The World Health Organization (WHO) first reported an influenza‐like illness (Swine Flu) caused by a novel influenza virus in the United States and Mexico on April 24, 2009, which had resulted in 59 confirmed deaths in Mexico alone. 1 The virus was reported as swine influenza A H1N1 because it included five RNA strands derived from pigs (three from North America and two from Europe) along with one RNA strand from humans and two from birds. 2 After several changes in nomenclature, the virus outbreak is now designated pandemic (H1N1) 2009. At that time the influenza pandemic phase alert was 3 owing to the widespread occurrence of highly pathogenic avian influenza H5N1, with some bird to human transmission, but no sustained human to human transmission. 1 By April 27, 2009, the WHO had raised the influenza pandemic phase alert to 4, which indicated human to human transmission, and within 2 days it was raised again to 5, which indicated sustained human to human infection in two or more countries in one WHO region. 1 Pandemic alert phase 6, a global epidemic, was declared on June 11, 2009, sometime after the criteria had actually been met. WHO may have been reluctant to initiate this level owing to the lower virulence of the pandemic (H1N1) 2009 influenza virus. Swine Flu spread quickly around the world, facilitated by global airlines travel. 3 The initial spread of Swine Flu closely matched the volumes of international passenger movements, 3 and eventually it was confirmed in Australia on May 9, 2009, just before the start of the Australian winter. Following the first Australian case, described on May 9, 2009 in the State of Queensland, Swine Flu was soon reported by all states and territories. 4Although the disease was considered relatively mild for a pandemic strain … Corresponding Author: Professor Peter A. Leggat, MD, PhD, DrPH, FAFPHM, FACTM, FFTM ACTM, FFTM RCPSG, FRGS, Head, School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Townsville, Queensland 4811, Australia. E‐mail: peterleggat{at}jcu.edu.au
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