Data reported to CDC by June 4, 2009, 5:00 PM ET

States and Territories*	Confirmed and Probable Cases	Deaths
States
Alabama	94 cases	0 deaths
Alaska	3cases	0 deaths
Arkansas	9cases	0 deaths
Arizona	547 cases	4 deaths
California	973 cases	0 deaths
Colorado	75 cases	0 deaths
Connecticut	395 cases	1 death
Delaware	142 cases	0 deaths
Florida	247 cases	0 deaths
Georgia	33 cases	0 deaths
Hawaii	115 cases	0 deaths
Idaho	16 cases	0 deaths
Illinois	1357 cases	5
Indiana	173 cases	0 deaths
Iowa	92 cases	0 deaths
Kansas	92	0 deaths
Kentucky	96	0 deaths
Louisiana	134 cases	0 deaths
Maine	17	0 deaths
Maryland	89	0 deaths
Massachusetts	787	0 deaths
Michigan	298 cases	1 death
Minnesota	82	0 deaths
Mississippi	40 cases	0 deaths
Missouri	46 cases	1 death
Montana	15 cases	0 deaths
Nebraska	60 cases	0 deaths
Nevada	128 cases	0 deaths
New Hampshire	64 cases	0 deaths
New Jersey	148 cases	0 deaths
New Mexico	108 cases	0 deaths
New York	858 cases	8 deaths
North Carolina	30 cases	0 deaths
North Dakota	23 cases	0 deaths
Ohio	35 cases	0 deaths
Oklahoma	93 cases	0 deaths
Oregon	167 cases	0 deaths
Pennsylvania	299 cases	0 deaths
Rhode Island	18 cases	0 deaths
South Carolina	60	0 deaths
South Dakota	10 cases	0 deaths
Tennessee	104 cases	0 deaths
Texas	1670 cases	3 deaths
Utah	461 cases	2 deaths
Vermont	9 cases	0 deaths
Virginia	55 cases	1 death
Washington	577 cases	1 death
Washington, D.C.	24 cases	0 deaths
West Virginia	6 cases	0 deaths
Wisconsin	2217 cases	0 deaths
Wyoming	25 cases	0 deaths
Territories
Puerto Rico	1 case	0 deaths
TOTAL*(52)	13,217 cases	27 deaths

Summary of Situation

Updated June 11, 2009, 12:30 PM ET

A Pandemic Is Declared

On June 11, 2009, theWorld Health Organization raised the worldwide pandemic alert level to Phase 6 in response to the ongoing global spread of the novel influenza A (H1N1) virus. A Phase 6 designation indicates that a global pandemic is underway.

More than 70 countries are now reporting cases of human infection with novel H1N1 flu. This number has been increasing over the past few weeks, but many of the cases reportedly had links to travel or were localized outbreaks without community spread. The WHO designation of a pandemic alert Phase 6 reflects the fact that there are now ongoing community level outbreaks in multiple parts of world.

WHO’s decision to raise the pandemic alert level to Phase 6 is a reflection of the spread of the virus, not the severity of illness caused by the virus. It’s uncertain at this time how serious or severe this novel H1N1 pandemic will be in terms of how many people infected will develop serious complications or die from novel H1N1 infection. Experience with this virus so far is limited and influenza is unpredictable. However, because novel H1N1 is a new virus, many people may have little or no immunity against it, and illness may be more severe and widespread as a result. In addition, currently there is no vaccine to protect against novel H1N1 virus.

In the United States, most people who have become ill with the newly declared pandemic virus have recovered without requiring medical treatment, however, CDC anticipates that there will be more cases, more hospitalizations and more deaths associated with this pandemic in the coming days and weeks. In addition, this virus could cause significant illness with associated hospitalizations and deaths in the fall and winter during the U.S. influenza season.

Background

Novel influenza A (H1N1) is a new flu virus of swine origin that first caused illness in Mexico and the United States in March and April, 2009. It’s thought that novel influenza A (H1N1) flu spreads in the same way that regular seasonal influenza viruses spread, mainly through the coughs and sneezes of people who are sick with the virus, but it may also be spread by touching infected objects and then touching your nose or mouth. Novel H1N1 infection has been reported to cause a wide range of flu-like symptoms, including fever, cough, sore throat, body aches, headache, chills and fatigue. In addition, many people also have reported nausea, vomiting and/or diarrhea.

