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2009 swine flu pandemic by country

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Main article: 2009 swine flu outbreak
See also: 2009 swine flu outbreak timeline

Template:WebSlice-begin Template:WebSlice-end This article deals with the status and efforts regarding the 2009 swine flu outbreak by country and continent, in alphabetical order.

  Confirmed cases followed by death
  Confirmed cases
  Unconfirmed or suspected cases
See also: Live map of swineflu, H1N1 live map

Template:2009 swine flu outbreak table

Africa

 Egypt

The Egyptian government has increased numbers of medical officers at Cairo Airport and will monitor passengers from Mexico during their stay.[1]

The Government ordered mass slaughter of all pigs in Egypt on April 29.[2]

 Nigeria

The Nigerian Health Minister Babatunde Osotimehin said that the country is stockpiling antiviral treatments, informing the public and increasing surveillance.[1]

 South Africa

On April 29, South Africa reported two possible cases of swine flu from two women who had recently travelled in Mexico.[3]

 Zambia

An emergency task force has been set up by the Zambian government.[1]

Asia

 Azerbaijan

On April 27, Azerbaijan imposed ban on import of animal husbandry products from America.[4] According to Chief of State Veterinary Service under Agriculture Ministry Ismayil Hasanov, the products brought to the country by April 27 received certificates and it was confirmed that those products were safe.[5] AZAL took additional safety measures and a sanitary quarantine unit of Health Ministry started to operate in Heydar Aliyev International Airport with all aircraft and passengers being checked.[6]

Azeri Minister of Health Ogtay Shiraliyev said the order prepared by him considers implementation of necessary measures in the epidemiological and various medical centers. "Azerbaijan is ready for this issue", he said.[7] According to the Agriculture Minister Ismat Abbasov, the State Veterinary Service is holding monitoring in the regions and pigs are kept in closed places in farms.[4] Abbasov also told: "I can say with full responsibility that the situation on prevention against swine flu virus is stabile in Azerbaijan".[4]

 Bangladesh

Medical officers, representatives from the WHO and International Centre for Diarrhoeal Diseases Research are stationed at airports and all travellers, particularly from affected countries, are to be screened.[1]

 People's Republic of China

The General Administration of Quality Supervision, Inspection and Quarantine (AQSIQ) of China issued an emergency notice on the evening of 26 April that visitors returning from flu-affected areas who experienced flu-like symptoms within two weeks would be quarantined.[8] The Ministry of Health has started prevention measures, and initiated cooperation with the WHO and the relevant departments of the Mexican and U.S. governments to help contain the outbreak. According to Wang Jing of the China Inspection and Quarantine Science Research Institute, the measures already in place in China against bird flu are sufficient for this new disease.[9]

 Republic of China (Taiwan)

Although no cases of the influenza have been reported in the Republic of China (Taiwan), the government has already taken several steps to prevent the possible outbreak of Swine Flu, including a command center set up, travel alerts for infected nations,[10] and more severe health check been conducted at international ports. Taiwan said visitors who came back from affected areas with fevers would be quarantined.[11] According to The Department of Health (DOH), Taiwan has a sufficient supply of surgical masks and vaccine to deal with the flu. The DOH also stated that they have 50 million to 60 million masks in stock and local manufacturers have the capability of producing 200,000 doses of the flu vaccine a month.[10] In an effort to prevent the entry of the swine influenza, the Centers for Disease Control has announced on April 28 that every flight from the Americas, specifically Canada and the United States, that arrives in Taiwan from April 29 and onward will be subject to a strict on-board screening procedure.[10]

 Hong Kong, China

The Food and Health Bureau of Hong Kong issued a travel warning for Mexico on 26 April, 2009, that advised Hongkongers not to travel to Mexico unless it is absolutely necessary.[12] The Bureau also escalated the alert level to "Serious" on the same day,[13] which activated health protection measures in all port of entries of Hong Kong. As such, temperature screening machines are used at all checkpoints to identify passengers with fever and respiratory symptoms. Any passenger who fails the temperature test and confirmed having a fever will be quarantined and sent to public hospital for further investigation. [12]Hong Kong also became one of the first cities to declare the swine flu as a notifiable disease.[14][15]

