sports industry.


2009 swine flu pandemic in Mexico, Economic impact
Many Liga MX México Primera División teams reported direct losses of over $900,000 dollars per game after the Mexican Football Federation ordered all pro soccer games in Mexico to be played without fans in an effort to slow the spread of the virus. It also prompted cancellations of all the festivals in the country. Additionally, the Mexican race of the 2008–09 A1 GP season has had to be cancelled because of the outbreak.


2009 swine flu pandemic in Mexico, Economic impact
The Mexican teams that qualified to the 2009 Copa Libertadores began to have problems related to the swine flu outbreak, specially the Guadalajara Chivas who travelled to Chile to play against Everton. Later, because the other teams not wanting to risk their players with the outbreak, CONMEBOL asked Guadalajara and San Luis clubs to make their games outside Mexico, both teams neglected the petition so both teams were withdrawn and Mexico was dismissed from competitions. Days later, CONMEBOL reconsidered their actions and seeded the teams in the next Libertadores Cup for the Round of 16.


2009 swine flu pandemic in New Zealand
In 2009, New Zealand had 3,175 cases and 19 deaths due to swine influenza.


2009 swine flu pandemic in New Zealand, Outbreak history
On 25 April 2009 ten students from Rangitoto College, a secondary school in North Shore City, Auckland, exhibited influenza symptoms on returning from a three-week language trip to Mexico. All 22 students and three accompanying teachers from the trip and those in close contact with them were placed in voluntary home isolation and treated with oseltamivir. The ten students tested positive for an influenza A virus, with three of them later testing positive for swine flu. The symptoms were reportedly mild and all affected individuals have since recovered.


2009 swine flu pandemic in New Zealand, Outbreak history
As of 30 May 2009, New Zealand had 9 laboratory confirmed cases and 10 probable cases. New Zealand continued to identify isolate and treat suspected cases; there were 30 suspected cases and 23 people were in isolation being treated with Tamiflu. Confirmed cases have tested positive for the Mexican swine flu strain of influenza type A. Probable cases had tested positive for influenza type A after possible recent exposure to the Mexican strain. Suspected cases have flu symptoms after possible recent exposure to the Mexican strain. On 6 June a one-year-old boy from Manukau City was diagnosed with swine flu and several other people who had been exposed to him had gone into isolation.


2009 swine flu pandemic in New Zealand, Outbreak history
On 8 June, the Ministry of Health confirmed three further cases of novel Influenza A(H1N1); bringing the national total to 17. One of the new cases is the son of a Canterbury man who recently flew into New Zealand On Air NZ flight NZ5. The other two new cases came from international flights from Los Angeles (NZ5) and Melbourne (NZ124). These people have been isolated and are being treated with Tamiflu. Health officials are in the process of contacted those who may have had contact with those confirmed of having Influenza A(H1N1).


2009 swine flu pandemic in New Zealand, Outbreak history
The following day (9 June), the Ministry of Health reported two further cases. Both of these new cases travelled to New Zealand from Los Angeles on 31 May, and are currently in isolation with their close contacts. Concern has also be raised after 19 people (16 students, two teachers and one parent) from Gisborne Boys' High School returned to New Zealand on 9 June, and five students began experiencing flu-like symptoms. ItA(H1N1) It was confirmed on 11 June that swabs taken from the students returned negative for novel Influenza.


2009 swine flu pandemic in New Zealand, Outbreak history
On 17 June, there was a cumulative total of 127 confirmed cases of novel H1N1 influenza in the country. Some of these represent person to person transfers without a link to a person who had travelled recently meaning New Zealand has experienced a community level outbreak.


2009 swine flu pandemic in New Zealand, Outbreak history
As of 29 June 2009, there were 523 confirmed cases. There was 1 critical case in Hawkes Bay. The patient was said to have pre-existing medical conditions, but the doctors have put her condition down to swine flu.


2009 swine flu pandemic in New Zealand, Outbreak history
As of 7 July 2009, there were 1195 confirmed cases. There were 12 critical cases in Nationwide and 53 people had been hospitalised due to the flu.


