2009 swine flu pandemic in the United States

Last updated

Reported cases by state/territory
State or territoryState-reported confirmed cases [1] State-reported hospital- izations [1] Confirmed deaths
Total115,31827,6323,433
Alabama 2,453/NLU [2] NR19 [2]
Alaska 1,563 [3] [4] 18 [3] wave 113 [5] (11) [6]
Arizona 8,726 [7] 1,897 [7] 152 [7]
Arkansas 154/NLU [8] NR53 [9]
California 10,545 [10] 8,589 [10] 657
Colorado 1,321 [11] 578 [12] 70 [12]
Connecticut 5,491 [13] 766 [13] 35 [13]
Delaware 381 [14] [15] NR7 [16]
District of Columbia 54 [14] NR1 [17]
Florida 3,676 [18] 1,227 [18] 230 [19] [20]
Georgia 1,012 [21] 860 [21] 81 [22]
Hawaii 2,221 [23] NR13 [24]
Idaho 1,171 [25] 389 [25] wave 223 [25] wave 2
Illinois 3,387 [26] 3,042 [27] 111 [27]
Indiana 782 [28] NR39 [28]
Iowa 929 [29] 700 [30] 41 [31]
Kansas 1,201 [32] NR29 [33]
Kentucky 2,092 [34] NR39 [34]
Louisiana 1,876 [35] NR52 [36]
Maine 2,232 [37] 230 [37] 21 [38]
Maryland 1,772 [39] 996 [40] 45 [41]
Massachusetts 1,979 [42] 397 [42] 33 [43]
Michigan 655/NLU [44] NR88 [45]
Minnesota 2,220 [14] 1,813 [46] 61 [47]
Mississippi 1,292 [48] NR26 [49]
Missouri 1,523 [50] NR17 [51]
Montana 961 [52] 9 [52] 19 [53]
Nebraska 430 [54] 40 [54] 15 [55]
Nevada 5,516 [56] [57] NR44 [56] [58]
New Hampshire 722 [59] NR10 [60]
New Jersey 1,006/NLU [61] 512 [62] 42 [63]
New Mexico 1,007 [64] 1,007 [65] 58 [66]
New York 2,738 [14] [67] 909 [68] 206
North Carolina 638 [69] 267 [69] 107 [70]
North Dakota 650 [71] 60 [71] 2 [72]
Ohio 227/NLU [73] NR52 [74]
Oklahoma 237/NLU [75] 7 [75] 44 [76]
Oregon 1,833 [77] 1,419 [77] 79 [78]
Pennsylvania 10,940 [79] NR78 [79]
Rhode Island 203 [80] 76 [81] 13 [82] [83]
South Carolina 1,634 [84] NR49 [85]
South Dakota 2,081 [86] 422 [86] 23 [86]
Tennessee 1,163 [87] NR57 [88]
Texas 6,128 [89] 1,994 [90] 231 [91]
Utah 988 [14] 302 [92] 48 [93]
Vermont 404 [94] 149 [94] 3 [95]
Virginia 327 [14] [96] NR37 [97]
Washington 1,882 [14] [98] 1,561 [99] 99 [99]
West Virginia 1,214 [100] 853 [101] 22 [102]
Wisconsin 9,579 [103] 1,317 [103] 55 [103]
Wyoming 725 [104] NR10 [105]
American Samoa 90 [106] NR1 [107]
Guam 338 [108] NR2 [109]
Northern Mariana Islands 71 [110] NR0
Puerto Rico 908 [111] NR60 [112]
U.S. Virgin Islands 80 [113] NR1 [113]
NR: Not Reported - NLU: No Longer Updated

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. [114] While the 2009 H1N1 virus strain was commonly referred to as "swine flu", there is no evidence that it is endemic to pigs (i.e. actually a swine flu) or of transmission from pigs to people; instead, the virus spreads from person to person. [115] On April 25, the World Health Organization declared a public health emergency, followed concurringly by the Obama administration on April 26. [114]

Contents

The U.S. Centers for Disease Control and Prevention (CDC) reported that during the outbreak about half of all influenza viruses being reported were 2009 H1N1 viruses, with the other half being those of the regular seasonal influenza. Unique to this particular strain, about 60% of the 2009 H1N1 influenza cases were occurring among people between 5 years and 24 years of age, and 40% of the hospitalizations were occurring among children and young adults. About 80% of the deaths were in people younger than 65 years of age. The CDC noted that this differed greatly from typical seasonal influenza epidemics, during which about 70% to 90% of deaths are estimated to occur in people 65 years and older. Antibody studies showed that children had no existing cross-reactive antibody to the 2009 H1N1 influenza virus, while about one-third of adults older than 60 years of age had cross-reactive antibody. [116]

By April 21, 2009, CDC had begun working to develop a virus that could be used to make a vaccine to protect against the new virus. Following preparation for distribution beginning in June, the first doses were administered in October 2009. [117] On August 10, 2010, WHO declared an end to the global 2009 H1N1 influenza pandemic. However, the virus continues to circulate as a seasonal flu virus, and cause illness, hospitalization, and deaths worldwide every year. [118] From April 12, 2009, to April 10, 2010, the CDC estimates there were 60.8 million cases (range: 43.3 - 89.3 million), 274,304 hospitalizations (range: 195,086 - 402,719), and 12,469 deaths (range: 8868 - 18,306) in the United States due to the virus. [119]

A follow-up study done in September 2010 showed that the risk of serious illness resulting from the 2009 H1N1 flu was no higher than that of the yearly seasonal flu. [120] For comparison, the CDC estimates the global H1N1 death toll at 284,000 and the WHO estimates that 250,000 to 500,000 people die of seasonal flu annually. [121]

History

The earliest reported cases in the US began appearing in early April 2009, in California. [122] [123] In late April, the Centers for Disease Control and Prevention (CDC) activated its Emergency Operations Center and declared a public health emergency. [124] On April 25, the World Health Organization (WHO) declared a public health emergency of international concern. WHO declared H1N1 a pandemic on June 11.[ citation needed ]

By the end of May, the flu had infected people in all 50 states. As of June 16, the total number of confirmed cases was 27,717 [125] and on June 25, the CDC said there were over one million (1,000,000) cases, most of which had not been reported or diagnosed. [126] [127] Deaths relating to influenza began appearing in the US in late April, and by early June, 15 states had reported fatalities related to or directly occurring from the virus.

By October 5, the first doses of an H1N1 vaccine were given in the U.S. The CDC distributed vaccines for the flu [128] using mechanisms already in place for its Vaccines for Children (VFC) program. [129]

On October 24, and the CDC said more than 1,000 had died from the flu. President Obama declared a national emergency. [130] [114] [131] On December 10, 2009, the CDC reported an estimated 50 million Americans or 1 in 6 had been infected and 10,000 had died. [132] On December 23, 2009, the CDC reported a reduction of the disease by 59% percent. On February 12, the CDC reported 57 million Americans had been sickened, 257,000 had been hospitalized and 11,690 people had died (including 1,180 children) due to flu from April through to mid-January. [133] [134]

Initial cases

The Centers for Disease Control and Prevention (CDC) identified the first two A/09(H1N1) swine flu cases in California on April 17, 2009, via the Border Infectious Disease Program, [135] for a San Diego County child, and a naval research facility studying a special diagnostic test, where influenza sample from the child from Imperial County was tested. [136] By April 21, enhanced surveillance was established to search for additional cases in both California and Texas and the CDC determined that the virus strain was genetically similar to the previously known A(H1N1) swine flu circulating among pigs in the United States since about 1999.[ citation needed ]

It was established that the virus was a combination of human, North American swine, and Eurasian swine influenza viruses; the viruses from the initial two Californian cases were also noted to be resistant to amantadine and rimantadine, two common influenza antiviral drugs. [137] No contact with pigs was found for any of the seven Californian nor either of the two Texas cases, suggesting human-to-human transmission of the virus.[ citation needed ]

On April 28, 2009, the director of the Centers for Disease Control and Prevention confirmed the first official US death of swine flu. Tests confirmed that a 23-month-old toddler from Mexico, who was probably infected there, died on April 27 from the flu while visiting Texas. [138]

Outbreak across the US

CDC report for the 2008-2009 flu season week 18 (May 17), subtypes and percent positive tests WhoLab18.GIF
CDC report for the 2008–2009 flu season week 18 (May 17), subtypes and percent positive tests

Cases of H1N1 spread rapidly across the United States, with particularly severe outbreaks in Texas, New York, Utah, and California. Early cases were associated with recent travel to Mexico; many were students who had traveled to Mexico for spring break. [139] On May 4, 2009, the CDC reported one death, 286 confirmed cases of H1N1 flu across 36 states, 35 hospitalizations, and expected H1N1 to eventually spread to all states. A large number of cases, according to medics, have happened in the days that preceded the launch of the alert and came out only in these days due to a massive backlog. [140] By May 5, 2009, the number had risen to 403 [125] and a second death was reported in Texas. [141] The CDC and government officials had expressed cautious optimism about the severity and spread of H1N1. [142] [143]

Changes in surveillance of cases of influenza-like illness, including new guidelines for identifying cases to test, increased laboratory testing, and new test kits able to distinguish this novel strain, resulted in a spike in the percent of cases tested positive for influenza. Of the positive cases, about a third were due to the novel strain. Also found were a substantial number of cases where the strain could not be subtyped. [144]