The Secretary for Food and Health Dr. York Chow states that special attention will be paid to passengers who come from countries where human infection of swine influenza cases have been reported. [13]

 India

The Government of India has decided to screen all people entering India via the main airport hubs of Mumbai, New Delhi, Goa, Jaipur, Kochi, Chennai, Bangalore and Hyderabad. It said the primary focus will be on passengers entering from the United States of America, The United Kingdom, Canada, Mexico, France, and New Zealand. A team of 32 highly skilled medical professionals have been posted at these airports. The Ministry of Health is also trying to track down people who have entered India from Mexico in the last 10 days.[16]

 Indonesia

After a coordination meeting about the flu on April 27, 2009, the Indonesian government halted the importation of pigs and initiated the examination of 9 million pigs in Indonesia.[17] Thermal scanners which can detect human body temperature have been installed at Indonesian ports of entry. Temperatures above 38 degrees Celsius (100.4 Fahrenheit) cause the devices to beep, indicating fever. The devices have been installed in Soekarno-Hatta International Airport and Halim Perdana Kusuma Airport in Jakarta, Juanda Airport in Surabaya, Hang Nadim Airport in Batam, Hasanudin Airport in Makassar, Ngurah Rai Airport in Denpasar, Sepinggan Airport in Balikpapan, and Tanjung Priok Seaport, gates one and two in Jakarta.[18]

 Israel

Two cases have been confirmed in Israel, and one more is suspected.[19] In response to the outbreak, the Israeli Deputy Minister of Health, Yaakov Litzman, has said that because swine are unclean, the outbreak needs to be renamed, and so in Israel, out of respect for the religious sensibilities of Jews and Muslims, it will be called "Mexican Flu". [20][21]

 Japan

The Ministry of Agriculture, Forestry and Fisheries of Japan instructed animal quarantine offices across Japan to examine any live pigs being brought into Japan to make sure they are not infected with the influenza.[22] Japanese Agriculture Minister Shigeru Ishiba appeared on television to reassure customers that it was safe to eat pork.[10] The Japanese farm ministry said that it would not ask for restrictions on pork imports because the virus was unlikely to turn up in pork, and would be killed by cooking.[23]

 Kyrgyzstan

All meat imports from the United States and Mexico have been banned temporarily.[1]

 Lebanon

The Lebanese Health Minister Mohammad Khalifeh asked Lebanon to stop the social habit of kissing. He also asked to keep affected schoolchildren at home and avoiding travel to country where the flu appeared. [2] Beirut also banned the import of pork. [3]

 Malaysia

According to the Malaysian Health Ministry, health screenings will be carried out on passengers traveling to and from Mexico beginning on April 17.[24] The Health Ministry’s disease control division has activated its operations room to monitor the swine flu situation and informed medical practitioners who are treating cases with symptoms of influenza-like illness or severe pneumonia and persons had visited Mexico, California or Texas, to inform the district health office immediately for preventive and control measures.[25]

 Nepal

All visitors from the United States and Mexico will be screened and medical officials are stationed at Tribhuvan International Airport.[1]

 Pakistan

Pakistan has taken precautionary measures at the international airports to check passengers coming from swine flu affected countries[26] . Doctors are checking the incoming passengers and allow entry only to those with no flu symptoms. The major hospitals in all the big cities are on high alert.

 Philippines

Philippines' Health Secretary Francisco T. Duque III has ordered the Bureau of Quarantine to use thermal imaging equipment at airports to screen passengers coming from the US for flu symptoms.[27] The Philippines may quarantine travelers arriving from Mexico with fevers.[28] Also, the Secretary of the Department of Agriculture of the Philippines issued an order banning the importation of hogs from the U.S. and Mexico, and the retraction of the restriction of swine influenza vaccine use.[29]

(For Russia, see Europe section below.)