2009 swine flu pandemic in New Zealand, Outbreak history
According to a three-month-long study coordinated by the Australian and New Zealand Intensive Care Research Centre that was published in the New England Journal of Medicine, up to 20% of intensive care unit (ICU) beds overall were occupied by swine flu patients at the height of the pandemic in July. In New Zealand hospitals, about 25% of all ICU activity was pandemic-related and about 12% of patients hospitalised with swine flu were admitted to ICU.


2009 swine flu pandemic in New Zealand, Outbreak history
The surge of patients with H1N1 influenza placed substantial strain on staff and resources, hospitals were stretched to the very limit of resources and were at the point where possible alternatives had to be considered. Unlike seasonal influenza strains, which tend to hit elderly people and those of severe underlying health problems more heavily, many of those who became critically ill with the swine flu were babies and middle-aged people, pregnant women, the obese, Pacific Islanders, Māori and Aboriginal patients.


2009 swine flu pandemic in New Zealand, Outbreak history
Rates of severe illness among Pacific people were seven times higher than the average, while those of Maori were twice as high. Overall, about one-third of patients who was admitted to an ICU because of swine flu had no underlying health problem. The first batch of swine flu vaccine arrived in the country in September. Currently only frontline health workers were in line to get the vaccine, but the Health Ministry is considering on widening access to include other "at risk" groups.


2009 swine flu pandemic in New Zealand, Outbreak history
On 21 October 2009, the Ministry of Health announced that the total number of death attributed to swine flu was 19, following a coroner's investigation of the 21 September death of a 35-year-old woman with underlying medical conditions in Waikato. The ministry expected the number to rise as the coroner completes investigations into a number of influenza-related deaths occurred over the last few months. Some students among a group visiting from Japan developed influenza in Christchurch in mid-October. Four tested positive for influenza H1N1, and a number of others had influenza-like symptoms. The ministry said it appeared that their illness originated in Japan. The group left New Zealand following treatment.


2009 swine flu pandemic in New Zealand, Impact
The impact in New Zealand was monitored by health authorities and had resulted in school closures throughout the country. There had been multiple instances of community transmission, and threats to close the nation's borders.


2009 swine flu pandemic in New Zealand, Seasonal flu
New Zealand had about 48,000 influenza cases in the 2008 flu season – 42% of which were type A – and approximately 100 deaths a year directly attributed to influenza viruses.


2009 swine flu pandemic in New Zealand, Preparation
New Zealand has had a well-developed Influenza Pandemic action plan since 2006. Following this plan New Zealand immediately upgraded its influenza pandemic alert status to code yellow. The national stockpile of 1.4 million doses of oseltamivir was released to regional health authorities. The initial response as specified in the Pandemic Action Plan is a policy of border control and cluster control via voluntary quarantine and treatment of contacts with oseltamivir.


2009 swine flu pandemic in North America
The 2009 flu pandemic in North America, part of an 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.


2009 swine flu pandemic in North America, Countries and territories, North America, Canada
Roughly 10% of Canadians had been infected with the virus as of mid-late November with 416 confirmed deaths as of January 7; there were over 10,000 confirmed cases when Health Canada stopped counting in July 2009. Canada began its vaccination campaign in October and 40% of the populace has since been immunized against H1N1.


2009 swine flu pandemic in North America, Countries and territories, North America, Canada
The widespread effect of H1N1 in Canada were a concern for the XXI Olympic Winter Games, which took place in Vancouver in February 2010.


2009 swine flu pandemic in North America, Countries and territories, North America, 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."


2009 swine flu pandemic in North America, Countries and territories, North America, Mexico
Soldiers mobilized by the government have handed out six million surgical masks to citizens in and around Mexico City.


2009 swine flu pandemic in North America, Countries and territories, North America, Mexico
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.


2009 swine flu pandemic in North America, Countries and territories, North America, Mexico
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.


2009 swine flu pandemic in North America, Countries and territories, North America, Mexico
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.


2009 swine flu pandemic in North America, Countries and territories, North America, Mexico
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.


2009 swine flu pandemic in North America, Countries and territories, North America, Mexico
On April 27, the Secretariat of Public Education announced that all schools in Mexico will remain closed at least until May 6.


