Skip to main content


In March and early April 2009, a new, swine-origin 2009-H1N1 influenza A virus emerged in Mexico and the United States. During the first few weeks of surveillance, the virus spread by human-to-human transmission worldwide to over 30 countries. On June 11, 2009, the World Health Organization (WHO) raised the worldwide pandemic alert level to Phase 6 in response to the ongoing global spread of the novel influenza A (H1N1) virus. By October 30, 2009, the H1N1 influenza A had spread to 191 countries and resulted in 5,700 fatalities. A national emergency was declared in the United States and the swine flu joined SARS and the avian flu as pandemics of the 21st century. Vaccination is currently available, but in limited supply, and with a 60 percent effectiveness rate against the virus.

The story of how this new influenza virus spread out of Mexico to other parts of North America and then on to Europe, the Far East, and now Australia and the Pacific Rim countries has its origins in the global interconnectedness of travel, trade, and tourism. Given the rapid spread of the virus, the international scientific, public health, security, and policy communities had to mobilize quickly to characterize this unique virus and address its potential effects. The World Health Organization and Centers for Disease Control have played critical roles in the surveillance, detection and responses to the H1N1 virus.

The Domestic and International Impacts of the 2009-H1N1 Influenza A Pandemic: Global Challenges, Global Solutions aimed to examine the evolutionary origins of the H1N1 virus and evaluate its potential public health and socioeconomic consequences, while monitoring and mitigating the impact of a fast-moving pandemic. The rapporteurs for this workshop reported on the need for increased and geographically robust global influenza vaccine production capacities; enhanced and sustained interpandemic demand for seasonal influenza vaccines; clear "triggers" for pandemic alert levels; and accelerated research collaboration on new vaccine manufacturing techniques. This book will be an essential guide for healthcare professionals, policymakers, drug manufacturers and investigators.

Suggested Citation

Institute of Medicine. 2010. The Domestic and International Impacts of the 2009-H1N1 Influenza A Pandemic: Global Challenges, Global Solutions: Workshop Summary. Washington, DC: The National Academies Press.

Import this citation to:

Publication Info

440 pages |  6.25 x 9.25 | 

  • Paperback:  978-0-309-14677-7
  • Ebook:  978-0-309-15688-2
Chapters skim
Front Matter i-xxii
Workshop Overview 1-94
Appendix A1 Technical Report for State and Local Public Health Officials and School Administrators on CDC Guidance for School (K-12) Responses to Influenza during the 2009-2010 School Year 95-110
A2 Predicting Emerging Diseases in the Twenty-first Century: The Case of Zoonotic Influenza 111-119
A3 The Spring 2009 Influenza A H1N1 Outbreak: A Local Public Health Perspective 120-136
A4 I nternational Law and Equitable Access to Vaccines and Antivirals in the Context of 2009-H1N1 Influenza 137-154
A5 In Vitro and In Vivo Characterization of New Swine-Origin H1N1 Influenza Viruses 155-190
A6 Estimation of the Reproductive Number and the Serial Interval in Early Phase of the 2009 Influenza AH1N1 Pandemic in the USA 191-207
A7 The Severity of Pandemic H1N1 Influenza in the United States, from April to July 2009: A Bayesian Analysis 208-247
A8 Hard Choices in Difficult Situations: Ethical Issues in Public Health Emergencies 248-268
A9 Rumors of Pandemic: Monitoring Emerging Disease Outbreaks on the Internet 269-282
A10 Preliminary Observation of the Epidemiology of Seasonal and Pandemic Influenza A (H1N1) in South Africa, 2009 283-296
A11 Reflections on the 1976 Swine Flu Vaccination Program 297-305
A12 Southern Hemisphere, Northern Hemisphere: A Global Influenza World 306-326
A13 Influenza (H1N1) Pandemic 2009 327-341
A14 Origins and Evolutionary Genomics of the 2009 Swine-Origin H1N1 Influenza A Epidemic 342-380
Appendix B Agenda 381-385
Appendix C Acronyms 386-388
Appendix D Glossary 389-396
Appendix E Forum Member Biographies 397-418

What is skim?

The Chapter Skim search tool presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter. You may select key terms to highlight them within pages of each chapter.

Copyright Information

The National Academies Press (NAP) has partnered with Copyright Clearance Center's Marketplace service to offer you a variety of options for reusing NAP content. Through Marketplace, you may request permission to reprint NAP content in another publication, course pack, secure website, or other media. Marketplace allows you to instantly obtain permission, pay related fees, and print a license directly from the NAP website. The complete terms and conditions of your reuse license can be found in the license agreement that will be made available to you during the online order process. To request permission through Marketplace you are required to create an account by filling out a simple online form. The following list describes license reuses offered by the NAP through Marketplace:

  • Republish text, tables, figures, or images in print
  • Post on a secure Intranet/Extranet website
  • Use in a PowerPoint Presentation
  • Distribute via CD-ROM
  • Photocopy

Click here to obtain permission for the above reuses. If you have questions or comments concerning the Marketplace service, please contact:

Marketplace Support
International +1.978.646.2600
US Toll Free +1.855.239.3415

To request permission to distribute a PDF, please contact our Customer Service Department at

loading iconLoading stats for The Domestic and International Impacts of the 2009-H1N1 Influenza A Pandemic: Global Challenges, Global Solutions: Workshop Summary...