reimagining relationships
Home   Store   Free GIS   Education   Free Shapefiles   Census   Weather   Energy   Climate Change   News   Maps   TOPO   Aerial   GPS   Learn GIS

DOWNLOAD SHAPEFILES: Canada FSA Postal - Zip Code - U.S. Waterbodies & Wetlands - Geographic Names - School Districts - Indian Federal Lands
Zip Code/Demographics - Climate Change - U.S. Streams, Rivers & Waterways - Tornadoes - Nuclear Facilities - Dams & Risk - 2013 Toxic Release Inventory TRI

ANWR Arctic National Wildlife Refuge; What is at stake; removed USFWS website; photos, maps, descriptions

tools for survival plans Maps Food Water Health Gardening Energy Housing Security Communications Livelihood

Money Making Tips Work from Home Make Money Used Lumber & Building Materal Beginner's Guide Buy/Sell Gold Electronics & Computer

GIS Shapefile Store - for Beginners & Experienced GIS Users Alike. Geographic Names Information System, Nuclear Facilities, Zip Code Boundaries, School Districts, Indian & Federal Lands, Climate Change, Tornadoes, Dams - Create digital GIS maps in minutes.

Toxic Release Inventory TRI Shapefiles

Canada FSA Postal Code Shapefile

GNIS Shapefiles 2,000,000+ Points

Nuclear Energy Facilities in the U.S.

Download Zip Code with Demographics Shapefiles

Download U.S. Streams & Rivers Shapefiles

Download Water Body & Wetland Shapefiles

Download Zip Code Boundary Shapefiles

Download School District Shapefiles

Download Indian & Federal Land Shapefiles

Download Climate Change Shapefiles

Download Tornado Shapefiles

Download Dams & Risks Shapefiles

Follow on Twitter Follow on Twitter

Didn't find what you are looking for? Email me and I'll find it for you.

Progressive Links

Federation of American Scientists

Physicians for Social Responsibility

Public Employees for Environmental Responsibility

Union of Concerned Scientists


Reader Supported News

Common Dreams


Huffington Post

Media Matters

Think Progress

Grist Environmental News

Climate Shift Blog

MapCruzin Consulting
Data Research and GIS Specialists.

GIS Tutorials

GIS Basics

GIS Terminology

Of Interest

Arctic National Wildlife Refuge Maps

Climate Shift - The effects of climate shift on the future of planet earth and its inhabitants.

Right to Know or Left to Wonder?

Hazardscapes - Toxic and Nuclear Risks in your backyard.

War & Environment

Worst Case Scenarios: Terrorism & industrial chemicals.

Swine Influenza A (H1N1) Infection in Two Children --- Southern California, March--April 2009


<-- Return To Pandemic Swine Flu News

Source: Center for Disease Control CDC

Swine Influenza A (H1N1) Infection in Two Children --- Southern California, March--April 2009


On April 17, 2009, CDC determined that two cases of febrile respiratory illness occurring in children who resided in adjacent counties in southern California were caused by infection with a swine influenza A (H1N1) virus. The viruses from the two cases are closely related genetically, resistant to amantadine and rimantadine, and contain a unique combination of gene segments that previously has not been reported among swine or human influenza viruses in the United States or elsewhere. Neither child had contact with pigs; the source of the infection is unknown. Investigations to identify the source of infection and to determine whether additional persons have been ill from infection with similar swine influenza viruses are ongoing. This report briefly describes the two cases and the investigations currently under way. Although this is not a new subtype of influenza A in humans, concern exists that this new strain of swine influenza A (H1N1) is substantially different from human influenza A (H1N1) viruses, that a large proportion of the population might be susceptible to infection, and that the seasonal influenza vaccine H1N1 strain might not provide protection. The lack of known exposure to pigs in the two cases increases the possibility that human-to-human transmission of this new influenza virus has occurred. Clinicians should consider animal as well as seasonal influenza virus infections in their differential diagnosis of patients who have febrile respiratory illness and who 1) live in San Diego and Imperial counties or 2) traveled to these counties or were in contact with ill persons from these counties in the 7 days preceding their illness onset, or 3) had recent exposure to pigs. Clinicians who suspect swine influenza virus infections in a patient should obtain a respiratory specimen and contact their state or local health department to facilitate testing at a state public health laboratory.