2009 swine flu pandemic in North America, Countries and territories, North America, Mexico
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.


2009 swine flu pandemic in North America, Countries and territories, North America, 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.


2009 swine flu pandemic in North America, Countries and territories, North America, United States
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.


2009 swine flu pandemic in North America, Countries and territories, North America, United States
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.


2009 swine flu pandemic in North America, Countries and territories, North America, United States
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.


2009 swine flu pandemic in North America, Countries and territories, North America, United States
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.


2009 swine flu pandemic in North America, Countries and territories, North America, United States
On May 10, a 30-year-old man with underlying health problems died in Washington from H1N1, the first fatality in that state.


2009 swine flu pandemic in North America, Countries and territories, North America, United States
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.


2009 swine flu pandemic in North America, Countries and territories, North America, United States
On May 19, 2009, a St. Louis County man became the first death in Missouri due to the Swine Flu.


2009 swine flu pandemic in North America, Countries and territories, North America, United States
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.


2009 swine flu pandemic in North America, Countries and territories, North America, United States
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.


2009 swine flu pandemic in North America, Countries and territories, North America, United States
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.


2009 swine flu pandemic in North America, Countries and territories, 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.


2009 swine flu pandemic in North America, Countries and territories, Central America and Caribbean, The Bahamas
Ten students and teachers who arrived from Mexico in the last week of April are in quarantine.


2009 swine flu pandemic in North America, Countries and territories, Central America and Caribbean, Barbados
The Minister Of Health, Donville Inniss has confirmed that two samples have been sent off to the  in Trinidad and Tobago to be tested for the virus.


2009 swine flu pandemic in North America, Countries and territories, Central America and Caribbean, 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.


2009 swine flu pandemic in North America, Countries and territories, Central America and Caribbean, 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.


2009 swine flu pandemic in North America, Countries and territories, Central America and Caribbean, Costa Rica
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.


2009 swine flu pandemic in North America, Countries and territories, Central America and Caribbean, Costa Rica
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.


2009 swine flu pandemic in North America, Countries and territories, Central America and Caribbean, Costa Rica
As of September 8 the Costa Rican Ministry of Health had 1,246 confirmed cases, 1,257 pending cases, 6,337 already discarded, and 33 deaths. The  mortality rate is  0.73 deaths by  100,000 people, and the fatality rate is 2.96%. From all deceased patients, 48.5% occurred among San José residents, and only the Guanacaste Province has not had any deaths related to the virus. The age of the deceased varies between 20 and 79 years, with an average age of 41 years.


2009 swine flu pandemic in North America, Countries and territories, Central America and Caribbean, Cuba
Cuba's Health Ministry is adopting precautionary measures to prevent the illness from coming into the country. The government has advised citizens to go to seek medical treatment if experiencing flu-like symptoms. Cuba has also banned flights to and from Mexico for 48 hours.


2009 swine flu pandemic in North America, Countries and territories, Central America and Caribbean, Cuba
Cuba has reported its first case of Influenza A H1N1 as a Mexican student who travelled to Cuba on April 25 for study


2009 swine flu pandemic in North America, Countries and territories, Central America and Caribbean, Cuba
The ministry statement said that in all of Cuba, authorities have tested 84 possible cases in people of eight nationalities for the virus. Only one case was positive - the Mexican student.


2009 swine flu pandemic in North America, Countries and territories, Central America and Caribbean, Dominican Republic
According to the Dominican Republic Government, two people were confirmed to be infected with the AH1N1 flu on May 27. One was a 58-year-old woman from Santiago de los Caballeros and the other was a 20-year-old woman from Santo Domingo Province. Each of them had visited the United States (Orlando and Seattle, respectively) before being diagnosed. On May 30, nine more cases were confirmed, all from the Carol Morgan school.


2009 swine flu pandemic in North America, Countries and territories, Central America and Caribbean, Dominican Republic
On June 5, a 17-year-old pregnant girl infected with the AH1N1 virus died. 44 cases were confirmed to this date.


