2009 swine flu pandemic, Epidemiology, Mexico
Mexico already had hundreds of non-lethal cases before the outbreak was officially discovered, and was therefore in the midst of a "silent epidemic". As a result, Mexico was reporting only the most serious cases which showed more severe signs different from those of normal flu, possibly leading to a skewed initial estimate of the case fatality rate.


2009 swine flu pandemic, Epidemiology, United States
The new strain was first identified by the CDC in two children, neither of whom had been in contact with pigs. The first case, from San Diego County, California, was confirmed from clinical specimens (nasopharyngeal swab) examined by the CDC on 14 April 2009. A second case, from nearby Imperial County, California, was confirmed on 17 April. The patient in the first confirmed case had flu symptoms including fever and cough upon clinical examination on 30 March and the second on 28 March.


2009 swine flu pandemic, Epidemiology, United States
The first confirmed H1N1/09 pandemic flu death, which occurred at Texas Children's Hospital in Houston, Texas, was of a toddler from Mexico City who was visiting family in Brownsville, Texas, before being air-lifted to Houston for treatment. The Infectious Diseases Society of America estimated that the total number of deaths in the U.S. was 12,469.


2009 swine flu pandemic, Epidemiology, Data reporting and accuracy
Influenza surveillance information "answers the questions of where, when, and what influenza viruses are circulating. Sharing of such information is especially crucial during an emergent pandemic as in April 2009, when the genetic sequences of the initial viruses were rapidly and openly shared via the GISAID Initiative within days of identification, playing a key role in facilitating an early response to the evolving pandemic. Surveillance is used to determine if influenza activity is increasing or decreasing, but cannot be used to ascertain how many people have become ill with influenza."


2009 swine flu pandemic, Epidemiology, Data reporting and accuracy
For example, as of late June, influenza surveillance information showed the U.S. had nearly 28,000 laboratory-confirmed cases including 3,065 hospitalizations and 127 deaths. But mathematical modelling showed an estimated 1 million Americans had the 2009 pandemic flu at the time, according to Lyn Finelli, a flu surveillance official with the CDC. Estimating deaths from influenza is also a complicated process. In 2005, influenza only appeared on the death certificates of 1,812 people in the US. The average annual US death toll from flu is, however, estimated to be 36,000. The CDC explains: "[I]nfluenza is infrequently listed on death certificates of people who die from flu-related complications" and hence, "Only counting deaths where influenza was included on a death certificate would be a gross underestimation of influenza's true impact."


2009 swine flu pandemic, Epidemiology, Data reporting and accuracy
Influenza surveillance information on the 2009 H1N1 flu pandemic is available, but almost no studies attempted to estimate the total number of deaths attributable to H1N1 flu. Two studies were carried out by the CDC; the later of them estimated that between 7,070 and 13,930 deaths were attributable to H1N1 flu from April to 14 November 2009. During the same period, 1,642 deaths were officially confirmed as caused by H1N1 flu. The WHO stated in 2010 that total mortality (including unconfirmed or unreported deaths) from H1N1 flu was "unquestionably higher" than their own confirmed death statistics.


2009 swine flu pandemic, Epidemiology, Data reporting and accuracy
The initial outbreak received a week of near-constant media attention. Epidemiologists cautioned that the number of cases reported in the early days of an outbreak can be very inaccurate and deceptive, due to several causes, among them selection bias, media bias and incorrect reporting by governments. Inaccuracies could also be caused by authorities in different countries looking at differing population groups. Furthermore, countries with poor health care systems and older laboratory facilities may take longer to identify or report cases.


2009 swine flu pandemic, Epidemiology, Data reporting and accuracy
"[E]ven in developed countries the [numbers of flu deaths] are uncertain, because medical authorities don't usually verify who actually died of influenza and who died of a flu-like illness". Joseph S. Bresee, then CDC flu division's epidemiology chief and Michael Osterholm, director of the Center for Infectious Disease Research and Policy pointed out that millions of people have had H1N1 flu, usually in a mild form, so the numbers of laboratory-confirmed cases were actually meaningless, and in July 2009, the WHO stopped keeping count of individual cases and focused more on major outbreaks.


2009 swine flu pandemic, Epidemiology, Follow-up
A Wisconsin study published in the Journal of the American Medical Association in September 2010, reported that findings showed that the 2009 H1N1 flu was no more severe than the seasonal flu. "The risk of most serious complications was not elevated in adults or children", the study's authors wrote. "Children were disproportionately affected by 2009 H1N1 infection, but the perceived severity of symptoms and risk of serious outcomes were not increased." Children infected in the 2009 H1N1 flu pandemic were no more likely to be hospitalized with complications or get pneumonia than those who catch seasonal strains. About 1.5% of children with the H1N1 swine flu strain were hospitalized within 30 days, compared with 3.7% of those sick with a seasonal strain of H1N1 and 3.1% with an H3N2 virus.


2009 swine flu pandemic, Epidemiology, Follow-up
CDC illness and death estimates from April 2009 to April 2010, in the US are as follows:


2009 swine flu pandemic, Epidemiology, Follow-up
It has been stated that about 36,000 die from the seasonal flu in the U.S. each year, and this is frequently understood as an indication that the H1N1 strain was not as severe as seasonal influenza. The 36,000 estimate was presented in a 2003 study by CDC scientists and refers to a period from 1990 to 1991 through 1998–99. During those years, the number of estimated deaths ranged from 17,000 to 52,000, with an average of about 36,000.


2009 swine flu pandemic, Epidemiology, Follow-up
Throughout that decade, influenza A (H3N2) was the predominant virus during most of the seasons, and H3N2 influenza viruses are typically associated with higher death rates. The JAMA study also looked at seasonal influenza-associated deaths over a 23-year period, from 1976 to 1977 and 1998–99 with estimates of respiratory and circulatory influenza-associated deaths ranging from about 5,000 to about 52,000, and an average of about 25,000. CDC believes that the range of deaths over the past 31 years (~3,000 to ~49,000) is a more accurate representation of the unpredictability and variability of flu-associated deaths. The annual toll from seasonal influenza in the US between 1979 and 2001 is estimated at 41,400 deaths on average. Therefore, the H1N1 pandemic estimated mortality of 8,870 to 18,300 is just below the mid-range of estimates.


2009 swine flu pandemic, Epidemiology, Follow-up
The 2009 pandemic caused US hospitals to make significant preparations in terms of hospital surge capacities, especially within the emergency department and among vulnerable populations. In many cases, hospitals were relatively successful in making sure that those patients most severely affected by the influenza strain were able to be seen, treated, and discharged in an efficient manner. A case-study of the preparation, planning, mitigation, and response efforts during the fall of 2009 is that of the Children's Hospital of Philadelphia (CHOP) which took several steps to increase the emergency department (ED) surge capacity response.


2009 swine flu pandemic, Epidemiology, Follow-up
CHOP used portions of the main lobby area as an ED waiting room; several of the region's hospital-based outpatient facilities were in use during evening and weekend hours for non-emergency cases; the ED's 24-hour short-stay unit was utilized to care for ED patients in a longer-term capacity; non-board certified physicians (in pediatric emergency medicine) and inpatient-unit medical nurses were utilized for ED patient care; hospital units normally utilized for other medical or therapeutic purposes were transformed into ED patient rooms; and rooms normally used for only one patient were expanded to at least a capacity of 2.


2009 swine flu pandemic, Comparisons to other pandemics and epidemics
Annual influenza epidemics are estimated to affect 5–15% of the global population. Although most cases are mild, these epidemics still cause severe illness in 3–5 million people and 290,000–650,000 deaths worldwide every year. On average 41,400 people die of influenza-related illnesses each year in the United States, based on data collected between 1979 and 2001. In industrialised countries, severe illness and deaths occur mainly in the high-risk populations of infants, the elderly and chronically ill patients, although the H1N1 flu outbreak (like the 1918 Spanish flu) differs in its tendency to affect younger, healthier people.


2009 swine flu pandemic, Comparisons to other pandemics and epidemics
In addition to these annual epidemics, Influenza A virus strains caused three global pandemics during the 20th century: the Spanish flu in 1918, Asian flu in 1957, and Hong Kong flu in 1968–69. These virus strains had undergone major genetic changes for which the population did not possess significant immunity.


2009 swine flu pandemic, Comparisons to other pandemics and epidemics
Recent genetic analysis has revealed that three-quarters, or six out of the eight genetic segments, of the 2009 flu pandemic strain arose from the North American swine flu strains circulating since 1998, when a new strain was first identified on a factory farm in North Carolina, and which was the first-ever reported triple-hybrid flu virus.


2009 swine flu pandemic, Comparisons to other pandemics and epidemics
The Spanish flu began with a wave of mild cases in the spring, followed by more deadly waves in the autumn, eventually killing hundreds of thousands in the United States and 50–100 million worldwide. The great majority of deaths in the 1918 flu pandemic were the result of secondary bacterial pneumonia. The influenza virus damaged the lining of the bronchial tubes and lungs of victims, allowing common bacteria from the nose and throat to infect their lungs. Subsequent pandemics have had many fewer fatalities due to the development of antibiotic medicines which can treat pneumonia.


2009 swine flu pandemic, Comparisons to other pandemics and epidemics
The influenza virus has caused several pandemic threats over the past century, including the pseudo-pandemic of 1947 (thought of as mild because although globally distributed, it caused relatively few deaths), the 1976 swine flu outbreak and the 1977 Russian flu, all caused by the H1N1 subtype. The world has been at an increased level of alert since the SARS epidemic in Southeast Asia (caused by the SARS coronavirus). The level of preparedness was further increased and sustained with the advent of the H5N1 bird flu outbreaks because of H5N1's high fatality rate, although the strains currently prevalent have limited human-to-human transmission (anthroponotic) capability, or epidemicity.


2009 swine flu pandemic, Comparisons to other pandemics and epidemics
People who contracted influenza before 1957 appeared to have some immunity to H1N1 flu. According to Daniel Jernigan, head of flu epidemiology for the U.S. CDC "Tests on blood serum from older people showed that they had antibodies that attacked the new virus ... That does not mean that everyone over 52 is immune, since Americans and Mexicans older than that have died of the new flu".


2009 swine flu pandemic, Comparisons to other pandemics and epidemics
In June 2012, a model based study found that the number of deaths related to the H1N1 influenza may have been fifteen times higher than the reported laboratory confirmed deaths, with 80% of the respiratory and cardiovascular deaths in people younger than 65 years and 51% occurring in southeast Asia and Africa. A disproportionate number of pandemic deaths might have occurred in these regions and that efforts to prevent future influenza pandemics need to effectively target these regions.


