Centers for Disease Control and Prevention
May 05, 2009-H1N1 Flu - Congressional Update
We are providing this document to help inform Congress and congressional staff about the current status of the 2009-H1N1 flu events. Any questions should be directed to CDC/Washington at 202-245-0600.
Note: Green text indicates new information. Black text indicates background and other information also included in previous updates.
U.S. Update
As of May 5, 2009 11:00 AM ET, a total of 403 confirmed human cases of 2009-H1N1 flu have been identified in the United States in 38 states. The average age of cases is 16 and range from 3 months to 81 years; 62 percent of cases are under age 18. There are 35 known hospitalizations. 702 additional probable cases in 42 states are currently being analyzed. The total number of cases reported likely represents an underestimation of the actual total number of cases because in order for a case to be confirmed and reported infected individuals must visit a healthcare provider with flu-like symptoms and be tested for 2009-H1N1 flu. There has been one death from 2009-H1N1 flu in Texas.
A summary of the cases is provided below. All questions related to specific cases should be directed to the state health department in the state in which the case occurred. A full list of state health departments and their contact information is available at http://www.astho.org/Programs/Infectious-Disease/H1N1/ under State H1N1 Information.
| U.S. Human Cases of 2009-H1N1 Flu Infection (As of May 5, 2009 11:00 AM ET) | ||
|---|---|---|
State |
# of laboratory confirmed cases |
# deaths reported among laboratory confirmed cases |
Alabama |
4 |
- |
Arizona |
17 |
- |
California |
49 |
- |
Colorado |
6 |
- |
Connecticut |
2 |
- |
Delaware |
20 |
- |
Florida |
5 |
- |
Georgia |
1 |
- |
Idaho |
1 |
- |
Illinois |
82 |
- |
Indiana |
3 |
- |
Iowa |
1 |
- |
Kansas |
2 |
- |
Kentucky* |
1 |
- |
Louisiana |
7 |
- |
Maine |
1 |
- |
Maryland |
4 |
- |
Massachusetts |
6 |
- |
Michigan |
2 |
- |
Minnesota |
1 |
- |
Missouri |
1 |
- |
Nebraska |
1 |
- |
Nevada |
1 |
- |
New Hampshire |
1 |
- |
New Jersey |
6 |
- |
New Mexico |
1 |
- |
New York |
90 |
- |
North Carolina |
1 |
- |
Ohio |
3 |
- |
Oregon |
15 |
- |
Pennsylvania |
1 |
- |
Rhode Island |
1 |
- |
South Carolina |
16 |
- |
Tennessee |
2 |
- |
Texas |
41 |
1 |
Utah |
1 |
- |
Virginia |
3 |
- |
Wisconsin |
3 |
- |
Total Count |
403 cases |
1 death |
| Source: CDC (http://www.cdc.gov/h1n1flu/) * Case is a resident of Kentucky but currently hospitalized in Georgia. |
||
International Update
The World Health Organization (WHO) is providing information on international 2009-H1N1 flu outbreaks at: http://www.who.int/csr/disease/swineflu/en/index.html.
On April 29, 2009 WHO raised the level of influenza pandemic alert from phase 4 to phase 5. Information on WHOs pandemic influenza phases is available at: http://www.who.int/csr/disease/avian_influenza/phase/en/index.html. As CDC was operating under the assumption that the outbreak would expand, the change in WHO's alert phase does not change our activities. As further information becomes available, WHO may decide to either revert to phase 4 or raise the level of alert to another phase. CDC will continue to adjust our response to changing events, and will make information available as we confirm it.
As of May 5, 2009 4:00 PM GMT, the Government of Mexico has reported 822 laboratory confirmed cases, including 29 deaths, of 2009-H1N1 flu. The higher number of cases in Mexico reflects ongoing testing of previously collected specimens.
As of May 5, 2009 4:00 PM GMT, the World Health Organization reported laboratory confirmed cases of 2009-H1N1 flu with no deaths in the following countries: Austria (1), Canada (140), China, Hong Kong Special Administrative Region (1), Costa Rica (1), Colombia (1), Denmark (1), El Salvador (2), France (4), Germany (9), Ireland (1), Israel (4), Italy (5), Netherlands (1), New Zealand (6), Portugal (1), Republic of Korea (2), Spain (57), Switzerland (1) and the United Kingdom (27).
