In March and April 2009, an

outbreak In epidemiology, an outbreak is a sudden increase in occurrences of a disease when cases are in excess of normal expectancy for the location or season. It may affect a small and localized group or impact upon thousands of people across an entire ...

of a new strain of influenza commonly referred to as

swine flu Swine influenza is an infection caused by any of several types of swine influenza viruses. Swine influenza virus (SIV) or swine-origin influenza virus (S-OIV) refers to any strain of the influenza family of viruses that is endemic in pigs. As ...

infected many people in

Mexico Mexico (Spanish: México), officially the United Mexican States, is a country in the southern portion of North America. It is bordered to the north by the United States; to the south and west by the Pacific Ocean; to the southeast by Guatema ...

and parts of the United States causing severe illness in the former. The new strain was identified as a combination of several different strains of

Influenzavirus A '' A virus'' (''IAV'') causes influenza in birds and some mammals, and is the only species of the genus ''Alphainfluenzavirus'' of the virus family ''Orthomyxoviridae''. Strains of all subtypes of influenza A virus have been isolated from wild ...

, subtype

H1N1 In virology, influenza A virus subtype H1N1 (A/H1N1) is a subtype of influenza A virus. Major outbreaks of H1N1 strains in humans include the Spanish flu, the 1977 Russian flu pandemic and the 2009 swine flu pandemic. It is an orthomyxoviru ...

, including separate strains of this subtype circulating in humans (see

Human influenza Influenza, commonly known as "the flu", is an infectious disease caused by influenza viruses. Symptoms range from mild to severe and often include fever, runny nose, sore throat, muscle pain, headache, coughing, and fatigue. These symptom ...

) and in pigs (see

Swine influenza Swine influenza is an infection caused by any of several types of swine influenza viruses. Swine influenza virus (SIV) or swine-origin influenza virus (S-OIV) refers to any strain of the influenza family of viruses that is endemic in pigs. As ...

). Spain was the first country in continental Europe to report cases of swine flu, in late April 2009.

First cases in Europe

On 27 April, Spain confirmed the first case of Swine influenza in Europe. The patient was a 23-year-old man that had returned from Mexico on the 22nd and was in hospital with flu-like symptoms. The case was confirmed in

Almansa Almansa () is a Spanish town and municipality in the province of Albacete, part of the autonomous community of Castile-La Mancha. The name "Almansa" stems from the Arabic (al-manṣaf), "half way of the road". The municipality borders with Al ...

, in the

province of Albacete Albacete ( es, Provincia de Albacete, ) is a province of central Spain, in the southern part of the autonomous community of Castile–La Mancha. As of 2012, Albacete had a population of 402,837 people. Its capital city, also called Albacete, is ...

. On 28 April, a second case was confirmed in

Valencia Valencia ( va, València) is the capital of the autonomous community of Valencia and the third-most populated municipality in Spain, with 791,413 inhabitants. It is also the capital of the province of the same name. The wider urban area al ...

. The patient had traveled to Mexico with the first confirmed patient. Other cases in Valencia and the Basque Country were reported soon afterwards. By 30 April, there were 13 confirmed and 80 unconfirmed cases throughout Spain. By 5 May, there were 73 confirmed cases, of which only nine had not travelled to Mexico in the previous four months. By 29 April 2010, Spain had confirmed 1,536 cases and 300 deaths, as well as reporting 155,051 unconfirmed cases.

Response

The Health and Social Policy minister,

Trinidad Jiménez Trinidad Jiménez García-Herrera (: born 4 June 1962) is a Spanish Socialist Workers' Party (PSOE) politician and was Spain's Foreign Affairs Minister. She is widely considered to be a confidante of former Spanish prime ministers Felipe Gonzál ...

, announced that all passengers coming from

, United States, Canada,

New Zealand New Zealand ( mi, Aotearoa ) is an island country in the southwestern Pacific Ocean. It consists of two main landmasses—the North Island () and the South Island ()—and over 700 smaller islands. It is the sixth-largest island count ...

, Colombia, France and

Israel Israel (; he, יִשְׂרָאֵל, ; ar, إِسْرَائِيل, ), officially the State of Israel ( he, מְדִינַת יִשְׂרָאֵל, label=none, translit=Medīnat Yīsrāʾēl; ), is a country in Western Asia. It is situated ...

have to fill a form during their flight. There was a reinforcement of medical teams in all airports to handle possible swine flu cases. The Ministry of Foreign Affairs recommended cancelling any travel to

unless strictly necessary. It also recommended reevaluating the need to travel to the United States.

