page_title: 2009 swine flu pandemic in North America
section_title: United States
hierarchical_section_title: 2009 swine flu pandemic in North America / Countries and territories / North America / United States
context_page_description: The 2009 flu pandemic in North America, part of an epidemic in 2009 of a new strain of influenza A virus subtype H1N1 causing what has been commonly called swine flu, began in The United States and has since spread worldwide.
context_section_description: Initial reports of atypical flu in two individuals in southern California led to the discovery of the novel swine flu virus by the CDC in mid-April. More than a hundred cases were confirmed in the next two weeks, spread through a dozen states. Outside of California and Texas, initial cases were all tied to recent travel to Mexico or close contact with those who had recently visited Mexico. St. Francis Preparatory School, a private school in New York, was the center of a large cluster of cases after a Spring Break trip by several students, and perforce one of the first U.S. schools to be closed as a public health measure during the early outbreak. Most of the cases in California and Texas are not linked and may reflect localized outbreaks of this virus in those areas. As of April 30, the disease was not as virulent outside of Mexico as within Mexico, for reasons not fully understood.
  The United States of America declared a state of Public Health Emergency but this was said to be standard procedure in cases as divergent as the recent inauguration and flooding. 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. The U.S. plans followed a guidebook developed over the past five years to fight a pandemic flu such as H5N1. The situation developed rapidly with the White House initially looking into the matter  on April 24 according to press releases, but rapidly adopting a serious stance as the WHO and CDC issued stronger recommendations.
  On April 29, the US suffered its first confirmed death of swine flu. On April 28, the Centers for Disease Control and Prevention had officially confirmed through tests that a 23-month-old child was infected with the flu. When the sickness continued to worsen the next day, he was transferred to Texas Children's Hospital in Houston, where he died.
  On May 5, Judy Trunnell, a woman in her 30s suffering from "chronic underlying health conditions" died of swine flu in Cameron County, near the US-Mexico border. She was the first US citizen to die from the disease. The woman, a special education teacher, had recently given birth to an eight-month-term healthy baby, delivered by caesarian section. She had been in a coma after being admitted to the hospital with breathing problems on April 19. The woman had also suffered from asthma, rheumatoid arthritis and a skin condition.
  On May 10, a 30-year-old man with underlying health problems died in Washington from H1N1, the first fatality in that state.
  On May 17, 55-year-old Mitchell Wiener, an assistant principal at Intermediate School 238 in Hollis, Queens died from H1N1, making it the first H1N1 related fatality in the state of New York. Wiener suffered from many other underlying health problems, weakening his resistance to the disease.
  On May 19, 2009, a St. Louis County man became the first death in Missouri due to the Swine Flu.
  As of mid-May 2009 many states had abandoned testing for likely influenza cases unless serious illness and/or hospitalization were present. Because reported numbers represent only confirmed cases, they are a "very great understatement" of the total number of cases of infection, according to the CDC.
  The real number of swine flu cases in the United States could be “upwards of 100,000,” a top public health official estimated on Friday — far higher than the official count of 7,415 cases confirmed by laboratories.
  On September 1, 2009, several new virus isolates were tested for neuraminidase inhibitor resistance. These included one seasonal influenza A (H1N1), 13 influenza A (H3N2), 23 Influenza B, and 1, 855 2009 influenza A (H1n1) virus isolates.
caption: Outbreak evolution in the United States:
    2000+ cases  500+ cases  100+ cases  1+ cases