Initial outbreaks

It is not known where the virus originated. Analysis in scientific journals have suggested that the H1N1 strain responsible for the current outbreak first evolved in September 2008, and circulated among humans for several months before being identified as a new strain of flu.

Semi-logarithmic plot of laboratory-confirmed

A(H1N1) influenza cases in 2009 according to

the WHO reports as of 3 August.

Mexico

The virus was first reported in two US children in March 2009, but health officials have reported that it apparently infected people as early as January 2008 in Mexico. The outbreak was first detected in Mexico City on March 18,2009, immediately after the outbreak was officially announced, Mexico requested material support from the US, and within days of the outbreak Mexico City was “effectively shut down”. Some countries canceled flights to Mexico while others halted trade. Calls to close the border to contain the spread were rejected. Mexico already had hundreds of cases before the outbreak was officially recognized, and was therefore in the midst of a “silent epidemic. As a result, Mexico was reporting only the most serious cases, possibly leading to a skewed initial estimate of the case fatality rate.

United States

The new strain was first identified by the CDC in two children, neither of whom had been in contact with pigs. The first case, from San Diego Country, California, was confirmed from clicical specimens (nasopharyngeal swab) examined by the CDC on April 14, 2009. A second case, from nearby Imperial Country, California, was confirmed on April 17. The patient in the first confirmed case had flu symptoms including fever and cough on clinical exam on March 30, and the second on March 28. It was not identified as a new strain in Mexico until April 24.

