Introduction

Since the first cases appeared in California and Mexico in April 2009, swine flu has been exhaustively tracked across regions by public health and news organizations alike. By 11 July, the World Health Organization (WHO) declared the H1N1 outbreak a pandemic, the first one since the Hong Kong influenza outbreak of 1968. Conceding that further spread of the virus was ‘inevitable’, WHO Director General Margaret Chan stated that although the flu was moderate in severity, it transmitted easily from person to person and across regions, having already spread to at least 74 countries in a matter of 2 months (Chan, 2009; Cumming-Bruce and Jacobs, 2009). As of 30 August 2009, 254,206 cases and 2837 deaths had been reported from regional WHO offices. Although the first wave of H1N1 never went away entirely, the predicted second wave moved across the globe in the autumn of 2009, affecting most countries of the world, albeit unevenly. The WHO, the American Centers for Disease Control (CDC), the French Institut de Veille Sanitaire (InVS) and other national surveillance institutions stopped attempting to count individually confirmed cases of H1N1 because of the practical difficulties of doing so. But as of late December 2009, the WHO estimated that the pandemic had spread to 208 countries, with some 12,220 deaths (WHO 2009).