 Singapore

Singapore's Minister of Health Khaw Boon Wan has urged citizens to limit travel to affected areas such as Mexico and the United States. The Health Ministry has advised the public to seek immediate medical attention if they experience influenza symptoms within seven days after arriving from affected areas, to maintain good hygiene, and for those who are sick with respiratory illnesses to avoid crowded areas and wear masks.[23]

On 28 April, Singapore's Ministry of Health raised its Disease Outbreak Response System to a Yellow alert, the second level of a 5 colour alert scale[30]. Medical staff working at critical areas such as Emergency Departments (EDs) and Intensive Care Units in hospitals have been advised to don full Personal Protective Equipment (PPE). Patients with flu-like symptoms and who have a travel history to affected areas or contact with someone who has, will be isolated within the hospitals. There is also a system for patients visiting outpatient clinics so as to avoid transmission. Elective admissions have been rescheduled, the number of visitors to patients have been cut down, and contact particulars of visitors are recorded so as to help reduce unnecessary exposure, provide for surge capacity and to facilitate contact tracing when the need arises.[31]

Thermal scanners have been deployed at arrival halls at Changi Airport, Singapore’s main airport, and Seletar airport to scan passengers arriving from affected areas. Passengers with higher-than-normal temperatures would be subject to more thorough medical assessments. Thermal scanners and thermometers will also be used at ferry terminals to screen visitors arriving by sea.[31]

 South Korea

South Korea warned against travel to Mexico City and three Mexican states.[10] The government has also stepped up quarantine and safety checks on travelers arriving from the United States and Mexico, and pork imports from those countries. An emergency quarantine system is also in place, with simple tests conducted on people arriving with flu symptoms at airports.[8] On April 28, South Korea reported its first probable case of swine flu after positive preliminary tests on a woman who had recently returned from a trip to Mexico.[32]

 Thailand

The Thai Government has installed thermal scanners in Suvarnabhumi Airport and other key airports. Airport health officials began using thermal screening equipment to monitor passengers arriving from the southern United States and Mexico for flu-like symptoms including fever to prevent spreading swine flu. Each unit comprises an infrared thermal camera, a processor and a monitor to show the results of readings. Travellers found with suspicious flu symptoms that could develop into swine influenza will be asked to undergo treatment at one of seventeen state hospitals. The hospitals are on full flu alert and they will be assisted by the private sector. Medical instruments and drugs are ready to support the operation. On the April 28, 2009, the Thai Public Health Ministry issued a warning for Thais to avoid visiting the United States and Mexico which have been hit by the Mexican Flu. The Thai cabinet has formed a national emergency committee to oversee prevention operations against the swine flu, Prime Minister Abhisit Vejjajiva said.[33][34] An initial test on a 42-year-old woman who had flu-like symptoms after returning from a trip to Mexico and the US between April 3 and 19 proved negative. She was admitted to Chulalongkorn Hospital after having a fever since Thursday when she travelled to Singapore. [35]

Public Health Minister Witthaya Kaewparadai instructed provincial public health offices to stock up influenza drug to cope with possible outbreak of the swine flu. Witthaya said he had instructed chief provincial public health officers nationwide to check stock of Oseltamivir anti-viral drug, used for influenza treatment, in their provinces and make sure the drug is available.[36]

 Vietnam

Vietnam's Ministry of Health released a emergency dispatch and urged agencies to take precautionary measures against swine flu. In addition, the Preventive Health and Environment Bureau requested all health facilities to carefully monitor any suspected H1N1 case and this Bureau head, Nguyen Huy Nga, also warned the pandemic could enter Vietnam through imported swines or border gates.[37] Thermal imaging devices were dispatched to airports and border gates to screen passengers.[38]

Europe

Outbreak evolution in Europe:
  Confirmed cases
  Unconfirmed or suspected cases

On April 27, the European Union health commissioner advised Europeans not to travel to the United States or Mexico unless urgent. This followed the first confirmed case being discovered in Spain.[39]

EU Foreign relations commissioner Benita Ferrero-Waldner said on April 29 the halt of all travel to Mexico and disinfecting all airports due to the global flu outbreak is being considered.[40]

 Austria

Outbreak evolution in Austria:
  Confirmed cases

Several possible cases in Austria turned out to be negative, whereas one test of a 28-year-old woman from Vienna had a positive result. Therefore Austria is the 9th country affected by a confirmed case of swine flu. [41]

 Belgium

Six suspected cases of swine flu in Belgium ultimately tested negative.[42]

Croatia

A traveler from Florida is held in quarantine in Osijek under suspicion of swine flu.[43]