Summary

2009 A(H1N1) Outbreak and Pandemic Milestones
17 March Mexico First case in the world of what would later be identified as swine flu.
28 March United States First case in the US of what would later be identified as swine flu.
12 April Mexico First known death due to what would later be identified as swine flu.
24 April World Health Organization First Diseases Outbreak Notice mention of the Swine Flu by the World Health Organization.
25 April United States Community outbreaks confirmed in United States.
Mexico Community outbreaks confirmed in Mexico.
27 April Canada First case confirmed in Canada.
Spain First case confirmed in Spain.
United Kingdom First case confirmed in the United Kingdom.
28 April Israel First case confirmed in Israel.
New Zealand First case confirmed in New Zealand.
29 April United States First death confirmed in the United States.
Germany First case confirmed in Germany.
Austria First case confirmed in Austria.
30 April Netherlands First case confirmed in Netherlands.
Switzerland First case confirmed in Switzerland.
Republic of Ireland First case confirmed in Ireland.
1 May Hong Kong First case confirmed in Hong Kong, China.
Denmark First case confirmed in Denmark.
France First case confirmed in France.
2 May Italy First case confirmed in Italy.
South Korea First case confirmed in South Korea.
Costa Rica First case confirmed in Costa Rica.
3 May Colombia First case confirmed in Colombia.
Portugal First case confirmed in Portugal.
Canada First human-to-animal transmission of the virus in Canada.
4 May El Salvador First case confirmed in El Salvador.
5 May Guatemala First case confirmed in Guatemala.
6 May Poland First case confirmed in Poland.
Sweden First case confirmed in Sweden.
7 May Argentina First case confirmed in Argentina.
Brazil First case confirmed in Brazil.
Canada First death confirmed in Canada.
Canada First case of zoonosis in Canada, where an infected pig infects a human.
8 May Japan First case confirmed in Japan.
Panama First case confirmed in Panama.
Canada Community outbreaks confirmed in Canada.
9 May Australia First case confirmed in Australia.
Norway First case confirmed in Norway.
Costa Rica First death confirmed in Costa Rica.
10 May People's Republic of China First case confirmed in China.
12 May Thailand First case confirmed in Thailand.
Cuba First case confirmed in Cuba.
Finland First case confirmed in Finland.
13 May Belgium First case confirmed in Belgium.
Costa Rica Community outbreaks confirmed in Costa Rica.
14 May Peru First case confirmed in Peru.
15 May Malaysia First case confirmed in Malaysia.
Ecuador First case confirmed in Ecuador.
16 May India First case confirmed in India.
Turkey First case confirmed in Turkey.
17 May Chile First case confirmed in Chile.
Japan Community outbreaks confirmed in Japan.
18 May Greece First case confirmed in Greece.
19 May Paraguay First case confirmed in Paraguay.
Republic of China First case confirmed in Taiwan.
21 May Philippines First case confirmed in Philippines.
22 May Honduras First case confirmed in Honduras.
Russia First case confirmed in Russia.
23 May Iceland First case confirmed in Iceland.
24 May Kuwait First case confirmed in Kuwait.
United Arab Emirates First case confirmed in United Arab Emirates.
25 May Bahrain First case confirmed in Bahrain.
Czech Republic First case confirmed in Czech Republic.
26 May Puerto Rico First case confirmed in Puerto Rico.
United Kingdom Community outbreaks confirmed in United Kingdom.
27 May Romania First case confirmed in Romania.
Singapore First case confirmed in Singapore.
Dominican Republic First case confirmed in Dominican Republic.
Uruguay First case confirmed in Uruguay.
28 May Bolivia First case confirmed in Bolivia.
Venezuela First case confirmed in Venezuela.
Slovakia First case confirmed in Slovakia.
Argentina Community outbreaks confirmed in Argentina.
Australia Community outbreaks confirmed in Australia.
29 May Hungary First case confirmed in Hungary.
30 May Cyprus First case confirmed in Cyprus.
Estonia First case confirmed in Estonia.
Lebanon First case confirmed in Lebanon.
Chile Community outbreaks confirmed in Chile.
31 May Vietnam First case confirmed in Vietnam.
The Bahamas First case confirmed in Bahamas.
Germany Community outbreaks confirmed in Germany.
1 June Bulgaria First case confirmed in Bulgaria.
2 June Chile First death confirmed in Chile.
Luxembourg First case confirmed in Luxembourg.
Ukraine First case confirmed in Ukraine.
Nicaragua First case confirmed in Nicaragua.
Egypt First case confirmed in Egypt.
Bermuda First case confirmed in Bermuda.
3 June Saudi Arabia First case confirmed in Saudi Arabia.
Barbados First case confirmed in Barbados.
Jamaica First case confirmed in Jamaica.
4 June Trinidad and Tobago First case confirmed in Trinidad and Tobago.
5 June Dominican Republic First death confirmed in Dominican Republic.
Cayman Islands First case confirmed in Cayman Islands.
Switzerland Community outbreaks confirmed in Switzerland.