International Human Cases of 2009-H1N1 Flu Infection (As of May 5, 2009 4:00 PM GMT) | ||
|---|---|---|
Country |
# of laboratory confirmed cases reported by country with cases |
# of deaths reported among laboratory confirmed cases |
Austria |
1 |
- |
Canada |
140 |
- |
China, Hong Kong, Special Administrative Region |
1 |
- |
Columbia |
1 |
- |
Costa Rica |
1 |
- |
Denmark |
1 |
- |
El Salvador |
2 |
- |
France |
4 |
- |
Germany |
9 |
- |
Ireland |
1 |
- |
Israel |
4 |
- |
Italy |
5 |
- |
Mexico |
822 |
29 |
Netherlands |
1 |
- |
New Zealand |
6 |
- |
Portugal |
1 |
- |
Republic of Korea |
2 |
- |
Spain |
57 |
- |
Switzerland |
1 |
- |
United Kingdom |
27 |
- |
Total Count |
1087 cases |
29 deaths |
| Source: World Health Organization (http://www.who.int/csr/don/2009_05_05a/en/index.html) | ||
Background Information About 2009-H1N1 Flu
Background information on 2009-H1N1 flu:
- http://www.cdc.gov/h1n1flu/swineflu_you.htm
- http://www.cdc.gov/h1n1flu/whatsnew.htm
- http://www.cdc.gov/h1n1flu/sick.htm
- http://www.cdc.gov/h1n1flu/parents.htm
- http://www.cdc.gov/h1n1flu/talkingtokids.htm
- http://wwwn.cdc.gov/travel/
- http://www.cdc.gov/h1n1flu/key_facts.htm
- http://www.cdc.gov/h1n1flu/pdf/brochure.pdf
- http://www.who.int/mediacentre/news/statements/2009/h1n1_20090430/en/index.html
- http://www.cdc.gov/h1n1flu/espanol/influenza-porcina-info-general.htm
- http://www.cdc.gov/h1n1flu/espanol/psa/
Most recent updates to information from CDC on 2009-H1N1 flu:
Information for individuals and parents on 2009-H1N1 flu:
Travel notices related to 2009-H1N1 flu:
Information on 2009-H1N1 flu and pork
Resources and Information in Spanish:
School (K-12) and Childcare Facilities
What does CDC recommend regarding the closure of schools (K-12) and childcare facilities?
School closure is not advised for a suspected or confirmed case of novel influenza A (H1N1) and, in general, is not advised unless there is a magnitude of faculty or student absenteeism that interferes with the schools ability to function. Schools that were closed under previous guidance related to this outbreak may reopen.
Individual students, faculty or staff with influenza-like illness (fever with a cough or sore throat) should stay home and not attend school or go into the community for a minimum of 7 days even if their symptoms resolve sooner, except to seek medical care. Students, faculty and staff who appear to have an influenza-like illness at arrival or become ill during the school day should be isolated promptly in a room separate from other students and sent home.
Strategic National Stockpile
Where can I learn about the Strategic National Stockpile?
http://emergency.cdc.gov/stockpile/
How is the Strategic National Stockpile (SNS) being used?
CDC has released 25 percent of states and localities allocation of SNS held antiviral drugs, personal protective equipment, and respiratory protection devices. This includes 11 million courses of treatment with antiviral drugs. All states and localities (localities include D.C., 8 U.S territories, New York City, Los Angeles, and Chicago) have requested supplies from the stockpile and CDC is working with states on the distribution of supplies. As of May 4, 2009, distribution is complete in 60 of the 62 states and localities scheduled to receive supplies.HHS Secretary Kathleen Sebelius announced on April 30th, 2009 that the Federal government will purchase an additional 13 million treatment courses to help fight influenza, including the 2009 H1N1 flu virus. The additional treatment courses will be added to the Strategic National Stockpile. The Secretary also announced that HHS began moving 400,000 treatment courses to Mexico to help slow the spread of the H1N1 virus.
This step will enable states to have medications and supplies on hand locally should they be needed. In addition, individual state stockpiles are available for use at the discretion of the states. No shortages of antiviral drugs have been reported.
Who is in charge of medicine in the Strategic National Stockpile (SNS) once it is deployed?
Local health officials have full control of SNS medicine once supplies are deployed to a city, state, or territory. Federal, state, and local community planners are working together to ensure that SNS medicines will be delivered to the affected area as soon as possible. Most cities, states, and territories have already received SNS supplies. After CDC sends medicine to a state or city, control and distribution of the supply is at the discretion of that state or local health department. Most states and cities also have their own medicines that they can access to treat infected persons.