Case Reports

Patient A. On April 13, 2009, CDC was notified of a case of respiratory illness in a boy aged 10 years who lives in San Diego County, California. The patient had onset of fever, cough, and vomiting on March 30, 2009. He was taken to an outpatient clinic, and a nasopharyngeal swab was collected for testing as part of a clinical study. The boy received symptomatic treatment, and all his symptoms resolved uneventfully within approximately 1 week. The child had not received influenza vaccine during this influenza season. Initial testing at the clinic using an investigational diagnostic device identified an influenza A virus, but the test was negative for human influenza subtypes H1N1, H3N2, and H5N1. The San Diego County Health Department was notified, and per protocol, the specimen was sent for further confirmatory testing to reference laboratories, where the sample was verified to be an unsubtypable influenza A strain. On April 14, 2009, CDC received clinical specimens and determined that the virus was swine influenza A (H1N1). The boy and his family reported that the child had had no exposure to pigs. Investigation of potential animal exposures among the boy's contacts is continuing. The patient's mother had respiratory symptoms without fever in the first few days of April 2009, and a brother aged 8 years had a respiratory illness 2 weeks before illness onset in the patient and had a second illness with cough, fever, and rhinorrhea on April 11, 2009. However, no respiratory specimens were collected from either the mother or brother during their acute illnesses. Public health officials are conducting case and contact investigations to determine whether illness has occurred among other relatives and contacts in California, and during the family's travel to Texas on April 3, 2009.

Patient B. CDC received an influenza specimen on April 17, 2009, that had been forwarded as an unsubtypable influenza A virus from the Naval Health Research Center in San Diego, California. CDC identified this specimen as a swine influenza A (H1N1) virus on April 17, 2009, and notified the California Department of Public Health. The source of the specimen, patient B, is a girl aged 9 years who resides in Imperial County, California, adjacent to San Diego County. On March 28, 2009, she had onset of cough and fever (104.3F [40.2C]). She was taken to an outpatient facility that was participating in an influenza surveillance project, treated with amoxicillin/clavulanate potassium and an antihistamine, and has since recovered uneventfully. The child had not received influenza vaccine during this influenza season. The patient and her parents reported no exposure to pigs, although the girl did attend an agricultural fair where pigs were exhibited approximately 4 weeks before illness onset. She reported that she did not see pigs at the fair and went only to the amusement section of the fair. The Imperial County Public Health Department and the California Department of Public Health are now conducting an investigation to determine possible sources of infection and to identify any additional human cases. The patient's brother aged 13 years had influenza-like symptoms on April 1, 2009, and a male cousin aged 13 years living in the home had influenza-like symptoms on March 25, 2009, 3 days before onset of the patient's symptoms. The brother and cousin were not tested for influenza at the time of their illnesses.

Epidemiologic and Laboratory Investigations

As of April 21, 2009, no epidemiologic link between patients A and B had been identified, and no additional cases of infection with the identified strain of swine influenza A (H1N1) had been identified. Surveillance data from Imperial and San Diego counties, and from California overall, showed declining influenza activity at the time of the two patients' illnesses. Case and contact investigations by the county and state departments of health in California and Texas are ongoing. Enhanced surveillance for possible additional cases is being implemented in the area.

Preliminary genetic characterization of the influenza viruses has identified them as swine influenza A (H1N1) viruses. The viruses are similar to each other, and the majority of their genes, including the hemagglutinin (HA) gene, are similar to those of swine influenza viruses that have circulated among U.S. pigs since approximately 1999; however, two genes coding for the neuraminidase (NA) and matrix (M) proteins are similar to corresponding genes of swine influenza viruses of the Eurasian lineage (1). This particular genetic combination of swine influenza virus segments has not been recognized previously among swine or human isolates in the United States, or elsewhere based on analyses of influenza genomic sequences available on GenBank.* Viruses with this combination of genes are not known to be circulating among swine in the United States; however, no formal national surveillance system exists to determine what viruses are prevalent in the U.S. swine population. Recent collaboration between the U.S. Department of Agriculture and CDC has led to development of a pilot swine influenza virus surveillance program to better understand the epidemiology and ecology of swine influenza virus infections in swine and humans.