Pneumonia and influenza deaths in 122 US cities, 5 years through October 2009 Bigpi43(2009).png
Pneumonia and influenza deaths in 122 US cities, 5 years through October 2009

The proportion of US deaths due to pneumonia and influenza climbed above the epidemic threshold in the 2007–2008 winter flu season but not in the 2008–2009 season. Although the 2009 H1N1 outbreak reached epidemic levels of infection early in 2009, it did not contribute to epidemic levels of pneumonia and influenza related deaths until October 2009.[ citation needed ]

2009 US Swine Flu Summary
Number of Confirmed Cases/DeathsSee Table Above
Number of States/Territories
with Reported Cases		56
Number of States/Territories
with Confirmed Deaths		55
Earliest Confirmed Infection in USMarch 28, 2009 [145]
First Death Inside the USApril 27, 2009 [138]
First Death of US CitizenMay 5, 2009 [146]
Number of People Hospitalized9,079 (as of September 3) [147]
Fatalities593 (as of September 3) [147]

The second wave

In early October 2009, the Centers for Disease Control and Prevention announced that swine flu was widespread across the country. It also said there was significant flu activity in virtually all states, which was considered to be quite unusual for this time of year. There was particular worry about pregnant women. As of late August, 100 had been hospitalized in intensive care units and 28 had died since the beginning of the outbreak in April. On October 1, it was acknowledged that a recruit in basic training in Fort Jackson, South Carolina, was the Army's first swine flu death. The recruit fell ill on September 1 and died of pneumonia on September 10.[ citation needed ]

Dell Children's Medical Center in Austin, Texas, erected two tents in its parking lot to handle emergency room visits, and hospitals around Colorado Springs recorded a 30 percent spike in flu visits. As pediatric cases were increasing, the Dept. of Health and Human Services released 300,000 courses of children's liquid Tamiflu from the national pandemic stockpile in late September, with the first batches sent to Texas and Colorado.[ citation needed ]

In late September, the disease centers reported that 936 had died of flu symptoms or of flu-associated pneumonia since August 30, when it began a new count of deaths, including some without laboratory-confirmed swine flu. [148]

The Agriculture Department reported on October 16 that three pigs at the Minnesota State Fair, in St. Paul, were tested positive in late August for H1N1 virus, which were the first cases in the country, although infected pigs had been found in eight other countries. There were 103 pigs tested at the Fair, including the three infected, though all appeared healthy. Scientists said the virus was already spreading widely among people, and, in fact, was more common in humans than in pigs, so humans were more likely to catch it from others than from pigs. [149]

In mid-October, it was reported that flu caused by the H1N1 virus was widespread in 41 states, and flu-like illnesses accounted for 6.1 percent of all doctor visits, which was considered high[ citation needed ], particularly for October. Forty-three children had died from H1N1 since August 30, which is approximately the number that usually dies in an entire flu season. Nineteen of the forty-three were teenagers while sixteen were between ages five to eleven. The rest were under five.[ citation needed ] It is reported that the severity of the disease was not increasing. About fifteen to twenty percent of the patients hospitalized for the flu were placed in the intensive care unit, a level similar to that for seasonal flu.[ citation needed ]

High-risk groups line up at a defunct Kmart on October 24, 2009, for the first H1N1 vaccines publicly available in Boise, Idaho. BoiseH1N1VaccinationClinic5578.JPG
High-risk groups line up at a defunct Kmart on October 24, 2009, for the first H1N1 vaccines publicly available in Boise, Idaho.

Projections of the supply of H1N1 vaccine had decreased significantly from a level of 120 million doses ready in October, estimated during the summer, to an estimate of 28 to 30 million doses by the end of the month. On October 14, 11.4 million doses of the H1N1 vaccine were said to be available. As of November 20, 2009, the CDC reported sharp declines in H1N1 activity throughout the United States, with influenza-like illness (which may also include meningitis, pneumonia, strep pharyngitis, gastroenteritis, and the common cold) accounting for 5.5% of doctors visits, down sharply from 8% in late October, the peak of the second wave. However, taking the vaccine is still urged by the CDC, as a third wave of the disease may sweep across the US, possibly in January/February 2010. [150] [ needs update ] As of December 24, the second wave of H1N1 has clearly peaked, with pneumonia and influenza deaths falling below the epidemic threshold for the first time in 11 weeks, and the proportion of doctors visits due to influenza-like illness falling to baseline (2.3%), down from 5.5% 1 month before, on November 20. However, it was reported that influenza activity was beginning to increase in West Virginia, with 5.2% of patients treated by West Virginia health care providers having influenza-like illness, a major increase from 2% of patients treated by West Virginia health care providers having influenza-like illness in November.[ citation needed ]

On August 10, 2010, WHO declared an end to the global 2009 H1N1 influenza pandemic. However, the virus continues to circulate as a seasonal flu virus, and cause illness, hospitalization, and deaths worldwide every year. [151]

H1N1 characteristics and severity

Influenza-associated pediatric deaths reported to CDC, from 2005-06 to start of 2009-2010 IPD40.GIF
Influenza-associated pediatric deaths reported to CDC, from 2005–06 to start of 2009–2010

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 (see human influenza) and in pigs (see swine influenza). The strain transmits between humans and was initially reported to have a relatively high mortality rate in Mexico. In April 2009 the World Health Organization (WHO) and the U.S. Centers for Disease Control and Prevention (CDC) expressed serious concerns that the new strain had the potential to become an influenza pandemic. [152] On April 25 it was reported that, because the virus was already widespread, containment would be "nearly impossible." [153]

By this time, there had also been speculation that the flu death toll in Mexico could be lower than first thought. Gerald Evans, head of the Association of Medical Microbiology and Infectious Disease Canada and a member of a federal pandemic-planning committee, said on April 29: [154]

There was a lot of speculation and what seemed to be evidence there were dozens and dozens of deaths. Careful analysis showed these people likely died of something else, and not influenza. That's really good news, and that would fit with what we've seen outside of Mexico.

Another Canadian expert, Neil Rau, criticized the WHO's decision to raise its pandemic alert to level 5, saying: [155]

I don't agree with (the WHO) because I think it's a panic metre, not a pandemic metre. [...] If that flu-like illness is not deadly, I don't know what the cause for alarm is for people who are not really sickened by this virus. [...] I'm really eager to know how much worse this is than seasonal flu. So far it's looking like it's not that serious.

CNN noted on April 28, 2009, that in any individual week between January 1 and April 18, there had been at least 800 deaths in the U.S. due to normal influenza, which is higher than the 150 total deaths worldwide from the swine flu up to that time. [156]

As of May 28, 2010, the official U.S. death toll attributed directly to the novel H1N1 and seasonal influenza was 2,117. [157] This total exceeds the 849 U.S. deaths directly attributed to seasonal influenza in 2006. [158] Many of the other deaths commonly attributed to influenza are caused by complicated influenza, where a second infection causes death, usually pneumonia (of which 48,657 of 55,477 official deaths in 2006 occurred in people aged 65 years and older). [158] [159] The final estimate was of over 12,000 deaths throughout the pandemic (April 2009 – April 2010). [119]

H1N1 unique characteristics

The CDC reported that during the outbreak about half of all influenza viruses being detected through laboratory reports were 2009 H1N1 viruses, with the other half being those of the regular seasonal influenza viruses. Surveillance reports indicated that about 57% of the 2009 H1N1 influenza confirmed and probable cases were occurring among people between 5 years and 24 years of age, and 41% of the hospitalizations were occurring among older children and young adults. The highest rates of hospitalization were among children younger than 5 years of age; the next highest hospitalization rate was in people 5 years to 24 years of age. Antibody studies showed that children had no existing cross-reactive antibody to the 2009 H1N1 influenza virus, while about one-third of adults older than 60 years of age had cross-reactive antibody. One possible explanation for this pre-existing antibody in older adults was that they may have had previous exposure, either through infection or vaccination, to an influenza A H1N1 virus that was more closely related to the 2009 H1N1 flu virus. [160]

Based on data from previous influenza pandemics and seasonal influenza, pregnant women had been recognized as a high-risk group early in the outbreak. People with other previously recognized medical conditions that placed them at high risk of complications from seasonal influenza also appeared to be at increased risk of complications from 2009 H1N1 influenza. One report found that seventy-one percent of hospitalized patients had one or more underlying chronic medical conditions and reported deaths had occurred in people ranging in age from 22 months old to 57 years old. Also, only 13% of hospitalizations had occurred in people 50 years and older, and there were few cases and no deaths in people older than 65 years, which was unusual when compared with seasonal flu. [161]

Response

Congruent U.S. Government and WHO Pandemic Response Charts. FedFluPandemicResponse.png
Congruent U.S. Government and WHO Pandemic Response Charts.

The Federal response remained at US Pandemic Stage 0, congruent with the World Health Organization (WHO) Pandemic Phases 1, 2 and 3; [162] [163] however, the WHO's Pandemic Phase was raised to 4 on April 27, which is congruent with US Pandemic Stage 2. [164] On April 29, the WHO raised the pandemic alert level to phase 5. [165]

The United States federal government declared a public health emergency, and several U.S. states then indicated that they may follow suit. Secretary of Homeland Security Janet Napolitano noted that this declaration was standard operating procedure, which was also done for the 2009 presidential inauguration and for flooding. [166]

After many days of deliberation the WHO declared that the current influenza had become a true pandemic, raising the Pandemic Alert level to Phase 6, the highest on the WHO scale and congruent with U.S. Federal Government Response Stages 3–6. [167]

Obama administration reactions

Barack Obama being vaccinated on Dec. 20, 2009. A nurse vaccinates Barack Obama against H1N1.jpg
Barack Obama being vaccinated on Dec. 20, 2009.

