Counties with confirmed case counts in Norway as of 26 October 2009. Seven counties had 5-49 cases, 12 had 50-499 cases. No county had 500+ cases. Note that confirmed case counts are likely gross underestimations of actual flu cases.
500+ cases
50+ cases
5+ cases
1+ cases
Deaths
The 2009–2010 flu pandemic in Norway marked the initial phase of a new influenza pandemic. This pandemic began in the spring of 2009, the illness appeared in tourists returning from affected areas. By the summer of 2009, local person-to-person transmission within Norway was established. Soon thereafter, the number of patients being tested for swine flu exceeded capacity, and authorities recommended that only patients with severe symptoms be tested. The first Norwegian death from swine flu was reported in early September 2009.[citation needed]
Norway was notable among the Scandinavian countries for a high number of swine flu deaths—29 deaths as of 4 January 2010.[citation needed] All 19 counties of Norway had confirmed cases, and deaths occurred in five of the counties[citation needed]. Only Svalbard (an archipelago midway between Norway and the North Pole) had no reported cases of swine flu[citation needed]. About 10 million doses of flu vaccine were ordered from the pharmaceutical industry when the World Health Organization declared a pandemic[citation needed]. The first vaccination campaign started in Bergen, on 22 October 2009, with several hundred people queuing up[citation needed]. The flu was given widespread media coverage and the Norwegian government published a tally of laboratory-confirmed cases of swine flu, but made clear that this was an underestimation[citation needed][citation needed].
Timeline overview
On 25 April 2009, the Norwegian Institute for Public Health increased their level of alert after reports of a severe influenza in Mexico.[1] Three days later, it was considered "highly likely" that the new flu would reach Norway within the next few weeks.[2] The first confirmed Norwegian cases appeared on 9 May 2009, in tourists returning from affected areas.[3] By the summer of 2009, local spread of the influenza was established.
On 9 May 2009, the first confirmed cases were reported in two students from Oslo and Telemark returning from trips abroad.[4] As of early July 2009, there were 42 confirmed cases of swine flu, of which 39 of the people were infected while abroad.[5] In late July 2009, a local outbreak was reported in a summer camp in Western Norway.[6] The number of patients wanting tests for the suspected new flu soon exceeded the capacity to test, and by late July 2009, Norwegian authorities were recommending that only severe and special cases be tested.[7]
Influenza surveillance
The Norwegian government has operated an influenza surveillance system for many years[citation needed]. In this system, 201 selected general practices throughout the country report weekly the percentage of patients given a diagnosis of influenza. The study covers about 15% of the population. The results of the influenza study during the 2009 flu pandemic in Norway are shown in the figure below. The share of doctor contacts that ended in a diagnosis of influenza-like illness shot up to nearly 10% in week 44. The last time this percentage was this high was in the 1999-2000 flu season.
On the basis of the last reported data, as of 4 November 2009, the Norwegian Public Health Institute concluded "the pandemic influenza virus is spreading epidemically in large parts of the country".[8]
A time series of the percentage of doctor contacts resulting in a diagnosis of influenza-like illness in the Norwegian influenza surveillance system, from early May to October 2009
It was reported that 30% of the population would likely fall ill within six months, and that half of those would be confined to their beds[citation needed]. Ultimately, one out of every two persons would have acquired the disease at some point[citation needed]. This meant that about 700,000 Norwegians would have fallen ill, and in this period, 700 to 3,000 more deaths than a regular influenza season were to be expected.
The worst-case scenario was reported to be that 50% of the population would fall ill within six months, and half of those would be confined to their beds. In this case, 1.2 million Norwegians would have fallen ill in this period and an extra 5,000–13,000 deaths beyond the regular influenza season were expected.[26][27]
Norway had a stockpile of 1.4 million doses of Tamiflu and had ordered 200,000 doses of Relenza[relevant?].
The Norwegian Institute of Public Health (FHI) announced[when?] that it would be only a matter of time before the virus was transmitted within Norway, and that cases of travelers falling ill should be expected within the next few weeks[citation needed]. The main goal[according to whom?] was to quickly reduce the spread of the virus in Norway, even so, the closure of public institutions, such as schools and kindergartens, was to be avoided as long as possible.[28]
As of 15 May, the Norwegian government lifted their advisory against travel to Mexico, even so, people with increased risk of infection were advised to reconsider the need to travel.[29]
In early May, Norway pre-ordered 4.7 million doses of the then not-yet-developed Swine Influenza vaccine. The price was estimated to be $47.5 million.[30][31] Regarding the order, Health Care Minister Bjarne Håkon Hanssen said
The contract we are entering into will make it possible to secure vaccine for the population before a pandemic is declared. For myself and for the government it is important to follow up on the advice from the Pandemic Committee... This is also in line with professional advice from the health institutions.[30]
Vaccine
As of the fall of 2009, Norway was supplied with 9.4 million doses of the influenza vaccine from GlaxoSmithKline[citation needed]; every Norwegian could be given up to two doses. The vaccine was intended to be ready for use after clinical trials in November or December[citation needed], however, because swine influenza still was considered to be a mild disease, the influenza vaccine could not be used without approval by the European Medicines Agency (EMEA)[citation needed].
