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An HHS Retrospective on the 2009 H1N1 Influenza Pandemic to Advance All Hazards Preparedness

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  • An HHS Retrospective on the 2009 H1N1 Influenza Pandemic to Advance All Hazards Preparedness

    This report is intended to stimulate discussion within HHS, with other federal departments and across relevant organizations?both governmental and non-governmental?about how to build upon the successful elements of the response and concretely address areas that warrant improvement. Every function, activity, role, and area of responsibility involved in the response, no matter how successful, represents a potential area for improvement. It is important to keep a sense of balance in mind, in that even successes can be improved upon, and even areas identified for improvement often had positive attributes. Discussions, accompanied by careful analysis of scientific evidence, can inform concrete actions to improve pandemic and all-hazards preparedness. This report represents an early step in a multifaceted improvement process that will require continued participation by the public, and health and preparedness officials at all levels, both public and private.
    On April 15, 2009, the Centers for Disease Control and Prevention (CDC) in partnership with the Department of Defense (DOD) detected an influenza A in a 10 year old participating in an evaluation of a prototype point-of-care influenza diagnostic device, and that could not be subtyped by the study device; subsequent testing revealed an influenza virus never identified before. Two days later, a second California child who was participating in an influenza surveillance project was also found to have a very similar strain of influenza virus. These two new strains of influenza were, however, radically different from other known circulating seasonal influenza strains. They contained genes from at least two viruses of swine origin that were not known to be circulating among any herds of swine in the United States. An intensive and extensive epidemiological investigation was launched and by Thursday, April 23, additional cases were reported in Texas and California, along with recognition of earlier cases in Mexico. By the following Saturday, April 25, cases had been detected in Kansas, Ohio, and New York. By the end of the month, it was clear that the novel new strain of influenza also contained genes from an avian flu strain. This strain had crossed hosts from swine to humans and appeared to have the potentially dangerous capability of human-to-human transmission.