2009 swine flu pandemic in North America, Countries and territories, Central America and Caribbean, Guatemala
A 29-year-old, who had recently visited Mexico, was being tested for a suspected case of swine flu.


2009 swine flu pandemic in North America, Countries and territories, Central America and Caribbean, Guatemala
Guatemala is checking all travelers arriving from Mexico for signs of flu and stopping anyone with symptoms of the virus at border crossings.


2009 swine flu pandemic in North America, Countries and territories, Central America and Caribbean, Guatemala
On May 5, in a meeting with Health Minister and the Vicepresident, it was announced that an 11-year-old girl was infected with the AH1N1 virus. It was told that the family of the girl came from Mexico a few days ago, but no one else in the family it is infected.


2009 swine flu pandemic in North America, Countries and territories, Central America and Caribbean, Guatemala
On the same press meeting, Rafael Espada said: "We've to prepare ourselves for the worst, and just hope for the best".


2009 swine flu pandemic in North America, Countries and territories, Central America and Caribbean, Guatemala
The government has stated that they're prepared for a first wave of AH1N1. Nevertheless, other institutions have started to help population by giving them masks and information about the virus. University of San Carlos de Guatemala by the Faculty of Pharmacy and Pharmaceutics has started to prevent the virus among the students population, as the Rector Estuardo Gálvez said: "This people are prepared to counteratack the virus inside and outside this campus".


2009 swine flu pandemic in North America, Countries and territories, Central America and Caribbean, Honduras
Honduras reported its first confirmed case of swine flu(H1N1) on 27 May 2009. On 22 June it reported its first death of swine flu.


2009 swine flu pandemic in North America, Countries and territories, Central America and Caribbean, Jamaica
As of 7 July 2009, there has been 33 confirmed cases of swine flu in Jamaica. On the 6th of July, Jamaica recorded its first human mortality from the virus. Health Minister Ruddy Spencer told Parliament that the country has been placed on high alert. There has been heightened surveillance at health care facilities and port entry's.


2009 swine flu pandemic in North America, Countries and territories, Central America and Caribbean, Panama
As of July 23, 553 confirmed cases had been reported by Panamanian health authorities:


2009 swine flu pandemic in North America, Countries and territories, Central America and Caribbean, Panama
66% of the cases are teens (12–15) and the 34% are adults(20-49). Only one death has been reported. Schools with positive cases are being disinfected and thermographic cameras have been deployed at Tocumen International Airport to identify sickness in arriving passengers.


2009 swine flu pandemic in North America, Countries and territories, Central America and Caribbean, Trinidad and Tobago
The members of the Under 17 Trinidad and Tobago football team have taken Flu tests after returning from a World Cup qualifying football match in Mexico City. One female was confirmed as having contracted the H1N1 influenza. Her identity is being withheld. At the moment, people who travelled on the same aircraft as the infected woman are being asked to contact the relevant health authorities.


2009 swine flu pandemic in Norway
The 2009–2010 flu pandemic in Norway marked the initial phase of a new influenza pandemic. This pandemic began in the spring of 2009, the illness appeared in tourists returning from affected areas. By the summer of 2009, local person-to-person transmission within Norway was established. Soon thereafter, the number of patients being tested for swine flu exceeded capacity, and authorities recommended that only patients with severe symptoms be tested. The first Norwegian death from swine flu was reported in early September 2009.


2009 swine flu pandemic in Norway
Norway was notable among the Scandinavian countries for a high number of swine flu deaths—29 deaths as of January 4, 2010. All 19 counties of Norway had confirmed cases, and deaths occurred in five of the counties. Only Svalbard (an archipelago midway between Norway and the North Pole) had no reported cases of swine flu. About 10 million doses of flu vaccine were ordered from the pharmaceutical industry when the World Health Organization declared a pandemic. The first vaccination campaign started in Bergen, on October 22, 2009, with several hundred people queuing up. The flu was given widespread media coverage and the Norwegian government published a tally of laboratory-confirmed cases of swine flu, but made clear that this was an underestimation.