Affected areas

Confirmed cases

* There are 969 confirmed cases, with the latest all taken by awaiting samples. The Spanish government has affirmed the situation is under constant monitoring and control, recommending the population not to panic. *

Madrid Madrid ( , ) is the capital and most populous city of Spain. The city has almost 3.4 million inhabitants and a Madrid metropolitan area, metropolitan area population of approximately 6.7 million. It is the Largest cities of the Europ ...

has the greatest number of confirmed cases. * The North African Spanish cities of

Ceuta Ceuta (, , ; ar, سَبْتَة, Sabtah) is a Spanish autonomous city on the north coast of Africa. Bordered by Morocco, it lies along the boundary between the Mediterranean Sea and the Atlantic Ocean. It is one of several Spanish territorie ...

and Melilla and also

La Rioja La Rioja () is an autonomous community and province in Spain, in the north of the Iberian Peninsula. Its capital is Logroño. Other cities and towns in the province include Calahorra, Arnedo, Alfaro, Haro, Santo Domingo de la Calzada, an ...

have not reported any confirmed cases of

Deaths

A 19-year-old woman in Spain became the first patient in continental Europe who died because of swine flu. A second death was confirmed on 9 July in the Canary Islands, it was a 41-year-old man with a chronic disease. The second affected land in Europe has reported seven death cases up to 29 July.

Madrid outbreak

In early June, Madrid had an outbreak of swine flu among school children. By 9 June over 100 school children in Madrid had been confirmed to have swine flu.

Confirmed cases by autonomous community

Andalusia

On 21 August 2009 the first death occurred in Andalusia when a 39-year-old woman, 39 weeks pregnant, died six days after being admitted to the Hospital Valme in Sevilla. On the same day, a 50-year-old woman died in the Hospital de La Línea (Cádiz) after being admitted on 3 August

On 23 August, a morbidly obese 20-year-old woman died after being admitted to the Hospotal San Cecilio de Granada on 19 August. This was the third fatality due to H1N1 that weeken

Community of Madrid

On 22 May 2009, the Ministry of Defence quarantined the Military Engineering Academy in

Hoyo de Manzanares Hoyo de Manzanares is a municipality of the Community of Madrid, Spain, and is located on the northwestern side of the community of Madrid and to the south of the Sierra de Guadarrama. It has a stable population of roughly 7,457 residents (INE 2 ...

, where there were six confirmed and a further five suspected cases. On 1 June 2009, the Community of Madrid Health Office (represented by Juan José Güemes) confirmed two cases at the Isaac Albéniz secondary school and announced that this number could increase considerably in the future. The school head reported 25 cases, but these have not been confirmed. On 9 June 2009, the Community of Madrid Health Office confirmed 121 cases in 17 schools. On 11 June 2009, there were 139 cases confirmed in 22 schools. On 29 June 2009 a 20-year-old woman died after giving birth, becoming the first to die of H1N1 infection in Spain. On 16 July, the fourth death in Spain and second in the Community of Madrid occurred. A 71-year-old man with

chronic obstructive pulmonary disease Chronic obstructive pulmonary disease (COPD) is a type of progressive lung disease characterized by long-term respiratory symptoms and airflow limitation. The main symptoms include shortness of breath and a cough, which may or may not produce ...

died in the Hospital Universitario La Paz, Madrid. On 24 August 2009, a man died in a Madrid hospital (although his identity was not revealed on his family's request). This was the sixteenth death due to the H1N1 virus in Spain

Canary Islands

On 9 July 2009 the second death occurred in the Canary Islands. A 41-year-old man died in the ICU of the Hospital Universitario de Gran Canaria Doctor Negrín in

Las Palmas Las Palmas (, ; ), officially Las Palmas de Gran Canaria, is a Spanish city and capital of Gran Canaria, in the Canary Islands, on the Atlantic Ocean. It is the capital (jointly with Santa Cruz de Tenerife), the most populous city in the auto ...

. His rapid deterioration was due to a previous condition. On 12 August, the tenth death due to H1N1 occurred in Spain with the death of a 30-year-old man, admitted to the Hospital Insular de Gran Canaria on 20 July, who also showed additional risk factors. On 17 August, an 11-year-old boy died of a chronic illness which was aggravated by the H1N1 infection.

Balearic Islands

On 16 July 2009, the third death occurred in the Hospital Son Llàtzer,

Palma, Majorca Palma (; ; also known as ''Palma de Mallorca'', officially between 1983–88, 2006–08, and 2012–16) is the capital and largest city of the autonomous community of the Balearic Islands in Spain. It is situated on the south coast of Mallorca ...

. The deceased was a 33-year-old Nigerian woman with no previous health issues.