The first novel H1N1 patient in the United States was confirmed by laboratory testing at CDC on April 15, 2009. The second patient was confirmed on April 17, 2009. It was quickly determined that the virus was spreading from person-to-person. On April 22, CDC activated its Emergency Operations Center to better coordinate the public health response. On April 26, 2009, the United States Government declared a public health emergency and has been actively and aggressively implementing the nation’s pandemic response plan.

Since the outbreak was first detected, an increasing number of U.S. states have reported cases of novel H1N1 influenza with associated hospitalizations and deaths. By June 3, 2009, all 50 states in the United States and the District of Columbia and Puerto Rico were reporting cases of novel H1N1 infection. While nationwide U.S. influenza surveillance systems indicate that overall influenza activity is decreasing in the country at this time, novel H1N1 outbreaks are ongoing in parts of the U.S., in some cases with intense activity.
CDC is continuing to watch the situation carefully, to support the public health response and to gather information about this virus and its characteristics. The Southern Hemisphere is just beginning its influenza season and the experience there may provide valuable clues about what may occur in the Northern Hemisphere this fall and winter.

 

CDC Response

CDC continues to take aggressive action to respond to the outbreak. CDC’s response goals are to reduce the spread and severity of illness, and to provide information to help health care providers, public health officials and the public address the challenges posed by this new public health threat.

CDC is issuing updated interim guidance in response to the rapidly evolving situation.

Clinician Guidance

CDC has issued interim guidance for clinicians on  identifying and caring for pateints with novel H1N1, in addition to providing interim guidance on the use of antiviral drugs. Influenza antiviral drugs are prescription medicines (pills, liquid or an inhaled powder) with activity against influenza viruses, including novel influenza H1N1 viruses. The priority use for influenza antiviral drugs during this outbreak is to treat people hospitalized with influenza illness, and to treat people at increased risk of severe illness, including pregnant women, young children, and people with chronic health conditions like asthma, diabetes and other metabolic diseases, heart or lung disease, kidney disease, weakened immune systems, and persons with neurologic or neuromuscular disease.

With the H1N1 Swine Flu in 74 countries I expect to see an official pandemic declared by the WHO by the end of next week. With the moderate nature of the H1N1 flu to date it will not change much other than headlines.

The H1N1 Swine Flu has passed the threshold to be considered a worldwide pandemic. Politics are in play. A pandemic (level 6) declaration can be economically devastating to an already fragile world economy.Mexico all but stated the flu was gone after massive losses to the tourism industry. At this point the H1N1 Flu is a relatively mild form of influenza but pandemic declarations are based on geographic spread, not on severity. No one wants to be a flu country. Practically speaking, travel to Mexico isn’t much different than anywhere else as the numbers mount throughout the world. No politicians want what we have, a flu pandemic. So now the World Health Organization will undoubtedly find a way to redefine pandemic. Think about how pointless the colored terror threat levels have become.

Education instead of obfuscation is the better way. Yes we have a pandemic but it is mild. Give the public a little credit for not being as gullible as we are made out to be. And the mild character could change in the future. An interesting poll would be what percentage of Americans know the current threat assessment level. What percentage would know the pandemic level assessment? Call a pandemic a pandemic and educate people on prevention. Perception management has no place in the public health arena. Education does.

FYI:

Current Threat Level

June 2, 2009

• The United States government’s national threat level is Elevated, or Yellow.
• For all domestic and international flights, the U.S. threat level is High, or Orange.
• The Current HiN1 Flu is Level 5
• Hand Washing and staying 5-6 feet away from coughing people makes you very safe
• Odds of being killed in a terrorist attack-about 1 in ten million

The H1N1 virus continues to expand with over 170 patients hosptialized nationwide. The Swine Flu is the causitive agent for about 50% of the cases of flu in the U.S. at this time. There are no known reported cases in Larimer County at this time.