2009 swine flu pandemic, Comparisons to other pandemics and epidemics
A WHO-supported 2013 study estimated that the 2009 global pandemic respiratory mortality was ~10-fold higher than the World Health Organization's laboratory-confirmed mortality count (18.631). Although the pandemic mortality estimate was similar in magnitude to that of seasonal influenza, a marked shift toward mortality among persons less than 65 years of age occurred, so that many more life-years were lost. Between 123,000 and 203,000 pandemic respiratory deaths were estimated globally for the last nine months of 2009. The majority (62–85%) were attributed to persons under 65 years of age. The burden varied greatly among countries. There was an almost 20-fold higher mortality in some countries in the Americas than in Europe. The model attributed 148,000–249,000 respiratory deaths to influenza in an average pre-pandemic season, with only 19% in persons <65 years of age.


2009 swine flu pandemic, Comparisons to other pandemics and epidemics
The ongoing COVID-19 pandemic is not caused by an influenza virus but SARS-CoV-2, a coronavirus which also primarily affects the respiratory system. As of 16 September 2021 this pandemic had more than 226 million confirmed cases worldwide, and over 4.65 million associated deaths.


2009 swine flu pandemic actions concerning pigs
In reaction to the 2009 flu pandemic, governments around the world have responded with sometimes extreme reactions against pigs, which has included the official extermination of all domestic pigs in Egypt and the culling of three wild boars at the Baghdad Zoo in Iraq. Many of these slaughters occurred in Muslim countries, and religious restrictions on the consumption of pork have been cited as influencing the decision to take such action. Many other countries have banned international trade in pigs and pork products.


2009 swine flu pandemic actions concerning pigs
The World Health Organization (WHO) has stated that there is no reason to believe that pigs are transmitting the flu to humans.


2009 swine flu pandemic actions concerning pigs
On May 2, the first incidence of transmission of the flu from humans to pigs, was discovered on a farm in Alberta, where infected pigs were discovered. It is suspected that an infected farmhand who recently returned from Mexico infected the animals.


2009 swine flu pandemic actions concerning pigs, General responses, Virus source
According to researchers cited by The New York Times, "based on its genetic structure, the new virus is without question a type of swine influenza, derived originally from a strain that lived in pigs". This origin gave rise to the nomenclature "swine flu", largely used by mass media in the first days of the epidemic. Despite this origin, the current strain is a human-to-human transmitted virus, requiring no contact with swine.


2009 swine flu pandemic actions concerning pigs, General responses, Food safety and import bans
International health officials from the CDC, WHO, FAO, OIE and other food organizations have reaffirmed that pork is safe to eat and hogs are not to blame for the epidemic. However, as of early June, China, Russia and more than a dozen other countries were still banning pork imports from the U.S. The World Trade Organization (WTO) planned to highlight the pork bans in a forthcoming report on protectionism and reiterate that pork is not a source of infection and is safe to eat provided it is prepared properly.


2009 swine flu pandemic actions concerning pigs, General responses, Food safety and import bans
Some U.S. officials speculated that the bans may be more about "market share than health concerns," and were costing the hog industry millions of dollars every week. Dave Warner, a spokesman for the Washington-based National Pork Producers Council, pointed out that long-standing disagreements with China and Russia may be a factor.


2009 swine flu pandemic actions concerning pigs, General responses, Food safety and import bans
As a result, by mid-August, pork had become the second-worst commodity investment of 2009, and may fall 33 percent by yearend. U.S. exports plunged 20 percent in the first half of 2009 and are heading for the first annual decline since 1990. Tyson Foods Inc. idled slaughterhouses, and U.S. hog farmers haven't been profitable in a year. Imports from the U.S. fell 38 percent in Russia this year and 73 percent in China, including Hong Kong, USDA data show.


2009 swine flu pandemic actions concerning pigs, General responses, Surveillance of pig populations
At the beginning of June 2009, the U.S. Agriculture Department said it would launch a pilot surveillance project to look for new strains of flu virus in pigs. Some experts claim that global health officials have underestimated the risk that pig herds might be a source of new influenza strains, choosing instead to focus on the threat of bird flu. Until recently, health experts have done very little surveillance of influenza among pigs—even though the virus is very common in the animals and just as transmissible as it is among people. Flu viruses have also been shown to pass from pigs to people and from people to pigs.


2009 swine flu pandemic actions concerning pigs, Responses by country, Afghanistan
As reported by The Daily Telegraph, Afghanistan's only pig has been taken off display in the Kabul Zoo and "quarantined" as a response to visitor's fears about contracting swine flu.


2009 swine flu pandemic actions concerning pigs, Responses by country, Argentina
A case of human-to-swine transmission was discovered in Buenos Aires province, on June 25. The hog farm where it occurred has been interdicted.


2009 swine flu pandemic actions concerning pigs, Responses by country, Canada
On May 2, Canadian Food Inspection Agency executive vice-president Brian Evans announced that an infected Alberta farm worker recently returned from Mexico had apparently passed the virus to a swine herd in his care. Although the herd had been quarantined, Evans stressed that the infection represented no threat to food safety and judged the possibility of infected pigs passing the virus back to humans "remote". Evans said the infection of the herd was the first known case of the H1N1 virus being transmitted from humans to pigs.


2009 swine flu pandemic actions concerning pigs, Responses by country, Canada
In Canada in early June, an Alberta pig farmer whose herd was infected with the new swine flu virus culled his entire herd. In May he had already culled 500 animals from his herd. The farm owner said the animals cannot be marketed because they are under quarantine and he is facing a problem with overcrowding.


2009 swine flu pandemic actions concerning pigs, Responses by country, Canada
Transmission from the same herd of pigs back to humans was revealed on 20 July, though it occurred on 7 May when the humans, animal health inspectors, were taking samples from the infected herd with improper self-protective measures.


2009 swine flu pandemic actions concerning pigs, Responses by country, Egypt
On 29 April 2009, the Egyptian Government announced the decision to slaughter all pigs in the country, roughly 300,000, despite a lack of evidence that the pigs had, or were even suspected of having, the virus. This decision reportedly raised religious tensions since pig owners are mostly in the Coptic Christian minority (5% to 10% of the population) in the predominantly Islamic nation. Egyptian human rights lawyer Nadia Tawfiq claimed that the pig extermination was a form of attack on Christians. Many international newspapers attributed the action to the global swine-flu outbreak, even though no cases of swine flu had been reported in the country.


2009 swine flu pandemic actions concerning pigs, Responses by country, Egypt
According to the Egyptian Ministry of Health (MOH) the extermination was not based on either the swine flu outbreak, nor it is against a specific group of citizens. On the Elkahira Elyoum TV show, Dr. Hatem El-Gabaly announced the pig extermination was based on the fear that the bird flu could mutate in the unkempt pig herds. The decision was reached because so many of the areas used by pig growers are specifically trash dumps and do not follow any veterinary supervision, unlike most other countries that raise pigs in a tested and controlled environment.


2009 swine flu pandemic actions concerning pigs, Responses by country, Egypt
The extra attention and urgency by the emergence of the bird flu, then the swine flu, provided an opportunity to act on a plan that had been there for several years. Josep Domènech, the chief veterinary officer at the U.N. Food and Agriculture Organization (FAO) called the decision "a real mistake", saying that FAO had been trying to reach Egyptian officials but there has been no response.


2009 swine flu pandemic actions concerning pigs, Responses by country, Egypt
Egypt commenced the slaughter on 2 May 2009. This led to clashes between pig owners and the police in Cairo. On the next day in Cairo, an estimated 300 Coptic Christian residents of the Manshiyat Nasr district set up blockades on the street in attempt to keep government officers from confiscating their pigs, which led to clashes with the police. Al-Ahram, a widely circulated Egyptian newspaper, reported that owners of destroyed pigs will receive 1000 Egyptian pounds (approximately US$177.70) per animal in compensation, but Reuters reported that the issue was still "under discussion", citing an Egyptian cabinet spokesman.


2009 swine flu pandemic actions concerning pigs, Responses by country, Egypt
On June 5, the UK-based Compassion in World Farming organization warned Egypt that its brutal measures and its mass slaughter of pigs could negatively affect Egypt's tourism industry. Philip Lymbery the chief executive of the group was quoted saying that "Britons and people from around the world have joined the international storm of protest against this atrocity in Egypt, with many saying they'll no longer consider Egypt as a possible holiday destination,"


2009 swine flu pandemic actions concerning pigs, Responses by country, Indonesia
After a coordination meeting about the flu on April 27, 2009, the Indonesian government halted the importation of pigs and initiated the examination of 9 million pigs in Indonesia.


2009 swine flu pandemic actions concerning pigs, Responses by country, Iraq
Adel Salman Musa, the director of the Baghdad Zoo claims to have "received an order issued by the multi-ministry committee aimed at preventing swine flu" to kill Baghdad's supply of three wild boars. He said the cull was initiated "to break a barrier of fear" which had been developed amongst zoo visitors. There had been a decline in the number of visitors in the days prior to the culling.


2009 swine flu pandemic actions concerning pigs, Responses by country, Iraq
The health ministry said that killing the pigs would serve no purpose in preventing an outbreak in the country that has no reported cases of swine flu. Ehassan Jafar, a spokesperson for the country's health ministry, said that "it does not matter" since the virus is able to transmit itself between humans now. In its dispute with the agriculture ministry, the health ministry said "if you really want to kill them then just kill them".


2009 swine flu pandemic actions concerning pigs, Responses by country, Iraq
The boars were tested prior to their culling, and results proved negative. The zoo's director said they were killed humanely. This involved the use of an anesthetic. The three carcasses were later buried.


2009 swine flu pandemic actions concerning pigs, Responses by country, Iraq
The deaths were relayed around the world via Agence France-Presse, CNN, Israel's Ynetnews and China's Xinhua News Agency.


2009 swine flu pandemic actions concerning pigs, Responses by country, Iraq, Iraqi Kurdistan
Kurdistan's Regional Government has outlawed boar hunting. The area has a large population of wild boars.


2009 swine flu pandemic actions concerning pigs, Responses by country, Iraq, Iraqi Kurdistan
Inhabitants are told to avoid the consumption of pork. Travelers are being monitored for their activity in relation to this.


2009 swine flu pandemic actions concerning pigs, Responses by country, Japan
The Ministry of Agriculture, Forestry and Fisheries of Japan instructed animal quarantine offices across the country to examine any live pigs being brought into the country to make sure they are not infected with the H1N1 strain of influenza. Japanese Agriculture Minister Shigeru Ishiba appeared on television to reassure consumers that it is safe to eat pork. The Japanese farm ministry said that it would not ask for restrictions on pork imports because the virus was unlikely to turn up in pork, and would be killed by cooking.


2009 swine flu pandemic actions concerning pigs, Responses by country, Macedonia
On April 27, 2009, the government of the Republic of Macedonia prohibited all exports and imports of live pigs.


