2009 swine flu pandemic timeline, Timeline, November 2009, November 13
WHO In its 74th update, the WHO reports early signs that the early flu season has peaked in North America, even as the pandemic intensifies across much of Europe and Central and Eastern Asia.


2009 swine flu pandemic timeline, Timeline, November 2009, November 13
Bulgaria Health authorities confirm more than 12 people have died from H1N1 within a week; the latest victim is a 28-year-old man who died from respiratory failure.


2009 swine flu pandemic timeline, Timeline, November 2009, November 14
United States CDC FluView Week 45: Widespread influenza activity in forty-three states, regional activity in seven. "The proportion of outpatient visits for influenza-like illness (ILI) was 5.5% which is above the national baseline of 2.3%. All 10 regions reported ILI above region-specific baseline levels."


2009 swine flu pandemic timeline, Timeline, November 2009, November 18
United States First feline death confirmed, in the state of Oregon.


2009 swine flu pandemic timeline, Timeline, November 2009, November 20
Norway A potentially significant mutation is found in specimens taken of the H1N1 virus taken from two fatalities; a third victim was seriously ill.


2009 swine flu pandemic timeline, Timeline, November 2009, November 20
UK The first person-to-person transmission of Tamiflu-resistant H1N1 in the world is confirmed at the University Hospital of Wales in Cardiff. Five patients are so infected, with three apparently having been infected in hospital in a case of iatrogenic transmission.


2009 swine flu pandemic timeline, Timeline, November 2009, November 20
US An iatrogenic Tamiflu-resistant cluster is reported at Duke University Medical Center in North Carolina, with four severely ill cancer patients infected, the largest cluster in the U.S. More than fifty resistant cases have been reported in the world since April.


2009 swine flu pandemic timeline, Timeline, November 2009, November 21
United States CDC FluView Week 46: Widespread influenza activity in thirty-two states, regional activity in 17. "The proportion of outpatient visits for influenza-like illness (ILI) was 4.3% which is above the national baseline of 2.3%. All 10 regions reported ILI above region-specific baseline levels.


2009 swine flu pandemic timeline, Timeline, November 2009, November 23
Romania First death confirmed, that of a 43-year-old man with obesity, high blood pressure, and diabetes.


2009 swine flu pandemic timeline, Timeline, November 2009, November 24
United States First double infection case confirmed, in a pediatrician in West Virginia.


2009 swine flu pandemic timeline, Timeline, November 2009, November 27
WHO H1N1 mutations have led to roughly 75 people worldwide developing Tamiflu resistance. Furthermore, the separate D222G or D225G mutation which helps the virus to reach deep into the lungs has been reported in cases both severe and mild in Norway, Ukraine, Brazil, China, Japan, Mexico and the United States.


2009 swine flu pandemic timeline, Timeline, November 2009, November 27
France The H1N1 mutation first detected in Norway causes two deaths in separate French cities.


2009 swine flu pandemic timeline, Timeline, November 2009, November 27
South Korea First double infection case confirmed, in a two-year-old girl.


2009 swine flu pandemic timeline, Timeline, November 2009, November 28
China Two cases in dogs are confirmed, the first instance of canine zoonosis in the world.


2009 swine flu pandemic timeline, Timeline, November 2009, November 28
Indonesia First case in pigs is confirmed, in southwest Sulawesi.


2009 swine flu pandemic timeline, Timeline, November 2009, November 28
United States CDC FluView Week 47: Widespread influenza activity, in Twenty-five states, regional influenza activity in 17. "The proportion of outpatient visits for influenza-like illness (ILI) was 3.7% which is above the national baseline of 2.3%. Eight of the 10 regions reported ILI at or above region-specific baseline levels. Regions 6 and 10 reported ILI below their region specific baselines."


2009 swine flu pandemic timeline, Timeline, November 2009, November 30
United States The CDC states that H1N1 may have peaked as the number of states reporting widespread influenza dropped from 43 the previous week to 32 this week. Furthermore, influenza-like illness now account for 4.3% of doctor visits, down from 8% four weeks ago (on average, influenza accounts for 2.5% of doctor visits). The proportion of deaths attributed to pneumonia and influenza continues to be higher than expected for this time of year, however. This proportion has remained elevated for eight weeks now.


2009 swine flu pandemic timeline, Timeline, December 2009, December 1
Saudi Arabia Only five deaths and 73 cases are reported from the hajj.


2009 swine flu pandemic timeline, Timeline, December 2009, December 2
United Kingdom First case of reverse zoonosis in pigs is discovered, in Norfolk.


2009 swine flu pandemic timeline, Timeline, December 2009, December 5
US CDC FluView Week 48: Widespread flu activity in 14 states, regional activity in 25. "The proportion of deaths attributed to pneumonia and influenza (P&I) was above the epidemic threshold for the tenth consecutive week. The proportion of outpatient visits for influenza-like illness (ILI) was 2.7% which is above the national baseline of 2.3%."


2009 swine flu pandemic timeline, Timeline, December 2009, December 6
Gaza Strip First five cases are confirmed in the blockaded Gaza Strip.


2009 swine flu pandemic timeline, Timeline, December 2009, December 6
United StatesWith one in six Americans infected, or 15% of the country, nearly 10,000 have died to date, including 1,100 children and 7,500 younger adults. More than 200,000 Americans had been hospitalized to date — roughly the same number who are so affected by the regular seasonal flu variant in an entire year. Furthermore, with 12 million additional doses of H1N1 vaccine being released this week, several states begin to distribute the vaccine to the general public.


2009 swine flu pandemic timeline, Timeline, December 2009, December 7
North Korea First deaths are confirmed, according to newsletters released by the Seoul-based aid group Good Friends.


2009 swine flu pandemic timeline, Timeline, December 2009, December 7
United States A sophisticated Bayesian analysis of public health data from April to the end of June from New York City and Milwaukee indicates that the pandemic's symptomatic case-fatality ratio has been far lower than the previous three pandemics of 1968, 1957, and 1918, making it to date the mildest pandemic on record.


2009 swine flu pandemic timeline, Timeline, December 2009, December 12
Gaza The eighth fatality is reported, that of a child with underlying kidney failure, within a week of the first H1N1 case in the Gaza Strip.


2009 swine flu pandemic timeline, Timeline, December 2009, December 12
United States CDC FluView Week 49: Widespread influenza activity in 11 states, regional activity in twenty. "The proportion of deaths attributed to pneumonia and influenza (P&I) was above the epidemic threshold for the eleventh consecutive week... The proportion of outpatient visits for influenza-like illness (ILI) was 2.6% which is above the national baseline of 2.3%. Five of the 10 regions reported ILI at or above region-specific baseline levels."


2009 swine flu pandemic timeline, Timeline, December 2009, December 16
United States Roughly 100 million H1N1 vaccines become widely available to the general public in pharmacies in several American states as the supply increases and restrictions to high-risk groups are lifted.


2009 swine flu pandemic timeline, Timeline, December 2009, December 17
Thailand First confirmed case of H1N1 in a pig, in a case of reverse zoonosis in Saraburi Province. The pig recovered.


2009 swine flu pandemic timeline, Timeline, December 2009, December 19
United States CDC FluView Week 50: The CDC reports that levels of influenza are declining steadily, with only seven states reporting widespread influenza activity and 18 reporting regional activity; furthermore, the proportion of deaths attributed to pneumonia and influenza (P&I) is below the epidemic threshold. The CDC also notes that almost all isolates of H1N1 remain sensitive to oseltamivir. "The proportion of outpatient visits for influenza-like illness (ILI) was 2.3% which is at the national baseline of 2.3%."


2009 swine flu pandemic timeline, Timeline, December 2009, December 21
US First case of canine zoonosis confirmed. The 13-year-old dog from New York state was believed to have contracted the virus from his owner.


2009 swine flu pandemic timeline, Timeline, December 2009, December 23
US H1N1 is discovered at two North Carolina pig farms, making it the 10th state to identify the virus in animals. The swine caught the disease from infected workers and recovered after becoming moderately ill.


2009 swine flu pandemic timeline, Timeline, December 2009, December 23
Argentina An Argentine study published in the New England Journal of Medicine shows that "Pediatric 2009 H1N1 influenza was associated with pediatric death rates that were 10 times the rates for seasonal influenza than in previous years," and that the elevated risk for pregnant women extends for as long as two weeks after they give birth.


2009 swine flu pandemic timeline, Timeline, December 2009, December 26
US CDC FluView Week 51: Influenza activity decreases slightly, although the proportion of deaths attributed to P&I remained above the epidemic threshold. "Four states reported geographically widespread influenza activity, 13 states reported regional influenza activity, the District of Columbia, Puerto Rico, and 19 states reported local influenza activity, Guam and 13 states reported sporadic influenza activity, and one state reported no influenza activity, the U.S. Virgin Islands did not report."


2009 swine flu pandemic timeline, Timeline, December 2009, December 27
WHO At least 12,220 deaths globally are formally confirmed. (By contrast, the WHO estimates that the seasonal flu kills from 250,000 to 300,000 people around the world each year.) Overall, the activity of the H1N1 pandemic has peaked.


2009 swine flu pandemic timeline, Timeline, December 2009, December 27
Nepal First death confirmed, that of a woman who suffered major organ failure.


2009 swine flu pandemic timeline, Timeline, December 2009, December 29
WHO In Geneva Dr. Margaret Chan, Director-General of the WHO, remarks in the context of the H5N1 bird flu virus that "The fact that the long overdue influenza pandemic is so moderate in its impact is probably the best health news of the decade" but that "No, the world is not ready for a pandemic to be caused by H5N1." Given that H1N1 could still mutate, however, the WHO shall continue to monitor the pandemic for six months to a year. She also said that it would take at least two years before a true death total is established. (Approximately 11,500 people are believed to have died in more than 200 countries.)


2009 swine flu pandemic timeline, Timeline, December 2009, December 30
A study published in the New England Journal of Medicine finds that "household contacts less than 18 years of age were twice as susceptible to an acute respiratory illness as were those 19 to 50 years of age, whereas contacts older than 50 years were less susceptible".


2009 swine flu pandemic timeline, Timeline, December 2009, December 31
A joint US-UK study shows that children are twice as likely as adults to catch H1N1.


2009 swine flu pandemic timeline, 2010, January 2010, January 2
United States CDC FluView Week 52: The proportion of deaths attributed to P&I falls below the epidemic threshold. No influenza activity is reported in Nebraska. "One state reported geographically widespread influenza activity, 12 states reported regional influenza activity, Puerto Rico, the District of Columbia, and 17 states reported local influenza activity, the U.S. Virgin Islands, Guam, 19 states reported sporadic influenza activity, and one state reported no influenza activity."