Finland

Two suspected cases have been announced. The first suspected case is being investigated in Lahti, the patient returned from Mexico with flu symptoms. The results will be available in a week. [44] The second suspect, who recently returned from Spain, is being investigated in Kotka. [45]

France

Twenty suspected cases of swine flu are currently being investigated in France. Since April 25, over 100 cases of Influenza-like illness have been reported, of which 30 were identified as possible cases. 10 of those cases have since been excluded.[46]

Germany

File:H1N1 Germany Map-2009-29-04.svg
Outbreak evolution in Germany:
  Confirmed cases
  Unconfirmed or suspected cases

Two men and a woman from Bielefeld who had been suspected of having the virus tested negative on influenza type A.[47]

On April 29, the first case of swine flu in Germany was confirmed by the Robert Koch Institute in the area of Regensburg.[48][49][50] A 22-year-old woman from Hamburg is confirmed to have been infected by swine flu during a trip to Mexico.[50] A 37-year-old woman from Kulmbach is also confirmed to have become infected during a similar trip.[50] Further suspected cases are in examination.[50]

Iceland

Iceland is currently being briefed by the WHO and is cooperating closely with ECDC, CDC and the EU in terms of monitoring and response Initially the directorate of health warned people traveling to Mexico and the United States (especially California and Texas) to exercise caution and to contact a doctor immediately if they started showing symptoms of swine flu but on April 28 people traveling to Mexico were advised to cancel their trip unless its very urgent.[51][52]

On April 28 it was announced that passengers arriving in Iceland from the United States or Mexico would be monitored and will undergo medical examination even if the slightest signs of influenza are detected.[53]

On April 28 Haraldur Briem, Head of Infectious Disease Control, announced that two individuals arriving from the United States will be undergoing medical examination because of discomfort and vague symptoms. He added that its unlikely that they are suffering from swine flu.[54] On April 29 it was announced that the case of the two individuals arriving from the United States had been a false alarm and that they did in fact not have the swine flu.[55]

Iceland has stocks of Tamiflu and Relenza for one-third of its population.[53]

In a risk assessment made by the Icelandic government in 2008 in case of a influenza pandemic two scenarios are envisioned:

  • A worst-case scenario where 50% of the Icelandic population are infected and 3% of the infected population die.
  • A milder scenario where precautionary measures prevent infection, 25% of the Icelandic population are infected and 1% die.[56]

Ireland

Initial fears about four Irish people with symptoms proved negative, but three more could have to go through tests within the next few days.[57]

Ireland has over two million doses of anti-virals (Tamiflu and Relenza; enough for half the population) and a pandemic plan in place should the outbreak reach the country.

On 29 April, 2009, notices were put in place at Irish ports and airports offering advice to people returning from countries affected by the swine flu virus.[58]

Italy

Outbreak evolution in Italy:
  Unconfirmed or suspected cases

Italy's agriculture lobby, Coldiretti, warned against panic reaction, noting that farmers lost hundreds of millions of euros due to consumer boycotts during the 2001 mad cow scare and the 2005 bird flu outbreak.[59]

A woman who returned from San Diego was hospitalised in Venice for suspected swine flu.[60]

Lithuania

As of April 29, one possible case in Lithuania is currently under investigation. The institutions already confirmed that it is the A type influenza, but the details as to whether it is H1N1 are still not known.[61]

Netherlands

The Netherlands National Institute for Public Health and the Environment advised any traveller who returned from Mexico since April 17 and developed a fever of 38.5 degrees Celsius (101.3 degrees Fahrenheit) within four days of arriving in the Netherlands to stay at home.[28]

Norway

As of April 28, three persons have tested negative for swine flu.[62] Test results are not yet in for a two year old boy from Revetal, Vestfold, who returned from vacation in Mexico with flu-like symptoms.[63]

The Norwegian government projects that in the worst case, 1.2 million Norwegians may fall ill and 13,000 may die.[64]

Poland

As of April 29, four cases are currently under investigation.[65] Several other patients had been previously investigated but tests turned out negative.[66][67] The Polish Foreign Ministry issued a statement recommending that citizens avoid travel to affected areas until the outbreak is totally contained.[28]

Portugal

As of April 29, there has been one suspected case in Portugal, according to Reuters.