2009 swine flu pandemic actions concerning pigs, Responses by country, North Korea
According to Daily NK, the sale of pork has been prohibited in a portion of the jangmadang because A/H1N1 is still sometimes called "swine flu"


2009 swine flu pandemic actions concerning pigs, Responses by country, North Korea
No official decree has been issued by the state or any political entity, but some officials of the People's Safety Agency have been unilaterally preventing the sale of pork. In the Hyesan, Wiyeon and Masan Markets, it is still difficult to find pork.


2009 swine flu pandemic actions concerning pigs, Responses by country, Norway
500 pigs were mass slaughtered on October 16, after swine flu was detected on a farm in Nord-Trøndelag county the week before the slaughtering. Another 900 pigs from a second farm will also be slaughtered.


2009 swine flu pandemic actions concerning pigs, Responses by country, Philippines
The Philippines issued a ban on pig imports from countries affected by the disease. The ban was lifted on May 4 except imports from Canada because of authorities were still checking the possible transmission of the A(H1N1) from a human to a pig. The pig import ban from Canada was lifted on May 11.


2009 swine flu pandemic actions concerning pigs, Responses by country, Ukraine
Imports of pork and live pigs from all affected countries have been banned. The ban also applies to all shipments after April 21.


2009 swine flu pandemic actions concerning pigs, By region, Arab countries
As of June 2009 it was reported that Flu will halt import of pigs  by Arab countries, but they ban exporting porks to America.


2009 swine flu pandemic by country
This article deals with the status and efforts regarding the 2009 swine flu pandemic by country and continent/region.


2009 swine flu pandemic by country
As the pandemic progressed, laboratory testing and confirmation decreased. Confirmed figures for the United Kingdom, in particular, are only meaningful up to 2 July, when routine testing stopped and presumed cases were treated without laboratory confirmation of diagnosis. Following the recommendations of the World Health Organization (WHO), many countries stopped issuing estimates of the infected population, making this list inaccurate.


2009 swine flu pandemic by country, Affected continents/countries, Africa
The Egyptian government ordered the mass slaughter of all pigs in Egypt on 29 April, even though the current strain was a human-human transmittable, human influenza that had previously hybridized with avian flu and swine flu. The World Organization for Animal Health called the swine killing "scientifically unjustified".


2009 swine flu pandemic by country, Affected continents/countries, Africa
The first case of the H1N1 virus was discovered in Cairo, Egypt on 2 June 2009, in a 12-year-old girl coming from the US with her mother. Only the girl was infected and the officials caught the case before letting her out of the airport. A second and third case were discovered on Sunday 7 June, two students at the American University of Cairo. On 11 June 2 more cases were discovered, bringing the total number of cases to 12.


2009 swine flu pandemic by country, Affected continents/countries, Africa
The swine flu was confirmed in 21 African countries: Egypt, South Africa, Morocco, Algeria, Tunisia, Ethiopia, Côte d'Ivoire, Seychelles, Cape Verde, Libya, Kenya, Uganda, Botswana, Zimbabwe, Tanzania, Mauritius, Somalia, Sudan, Namibia, Zambia, Gabon, and Rwanda.


2009 swine flu pandemic by country, Affected continents/countries, Africa
The H1N1 virus was a concern in the months leading up to the 2010 FIFA World Cup, which took place in June 2010 in South Africa.


2009 swine flu pandemic by country, Affected continents/countries, Asia, Western and Central Asia
On 27 April, Azerbaijan imposed a ban on import of animal husbandry products from America. AZAL took additional safety measures and a sanitary quarantine unit of the Health Ministry started to operate in Heydar Aliyev International Airport, checking all aircraft and passengers. On 2 May Border checkpoints with disinfection barriers for both cars and pedestrians were installed at the Samur, Shirvanovka and Khan Oba checkpoints in Qusar and Khachmaz Raions. The veterinary services at checkpoints intensified their activities while hog farms in the northern regions switched to a closed farming regime.


2009 swine flu pandemic by country, Affected continents/countries, Asia, Western and Central Asia
Seventy-seven cases were confirmed in Israel. In response to the outbreak, the Israeli Deputy Minister of Health, Yaakov Litzman, suggested that out of respect for the religious sensibilities of Jews and Muslims, the flu should be called "Mexican Flu." This was done so as to not confuse the population into thinking that they could not acquire the virus if they did not eat pork. The Israeli government retracted this proposal following Mexican complaints.


2009 swine flu pandemic by country, Affected continents/countries, Asia, Western and Central Asia
The first confirmed cases were reported in Kuwait on 23 May, after about 18 people on U.S. military bases tested positive.


2009 swine flu pandemic by country, Affected continents/countries, Asia, Western and Central Asia
On 30 May 2009 the first three cases were confirmed in Lebanon. "One Lebanese man who was in Spain and two Canadians who arrived in Lebanon a week ago are suffering from swine flu," the health minister said. "We put them in quarantine and the blood samples we have taken every day have proven to be positive. The Lebanese man and the two visiting Canadians – a woman and her daughter – were given the proper medical treatment in time and they are well now." The Lebanese Health Minister had previously asked citizens to stop the habit of social kissing, that affected schoolchildren be kept at home and that travel to countries in which cases have been confirmed be avoided. Beirut also banned the import of pork.


2009 swine flu pandemic by country, Affected continents/countries, Asia, Western and Central Asia
In Saudi Arabia, the first case, which affected a Filipino nurse working at King Faisal Specialist Hospital and Research Center, was confirmed on 1 June. The Health Ministry, in cooperation with the hospital, applied the national plan for the prevention of swine flu in accordance with WHO's recommendations. Accordingly, the patient was isolated and treated.


2009 swine flu pandemic by country, Affected continents/countries, Asia, Southern Asia
All people entering India via the main airport hubs of Mumbai, New Delhi, Bengaluru and other metro cities were screened. The primary focus was on passengers entering from the US, the United Kingdom, Canada, Mexico, France and New Zealand. As of 25 October, over 13,000 cases had been confirmed in India, with 444 deaths, starting with a 13-year-old girl's death in the city of Pune, where almost 91 people died.


2009 swine flu pandemic by country, Affected continents/countries, Asia, Southern Asia
In the Maldives, a ministerial committee was established to supervise preventive measures to avoid an outbreak. All visitors arriving at the Malé International Airport and the country's three commercial seaports were screened.


2009 swine flu pandemic by country, Affected continents/countries, Asia, Southern Asia
Pakistan took precautionary measures at its international airports to check passengers coming from affected countries. Doctors checked incoming passengers and allowed entry only to those with no symptoms. Major hospitals were placed on high alert.


2009 swine flu pandemic by country, Affected continents/countries, Asia, Southeastern Asia
Since 8 July a total of 207 cases were reported in Brunei.


2009 swine flu pandemic by country, Affected continents/countries, Asia, Southeastern Asia
The Cambodian Pig Raiser Association told the government it should ban live pig imports. But Khlauk Chuon, the deputy director of Camcontrol at the Ministry of Commerce, said they would only ban live pig imports from affected countries.


2009 swine flu pandemic by country, Affected continents/countries, Asia, Southeastern Asia
The Indonesian government halted the importation of pigs and initiated the examination of 9 million pigs. Thermal scanners that can detect human body temperature were installed at Indonesian ports of entry.


2009 swine flu pandemic by country, Affected continents/countries, Asia, Southeastern Asia
The Lao government bought 10 thermal imaging machines to install at the country's major immigration border checkpoints. The Prime Minister Bouasone Bouphavanh said masks should be made available and health officials would be assigned to border checkpoints. On 22 July, Laos recorded its first death.


2009 swine flu pandemic by country, Affected continents/countries, Asia, Southeastern Asia
In Malaysia, health screenings were carried out on passengers traveling to and from Mexico via sea, air and land beginning 17 April. The Health Ministry's disease control division activated its operations room to monitor the situation and informed medical practitioners treating suspicious cases to inform the district health office immediately. Thermal scanners were installed at Kuala Lumpur International Airport. Screenings were imposed in Pengkalan Hulu, at the border with Thailand, in late April. Quarantine rooms were allocated in 28 hospitals and the country stockpiled more than 2 million doses of Tamiflu, as of May 2009.


2009 swine flu pandemic by country, Affected continents/countries, Asia, Southeastern Asia
Schools were issued strict hygiene procedures on 16 May to contain any outbreak. On 15 May, the Health Ministry confirmed Malaysia's first case: a male student who had arrived via air from Newark. The first death was reported on 23 July. As of 11 August there were 2,253 confirmed cases. As of 12 August the total number of deaths in Malaysia stood at 44.


2009 swine flu pandemic by country, Affected continents/countries, Asia, Southeastern Asia
In the Philippines, thermal imaging equipment at airports was implemented to screen passengers coming from the US. The Philippines quarantined travelers arriving from Mexico with fever. The importation of hogs from the U.S. and Mexico was banned and the restriction of vaccine use was retracted. On 18 May, a Filipina girl who arrived from Houston was the first confirmed case in the Philippines. As of 15 June, there were 193 confirmed cases. On 22 June, the first death was reported.


2009 swine flu pandemic by country, Affected continents/countries, Asia, Southeastern Asia
The first case in Singapore was confirmed on 27 May. It was announced on 18 June that Singapore appeared to have its first case. As of 7 July 1,217 confirmed cases had been reported. As of 25 July, there were 4 confirmed deaths.


2009 swine flu pandemic by country, Affected continents/countries, Asia, Southeastern Asia
Vietnam's Ministry of Health released an emergency dispatch and urged agencies to take precautionary measures. Thermal imaging devices were dispatched to airports and border gates to screen passengers. In response to WHO's warnings, Vietnam on 30 April raised its alert level to 4, which indicated a "threat of community level outbreaks" while local authorities executed precautionary measures. On 1 May 2009 a Ministry of Industry and Trade official said that the Ministry was considering a ban on pork import "under certain situations". On 31 May Vietnam announced its first case, a 23-year-old student recently returned from the United States.


2009 swine flu pandemic by country, Affected continents/countries, Asia, Eastern Asia
On 26 April, visitors returning from flu-affected areas to China who experienced flu-like symptoms within two weeks were to be quarantined. On 2 May, the Chinese government suspended flights from Tijuana to Shanghai. Meanwhile, the Civil Aviation Administration of China assigned a charter to transport stranded Chinese visitors home. The first suspected case was reported on 10 May 2009.