2009 swine flu pandemic timeline, 2010, January 2010, January 8
United States The CDC reports that only Alabama reports widespread influenza activity.


2009 swine flu pandemic timeline, 2010, January 2010, January 15
United States According to the CDC no states have reported widespread influenza activity.


2009 swine flu pandemic timeline, 2010, February 2010, February 5
United States The weekly report released by the CDC states that H1N1 activity has either remained stable or decreased over the past week in nine out of the ten regions of the United States. Furthermore, the proportion of deaths attributed to pneumonia and influenza, which technically remains above the epidemic threshold, has declined over the past week.


2009 swine flu pandemic timeline, 2010, February 2010, February 19
United States According to the CDC, only three states have reported regional influenza activity: Alabama, Georgia, and South Carolina.


2009 swine flu pandemic timeline, 2010, March 2010, March 5
United States According to the CDC, only four states have reported regional influenza activity: Mississippi, Alabama, Georgia, and South Carolina.


2009 swine flu pandemic timeline, 2010, March 2010, March 12
United States According to the CDC, five states have reported regional influenza activity: Mississippi, Alabama, Georgia, South Carolina, and Maine.


2009 swine flu pandemic timeline, 2010, March 2010, March 19
United States According to the CDC, only three states have reported regional influenza activity: Mississippi, Alabama, and Georgia.


2009 swine flu pandemic timeline, 2010, March 2010, March 26
United States According to the CDC, only three states have reported regional influenza activity: Alabama, Georgia, and South Carolina.


2009 swine flu pandemic timeline, 2010, March 2010, March 31
United States The CDC Morbidity and Mortality Weekly Report states that inoculation rates varied, with the highest rates in New England and the lowest in the South. (E.g., roughly 39% of the population of Rhode Island is immunized vis-à-vis 13% that of Mississippi.) Among children Georgia had the lowest vaccination rate, with 21%; the state currently has the highest level of H1N1 flu activity.


2009 swine flu pandemic timeline, 2010, April 2010, April 2
US According to the CDC, only three states have reported regional influenza activity: Alabama, Georgia, and South Carolina.


2009 swine flu pandemic timeline, 2010, April 2010, April 9
US According to the CDC, only three states have reported regional influenza activity: Alabama, Georgia, and South Carolina.


2009 swine flu pandemic timeline, 2010, April 2010, April 14
WHO An external panel advises against winding down the pandemic alert level until experts have tracked the southern hemisphere's traditional autumn and winter flu season. Accusations of undue influence from the pharmaceutical industry were also addressed.


2009 swine flu pandemic timeline, 2010, April 2010, April 17
US According to the CDC, no states have reported either widespread or regional influenza activity, and four have reported local activity: Hawaii, Alabama, Georgia, and South Carolina.


2009 swine flu pandemic timeline, 2010, April 2010, April 19
WHO Director-General Dr. Margaret Chan states that "It is still premature and too early for us to say we have come to an end of the pandemic influenza worldwide. It would be prudent and appropriate... to continue to monitor the evolution of this pandemic for the next six to 12 months," i.e. possibly into 2011. She also remarked that although the United States, Britain and Canada have passed through a second wave of H1N1, outbreaks in India, Egypt and elsewhere are intensifying, and reiterates that countries remain ill-prepared for a bird flu (H5N1) pandemic. More than 200 countries have now been affected by H1N1 with almost 12,000 confirmed deaths worldwide, although the vast majority of those infected recovered without special treatment.


2009 swine flu pandemic timeline, 2010, May 2010, May 16
WHO Director-General Dr. Margaret Chan states at the U.N.'s World Health Assembly that "We are just plain lucky ... This has been the case with the A/ H1N1 influenza pandemic... The virus did not mutate to a more lethal form. Cases of resistance to oseltamivir remained few and isolated. The vaccine closely matched circulating viruses and showed an excellent safety record," Chan said.


2009 swine flu pandemic timeline, 2010, May 2010, May 16
"Emergency wards and intensive care units were often strained, few health systems were overwhelmed ... Schools closed, but borders remained open, and disruptions to travel and trade were far less severe than feared," she told delegates from the agency's 193 member states. "Had things gone wrong in any of these areas, we would have a very different agenda before us today," she added."


2009 swine flu pandemic timeline, 2010, August 2010, August 6
US Researchers discover the mutation which had enabled the pandemic.


2009 swine flu pandemic timeline, 2010, August 2010, August 10
WHO Director-General Margaret Chan officially declares the H1N1 pandemic over  as countries are now seeing a mix of H1N1, H3N2, and B viruses, with some populaces displaying community-level immunity to H1N1 of 20% to 40%. Nevertheless, Angus Nicoll of the European Centre for Disease Prevention and Control urged health officials worldwide to "prepare for a new type of seasonal flu to appear in the near future that will combine elements of the pandemic A(H1N1) strain, and older A(H3N2) strain and several lesser strains". "Pandemics are unpredictable and prone to deliver surprises," Director-General Chan noted.


2009 swine flu pandemic timeline summary
This article covers the chronology of the 2009 novel influenza A (H1N1) pandemic. Flag icons denote the first announcements of confirmed cases by the respective nation-states, their first deaths (and other major events such as their first intergenerational cases, cases of zoonosis, and the start of national vaccination campaigns), and relevant sessions and announcements of the World Health Organization (WHO), the European Union (and its agency the European Centre for Disease Prevention and Control),and the U.S. Centers for Disease Control (CDC).


2009 swine flu pandemic timeline summary
Unless otherwise noted, references to terms like S-OIV, H1N1 and such, all refer to this new A(H1N1) strain and not to sundry other strains of H1N1 which are endemic in humans, birds and pigs.


2009 swine flu pandemic vaccine
The 2009 swine flu pandemic vaccines were influenza vaccines developed to protect against the pandemic H1N1/09 virus. These vaccines either contained inactivated (killed) influenza virus, or weakened live virus that could not cause influenza. The killed virus was injected, while the live virus was given as a nasal spray. Both these types of vaccine were produced by growing the virus in chicken eggs. Around three billion doses were produced, with delivery in November 2009.


2009 swine flu pandemic vaccine
In studies, the vaccine appeared both effective and safe, providing a strong protective immune response and having a similar safety profile to the usual seasonal influenza vaccine. However, about 30% of people already had some immunity to the virus, with the vaccine conferring greatest benefit on young people, since many older people are already immune through exposure to similar viruses in the past. The vaccine also provided some cross-protection against the 1918 flu pandemic strain.


2009 swine flu pandemic vaccine
Early results (pre-25 December 2009) from an observational cohort of 248,000 individuals in Scotland showed the vaccine to be effective at preventing H1N1 influenza (95.0% effectiveness [95% confidence intervals 76.0–100.0%]) and influenza-related hospital admissions (64.7% [95% confidence intervals 12.0–85.8%]).


2009 swine flu pandemic vaccine
Developing, testing, and manufacturing sufficient quantities of a vaccine is a process that takes many months. According to Keiji Fukuda of the World Health Organization, "There's much greater vaccine capacity than there was a few years ago, but there is not enough vaccine capacity to instantly make vaccines for the entire world's population for influenza." The nasal mist version of the vaccine started shipping on 1 October 2009.


2009 swine flu pandemic vaccine, Types of vaccine
TIV works by putting into the bloodstream those parts of three strains of flu virus that the body uses to create antibodies; while LAIV works by inoculating the body with those same three strains, but in a modified form that cannot cause illness.


2009 swine flu pandemic vaccine, Types of vaccine
LAIV is not recommended for individuals under age 2 or over age 49, but might be comparatively more effective among children over age two.


2009 swine flu pandemic vaccine, Manufacturing methods
For the inactivated vaccines, the virus is grown by injecting it, along with some antibiotics, into fertilized chicken eggs. About one to two eggs are needed to make each dose of vaccine. The virus replicates within the allantois of the embryo, which is the equivalent of the placenta in mammals. The fluid in this structure is removed and the virus purified from this fluid by methods such as filtration or centrifugation. The purified viruses are then inactivated ("killed") with a small amount of a disinfectant.


2009 swine flu pandemic vaccine, Manufacturing methods
The inactivated virus is treated with detergent to break up the virus into particles, and the broken capsule segments and released proteins are concentrated by centrifugation. The final preparation is suspended in sterile phosphate buffered saline ready for injection. This vaccine mainly contains the killed virus but might also contain tiny amounts of egg protein and the antibiotics, disinfectant and detergent used in the manufacturing process. In multi-dose versions of the vaccine, the preservative thimerosal is added to prevent growth of bacteria. In some versions of the vaccine used in Europe and Canada, such as Arepanrix and Fluad, an adjuvant is also added, this contains squalene, vitamin E and an emulsifier called polysorbate 80.


2009 swine flu pandemic vaccine, Manufacturing methods
To make the live vaccine, the virus is first adapted to grow at 25 °C (77 °F) and then grown at this temperature until it loses the ability to cause illness in humans, which requires the virus to grow at normal human body temperature of 37 °C (99 °F). Multiple mutations are needed for the virus to grow at cold temperatures, so this process is effectively irreversible and once the virus has lost virulence (become "attenuated"), it will not regain the ability to infect people. The attenuated virus is then grown in chicken eggs as before. The virus-containing fluid is harvested and the virus purified by filtration; this step also removes any contaminating bacteria. The filtered preparation is then diluted into a solution that stabilizes the virus. This solution contains monosodium glutamate, potassium phosphate, gelatin, the antibiotic gentamicin, and sugar.


2009 swine flu pandemic vaccine, Manufacturing methods
A different method of producing influenza virus was used to produce the Novartis vaccine Optaflu. In this vaccine the virus is grown in cell culture instead of in eggs. This method is faster than the classic egg-based system and produces a purer final product. There are no traces of egg proteins in the final product, so it is safe for people with egg allergies.


2009 swine flu pandemic vaccine, Previous seasonal vaccine production
Prior to the H1N1/09 outbreak, WHO recommended that vaccines for the Northern Hemisphere's 2009–2010 flu season contain an A(H1N1)-like virus, and stocks were made available. However, the strain of H1N1 in the seasonal flu vaccine was different from the pandemic strain H1N1/09 and offered no immunity against it. The US Centers for Disease Control and Prevention (CDC) characterized over 80 new H1N1 viruses that may be used in a vaccine.


2009 swine flu pandemic vaccine, Production questions and decisions, Questions
There was concern in mid-2009 that, should a second, deadlier wave of this new H1N1 strain appear during the northern autumn of 2009, producing pandemic vaccines ahead of time could turn out to be a serious waste of resources as the vaccine might not be effective against it, and there would also be a shortage of seasonal flu vaccine available if production facilities were switched to the new vaccine. Seasonal flu vaccine was being made as of May 2009.


