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 child. The child’s virus was evaluated by a prototype point-of-care influenza diagnostic device, and the virus could not be subtyped by the device; subsequent testing revealed an influenza virus never before identified. 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.
The 2009 H1N1 influenza pandemic, which was declared by the World Health Organization (WHO) in June 2009 and officially ended in August 2010, provided an important test of our nation’s preparedness activities and our ability to respond and adapt to a large-scale, protracted public health emergency with the potential for enormous health consequences. For the first time since 1968, we faced the prospect of a pandemic influenza virus that could have had an enormous impact on morbidity and mortality, as well as on our nation’s economy. The pandemic occurred at a time when a severe economic downturn was stretching public and private resources. In addition, the federal government was in the midst of transitioning to a new administration, adding further challenges to the pandemic response.
In response to these events, Department of Health and Human Services (HHS) has taken a step back to examine what has worked well and what has not, as well as which elements of our preparedness were not stressed in our response to the 2009 H1N1 pandemic, but could be in a very severe pandemic as experienced in 1918. Our findings are summarized in the 2009 H1N1 retrospective and improvement plan.
An HHS Retrospective on the 2009 H1N1 Influenza Pandemic to Advance All Hazards Preparedness
An HHS Retrospective on the 2009 H1N1 Influenza Pandemic to Advance All Hazards Preparedness 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. Read the Full Report >>
2009 H1N1 Influenza Improvement Plan
Within the context of all-hazards preparedness, the HHS 2009 H1N1 Influenza Improvement Plan
is a refined blueprint that outlines next priorities for those aspects of pandemic influenza preparedness that are influenza-specific and describes the ways in which those next steps need to be accomplished, informed by the 2009 H1N1 influenza pandemic experience. The intent of this plan is to communicate key priorities of HHS for modifying and updating the prior pandemic plans, and through this document, inform pandemic influenza preparedness planning of state, local, tribal, and territorial agencies, international organizations, and emergency planners in the non-profit and private sectors. By sharing this new approach to pandemic preparedness, we hope to expand wide-ranging collaboration between HHS and our many stakeholders as we re-enter the inter-pandemic phase and work together to enhance the public health resiliency of the nation. Read the Full Improvement Plan >>