2009 swine flu pandemic by country, Affected continents/countries, Asia, Eastern Asia
On 29 April the Food and Health Bureau of Hong Kong advised Hong Kong residents not to travel to Mexico unless absolutely necessary. The first case was a Mexican who arrived from Shanghai. The Bureau escalated the alert level from "alert" to "serious", which activated health protection measures in all ports of entry of Hong Kong. Thermal screening machines were used to identify passengers with fever and respiratory symptoms. Any passenger who is confirmed to have a fever were quarantined and sent to public hospital for investigation.


2009 swine flu pandemic by country, Affected continents/countries, Asia, Eastern Asia
Hong Kong became one of the first jurisdictions to declare the swine flu as a notifiable disease. Much of the procedures against the contagion were learned from the 2003 SARS outbreak, of which Hong Kong was the epicenter of the outbreak. On 1 May, the first case in Hong Kong and also the first in Asia was confirmed. The Mexican patient arrived in Hong Kong on 30 April. Metropark Hotel Wanchai, where the patient stayed, was quarantined. After the first case was confirmed, Hong Kong's response level was raised from "serious" to "emergency".


2009 swine flu pandemic by country, Affected continents/countries, Asia, Eastern Asia
In Japan, live pig imports were inspected. Japanese Agriculture Minister Shigeru Ishiba appeared on television to reassure customers that it was safe to eat pork. The Japanese farm ministry said that it would not ask for restrictions on pork imports because the virus was unlikely to turn up in pork and would be killed by cooking. On 8 May, the first three cases were confirmed. The infected patients had spent time in Canada and returned to Japan via Detroit. The first domestic infection was confirmed on 16 May in Kobe. As of 18 May 130 cases had been confirmed.


2009 swine flu pandemic by country, Affected continents/countries, Asia, Eastern Asia
South Korea warned against travel to Mexico City and three Mexican states. The government stepped up quarantine and safety checks on travelers arriving from the United States and Mexico, and pork imports from those countries. An emergency quarantine system was instituted, with simple tests conducted on people with flu symptoms at airports. On 28 April, South Korea reported its first probable case after positive preliminary tests on a nun who had recently returned from Mexico. One case was confirmed on 30 April. On 2 May, the first suspected woman turned out to be infected. South Korea became the second infected nation in Asia. On 13 September, five people died, and 1 person experienced brain death. As of November, 107,939 had been infected.


2009 swine flu pandemic by country, Affected continents/countries, Asia, Eastern Asia
On 20 May the first case of the influenza was confirmed in Taiwan. The government had previously taken steps to prevent an outbreak, including a command center, travel alerts for infected nations, and more severe health checks at international ports. Taiwan said visitors who arrived from affected areas with fevers would be quarantined. According to The Department of Health (DOH), Taiwan had a sufficient supply of surgical masks and vaccine to deal with the flu.


2009 swine flu pandemic by country, Affected continents/countries, Asia, Eastern Asia
The DOH stated that they had 50 to 60 million masks in stock and that local manufacturers had the capability of producing 200,000 doses of the flu vaccine a month. The Centers for Disease Control announced on 28 April that every flight from the Americas, specifically Canada and the United States, that arrived in Taiwan would be subject to a strict on-board screening procedure.


2009 swine flu pandemic by country, Affected continents/countries, Asia, Eastern Asia
On 2 July, the first case of oseltamivir-resistant virus in Asia was announced in Japan, in a woman who had been taking Tamiflu prophylactically.


2009 swine flu pandemic by country, Affected continents/countries, Asia, Eastern Asia
On 18 July 2009, Hong Kong had its first swine flu death.


2009 swine flu pandemic by country, Affected continents/countries, Asia, Eastern Asia
On 3 July, a case of Tamiflu-resistant virus was discovered. The woman had not previously taken Tamiflu, so concern has been expressed that she may have contracted an already resistant virus from someone else.


2009 swine flu pandemic by country, Affected continents/countries, Asia, Eastern Asia
On 28 August 2009, the Japanese Ministry of Health, Labour and Welfare announced that it estimated approximately 760,000 people would be infected and 46,400 hospitalized per day during the expected peak month of October. Overall they predicted that 20% of rural Japanese would become infected and 30% in city areas.


2009 swine flu pandemic by country, Affected continents/countries, Europe
On 27 April, the Spanish Ministry of Health and Social Policy announced its first case (the first in Europe) in a 23-year-old man who had recently returned from Mexico on 22 April and had been quarantined on the 25th. The day the European Union health commissioner advised Europeans not to travel to the United States or Mexico unless urgent.


2009 swine flu pandemic by country, Affected continents/countries, Europe
On 14 June, it was reported that the United Kingdom had its first confirmed death.


2009 swine flu pandemic by country, Affected continents/countries, Europe
As of 22 December, every European country, apart from the 5 microstates had confirmed deaths. France had 27; Spain, 33; Norway, 29 (4 January 2010); Italy, 6; Belgium and Germany, 8; Sweden, 3 (3 November); Malta and Greece, 3; Denmark, Finland, Hungary and Luxemburg, 1; Ireland and the Netherlands, 10, and the United Kingdom, 79. The British government suggested 55,000 new cases in the week up to 16 July.


2009 swine flu pandemic by country, Affected continents/countries, Europe
Hungary reported the first death in the country on 22 July. Ireland reported its first death on 7 August.


2009 swine flu pandemic by country, Affected continents/countries, Europe
As of 19 August, all European countries with the exception of the micro states San Marino and Vatican City had reported cases.


2009 swine flu pandemic by country, Affected continents/countries, North America
The swine flu began in Mexico, North America, which turn out to be a new strain of H1N1 virus and the first case could have been as early as March or April. In Canada, roughly 10% of the populace were infected with the virus, with 363 confirmed deaths (as of 8 December); confirmed cases had reached 10,000 when Health Canada stopped counting in July. Canada began its vaccination campaign in October and vaccinated a higher proportion of its citizens than any other country. The pandemic was a concern in the months leading to the XXI Olympic Winter Games, which took place in Vancouver in February 2010.


2009 swine flu pandemic by country, Affected continents/countries, North America
Dr. José Ángel Córdova Villalobos, Mexico's Secretariat of Health, stated that since March 2009, over 1,995 suspected cases and 149 deaths were confirmed. Twenty were confirmed to be linked to a new strain of Influenza A virus subtype H1N1. "'As many as 23,000 Mexicans were likely infected with the swine flu virus,' Neil Ferguson of Imperial College London and colleagues reported in the journal Science." Soldiers mobilized by the government have handed out six million surgical masks to citizens in and around Mexico City.


2009 swine flu pandemic by country, Affected continents/countries, North America
On 24 April 2009, schools (from pre-school to university level) as well as libraries, museums, concerts and any public gathering place, were shut down by the government in Mexico City and the neighboring State of Mexico to prevent the disease from spreading further; the schools in Mexico City, the State of Mexico, and the state of San Luis Potosí would remain quarantined until at least 5 May. Marcelo Ebrard, Mexico City's mayor, asked all night-life operators to shut down their places of business for ten days to prevent further infections.


2009 swine flu pandemic by country, Affected continents/countries, North America
On 25 April, President Felipe Calderón declared an emergency which granted him the power to suspend public events and order quarantines. On 26 April, the World Bank announced US$25 million in immediate aid loans to Mexico, an additional US$180 million for long-term assistance to address the outbreak, and advice on how other nations have responded to similar crises. On 27 April, the Secretariat of Public Education announced that all schools in Mexico would remain closed at least until 6 May. On 28 April, the Mexico City government closed all restaurants and cinemas. The National History and Anthropology Institute closed all archaeological sites and museums, including the most famous Mayan and Aztec ruins, until further notice.


2009 swine flu pandemic by country, Affected continents/countries, North America
In the United States, initial reports of atypical flu in two individuals in southern California led to the discovery of the virus by the Center for Disease Control in mid-April. More than a hundred cases were confirmed in the following two weeks, across a dozen states. Outside of California and Texas, initial cases were all tied to recent travel to Mexico or close contact with those who had. St. Francis Preparatory School, a private school in New York, was the center of a large cluster of cases after a spring break trip by several students.


2009 swine flu pandemic by country, Affected continents/countries, North America
It was one of the first US schools to be closed during the early outbreak. Most of the cases in California and Texas were not linked and may have reflected localized outbreaks. The disease was not as virulent outside of Mexico, for reasons not fully understood. The US declared a state of Public Health Emergency, but this was said to be standard procedure in cases as divergent as the recent inauguration and flooding. On 29 April, the US suffered its first confirmed death, and on 5 May the first US citizen died from swine flu.


2009 swine flu pandemic by country, Affected continents/countries, North America
On 6 June, there were 17 confirmed deaths from swine flu in the US. By mid-May 2009 many states had abandoned testing unless serious illness and/or hospitalization were present. Because reported numbers represented only confirmed cases, they were a "very great understatement" of the total number of cases of infection, according to the CDC. From April 12, 2009 to April 10, 2010, CDC estimated there were 60.8 million cases, 274,304 hospitalizations, and 12,469 deaths in the US due to the virus.


2009 swine flu pandemic by country, Affected continents/countries, North America, Caribbean
In Aruba, all passengers arriving by airplane or cruise ship were required to fill out a health questionnaire beginning on 27 April 2009. Hotels and resorts were required to report to authorities if any tourists were showing flu-like symptoms. The government ordered antiviral medication and other supplies from the Netherlands and the United States. No cases were reported.


2009 swine flu pandemic by country, Affected continents/countries, North America, Caribbean
In Barbados, the first confirmed case occurred on 3 June 2009. The second case was confirmed on 6 June. The third case was confirmed on 10 June. The fourth case was confirmed on 17 June. Twenty five samples were sent to the Caribbean Epidemiology Center.


2009 swine flu pandemic by country, Affected continents/countries, North America, Caribbean
Cuba suspended flights to and from Mexico for 48 hours. The first case in Cuba was confirmed in mid-May.


2009 swine flu pandemic by country, Affected continents/countries, North America, Caribbean
The first two cases in the Dominican Republic were confirmed on 27 May. By 7 June 93 cases had been confirmed, primarily mild infections.


2009 swine flu pandemic by country, Affected continents/countries, North America, Caribbean
As of 7 July 2009, 33 cases were confirmed in Jamaica. Health Minister Ruddy Spencer told Parliament that the country had been placed on high alert. There was heightened surveillance at health care facilities and ports of entry.


2009 swine flu pandemic by country, Affected continents/countries, North America, Caribbean
In the Bahamas, ten students and teachers who arrived from Mexico in the last week of April were in quarantine.


2009 swine flu pandemic by country, Affected continents/countries, North America, Central America
The first two cases of the flu in Costa Rica, both of whom had traveled to Mexico, were confirmed on 28 April. On 31 July local authorities announced that the country was among the sample countries that would test the vaccine developed by Swiss pharmaceutical giant Novartis. The local sample would include 784 Costa Ricans ages 3 to 64. Besides Costa Rica, this vaccine prototype would be tested in Mexico and the United States.