2009 swine flu pandemic vaccine, Production questions and decisions, Questions
Although vaccine makers would be ready to switch to making a swine flu vaccine, many questions remained unanswered, including: "Should we really make a swine flu vaccine? Should we base a vaccine on the current virus, since flu viruses change rapidly? Vaccine against the current virus might be far less effective against a changed virus – should we wait to see if the virus changes? If vaccine production doesn't start soon, swine flu vaccine won't be ready when it's needed."


2009 swine flu pandemic vaccine, Production questions and decisions, Questions
The costs of producing a vaccine also became an issue, with some U.S. lawmakers questioning whether a new vaccine was worth the unknown benefits. Representatives Phil Gingrey and Paul Broun, for instance, were not convinced that the U.S. should spend up to US$2 billion to produce one, with Gingrey stating "We can't let all of our spending and our reaction be media-driven in responding to a panic so that we don't get Katrina-ed. ...


2009 swine flu pandemic vaccine, Production questions and decisions, Questions
It's important because what we are talking about as we discuss the appropriateness of spending $2 billion to produce a vaccine that may never be used – that is a very important decision that our country has to make." In fact, a Fairleigh Dickinson University PublicMind poll found in October 2009 that a majority (62%) of New Jerseyans were not planning on getting the vaccine at all.


2009 swine flu pandemic vaccine, Production questions and decisions, Questions
Before the pandemic was declared, the WHO said that if a pandemic was declared it would attempt to make sure that a substantial amount of vaccine was available for the benefit of developing countries. Vaccine makers and countries with standing orders, such as the U.S. and a number of European countries, would be asked, according to WHO officials, "to share with developing countries from the moment the first batches are ready if an H1N1 vaccine is made" for a pandemic strain. The global body stated that it wanted companies to donate at least 10% of their production or offer reduced prices for poor countries that could otherwise be left without vaccines if there is a sudden surge in demand.


2009 swine flu pandemic vaccine, Production questions and decisions, Questions
Gennady Onishchenko, Russia's chief doctor, said on 2 June 2009 that swine flu was not aggressive enough to cause a worldwide pandemic, noting that the current mortality rate of confirmed cases was 1.6% in Mexico and only 0.1% in the United States. He stated at a press conference, "So far it is unclear if we need to use vaccines against the flu because the virus that is now circulating throughout Europe and North America does not have a pandemic nature."


2009 swine flu pandemic vaccine, Production questions and decisions, Questions
In his opinion, a vaccine could be produced, but said that preparing a vaccine now would be considered "practice," since the world would soon need a new vaccine against a new virus. "What's 16,000 sick people? During any flu season, some 10,000 a day become ill in Moscow alone," he said.


2009 swine flu pandemic vaccine, Production questions and decisions, Production timelines
After a meeting with the WHO on 14 May 2009, pharmaceutical companies said they were ready to begin making a swine flu vaccine. According to news reports, the WHO's experts would present recommendations to WHO Director-General Margaret Chan, who was expected to issue advice to vaccine manufacturers and the Sixty-second World Health Assembly. WHO's Keiji Fukuda told reporters "These are enormously complicated questions, and they are not something that anyone can make in a single meeting." Most flu vaccine companies can not make both seasonal flu vaccine and pandemic flu vaccine at the same time.


2009 swine flu pandemic vaccine, Production questions and decisions, Production timelines
Production takes months and it is impossible to switch halfway through if health officials make a mistake. If the swine flu mutates, scientists aren't sure how effective a vaccine made now from the current strain will remain. Rather than wait on the WHO decision, however, some countries in Europe have decided to go ahead with early vaccine orders.


2009 swine flu pandemic vaccine, Production questions and decisions, Production timelines
On 20 May 2009, AP reported: "Manufacturers won't be able to start making the [swine flu] vaccine until mid-July at the earliest, weeks later than previous predictions, according to an expert panel convened by WHO. It will then take months to produce the vaccine in large quantities.


2009 swine flu pandemic vaccine, Production questions and decisions, Production timelines
The swine flu virus is not growing very fast in laboratories, making it difficult for scientists to get the key ingredient they need for a vaccine, the 'seed stock' from the virus [...] In any case, mass producing a pandemic vaccine would be a gamble, as it would take away manufacturing capacity for the seasonal flu vaccine for the flu that kills up to 500,000 people each year. Some experts have wondered whether the world really needs a vaccine for an illness that so far appears mild."


2009 swine flu pandemic vaccine, Production questions and decisions, Production timelines
Another option proposed by the CDC was an "earlier rollout of seasonal vaccine," according to the CDC's Daniel Jernigan. He said the CDC would work with vaccine manufacturers and experts to see if that would be possible and desirable. Flu vaccination usually starts in September in the United States and peaks in November. Some vaccine experts agree it would be better to launch a second round of vaccinations against the new H1N1 strain instead of trying to add it to the seasonal flu vaccine or replacing one of its three components with the new H1N1 virus.


2009 swine flu pandemic vaccine, Production questions and decisions, Production timelines
The Australian company CSL said that they were developing a vaccine for the swine flu and predicted that a suitable vaccine would be ready by August. However, John Sterling, Editor in Chief of Genetic Engineering & Biotechnology News, said on 2 June, "It can take five or six months to come up with an entirely novel influenza vaccine. There is a great deal of hope that biotech and pharma companies might be able to have something ready sooner."


2009 swine flu pandemic vaccine, Production questions and decisions, Production timelines
As of September 2009 a vaccine for H1N1/09 was expected to be available starting in November 2009, with production of three billion doses per year. It was expected that two doses would be needed to provide sufficient protection, but tests indicated that one dose would be sufficient for adults.


2009 swine flu pandemic vaccine, Production questions and decisions, Production timelines
As of 28 September 2009 GlaxoSmithKline produced a vaccine made by growing the virus in hens' eggs, then breaking and deactivating the virus,and Baxter International produced a vaccine made in cell culture, suitable for those who have an egg allergy. The vaccines have been approved for use in the European Union.


2009 swine flu pandemic vaccine, Production questions and decisions, Testing
Initial Phase I human testing began with Novartis' MF59 candidate in July 2009, at which time phase II trials of CSL's candidate CSL425 vaccine were planned to start in August 2009, but had not begun recruiting. Sanofi Pasteur's candidate inactivated H1N1 had several phase II trials planned as of 21 July 2009, but had not begun recruiting. News coverage conflicted with this information, as Australian trials of the CSL candidate were announced as having started on 21 July, and the Chinese government announced the start of trials of the Hualan Biological Engineering candidate.


2009 swine flu pandemic vaccine, Production questions and decisions, Testing
Pandemrix, made by GlaxoSmithKline (GSK), and Focetria, made by Novartis were approved by the European Medicines Agency on 25 September 2009, and Celvapan, made by Baxter was approved the following week. The first comparative clinical study of both vaccines started on children in the United Kingdom on 25 September 2009. GSK announced results from clinical trials assessing the use of Pandemrix in children, adults, and the elderly. A 2009 trial examined the safety and efficacy of two different doses of the split-virus vaccine, and was published in The New England Journal of Medicine.


2009 swine flu pandemic vaccine, Production questions and decisions, Testing
The vaccine used in the trial was prepared by CSL Biotherapies in chicken eggs, in the same way as the seasonal vaccine. A robust immune response was produced in over 90% of patients after a single dose of either 15 or 30 μg of antigen. This study suggested that the current recommendation for two doses of vaccine are overkill and that a single dose is quite sufficient.


2009 swine flu pandemic vaccine, Production questions and decisions, Testing
Arepanrix, an AS03-Adjuvanted H1N1 Pandemic Influenza Vaccine similar to Pandemrix and also made by GSK, was authorized by Canada's Minister of Health on 21 October 2009.


2009 swine flu pandemic vaccine, Adverse events
A review by the U.S. National Institutes of Health (NIH) concluded that the 2009 H1N1 ("swine flu") vaccine has a safety profile similar to that of seasonal vaccine.


2009 swine flu pandemic vaccine, Adverse events
In an initial clinical trial in Australia, non-serious adverse events were reported by about half of the 240 people vaccinated, with these events including tenderness and pain at the site of injection, headache, malaise, and muscle pain. Two people had more severe events, with a much longer spell of nausea, muscle pain and malaise that lasted several days. The authors stated that the frequency and severity of these adverse events were similar to those normally seen with seasonal influenza vaccines. A second trial involved 2,200 people ranging from 3 to 77 years of age.


2009 swine flu pandemic vaccine, Adverse events
In this study no patients reported serious adverse events, with the most commonly observed events being pain at the injection site and fever, which occurred in 10–25% of people. Although this trial followed up patients individually, the Government has been criticized for relying on voluntary reporting for post-vaccination evaluation in other circumstances, since this is "unlikely to accurately measure the percentage of people who get adverse effect".


2009 swine flu pandemic vaccine, Adverse events
As of 19 November 2009, the World Health Organization (WHO) said that 65 million doses of vaccine had been administered and that it had a similar safety profile to the seasonal flu vaccine, with no significant differences in the adverse events produced by the different types of vaccine. There has been one report of an adverse event per 10,000 doses of vaccine, with only five percent of these adverse events being serious, an overall rate of serious events of one in 200,000 doses.


2009 swine flu pandemic vaccine, Adverse events
In Canada, after 6.6 million doses of vaccine had been distributed between 21 October and 7 November, there were reports of mild adverse events in 598 people vaccinated including: nausea, dizziness, headache, fever, vomiting, and swelling or soreness at the injection site. There were reports of tingling lips or tongue, difficulty breathing, hives, and skin rashes. Thirty six people had serious adverse events, including anaphylaxis and febrile convulsions. The rate of serious adverse events is one in 200,000 doses distributed, which according to Canada's chief public health officer, is less than expected for the seasonal flu vaccine. GlaxoSmithKline recalled a batch of vaccine in Canada after it appeared to cause higher rates of adverse events than other batches.


2009 swine flu pandemic vaccine, Adverse events
In the USA 46 million doses had been distributed as of 20 November 2009 and 3182 adverse events were reported. The CDC stated that the "vast majority" were mild, with about one serious adverse event in 260,000 doses.


2009 swine flu pandemic vaccine, Adverse events
In Japan around 15 million people had been vaccinated by 31 December 2009. 1,900 cases of side effects and 104 cases of death were reported from medical institutions. The health ministry announced that it will conduct epidemiologic investigation.


2009 swine flu pandemic vaccine, Adverse events
In France, around five million people had been vaccinated by 30 December 2009. 2,657 cases of side effects, eight cases of intrauterine death and five cases of miscarriages were reported after vaccination by afssaps.