Russia

Russia has banned the import of pork meat from Guatemala, Honduras, Dominican Republic, Colombia, Costa Rica, Cuba, Nicaragua, Panama, El Salvador, 9 US States (Alabama, Arizona, Arkansas, Georgia, Kansas, Louisiana, New Mexico, Oklahoma and Florida) and all types of meat and meat products from Mexico and 5 US States (California, Texas, Kansas, New York and Ohio).[68][69][70]

The President instructed the regional governors to take urgent steps to prevent swine flu from spreading to Russia. Mr Medvedev also instructed the presidential plenipotentiary envoys in the federal districts to personally supervise the preventive measures to ensure the disease did not spread [in Russia] and stipulated monthly reports on the situation.[71]

Serbia

Serbia, on Saturday, April 25, banned all imports of pork from North America, despite reassurances from the Food and Agriculture Organization (FAO) of United Nations that pigs appear not to be the immediate source of infection.[59]

According to Deputy Health Minister Svetlana Mijatović, Serbia will adhere to all WHO recommendations for monitoring the swine flu epidemic.[72] "A sanitary inspection, together with Serbian Ministry of Internal Affairs (MUP), is checking travelers, [...] while the media and all the agencies throughout the world, as well as our own, are constantly informing the public that if anyone feels ill, or is coming from a contaminated area, to consult the authorities at any airport in the world [...]," Mijatović said.[72]

Flights and holidays to Mexico and the U.S. have yet to be canceled, and the advice to citizens traveling to infected countries is to take precautions in terms of immunity and to maintain personal hygiene.[72]

Spain

Main article: 2009 swine flu outbreak in Spain
  Confirmed cases
  Unconfirmed or suspected cases

On April 27 the Spanish Ministry of Health and Social Policy announced that a man in Castilla-La Mancha who had recently returned from Mexico had contracted the disease. The man, aged 23, had returned from Mexico on April 22 and had been quarantined on the 25th. This was the first confirmed case in Europe.[73]

The Spanish government is also observing other 35 possible swine flu cases in the Basque Country, Catalonia, the Balearic Islands, Andalusia, Murcia, Madrid and the Valencian Community.[74]

AENA, the Spanish state owned company who manages all Spanish airports and Air Traffic Control established a protocol for the flights coming from and to Spain from the affected areas.[75] Three patients who had just returned from Mexico were under observation in multiple regions of Spain.[59]

Sweden

On April 28, at least eighteen Swedish people were tested for swine flu after returning from trips in Mexico and the USA, but the results were negative.[76] [77]

Switzerland

A map about The N1H1 in Switzerland.
The N1H1 in Switzerland.

The first suspicious case was officially confirmed on April 27. A young man returning from holiday in Mexico informed his family doctor about fever and flu-like symptoms. He was immediately put under quarantine in a hospital. 8 more people are under observation. A container of inactive swine flu virus samples packed in dry ice exploded on a Swiss train, injuring one person but posing no other risks to humans. [78]

Ukraine

Imports of pork and live pigs from all affected countries have been banned. The ban also applies to all shipments after April 21.[1]

United Kingdom

Main article: 2009 swine flu outbreak in the United Kingdom
  Confirmed cases
  Suspected Cases
  Currently none

On April 25, 2009, a member of British Airways cabin crew was taken to Northwick Park Hospital in Harrow and quarantined after falling ill with flu-like symptoms on a flight from Mexico City though he was later found not to have swine flu.[79]

On April 26, two people were admitted to hospital in Scotland suffering from mild flu-like symptoms after returning from Mexico, later confirmed as swine flu.[80] The Scottish Health Minister reported that seven of the 22 people who were in "close contact" with the two confirmed Scottish cases after they returned home were showing flu-like symptoms.[80] Four people were given medication and advised to stay in their home in Stanwick, Northamptonshire, again after returning from Mexico with mild flu-like symptoms.[81]

On April 27 the UK Health Secretary Alan Johnson told the House of Commons that 25 possible cases had been reported. He also stated that protective facemasks were not planned, as despite their use in Mexico, scientific evidence did not suggest that they proved an effective preventative measure.[82] On the same date, passengers were held on planes arriving at Heathrow, from Mexico City, whilst officials carried out health checks.[83]

On 29 April the government officially made public three more confirmed cases in the UK. These were two adults (one in Birmingham, and one in London), and a 12-year-old girl in Torbay, Devon. All three new cases had recently arrived back from Mexico.