An official for the White House said on April 24 that "the White House is taking the situation seriously and monitoring for any new developments. The president has been fully briefed." [168] President Barack Obama stated that "We are closely monitoring the emerging cases of swine flu." He also noted, "This is obviously a cause for concern ... but it is not a cause for alarm." [169] Obama suggested that U.S. schools should consider shutting down, as a future possibility, if their students were to become infected. [170] White House Press Secretary Robert Gibbs said the effort to get a team in place to respond to the health scare had not been hindered by the lack of a secretary of Health and Human Services or appointees in any of the department's 19 key posts. [171] The president's nominee, Kansas Gov. Kathleen Sebelius, was still awaiting confirmation from the U.S. Senate until passing on April 28. The President had not yet made appointments to either the Commissioner of the Food and Drug Administration, the Surgeon General, or the Director of the Centers for Disease Control and Prevention. [171] The current acting Surgeon General, Steven K. Galson, was also currently serving as the Acting Assistant Secretary for Health. [172]

Health and Human Services Secretary Kathleen Sebelius in a meeting in the Situation Room of the White House regarding the H1N1 virus. Kathleen Sebelius in HHS meeting 4-28-09.jpg
Health and Human Services Secretary Kathleen Sebelius in a meeting in the Situation Room of the White House regarding the H1N1 virus.

On April 30, it was reported that an aide to Steven Chu, the US Energy Secretary, had fallen ill from the virus after helping arrange President Obama's trip to Mexico. [173] However, the White House stated that the President was not at risk of contracting the flu. [173] Kathleen Sebelius was confirmed as the Secretary of Health and Human Services by the Senate on April 28, 2009, with a vote of 65–31. [174] [175]

On October 24, President Obama declared the 2009 H1N1 swine flu a national emergency. [176] The declaration made it easier for U.S. medical facilities to handle a surge in flu patients by allowing the waiver of some requirements of Medicare, Medicaid and other federal health insurance programs as needed.

Centers for Disease Control and Prevention (CDC)

In this video, Joe Bresee, with CDC's Influenza Division, describes the symptoms of swine flu and warning signs to look for that indicate the need for urgent medical attention.
See also this video with subtitles: Video on YouTube

Activation of Emergency Operations Center

During the week of April 19, 2009, the CDC activated its Emergency Operations Center (EOC), with RADM Stephen Redd as the Incident Commander, to augment the ongoing investigation of human cases of swine influenza A (H1N1). [177] More than 250 CDC professionals worked from the CDC EOC as part of the agency's response. [178] As of May 4, 2009, the CDC reported that it had deployed 25% of the supplies and medicines in the Strategic National Stockpile to the various states. [179]

Swine flu test kits

As of April 29, only the CDC could confirm U.S. swine flu cases. [180] Besser stated during an April 30 press briefing that California and New York had diagnostic test kits, and that the kits would be sent to all states starting the following day. [181] On May 6, the CDC announced that testing kits were now available for all states. It was expected this would generate an increase in the number of confirmed cases as more states began doing their own tests. [182]

President Obama is briefed in the Situation Room about the swine flu outbreak. Barack Obama being briefed on swine flu oubreak 4-29.jpg
President Obama is briefed in the Situation Room about the swine flu outbreak.

Influenza reporting requirements

In the United States, the majority of the 70 National Respiratory and Enteric Virus Surveillance System (NREVSS) laboratories do not report the influenza A subtype.[ citation needed ]

However, in 2007, human infection with a novel influenzavirus A became a nationally notifiable condition. Novel influenza A virus infections include all human infections with influenza A viruses that are different from currently circulating human influenza H1 and H3 viruses. These viruses include those that are subtyped as nonhuman in origin and those that are unsubtypable with standard methods and reagents. [183] The new strain responsible for this outbreak was one such virus.[ citation needed ]

Recommendations for schools

Initially the CDC had issued a recommendation that schools close for as long as two weeks if a student catches swine flu. [184] Some school districts closed all schools if a single child was classified as probable. [139] On May 5 the CDC retracted its advice stating that schools that were closed based on previous CDC guidance related to this outbreak may reopen. [185] By that time at least 726 schools nationwide serving more than 480,000 students had closed for at least some period of time. [184] The CDC amended its advice, citing new information on disease severity and the limiting effectiveness of school closure as a control measure. [185] The new advice given stated, "Decisions about school closure should be at the discretion of local authorities based on local considerations, including public concern and the impact of school absenteeism and staffing shortages." [185]

Food and Drug Administration

The Food and Drug Administration (FDA) authorized emergency use of medicines and diagnostic tests for flu. (FDA is part of Department of Health and Human Services.) [186] The FDA stated it was also responding to this threat by:

On May 6, 2009, the FDA announced that it had approved a new manufacturing facility for seasonal flu vaccine, owned by Sanofi Pasteur, which could also be used for manufacturing a vaccine for the new H1N1 flu strain. [188] The FDA also issued a warning for consumers to be wary of products claiming to cure or prevent swine flu. [189]

Other federal agencies

Department of Homeland Security

Secretary Napolitano stated that DHS was the principal federal office for incidents such as the H1N1 flu outbreak, and "Under that role, we have been leading a true collaborative effort." [190] The Department of Homeland Security issued a document, dated November 1, 2005, entitled "National Strategy for Pandemic Influenza", detailing planning for potential pandemics. https://web.archive.org/web/20090507013213/http://www.pandemicflu.gov/plan/federal/pandemic-influenza.pdf

State Department

The State Department suggested travelers to Mexico stay alert and comply with guidance from Mexican public health officials, but did not impose any travel restrictions on US citizens to Mexico. [191] However, the State Department did recommend US citizens avoid non-essential travel to Mexico. [192]

Department of Agriculture

The Department of Agriculture (USDA) reported no swine in the US have been infected so far, but the USDA is monitoring swine across the US for signs of infection. [193]

Department of Commerce

The Department of Commerce sent a letter to Russia and China requesting that those countries lift their ban on American pork products. [194]

Department of Defense

The Department of Defense (DOD) monitored the swine flu situation and had contingency plans to deal with such outbreaks. [195] As of May 7, 2009, the DOD reported 104 confirmed cases among Armed Forces personnel and their families. DOD maintained a daily summary and map. [196]

Department of Education

The Department of Education provided guidance to schools in the US affected by swine flu, as well as precautions to take. [197]

State and local

Schools closed in many states in response to local flu outbreaks. By April 30, 2009, 300 U.S. schools and school districts had announced closures in response to the outbreak, giving 169,000 students time off. [198] On May 4, 2009, about 533 schools in 24 states in the U.S. were closed, affecting about 330,000 students. [199] On September 25, 2009, 42 schools were closed in eight states as the second wave of the pandemic began. [200]

On May 5, Kathleen Sebelius stated in a CDC news conference that school closures for single confirmed cases of H1N1 influenza were unnecessary, but that children displaying an influenza-like illness should stay home. [201]

Travel industry

Several US airlines waived fees for cancellations and flight changes. [202] At least one cruise line changed itinerary to avoid Mexican ports of call. [203]

Summary

[ citation needed ]