2009 swine flu pandemic vaccine, Adverse events
Rare potential adverse events are temporary bleeding disorders and Guillain–Barré syndrome (GBS), a serious condition involving the peripheral nervous system, from which most patients recover fully within a few months to a year. Some studies have indicated that influenza-like illness is itself associated with an increased risk of GBS, suggesting that vaccination might indirectly protect against the disorder by protecting against flu. According to Marie-Paule Kieny of WHO assessing the side-effects of large-scale influenza vaccination is complicated by the fact that in any large population a few people will become ill and die at any time.


2009 swine flu pandemic vaccine, Adverse events
For example, in any six-week period in the UK six sudden deaths from unknown causes and 22 cases of Guillain–Barré syndrome would be expected, so if everyone in the UK were vaccinated, this background rate of illness and death would continue as normal and some people would die simply by chance soon after the vaccination.


2009 swine flu pandemic vaccine, Adverse events
Some scientists have reported concerns about the longer-term effects of the vaccine. For instance, Sucharit Bhakdi, professor of medical microbiology at the Johannes Gutenberg University of Mainz in Germany, wrote in the journal, Medical Microbiology and Immunology, of the possibility that immune stimulation by vaccines or any other cause might worsen pre-existing heart disease. Chris Shaw, a neuroscientist at the University of British Columbia, expressed concern that serious side-effects may not appear immediately; he said it took five to ten years to see most of the Gulf War syndrome outcomes.


2009 swine flu pandemic vaccine, Adverse events
The CDC states that most studies on modern influenza vaccines have seen no link with GBS, Although one review gives an incidence of about one case per million vaccinations, a large study in China, reported in The New England Journal of Medicine covering close to 100 million doses of H1N1 flu vaccine found only eleven cases of Guillain–Barré syndrome, actually lower than the normal rate of the disease in China, and no other notable side effects.


2009 swine flu pandemic vaccine, Adverse events, Pregnant women and children
A 2009 review of the use of influenza vaccines in pregnant women stated that influenza infections posed a major risk during pregnancy and that multiple studies had shown that the inactivated vaccine was safe in pregnant women, concluding that this vaccine "can be safely and effectively administered during any trimester of pregnancy" and that high levels of immunization would avert "a significant number of deaths".


2009 swine flu pandemic vaccine, Adverse events, Pregnant women and children
A 2004 review of the safety of influenza vaccines in children stated that the live vaccine had been shown to be safe but that it might trigger wheezing in some children with asthma; less data for the trivalent inactivated vaccine was available, but no serious symptoms had been seen in clinical trials.


2009 swine flu pandemic vaccine, Adverse events, Squalene
Newsweek states that "wild rumours" about the swine flu vaccine are being spread through e-mails, it writes that "The claims are nearly pure bunk, with only trace amounts of fact." These rumours generally make unfounded claims that the vaccine is dangerous and they may also promote conspiracy theories. For example, Newsweek states that some chain e-mails make false claims about squalene (shark liver oil) in vaccines. The New York Times also notes that anti-vaccine groups have spread "dire warnings" about formulations of the vaccine that contain squalene as an adjuvant.


2009 swine flu pandemic vaccine, Adverse events, Squalene
An adjuvant is a substance that boosts the body's immune response, thereby stretching the supply of the vaccine and helping immunize elderly people with a weak immune system. Squalene is a normal part of the human body, made in the liver and circulating in the blood, and is also found in many foods, such as eggs and olive oil. None of the formulations of vaccine used in the US contain squalene, or any other adjuvant. However, some European and Canadian formulations do contain 25 μg of squalene per dose, which is roughly the amount found in a drop of olive oil. Some animal experiments have suggested that squalene might be linked to autoimmune disorders. although others suggest squalene might protect people against cancer.


2009 swine flu pandemic vaccine, Adverse events, Squalene
Squalene-based adjuvants have been used in European influenza vaccines since 1997, with about 22 million doses administered over the past twelve years. The WHO states that no severe side effects have been associated with these vaccines, although they can produce mild inflammation at the site of injection. The safety of squalene-containing influenza vaccines have also been tested in two separate clinical trials, one with healthy non-elderly people, and one with elderly people, in both trials the vaccine was safe and well tolerated, with only weak side-effects, such as mild pain at the injection site.


2009 swine flu pandemic vaccine, Adverse events, Squalene
A 2009 meta-analysis brought together data from 64 clinical trials of influenza vaccines with the squalene-containing adjuvant MF59 and compared them to the effects of vaccines with no adjuvant. The analysis reported that the adjuvanted vaccines were associated with slightly lower risks of chronic diseases, but that neither type of vaccines altered the normal rate of autoimmune diseases; the authors concluded that their data "supports the good safety profile associated with MF59-adjuvanted influenza vaccines and suggests there may be a clinical benefit over non-MF59-containing vaccines".


2009 swine flu pandemic vaccine, Adverse events, Squalene
A 2004 review of the effects of adjuvants on mice and humans concluded that "despite numerous case reports on vaccination induced autoimmunity, most epidemiological studies failed to confirm the association and the risk appears to be extremely low or non-existent", although the authors noted that the possibility that adjuvants might cause damaging immune reactions in a few susceptible people has not been completely ruled out. A 2009 review of oil-based adjuvants in influenza vaccines stated that this type of adjuvant "neither stimulates antibodies against squalene oil naturally produced by the humans body nor enhances titers of preexisting antibodies to squalene" and that these formulations did not raise any safety concerns.


2009 swine flu pandemic vaccine, Adverse events, Squalene
A paper published in 2000 suggested that squalene might have caused of Gulf War syndrome by producing anti-squalene antibodies, although other scientists stated that it was uncertain if the methods used were actually capable of detecting these antibodies. A 2009 U.S. Department of Defense study comparing healthy Navy personnel to those suffering from Gulf War syndrome was published in the journal Vaccine, this used a validated test for these antibodies and found no link between the presence of the antibodies and illness, with about half of both groups having these antibodies and no correlation between symptoms and antibodies. Furthermore, none of the vaccines given to US troops during the Gulf war actually contained any squalene adjuvants.


2009 swine flu pandemic vaccine, Adverse events, Thiomersal
Multi-dose versions of the vaccine contain the preservative thiomersal (also known as thimerosal), a mercury compound that prevents contamination when the vial is used repeatedly. Single-dose versions and the live vaccine do not contain this preservative. In the U.S., one dose from a multi-dose vial contains approximately 25 micrograms of mercury, a bit less than a typical tuna fish sandwich. In Canada, different variants contain five and 50 micrograms of thimerosal per dose. The use of thiomersal has been controversial, with claims that it can cause autism and other developmental disorders.


2009 swine flu pandemic vaccine, Adverse events, Thiomersal
The U.S. Institute of Medicine examined these claims and concluded in 2004 that the evidence did not support any link between vaccines and autism. Other reviews came to similar conclusions, with a 2006 review in the Canadian Journal of Neurological Sciences stating that there is no convincing evidence to support the claim that thimerosal has a causal role in autism, and a 2009 review in the journal Clinical Infectious Diseases stating that claims that mercury can cause autism are "biologically implausible".


2009 swine flu pandemic vaccine, Adverse events, Thiomersal
The U.K. National Health Service stated in 2003 that "There is no evidence of long-term adverse effects due to the exposure levels of thiomersal in vaccines." The World Health Organization concluded that there is "no evidence of toxicity in infants, children or adults exposed to thiomersal in vaccines". Indeed, in 2008 a review noted that even though thiomersal was removed from all US childhood vaccines in 2001, this has not changed the number of autism diagnoses, which are still increasing.


2009 swine flu pandemic vaccine, Adverse events, Dystonia
According to the CDC, there is no evidence either for or against dystonia being caused by the vaccinations. Dystonia is extremely rare. Due to the very low numbers of cases, dystonia is poorly understood. There were only five cases noted that might have been associated with influenza vaccinations over a span of eighteen years. In one recent case, a woman noted flu-like symptoms, followed by difficulties with movement and speech starting ten days after a seasonal influenza vaccination. However the Dystonia Medical Research Foundation stated that it is unlikely that the symptoms in this case were actually dystonia and stated that there has "never been a validated case of dystonia resulting from a flu shot".


2009 swine flu pandemic vaccine, Adverse events, Children vaccine recall
On 15 December 2009, one of the five manufacturers supplying the H1N1 vaccine to the United States recalled thousands of doses because they were not as potent as expected. The French manufacturer Sanofi Pasteur voluntarily recalled about 800,000 doses of vaccine meant for children between the ages of six months and 35 months.


2009 swine flu pandemic vaccine, Adverse events, Children vaccine recall
The company and the Centers for Disease Control and Prevention (CDC) emphasized that the recall was not prompted by safety concerns, and that even though the vaccine is not quite as potent as it is supposed to be, children who received it do not need to be immunized again. The CDC emphasized that there is no danger for any child who received the recalled vaccine. When asked what parents should do, CDC spokesman Tom Skinner said, "absolutely nothing." He said if children receive this vaccine, they will be fine.


2009 swine flu pandemic vaccine, Adverse events, Pandemrix-related increase of narcolepsy in Finland and Sweden
In 2010, The Swedish Medical Products Agency (MPA) and The Finnish National Institute for Health and Welfare (THL) received reports from Swedish and Finnish health care professionals regarding narcolepsy as suspected adverse reaction following Pandemrix flu vaccination. The reports concern children aged 12–16 years where symptoms compatible with narcolepsy, diagnosed after thorough medical investigation, have occurred one to two months after vaccination.


2009 swine flu pandemic vaccine, Adverse events, Pandemrix-related increase of narcolepsy in Finland and Sweden
THL concluded in February 2011 that there is a clear connection between the Pandemrix vaccination campaign of 2009 and 2010 and narcolepsy epidemic in Finland: there was a nine times higher probability to get narcolepsy with vaccination than without it.


2009 swine flu pandemic vaccine, Adverse events, Pandemrix-related increase of narcolepsy in Finland and Sweden
At the end of March 2011, an MPA press release stated: "Results from a Swedish registry based cohort study indicate a 4-fold increased risk of narcolepsy in children and adolescents below the age of 20 vaccinated with Pandemrix, compared to children of the same age that were not vaccinated." The same study found no increased risk in adults who were vaccinated with Pandemrix.


2009 swine flu pandemic vaccine, Availability, Centers for Disease Control and Prevention
The American Centers for Disease Control and Prevention issued the following recommendations on who should be vaccinated (order is not in priority):


2009 swine flu pandemic vaccine, Availability, Centers for Disease Control and Prevention
Children through 9 years of age should get two doses of vaccine, about a month apart. Older children and adults need only one dose.