The viruses in these two patients demonstrate antiviral resistance to amantadine and rimantadine, and testing to determine susceptibility to the neuraminidase inhibitor drugs oseltamivir and zanamivir is under way. Because these viruses carry a unique combination of genes, no information currently is available regarding the efficiency of transmission in swine or in humans. Investigations to understand transmission of this virus are ongoing.

Reported by: M Ginsberg, MD, J Hopkins, MPH, A Maroufi, MPH, G Dunne, DVM, DR Sunega, J Giessick, P McVay, MD, San Diego County Health and Human Svcs; K Lopez, MD, P Kriner, MPH, K Lopez, S Munday, MD, Imperial County Public Health Dept; K Harriman, PhD, B Sun, DVM, G Chavez, MD, D Hatch, MD, R Schechter, MD, D Vugia, MD, J Louie, MD, California Dept of Public Health. W Chung, MD, Dallas County Health and Human Svcs; N Pascoe, S Penfield, MD, J Zoretic, MD, V Fonseca, MD, Texas Dept of State Health Svcs. P Blair, PhD, D Faix, PhD, Naval Health Research Center; J Tueller, MD, Navy Medical Center, San Diego, California. T Gomez, DVM, Animal and Plant Health Inspection Svc, US Dept of Agriculture. F Averhoff, MD, F Alavrado-Ramy, MD, S Waterman, MD, J Neatherlin, MPH, Div of Global Migration and Quarantine; L Finelli, DrPH, S Jain, MD, L Brammer, MPH, J Bresee, MD, C Bridges, MD, S Doshi, MD, R Donis, PhD, R Garten, PhD, J Katz, PhD, S Klimov, PhD, D Jernigan, MD, S Lindstrom, PhD, B Shu, MD, T Uyeki, MD, X Xu, MD, N Cox, PhD, Influenza Div, National Center for Infectious and Respiratory Diseases, CDC. Editorial Note:

In the past, CDC has received reports of approximately one human swine influenza virus infection every 1--2 years in the United States (2,3). However, during December 2005--January 2009, 12 cases of human infection with swine influenza were reported; five of these 12 cases occurred in patients who had direct exposure to pigs, six in patients reported being near pigs, and the exposure in one case was unknown (1,4,5). In the United States, novel influenza A virus infections in humans, including swine influenza infections, have been nationally notifiable conditions since 2007. The recent increased reporting might be, in part, a result of increased influenza testing capabilities in public health laboratories, but genetic changes in swine influenza viruses and other factors also might be a factor (1,4,5). Although the vast majority of human infections with animal influenza viruses do not result in human-to-human transmission (2,3), each case should be fully investigated to be certain that such viruses are not spreading among humans and to limit further exposure of humans to infected animals, if infected animals are identified. Such investigations should include close collaboration between state and local public health officials with animal health officials.

The lack of known exposure to pigs in the two cases described in this report increases the possibility that human-to-human transmission of this new influenza virus has occurred. Clinicians should consider animal as well as seasonal influenza virus infections in the differential diagnosis of patients with febrile respiratory illness who live in San Diego and Imperial counties or have traveled to these areas or been in contact with ill persons from these areas in the 7 days before their illness onset. In addition, clinicians should consider animal influenza infections among persons with febrile respiratory illness who have been near pigs, such as attending fairs or other places where pigs might be displayed. Clinicians who suspect swine influenza virus infections in humans should obtain a nasopharyngeal swab from the patient, place the swab in a viral transport medium, and contact their state or local health department to facilitate transport and timely diagnosis at a state public health laboratory. CDC requests that state public health laboratories send all influenza A specimens that cannot be subtyped to the CDC, Influenza Division, Virus Surveillance and Diagnostics Branch Laboratory.

Interim guidance on infection control, treatment, and chemoprophylaxis for swine influenza is available at Additional information about swine influenza is available at References

1. Vincent AL, Ma W, Lager KM, Janke BH, Richt JA. Swine influenza viruses: a North American perspective. Adv Virus Res 2008;72:127--54.
2. Myers KP, Olsen CW, Gray GC. Cases of swine influenza in humans: a review of the literature. Clin Infect Dis 2007;44:1084--8.
3. Wells DL, Hopfensperger DJ, Arden NH, et al. Swine influenza virus infections. Transmission from ill pigs to humans at a Wisconsin agricultural fair and subsequent probable person-to-person transmission. JAMA 1991;265:478--81.
4. Vincent AL, Swenson SL, Lager KM, Gauger PC, Loiacono C, Zhang Y. Characterization of an influenza A virus isolated from pigs during an outbreak of respiratory disease in swine and people during a county fair in the United States. Vet Microbiol 2009;online publication ahead of print.
5. Newman AP, Reisdorf E, Beinemann J, et al. Human case of swine influenza A (H1N1) triple reassortant virus infection, Wisconsin. Emerg Infect Dis 2008;14:1470--2.