2009A(H1N1) Outbreak and pandemic milestones
28 March Flag of the United States.svg First case in the US of what would later be identified as swine flu origin.
21 April Flag of California.svg First case confirmed in California.
23 April Flag of Texas.svg First case confirmed in Texas.
25 April Flag of Kansas.svg First case confirmed in Kansas.
Flag of the United States.svg Community outbreaks confirmed in the United States.
26 April Flag of New York.svg First case confirmed in New York.
Flag of Ohio.svg First case confirmed in Ohio.
Acting HHS Secretary Charles E. Johnson declares 2009 H1N1 a public health emergency [204] [205]
28 April Flag of Indiana.svg First case confirmed in Indiana.
29 April Flag of Texas.svg First non-US citizen death confirmed in Texas.
Flag of Nevada.svg First case confirmed in Nevada.
Flag of Arizona.svg First case confirmed in Arizona.
Flag of Maine.svg First case confirmed in Maine.
Flag of Massachusetts.svg First case confirmed in Massachusetts.
Flag of Michigan.svg First case confirmed in Michigan.
30 April Flag of Nebraska.svg First case confirmed in Nebraska.
Flag of South Carolina.svg First case confirmed in South Carolina.
Flag of Minnesota.svg First case confirmed in Minnesota.
Flag of Colorado.svg First case confirmed in Colorado.
Flag of Virginia.svg First case confirmed in Virginia.
Flag of Kentucky.svg First case confirmed in Kentucky.
Flag of New Jersey.svg First case confirmed in New Jersey.
1 May Flag of Florida.svg First case confirmed in Florida.
Flag of Missouri.svg First case confirmed in Missouri.
Flag of Connecticut.svg First case confirmed in Connecticut.
Flag of Delaware.svg First case confirmed in Delaware.
2 May Flag of New Mexico.svg First case confirmed in New Mexico.
Flag of Utah.svg First case confirmed in Utah.
Flag of New Hampshire.svg First case confirmed in New Hampshire.
Flag of Rhode Island.svg First case confirmed in Rhode Island.
Flag of Iowa.svg First case confirmed in Iowa.
Flag of Wisconsin.svg First case confirmed in Wisconsin.
Flag of Alabama.svg First case confirmed in Alabama.
3 May Flag of Idaho.svg First case confirmed in Idaho.
Flag of Pennsylvania.svg First case confirmed in Pennsylvania.
Flag of Louisiana (2006-2010).svg First case confirmed in Louisiana.
Flag of North Carolina.svg First case confirmed in North Carolina.
Flag of Tennessee.svg First case confirmed in Tennessee.
4 May Flag of Oregon.svg First case confirmed in Oregon.
Flag of Georgia (U.S. state).svg First case confirmed in Georgia.
Flag of Maryland.svg First case confirmed in Maryland.
5 May Flag of Washington.svg First case confirmed in Washington.
Flag of Oklahoma.svg First case confirmed in Oklahoma.
Flag of Hawaii.svg First case confirmed in Hawaii.
Flag of Texas.svg First US citizen death confirmed in Texas.
6 May Flag of Washington, D.C.svg First case confirmed in District of Columbia.
7 May Flag of South Dakota.svg First case confirmed in South Dakota.
8 May Flag of Vermont.svg First case confirmed in Vermont.
Flag of Arkansas.svg First case confirmed in Arkansas.
9 May Flag of Washington.svg First death confirmed in Washington.
11 May Flag of Montana.svg First case confirmed in Montana.
13 May Flag of North Dakota.svg First case confirmed in North Dakota.
14 May Flag of Arizona.svg First death confirmed in Arizona.
15 May Flag of Mississippi (2001-2020).svg First case confirmed in Mississippi.
17 May Flag of New York.svg First death confirmed in New York.
19 May Flag of Missouri.svg First death confirmed in Missouri.
20 May Flag of Utah.svg First death confirmed in Utah.
25 May Flag of Illinois.svg First death confirmed in Illinois.
26 May Flag of Puerto Rico.svg First case confirmed in Puerto Rico.
27 May Flag of Wyoming.svg First case confirmed in Wyoming.
Flag of Alaska.svg First case confirmed in Alaska.
2 June Flag of West Virginia.svg First case confirmed in West Virginia. All 50 states have confirmed H1N1.
Flag of Virginia.svg First death confirmed in Virginia.
3 June Flag of Michigan.svg First death confirmed in Michigan.
Flag of Connecticut.svg First death confirmed in Connecticut.
4 June Flag of California.svg First death confirmed in California.
5 June Flag of Pennsylvania.svg First death confirmed in Pennsylvania.
Flag of Wisconsin.svg First death confirmed in Wisconsin.
8 June Flag of Oregon.svg First death confirmed in Oregon.
Flag of Oklahoma.svg First death confirmed in Oklahoma.
15 June Flag of New Jersey.svg First death confirmed in New Jersey.
Flag of Massachusetts.svg First death confirmed in Massachusetts.
Flag of Minnesota.svg First death confirmed in Minnesota.
16 June Flag of Florida.svg First death confirmed in Florida.
Flag of Rhode Island.svg First death confirmed in Rhode Island.
Flag of the United States Virgin Islands.svg First case confirmed in US Virgin Islands.
23 June Flag of Maryland.svg First death confirmed in Maryland.
24 June Flag of North Carolina.svg First death confirmed in North Carolina.
26 June Flag of American Samoa.svg First case confirmed in American Samoa.
29 June Flag of Hawaii.svg First death confirmed in Hawaii.
1 July Flag of Guam.svg First case confirmed in Guam.
6 July Flag of Ohio.svg First death confirmed in Ohio.
Flag of Nevada.svg First death confirmed in Nevada.
10 July Flag of Indiana.svg First death confirmed in Indiana.
Flag of Georgia (U.S. state).svg First death confirmed in Georgia.
15 July Flag of Nebraska.svg First death confirmed in Nebraska.
Flag of Tennessee.svg First death confirmed in Tennessee.
20 July Flag of Guam.svg First death confirmed in Guam.
21 July Flag of the Northern Mariana Islands.svg First case confirmed in Northern Mariana Islands.
27 July Flag of Alaska.svg First death confirmed in Alaska.
29 July Flag of Alabama.svg First death confirmed in Alabama.
Flag of Colorado.svg First death confirmed in Colorado.
3 August Flag of Iowa.svg First death confirmed in Iowa.
6 August Flag of Kansas.svg First death confirmed in Kansas.
Flag of Montana.svg First death confirmed in Montana.
Flag of Mississippi (2001-2020).svg First death confirmed in Mississippi.
8 August Flag of Arkansas.svg First death confirmed in Arkansas.
10 August Flag of New Mexico.svg First death confirmed in New Mexico.
13 August Flag of Maine.svg First death confirmed in Maine.
Flag of Louisiana (2006-2010).svg First death confirmed in Louisiana.
14 August Flag of the United States.svg First case of Oseltamivir (Tamiflu) resistance confirmed.
17 August Flag of New Hampshire.svg First death confirmed in New Hampshire.
19 August Flag of Wyoming.svg First death confirmed in Wyoming.
28 August Flag of South Carolina.svg First death confirmed in South Carolina.
2 September Flag of the United States Virgin Islands.svg First death confirmed in US Virgin Islands.
3 September Flag of Kentucky.svg First death confirmed in Kentucky.
4 September Flag of West Virginia.svg First death confirmed in West Virginia.
10 September Flag of the United States.svg First Oseltamivir (Tamiflu) resistance spread from person to person confirmed.
28 September Flag of Idaho.svg First death confirmed in Idaho.
2 October Flag of South Dakota.svg First death confirmed in South Dakota.
22 October Flag of Delaware.svg First death confirmed in Delaware.
26 October Flag of North Dakota.svg First death confirmed in North Dakota.
28 OctoberPresident Obama declares H1N1 a National Emergency. [205]
Flag of Vermont.svg First death confirmed in Vermont. All 50 states have confirmed H1N1 deaths.
4 November Flag of Iowa.svg First feline zoonosis confirmed in Iowa.
19 November Flag of American Samoa.svg First death confirmed in American Samoa.
Flag of Oregon.svg First feline death confirmed in Oregon.
24 November Flag of West Virginia.svg First double infection case confirmed in West Virginia.

See also

Related Research Articles

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<span class="mw-page-title-main">2009 swine flu pandemic by country</span>

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<span class="mw-page-title-main">2009 swine flu pandemic in Asia</span>

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<span class="mw-page-title-main">2009 swine flu pandemic in North America</span>

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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.

<span class="mw-page-title-main">2009 swine flu pandemic in Turkey</span>

The 2009 flu pandemic was a global outbreak of a new strain of influenza A virus subtype H1N1, first identified in April 2009, termed Pandemic H1N1/09 virus by the World Health Organization (WHO) and colloquially called swine flu. The outbreak was first observed in Mexico, and quickly spread globally. On 11 June 2009, WHO declared the outbreak to be a pandemic. The overwhelming majority of patients experience mild symptoms", but some persons are in higher risk groups, such as those with asthma, diabetes, obesity, heart disease, or who are pregnant or have a weakened immune system. In the rare severe cases, around 3–5 days after symptoms manifest, the person's condition declines quickly, often to the point respiratory failure.

2009 swine flu pandemic in Taiwan began on May 20, 2009, when a non-citizen who had been living in Taiwan returned from the United States via Hong Kong. By the end of September, more than 90% of influenza A detected in the community were Influenza A (H1N1).