2009 swine flu pandemic vaccine, Availability, National Health Service
The UK's National Health Service policy is to provide vaccine in this order of priority:


2009 swine flu pandemic vaccine, Availability, National Health Service
This excludes the large majority of individuals aged six months to 24 years, a group for which the CDC recommends vaccination.


2009 swine flu pandemic vaccine, Availability, National Health Service
The United Kingdom began its administration program 21 October 2009. UK Soldiers serving in Afghanistan will also be offered vaccination.


2009 swine flu pandemic vaccine, Availability, National Health Service
By April 2010, it was apparent that most of the vaccine was not needed. The US government had bought 229 million doses of H1N1 vaccines of which 91 million doses were used; of the surplus, 5 million doses were stored in bulk, 15 million doses were sent to developing countries and 71 million doses were destroyed. The World Health Organization is planning to examine if it overreacted to the H1N1 outbreak.


2009 swine flu pandemic vaccine, Political issues
General political issues, not restricted to the 2009 outbreak, arose regarding the distribution of vaccine. In many countries supplies are controlled by national or local governments, and the question of how the vaccine will be allocated should there be an insufficient supply for everyone is critical, and will likely depend on the patterns of any pandemic, and the age groups most at risk for serious complications, including death. In the case of a lethal pandemic people will be demanding access to the vaccine and the major problem will be making it available to those who need it.


2009 swine flu pandemic vaccine, Political issues
While it has been suggested that compulsory vaccination may be needed to control a pandemic, many countries do not have a legal framework that would allow this. The only populations easily compelled to accept vaccination are military personnel (who can be given routine vaccinations as part of their service obligations), health care personnel (who can be required to be vaccinated to protect patients), and school children, who (under United States constitutional law) could be required to be vaccinated as a condition of attending school.


2009 term opinions of the Supreme Court of the United States
The 2009 term of the Supreme Court of the United States began October 5, 2009, and concluded October 3, 2010. The table illustrates which opinion was filed by each justice in each case and which justices joined each opinion.


2009 term opinions of the Supreme Court of the United States, 2009 term membership and statistics
This was the fifth term of Chief Justice Roberts' tenure, the first term for Justice Sotomayor, and the last term for Justice Stevens.


2009 term per curiam opinions of the Supreme Court of the United States
The Supreme Court of the United States handed down nineteen per curiam opinions during its 2009 term, which began on October 5, 2009, and concluded October 3, 2010.


2009 term per curiam opinions of the Supreme Court of the United States
Because per curiam decisions are issued from the Court as an institution, these opinions all lack the attribution of authorship or joining votes to specific justices. All justices on the Court at the time the decision was handed down are assumed to have participated and concurred unless otherwise noted.


2009 term per curiam opinions of the Supreme Court of the United States, Court membership
Associate Justices: John Paul Stevens, Antonin Scalia, Anthony Kennedy, Clarence Thomas, Ruth Bader Ginsburg, Stephen Breyer, Samuel Alito, Sonia Sotomayor


2009 term per curiam opinions of the Supreme Court of the United States, Corcoran v. Levenhagen
558 U.S. 1 Decided October 20, 2009. Seventh Circuit vacated and remanded.


2009 term per curiam opinions of the Supreme Court of the United States, Corcoran v. Levenhagen
The petitioner was convicted of murder and sentenced to death in state court. He filed a writ of habeas corpus in federal court, arguing, inter alia, that his sentence violated the Sixth Amendment. The District Court granted his petition on that basis alone and ordered the defendant to be resentenced, and did not discuss his other claims as it considered those moot. On appeal, the Seventh Circuit reversed the District Court and directed it upon remand to deny the habeas writ, without permitting the District Court to review the other claims, and without explaining why those claims should not be considered.


2009 term per curiam opinions of the Supreme Court of the United States, Corcoran v. Levenhagen
The Supreme Court vacated the Seventh Circuit's decision, explaining that it was error for that court to dispose of the petitioner's other claims without any explanation. The Seventh Circuit was to either permit the District Court to consider the unaddressed claims on remand, or itself explain why that consideration was not necessary.


2009 term per curiam opinions of the Supreme Court of the United States, Bobby v. Van Hook
558 U.S. 4 Decided November 9, 2009. Sixth Circuit reversed and remanded.


2009 term per curiam opinions of the Supreme Court of the United States, Bobby v. Van Hook
The Sixth Circuit had granted habeas relief to the petitioner on the ground of ineffective assistance of counsel during the capital phase of his sentencing, in violation of the Sixth Amendment. The Supreme Court reversed, believing it was clear the petitioner's attorneys "met the constitutional minimum standard of competence under the correct standard." The Sixth Circuit had instead improperly relied on professional guidelines that were published many years after the trial to determine the applicable standard.


2009 term per curiam opinions of the Supreme Court of the United States, Bobby v. Van Hook
Van Hook was convicted in 1985 for aggravated robbery and aggravated murder. Using a strategy he had used since a teenager, he picked up a homosexual man at a gay bar and lured him into a secluded place to rob him; in this instance, Van Hook concluded the robbery by stabbing the victim to death and disfiguring his body. At his sentencing hearing, the defense called several witnesses, and Van Hook himself gave an unsworn statement, presenting mitigating evidence regarding Van Hook's traumatic childhood, personality disorder, and substance abuse. The court weighed the factors and sentenced him to death.


2009 term per curiam opinions of the Supreme Court of the United States, Bobby v. Van Hook
In 1995, Van Hook submitted his petition for a writ of habeas corpus, which was finally denied by the District Court in 2003. A panel of the Sixth Circuit reversed, ruling that his confession had been unconstitutionally obtained. That decision was vacated on rehearing en banc. On remand, the Sixth Circuit panel again granted the petition, finding that Van Hook's attorneys were ineffective during Van Hook's sentencing for failing to adequately investigate and present mitigating evidence, for not securing an independent mental health expert, and for failing to object to damaging evidence in an investigation report.


2009 term per curiam opinions of the Supreme Court of the United States, Bobby v. Van Hook
The en banc Sixth Circuit again vacated, and remanded for the panel to revise its opinion. In its third opinion, the panel granted relief to Van Hook on the sole ground that his lawyers did not adequately investigate and present mitigating evidence, relying on the American Bar Association Guidelines for the Appointment and Performance of Defense Counsel in Death Penalty Cases published in 2003.


2009 term per curiam opinions of the Supreme Court of the United States, Bobby v. Van Hook
In reversing, the Supreme Court observed that the Sixth Amendment guarantee to criminal defendants of effective counsel is only a "general standard"—"an objective standard of reasonableness," as explained in the governing case, Strickland v. Washington, 466 U.S. 668 (1984). Restatements of professional standards, such as the ABA Guidelines, can be useful as "guides", "but only to the extent they describe the professional norms prevailing when the representation took place." The Supreme Court ruled that the Sixth Circuit erred in treating the ABA Guidelines as "inexorable commands" rather than as "evidence of what reasonably diligent attorneys would do." The Sixth Circuit further erred in relying on Guidelines published 18 years after Van Hook went to trial, "without even pausing to consider whether they reflected the prevailing professional practice at the time of trial."


2009 term per curiam opinions of the Supreme Court of the United States, Bobby v. Van Hook
Even applying the standards prevailing at the time, the Supreme Court found that Van Hook's counsel was not ineffective. The Sixth Circuit had incorrectly characterized defense counsel as waiting until the "last minute" to begin their mitigation investigation, as the record showed counsel had repeatedly interviewed family members, contacted an expert, and reviewed Van Hook's military history months before the start of trial. The Sixth Circuit panel believed that the evidence counsel did uncover should have prompted them to seek more. The Supreme Court, however, considered that such further testimony on the same points would have added nothing of value, and the decision not to investigate further was reasonable under the circumstances.


2009 term per curiam opinions of the Supreme Court of the United States, Bobby v. Van Hook
The Supreme Court further found that the aggravating factors were strong. Van Hook was indisputably the sole perpetrator and had the intent to rob the victim from the start, even using the same strategy he had used in past robberies and deviating in this case only by killing his victim. The Sixth Circuit ultimately "focused on the number of aggravating factors instead of their weight...leading it to overstate further the effect additional mitigating evidence might have had."


2009 term per curiam opinions of the Supreme Court of the United States, Bobby v. Van Hook
Alito filed a concurrence, emphasizing his understanding that the Supreme Court's opinion "in no way suggests that the [ABA Guidelines] have special relevance in determining whether an attorney’s performance meets the standard required by the Sixth Amendment." He wrote that it is purely the responsibility of the courts to determine what work by an attorney meets constitutional standards, and he saw "no reason why the ABA Guidelines should be given a privileged position in making that determination."


2009 term per curiam opinions of the Supreme Court of the United States, Wong v. Belmontes
558 U.S. 15 Decided November 16, 2009. Ninth Circuit reversed and remanded.


2009 term per curiam opinions of the Supreme Court of the United States, Wong v. Belmontes
For the third time, the Supreme Court set aside the Ninth Circuit's reversal of a death sentence in a California murder case. The Supreme Court ruled that the petitioner's claim of ineffective assistance of counsel, in violation of the Sixth Amendment, failed the two-prong test under Strickland v. Washington, 466 U.S. 668 (1984), because he could not establish that prejudice resulted even if his attorney's performance was constitutionally deficient.


2009 term per curiam opinions of the Supreme Court of the United States, Wong v. Belmontes
In 1981, Belmontes broke into a woman's home in Victor, California, and bludgeoned her to death, repeatedly striking her in the head with a steel bar. He and his accomplices then stole the victim's stereo, sold it for $100, and used the money to buy beer and drugs for the night. Belmontes was convicted of murder in state court in 1982.


2009 term per curiam opinions of the Supreme Court of the United States, Wong v. Belmontes
During the sentencing phase, his defense attorney successfully excluded evidence he had committed another murder, for which he had served time only as an accessory, though the court warned that the prior murder could be admissible as rebuttal evidence if the defense made it an issue. Constrained by that limit, the defense attorney nevertheless presented several witnesses, and testimony from Belmontes himself, regarding the abuse he suffered as a child, and his religious conversion while in jail on the accessory charge. The jury returned a sentence of death.


2009 term per curiam opinions of the Supreme Court of the United States, Wong v. Belmontes
The District Court denied Belmontes' petition for habeas relief, and the Ninth Circuit reversed, finding error in the jury's instructions. The Supreme Court summarily vacated that decision and remanded for reconsideration in light of Brown v. Payton, 544 U.S. 133 (2005). On remand, the Ninth Circuit reaffirmed its decision, and the Supreme Court reversed in Ayers v. Belmontes, 549 U.S. 7 (2006). On remand, the Ninth Circuit again granted Belmontes relief, this time on the basis of ineffective assistance of counsel during the sentencing phase of his trial.