7 June Martinique First case confirmed in Martinique.
8 June Dominica First case confirmed in Dominica.
9 June Colombia First death confirmed in Colombia.
10 June Guatemala First death confirmed in Guatemala.
French Polynesia First case confirmed in French Polynesia.
Guatemala Community outbreaks confirmed in Guatemala.
11 June World Health OrganizationThe WHO raises its Pandemic Alert Level to Phase 6.
Palestinian territories First case confirmed in the Palestinian Territories.
British Virgin Islands First case confirmed in British Virgin Islands.
Hong Kong Community outbreaks confirmed in Hong Kong.
12 June Morocco First case confirmed in Morocco.
Isle of Man First case confirmed in Isle of Man.
Uruguay Community outbreaks confirmed in Uruguay.
14 June United Kingdom First death confirmed in the United Kingdom.
Philippines Community outbreaks confirmed in Philippines.
15 June Solomon Islands First case confirmed in Solomon Islands.
Argentina First death confirmed in Argentina.
16 June Jordan First case confirmed in Jordan.
Qatar First case confirmed in Qatar.
Samoa First case confirmed in Samoa.
Sri Lanka First case confirmed in Sri Lanka.
Suriname First case confirmed in Suriname.
Yemen First case confirmed in Yemen.
Thailand Community outbreaks confirmed in Thailand.
17 June Monaco First case confirmed in Monaco.
United States Virgin Islands First case confirmed in U.S. Virgin Islands.
Netherlands Antilles First case confirmed in Netherlands Antilles.
Oman First case confirmed in Oman.
Malaysia Community outbreaks confirmed in Malaysia.
France Community outbreaks confirmed in France.
18 June Laos First case confirmed in Laos.
Macau First case confirmed in Macao.
South Africa First case confirmed in South Africa. H1N1 now present in all WHO regions.
Papua New Guinea First case confirmed in Papua New Guinea.
Jersey First case confirmed in the island of Jersey.
19 June Australia First death confirmed in Australia.
Antigua and Barbuda First case confirmed in Antigua and Barbuda.
Bangladesh First case confirmed in Bangladesh.
Ethiopia First case confirmed in Ethiopia.
Slovenia First case confirmed in Slovenia.
20 June Algeria First case confirmed in Algeria.
Venezuela Community outbreaks confirmed in Venezuela.
21 June Fiji First case confirmed in Fiji.
Brunei First case confirmed in Brunei.
22 June Philippines First death confirmed in the Philippines.
Iran First case confirmed in Iran.
Montenegro First case confirmed in Montenegro.
Tunisia First case confirmed in Tunisia.
Honduras First death confirmed in Honduras.
23 June Latvia First case confirmed in Latvia.
Macau Community outbreaks confirmed in Macao.
24 June Indonesia First case confirmed in Indonesia.
Cape Verde First case confirmed in Cape Verde Islands.
Côte d'Ivoire First case confirmed in Ivory Coast.
Cambodia First case confirmed in Cambodia.
Iraq First case confirmed in Iraq.
Serbia First case confirmed in Serbia.
Vanuatu First case confirmed in Vanuatu.
25 June Argentina First human-to-animal transmission of the virus in Argentina.
26 June Lithuania First case confirmed in Lithuania
Guernsey First case confirmed in Guernsey.
People's Republic of China Community outbreaks confirmed in China.
27 June Myanmar First case confirmed in Myanmar.
New Caledonia First case confirmed in New Caledonia.
Thailand First death confirmed in Thailand.
28 June Brazil First death confirmed in Brazil.
29 June Spain First death confirmed in Spain.
Uruguay First death confirmed in Uruguay.
Denmark First case of Oseltamivir (Tamiflu) resistance from Denmark found in the world.
Bosnia and Herzegovina First case confirmed in Bosnia and Herzegovina.
Kenya First case confirmed in Kenya.
Mauritius First case confirmed in Mauritius.
Nepal First case confirmed in Nepal.
Italy Community outbreaks confirmed in Italy.
Singapore Community outbreaks confirmed in Singapore.
30 June Saint Lucia First case confirmed in Saint Lucia.
Egypt Community outbreaks confirmed in Egypt.
Chile First case of Oseltamivir (Tamiflu) resistance found in Chile.
1 July Guam First case confirmed in Guam.
Malta First case confirmed in Malta.
South Korea Community outbreaks confirmed in South Korea.
2 July Brunei First death confirmed in Brunei.
Paraguay First death confirmed in Paraguay.
Japan First case of Oseltamivir (Tamiflu) resistance found in Japan.
Uganda First case confirmed in Uganda.
Saint Vincent and the Grenadines First case confirmed in Saint Vincent and the Grenadines.
3 July Hong Kong First case of Oseltamivir (Tamiflu) resistance found in Hong Kong, China.
Aruba First case confirmed in Aruba.
El Salvador First death confirmed in El Salvador.
4 July New Zealand First death confirmed in New Zealand.
Croatia First case confirmed in Croatia.
Republic of Macedonia First case confirmed in Macedonia.
Syria First case confirmed in Syria.
Spain Community outbreaks confirmed in Spain.
5 July Peru First death confirmed in Peru.
Palau First case confirmed in Palau.
6 July France First case confirmed in Guadeloupe.
Libya First case confirmed in Libya.
