Critique of 2009 H1N1 Influenza Outbreak

This article critically evaluates the 2009 H1N1 influenza outbreak and the international response to it. It discusses the impact, death toll, global efforts, and prevention methods. The importance of disease surveillance and the One Health movement is also highlighted. Relevant research and statistics are included.

Running head: CRITIQUE OF 2009 H1N1 INFLUENZA OUTBREAK
Critique of 2009 H1N1 Influenza Outbreak
Name of the Student
Name of the University
Author’s Note:

1CRITIQUE OF 2009 H1N1 INFLUENZA OUTBREAK
Introduction:
In the last decade, new threats have been emerged for global health in the form
infectious diseases. These diseases are new strains of virus or bacteria which were previously
non-existent (Leung &Nicoll, 2010). One of those incidents is the H1N1 influenza outbreak
in the year 2009. The viral strain was first detected in the United States of America and it was
quickly spread across the global due to modern commute and transport system. In regard to
the previous statement, it can be stated that any infectious disease can spread across the world
very quickly if proper prevention method has not been employed. Hence, there is an urgent
need of developing disease surveillance system to control and assess the risk of disease
management. At present, most of the available disease surveillance system comes in to effect
after the outbreak of the disease (Morens&Fauci, 2013). Thus, there is a need to develop a
disease surveillance system which will be warn about an outbreak before its occurrence by
studying relationship between the disease outbreak and risk factors.
In this regard, the aim of this article is to critically evaluate a global disease outbreak
in respect to the international response against it. The outbreak that was chosen with that
regard is the H1N1 influenza outbreak in the year 2009. Therefore, in the following sections,
the effect of this outbreak and worldwide response to this outbreak will be critically
evaluated.
Discussion:
This H1N1 influenza outbreak started on the April of 2009 and lasted about a year. It
was classified as a pandemic due to its massive spread and death toll. The viral strain that was
responsible for this outbreak is classified as influenza A (H1N1) pdm09 virus (Peiris, Poon &
Guan, 2009). Centre for Disease Control has estimated that around 12,469 people were died
in one year just in the United States of America. The worldwide death toll was massive and

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the death toll lies between the ranges of 151700 to 575400 as per CDC estimation(Cdc.gov,
2019). It has been reported that the around 0.001 per cent to 0.007 per cent of world’s
population were died by this virus in the first year of the outbreak (Cdc.gov, 2019). World
Health Organisation (WHO) declared on August 10, 2010 that the pandemic has been ended.
Although, this particular strain is circulates and emerge as a seasonal influenza
virus(Who.int, 2019). Due to the huge death toll caused by H1N1 virus worldwide in 2009,
this outbreak has been chosen for the critical evaluation.
In order to properly evaluate the 2009 H1N1 outbreak, contemporary research
publication has been consulted. In order to find the most relevant publication regarding this
matter, a search strategy also employed. Google scholar was used for the searching of this
published journal (Google Scholar, 2019). To make the journal contemporary and relevant
selection criteria was applied. Journal from peer reviewed article and published within the
last 10 year were selected for the consultation purpose. Statistical data were collected from
the CDC official website.
The purpose of this paper is to critique the international response of the 2009 H1N1
influenza outbreak. To critique the outbreak a roadmap a plan is followed in this regard. The
plan or framework that was followed here was according to the framework adopted by Scott,
Crawford-Browne and Sanders (2016). In their paper, similar like this, they have also
evaluated and critiqued the response of Ebola outbreak. Hence, this plan or framework was
chosen for the evaluation of H1N1 influenza outbreak.
The global response for this influenza pandemic went generally well after the first
outbreak. The infection made by this viral strain was confirmed by almost every country in
the world and it was spread among almost every territory of the world. After the first
isolation of this viral strain, the knowledge was shared immediately around the world.