2009 term per curiam opinions of the Supreme Court of the United States, Wong v. Belmontes
In Wong v. Belmontes, the Supreme Court again reversed, holding that Belmontes failed to establish the showing of prejudice required by Strickland, regardless of whether his attorney's performance was constitutionally deficient. The Supreme Court criticized the Ninth Circuit for changing its view of the case; the same panel of judges that characterized the mitigation evidence presented as merely "cursory" in its most recent opinion had characterized the same evidence as "substantial" in its first opinion.


2009 term per curiam opinions of the Supreme Court of the United States, Wong v. Belmontes
Though the Ninth Circuit ruled that Belmontes was prejudiced by his attorney's failure to present even more evidence to "humanize" him, the Supreme Court disagreed, finding that such evidence would either be merely cumulative, or would have opened the door for the admissibility of evidence of the prior murder. The Supreme Court dismissed as "fanciful" the notion that the jury's result could have been different if only the defense attorney had called more witnesses, in light of the circumstances of the murder.


2009 term per curiam opinions of the Supreme Court of the United States, Wong v. Belmontes
The Supreme Court took particular issue with the Ninth Circuit's assertion that the case did not involve "needless suffering", given that the motive for the murder was petty burglary, and the victim had been beaten 15-20 times on the head, suffered defensive wounds that indicated a struggle, and remained alive in that state until shortly after police found her.


2009 term per curiam opinions of the Supreme Court of the United States, Wong v. Belmontes
Stevens filed a concurrence. He criticized the Supreme Court's prior decision, from which he had dissented, and stated that he strongly disagreed with the decision to review the case again. Stevens agreed, however, with the Court's present conclusion that the failure to present additional mitigating evidence probably did not affect the outcome.


2009 term per curiam opinions of the Supreme Court of the United States, Porter v. McCollum
558 U.S. 30 Decided November 30, 2009. Eleventh Circuit reversed and remanded.


2009 term per curiam opinions of the Supreme Court of the United States, Porter v. McCollum
The Supreme Court reversed the death sentence of a Korean War veteran who suffered from post-traumatic stress disorder, ruling that his defense attorney's failure to uncover or present any mitigating evidence regarding his military service or his mental health deprived him of the effective assistance of counsel in violation of the Sixth Amendment.


2009 term per curiam opinions of the Supreme Court of the United States, Porter v. McCollum
Porter was convicted in 1987 of murdering his ex-girlfriend and her boyfriend in Melbourne, Florida. He represented himself at trial, but eventually pleaded guilty and then was represented by a court-appointed attorney during the penalty phase. That attorney failed to uncover or present any evidence of Porter's mental health, his family background, or his military service. The sum total of the mitigating evidence presented was instead inconsistent testimony about Porter's behavior when intoxicated and testimony that Porter had a good relationship with his son. The jury recommended a sentence of death.


2009 term per curiam opinions of the Supreme Court of the United States, Porter v. McCollum
Porter filed a postconviction petition in 1995. The reviewing state trial court conducted a 2-day evidentiary hearing, during which Porter presented extensive mitigating evidence that was apparently unknown to his penalty-phase attorney. His siblings testified to the physical abuse Porter suffered from their father and witnessed towards his mother. Porter enlisted in the Army at age 17 to fight in the Korean War, and his company commander testified at the hearing regarding his service. Porter fought in the brutal battles of Kunuri and Chipyong, was wounded twice, and earned medals for his service.


2009 term per curiam opinions of the Supreme Court of the United States, Porter v. McCollum
The trial court denied his postconviction petition, not reaching the issue of whether his attorney's performance was deficient, but finding that the failure to present this evidence did not prejudice Porter at trial. It discounted the evidence of his military service in light of his AWOL periods. The Florida Supreme Court affirmed. Porter next filed a petition for habeas relief in federal court. The District Court granted his petition, granting him a new sentencing hearing. The Eleventh Circuit reversed, in deference to the state court's judgment.


2009 term per curiam opinions of the Supreme Court of the United States, Porter v. McCollum
In reversing, the Supreme Court held that the decision of Porter's attorney not to investigate did not reflect reasonable professional judgment.


2009 term per curiam opinions of the Supreme Court of the United States, Porter v. McCollum
Regarding the second prong of the Strickland test, whether that deficiency prejudiced the results of Porter's trial, the judge and jury at Porter’s original sentencing heard almost nothing that would humanize Porter or allow them to accurately gauge his moral culpability.


2009 term per curiam opinions of the Supreme Court of the United States, Porter v. McCollum
Our Nation has a long tradition of according leniency to veterans in recognition of their service, especially for those who fought on the front lines as Porter did. Moreover, the relevance of Porter’s extensive combat experience is not only that he served honorably under extreme hardship and gruesome conditions, but also that the jury might find mitigating the intense stress and mental and emotional toll that combat took on Porter. Porter, slip op. at 14.


2009 term per curiam opinions of the Supreme Court of the United States, Michigan v. Fisher
558 U.S. 45 Decided December 7, 2009. Court of Appeals of Michigan reversed and remanded.


2009 term per curiam opinions of the Supreme Court of the United States, Michigan v. Fisher
Jeremy Fisher was charged under Michigan law with assault with a dangerous weapon and possession of a firearm during the commission of a felony, namely pointing a long gun at a police officer who was opening Fisher's front door to enter without a warrant. The trial court suppressed the officer's statement on Fourth Amendment grounds. The Michigan Court of Appeals remanded for an evidentiary hearing, and the trial court reinstated its order to suppress. The Court of Appeals affirmed. The Michigan Supreme Court initially granted and then denied leave to appeal.


2009 term per curiam opinions of the Supreme Court of the United States, Michigan v. Fisher
The U.S. Supreme Court reversed and remanded, ruling that the officer's attempted entry was a reasonable exception to the Fourth Amendment prohibition against unreasonable searches.


2009 term per curiam opinions of the Supreme Court of the United States, McDaniel v. Brown
558 U.S. 120 Decided January 11, 2010. Ninth Circuit reversed and remanded.


2009 term per curiam opinions of the Supreme Court of the United States, McDaniel v. Brown
The Court had originally granted certiorari and scheduled the case for argument, but then removed it from the calendar and decided it purely on the briefs.


2009 term per curiam opinions of the Supreme Court of the United States, Hollingsworth v. Perry
558 U.S. 183 Decided January 13, 2010. Application for stay granted.


2009 term per curiam opinions of the Supreme Court of the United States, Hollingsworth v. Perry
Breyer filed a dissent, joined by Stevens, Ginsburg, and Sotomayor.


2009 term per curiam opinions of the Supreme Court of the United States, Presley v. Georgia
558 U.S. 209 Decided Decided January 19, 2010. Supreme Court of Georgia reversed and remanded.


2009 term per curiam opinions of the Supreme Court of the United States, Wellons v. Hall
558 U.S. 220 Decided January 19, 2010. Eleventh Circuit vacated and remanded.


2009 term per curiam opinions of the Supreme Court of the United States, Wellons v. Hall
Scalia filed a dissent, joined by Thomas. Alito filed a dissent, joined by Roberts.


2009 term per curiam opinions of the Supreme Court of the United States, Wilkins v. Gaddy
559 U.S. 34 Decided February 22, 2010. Fourth Circuit reversed and remanded.


2009 term per curiam opinions of the Supreme Court of the United States, Thaler v. Haynes
559 U.S. 43 Decided February 22, 2010. Fifth Circuit reversed and remanded.


2009 term per curiam opinions of the Supreme Court of the United States, Thaler v. Haynes
Anthony Cardell Haynes was tried in a Texas court after the murder of a police officer.


2009 term per curiam opinions of the Supreme Court of the United States, Kiyemba v. Obama
559 U.S. 131 Decided March 1, 2010. District of Columbia Circuit vacated and remanded.


2009 term per curiam opinions of the Supreme Court of the United States, Kiyemba v. Obama
Twenty-two members of a Chinese ethnic minority called Uighurs were captured by U.S. forces at a terrorist training camp shortly after the beginning of the Afghanistan War. They were imprisoned at the Guantanamo Bay detention camp despite the fact that they were not designated enemy combatants. U.S. law prevents them from being released back to China because, as terrorists, they would be tortured or executed.


2009 term per curiam opinions of the Supreme Court of the United States, Kiyemba v. Obama
The Uighars challenged their detention on the basis of habeas corpus, demanding their freedom even if it meant releasing them into the U.S. Meanwhile, the detainees have received at least one offer of resettlement in another country. All but five have accepted those offers. The remaining five have in fact rejected two such offers.


2009 term per curiam opinions of the Supreme Court of the United States, Kiyemba v. Obama
No court had yet ruled on this case in light of the offers of resettlement. Therefore the Supreme Court declined to rule on the question of whether a federal court has the right to release the prisoners held at Guantanamo Bay. "We are a court of review, not of first view."


2009 term per curiam opinions of the Supreme Court of the United States, Robertson v. United States ex rel. Watson
560 U.S. 272 Argued March 31, 2010.Decided May 24, 2010. The Court dismissed the writ of certiorari as improvidently granted.


2009 term per curiam opinions of the Supreme Court of the United States, Robertson v. United States ex rel. Watson
Roberts filed a dissent, joined by Scalia, Kennedy, and Sotomayor. Sotomayor filed a dissent, joined by Kennedy, to clarify her understanding of the rule the Chief Justice proposed in his opinion.


2009 term per curiam opinions of the Supreme Court of the United States, Jefferson v. Upton
560 U.S. 284 Decided May 24, 2010. Eleventh Circuit vacated and remanded.


2009 term per curiam opinions of the Supreme Court of the United States, Jefferson v. Upton
Lawrence Jefferson was sentenced to death for a capital crime. He subsequently argued in state and then federal court that his lawyers had been constitutionally inadequate because they failed to investigate a traumatic head injury he sustained as a child. This injury may have caused abnormal behavior leading to limited or no impulse control.


2009 term per curiam opinions of the Supreme Court of the United States, Jefferson v. Upton
In state court his lawyers explained that they did not pursue testing of the head injury because the case mental health expert had told them verbally that further testing was a waste of time. This explanation is disputed by the expert himself. The state court held that the defense lawyers made a reasonable investigation into his mental health and thus Jefferson's claim was rejected.


2009 term per curiam opinions of the Supreme Court of the United States, Jefferson v. Upton
Under federal law, facts found by the state must be presumed correct, unless any of eight criteria are met, as outlined in Townsend v. Sain. On appeal, the Eleventh Circuit upheld the ruling of the state court because they were "duty bound" to accept their factual findings.