As of late April 2009 Britain has a stockpile of about 33 million courses of antiviral drugs effective against this strain. There is a pandemic plan covering topics from distributing the drugs and setting up helplines to closing schools and banning public events which was tested in a large exercise in 2007.[84]

North America

Canada

Main article: 2009 swine flu outbreak in Canada
Outbreak evolution in Canada:
  Confirmed cases
  Unconfirmed or suspected cases

As of April 28, thirteen cases of swine flu have been confirmed in the country, four in Nova Scotia, four in Ontario, three in British Columbia and two in Alberta.[85][86][87] Nova Scotia's chief medical officer, Dr. Robert Strang, said on 26 April that the National Microbiology Laboratory in Winnipeg confirmed late the previous day, that four young people in the province were recovering from "relatively mild" cases of the disease. The four all attended King's-Edgehill preparatory school in Windsor; and one of the four infected students had been on a recent school trip to the Yucatán Peninsula.[85][88] There is evidence that the disease is spreading beyond the first 4 Nova Scotia cases, as friends and relatives are starting to show symptoms. Dr Robert Strang indicated that he expects the disease to spread to the rest of Nova Scotia within a few weeks[89]

Dr. Michael Gardam, director of infectious disease prevention and control at Ontario's public health agency, said in an interview with the CBC that an outbreak of swine flu in Ontario, Canada's most populous province, would not be as serious as the 2003 SARS epidemic.[90] In preparing for and dealing with an influenza pandemic, the Public Health Agency of Canada follows the WHO's categories, but has expanded them somewhat.[91] Despite initial reports of two swine influenza cases in a Montreal hospital, an official on the Montreal regional health board confirmed negative results for all quarantined patients at the hospital and that no quarantines were currently in effect at the hospital.[92]

Canada's Chief Public Health Officer, Dr. David Butler-Jones, stated that the six affected Canadians suffered from only mild symptoms and have already started to recover. Butler-Jones warned against complacency though, stating that the fact that only mild cases have been reported so far "doesn’t mean we won’t see either some more severe illness or potentially deaths."[93] In both provinces, the cases either involved people who had recently returned from Mexico or those in close contact with them.[94]

Costa Rica

A 21 year old woman was confirmed as carrying the swine flu virus on April 28. The woman, whose identity and location is kept hidden, came back from Mexico by airplane. Local authorities are tracking back all possible occupants of the same or related flights. [95] A second case was confirmed on the same day, a 30-year old man who traveled to Mexico the week before.[96]

Cuba

Cuba's Health Ministry is adopting precautionary measures to prevent the illness from coming into the country. The government has advised citizens to go to seek medical treatment if experiencing flu-like symptoms. [97] Cuba has also banned flights to and from Mexico for 48 hours.[98]

Mexico

Main article: 2009 swine flu outbreak in Mexico
Outbreak evolution in Mexico:
  Deaths
  Confirmed cases

Dr. Jose A. Cordova Villalobos, Mexico's Secretary of Health has stated that since March 2009, there have been over 1,995 suspected cases and 149 deaths, with 20 confirmed to be linked to a new swine influenza strain of Influenza A virus subtype H1N1.[99][100] As of April 26 there had been 1,614 cases, with 103 deaths and about 400 patients in hospital; approximately two-thirds of the sick patients had recovered.[101]