Distribution
Norway had enough vaccine for every citizen by the fall of 2009[citation needed]. Health personnel, as well as people with an increased risk of complications, were advised to receive early vaccinations[by whom?][citation needed]. The Healthcare Ministry provided recommendations for which groups to prioritize in vaccination distribution[citation needed].
The Norwegian Institute of Public Health (FHI) updated their homepage with information about the swine flu outbreak in Norway every day at 10:00 (UTC).[28] FHI believed that the northern hemisphere would not be greatly affected by the virus, with the exception of a few outbreaks in enclosed places (schools and other institutions, cruise ships), followed by a bigger epidemic in the fall or winter[citation needed].
On 9 May, two Norwegian students from Oslo and Telemark, were confirmed to be infected with swine flu after they came home from studying in Mexico. Neither of them became seriously ill and they recovered quickly. These were the first two cases of swine influenza in Norway[citation needed].
On 19 May, a Norwegian woman from Oslo was confirmed to be infected with swine flu after coming home from the United States. This was the third confirmed case of swine influenza in Norway.[28][33]
On 20 May, a Norwegian man from Vest-Agder was confirmed to be infected with swine influenza after returning from a trip to the United States. This was the fourth confirmed case of swine influenza in Norway.[34]
On 27 May, a Norwegian man was confirmed to be infected with swine influenza in Düsseldorf, Germany. The man was put in isolation where he stayed for 10 days. He showed obvious symptoms of influenza on the flight from the United States to Germany, and when he exited the plane, he was met by four doctors. His trip home to Norway was delayed. This case, however, is not reported as a Norwegian case of swine influenza, but a German one.[35]
On 29 May, a Norwegian woman from Oslo was confirmed to be infected with swine influenza after returning from a trip to the United States. She was the fifth confirmed case in Norway.[36]
On 30 May, two Norwegians were confirmed to be infected with swine influenza. One of them was a woman from Rogaland returning from Mexico; the other one was a woman from Oslo returning from the United States. These were the sixth and seventh confirmed swine influenza cases in Norway.[28]
On 3 June, a Norwegian woman coming home from the United States was confirmed to be infected with swine influenza. This is the eighth confirmed case of swine influenza.
On 4 June, a Norwegian woman from Vest-Agder who recently had been to the United States was confirmed to be infected with swine influenza. This was the ninth confirmed case of swine influenza.[28]
On 9 June, two Norwegian men from Vest-Agder and Oslo who recently had been to the United States were confirmed to be infected with swine influenza. These were the 10th and 11th cases of swine influenza in Norway.
On 10 June, a Norwegian man from Vest-Agder was confirmed to be infected with swine influenza. Although he had not been infected abroad, he had been living with a person who had been infected abroad. This was the first domestic infection and was the 12th case of swine influenza in Norway.[37]
On 11 June, a Norwegian man from Oslo was confirmed to be infected with swine influenza. He had not recently been traveling abroad. This was the second domestic infection and the 13th case of swine influenza in Norway.
On 12 June, a Norwegian man from Buskerud was confirmed to be infected with swine influenza. He had not been traveling abroad but was working with an infected person. This was the third domestic infection and 14th case of swine influenza in Norway.
On 13 June, a Norwegian woman from Rogaland was confirmed to be infected with swine influenza. She had recently been to the United States and was infected there. This was the 15th case of swine influenza in Norway.
On 15 June, a Norwegian man from Sør-Trøndelag was confirmed to be infected with swine influenza. He had recently been on a trip to the United States. This was the 16th case of swine influenza in Norway and first case of swine influenza in Sør-Trøndelag.
On 17 June, a Norwegian man from Akershus was confirmed to be infected with swine influenza. He had recently been to the United States. This was the 17th case of swine influenza in Norway.
On 18 June, a Norwegian man from Rogaland and two women from Akershus were confirmed to be infected with swine influenza. They had all recently been in the United States and were the 18th, 19th, and 20th cases of swine influenza in Norway.
On 23 June, a Norwegian woman from Oslo and a Norwegian woman from Østfold were confirmed to be infected with swine influenza. They had recently been in the United States and were the 21st and 22nd cases of swine influenza in Norway.
