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Summary

On April 29, 2009, in response to the global spread of a new strain of influenza, the World Health Organization (WHO) raised its influenza (flu) pandemic alert level to Phase 5, one level below declaring that a global influenza pandemic was underway. According to WHO, the declaration of Phase 5 is a strong signal that a pandemic is imminent and that the time to finalize the organization, communication, and implementation of the planned mitigation measures is short. In hindsight, officials now believe the outbreak began as clusters of severe respiratory illness in Mexico in March 2009, or perhaps earlier. The novel flu virus was first identified in two children in Southern California in late April 2009. Health officials quickly confirmed that many of the illnesses in Mexico involved the same new flu strain. Since then, a growing number of single or clustered cases of illness have been identified across the United States, Canada, and several other countries. As of May 5, 2009, 1,124 cases meeting the WHO criteria for confirmation have been confirmed in 21 countries in North America, Europe, Asia, and Oceania. These include more than 400 U.S. cases, as well as cases in multiple states in Mexico and provinces in Canada. The majority of the WHO confirmed cases are in Mexico, the United States, and Canada. Investigations to date suggest that human infections with the new flu strain are usually mild, although severe illnesses and deaths have been reported. This pattern is similar to the behavior of seasonal flu, which circulates the globe each year. Health officials continue to monitor the situation, noting that the efficiency of viral transmission and the severity of illness could change. The new flu strain was initially dubbed swine flu because it contains genetic material from flu strains that normally circulate in swine. But there has been no evidence to date that pigs are involved in the transmission of this virus to humans. There have been concerns that the term swine flu has had unwarranted trade implications for swine and pork products. On April 30, 2009, WHO began referring to the new strain as influenza A(H1N1). On May 2, the Canadian Food Inspection Agency (CFIA) reported finding the outbreak strain in a swine herd in Alberta, the first time the strain has been identified in swine. Preliminary investigation suggests that the herd was exposed to the virus from a Canadian who had recently returned from Mexico and had been exhibiting flu-like symptoms. Federal agencies have adopted a pandemic response posture under the overall coordination of the Secretary of Homeland Security. Among other things, officials have released antiviral drugs from the national stockpile, and efforts to develop a vaccine are underway. The Obama Administration has requested $1.5 billion in emergency supplemental appropriations to address the threat, and congressional committees in both chambers have convened hearings to assess the situation. This report provides an overview of key actions taken and authorities invoked by WHO and the U.S. government. First, it discusses the WHO process to determine the phase of a threatened or emerging flu pandemic and touches on a number of related issues. The report then examines actions taken by the Departments of Homeland Security and Health and Human Services and provides information about appropriations and funding for pandemic flu activities. Finally, the report summarizes U.S. government pandemic flu planning documents and lists sources for additional information about the situation as it unfolds. This report will be continually updated to reflect unfolding events.

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