3CRITIQUE OF 2009 H1N1 INFLUENZA OUTBREAK
Detection assays were developed which was also spread among the countries globally.
Additionally, antiviral medicines were developed soon after the isolation of the strain and the
antiviral were available in almost every affected country. As a result, the death was for this
influenza outbreak was relatively small in comparison with the previous two influenza
outbreak reported in the 1968 and 1918. Amongst them, maximum death toll was recorded in
1918 pandemic (Guan et al., 2010). Another factor which influenced the management and
control the 2009 H1N1 outbreak is that it is the first major outbreak to occur after the various
global initiative were taken to counter pandemic. It was also the first pandemic outbreak
which occurs within the set regulations of the International Health Regulations and global
governance. As a global response to this outbreak, different intervention method was
employed to contain the outbreak. The intervention method can be classified as non-
pharmaceutical and pharmaceutical. Under the non- pharmaceutical intervention, border
measures like quarantine, screening, and isolation was implemented. The intention behind
this intervention was to delay and reduce the spread of the outbreak. However, various
countries did not implement these procedures due to the logistics issue or cost – benefit
consideration. Although, Hong Kong, China, Japan did implemented these procedures
(Girard et al., 2010). Another non- pharmaceutical that was implemented was targeted at the
general population and the objective of this employ personal protective measure like hand
hygiene, mask and cough etiquette. Under the pharmaceutical intervention approach,
vaccines and antiviral treatment were employed.
In the course of human history, bacteria and viruses have been evolved and new strain
of bacteria or virus has been emerged in regular interval. New emergence of bacteria
generally brings devastating harmful effect to a new population in comparison with the
diseases that have been present for years. In addition to the natural aspect, human plays a
vital role in the emergence of the new infectious diseases with respect to travel patterns,

4CRITIQUE OF 2009 H1N1 INFLUENZA OUTBREAK
population range and population density (Kozlowski, 2012). Along with that, movement of
animals also influence the emergence of new strain in the environment. Similar like human,
change population, range and density in the animal population also influences the emergence
of the new pathogens. In Australia, some pathogens have emerged due to this reason and
Hendra virus,Bat Lyssavirus, and Tularemia are example of these type of emergence over the
last 30 or 40 years (Jackson et al., 2012). This is also true in global sense in last 30 to 40 year
and HIV or Human Immunodeficiency Virus is one example of this. HIV is particularly
responsible for the re- emergence of Ebola virus and tuberculosis.
From the above discussion it can be seen that the particular care and prevention
method need to be taken for the management and control of this kind of outbreak. In this
scenario, One Health movement plays a significant movement. One Health movement is
based on the belief that health of animal, human and ecosystem are all intertwined and
interconnected. The One Health approach is based on the implementation of
collaborative,coordinated, cross-sectoral and multidisciplinary approach for the management
of the potential risk which might engender at the human- animal – ecosystem interface(One
Health | CDC, 2019). This approach of the One Health movement have gained a significant
movement and it has been supported and endorsed by various organisation including US
Centres for Disease Control and Prevention (CDC),European Commission, the US
Department of State, World Bank, US Department of Agriculture, Food and Agriculture
Organization of the United Nations (FAO),World Health Organization (WHO), United
Nations System Influenza Coordination (UNSIC),World Organization for Animal Health
(OIE), NGOs from all over the world along with many Universities. In the year 2011, an
expert meeting has been taken place in the Atlanta, Georgia, USA on One health global
network and governance and a road map for way forward has been laid in that meeting(One
Health | CDC, 2019).

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It can be said from the above discussion that understanding of natural environment,
history, and ecology is essential for the management and prevention of outbreak of infectious
disease. To cite one example, Hendra virus outbreak in Queensland, Australia was due to the
close proximity of the horses and flying foxes. Epidemiological investigation has found out
that the subsequent contact of bat saliva or urine was responsible for the inception of the
disease (Smith et al., 2014). Then it was spread to the human from horses. Therefore, it can
be stated that these factors have to be considered while managing and controlling infectious
outbreak. The International Health Regulation plays a major role in the prevention and
management of pandemic outbreak. The International Health Regulation is in effect since
2007 and it is fact between 196 WHO countries who all have decided to work together for the
prevention of major outbreak (Mackenzie et al., 2014). However, data in epidemiological
sector is very volatile and therefore, WHO have developed an ‘event management system’ for
the management of outbreak with respect to public health. Independent researchers are
working and investigating in this area and some of the researchers have provided outbreak
risk management system like BBN or Bayesian belief network (Liao et al., 2017).
Conclusion:
Therefore, from the above discussion, it can be said that the H1N1 influenza outbreak in the
year 2009 was one of the major pandemic in the recent years. It was not as devastating as
previous two influenza outbreak in 1968 and 1918. This outbreak was fairly well contained
and WHO declared that the end of the outbreak within a year and half. All the countries work
together to prevent this outbreak in terms of collaboration and sharing information.
Preventive measured is required for early warning system and WHO has developed an ‘event
management system’ for this purpose. Additionally, academic researchers are also working
together is this regard.

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