Abstract
The first two U.S. cases of H1N1 influenza in San Diego last April were barely noticed. Soon, however, a surge of such cases hit Mexico, mainly near Mexico City, quickly contributing via returning visitors to another surge in metropolitan New York. For the next several months, similarly unseasonable outbreaks of H1N1 were being reported throughout the United States, Mexico, Canada, and, soon, Europe and Asia, and then much of the rest of the world.
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