References

  1. 1 2 "Interim Guidance on Case Definitions to be Used For Investigations of Swine-Origin Influenza A (H1N1) Cases*". Centers for Disease Control and Prevention. April 30, 2009. Archived from the original on May 2, 2009. Retrieved May 1, 2009.
  2. 1 2 "H1N1 Flu". Alabama Department of Public Health. October 21, 2009. Archived from the original on October 28, 2009. Retrieved March 2, 2014.{{cite web}}: CS1 maint: bot: original URL status unknown (link)Reporting of aggregate statistics ended between 21 and 28 October, 2009 were "impractical because of the large number of people infected." (quote from )
  3. 1 2 "Novel H1N1 Influenza (Swine Flu)". Alaska Department of Health and Social Services. September 17, 2009. Archived from the original on September 17, 2009. Retrieved June 8, 2009. updated September 2, 2009 at 12:00 PM{{cite web}}: CS1 maint: bot: original URL status unknown (link)
  4. ↑ "Alaska Positive Rapid Tests For Influenza". Epidemiology. Alaska Department of Health and Social Services. Archived from the original on June 9, 2010. Retrieved March 2, 2014. ...(n=1,103)...from September 1, 2009 through April 6, 2010
  5. ↑ Armstrong, Michael (February 15, 2010). "Homer woman who died at 44 tested positive for swine flu: Swine flu (H1N1)". Anchorage Daily News . Associated Press. Archived from the original on June 2, 2013. Retrieved March 2, 2014.
  6. ↑ "Alaska Laboratory-Confirmed Influenza Deaths by Week". Epidemiology. Alaska Department of Health and Social Services. Archived from the original on June 9, 2010. Retrieved March 2, 2014.
  7. 1 2 3 "Arizona - Weekly Influenze Summary: MMWR Week 25-26 (6/20/10 - 7/03/10)" (PDF). Arizona Department of Health Services. 2010. p. 4. Archived from the original (PDF) on October 2, 2010.
  8. ↑ "H1N1 Flu (Swine Flu) Resources". Arkansas Department of Health. July 29, 2009. Archived from the original on November 13, 2009.
  9. ↑ "State logs year's first flu death". Arkansas Democrat-Gazette. February 2, 2011. Archived from the original on April 5, 2023. Retrieved April 6, 2022.
  10. 1 2 "Novel Influenza A (H1N1) Virus (Swine Flu) - Latest News". California - Department of Public Health. August 25, 2007. Archived from the original on September 1, 2009. Retrieved August 27, 2009.
  11. ↑ "Influenza-Associated Hospitalizations by County by Diagnosis Date" (PDF). Colorado - Department of Public Health and Environment. August 30, 2009. Retrieved November 9, 2009.
  12. 1 2 "Department of Public Health and Environment |". www.colorado.gov. Archived (PDF) from the original on May 21, 2009. Retrieved July 14, 2019.
  13. 1 2 3 "CTFLUWATCH". Connecticut Department of Public Health. October 19, 2010. Archived from the original on October 19, 2010. Retrieved March 2, 2014. Pandemic (H1N1) 2009 influenza A information for July 20, 2010{{cite web}}: CS1 maint: bot: original URL status unknown (link)
  14. 1 2 3 4 5 6 7 "PAHO Influenza A(H1N1) Surveillance". PAHO. August 26, 2009. Archived from the original on October 8, 2009. Retrieved August 26, 2009.
  15. ↑ No longer updating "H1N1 UPDATE - JUNE 18". Delaware - Department of Health and Social Services. June 18, 2009. Archived from the original on June 19, 2009. Retrieved June 19, 2009.
  16. ↑ "7th death in DE from H1N1 influenza - WGMD.COM". Archived from the original on July 18, 2011. Retrieved March 13, 2010.
  17. ↑ "Drug-resistant swine flu reported in Va., Md". Archived from the original on July 14, 2019. Retrieved July 14, 2019– via www.washingtonpost.com.
  18. 1 2 Update each Wednesday "Swine Flu Information". Florida - Department of Health. July 30, 2009. Archived from the original on August 2, 2009.
  19. ↑ "H1N1 Media Releases". Archived from the original on March 20, 2010. Retrieved March 13, 2010.
  20. ↑ "Weekly County Influenza Activity" (PDF). Florida Department of Health. Archived from the original (PDF) on June 8, 2010.
  21. 1 2 "H1N1". Georgia - Division of Public Health. September 24, 2009. Archived from the original on September 10, 2009. Retrieved September 24, 2009.
  22. ↑ "Seasonal Flu | Georgia Department of Community Health". dch.georgia.gov. Archived from the original on July 14, 2019. Retrieved July 14, 2019.
  23. ↑ "Influenza Surveillance Report" (PDF). July 19–August 1, 2009. HAWAI‘I STATE DEPARTMENT OF HEALTH DISEASE OUTBREAK CONTROL DIVISION. August 6, 2009. Archived (PDF) from the original on June 15, 2011. Retrieved August 26, 2009.
  24. ↑ "Delawareonline - Levi Johnston wants to be mayor; has no platform". Archived from the original on July 23, 2011. Retrieved January 21, 2010.
  25. 1 2 3 "Idaho Case Counts". 2009 H1N1 Flu Surveillance Data. Idaho Department of Health & Welfare. Archived from the original on April 22, 2012.
  26. ↑ "Statistics". H1N1 flu. Illinois Department of Public Health. August 12, 2009. Archived from the original on August 12, 2009. Retrieved March 2, 2014. Illinois Cases of H1N1 Flu by County (As of July 31, 2009, 10 a.m.){{cite web}}: CS1 maint: bot: original URL status unknown (link)
  27. 1 2 "Statistics". H1N1 flu. Illinois Department of Public Health. May 8, 2010. Archived from the original on May 8, 2010. Retrieved March 2, 2014. Confirmed H1N1 2009 Hospitalizations and Deaths (As of May 7, 2010, 10 a.m.){{cite web}}: CS1 maint: bot: original URL status unknown (link)
  28. 1 2 "ISDH Press releases". Indiana - State Department of Health. August 20, 2009. Retrieved August 27, 2009.
  29. ↑ "Influenza and Other Respiratory Virus Weekly Activity Report" (PDF). Iowa - Department of Public Health. August 1, 2009. Retrieved August 26, 2009.
  30. ↑ "H1N1 vaccine plentiful in Iowa". www.newtondailynews.com. Archived from the original on July 14, 2019. Retrieved July 14, 2019.
  31. ↑ "Iowa Influenza Surveillance Network (IISN) Reports". Archived from the original on March 1, 2011. Retrieved March 13, 2010.
  32. ↑ update at Monday "Kansas H1N1 Flu Virus Information". Kansas - Department of Health and Environment. August 24, 2009. Archived from the original on December 9, 2009. Retrieved December 8, 2009.
  33. ↑ "Kansan dies from H1N1 - Pratt, KS - Pratt Tribune". Archived from the original on April 6, 2010. Retrieved April 6, 2010.
  34. 1 2 "Flu Activity". Commonwealth of Kentucky. October 29, 2009. Archived from the original on November 25, 2009. Retrieved November 25, 2009.
  35. ↑ "DHH Updates Status of Fight the Flu Campaign". Louisiana - Department of Health & Hospitals. November 9, 2009. Archived from the original on December 10, 2009. Retrieved November 9, 2009.
  36. ↑ "Department of Health & Hospitals | State of Louisiana". Archived from the original on March 29, 2010. Retrieved March 22, 2010.
  37. 1 2 update weekly "Maine - H1N1 Influenza ("Swine Flu") Update". Maine - Center for Disease Control and Prevention. August 26, 2009. Archived from the original on August 27, 2009. Retrieved August 27, 2009.
  38. ↑ "Maine Center for Disease Control & Prevention: DHHS - Maine". www.maine.gov. Archived from the original on December 25, 2018. Retrieved July 14, 2019.
  39. ↑ "Maryland weekly flu report". The Baltimore Sun. July 2, 2009. Retrieved July 2, 2009.
  40. ↑ Maryland Flu Watch
  41. ↑ "Department of Health and Mental Hygiene Seasonal Influenza Preparedness Guide". Archived from the original on December 1, 2009. Retrieved November 30, 2009.
  42. 1 2 "Confirmed H1N1 Influenza (swine flu)". Massachusetts - Department of Public Health. August 27, 2009. Archived from the original on June 8, 2009. Retrieved June 5, 2009.
  43. ↑ "Mass Public Health Blog | Promoting public health & wellness in Massachusetts". Archived from the original on July 14, 2019. Retrieved July 14, 2019.
  44. ↑ Daily Update of fatalities "MDCH-Influenza A (H1N1)". Michigan - Department of Community Health. June 13, 2009. Archived from the original on July 22, 2009. Retrieved July 30, 2009.
  45. ↑ "Reports of flu-like illness in Michigan" (PDF). www.michigan.gov. 2010. Retrieved July 14, 2019.
  46. ↑ "Weekly Influenza Activity: Statistics". Minnesota - Department of Health. August 17, 2009. Archived from the original on September 22, 2009. Retrieved October 22, 2009.
  47. ↑ "Weekly Influenza and Respiratory Activity: Statistics - Minnesota Dept. of Health". www.health.state.mn.us. Archived from the original on July 14, 2019. Retrieved July 14, 2019.
  48. ↑ "Mississippi H1N1 Swine Flu Cases by County, 2009". Mississippi - State Department of Health. September 23, 2009. Archived from the original on September 23, 2009. Retrieved September 23, 2009.
  49. ↑ "Flu claims life of Lafayette County child". WTVA. March 19, 2009. Archived from the original on March 23, 2010.