Mexican soldiers distributing protective masks to citizens

Soldiers mobilized by the Mexican government have handed out six million surgical masks to citizens in and around Mexico City.[102] On April 24, 2009, schools (from pre-school to university level) as well as libraries, museums, concerts and any public gathering place, were shut down by the government in Mexico City and the neighboring State of Mexico to prevent the disease from spreading further; the schools in Mexico City, the State of Mexico, and the state of San Luis Potosí will remain closed until at least May 5.[103] Marcelo Ebrard, Mexico City's mayor, has also asked all night-life operators to shut down their places of business for ten days to prevent further infections.[104] José Ángel Córdova, federal Secretary of Health, said on April 24 that schools will probably be suspended for at least the following week then, and that it will take around ten days to see the evolution of the virus' behavior, and to consider other measures after such.[105] On April 25, President Felipe Calderón declared an emergency which granted him the power to suspend public events and order quarantines.[106] Hours later, Córdova announced that classes in Mexico City would be officially suspended through May 6.[107] On 26 April, Natividad Gonzalez Paras, governor of the northeastern State of Nuevo León, announced that state-wide schools will remain closed until 6 May, and established a quarantine system in airports, central bus stations and the creation of observation points mainly in the southern part of the state at the nearest highways to the borders with other states, in order to realize tests conducted on people arriving from other states. However, as for April 27, there are no confirmed reported cases of infection in this state.[108]

On 26 April, the World Bank announced US$ 25 million in immediate aid loans to Mexico, an additional US$ 180 million for long-term assistance to address the outbreak, and advice on how other nations have responded to similar crises.[102]

On 27 April, the Secretaría de Educación Pública (Secretariat of Public Education) announced that all schools in Mexico will remain closed at least until May 6.[109]

On 28 April, The Government of Mexico City closed all restaurants and cinemas. All Mayan and Aztec pyramid ruins, dotted through central and southern Mexico, were closed until further notice.

United States of America

Outbreak evolution in the United States:
  Deaths
  Confirmed cases
  Unconfirmed or suspected cases
Confirmed human cases with known dates of illness onset (USA, April 27, 2009).
Main article: 2009 swine flu outbreak in the United States

Officials in the United States confirmed that seven people in California, two students from a high school in Texas, and a married couple in Kansas were infected with the A/09(H1N1) swine flu; all have recovered.[110] One additional student from the same high school in Texas is suspected of probably having the influenza strain. St. Francis Preparatory School, a private school in New York, has 28 confirmed cases of swine flu.[111] The cases in Kansas and New York are linked to travel to Mexico; most of the cases in California and Texas are not linked and may reflect localized outbreaks of this virus in those areas.[112] One case has been confirmed in Elyria, Ohio.[110] A public health emergency has been declared, but it was said that this is standard procedure in cases as divergent as the recent inauguration and flooding.[113]

The United States of America has declared a state of Public Health Emergency. According to the New York Times, "the emergency declaration frees resources to be used toward diagnosing or preventing additional cases and releases money for more antiviral drugs," including the transfer of approximately 12 million influenza medications from a federal stockpile to states.[102][114] The U.S. plans to follow a guidebook developed over the past five years to fight a pandemic flu, such as H5N1. The situation has developed rapidly with the White House initially looking into the matter according to press releases on April 24, but rapidly adopting a more serious stance as the WHO and CDC issue stronger recommendations.

On April 28, the US suffered its first confirmed death of swine flu. The Centers for Disease Control and Prevention officially confirmed through tests that a 23-month old child was killed due to the flu. The child was a resident of Mexico who had either come to Houston for treatment, according to the Houston Health Department, or was visiting relatives in Houston when the illness was identified, as reported by the BBC.[115][116]

Oceania

Australia

Outbreak evolution in Australia:
  Unconfirmed or suspected cases

As of 28 April 2009, Australia has reported at least 91 suspected cases of swine flu that are being tested. Australia has a stockpile of 8.7 million doses of Tamiflu and Relenza.[117] Airlines have been required to report passengers from the Americas with influenza symptoms, and nurses have been deployed at international airports.[117]

New Zealand

The impact in New Zealand has been almost negligible with no fatalities reported in this country.

Following a three-week language trip to Mexico, ten students from Rangitoto College, a secondary school in North Shore City, Auckland, exhibited influenza symptoms. All 22 students and three accompanying teachers from the trip are currently in home isolation, with oseltamivir provided to the patients and those in contact with them. Ten students tested positive for an influenza A virus,[118][119] with three of them later testing positive for swine flu.[120] The symptoms are reportedly mild and all affected individuals are recovering.[121] A further five people are being tested for influenza A.[122]

New Zealand has a well developed Influenza Pandemic action plan.[123] New Zealand has upgraded its influenza pandemic alert status to code yellow.[124] The national stockpile of 1.4 million doses of oseltamivir has been released to regional health authorities. New Zealand is currently following a policy of border control and cluster control via voluntary quarantine and treatment of contacts with oseltamivir.