U.S. Human Cases of H1N1 Flu Infection
(As of May 15, 2009, 11:00 AM ET) States* Confirmed and Probable Cases Deaths
Alabama 55 cases 0 deaths
Arkansas 2 cases 0 deaths
Arizona 435 cases 1 death
California 504 cases 0 deaths
Colorado 55 cases 0 deaths
Connecticut 47 cases 0 deaths
Delaware 60 cases 0 deaths
Florida 68 cases 0 deaths
Georgia 18 cases 0 deaths
Hawaii 10 cases 0 deaths
Idaho 5 cases 0 deaths
Illinois 638 cases 0 deaths
Indiana 71 cases 0 deaths
Iowa 66 cases 0 deaths
Kansas 30 cases 0 deaths
Kentucky** 13 cases 0 deaths
Louisiana 57 cases 0 deaths
Maine 14 cases 0 deaths
Maryland 28 cases 0 deaths
Massachusetts 135 cases 0 deaths
Michigan 142 cases 0 deaths
Minnesota 36 cases 0 deaths
Missouri 19 cases 0 deaths
Montana 4 cases 0 deaths
Nebraska 27 cases 0 deaths
Nevada 26 cases 0 deaths
New Hampshire 18 cases 0 deaths
New Jersey 14 cases 0 deaths
New Mexico 68 cases 0 deaths
New York 242 cases 0 deaths
North Carolina 12 cases 0 deaths
North Dakota 2 cases 0 deaths
Ohio 14 cases 0 deaths
Oklahoma 26 cases 0 deaths
Oregon 94 cases 0 deaths
Pennsylvania 47 cases 0 deaths
Rhode Island 8 cases 0 deaths
South Carolina 36 cases 0 deaths
South Dakota 4 cases 0 deaths
Tennessee 74 cases 0 deaths
Texas 506 cases 2 deaths
Utah 91 cases 0 deaths
Vermont 1 cases 0 deaths
Virginia 21 cases 0 deaths
Washington 246 cases 1 death
Washington, D.C. 12 cases 0 deaths
Wisconsin 613 cases 0 deaths
TOTAL*(47) 4,714 cases 4 deaths

Park Lane Elementary School in Aurora Colorado was closed indefinitely today due to one confirmed case of  H1N1 (swine flu) in a student. The CDC just changed it’s guidelines and does not suggest school closures based on one confirmed case. In conjunction with the state health department Park Lane Elementary School felt closure was in the best interest of the students. For further information see Aurora Public Schools
There are now 10 cases of H1N1 flu in Colorado.

You can prepare for an influenza pandemic now. You should know both the magnitude of what can happen during a pandemic outbreak and what actions you can take to help lessen the impact of an influenza pandemic on you and your family. This checklist will help you gather the information and resources you may need in case of a flu pandemic.

1. To plan for a pandemic:
* Store a two week supply of water and food. During a pandemic, if you cannot get to a store, or if stores are out of supplies, it will be important for you to have extra supplies on hand. This can be useful in other types of emergencies, such as power outages and disasters.
* Periodically check your regular prescription drugs to ensure a continuous supply in your home.
* Have any nonprescription drugs and other health supplies on hand, including pain relievers, stomach remedies, cough and cold medicines, fluids with electrolytes, and vitamins.
* Talk with family members and loved ones about how they would be cared for if they got sick, or what will be needed to care for them in your home.
* Volunteer with local groups to prepare and assist with emergency response.
* Get involved in your community as it works to prepare for an influenza pandemic.

2. To limit the spread of germs and prevent infection:
* Teach your children to wash hands frequently with soap and water, and model the correct behavior.
* Teach your children to cover coughs and sneezes with tissues, and be sure to model that behavior.
* Teach your children to stay away from others as much as possible if they are sick. Stay home from work and school if sick.

3. Items to have on hand for an extended stay at home:

Examples of food and non-perishables

Examples of medical, health, and emergency supplies
* Ready-to-eat canned meats, fish, fruits, vegetables, beans, and soups

* Prescribed medical supplies such as glucose and blood-pressure monitoring equipment
* Protein or fruit bars

* Soap and water, or alcohol-based (60-95%) hand wash
* Dry cereal or granola

* Medicines for fever, such as acetaminophen or ibuprofen
* Peanut butter or nuts

* Thermometer
* Dried fruit

* Anti-diarrheal medication
* Crackers

* Vitamins
* Canned juices

* Fluids with electrolytes
* Bottled water

* Cleansing agent/soap
* Canned or jarred baby food and formula

* Flashlight
* Pet food

* Batteries
* Other non-perishable items

* Portable radio

* Manual can opener

* Garbage bags

* Tissues, toilet paper, disposable diapers

A possible case of Swine Flu in Denver, Colorado is awaiting test results. If positive this will be the first of initial case of the  Swine Flu Outbreak in Colorado.