France First case confirmed in Saint Martin.
Jamaica First death confirmed in Jamaica.
7 July Guyana First case confirmed in Guyana.
Belize First case confirmed in Belize.
Cook Islands First case confirmed in Cook Islands.
Portugal Community outbreaks confirmed in Portugal.
8 July Afghanistan First case confirmed in Afghanistan.
Seychelles First case confirmed in Seychelles.
Malta Community outbreaks confirmed in Malta.
9 July Tanzania First case confirmed in Tanzania.
Panama Community outbreaks confirmed in Panama.
10 July Botswana First case confirmed in Botswana.
France First case confirmed in Reunion.
Zimbabwe First case confirmed in Zimbabwe.
Bolivia First death confirmed in Bolivia.
Ecuador First death confirmed in Ecuador.
Hong Kong First death confirmed in Hong Kong.
11 July Andorra First case confirmed in Andorra.
New Zealand Community outbreaks confirmed in New Zealand.
13 July Saudi Arabia Community outbreaks confirmed in Saudi Arabia.
14 July Haiti First case confirmed in Haiti.
Marshall Islands First case confirmed in Marshall Islands.
Saint Kitts and Nevis First case confirmed in Saint Kitts and Nevis.
Puerto Rico First death confirmed in Puerto Rico.
15 July Tonga First case confirmed in Tonga.
16 July Sudan First case confirmed in Sudan.
Somalia First case confirmed in Somalia.
Singapore First death confirmed in Singapore.
Brazil Community outbreaks confirmed in Brazil.
Morocco Community outbreaks confirmed in Morocco.
Colombia Community outbreaks confirmed in Colombia.
18 July Venezuela First death confirmed in Venezuela.
19 July Georgia (country) First case confirmed in Georgia.
Egypt First death confirmed in Egypt.
Panama First death confirmed in Panama.
Israel Community outbreaks confirmed in Israel.
20 July Guam First death confirmed in Guam.
Albania First case confirmed in Albania.
Namibia First case confirmed in Namibia.
Norway Community outbreaks confirmed in Norway.
21 July Federated States of Micronesia First case confirmed in Federated States of Micronesia.
Northern Mariana Islands First case confirmed in Northern Mariana Islands.
Canada First case of Oseltamivir (Tamiflu) resistance found in Canada.
Indonesia Community outbreaks confirmed in Indonesia.
22 July Hungary First death confirmed in Hungary.
Laos First death confirmed in Laos.
Tonga First death confirmed in Tonga.
India Community outbreaks confirmed in India.
Republic of Ireland Community outbreaks confirmed in Ireland.
Peru Community outbreaks confirmed in Peru.
Vietnam Community outbreaks confirmed in Vietnam.
Jamaica Community outbreaks confirmed in Jamaica.
23 July Malaysia First death confirmed in Malaysia.
American Samoa First case confirmed in American Samoa.
Bhutan First case confirmed in Bhutan.
Kazakhstan First case confirmed in Kazakhstan.
Turks and Caicos Islands First case confirmed in Turks and Caicos Islands.
Bolivia Community outbreaks confirmed in Bolivia.
Sweden Community outbreaks confirmed in Sweden.
24 July Fiji Community outbreaks confirmed in Fiji.
Falkland Islands First case confirmed in Falklands Islands.
Gibraltar First case confirmed in Gibraltar.
Grenada First case confirmed in Grenada.
Maldives First case confirmed in Maldives.
25 July Brunei Community outbreaks confirmed in Brunei.
Ecuador Community outbreaks confirmed in Ecuador.
El Salvador Community outbreaks confirmed in El Salvador.
Greece Community outbreaks confirmed in Greece.
Nicaragua Community outbreaks confirmed in Nicaragua.
South Africa Community outbreaks confirmed in South Africa.
Republic of China Community outbreaks confirmed in Taiwan.
Indonesia First death confirmed in Indonesia.
26 July Cuba Community outbreaks confirmed in Cuba.
Cyprus Community outbreaks confirmed in Cyprus.
Honduras Community outbreaks confirmed in Honduras.
Paraguay Community outbreaks confirmed in Paraguay.
Turkey Community outbreaks confirmed in Turkey.
27 July Denmark Community outbreaks confirmed in Denmark.
Netherlands Community outbreaks confirmed in Netherlands.
United Arab Emirates Community outbreaks confirmed in United Arab Emirates.
Israel First death confirmed in Israel.
Saint Kitts and Nevis First death confirmed in Saint Kitts and Nevis.
Saudi Arabia First death confirmed in Saudi Arabia.
Kosovo First case confirmed in Kosovo.
Zambia First case confirmed in Zambia.
28 July Argentina First case of Oseltamivir (Tamiflu) resistance found in Argentina.
29 July Swaziland First case confirmed in Swaziland.
30 July Azerbaijan First case confirmed in Azerbaijan.
Gabon First case confirmed in Gabon.
Moldova First case confirmed in Moldova.
Belgium First death confirmed in Belgium.
France First death confirmed in France.
Lebanon First death confirmed in Lebanon.
Republic of China First death confirmed in Taiwan.
31 July France First case confirmed in French Guiana.
Nauru First case confirmed in Nauru.
Qatar First death confirmed in Qatar.
Brazil First case of zoonosis in Brazil, where an infected pig infects a human.
2 August India First death confirmed in India.