This disease is not new to New Zealand. In prior outbreaks, the impact was notable. In the 1918 outbreak of the same disease, over 8600 people died in New Zealand. [125]

Tonga

Tonga has set up an Emergency Taskforce and is performing screen checks at its International Airport for passengers experiencing influenza symptoms, most importantly from flights originating from Los Angeles.[citation needed]

South America

 Argentina

According to an Epidemic Alert order issued by the Ministry of Health, Airlines have been required to report passengers with influenza symptoms arriving from Mexico and United States. Passangers from these countries must fill out a form to be located should they experience any symptoms. [126] In addition, the government has also stepped up safety checks, and thermal scanners are being used on airports to detect passangers with fever and other influenza symptoms. As of April 28, the Goverment has suspended all flights originated from Mexico until May 4 as a precautionary measure.[127]

12 cases are being studied under isolation as possible swine flu infections. [128]

 Bolivia

A "state of health" alert has been declared and health service workers will be transferred to airports and border areas if an outbreak occurred.[1]

 Brazil

Outbreak evolution in Brazil:
  Unconfirmed or suspected cases

Two people who had arrived in Brazil from Mexico with symptoms of an undefined illness were hospitalized in São Paulo on April 25. It was initially suspected that they were suffering from the swine flu virus.[129] The Brazilian Ministry of Health later issued a press release stating that while the exact cause of the two patients illnesses remained unknown, they "did not meet the definition of suspected cases of swine influenza because they did not have signs and symptoms consistent with the disease: fever over 39 °C, accompanied by coughing and/or a headache, muscle and joint pain."[130]

The press release also stated that airports would monitor travelers arriving from affected areas, under the direction of the National Sanitary Surveillance Agency (ANVISA). Air crews are also being trained on signs and symptoms of swine influenza so that passengers displaying symptoms may receive guidance from ANVISA upon arrival.

On April 27, a person who had arrived in Salvador, Bahia, from the United States was hospitalized.[131]

 Chile

On April 27, the Assistant Secretary of Health Jeanette Vega, confirmed that there are eight suspected cases of swine influenza in the country, which are being examined at the Hospital del Tórax in Santiago. Five other cases have been dismissed by the authorities. [132]

 Colombia

The Minister of Social Protection, Diego Palacio Betancourt, announced on April 26, 2009, that 12 suspect cases have been detected, 9 in Bogotá and 3 on the Caribbean coast. Samples of the virus have been sent to the USA for comparisons and analysis. Results of the testing are expected in a few days. On April 27, the Government declared a "national disaster" state[133] in order to face the emergency, which allows health authorities to have a special budget to do so.[134] As of April 28, most of the suspect cases were excluded, with only four remaining: three Mexican teachers in Bogotá, and one person in Cartagena.[135] Another 38 suspect cases are under observation.[136]

 Ecuador

Health officials are carrying out checks on people with flu symptoms entering the country from sea or air.[1]

 Peru

The Governor of Callao, Alex Kouri, ordered that all passengers from any infected country, mainly Mexico, Canada and USA, must be checked before their arrival on Peruvian territory. Also, the Peruvian government must be warned of any case or symptom of fever. This step is in order to prevent any infections, since the main port and airport of Peru are located in Callao. Also, the government has prepared a special area at the Hospital "Daniel Alcides Carrión" to treat cases of this disease.[137]

The first suspicious case has been detected in the morning of April 27, 2009. It was a Peruvian woman who returned from Mexico.[138]

In Peru 5 people were considered suspects with the virus, but as of April 28 have been confirmed to be healthy and not carrying the H1N1 virus. The government has stated that the country is clean, but efforts are being made to examine slaughterhouses and they are screening incoming passengers from problem areas. [139]

Venezuela

Controls have been raised at airports to prevent contagion from spreading. Travellers from the United States and Mexico with flu symptoms are being isolated until they are given the all clear. Pig farms in the country are being "closely inspected" and stockpiles of medicines built up.[1]

Notes

References

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