* Available at

Use of trade names and commercial sources is for identification only and does not imply endorsement by the U.S. Department of Health and Human Services.References to non-CDC sites on the Internet are provided as a service to MMWR readers and do not constitute or imply endorsement of these organizations or their programs by CDC or the U.S. Department of Health and Human Services. CDC is not responsible for the content of pages found at these sites. URL addresses listed in MMWR were current as of the date of publication.

All MMWR HTML versions of articles are electronic conversions from typeset documents. This conversion might result in character translation or format errors in the HTML version. Users are referred to the electronic PDF version ( and/or the original MMWR paper copy for printable versions of official text, figures, and tables. An original paper copy of this issue can be obtained from the Superintendent of Documents, U.S. Government Printing Office (GPO), Washington, DC 20402-9371; telephone: (202) 512-1800. Contact GPO for current prices.

**Questions or messages regarding errors in formatting should be addressed to [email protected]

Date last reviewed: 4/21/2009

Didn't find what you are looking for? We've been online since 1996 and have created 1000's of pages. Search below and you may find just what you are looking for.

Michael R. Meuser
Data Research & GIS Specialist is an independent firm specializing in GIS project development and data research. We created the first U.S. based interactive toxic chemical facility maps on the internet in 1996 and we have been online ever since. Learn more about us and our services.

Have a project in mind? If you have data, GIS project or custom shapefile needs contact Mike.

Contact Us

Report Broken Links

Subscribe for Updates

<-- Return To Swine Flu News

Advertise on MapCruzin

Follow on Facebook
News & Updates

Find: Maps, Shapefiles, GIS Software & More

MapCruzin Blog for updates, questions and answers
Blog Updates

More Blog Updates


Google Earth Toxic Release Inventory (TRI) Maps
Lester Brown's Plan B 3.0
State GIS Shapefiles, Maps & Resources
GIS Shapefiles & Maps
GIS Programs, Tools & Resources
Free World Country & Regional Maps
GIS / GPS Careers and Job Positions
Disease Outbreak Maps
Extreme Weather & Disaster Maps
Free World Maps from the CIA Factbook
Arctic National Wildlife Refuge ANWR Maps
Oil and Gas Maps
Africanized Honey Bees
Renewable Energy Potential Maps of the United States
Terrorism Maps
War Maps
Google Maps
Weather Maps
GPS Resources
Historical Maps of the World
Google Earth
Library of Congress American Memory Map Downloads
Toxic Chemical Pollution Maps
Climate Change Maps
Toxic Release Inventory (TRI) Maps
Census Shapefiles
World Maps


Environmental Justice
Data Sources
Greenwash & JunkScience
Statistical Resources
Wireless Dangers
Surviving Climate Change
Global Right-To-Know
Creating Living Economies
Books of Note
Toxic Klamath River
Federal Lands Maps
TRI Analysis
TRI Webmaps
EnviroRisk Map Network
Community-Based Research
Right-To-Know or Left to Wonder?
Chemical Industry Archives
21st Century Warfare
National Parks and Public Lands
Trade Secrets/Toxic Deception
GIS Books
Our Projects
Other Projects
1999 Archive Environews
Environmental Books
Environmental Links
Redwood Coast Information
Recycle, Salvage, Reuse

Shapefile Store
Free GIS Software
Free Map Downloads
Free Shapefiles
Free Remote Sensing
Free Topo Maps
Free GIS Tutorial
Free GPS

About MapCruzin - Cookies, Privacy, Fair Use and Disclaimer - Advertise on

Copyright © 1996 - 2019 Michael Meuser, All Rights Reserved
MapCruzin is a Pop-Up Free Website -- Best Viewed With ANY Browser