Valencian community

On 20 July 2009 in

Teulada, Spain Teulada (, ) is a small coastal town on Spain's Costa Blanca, located 3 km north from Junction 63 of the A7 E-15 toll motorway on the N-332 coast road. Setting it apart from its coastal neighbours of Calpe and further south, Benidorm, the to ...

a man who had been on dialysis since 1993 died. This was the fifth death at the national level. On 27 July 2009 the sixth person died: a 53-year-old man, in the Hospital La Ribera in

Alzira, Valencia Alzira ( es, Alcira) is a city and municipality of 45.088 inhabitants (62,094 floating population) in Valencia, eastern Spain. It is the capital of the ''comarca'' of Ribera Alta in the province of Valencia. The city is the heart of the second l ...

. He had a serious prior pathology. On 10 August the ninth person died: a 28-year-old woman admitted to the Hospital 9 de Octubre in

. On 14 August the eleventh person died, a 31-year-old pregnant woman in an irreversible coma in the Hospital General,

Castellón de la Plana Castellón de la Plana (officially in ca-valencia, Castelló de la Plana), or simply Castellón ( ca-valencia, Castelló, link=no) is the capital city of the province of Castellón, in the Valencian Community, Spain. It is located in the east ...

Castilla-La Mancha

On 29 July 2009, a 34-year-old man died (the seventh in Spain) in

Villarrobledo Villarrobledo () is a Spanish city and municipality in the province of Albacete, part of the autonomous community of Castile-La Mancha. It's better known for having the world's largest area covered by vineyards (more than 30,000 has., approxima ...

Albacete Albacete (, also , ; ar, ﭐَلبَسِيط, Al-Basīṭ) is a city and municipality in the Spanish autonomous community of Castilla–La Mancha, and capital of the province of Albacete. Lying in the south-east of the Iberian Peninsula, the ...

. He had been admitted on 12 July with a serious illness.

Catalonia

On 4 August 2009 the first death in Catalonia and eighth in the country occurred. The patient, a 35-year-old woman, died in

Girona Girona (officially and in Catalan , Spanish: ''Gerona'' ) is a city in northern Catalonia, Spain, at the confluence of the Ter, Onyar, Galligants, and Güell rivers. The city had an official population of 103,369 in 2020. Girona is the capital ...

after being admitted to hospital two days before.

Galicia

The first case of H1N1 in Galicia was recorded on 29 April 2009 in the province of Ourense, although it was not confirmed until several days later. The deceased was a woman who had recently travelled to Mexico. Patients with similar symptoms to those of H1N1 had been recorded previously and were considered as possible cases at the time. The first was detected in MosDetectado en el centro de salud de Mos el primer posible caso de gripe porcina en Galicia
''

La Voz de Galicia ''La Voz de Galicia'' ( en, The Voice of Galicia) is a Spanish daily newspaper owned by the Corporación Voz de Galicia. ''La Voz'' is highest circulation newspaper in Galicia and the eighth-highest circulation general-interest daily newspaper ...

'', 27 April 2008 on 27 April 2009 in a middle-aged male patientLa Consejería de Sanidad estudia un posible caso sospechoso de gripe humana de origen porcina
, web de Sergas, 27 April 2009 who had arrived from Mexico several days beforehand. The first flu case in Spain was confirmed on the same day in Almansa, but was unrelated. On 1 May 2009 another new suspected case appeared in

A Coruña A Coruña (; es, La Coruña ; historical English: Corunna or The Groyne) is a city and municipality of Galicia, Spain. A Coruña is the most populated city in Galicia and the second most populated municipality in the autonomous community and s ...

,La Consejería de Sanidad estudia un tercer caso sospechoso de nueva gripe en Galicia
web do Sergas, 1 May 2009 also in a Mexican person. Several days later these cases were confirmed to be unrelated to H1N1.Comunicado da consellería polo brote de gripe polo novo virus AH1N1
web do Sergas, 2 May 2009 On 27 August 2009 a 33-year-old male died in

Vigo Vigo ( , , , ) is a city and municipality in the province of Pontevedra, within the autonomous community of Galicia, Spain. Located in the northwest of the Iberian Peninsula, it sits on the southern shore of an inlet of the Atlantic Ocean, the ...

due to complications from flu, although he had other serious conditions.
Muerte de un hombre en Galicia por influenza A H1N1

References

External links

Swine Influenza official data (in spanish)
– Ministerio de Sanidad y Políticas Sociales. Gobierno de España

– Updates periodically and links to archived WHO releases
Centers for Disease Control and Prevention (CDC): Swine Influenza (Flu)

Spanish Health Services

* ttp://www.osasun.ejgv.euskadi.net Department of Health of the Basque Government
Official website of the Basque Health Service/Osakidetza

{{DEFAULTSORT:2009 Flu Pandemic In Spain Flu Pandemic in Spain, 2009 Health disasters in Spain

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