2009 term per curiam opinions of the Supreme Court of the United States, Jefferson v. Upton
The Supreme Court found that the federal court incorrectly upheld the decision of the state court because they failed to consider seven of the eight criteria. The case was remanded back to the federal court to reconsider whether or not to accept the factual evidence found by the state by applying all eight criteria.


2009 term per curiam opinions of the Supreme Court of the United States, Sears v. Upton
561 U.S. 945 Decided June 29, 2010. Supreme Court of Georgia vacated and remanded.


2009 term per curiam opinions of the Supreme Court of the United States, Sears v. Upton
Having found Demarcus Ali Sears guilty of a capital crime, a Georgia court sentenced him to death despite several mitigating circumstances, including a severe cognitive impairment and an abusive childhood. Most of these mitigating circumstances were never brought out by the defense attorney during the sentencing phase of the trial. A lower court ruled that the Sears' claim of ineffective assistance of counsel, in violation of the Sixth Amendment, failed the two-prong test under Strickland v. Washington.


2009 term per curiam opinions of the Supreme Court of the United States, Sears v. Upton
The two parts of the test are to show that the defense was inadequate and to show that this prejudiced the outcome of the trial. The lower court ruled that although the defense attorney clearly provided an inadequate defense, there was no way to know – without speculation – whether that might have prejudiced the sentencing phase of the trial.


2009 term per curiam opinions of the Supreme Court of the United States, Sears v. Upton
The Supreme Court vacated the judgment of the lower court and required them to reconsider the claim. Proper application of the prejudice test of Strickland v. Washington "requires precisely the type of probing and fact-specific analysis that the state trial court failed to undertake." Courts must undertake a point-by-point investigation of the deficiencies in the defense and reweigh the likely outcome. Courts may not perform a cursory analysis and claim that there is no way to know how the inadequate defense might have affected the outcome of the trial.


2009 term per curiam opinions of the Supreme Court of the United States, Sears v. Upton
Roberts and Alito noted without separate opinion that they would deny the petition for a writ of certiorari. Scalia filed a dissent, joined by Thomas.


2009 timeline of the Somali Civil War
The 2009 timeline of events in the Somalia War (2006–2009) during January 2009 is set out below. From the beginning of February the timeline of events in the Somali Civil War (2009–present) is set out following the conclusion of the previous phase of the civil war.


2009 timeline of the Somali Civil War, Casualties
*The number includes policemen, militiamen and intelligence personnel**Other soldiers killed: 8  Ugandan 16  Burundi***Other civilians killed: 2  Ethiopian 1  French


2009 timeline of the Somali Civil War, January, January 1, 2009
In Afgoi District eighteen miles south of Mogadishu a Somali journalist covering fighting between al-Shabaab members and a moderate Islamist group was shot and killed in the cross-fire of a vicious firefight. No other casualties are known.


2009 timeline of the Somali Civil War, January, January 1, 2009
A Transitional Federal Government parliamentarian was assassinated in Baidoa as the TFG's care-taker President promised the appointment of a new President soon as attacks increase on TFG and Ethiopian soldiers.


2009 timeline of the Somali Civil War, January, January 1, 2009
Insurgents attacked and killed eight civilians in an attack on Bakara Market.


2009 timeline of the Somali Civil War, January, January 2, 2009
A roadside bomb exploded killing two Ethiopian soldiers hours before Ethiopian troops began to withdraw from the capital of Mogadishu. Soldiers then opened fire into a crowd of civilians killing at least 5.


2009 timeline of the Somali Civil War, January, January 2, 2009
Four assassinations were carried out in Mogadishu and Baidoa killing two TFG government officials and two civilians, including a powerful Sufi sheik.


2009 timeline of the Somali Civil War, January, January 3, 2009
Fighting occurred in northern Somalia in the community of Guri'el 270 miles north of Mogadishu between Sufi militiamen nominally in support of the transitional government under the banner of Ahlu Sanah Waljama'ah against Al Shabaab insurgents that resulted in the deaths of six people mostly on each side except for one civilian that had been shot to death earlier in the day by Ethiopian soldiers.


2009 timeline of the Somali Civil War, January, January 4, 2009
A roadside bomb on the outskirts of Mogadishu killed four Ethiopian soldiers as they were heading out of the city on a military withdrawal convoy. Elsewhere in Mogadishu three civilians were shot to death by mutinous TFG soldiers who were trying to extort these civilians and soon after the shooting other government soldiers opened fire on the mutinous soldiers resulting in the deaths of two TFG soldiers, not known if they were mutineers or TFG supporters.


2009 timeline of the Somali Civil War, January, January 5, 2009
40 civilians were confirmed killed in recent fighting in the Galgaduud region.


2009 timeline of the Somali Civil War, January, January 5, 2009
Also, a brief firefight erupted in Qansah Dheere resulting in the death of one Ethiopian soldier that was assisting the takeover of the town from Al Shabaab militants. Al Shabaab withdrew and there isn't any information on insurgent casualties.


2009 timeline of the Somali Civil War, January, January 6, 2009
A roadside bomb on the outskirts of Mogadishu struck a Ugandan patrol vehicle killing one Ugandan soldier and injuring another. In south-western Somalia gunmen shot and killed a World Food Program officer.


2009 timeline of the Somali Civil War, January, January 6, 2009
In Guriel, fighting between insurgents and government backed moderate militiamen resulted in the deaths of six people, four believed to be militiamen and two thought to be Al Shabaab insurgents.


2009 timeline of the Somali Civil War, January, January 7, 2009
A roadside bomb exploded in the community of Towflig in the Yagshid district which is north of Mogadishu killing four TFG soldiers and injuring two others.


2009 timeline of the Somali Civil War, January, January 7, 2009
On the road between Baydao and Diinsoor in the Bay region of South-western Somalia an Al-Shabaab ambush hit a militia driven out of Kismayo in September and Ethiopian troops in support of the militia. This militia is independent of the transitional government and it has recently seized at least two towns in the Bay Region to further the conflict with Ethiopian backing. In this attack insurgents reported heavy enemy casualties, 3 militiamen, 2 Ethiopians seen dead and a fellow insurgent killed in the exchange of fire.


2009 timeline of the Somali Civil War, January, January 8, 2009
A Somali national working for the World Food Program was shot and killed in the village of Daynile. His body was placed into a vehicle after he was shot and then dumped on the highway where other aid workers collected it. This is the second U.N official killed in Somalia this week.


2009 timeline of the Somali Civil War, January, January 8, 2009
Fighting in Mogadishu between government soldiers and Al Shabaab insurgents left one soldier dead and another seriously wounded.


2009 timeline of the Somali Civil War, January, January 9, 2009
In the district of Cabud Waaq an Islamic Court Union official was shot and killed and another seriously injured.


2009 timeline of the Somali Civil War, January, January 9, 2009
The mayor of Garbaharey town in Gedo region where fighting has been ongoing between al-Shabaab forces and Ethiopians for the last two weeks and resulted in the deaths of 5 bodyguards.


2009 timeline of the Somali Civil War, January, January 10, 2009
A small skiff connected with the ransoming of a Saudi supertanker capsized killing five pirates in the Sea of Aden.


2009 timeline of the Somali Civil War, January, January 10, 2009
The town of Balad 45 kilometers east of Mogadishu fell to heavy-armed Islamic Court Union (ICU) forces after an intense firefight with Al Shabaab militants. Four civilians are reported dead and an unknown number, thought to be high, dead on both insurgent sides.


2009 timeline of the Somali Civil War, January, January 11, 2009
The town of Guriel was occupied by Sufi transitional government militiamen early this morning after Al Shabaab fighters left the town thinking Ethiopian troops were coming. At day break, Al Shabaab fighters returned to the town and retook the community from government forces leaving 41 fighters dead in total, 25 suspected TFG fighters and 16 Al Shabaab fighters.


2009 timeline of the Somali Civil War, January, January 11, 2009
In Mogadishu, three government soldiers were shot and killed in the K4 area of the city in fighting that also left two insurgents dead, the four remaining insurgents who attacked the soldiers grabbed rifles and ammunition from their corpses before other troops arrived on the scene. A rocket-propelled grenade struck an Ethiopian convoy in another part of the city killing three Ethiopian soldiers. Elsewhere 4 civilians were killed in a grenade attack.


2009 timeline of the Somali Civil War, January, January 12, 2009
Islamic insurgents launched mortars onto the Presidential Palace in Mogadishu when Prime Minister Hussein was in the building resulting in a government return of fire into Bakara market that resulted in the deaths of 8 civilians. In total, 2 Somali soldiers and 3 more civilians were killed in the mortar attack on the palace.


2009 timeline of the Somali Civil War, January, January 12, 2009
Meanwhile, in fighting 12 kilometers north of Bardhere town in southern Somalia 9 fighters, including at least 5 insurgents, were killed. The fighting occurred on Kilaliyow Mountain and Ethiopian and Somali troops were victorious.


2009 timeline of the Somali Civil War, January, January 13, 2009
Ethiopian troops started to withdraw from Mogadishu, pulling out of their two main bases in the city overnight, and were heading back into Ethiopia. There were scenes of jubilation among Mogadishu residents as the troops left.


2009 timeline of the Somali Civil War, January, January 14, 2009
Insurgents fired mortars at the presidential palace in Mogadishu to which government forces retaliated with their own mortar fire which killed five civilians. Also, in fighting in the Wardigley district another nine civilians were killed.


2009 timeline of the Somali Civil War, January, January 15, 2009
Fighting between Al Shabaab forces and a government backed militia in the Lower Shabelle region of KM60 resulted in the deaths of 7 Somali militiamen and 2 Al Shabaab insurgents and the capture of at least 100 militiamen as prisoners. In Bardhere Town SW Somalia an explosion killed 4 Somali militiamen including a commander and killed 2 civilians and injured two civilians.


2009 timeline of the Somali Civil War, January, January 16, 2009
Abdirahaman Xaji Mohamed known as Wadiiro was executed in Kisamayo by Islamic insurgents after being convicted in a kangaroo setting of being against the Al Shabaab government in the Lower Shabelle region. He was then shot and killed by gunmen.


2009 timeline of the Somali Civil War, January, January 17, 2009
310 civilians in two different incidents drowned trying to cross the Sea of Aden to Yemen from Somalia directly linked to the anarchy of President Yusuf's resignation and the resurgent Al Shabaab insurgents and subsequent pull-out of Ethiopian soldiers.


2009 timeline of the Somali Civil War, January, January 18, 2009
Al Shabaab insurgents launched mortar shells at AU peacekeepers in Mogadishu killing 2 civilians and injuring nine other people.