Guidance Documents
CDC has and continues to develop a number of guidance documents related to 2009-H1N1 flu. The documents target a variety of clinical, professional, and individual audiences. The guidance documents are regularly updated as CDC continues to learn more about 2009-H1N1 flu. All current guidance documents are available at: 2009-H1N1 Flu Guidance. Guidance documents include:
Guidance for Schools, Colleges and University
Guidance for Pregnant and Breastfeeding Women
- Breastfeeding Your Baby: What Parents Should Know.
- Information for Pregnant Women in Education, Child Care, and Health Care.
- What Pregnant Women Should Know About H1N1 (formerly called swine flu) Virus
Clinician Guidance for Patients
- Patients With Cardiovascular Disease.
- Caring for a Sick Person in Your Home
- Identifying and Caring For Patients
- Infection Control for Patients In a Healthcare Setting
Clinician Guidance for Specific Audiences
- Patients With Cardiovascular Disease.
- HIV-Infected Adults and Adolescents
- Pregnant Women.
- Young Children
Screening & Specimen Collection
- Guidelines for the Submission of Tissue Specimens for the Pathologic Evaluation of Influenza Virus Infections
- Case Definitions for Investigations of Cases
- Screening in Regions with Few or no Reported Cases
- Specimen Collection, Processing, and Testing for Suspected Infection
- Biosafety Guidelines for Lab Workers
Treatment Guidance
- Key Mental and Behavioral Health Issues Related to Social Distancing For State, Local, And Tribal Health Departments And Community Based Organizations NEW!
- Antiviral Recommendations
- Facemask and Respirator Use
- Reducing Risks in the Community (Community Mitigation)
- Emergency Use Authorization (EUA) of Medical Products
- Patients With Cardiovascular Disease
Laboratories
- Use of Rapid Influenza Diagnostic Tests
- Protocol for Antiviral Susceptibility Testing by Pyrosequencing
- Sequencing Primers and Protocol
- CDC Protocol of Realtime RTPCR for Swine Influenza A(H1N1)
Travel & Travel Industry Guidance
- Guidance for Cruise Ships
- Flight Crews Arriving from Affected Areas
- Identifying Passengers Who May Have Swine Influenza
Emergency Personnel Guidance
Protection of Migrant Farm Workers
Identification and Confirmation of Infections
What is CDCs role in evaluating possible 2009-H1N1 flu infections?
CDC is collaborating with clinicians and state and local health departments to identify and confirm 2009-H1N1 flu virus infections. CDC has also provided guidance for clinicians with patients presenting with possible 2009-H1N1 flu infection. Clinicians are asked to obtain a respiratory swab for 2009-H1N1 flu testing. Once collected, the clinician should contact their state or local health department to facilitate transport and timely diagnosis at a state public health laboratory. CDC has distributed diagnostic test kits to states to enable state laboratories to confirm cases directly. A growing number of states are able to confirm cases in their states. CDC is working with additional states to ensure testing kits are functioning properly before they begin confirming cases independently and reporting information back to CDC, as is generally done for seasonal flu. Once states begin employing independent confirmation testing, the number of samples being tested will increase and may result in a rapid increase in case count. Some of this will likely be due to more widespread infection, but some of it may result from an increase in testing capacity and laboratory results.
Major investments in state laboratory capacity over the last five years have enhanced capabilities such that the confirmation testing can be conducted at the state level with distribution of testing kits.
How can human infections with 2009-H1N1 influenza be diagnosed?
To diagnose 2009-H1N1 flu infection, a respiratory specimen would generally need to be collected within the first 4 to 5 days of illness (when an infected person is most likely to be shedding virus). However, some people, especially children, may shed virus for 10 days or longer.
Travel and Border Control
What travel warnings have CDC issued?
On April 27th, CDC recommended that travelers avoid all non-essential travel to Mexico. CDC is providing recommendations to reduce risk of infection and help travelers stay healthy. Information is available at: http://wwwn.cdc.gov/travel/contentSwineFluMexico.aspx.
What is being done to protect travelers and flight crews from 2009-H1N1 flu infections?
CDC has issued guidance to assist airline flight deck and cabin crew members in identifying passengers that may have 2009-H1N1 flu. The guidance is available at: http://www.cdc.gov/h1n1flu/aircrew.htm. CDC also issued guidance for airlines regarding flight crews returning from areas with 2009-H1N1 infections, available at: http://www.cdc.gov/h1n1flu/guidance/air-crew-dom-intl.htm.