On 24 June, a Norwegian woman from Oslo was confirmed to be infected with swine influenza. She had recently been in England and was the 23rd case of swine influenza in Norway.
On 25 June, a Norwegian man from Oslo was confirmed to be infected with swine influenza. He had recently been in Argentina and was the 24th case of swine influenza in Norway.
On 26 June, a Norwegian woman from Sogn og Fjordane was confirmed to be infected with swine influenza. She had recently been in Greece and was the 25th case of swine influenza in Norway.
On 29 June, a Norwegian woman from Hordaland was confirmed to be infected with swine influenza. She had recently been in the United States and was the 26th case of swine influenza in Norway.
On 30 June, four Norwegian women (one from Oslo, one from Østfold and two from Sør-Trøndelag), two Norwegian men (one from Oslo and one from Sør-Trøndelag), and a Norwegian boy from Østfold were confirmed to be infected with swine influenza. They had all been traveling abroad; five of them had recently been in the United States, and the other two had recently been in Argentina. These were the 27th, 28th, 29th, 30th, 31st, 32nd and 33rd cases of swine influenza in Norway.
On 1 July, seven Norwegians were confirmed to be infected with swine influenza. They were passengers on a cruise ship that had docked in Oslo. The sick passengers had not gone ashore and did not infect any persons on land. These cases were not counted as Norwegian cases and were therefore not included in the Norwegian total.
On 2 July, a Norwegian woman from Bergen was confirmed to be infected with swine influenza. She had recently been in the United States. This was the 34th case of swine influenza in Norway.
On 3 September, the first confirmed death caused by swine flu in Norway was reported.
On 10 September, the third death was reported.
On 19 October, the seventh death was confirmed in Bergen in a previously healthy male who was in his 50s.[17]
On 20 October, an alarming increase in absences caused by flu was reported at primary schools in Oslo and Bergen. In one school, over half of the elementary school students were absent because of the flu.[38][39]
On 20 October, the eighth death from the flu was confirmed as a woman in her twenties in Akershus county.[18]
On 22 October, the city of Bergen started widespread vaccination and a long queue of persons was reported.[40]
On 22 October, the ninth death from the flu was confirmed as a woman in her fifties in Akershus county.[19]
On 23 October, the 10th death from the flu was confirmed as a two-year-old child in Vest-Agder county.
On 26 October, the 11th death from the flu was confirmed as a nine-year-old child in Oslo.[21]
On 28 October, the 12th and 13 deaths from the flu were reported.[22]
On 30 October, the 14th death from flu was confirmed. A woman in her forties from Ringsaker died at the hospital in Hamar.
On 2 November, the 15th death from flu was announced. A woman less than 20 years of age from Hedmark county died November 1 at Rikshospitalet.[24]
Influenza A virus subtype H1N1 (A/H1N1) is a subtype of influenza A virus (IAV). Some human-adapted strains of H1N1 are endemic in humans and are one cause of seasonal influenza (flu). Other strains of H1N1 are endemic in pigs and in birds. Subtypes of IAV are defined by the combination of the antigenic H and N proteins in the viral envelope; for example, "H1N1" designates an IAV subtype that has a type-1 hemagglutinin (H) protein and a type-1 neuraminidase (N) protein.
The 2009 swine flu pandemic, caused by the H1N1/swine flu/influenza virus and declared by the World Health Organization (WHO) from June 2009 to August 2010, was the third recent flu pandemic involving the H1N1 virus. The first identified human case was in La Gloria, Mexico, a rural town in Veracruz. The virus appeared to be a new strain of H1N1 that resulted from a previous triple reassortment of bird, swine, and human flu viruses which further combined with a Eurasian pig flu virus, leading to the term "swine flu".
The 2009 flu pandemic in the United States was caused by a novel strain of the Influenza A/H1N1 virus, commonly referred to as "swine flu", that was first detected on 15 April 2009. While the 2009 H1N1 virus strain was commonly referred to as "swine flu", there is no evidence that it is endemic to pigs or of transmission from pigs to people; instead, the virus spreads from person to person. On April 25, the World Health Organization declared a public health emergency, followed concurringly by the Obama administration on April 26.
The 2009 swine flu pandemic in Canada was part of an epidemic in 2009 of a new strain of influenza A virus subtype H1N1 causing what has been commonly called swine flu. In Canada, roughly 10% of the populace has been infected with the virus, with 428 confirmed deaths ; non-fatal individual cases are for the most part no longer being recorded. About 40% of Canadians have been immunized against H1N1 since a national vaccination campaign began in October 2009, with Canada among the countries in the world leading in the percentage of the population that has been vaccinated. The widespread effect of H1N1 in Canada raised concerns during the months leading to the XXI Olympic Winter Games, which took place in Vancouver in February 2010.