3 August South Africa First death confirmed in South Africa.
United Kingdom First case confirmed in Akrotiri and Dhekelia.
Pakistan First case confirmed in Pakistan.
4 August Vietnam First death confirmed in Vietnam.
Netherlands First death confirmed in Netherlands.
5 August Iran First death confirmed in Iran.
Anguilla First case confirmed in Anguilla.
6 August Ghana First case confirmed in Ghana.
Kiribati First case confirmed in Kiribati.
Liechtenstein First case confirmed in Liechtenstein.
7 August Republic of Ireland First death confirmed in Ireland.
Palestinian territories First death confirmed in Palestine.
Samoa First death confirmed in Samoa.
8 August Ghana First death confirmed in Ghana.
Thailand First case of Oseltamivir (Tamiflu) resistance found in Thailand.
9 August Algeria Community outbreaks confirmed in Algeria.
Iraq First death confirmed in Iraq.
10 August Mauritius First death confirmed in Mauritius.
12 August East Timor First case confirmed in East Timor.
Wallis and Futuna First case confirmed in Wallis and Futuna.
Nicaragua First death confirmed in Nicaragua.
Brazil First case of Oseltamivir (Tamiflu) resistance found in Brazil.
13 August Tuvalu First case confirmed in Tuvalu.
14 August Cameroon First case confirmed in Cameroon.
Madagascar First case confirmed in Madagascar.
People's Republic of China First case of Oseltamivir (Tamiflu) resistance found in China.
Singapore First case of Oseltamivir (Tamiflu) resistance found in Singapore.
United States First case of Oseltamivir (Tamiflu) resistance found in United States.
15 August Peru First case of Oseltamivir (Tamiflu) resistance found in Peru.
Japan First death confirmed in Japan.
South Korea First death confirmed in South Korea.
Democratic Republic of the Congo First case confirmed in the Democratic Republic of the Congo.
17 August Mozambique First case confirmed in Mozambique.
18 August Malta First death confirmed in Malta.
Cook Islands First death confirmed in Cook Islands.
Yemen First death confirmed in Yemen.
19 August Belarus First case confirmed in Belarus.
20 August Kuwait First death confirmed in Kuwait.
United Arab Emirates First death confirmed in United Arab Emirates.
21 August Chile First cases in birds from Chile found in the world.
Oman First death confirmed in Oman.
22 August New Caledonia First death confirmed in New Caledonia.
23 August Greece First death confirmed in Greece.
24 August French Polynesia First death confirmed in French Polynesia.
Kyrgyzstan First case confirmed in Kyrgyzstan.
26 August
Syria First death confirmed in Syria.
Brazil First human-to-animal transmission of the virus in Brazil.
Angola First case confirmed in Angola.
28 August Brazil First cases in birds confirmed in Brazil.
29 August Bangladesh First death confirmed in Bangladesh.
30 August Colombia First head of state to have swine flu confirmed in Colombia
31 August Djibouti First case confirmed in Djibouti.
Sweden First death confirmed in Sweden.
Bahrain First death confirmed in Bahrain.
1 September Lesotho First case confirmed in Lesotho.
Réunion First death confirmed in Reunion.
2 September Macau First death confirmed in Macau.
3 September Norway First death confirmed in Norway.
Marshall Islands First death confirmed in Marshall Islands.
United States Virgin Islands First death confirmed in U.S. Virgin Islands.
4 September Italy First death confirmed in Italy.
7 September Namibia First death confirmed in Namibia.
Ecuador Ecuador’s Chief of Presidential Security dies.
8 September Suriname First death confirmed in Suriname.
9 September Madagascar First death confirmed in Madagascar.
10 September Malawi First case confirmed in Malawi.
Israel First case of Oseltamivir (Tamiflu) resistance found in Israel.
11 September Australia First case of Oseltamivir (Tamiflu) resistance found in Australia.
14 September Mozambique First death confirmed in Mozambique.
15 September Solomon Islands First death confirmed in Solomon Islands.
17 September Belgium Community outbreaks confirmed in Belgium.
Luxembourg First death confirmed in Luxembourg.
18 September Martinique First death confirmed in Martinique.
23 September Portugal First death confirmed in Portugal.
25 September Germany First death confirmed in Germany.
28 September Cambodia First death confirmed in Cambodia.
30 September Bulgaria First death confirmed in Bulgaria.
Barbados First death confirmed in Barbados.
People's Republic of China First completed clinical trials for 2009/H1N1 vaccine in the world.
4 October Tajikistan First case confirmed in Tajikistan.
6 October People's Republic of China First death confirmed in China.
10 October Cuba First death confirmed in Cuba.
12 October Vietnam First case of Oseltamivir (Tamiflu) resistance found in Vietnam.
Rwanda First case confirmed in Rwanda.
São Tomé and Príncipe First case confirmed in São Tomé and Príncipe.
13 October Mongolia First case confirmed in Mongolia.
15 October Trinidad and Tobago First death confirmed in Trinidad and Tobago.

About this entry