  50. ↑ "Special Weekly Influenza Surveillance 2009-2010 Pre-Season Report, Missouri" (PDF). Missouri - Department of Health and Senior Services. August 22, 2009. Archived (PDF) from the original on December 26, 2009. Retrieved August 27, 2009.
  51. ↑ "Missouri health officials add up the H1N1 numbers". KMOX TV.[ permanent dead link ]
  52. 1 2 "Confirmed Novel Influenza A/H1N1 (Swine Flu)". Billings Gazette. August 6, 2009. Retrieved August 6, 2009.
  53. ↑ Missoulian, MICHAEL JAMISON of the. "Flathead County man dies of swine flu; 19th such death in Montana". missoulian.com. Archived from the original on July 14, 2019. Retrieved July 14, 2019.
  54. 1 2 "Influenza Report" (PDF). Week 34 (August, 29). Nebraska - Department of Health & Human Services. August 21, 2009. Archived from the original (PDF) on July 18, 2011. Retrieved August 27, 2009.
  55. ↑ AP Health News Online Breaking News & Headlines from Associated Press - pennlive.com
  56. 1 2 "Nevada State Health Division Weekly Influenza Report". Nevada - State Health Division. August 21, 2009. Archived from the original on September 7, 2009. Retrieved August 27, 2009.
  57. ↑ Gibson, Tiffany (January 6, 2010). "Woman, 29, first H1N1 death in new year - Las Vegas Sun Newspaper". lasvegassun.com. Archived from the original on July 14, 2019. Retrieved July 14, 2019.
  58. ↑ "Las Vegas News | Breaking News & Headlines". Las Vegas Review-Journal. Archived from the original on February 15, 2001. Retrieved July 14, 2019.
  59. ↑ "WEEKLY INFLUENZA SURVEILLANCE REPORT" (PDF). New Hampshire - Department of Health & Human Services. August 29, 2009. Archived (PDF) from the original on May 10, 2009. Retrieved September 16, 2009.
  60. ↑ NH reports 10th H1N1-related death » New Hampshire » EagleTribune.com, North Andover, MA
  61. ↑ "New Jersey Department of Health and Senior Services Communicable Disease Service Influenza Brief" (PDF). Week Ending August 29, 2009 (MMWR Week 34). Archived (PDF) from the original on October 18, 2012. Retrieved September 23, 2009.
  62. ↑ "H1N1 Flu Hospitalizations and Deaths in NJ". New Jersey DHSS. August 26, 2009. Archived from the original on August 26, 2009. Retrieved August 27, 2009.
  63. ↑ Report, Staff (January 13, 2010). "Two New H1N1-Related Deaths Reported". Archived from the original on February 12, 2010. Retrieved January 14, 2010.
  64. ↑ "Flu in New Mexico - Influenza Information". Archived from the original on September 17, 2009. Retrieved September 16, 2009.
  65. ↑ "New Mexico Analyzes Swine Flu | KDBC.com". Archived from the original on March 16, 2010. Retrieved January 29, 2010.
  66. ↑ "NM Department of Health Seasonal & H1N1Flu Information". Archived from the original on April 7, 2010. Retrieved May 7, 2010.
  67. ↑ "H1N1 Flu (Swine Flu)". New York State - Department of Health. June 19, 2009. Archived from the original on May 24, 2009. Retrieved June 19, 2009.
  68. ↑ "Health Alert #27" (PDF). New York City DHMH. July 8, 2009. Archived (PDF) from the original on January 22, 2010. Retrieved September 2, 2009.
  69. 1 2 Update each Wednesday "NCPH: Influenza in N.C." North Carolina - Public Health. July 29, 2009. Archived from the original on July 29, 2009. Retrieved July 30, 2009.
  70. ↑ "North Carolina Influenza Sentinel Surveillance Program". Archived from the original on November 4, 2009. Retrieved November 4, 2009.
  71. 1 2 "ND Flu". Archived from the original on December 23, 2009. Retrieved December 25, 2009.
  72. ↑ "Few flu cases reported this year". Bismarck Tribune. Archived from the original on July 14, 2019. Retrieved July 14, 2019.
  73. ↑ "Swine flu" (PDF). Ohio - Department of Health. July 30, 2009. Archived (PDF) from the original on July 29, 2009. Retrieved July 30, 2009.
  74. ↑ "Local death blamed on H1N1 virus". The Daily Standard. Archived from the original on July 14, 2019. Retrieved July 14, 2019.
  75. 1 2 updated on Mondays and Thursdays "Novel Influenza A H1N1 (Swine Flu) Daily Updates & Alerts". Oklahoma - State Department of Health. July 29, 2009.
  76. ↑ "Swine flu death is 44th in Oklahoma | Tulsa World". Archived from the original on October 11, 2012. Retrieved April 6, 2010.
  77. 1 2 Update each Friday "H1N1 Influenza Update". Oregon - Department of Human Services. July 24, 2009. Archived from the original on May 2, 2009. Retrieved July 30, 2009.
  78. ↑ "Oregon Health Authority : Prevent the flu by getting vaccinated each year : Flu Prevention : State of Oregon". www.oregon.gov. Archived from the original on July 14, 2019. Retrieved July 14, 2019.
  79. 1 2 H1N1 in PA › PA Situation Update
  80. ↑ "Rhode Island Department of Health Swine Flu". Rhode Island - Department of Health. July 30, 2009. Archived from the original on September 1, 2009. Retrieved June 17, 2009.
  81. ↑ "H1N1 Virus Partner Briefing". Rhode Island Department of Health. Archived from the original on September 21, 2009.
  82. ↑ "Third swine flu death reported in RI | Turn to 10". Archived from the original on November 18, 2009. Retrieved November 25, 2009.
  83. ↑ RI sees 10th H1N1 death; vaccine to be offered broadly - Projo 7 to 7 News Blog | Rhode Island news | The Providence Journal
  84. ↑ "South Carolina Influenza Activity and Surveillance: 2008-2009 Season" (PDF). South Carolina - Department of Health and Environmental Control. June 13, 2009. Archived (PDF) from the original on February 11, 2010. Retrieved June 19, 2009.
  85. ↑ "Flu Watch - Data, Reports, Maps" (PDF). South Carolina Department of Health and Environmental Control.[ permanent dead link ]
  86. 1 2 3 "South Dakota (A)H1N1 Surveillance". South Dakota - Department of Health. May 28, 2009. Retrieved June 5, 2009.
  87. ↑ "Sentinel Provider Influenza-Like Illness (ILI) Surveillance Summary" (PDF). Tennessee - Department of Health. November 21, 2009. Archived (PDF) from the original on December 23, 2009. Retrieved November 27, 2009.
  88. ↑ "Third wave of H1N1 could hit within the month". WVLT TV. February 8, 2010. Archived from the original on March 9, 2016.
  89. ↑ Update each Wednesday "Surveillance". Texas - Department of State Health Services. Archived from the original on October 20, 2009. Retrieved October 24, 2009.
  90. ↑ "Cumulative age data" (PDF). www.dshs.state.tx.us. Archived (PDF) from the original on March 4, 2016. Retrieved July 14, 2019.
  91. ↑ "Texas Department of State Health Services, Infectious Disease Control Unit > Surveillance". Archived from the original on October 20, 2009. Retrieved October 23, 2009.
  92. ↑ "Utah Pandemic A (H1N1) 2009 Hospitalized Case Surveillance". Utah - Department of Health. July 29, 2009. Archived from the original on July 29, 2009. Retrieved July 31, 2009.
  93. ↑ "Utah women account for 75% of H1N1 deaths". Salt Lake Tribune. March 16, 2010. Archived from the original on March 23, 2010.
  94. 1 2 "Novel H1N1 Flu (Swine Flu): Status Update". Vermont - Department of Health. June 24, 2009. Archived from the original on August 29, 2009. Retrieved June 26, 2009.
  95. ↑ "Vt. Reports Third Swine Flu Death - WCAX.COM Local Vermont News, Weather and Sports". Archived from the original on February 24, 2012. Retrieved December 4, 2009.
  96. ↑ "Confirmed Influenza A (H1N1) Case Counts". Virginia - Department of Health. July 10, 2009. Archived from the original on July 12, 2009. Retrieved July 11, 2009.
  97. ↑ "Epidemiology – Virginia Department of Health" (PDF). Vdh.virginia.gov. March 2, 2016. Archived (PDF) from the original on January 11, 2015. Retrieved July 14, 2019.
  98. ↑ "Swine flu (H1N1) monitoring changes in Washington". WSDOH. May 26, 2009. Archived from the original on June 14, 2009. Retrieved June 25, 2009.
  99. 1 2 "H1N1 Newsroom". Washington State Department of Health. September 19, 2009. Archived from the original on August 26, 2010.
  100. ↑ Updated each Wednesday "Influenza Surveillance Data 2008-2009". West Virginia - Department of Health and Human Resources. June 18, 2009. Archived from the original on June 24, 2009. Retrieved June 18, 2009.
  101. ↑ "Breaking News from your Local News Source Leader in Buckhannon, West Virginia | The Record Delta". therecorddelta.com. Archived from the original on July 6, 2019. Retrieved July 14, 2019.
  102. ↑ "Influenza Surveillance | Infectious Disease Epidemiology". Archived from the original on July 14, 2019. Retrieved July 14, 2019.
  103. 1 2 3 "Current H1N1 Situation in Wisconsin". Wisconsin - Department of Health Services. July 29, 2009. Archived from the original on July 29, 2009. Retrieved July 29, 2009.
  104. ↑ "Swine Influenza (Swine Flu)". Wyoming - Department of Health. August 5, 2009. Archived from the original on July 12, 2009. Retrieved May 20, 2009.