2009 swine flu pandemic in Norway, Timeline overview
On April 25, 2009, the Norwegian Institute for Public Health increased their level of alert after reports of a severe influenza in Mexico. Three days later, it was considered "highly likely" that the new flu would reach Norway within the next few weeks. The first confirmed Norwegian cases appeared on May 9, 2009 in tourists returning from affected areas. By the summer of 2009, local spread of the influenza was established.


2009 swine flu pandemic in Norway, Timeline overview
On May 9, 2009, the first confirmed cases were reported in two students from Oslo and Telemark returning from trips abroad. As of early July 2009, there were 42 confirmed cases of swine flu, of which 39 of the people were infected while abroad. In late July 2009, a local outbreak was reported in a summer camp in Western Norway. The number of patients wanting tests for the suspected new flu soon exceeded the capacity to test, and by late July 2009, Norwegian authorities were recommending that only severe and special cases be tested.


2009 swine flu pandemic in Norway, Influenza surveillance
The Norwegian government has operated an influenza surveillance system for many years. In this system, 201 selected general practices throughout the country report weekly the percentage of patients given a diagnosis of influenza. The study covers about 15% of the population. The results of the influenza study during the 2009 flu pandemic in Norway are shown in the figure below. The share of doctor contacts that ended in a diagnosis of influenza-like illness shot up to nearly 10% in week 44. The last time this percentage was this high was in the 1999-2000 flu season.


2009 swine flu pandemic in Norway, Influenza surveillance
On the basis of the last reported data, as of November 4, 2009, the Norwegian Public Health Institute concluded "the pandemic influenza virus is spreading epidemically in large parts of the country".


2009 swine flu pandemic in Norway, Scenarios
It was reported that 30% of the population would likely fall ill within six months, and that half of those would be confined to their beds. Ultimately, one out of every two persons would have acquired the disease at some point. This meant that about 700,000 Norwegians would have fallen ill, and in this period, 700 to 3,000 more deaths than a regular influenza season were to be expected.


2009 swine flu pandemic in Norway, Scenarios
The worst-case scenario was reported to be that 50% of the population would fall ill within six months, and half of those would be confined to their beds. In this case, 1.2 million Norwegians would have fallen ill in this period and an extra 5,000–13,000 deaths beyond the regular influenza season were expected.


2009 swine flu pandemic in Norway, Preparations
Norway had a stockpile of 1.4 million doses of Tamiflu and had ordered 200,000 doses of Relenza.


2009 swine flu pandemic in Norway, Preparations
The Norwegian Institute of Public Health (FHI) announced that it would be only a matter of time before the virus was transmitted within Norway, and that cases of travelers falling ill should be expected within the next few weeks. The main goal was to quickly reduce the spread of the virus in Norway, even so, the closure of public institutions, such as schools and kindergartens, was to be avoided as long as possible.


2009 swine flu pandemic in Norway, Preparations
As of May 15, the Norwegian government lifted their advisory against travel to Mexico, even so, people with increased risk of infection were advised to reconsider the need to travel.


2009 swine flu pandemic in Norway, Preparations
In early May, Norway pre-ordered 4.7 million doses of the then not-yet-developed Swine Influenza vaccine. The price was estimated to be $47.5 million. Regarding the order, Health Care Minister Bjarne Håkon Hanssen said


2009 swine flu pandemic in Norway, Preparations
The contract we are entering into will make it possible to secure vaccine for the population before a pandemic is declared. For myself and for the government it is important to follow up on the advice from the Pandemic Committee... This is also in line with professional advice from the health institutions.


2009 swine flu pandemic in Norway, Preparations, Vaccine
As of the fall of 2009, Norway was supplied with 9.4 million doses of the influenza vaccine from GlaxoSmithKline; every Norwegian could be given up to two doses. The vaccine was intended to be ready for use after clinical trials in November or December, however, because swine influenza still was considered to be a mild disease, the influenza vaccine could not be used without approval by the European Medicines Agency (EMEA).


2009 swine flu pandemic in Norway, Preparations, Vaccine, Distribution
Norway had enough vaccine for every citizen by the fall of 2009. Health personnel, as well as people with an increased risk of complications, were advised to receive early vaccinations. The Healthcare Ministry provided recommendations for which groups to prioritize in vaccination distribution.