The U.S .Department of Homeland Security (DHS) Customs and Border Protection (CBP) is monitoring incoming travelers to identify individuals experiencing symptoms entering the U.S. and is providing information about the 2009 H1N1 flu virus to travelers. Information is being provided to passengers arriving from areas with 2009-H1N1 infections regarding symptoms and steps to take if they develop symptoms. This information is available at: http://wwwn.cdc.gov/travel/fileSwineFluPassengers.ashx.
Where can I obtain information on quarantine stations?
A fact sheet with background information on the U.S. quarantine stations located at 20 ports of entry and land-border crossings is available at: Quarantine Stations Fact Sheet.
What is the WHO recommending concerning world travel?
WHO is not recommending travel restrictions related to the outbreak of the influenza A(H1N1) virus. Today, international travel moves rapidly, with large numbers of individuals visiting various parts of the world. Limiting travel and imposing travel restrictions would have very little effect on stopping the virus from spreading, but would be highly disruptive to the global community. See http://www.who.int/csr/disease/swineflu/guidance/public_health/travel_advice/en/index.html
HHS and CDC Roles
CDC is actively responding to and investigating the current outbreak of 2009-H1N1 flu.
CDC has fully activated its Emergency Operations Center. In addition to response and laboratory activities described above, 81 staff have been deployed in the U.S. and Mexico to assist with the public health investigation. Deployment of 35 additional personnel is in process. On April 21st CDC described the first two cases in a Morbidity and Mortality Weekly Report (MMWR), Swine Influenza A (H1N1) Infection in Two Children --- Southern California, March--April 2009 (http://www.cdc.gov/mmwr/preview/mmwrhtml/mm58d0421a1.htm). An MMWR describing additional cases was published on April 24th and is available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm58d0424a1.htm?s_cid=mm58d0424a1_e.
As a part of the U.S. Department of Health and Human Services (HHS), CDC is coordinating and communicating closely with HHS officials. On April 26th, as a consequence of confirmed cases of 2009-H1N1 flu in California, Texas, Kansas, and New York and after consultation with public health officials, including CDC, the Acting Secretary of HHS, Charles Johnson, declared a national public health emergency involving 2009-H1N1 flu.
HHS, in turn, is closely coordinating with other state, local and Federal Agencies, including Department of Homeland Security, Department of Agriculture, and Department of State; and our international counterparts.
For more information regarding CDCs 2009-H1N1 flu activities, go to: http://www.cdc.gov/h1n1flu/.
Pandemic Planning Investments at Work
In recent years, CDC has received congressional appropriations pandemic influenza activities.
CDCs Pandemic Influenza Appropriations | |
|---|---|
Fiscal Year |
Amount |
2007 |
$70,000,000 |
2008 |
$154,632,000 |
2009 |
$156,046,000 |
Total Appropriations |
$380,678,000 |
These recent investments have enhanced many areas critical to pandemic influenza preparedness and response, including health monitoring, epidemiology, laboratory capabilities, response, and recovery. The appropriated resources have allowed CDC to work with states and territories to test national infrastructure and develop operational plans, strengthen crisis communication plans and tools, expand the Strategic National Stockpile, improve surveillance systems, and work with international partners to prepare for a pandemic. All of these activities have increased both CDCs and our partners capacity and capabilities for dealing with the current 2009-H1N1 flu outbreak.
For more information about CDCs pandemic influenza activities and appropriations, please contact CDC/Washington, at (202) 245-0600.
Where to Find Updates
CDC is committed to ensuring Congress, public health partners, the media, and the public are able to obtain up-to-date and accurate information regarding the human 2009-H1N1 flu cases and CDCs related activities. CDC is providing daily updates on our Web site. Information is available at: http://www.cdc.gov/h1n1flu/index.htm.
In addition, the World Health Organization (WHO) has additional information on the global situation at: http://www.who.int/csr/disease/swineflu/en/index.html. Many state health departments are adding or updating information on 2009-H1N1 flu on their Web sites. A full list of state health departments and their contact information is available at http://www.astho.org/Programs/Infectious-Disease/H1N1/ under State H1N1 Information.
- Historical Document: May 06, 2009
- Content source: CDC Washington
Content Management: Office of Enterprise Communication - Notice: Linking to a non-federal site does not constitute an endorsement by HHS, CDC or any of its employees of the sponsors or the information and products presented on the site.