2009 swine flu pandemic by country, Affected continents/countries, North America, Central America
On 11 August, it was confirmed that Costa Rica's President, Óscar Arias Sánchez, was infected with the virus, becoming the first head of state. President Arias returned to normal activities after one week of isolation. As of 15 October the Costa Rican Ministry of Health had 1,530 confirmed cases, 1,242 pending cases and 38 deaths.


2009 swine flu pandemic by country, Affected continents/countries, North America, Central America
Guatemala checked all travelers arriving from Mexico and stopped anyone with symptoms at border crossings. On 5 May, in a meeting with Health Minister and the Vice President, it was announced that an 11-year-old girl was infected. As of 7 July Guatemala had 286 confirmed cases leading to two fatalities.


2009 swine flu pandemic by country, Affected continents/countries, North America, Central America
Honduras reported its first confirmed case on 27 May. By 7 June the country had reported 67 cases, mostly in San Pedro Sula and along the Atlantic Coastline. All airports and commercial sites as well as public events were monitored. As of 7 July there were 123 confirmed cases and one fatality.


2009 swine flu pandemic by country, Affected continents/countries, North America, Central America
As on 4 June 179 confirmed cases had been reported by Panamanian health authorities. Of these, 91 were male and 88 were female. Schools with positive cases were being disinfected. Thermal cameras had been deployed in Tocumen International Airport to identify symptomatic passengers.


2009 swine flu pandemic by country, Affected continents/countries, North America, Central America
As of 7 July, El Salvador reported 319 confirmed cases, and Nicaragua 321. Panama and Nicaragua reported no fatalities.


2009 swine flu pandemic by country, Affected continents/countries, Oceania
The first confirmed case in Australia was reported on 9 May. As of 3 July, Australia had 7,290 confirmed cases. The first Australian death was on 19 June and the total death toll reached 20. The alert level was raised from "delay" to "contain", giving authorities in all states the option to close schools. Australia stockpiled 8.7 million doses of Tamiflu and Relenza. At the beginning of the outbreak airlines were required to report passengers from the Americas with influenza symptoms and nurses were deployed at international airports.


2009 swine flu pandemic by country, Affected continents/countries, Oceania
Researchers in Australia and New Zealand reaffirmed that infants under the age of 1 had the highest risk of developing severe illness. Canadian health officials reported that swine flu is hospitalizing three to four times as many children as regular seasonal flu.


2009 swine flu pandemic by country, Affected continents/countries, Oceania
On 30 May, New Zealand had 9 confirmed cases and 10 probables. During June cases in New Zealand rose rapidly. On 14 June the Ministry of Health announced a 65% increase in cases in just 24 hours. On 4 July, the Ministry of Health announced the first New Zealand deaths. Three confirmed deaths were confirmed, however two had known underlying medical conditions. The total number of confirmed cases reached 945.


2009 swine flu pandemic by country, Affected continents/countries, Oceania
Two cases were confirmed in the Pacific Islands. Both cases were confirmed on 15 June, one in the Solomon Islands and another in Samoa. 5 cases were confirmed in Fiji as of 24 June and 1 case in Vanuatu.


2009 swine flu pandemic by country, Affected continents/countries, South America
In Argentina, as of April, passengers with symptoms arriving from Mexico and United States were required to list where they would be should they experience any symptoms. In addition, the government stepped up safety checks, and thermal scanners were being used at airports to detect passengers with fever and other influenza symptoms. Flights from Mexico were temporarily suspended. These measures proved to be largely ineffective.


2009 swine flu pandemic by country, Affected continents/countries, South America
As of 22 June, Argentina had 1,213 confirmed cases and 10 confirmed deaths, increasing to 52 confirmed deaths and an estimated number of as many as 100,000 infected on 2 July, as confirmed by Minister of Health Juan Luis Manzur. As of 14 July, the number of officially recognised cases skyrocketed, with 137 deaths, making the death toll in Argentina the second highest in the world at the time, behind only the US.


2009 swine flu pandemic by country, Affected continents/countries, South America
As of April, Brazilian airports were monitoring arrivals from affected areas, under the direction of the National Sanitary Surveillance Agency (ANVISA). Air crews were trained on signs and symptoms. As of 4 June, there were 28 confirmed cases.


2009 swine flu pandemic by country, Affected continents/countries, South America
The first case flu in Chile was confirmed on 17 May. On 29 May, the Chilean Health ministry confirmed the number of cases had risen to 226. On 3 June Chile suffered its first confirmed death, a 37-year-old man from Puerto Montt. To the date, and since laboratory tests were no longer mandatory, the estimate of cases in Chile reached 500.000 cases.


2009 swine flu pandemic by country, Affected continents/countries, South America
On 3 May, Minister Palacio confirmed the first case in Colombia, in a 42-year-old, who had recently traveled to Mexico. According to Palacio, only one of 18 tests sent to Atlanta was positive. The patient was isolated and put under medical treatment. On the same day, Palacio stated there were 108 suspect cases in the country. On 27 April, the Government declared a "national disaster" state which allowed health authorities to have a special budget. The government purchased 400,000 oseltamivir (Tamiflu) doses, to be distributed through the Social Protection ministry.


2009 swine flu pandemic by country, Affected continents/countries, South America
Health officials examined arrivals with flu symptoms. On 29 April, Ecuador closed its borders to Mexican citizens and foreigners of other nationalities arriving from Mexico for 30 days. On 15 May, health officials confirmed the first case in Ecuador. On 20 May, the Health Department confirmed 7 more new cases, raising the total to 8, and then to 41.


2009 swine flu pandemic by country, Affected continents/countries, South America
The first case in Peru was confirmed on 14 May. On 17 May, the second case was confirmed. He had returned from the US on 12 May, showing symptoms only two days later. On 18 May a new case was confirmed, a scholar returning from a trip to Dominican Republic. Another case of a scholar came from the same trip. The student had contact with the third victim and both studied in the same school. The Governor of Callao ordered that all passengers from any infected country be checked before their entry into Peruvian territory.


2009 swine flu pandemic by country, Affected continents/countries, South America
The Peruvian government was to be warned of any case or symptom. This step affected the main port and airport of Peru, located in Callao. The government prepared a special area at the Hospital "Daniel Alcides Carrión" to treat cases. Slaughterhouses were inspected and screened incoming passengers from problem areas. All commercial flights from Mexico to Peru were suspended on 29 April.


2009 swine flu pandemic by country, Affected continents/countries, South America
In Venezuela, controls were raised at airports to prevent contagion from spreading. Travellers from the United States and Mexico with symptoms were isolated until they cleared. Pig farms in the country were "closely inspected" and medicine stockpiled. On 28 May Health Minister Jesús Mantilla confirmed the first case in a Venezuelan citizen who flew from Panama. He was isolated and treated. The following day, a second case was confirmed from another person on the same flight.


2009 swine flu pandemic by country, Reporting bias
Epidemiologists cautioned that the number of cases reported in the early days of an outbreak could be very inaccurate. Causes included selection bias, media bias and incorrect reporting by governments.


2009 swine flu pandemic by country, Reporting bias
Selection bias in epidemiology occurs when authorities in different jurisdictions look at differing sets of patient. For example, in the early days of the pandemic, doctors in Mexico may have been concentrating on patients in hospitals, rather than the larger vulnerable population. This may in part explain the higher mortality recorded there. Conversely, it is implausible that few, if any, died in Mexico while Brazil and the United States accumulated hundreds of additional lab-confirmed deaths. Media bias may have skewed incidence maps based on these media reports. Countries with poor health care systems and poor laboratory facilities may take longer to identify suspected cases, analyse those cases and report them.


2009 swine flu pandemic by country, Reporting bias
Passive data collection methodologies (waiting for the patient to arrive at a health care facility) are considered inferior to active data collection techniques (performing random stratified sampling) due to selection bias and because laboratory facilities to perform swift genetic tests on patient samples are not widely available. As of July 2009 no properly controlled epidemiological studies had been conducted for the 2009 outbreak.


2009 swine flu pandemic in Africa
The 2009 flu pandemic hit Africa two months later than other continents with the first case reported in Egypt on June 2, 2009. As of December 1, 30 countries in Africa had reported cases and 7 countries in Africa had reported a total of 108 deaths. It was the least affected continent.


2009 swine flu pandemic in Africa
Symptoms of H1N1 swine flu are like regular flu symptoms and include fever, cough, sore throat, runny nose, body aches, headache, chills, and fatigue. Many people with swine flu have had diarrhea and vomiting, but these symptoms can also be caused by many other conditions. That means that you and your doctor can't know, just based on your symptoms, if you've got swine flu. Healthcare professionals may offer a rapid flu test, although a negative result doesn't mean you don't have the flu. The accuracy of the test depends on the quality of the manufacturer's test, the sample collection method, and how much of the virus a person is emitting at the time of testing.


2009 swine flu pandemic in Africa
Like seasonal flu, pandemic swine flu can cause neurological symptoms in children. These events are rare, but, as cases associated with seasonal flu have shown, they can be very severe and often fatal. Symptoms include seizures or changes in mental status (confusion or sudden cognitive or behavioral changes). It's not clear why these symptoms occur, although they may be caused by Reye's syndrome. Reye's syndrome usually occurs in children with a viral illness who have taken aspirin -- something that should always be avoided.


2009 swine flu pandemic in Africa, Algeria
The first case of swine influenza was detected in Algeria on June 20. This was an Algerian national, resident in Frankfurt and coming from Miami with her two children.


2009 swine flu pandemic in Africa, Algeria
This first case was detected at Houari Boumediene Airport. Many Algerian immigrants and tourists were arriving during this holiday period, increasing the risk of spreading the virus. The woman suffering from flu was immediately transferred to the hospital of El-Kettar’ in Algiers.


2009 swine flu pandemic in Africa, Benin
As of May 2, 2009 there was one suspected case of swine flu in Benin.


2009 swine flu pandemic in Africa, Egypt
The Egyptian government increased numbers of medical officers at Cairo Airport and pledged to monitor passengers from Mexico during their stay.


2009 swine flu pandemic in Africa, Egypt
The government ordered the mass slaughter of all pigs in Egypt on April 29, even though the pandemic strain was a human-human transmittable, human influenza that has already previously hybridized with avian and swine flu. The World Organization for Animal Health called the swine killing "scientifically unjustified".


2009 swine flu pandemic in Africa, Egypt
Egypt commenced the slaughter on 2 May 2009. On the next day in Cairo, an estimated 300 Coptic Christian residents of the Manshiyat Nasr district set up blockades on the street in attempt to keep government officers from confiscating their pigs, which led to clashes with the police. Al-Ahram, a widely circulated Egyptian newspaper, reported that owners of destroyed pigs would receive 1000 Egyptian pounds (approximately US$177.70) per animal in compensation, but Reuters reported that the issue was still "under discussion", citing an Egyptian cabinet spokesman.