  105. ↑ Press, The Associated. "More deaths as flu season continues in Wyoming". Casper Star-Tribune Online. Archived from the original on November 18, 2014. Retrieved July 14, 2019.
  106. ↑ "pandemic influenza A/H1N1 2009 surveillance". phs.spc.int. Archived from the original on July 14, 2019. Retrieved July 14, 2019.
  107. ↑ "Topix". www.topix.com. Archived from the original on July 14, 2019. Retrieved July 14, 2019.
  108. ↑ "pandemic influenza A/H1N1 2009 suveillance report as of 27 October 2009". phs.spc.int. Archived from the original on July 14, 2019. Retrieved July 14, 2019.
  109. ↑ "Saipan Tribune". Archived from the original on February 24, 2012. Retrieved September 9, 2009.
  110. ↑ "Saipan Tribune". Archived from the original on March 8, 2012. Retrieved January 17, 2010.
  111. ↑ "Diario La Verdad". Diario La Verdad. Archived from the original on January 29, 2021. Retrieved October 21, 2009.
  112. ↑ "Noticias de Prensa Latina". Archived from the original on January 19, 2010. Retrieved January 10, 2010.
  113. 1 2 "AP National News Online Breaking News & Headlines from Associated Press - oregonlive.com". Archived from the original on June 9, 2011. Retrieved September 2, 2009.
  114. 1 2 3 CDC (May 8, 2019). "2009 H1N1 Flu Pandemic Timeline". Centers for Disease Control and Prevention. Archived from the original on March 5, 2020. Retrieved May 19, 2020.
  115. ↑ Zampaglione M (September 19, 2020). "Press Release: A/H1N1 influenza like human illness in Mexico and the USA: OIE statement". World Organisation for Animal Health. Archived from the original on April 30, 2009. Retrieved April 29, 2009.
  116. ↑ "The 2009 H1N1 Pandemic: Summary Highlights, April 2009-April 2010". CDC. Archived from the original on April 17, 2021. Retrieved September 19, 2020.
  117. ↑ "The 2009 H1N1 Pandemic: Summary Highlights, April 2009-April 2010". CDC. Archived from the original on April 17, 2021. Retrieved September 19, 2020.
  118. ↑ "2009 H1N1 Pandemic (H1N1pdm09 virus)". CDC. June 11, 2019. Archived from the original on March 18, 2020. Retrieved September 19, 2020.
  119. 1 2 "2009 H1N1 Pandemic". Centers for Disease Control and Prevention. June 11, 2019. Archived from the original on March 18, 2020.
  120. ↑ DeNoon DJ. "H1N1 Swine Flu No Worse Than Seasonal Flu". WebMD. Archived from the original on October 17, 2020. Retrieved March 13, 2020.
  121. ↑ Roos R (June 27, 2012). "CDC estimate of global H1N1 pandemic deaths: 284,000". CIDRAP. Archived from the original on September 19, 2020. Retrieved March 23, 2020.
  122. ↑ "Swine Influenza A (H1N1) Infection in Two Children--- Southern California, March—April 2009". Morbidity and Mortality Weekly Report . 58 (Dispatch) (15). Centers for Disease Control: 400–402. April 24, 2009. Archived from the original on October 1, 2009. Retrieved October 4, 2009.
  123. ↑ "CDC Press Briefing Transcripts April 23, 2009". CDC. April 23, 2009. Archived from the original on June 5, 2009. Retrieved June 11, 2009.
  124. ↑ "CDC Novel H1N1 Flu | The 2009 H1N1 Pandemic: Summary Highlights, April 2009 – April 2010". www.cdc.gov. Archived from the original on April 17, 2021. Retrieved March 24, 2020.
  125. 1 2 "H1N1 Flu (Swine Flu)". H1N1 Flu. Centers for Disease Control and Prevention. May 6, 2009. Archived from the original on September 10, 2009. Retrieved May 6, 2009.
  126. ↑ "1 Million Americans Likely Stricken by Swine Flu: CDC". Forbes. June 25, 2009. Archived from the original on June 27, 2009. Retrieved June 25, 2009.
  127. ↑ "U.S. swine flu cases may have hit 1 million". NBC News. June 25, 2009. Retrieved July 14, 2024.
  128. ↑ "CDC 2009 H1N1 Flu – Graph and Table of 2009 H1N1 Influenza Vaccine Doses Allocated, Ordered, and Shipped". www.cdc.gov. Archived from the original on July 13, 2017. Retrieved April 22, 2018.
  129. ↑ "CDC H1N1 Flu – State & Local Vaccination Guidance – Vaccine Distribution Q&A". www.cdc.gov. Archived from the original on July 11, 2017. Retrieved April 22, 2018.
  130. ↑ "Declaration of a National Emergency with Respect to the 2009 H1N1 Influenza Pandemic". whitehouse.gov . Archived from the original on March 12, 2020. Retrieved March 12, 2020– via National Archives.
  131. ↑ Fichera, Angelo (March 31, 2020). "Flawed Comparison on Coronavirus, H1N1 Emergency Timelines". FactCheck.org. Archived from the original on April 13, 2020. Retrieved May 19, 2020.
  132. ↑ "Swine flu has killed 10,000 Americans since April". Reuters. December 10, 2009. Archived from the original on December 17, 2009. Retrieved December 13, 2009.
  133. ↑ "Swine flu sickened 57 million Americans". NBC News. February 12, 2010. Archived from the original on March 9, 2020. Retrieved April 22, 2018.
  134. ↑ "Swine flu death toll surpasses 11,000". NBC News. January 15, 2010. Archived from the original on September 23, 2020. Retrieved April 22, 2018.
  135. ↑ "Border Disease Program Helped Sound Alarm on Swine Flu". KPBS San Diego. May 7, 2009. Archived from the original on November 5, 2009. Retrieved September 2, 2010.
  136. ↑ "CDC Briefing on Public Health Investigation of Human Cases of Swine Influenza". CDC. April 23, 2009. Archived from the original on April 26, 2009. Retrieved April 26, 2009.
  137. ↑ CDC (April 21, 2009). "Swine Influenza A (H1N1) Infection in Two Children --- Southern California, March—April 2009". Morbidity and Mortality Weekly Report. Archived from the original on April 26, 2009. Retrieved April 26, 2009.
  138. 1 2 "Swine flu fatality in Texas likely infected in Mexico, official says". CNN . Archived from the original on May 3, 2009. Retrieved June 24, 2009.
  139. 1 2 "Queens School At Flu Epicenter Reopens". CBS News. May 4, 2009. Archived from the original on May 7, 2009. Retrieved May 8, 2009.
  140. ↑ "Flu spreads across U.S., officials weigh measures | Top News". Uk.reuters.com. February 9, 2009. Archived from the original on May 7, 2009. Retrieved May 5, 2009.
  141. ↑ Sherman, Christopher (May 4, 2009). "Texas confirms first flu death of US resident". The Courier of Montgomery County. Retrieved July 14, 2024.
  142. ↑ Harris, Gardiner; Malkin, Elisabeth (May 5, 2009). "Health Officials Begin to Ease Public Alerts About Swine Flu". The New York Times. Archived from the original on January 11, 2015. Retrieved June 24, 2009.
  143. ↑ Bowman, Michael (July 15, 2008). "US Officials 'Cautiously Optimistic' About Swine Flu Spread". VOA News. Archived from the original on May 6, 2009. Retrieved May 5, 2009.
  144. ↑ "2008–2009 Influenza Season Week 18 ending May 9, 2009". FluView: A Weekly Influenza Surveillance Report Prepared by the Influenza Division. Centers for Disease Control and Prevention. May 15, 2009. Archived from the original on May 17, 2009. Retrieved May 17, 2009.
  145. ↑ David Brown (April 22, 2009). "New Strain of Swine Flu Investigated: Two Children in San Diego Area Had No Contact with Pigs". The Washington Post . Archived from the original on April 29, 2009. Retrieved April 24, 2009.
  146. ↑ CHRISTOPHER SHERMAN (May 6, 2009). "Texas woman with flu who died beloved teacher". Dallas Morning News/Associated Press. Archived from the original on May 10, 2009. Retrieved May 6, 2009.
  147. 1 2 "CDC H1N1 Flu | Situation Update". Archived from the original on September 10, 2009. Retrieved August 26, 2009.
  148. ↑ Donald G. McNeil Jr. (October 2, 2009). "Swine Flu Spread Prompts Move on Vaccine". The New York Times .
  149. ↑ Denise Grady (October 17, 2009). "Three Pigs May be the First in the U.S. With Swine Flu". The New York Times .
  150. ↑ "Official warns 'third wave' of H1N1 on the way". Sioux City Journal News. December 15, 2009. Archived from the original on July 25, 2020. Retrieved December 25, 2009.
  151. ↑ "2009 H1N1 Pandemic (H1N1pdm09 virus)". CDC. June 11, 2019. Archived from the original on March 18, 2020. Retrieved September 19, 2020.
  152. ↑ "CDC Press Briefing Transcripts". CDC. April 24, 2009. Archived from the original on April 28, 2009. Retrieved April 25, 2009.
  153. ↑ Laura Kennedy (April 25, 2009). "Swine Flu Spreading In The U.S." WDIO-TV. Archived from the original on May 4, 2009. Retrieved April 26, 2009.
  154. ↑ "Flu death toll in Mexico could be lower than first thought". National Post, Canada. Archived from the original on May 3, 2009. Retrieved May 3, 2009.
  155. ↑ "Seasonal flu killing much more than swine flu". CTV, Canada. Archived from the original on May 2, 2009. Retrieved April 29, 2009.
  156. ↑ "Regular flu has killed thousands since January". CNN. April 28, 2009. Archived from the original on June 20, 2009. Retrieved June 24, 2009.
  157. ↑ "2009 H1N1 Flu U.S. Situation Update". CDC. May 28, 2010. Archived from the original on March 18, 2020. Retrieved March 19, 2020.