This article covers the chronology of the 2009 novel influenza A (H1N1) pandemic. Flag icons denote the first announcements of confirmed cases by the respective nation-states, their first deaths, and relevant sessions and announcements of the World Health Organization (WHO), the European Union , and the U.S. Centers for Disease Control (CDC).
In March and April 2009, an outbreak of a new strain of influenza commonly referred to as swine flu infected many people in Mexico and parts of the United States causing severe illness in the former. The new strain was identified as a combination of several different strains of Influenzavirus A, subtype H1N1, including separate strains of this subtype circulating in humans and in pigs. Spain was the first country in continental Europe to report cases of swine flu, in late April 2009.
Australia had 37,537 confirmed cases of H1N1 Influenza 2009 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. On 23rd of May 2009 the federal government classified the outbreak as CONTAIN phase except in Victoria where it was escalated to the SUSTAIN phase on 3rd of 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.
This article deals with the status and efforts regarding the 2009 swine flu pandemic by country and continent/region.
The pandemic H1N1/09 virus is a swine origin influenza A virus subtype H1N1 strain that was responsible for the 2009 swine flu pandemic. This strain is often called swine flu by the public media due to the prevailing belief that it originated in pigs. The virus is believed to have originated around September 2008 in central Mexico.
The 2009 flu pandemic in South America was part of a global epidemic in 2009 of a new strain of influenza A virus subtype H1N1, causing what has been commonly called swine flu. As of 9 June 2009, the virus had affected at least 2,000 people in South America, with at least 4 confirmed deaths. On 3 May 2009, the first case of the flu in South America was confirmed in a Colombian man who recently travelled from Mexico – since then, it has spread throughout the continent. By far, the most affected country has been Chile, with more than 12,000 confirmed cases, 104 deaths, and the highest per capita incidence in the world.
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.
The 2009 swine flu pandemic in North America, part of a pandemic in 2009 of a new strain of influenza A virus subtype H1N1 causing what has been commonly called swine flu, began in the United States or Mexico.
The 2009 flu pandemic in Oceania, part of an epidemic in 2009 of a new strain of influenza A virus subtype H1N1 causing what has been commonly called swine flu, has afflicted at over 22,000 people in Oceania, with 56 confirmed deaths. Almost all of the cases in Oceania have been in Australia, where the majority of cases have resulted from internal community spread of the virus. In addition, the government of New Zealand, where most of the remainder of cases in Oceania have occurred, is on high alert for any people travelling into the country with flu-like symptoms.
The 2009 flu pandemic in Europe was part of a pandemic involving a new strain of influenza, subtype H1N1. H1N1 is commonly called swine flu. The pandemic infected at least 125,550 people in Europe. There were 458 confirmed deaths in Turkey, 438 confirmed deaths in Russia, and 457 confirmed deaths in the United Kingdom.
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.
The United States experienced the beginnings of a pandemic of a novel strain of the influenza A/H1N1 virus, commonly referred to as "swine flu", in the spring of 2009. The earliest reported cases in the US began appearing in late March 2009 in California, then spreading to infect people in Texas, New York, and other states by mid-April. Early cases were associated with recent travel to Mexico; many were students who had traveled to Mexico for Spring Break. This spread continued across the country's population and by the end of May there were approximately 0 confirmed cases throughout all 50 states.
The 2009 swine flu pandemic in New Zealand was caused by a novel strain of the A/H1N1 influenza virus. A total of 3,175 cases and 69 deaths were recorded, although a seroprevalence study estimated that around 800,000 individuals may have been infected during the initial wave of the pandemic.
The 2009 swine flu pandemic in India was the outbreak of swine flu in various parts of India. Soon after the outbreak of H1N1 virus in the United States and Mexico in March, the Government of India started screening people coming from the affected countries at airports for swine flu symptoms. The first case of the flu in India was found on the Hyderabad airport on 13 May, when a man traveling from US to India was found H1N1 positive. Subsequently, more confirmed cases were reported and as the rate of transmission of the flu increased in the beginning of August, with the first death due to swine flu in India in Pune, panic began to spread. As of 24 May 2010, 10193 cases of swine flu have been confirmed with 1035 deaths.
The 2009 flu pandemic, involving an outbreak of a new strain of influenza commonly known as swine flu, reached Germany in April 2009.
The COVID-19 pandemicin Norway resulted in 1,525,190 confirmed cases of COVID-19 and 5,732 deaths.
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