2009 timeline of the Somali Civil War, January, January 19, 2009
Islamist insurgents re-capture the town of Bardhere after Ethiopian troops withdraw from the town.


2009 timeline of the Somali Civil War, January, January 19, 2009
Islamic fighters attacked government militiamen in Mogadishu at an illegal checkpoint resulting in a heavy fire fight of heavy weapons that claimed the lives of two civilians in the cross-fire. Insurgents took over the checkpoint but withdrew when government forces began arriving.


2009 timeline of the Somali Civil War, January, January 20, 2009
Two battles occurred in Mogadishu resulting in the capture of a government checkpoint by Islamist insurgents in the Sinay district and the push back by government forces in the Madina district resulting in the deaths of 5 soldiers, 1 insurgent and at least 6 civilians.


2009 timeline of the Somali Civil War, January, January 24, 2009
A suicide car-bomb intended for AU peacekeepers in the capital exploded killing 17 civilians. No AU soldiers were hurt or killed. An ensuing gunfight left another four civilians and one policeman dead.


2009 timeline of the Somali Civil War, January, January 26, 2009
Both ARS wings (Asmara and Djibouti) call for an end to fighting in Mogadishu and dialogue over the presence of AU forces in the capital. Islamist forces take Baidoa, the last major city controlled by the Transitional Government. Pro -Government (or rather anti-Islamist) forces remain in control of a corridor of territory along the border with Ethiopia, and most of Gedo and Bakool.


2009 timeline of the Somali Civil War, January, January 26, 2009
Fighting between victorious Al Shabaab militants and government soldiers in the capture of Baidoa left four government soldiers dead and a number of them taken prisoner by the Al Shabaab Islamists. However, by decree all Somali soldiers that were captured in the battle were released by the Islamists and local clan elders told civilians in Baidoa to continue "life as before".


2009 timeline of the Somali Civil War, January, January 27, 2009
Police and military units connected to TFG politicians personal clans have entered into Baidoa to fight Al Shabaab militants but have turned on each other over clan differences. Explosions and heavy fighting has been heard and at least five civilians have been killed and ten combatants wounded. Al Shabaab is getting a hold of the situation.


2009 timeline of the Somali Civil War, January, January 28, 2009
Fighting between two clans in Central Somalia killed five civilians in each clash. Tribal elders had earlier tried to end hostilities between both sides and it unknown why the fighting began.


2009 timeline of the Somali Civil War, January, January 29, 2009
Fighting in Central Somalia has left four people dead after government-allied Sufi militiamen took over a community from Al Shabaab forces.


2009 timeline of the Somali Civil War, February, February 2, 2009
A roadside bomb was detonated by an AU convoy in the capital of Somalia killing three civilians and injuring a Ugandan AU peacekeeper. Peacekeepers then opened fire onto several buses filled with Somali's killing at least 36 more civilians.


2009 timeline of the Somali Civil War, February, February 3, 2009
Amisom soldiers are being blamed for several deaths in the Mogadishu area after Somali fishermen reported that their boats have been fired on by African Union peacekeepers killing several people in the last few days.


2009 timeline of the Somali Civil War, February, February 4, 2009
Tahlil Ahmed, a journalist for HornAfrik was shot and killed in the capital of Mogadishu.


2009 timeline of the Somali Civil War, February, February 5, 2009
Two pirates were shot and killed in an ongoing feud between several pirate gangs in Puntland. Puntland authorities quickly arrested the attackers and are holding them for their own protection for fear of retaliation.


2009 timeline of the Somali Civil War, February, February 5, 2009
Sheik Hussein Khalif was killed in Central Somalia in a targeted slaying by unknown gunmen along with a second civilian. He is the second religious leader in 2009 to be killed.


2009 timeline of the Somali Civil War, February, February 8, 2009
Fighting in Mogadishu between AU peacekeepers and Al Shabaab insurgents resulted in their deaths of three civilians.


2009 timeline of the Somali Civil War, February, February 10, 2009
At least three people were killed when Islamist insurgents of Al-Shabaab and government soldiers fought near Hudur district in Bakool region, after Al-Shabaab launched an offensive to take the region and reached its capital. Residents say the dead were all combatants from the warring sides who were using heavy gunfire. Government forces captured the town from Al Shabaab fighters. Four people were killed after Al Shabaab got involved in between two different tribal groups. Elders have put an end to the fighting in central Somalia.


2009 timeline of the Somali Civil War, February, February 12, 2009
2 Civilians killed as Al-Shabaab launches 11 mortars into the Mogadishu sea port.


2009 timeline of the Somali Civil War, February, February 15, 2009
Three children were killed in an intentionally set fire in southern Somalia.


2009 timeline of the Somali Civil War, February, February 17, 2009
One civilian businessman was shot and killed in Bossasso Puntland similarly eerily to attacks on business people in Bakara Market in Mogadishu during the Ethiopian occupation. None of the gunmen were caught.


2009 timeline of the Somali Civil War, February, February 20, 2009
One civilian was shot in an exchange between insurgents and AU peacekeepers in Mogadishu.


2009 timeline of the Somali Civil War, February, February 21, 2009
Fighting in Afgoye town has killed one security guard and an insurgent


2009 timeline of the Somali Civil War, February, February 22, 2009
Two Al Shabaab insurgents blew themselves up at a Burundian camp for AU peacekeepers in Mogadishu killing 11 Burundian soldiers.


2009 timeline of the Somali Civil War, February, February 23, 2009
Fighting occurred in Mogadishu killing two civilians and one TFG government soldier. Fighting was between two different government factions.


2009 timeline of the Somali Civil War, February, February 24–25, 2009
In two days of fighting in Mogadishu 48 civilians were killed along with at least 15 insurgents and 6 TFG policemen as AU peacekeepers and TFG forces tried to take control of the capital from Al Shabaab and other Islamist forces.


2009 timeline of the Somali Civil War, February, February 24–25, 2009
In the Gulf of Aden a ship carrying Somali refugees sank resulting in the deaths of at least 17 civilians.


2009 timeline of the Somali Civil War, February, February 24–25, 2009
In Galgadud region a water shortage hampered by fighting in the region has killed at least two children as reported by village elders.


2009 timeline of the Somali Civil War, February, February 25, 2009
In North-western Somalia in the town of Hudor Al Shabaab took over the community from TFG-led forces resulting in the deaths of 10 TFG soldiers, six Al Shabaab insurgents and at least four civilians. This is in addition to the heavy fighting in Mogadishu.


2009 timeline of the Somali Civil War, February, February 28, 2009
A boat with Somali refugees sank in the coastal waters of Yemen leaving 45 people dead.


2009 timeline of the Somali Civil War, February, February 28, 2009
The Somali transitional government has signed a cease-fire and a truce with a four-party Islamist group called Hizbul Ismal leaving only Al Shabaab and foreign Mujahedeen as the enemies of the Transitional Government. From today, the government of Somalia will be run by Sharia law.


2009 timeline of the Somali Civil War, March, March 3, 2009
In Somaliland an Islamic cleric aged 80 was killed in the capital of the semi-separatist region.


2009 timeline of the Somali Civil War, March, March 4, 2009
Fighting in north-eastern province of Puntland resulted in the deaths of two militiamen and two civilians after two different clan militias fought it out in a small village.


2009 timeline of the Somali Civil War, March, March 5, 2009
An Iman in the southern city of Gelkcayo was shot and killed by Al Shabaab gunmen.


2009 timeline of the Somali Civil War, March, March 6, 2009
Al Shabaab militants attacked Au peacekeepers in Mogadishu killing 3 civilians.


2009 timeline of the Somali Civil War, March, March 6, 2009
Fighting near an oil exploration site by foreign workers left five fighters from two different clans dead and resulted in evacuation of site.


2009 timeline of the Somali Civil War, March, March 8, 2009
Cholera outbreak in Middle Shabelle Region. This is on top of three children last month.


2009 timeline of the Somali Civil War, March, March 10, 2009
At a checkpoint in the semi-autonomous region of Puntland an explosion at a police checkpoint killed seven Somali police officers and three civilians and injured at least two dozen other people.


2009 timeline of the Somali Civil War, March, March 11, 2009
A landmine detonated in Mogadishu killing a former Somali parliamentarian and three soldiers.


2009 timeline of the Somali Civil War, March, March 13, 2009
Burundi soldiers were attacked in the capital of Mogadishu by Al Shabaab insurgents resulting in the death of two fighters and the injuring of eight other people, 7 civilian, and 1 peacekeeper.


2009 timeline of the Somali Civil War, March, March 14, 2009
A mass grave was reported found by Al Shabaab militants in Baidoa and they reported that the bodies of 12 Muslim men, several wearing the religious clothing of Imams were found in a mass grave. Al Shabaab quickly blamed Ethiopian soldiers for the massacre.


2009 timeline of the Somali Civil War, March, March 14, 2009
A roadside bomb in Mogadishu killed three Somali soldiers and a civilian.


2009 timeline of the Somali Civil War, March, March 15, 2009
A pro-government militia took Wabho town in central Somalia from Al Shabaab militants killing eight insurgents in the fight for the town while losing two fighters and a civilian was killed in the cross fire. Ahlu Sunna Waljamaca fighters are currently heading to the Al Shabaab main base in El Bur. Al Shabaab has recently reinforced its central region forces as its control of Central Somalia is weak and close to collapse.


2009 timeline of the Somali Civil War, March, March 15, 2009
Ahlu Sunna Waljamaca fighters continued their offensive against Al Shabaab militants in Central Somalia after the capture of Wabho town following that victory with the capture of Dac, a small nomadic village near Wabho town. The fighting in Dac left four Al Shabaab fighters and two moderate Islamists dead.


2009 timeline of the Somali Civil War, March, March 15, 2009
A bomb exploded in Mogadishu killing a civilian driver and wounding three Somali officials riding in the vehicle.


2009 timeline of the Somali Civil War, March, March 17, 2009
Fighting occurred between factions in the Islamic Courts Union in Bedelwyen town in Central Somalia. One Islamist and one civilian were killed in the fighting.


2009 timeline of the Somali Civil War, March, March 18, 2009
Fighting in southwestern Somalia in the town of Radhure left 16 TFG soldiers and one Al Shabaab insurgent dead.


2009 timeline of the Somali Civil War, March, March 19, 2009
Ahmed Hussein of the U.N World Food Program was shot and killed in Mogadishu by two young gunmen.


2009 timeline of the Somali Civil War, March, March 19, 2009
A roadside bomb in Mogadishu killed one AU peacekeeper and wounded two others.


2009 timeline of the Somali Civil War, March, March 19, 2009
In Balad town, north of Mogadishu it was reported by Reuters that two moderate Islamist leaders were executed by Al Shabaab militants.