2009 swine flu pandemic in Africa, Egypt
The first case of the novel H1N1 virus was discovered in Cairo, Egypt on the second of June, in a 12-year-old girl coming from the US with her mother. Only the girl was infected, and the officials caught the case before she left the airport.


2009 swine flu pandemic in Africa, Egypt
A second and third case were discovered on Sunday 7 June: two students at the American University of Cairo.


2009 swine flu pandemic in Africa, Egypt
As of June 9, there was 8 confirmed case of swine flu in Egypt.


2009 swine flu pandemic in Africa, Egypt
On June 11, 2 more cases were discovered, along with 2 cases discovered a day earlier, bringing the total number of swine flu cases to 12.


2009 swine flu pandemic in Africa, Egypt
As of December 3, the confirmed cases were 3558 and the deaths of 24. As of January 31, there were 258 confirmed deaths from A/H1N1 influenza in Egypt, and in excess of 15,800 confirmed cases of H1N1.


2009 swine flu pandemic in Africa, Ethiopia
On June 19, 2009 the Ethiopian government reported two cases of swine flu. They were both in girls who had returned from school in the United States for summer break. One additional case was reported by July 6. By December 14, 2009, six cases had been reported with no deaths contributed to the flu.


2009 swine flu pandemic in Africa, Ghana
Ghana banned the importation of pork and pork products. As of December 14, 2009, Ghana had 54 cases with no deaths reported.


2009 swine flu pandemic in Africa, Kenya
Kenya health authorities started screening travellers at Jomo Kenyatta and Moi international airports on April 28. Public Health and Sanitation minister Beth Mugo said travellers from Mexico and those from Texas, California and New York were being screened.


2009 swine flu pandemic in Africa, Kenya
On June 29, a British medical student became the first confirmed case of swine flu in Kenya. The student, who was in a group of 33, was in Kenya to attend a series of medical camps in Nyanza province. The whole group was quarantined in their hotel in Kisumu while undergoing treatment.


2009 swine flu pandemic in Africa, Kenya
There was a panic in Nairobi as mobile text messages circulated warning people to stay away from Sarit centre, a popular commercial establishment where another suspected case had been diagnosed. The patient's test results, however, came back negative for the H1N1 virus.


2009 swine flu pandemic in Africa, Kenya
As of December 14, 2009, Kenya had 417 cases with no deaths reported.


2009 swine flu pandemic in Africa, Libya
On 6 July 2009, Libya had its first confirmed case of swine flu from a man that had travelled from Thailand via Dubai. As of December 5, 2009, Libya had 124 cases with no deaths.


2009 swine flu pandemic in Africa, Morocco
Morocco confirmed the first case of novel human swine flu (A/H1N1-2009) on 12 June, in an 18-year-old university student returning from Canada. As of December 5, 2009, Morocco had 1,763 cases with 5 deaths.


2009 swine flu pandemic in Africa, Namibia
Namibia confirmed its first two cases of swine flu on July 20.


2009 swine flu pandemic in Africa, Namibia
Both cases involved young adults who had been traveling in other countries: a 13-year-old boy from Rehoboth who returned from a rugby trip with 20 other students in South Africa and a young student returning from Europe. The latter was taken by ambulance to hospital directly from the international airport in Windhoek as she showed severe signs of flu.


2009 swine flu pandemic in Africa, Nigeria
Nigerian Health Minister Babatunde Osotimehin announced that the country was stockpiling antiviral treatments, informing the public and increasing surveillance.


2009 swine flu pandemic in Africa, Nigeria
The first A/H1N1 death was confirmed in Nigeria on 5 January 2010, with the victim being a 38-year-old woman from Lagos who was infected in the US.


2009 swine flu pandemic in Africa, Tunisia
Tunisia confirmed the two first cases of swine flu (A/H1N1-2009) on June 22. Both cases were returning from the United States, and recovered quickly.


2009 swine flu pandemic in Africa, South Africa
On April 29, South Africa reported two possible cases of swine flu from two women who had recently travelled in Mexico. On June 18, the first case was confirmed. Later, on 29 June the South African National Department of Health confirmed 7 cases of swine influenza in the country.


2009 swine flu pandemic in Africa, South Africa
The first death in South Africa was confirmed on 3 August. The victim was a student at the University of Stellenbosch. A few days later the second confirmed death was announced: a male in Durban, Mount Edgecombe As of December 14, 2009, South Africa had 12631 cases with 91 deaths.


2009 swine flu pandemic in Africa, South Africa
The H1N1 virus was a concern for the 2010 FIFA World Cup, which took place in June 2010 but there were not any major issues with the flu during the tournament.


2009 swine flu pandemic in Africa, Sudan
The first case of swine flu in Sudan was confirmed in mid-July 2009. At the end of November the first case was confirmed in Southern Sudan.


2009 swine flu pandemic in Africa, Sudan
As of December 28, 2009, there were five deaths and over 150 confirmed cases of swine flu in Sudan.


2009 swine flu pandemic in Africa, Zambia
An emergency task force was set up by the Zambian government.


2009 swine flu pandemic in Argentina
The influenza A virus subtype H1N1 (initially known as swine influenza virus or as new flu) arrived in Argentina in late April 2009, through air traffic contact with endemic areas, especially Mexico and the United States.


2009 swine flu pandemic in Argentina
The World Health Organization (WHO) and the Argentine health authorities expressed their concern from the beginning of the outbreak, that the imminent arrival of the southern winter could cause "more serious" effects in the southern hemisphere than those caused in Mexico, and could lead to a rebound of the epidemic around the world. The flu or influenza is mainly a seasonal disease that becomes most prevalent in winter.


2009 swine flu pandemic in Argentina
The first infection was confirmed on May 7 in a man who had come from Mexico City and had entered the country without symptoms on April 24. The second case was detected on May 22. Towards the end of May infection started in some schools in the northern community of the City of Buenos Aires and its suburbs, the main part of the country affected by the epidemic.


2009 swine flu pandemic in Argentina
On June 15 the first death was announced: a three-month-old baby in the Greater Buenos Aires area. In the second half of June, coinciding with the onset of winter, the virus was widely transmitted in Buenos Aires and spread to other parts of the country, especially the Province of Santa Fe, with its center in the city of Rosario.


2009 swine flu pandemic in Argentina
On June 29, the Government decided to close schools throughout the month of July, a measure which affected 11 million students. Pregnant women and other categories at risk were also dispensed from working. The measures taken by the authorities were primarily targeted to limit contagion during the winter months until the start of spring.


2009 swine flu pandemic in Argentina
The peak of infection lasted from the end of June until the beginning of July, increasing normal hospital demand fivefold and causing the collapse of the systems organizing hospital wards, home doctors and work place doctors. The most affected area was Greater Buenos Aires, home to some 12 million people. It was estimated that up to 10% of the population of that region (approximately 1,200,000 people) could be affected by the pandemic of influenza A.


2009 swine flu pandemic in Argentina
In Argentina, seasonal flu outbreaks kill about 4,000 people each year, equivalent to a rate of 10 deaths per 100,000 inhabitants. The contingency plan developed in 2006 to face a possible influenza pandemic estimated that the dead could reach 13,000 in the event of a moderate rate of infection (15%) and 30,000 in the event of a serious infection rate (35%).


2009 swine flu pandemic in Argentina, Timeline, April
April 26:The Ministry of Health issued an Epidemic Alert order asking airlines to report passengers with influenza symptoms arriving from Mexico and United States. The government also stepped up safety checks, and thermal scanners were used in airports to detect passengers running fevers.


2009 swine flu pandemic in Argentina, Timeline, April
April 28:The Argentine government suspended all flights originating in Mexico until May 15 as a precautionary measure. The first flight coming from Mexico arrived at Ezeiza International Airport on May 20.


2009 swine flu pandemic in Argentina, Timeline, May
May 1:The Argentine government sent charter flights to Mexico to pick up all Argentine tourists abroad who wished to return.


2009 swine flu pandemic in Argentina, Timeline, May
May 7:The first case of Influenza A (H1N1) was confirmed in the country, a tourist who had recently returned from Mexico. This man was from Puerto Madryn, Chubut Province.


2009 swine flu pandemic in Argentina, Timeline, May
May 22:Health Authorities confirmed the second case, a woman who had arrived from the United States about 20 days before.


2009 swine flu pandemic in Argentina, Timeline, June
June 25:A case of human-to-swine transmission was discovered in Buenos Aires province. The hog farm where it occurred was interdicted. This was the second known case of reverse-zoonosis in the world.


2009 swine flu pandemic in Argentina, Timeline, June
June 28:Due to the ongoing legislative elections and the possible resignation of the Health Minister, Graciela Ocaña, reports of confirmed cases and deaths were suspended.


2009 swine flu pandemic in Argentina, Timeline, June
June 29:Argentina's Health Minister, Graciela Ocaña, announced her resignation due to some political instability in the country and stated that the current government did not support her on some projects and plans she recommended for the betterment of the country. The Provinces of Santa Fe (after confirming the first two deaths), San Luis (with 5 confirmed cases and more than 30 suspected cases) and Santiago del Estero (which on the same day confirmed 12 cases of swine flu) each decided to suspend all classes of elementary, primary and secondary schools, and recommended that the universities adopt the same procedure.


2009 swine flu pandemic in Argentina, Timeline, June
June 30:The government of the Autonomous City of Buenos Aires alongside the government of the Buenos Aires province, decreed a Health Emergency, though public services continued their operations. Winter holidays for students had started two weeks before.


2009 swine flu pandemic in Argentina, Timeline, July
July 2:The newly appointed Health Minister Juan Luis Manzur estimated the number of affected people to be as high as 100,000, as well as 44 confirmed deaths.


2009 swine flu pandemic in Argentina, Timeline, July
July 14:The number of officially recognised cases skyrocketed, with 137 deaths, making the death toll in Argentina the second highest in the world, only behind the United States and surpassing confirmed cases in Mexico.


2009 swine flu pandemic in Argentina, Timeline, July
July 28:Impact on health services diminished significantly according to various specialists, though the death toll continued to increase, partly because of the delay in confirming previous fatalities. There had been no official report by the national Health Ministry since July 14.


2009 swine flu pandemic in Argentina, Timeline, July
July 30:Official reports of confirmed deaths from the provinces put the death toll around 260, while Critica newspaper published an interview with Jorge Yabkowski, president of the Sindical Federation of Health Professionals of Argentina (Fesprosa), giving an estimate death toll from H1N1 flu of above 400 (while USA was at 340), based on the false death count in Buenos Aires, where many patients may have "entered the hospitals almost dead and were not tested for H1N1".


