Influenza pandemic (H1N1) of 2009, also called H1N1 flu, byname swine flu, the first major influenza

outbreak in the 21st century, noted for its rapid global spread, which was facilitated by an unusually high
degree of viral contagiousness. Global dissemination of the virus was further expedited by the
unprecedented rates of passenger travel that characterize the modern era.

Doctors at the Mexico City Navy Hospital wearing protective gear as they tend to patients complaining of
H1N1 flu-like symptoms.

Doctors at the Mexico City Navy Hospital wearing protective gear as they tend to patients complaining of
H1N1 flu-like symptoms.

Joe Raedle/Getty Images

The pandemic virus caused a respiratory disease typical of that resulting from infection with seasonal
influenza. However, despite local, national, and international efforts to contain the virus, its more
contagious nature led to the infection of millions of people. The calculation of accurate global figures by
entities such as the World Health Organization (WHO) was precluded by case underreporting and
difficulty in obtaining samples from affected individuals, particularly in developing countries. As a result,
the 622,482 cases and 18,500 deaths confirmed by laboratory analysis by WHO were considered gross
underestimates. Indeed, later analyses based on statistical models that took into account countries with
limited influenza-surveillance data indicated that the actual total number of deaths from the outbreak
may have been as high as 284,500 to 575,400.

Symptoms And Transmission

Persons infected with H1N1 experienced fever and mild respiratory symptoms, such as coughing, runny
nose, and congestion. In some cases symptoms were severe and included diarrhea, chills, and vomiting,
and in rare cases respiratory failure occurred. The H1N1 virus caused relatively few deaths in humans. In
the United States, for example, it caused fewer deaths (between 8,870 and 18,300) than seasonal
influenza, which, based on data for the years 1993–2003, causes an average of about 36,170 deaths each
year. The H1N1 virus was most lethal in individuals affected by chronic disease or other underlying
health conditions.