  158. 1 2 Heron, Melonie; Hoyert, Donna L.; Murphy, Sherry L.; Xu, Jiaquan; Kochanek, Kenneth D.; Tejada-Vera, Betzaida (April 17, 2009). "Table 10. Number of deaths from 113 selected causes and Enterocolitis due to Clostridioides difficile, by age: United States,2006—Con" (PDF). National Vital Statistics Reports: Deaths: Final Data for 2006. CDC. Archived (PDF) from the original on November 4, 2009. Retrieved November 19, 2009.
  159. ↑ Boyd, Mark; et al. (November 20, 2006). "Pandemic influenza: clinical issues". Medical Journal of Australia. 185 (10 Suppl): S44–7. doi:10.5694/j.1326-5377.2006.tb00706.x. PMID   17115951. S2CID   6553096. Archived from the original on October 29, 2009. Retrieved November 22, 2009.
  160. ↑ "The 2009 H1N1 Pandemic: Summary Highlights, April 2009-April 2010". CDC. Archived from the original on April 17, 2021. Retrieved September 19, 2020.
  161. ↑ "The 2009 H1N1 Pandemic: Summary Highlights, April 2009-April 2010". CDC. Archived from the original on April 17, 2021. Retrieved September 19, 2020.
  162. ↑ "Federal Response Stages". U.S. Government. Archived from the original on May 3, 2009. Retrieved April 26, 2009.
  163. ↑ "Swine Flu Investigation". U.S. Government. Archived from the original on April 26, 2009. Retrieved April 26, 2009.
  164. ↑ Staff Writer (April 27, 2009). "Mexico suspected flu toll soars". BBC. Archived from the original on April 28, 2009. Retrieved April 27, 2009.
  165. ↑ "WHO raises pandemic alert level". BBC. April 29, 2009. Archived from the original on April 30, 2009. Retrieved April 29, 2009.
  166. ↑ "Press Briefing on Swine Influenza". Department of Homeland Security. April 26, 2009. Archived from the original on April 30, 2009. Retrieved May 2, 2009.
  167. ↑ Margaret Chan (June 11, 2009). "World now at the start of 2009 influenza pandemic". World Health Organization. Archived from the original on June 12, 2009. Retrieved June 11, 2009.
  168. ↑ Staff Writer (April 24, 2009). "White House closely following U.S. swine flu outbreak". Reuters. Archived from the original on May 3, 2009. Retrieved April 26, 2009.
  169. ↑ Mark Silva (April 27, 2009). "Obama says he has his eye on swine flu threat". Los Angeles Times . Archived from the original on May 1, 2009. Retrieved April 27, 2009.
  170. ↑ "The President's Remarks on H1N1". whitehouse.gov . April 30, 2009. Archived from the original on April 6, 2023. Retrieved May 2, 2009– via National Archives.
  171. 1 2 "As flu hits, holes in W.H. health team – Carrie Budoff Brown". Politico.Com. April 26, 2009. Archived from the original on April 29, 2009. Retrieved April 28, 2009.
  172. ↑ "Office of the Surgeon General (OSG)". Surgeongeneral.gov. Archived from the original on April 28, 2009. Retrieved April 28, 2009.
  173. 1 2 "White House Aide's Family Likely Has Swine Flu". GoUpstate. May 1, 2009. Retrieved July 14, 2024.
  174. ↑ "Sebelius wins panel approval as health secretary". NBC News. April 21, 2009. Archived from the original on July 29, 2018. Retrieved April 22, 2018.
  175. ↑ Goldstein, David; Klepper, David (April 28, 2009). "Sebelius sworn in to Cabinet, Parkinson becomes Kansas governor". The Kansas City Star. Archived from the original on April 30, 2009. Retrieved April 29, 2009.
  176. ↑ "Obama declares swine flu a national emergency". Reuters. October 24, 2009. Archived from the original on October 25, 2009. Retrieved October 24, 2009.
  177. ↑ Olson, Steve; Patel, Deepali M., eds. (March 1, 2012). Information Sharing and Collaboration: Applications to Integrated Biosurveillance: Workshop Summary. National Academies Press. p. 89. ISBN   9780309224031.
  178. ↑ CDC Responds to Swine Flu Outbreak Among Humans Archived May 3, 2009, at the Wayback Machine , US Centers for Disease Control and Prevention Archived April 18, 2016, at the Wayback Machine , April 27, 2009. Retrieved 2009-05-02.
  179. ↑ "CDC H1N1 Flu". Cdc.gov. Archived from the original on September 10, 2009. Retrieved May 6, 2009.
  180. ↑ "Interim Guidance on Specimen Collection, Processing, and Testing for Patients with Suspected Swine-Origin Influenza A (H1N1) Virus Infection". Centers for Disease Control and Prevention. April 30, 2009. Archived from the original on May 2, 2009. Retrieved April 30, 2009.
  181. ↑ "CDC Briefing on Public Health Investigation of Human Cases of Swine Influenza". CDC. April 30, 2009. Archived from the original on May 4, 2009. Retrieved May 1, 2009.
  182. ↑ "CDC Press Briefing Transcripts May 6, 2009". Cdc.gov. May 6, 2009. Archived from the original on May 19, 2009. Retrieved May 19, 2009.
  183. ↑ "Flu Activity & Surveillance". Centers for Disease Control and Prevention. April 17, 2009. Archived from the original on April 27, 2009. Retrieved April 26, 2009.
  184. 1 2 Stein, Rob (May 6, 2009). "Schools Shut by Flu Can Reopen". The Washington Post . Archived from the original on November 19, 2016. Retrieved July 19, 2020.
  185. 1 2 3 "CDC H1N1 Flu | Update on School (K – 12) Dismissal and Childcare Facilities". Cdc.gov. Archived from the original on May 6, 2009. Retrieved May 6, 2009.
  186. ↑ "FDA Authorizes Emergency Use of Influenza Medicines, Diagnostic Test in Response to Swine Flu Outbreak in Humans". Fda.gov. April 27, 2009. Archived from the original on July 29, 2009. Retrieved July 31, 2009.
  187. ↑ "2009 H1N1 (Swine) flu virus". Food and Drug Administration. May 12, 2009. Archived from the original on July 29, 2009. Retrieved July 31, 2009.
  188. ↑ "Welcome to AJC!". ajc.com. May 6, 2009. Archived from the original on May 9, 2009. Retrieved May 19, 2009.
  189. ↑ "FDA, FTC Warn Public of Fraudulent 2009 H1N1 Influenza Products". Food and Drug Administration. May 1, 2009. Archived from the original on July 29, 2009. Retrieved July 31, 2009.
  190. ↑ "DHS: Testimony by Secretary Napolitano to the Senate Committee on Homeland Security and Governmental Affairs on Federal Coordination in Response to the H1N1 Flu Outbreak". Dhs.gov. April 29, 2009. Archived from the original on May 6, 2009. Retrieved May 5, 2009.
  191. ↑ "Threats of Increased Violence in Ciudad Juarez during the weekend of May 23–25, 2008". Mexico.usembassy.gov. Archived from the original on May 10, 2009. Retrieved May 8, 2009.
  192. ↑ "Travel Alert – 2009-H1N1 Influenza". Travel.state.gov. Archived from the original on May 6, 2009. Retrieved May 8, 2009.
  193. ↑ "Release No. 0131.09". Usda.gov. Archived from the original on May 6, 2009. Retrieved May 8, 2009.
  194. ↑ ksullivan (May 1, 2009). "Department of Commerce – Press Releases, Fact Sheets and Opinion Editorials – Commerce Secretary Gary Locke Urges China, Russia to End Ban on U.S. Pork". Commerce.gov. Archived from the original on May 7, 2009. Retrieved May 8, 2009.
  195. ↑ "DefenseLink News Article: Military Monitors H1N1 Flu With Focus on Protecting Force". Defenselink.mil. Archived from the original on May 6, 2009. Retrieved May 8, 2009.
  196. ↑ "DoD Pandemic Influenza Watchboard – U.S. DoD Official Website". Fhp.osd.mil. Archived from the original on May 25, 2009. Retrieved May 19, 2009.
  197. ↑ "Additional Flu Resources for School Leaders Seeking Guidance – ED.gov Blog". Edgovblogs.org. April 29, 2009. Archived from the original on May 5, 2009. Retrieved May 8, 2009.
  198. ↑ "US closes 300 schools amid swine flu scare". Google News. Agence France-Presse. April 30, 2009. Archived from the original on March 3, 2011. Retrieved April 30, 2009.
  199. ↑ Randall, Tom; Lauerman, John (May 5, 2009). "Swine Flu Sickens 1,490 as Answers Sought in South (Update4)". Bloomberg. Archived from the original on July 19, 2012. Retrieved May 5, 2009.
  200. ↑ Stein, Rob (September 27, 2009). "Swine Flu Surge Closes Schools, Tests Hospitals". The Washington Post. Archived from the original on September 28, 2009. Retrieved September 28, 2009.
  201. ↑ "CDC Press Briefing Transcripts May 5, 2009". Centers for Disease Control. May 5, 2009. Archived from the original on May 4, 2009. Retrieved May 5, 2009.
  202. ↑ Miles, Kent A. (April 27, 2009). "Airlines waiving change fees amid swine flu scare". The Atlanta Journal-Constitution. Archived from the original on April 30, 2009. Retrieved May 5, 2009.
  203. ↑ Allen, Mike (April 5, 2009). "Flu Forces Cruise Lines to Reroute Ships to San Diego". San Diego Business Journal. Archived from the original on June 30, 2009. Retrieved May 5, 2009.
  204. ↑ "2009 H1N1 Pandemic Timeline". May 8, 2019. Archived from the original on March 5, 2020. Retrieved March 12, 2020.
  205. 1 2 "Declaration of a National Emergency with Respect to the 2009 H1N1 Influenza Pandemic". whitehouse.gov . Archived from the original on March 12, 2020. Retrieved March 12, 2020– via National Archives.

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