2009 swine flu pandemic in Argentina, Timeline, August
August 3:The students returned to schools in all except 3 provinces, while awaiting a possible second wave. The estimated cumulative number of H1N1 cases was more than 400,000 Argentinians.


2009 swine flu pandemic in Argentina, Timeline, August
August 5:A new report was released by the ministry of health, showing 762,711 ILI cases up to Aug 1, 2009, of which more than 700,000 were of the A (H1N1) swine flu type. Only 47% of the 337 confirmed H1N1 flu deaths had a history of chronic disease or any other risk factor. Additionally, 402 deaths were in the process of being confirmed, whereas the number of cases began to decrease in 18 of the 24 provinces.


2009 swine flu pandemic in Argentina, Timeline, August
August 14: Further decrease in activity levels. Official death count: 404.


2009 swine flu pandemic in Argentina, Timeline, August
August 24:Indicators showed a decreasing activity tendency, while intensity was still high. The impact on health services returned to low, and most provinces had no recent deaths. The official death count was 439.


2009 swine flu pandemic in Argentina, Timeline, August
August 29:Week 32 saw no further decrease in new ILI cases, reaching 818,031 cumulative cases. Confirmed deaths: 465, deaths under study: 349.


2009 swine flu pandemic in Argentina, Timeline, September
September 7: ILI cases reported up to week 33: 1,054,707. Cumulative data up to week 32: 8,384 H1N1 lab-confirmed cases, 512 deaths (+196 under study), respiratory disease cases requiring hospitalization: 8,962.


2009 swine flu pandemic in Argentina, Timeline, September
September 12: Week 35 national report stated that up to week 34 there were 8,851 (+467) total lab-confirmed cases, with 514 (+2) confirmed deaths among them and 196 (+0) additional deaths under study (no provinces specified). The cumulative respiratory disease cases requiring hospitalization were 9,480 (+518), and the cumulative ILI cases reported were 1,060,285 (+5,578).


2009 swine flu pandemic in Argentina, Timeline, September
September 26: There was no official report for week 36. Week 37 national report: 9,036 (+185) total lab-confirmed cases; 538 (+24) confirmed deaths; 252 (+56) additional deaths under study. Cumulative respiratory disease cases requiring hospitalization: 10,306 (+826); cumulative ILI cases reported: 1,098,834 (+38,549).


2009 swine flu pandemic in Argentina, Timeline, October
October 2: Week 38 national report: 9,049 (+13) total lab-confirmed cases; 539 (+1) confirmed deaths; 254 (+2) additional deaths under study. Cumulative respiratory disease cases requiring hospitalization: 10,773 (+467); cumulative ILI cases reported: 1,151,655 (+52,821).


2009 swine flu pandemic in Argentina, Timeline, October
October 10: Week 39 national report: 9,119 (+70) total lab-confirmed cases; 580 (+41) confirmed deaths; 247 (−7) additional deaths under study. Notably, the date of decease of last confirmed death is August 20. Cumulative respiratory disease cases requiring hospitalization: 11,086 (+313); cumulative ILI cases reported: 1,163,433 (+11,778).


2009 swine flu pandemic in Argentina, Timeline, October
October 24: Week 40 national report: 9,196 (+77) total lab-confirmed cases; 585 (+5) confirmed deaths; 247 (+0) additional deaths under study. Last confirmed death: September 5. Cumulative respiratory disease cases requiring hospitalization: 11,689 (+603); cumulative ILI cases reported: 1,187,540 (+24,107).


2009 swine flu pandemic in Argentina, Timeline, November
November 1: Week 42 national report: 10,209 (+1,013) total lab-confirmed cases; 593 (+8) confirmed deaths; 248 (+1) additional deaths under study. Last confirmed death: September 12. Cumulative respiratory disease cases requiring hospitalization: 12,139 (+450); cumulative ILI cases reported: 1,219,949 (+32,409).


2009 swine flu pandemic in Asia
The 2009 flu pandemic in Asia, part of an epidemic in 2009 of a new strain of influenza A virus subtype H1N1 causing what has been commonly called swine flu, afflicted at least 394,133 people in Asia with 2,137 confirmed deaths: there were 1,035 deaths confirmed in India, 737 deaths in China, 415 deaths in Turkey, 192 deaths in Thailand, and 170 deaths in South Korea. Among the Asian countries, South Korea had the most confirmed cases, followed by China, Hong Kong, and Thailand.


2009 swine flu pandemic in Asia, Azerbaijan
On 27 April 2009 Azerbaijan imposed a ban on import of animal husbandry products from the Americas. AZAL took additional safety measures and a sanitary quarantine unit of the Health Ministry started to operate in Heydar Aliyev International Airport with all aircraft and passengers being checked.


2009 swine flu pandemic in Asia, Azerbaijan
On 31 July, the first case of influenza A (H1N1) was confirmed.


2009 swine flu pandemic in Asia, Bahrain
In July, the Ministry of Health launched an awareness campaign ahead of the start of the academic year, with many fearing the reopening of schools would lead to a much greater outbreak of the flu. By early August, 18 confirmed cases of the flu were reported. Haj travel agencies reported that thousands of Bahraini pilgrims cancelled their trips to Mecca over fears of contracting swine flu. Over 180 confirmed cases of the flu were reported in late August, all of whom had returned from traveling abroad.


2009 swine flu pandemic in Asia, Bahrain
On 31 August, a 30-year-old Filipino housemaid died after contracting the H1N1 virus, becoming Bahrain's first confirmed death as a result of the virus. On 3 September, it was reported that a 24-year-old Bahraini man died after succumbing to the H1N1 virus, being the first Bahraini to die of the disease. On 8 September, it was announced that patients with flu-like symptoms would be treated with Tamiflu nationwide, regardless of having a fever or not. It was also announced that a million doses of the swine flu vaccine were ordered.


2009 swine flu pandemic in Asia, Bahrain
The Bahraini Ministry of Education had decided to postpone the opening of schools until October as a precaution, a decision that drew criticism from the World Health Organization. In November 2009, the government stated that up to 1,346 cases of the H1N1 virus were confirmed in the country, along with 15,000 suspected cases of the virus.


2009 swine flu pandemic in Asia, Bangladesh
As of 22 August 98 cases of the A (H1N1) virus were confirmed in Bangladesh.


2009 swine flu pandemic in Asia, Burma (Myanmar)
On 1 May 2009 Chairman of Global Human Flu Prevention and Response Work Committee Deputy Minister for Health Dr Mya Oo inspected preventive measures against the human flu at Yangon International Airport, Burma (also known as Myanmar). On 27 June, Burmese state-run Radio Myanmar confirmed the first case of influenza A/H1N1 – a 13-year-old girl who just returned from a trip to Singapore.


2009 swine flu pandemic in Asia, China
The first suspected case found on mainland China was reported on 11 May 2009. As of 29 July 2009, the number of confirmed A/H1N1 cases on the Chinese mainland topped 2,000, with no deaths or serious cases reported, according to the Ministry of Health (MOH). Of the total 2,003 confirmed cases, 1,853 had recovered, said a statement on the MOH website.


2009 swine flu pandemic in Asia, China
The General Administration of Quality Supervision, Inspection and Quarantine (AQSIQ) of China issued an emergency notice on the evening of 26 April that visitors returning from flu-affected areas who experienced flu-like symptoms within two weeks would be quarantined.


2009 swine flu pandemic in Asia, China
In early September 2009, China's State Food and Drug Administration granted approval to a homegrown swine flu vaccine, which producer Sinovac Biotech claimed to be effective after only one dose.


2009 swine flu pandemic in Asia, China
On 4 January 2010, the Chinese Health Ministry announced that 659 deaths from swine flu have been recorded in 2009, with 120,940 confirmed detected cases throughout the year.


2009 swine flu pandemic in Asia, Cyprus
Cyprus identified its first case of H1N1 on 30 May in a 39-year-old woman from Moldova, living in Cyprus, who returned from the United States on 28 May. As of 11 July 250 cases were confirmed in Cyprus.


2009 swine flu pandemic in Asia, Hong Kong
The Food and Health Bureau of Hong Kong issued travel advice for Mexico on 26 April 2009, which advised Hong Kong residents not to travel to Mexico unless absolutely necessary. The first case reported was a Mexican who flew in from Shanghai. The Bureau also escalated the alert level from "alert" to "serious" on the same day, which activated health protection measures in all ports of entry of Hong Kong. As such, temperature screening machines were used at all checkpoints to identify passengers with fever and respiratory symptoms.


2009 swine flu pandemic in Asia, Hong Kong
Any passenger who failed the temperature test and was confirmed as having a fever was quarantined and sent to public hospital for further investigation. Hong Kong also became one of the first jurisdictions to declare swine flu as a notifiable disease, and much of the procedures against the spread of the swine flu were learned from the 2003 SARS outbreak, of which Hong Kong was the epicenter of the outbreak.


2009 swine flu pandemic in Asia, Hong Kong
The Secretary for Food and Health York Chow stated that special attention will be paid to passengers who came from countries where human infection of swine influenza cases were reported.


2009 swine flu pandemic in Asia, Hong Kong
On 1 May, one case became the first confirmed case of swine flu in Hong Kong and also the first in Asia after being tested positive by the University of Hong Kong and the Department of Health of Hong Kong. The Mexican patient, who travelled with two companions from Mexico to Hong Kong with a stopover in Shanghai Pudong Airport, arrived in Hong Kong on 30 April. Metropark Hotel Wanchai, where the patient stayed, was cordoned off by the police and health officials from the Centre for Health Protection. All 350 guests and hotel staff had to remain inside the hotel for seven days. After the first swine flu case was confirmed by laboratory, Chief Executive Sir Donald Tsang raised Hong Kong's response level from "serious" to "emergency".


2009 swine flu pandemic in Asia, Hong Kong
As of 27 August 2009, there have been 10,468 confirmed cases of swine flu in the city.


2009 swine flu pandemic in Asia, India
The Government of India decided to screen all people entering India via the main airport hubs of Mumbai, New Delhi, Goa, Jaipur, Kochi, Kolkata, Chennai, Bangalore and Hyderabad, with the primary focus being passengers entering from the United States of America, United Kingdom, Canada, Mexico, France, and New Zealand. All in all, 50,000 people were affected by the virus, with 2,700 confirmed deaths.


2009 swine flu pandemic in Asia, Indonesia
After a coordination meeting about the flu on 27 April 2009, the Indonesian government halted the importation of pigs and initiated the examination of 9 million pigs in Indonesia. Thermal scanners, which can detect human body temperature, were installed at Indonesian ports of entry. Temperatures above 38 degrees Celsius (100.4 Fahrenheit) cause the devices to beep, indicating fever.


2009 swine flu pandemic in Asia, Israel and the West Bank
Over 4000 cases were confirmed in Israel, and over 60 people died. In response to the outbreak, the Israeli Deputy Minister of Health, Yaakov Litzman, said that because swine are unclean, the outbreak needed to be renamed; and so in Israel, out of respect for the religious sensibilities of Muslims, it was called "Mexican Flu". This was done so as to not confuse the population into thinking that they could not acquire the virus if they did not eat pork. The Israeli government retracted this proposal following Mexican complaints.


2009 swine flu pandemic in Asia, Japan
The Ministry of Agriculture, Forestry and Fisheries of Japan instructed animal quarantine offices across Japan to examine any live pigs being brought into Japan to make sure they were not infected with the influenza. Japanese Agriculture Minister Shigeru Ishiba appeared on television to reassure customers that it was safe to eat pork. The Japanese farm ministry said that it would not ask for restrictions on pork imports because the virus was unlikely to turn up in pork, and would be killed by cooking.


2009 swine flu pandemic in Asia, Japan
On 8 May, the first three cases were confirmed. The infected patients had spent time in Oakville, Canada and returned to Japan via Detroit. On 10 May, another case was confirmed from a student who came from a school trip to Canada, making it the fourth case in Japan.


2009 swine flu pandemic in Asia, Japan
There have been 944 case confirmed in Japan as of 24 June 2009.


2009 swine flu pandemic in Asia, Japan
On 2 July, the first case of oseltamivir-resistant virus in Asia was announced in Japan, in a woman who had been taking Tamiflu prophylactically.


2009 swine flu pandemic in Asia, Kazakhstan
The first cases of A (H1N1) virus were discovered in 3 students from the capital Astana according to Natalia Buenko, an advisor to the Ministry of Health of Kazakhstan.


2009 swine flu pandemic in Asia, Laos
The Lao government agreed to buy 10 thermal imaging machines and install them at the country's major immigration border checkpoints. The machines would help officials identify anyone entering the country with a high temperature and create confidence among Lao people, foreigners living in Laos and people traveling to Laos. Health officials would be on hand at international border checkpoints to ensure anyone found to be infected could be treated immediately. Each machine could cost about US$25,000. The decision to buy them was made after the government found visitors to Laos included people coming from the United States, Spain and other affected countries.


2009 swine flu pandemic in Asia, Laos
The Prime Minister Bouasone Bouphavanh said masks should be made available and health officials would be assigned to work at border checkpoints. Health officials would be on hand at international border checkpoints to ensure anyone found to be infected could be treated immediately. On 18 June, the first case in Laos was confirmed.


2009 swine flu pandemic in Asia, Lebanon
A Lebanese man suffering from a serious illness died from the H1N1 swine flu strain on Thursday 30 July 2009, which makes the first death in Lebanon, Health Minister Mohammad Khalifeh told Reuters. The 30-year-old victim had been receiving treatment for leukemia when he contracted the virus, possibly from relatives who had just traveled from Australia to Lebanon, the minister said. Lebanon has recorded more than 100 cases of H1N1.


2009 swine flu pandemic in Asia, Malaysia
Malaysia detected the first case of influenza A(H1N1) on 15 May 2009 in a 21-year-old student who returned from the United States. As of 11 August 2009 there were 2,253 confirmed cases in Malaysia. The Health Ministry announced that from 12 August 2009 they had discontinued the counting of the total number of H1N1 cases in line with guidelines issued by the World Health Organization.


2009 swine flu pandemic in Asia, Maldives
The first death from H1N1 flu virus was confirmed on 19 November.


2009 swine flu pandemic in Asia, Mongolia
The Mongolian Health Ministry sought to prevent the spread of swine flu in Mongolia by urging people to avoid public places.


2009 swine flu pandemic in Asia, Mongolia
As of 22 October 126 cases were confirmed in Mongolia. Just after seven days, the number increased to 394 with five deaths.


2009 swine flu pandemic in Asia, North Korea
Most defectors with backgrounds in health care agree that, considering the isolation of North Korean society and its highly inadequate health care system, incidents of swine flu are likely to be either suppressed or merely misdiagnosed.


2009 swine flu pandemic in Asia, North Korea
Following the confirmation of the first case of the disease in Mongolia, heightened concerns arose.


2009 swine flu pandemic in Asia, North Korea
On 16 November, the first known case was confirmed by the Ministry of Unification, released in a report by Korea Times. The first case was confirmed in a South Korean worker in Gaeseong Industrial Complex.


2009 swine flu pandemic in Asia, Oman
As of 13 August 2009, 337 cases have been confirmed by the National Pandemic Influenza Committee in Oman.


2009 swine flu pandemic in Asia, Pakistan
There were 90 confirmed cases as of 26 January 2010.


2009 swine flu pandemic in Asia, Philippines
Health Secretary Francisco T. Duque III ordered the Bureau of Quarantine to use thermal imaging equipment at airports to screen passengers coming from the US for flu symptoms. The Philippines may quarantine travelers arriving from Mexico with fevers. Also, the Secretary of the Department of Agriculture issued an order banning the importation of hogs from the U.S. and Mexico, and the retraction of the restriction of swine influenza vaccine use. The medical alert phase is already Code White, the lowest.


2009 swine flu pandemic in Asia, Philippines
On 18 May 2009, a Filipina girl who arrived from Houston, Texas, United States was the first confirmed case of H1N1 virus in the Philippines.


2009 swine flu pandemic in Asia, Philippines
The highest confirmed in one day was on 24 June 2009 with 131 cases. The next day, the confirmed cases added was 123. Because of that, the Department of Health ordered the people that should get swab tests are the only people with very complicated cases (e.g. with lung disorders, hearth disorders, babies etc.). The government said that the very fast spreading of the disease was caused by the population density of the country.


2009 swine flu pandemic in Asia, Saudi Arabia
By 17 August, there have been about 2,000 cases of the flu, resulting in 14 deaths.


2009 swine flu pandemic in Asia, Singapore
On 30 April 2009, the Singapore Ministry of Health raised its Disease Outbreak Response System to "Alert Orange". The first case of the H1N1 virus in Singapore was confirmed on 27 May 2009, in which a then 22-year-old woman picked up the virus after visiting New York City, United States. As of 7 July 2009, there were 1,217 confirmed cases. As of 17 October 2009, there were 18 confirmed deaths from the H1N1 virus in Singapore. On 12 February 2010, the Singapore Ministry of Health moved its alert level to Green.


2009 swine flu pandemic in Asia, Sri Lanka
The first case of Influenza A (H1N1-2009) was confirmed on 16 June, 2009 in Sri Lanka.


2009 swine flu pandemic in Asia, South Korea
On 28 April, South Korea reported its first probable case of swine flu after positive preliminary tests on a nun who had recently returned from a trip to Mexico. South Korea became the third infected nation in Asia, after Israel and Hong Kong. On 15 August, the first Korean death by the new influenza was confirmed and a second death was announced on 16 August. Around late November 2009, there was a double cases from the US. Around 15000 cases and 14 deaths have been reported as of 12 October 2009.


2009 swine flu pandemic in Asia, Taiwan (Republic of China)
On 20 May 2009, the first case of the influenza was confirmed in Taiwan.


2009 swine flu pandemic in Asia, Turkey
The first case of A(H1N1) in Turkey was reported on 16 May 2009. A U.S. citizen, flying from the United States via Amsterdam was found to be suffering from the swine flu after arriving Istanbul's Atatürk International Airport. Turkey is the 36th country in the world to report an incident of swine flu. The Turkish Government has taken measures at the international airports, using thermal imaging cameras to check passengers coming from international destinations. As of 11 August, there were 312 confirmed cases in Turkey. As of 24 October, there is 1 confirmed death in Turkey. It is reported by Ministry of Health that one person died in Ankara. In addition, there are 958 confirmed cases in Turkey.


2009 swine flu pandemic in Asia, Vietnam
On 31 May 2009, The government of Vietnam announced its first case of A (H1N1) virus in the country.


2009 swine flu pandemic in Asia, Yemen
As of 4 July 2009 there have been reported 7 cases of A(H1N1) flu in Yemen.


2009 swine flu pandemic in Australia
Australia had 37,537 confirmed cases of H1N1 Influenza 2009 (Human Swine Influenza) and 191 deaths reported by Department of Health but only 77 deaths reported by the Australian Bureau of Statistics. The actual numbers are much larger, as only serious cases warranted being tested and treated at the time. Suspected cases have not been reported by the Department of Health and Ageing since 18 May 2009 because they were changing too quickly to report. Sources say that as many as 1600 Australians may have actually died as a result of this virus.


2009 swine flu pandemic in Australia
On 23 May 2009 the federal government classified the outbreak as CONTAIN phase except in Victoria where it was escalated to the SUSTAIN phase on 3 June 2009. This gave government authorities permission to close schools in order to slow the spread of the disease. On 17 June 2009 the Department of Health and Ageing introduced a new phase called PROTECT. This modified the response to focus on people with high risk of complications from the disease. Testing at airports was discontinued. The national stockpile of antiviral drugs were no longer made available to people with the flu unless there were more than mild symptoms or a high risk of dying.


2009 swine flu pandemic in Australia, Context
There are on average 2,500–3,000 deaths every year as a result of seasonal influenza in Australia. An estimated 1 billion are infected seasonally throughout the world. By 18 December 2009 in Australia, 37,537 swine flu tests yielded positive results and the confirmed death toll of people infected with swine flu was 191.


2009 swine flu pandemic in Australia, Epidemiology
The first case of swine flu in Australia was reported on 9 May 2009 in a 33-year-old woman from Queensland when she touched down from a flight from Los Angeles to Brisbane. Although it was confirmed to be not infectious (coming out as a "weak but positive result"), family members and people who were sitting close to her during the flight were contacted and urged to seek immediate medical attention if they began to show flu-like symptoms. On 24 May Queensland confirmed its second case. 41 deaths were recorded in Queensland. The first person to die in Queensland was a 38-year-old woman on 15 July at the Mater Hospital Pimlico.


2009 swine flu pandemic in Australia, Reported cases by state and territory, Victoria
In Victoria 2,440 cases were reported, including 24 deaths. An 11-year-old boy, and later his 2 brothers, were confirmed on 20 May to carry the virus. Victorian health authorities closed Clifton Hill Primary School for two days on 21 May, initially, after the three brothers returned to the school from a trip to Disneyland. Another case delayed the reopening of the school until Thursday 28 May 2009. On 23 May about 22 year-nine students of Mill Park Secondary College were given anti-viral Tamiflu after one of their classmates was diagnosed with swine flu.