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Chronological Overview of the 2009/2010 H1N1 Influenza Pandemic and the Response of the Centre for Infectious Disease Control RIVM

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Chronological Overview of the 2009/2010 H1N1 Influenza Pandemic and the Response of the Centre for Infectious Disease Control RIVM Chronological overview of the 2009/2010 H1N1 influenza pandemic and the response of the Centre for Infectious Disease Control RIVM RIVM Report 215011006/2011 M.L. Stein | J.A. van Vliet | A. Timen National Insitute for Public Health and the Environment P.O. Box 1 | 3720 BA Bilthoven www.rivm.com Chronological overview of the 2009/2010 H1N1 influenza pandemic and the response of the Centre for Infectious Disease Control RIVM RIVM Report 215011006/2011 RIVM Report 215011006 Colophon © RIVM 2011 Parts of this publication may be reproduced, provided acknowledgement is given to the 'National Institute for Public Health and the Environment', along with the title and year of publication. M.L. Stein J.A. van Vliet A. Timen Contact: Mart Stein LCI, Centre for Infectious Disease Control, RIVM [email protected] This research was conducted as commissioned by the Ministry of Health, Welfare and Sport (VWS) within the framework of the project ‘Evaluating the policy approach to the 2009 H1N1 pandemic’. Page 2 of 152 RIVM Report 215011006 Abstract Chronological overview of the 2009 H1N1 pandemic and the response of the Centre for Infectious Disease Control RIVM. The outbreak of the 2009/2010 H1N1 pandemic was a unique test case for infectious disease control in the Netherlands. During the pandemic numerous control measures were implemented at both national and international levels. Events unfolded in rapid succession and were mostly complex in nature, due not only to the actual transmission of the virus in the Netherlands but also to the reactions and responses of international authorities, findings of scientists and the reactions of the public at large. In the Netherlands, the Minister of Health, Welfare and Sport (VWS) bore the responsibility of coordinating the national response to the influenza pandemic. The Centre for Infectious Disease Control (CIb) of the National Institute for Public Health and the Environment (RIVM), under the authority of VWS, worked in close collaboration with a large number of organizations. The actions undertaken by the CIb went well beyond its routine activities. Under tremendous time pressure, crisis response guidelines needed to be developed and existing ones modified to meet the demands of the situation – all with great care and in close consultation with all parties involved. The many response activities had to be continuously adapted to the changing circumstances. It is now time to review and evaluate the response. The aim of this report is to provide a systematically documented chronological overview of the many events that took place and the control measures taken during the 2009 H1N1 pandemic from the viewpoint of the CIb. It has been written for policy-makers and health care professionals who were actively involved in the control and the effects of this pandemic. This report was commissioned by the Ministry of Health, Welfare and Sport and is intended to serve – alongside other sources – as core information for the evaluation of the policy adopted in the Netherlands during the 2009 H1N1 pandemic. Key words: chronological overview, 2009 H1N1 pandemic, novel influenza A (H1N1) 2009, Mexican flu, influenza, flu, pandemic, infectious disease control Page 3 of 152 RIVM Report 215011006 Rapport in het kort Chronologisch overzicht van de Nieuwe Influenza A (H1N1) 2009/2010 pandemie en de reactie van het Centrum Infectieziektebestrijding RIVM De Nieuwe Influenza A (H1N1) 2009/2010 pandemie vormde een unieke testcase voor de infectieziektebestrijding in Nederland. Tijdens de pandemie werden er op nationaal en internationaal niveau veel maatregelen getroffen. Gebeurtenissen volgden elkaar snel op en waren complex van karakter, want behalve de virustransmissie in Nederland waren er ook de reacties van internationale instanties, de bevindingen van wetenschappers en de publieke reactie. In Nederland was de coordinatie van de bestrijding in handen van de minister van Volksgezondheid, Welzijn en Sport (VWS), onder wiens verantwoordelijkheid het Centrum Infectieziektebestrijding (CIb) van het RIVM samen met een groot aantal organisaties nauw samenwerkte. De reactie van het Centrum Infectieziektebestrijding was allerminst routinematig, er moest onder grote tijdsdruk maar wel zorgvuldig en in overleg met betrokkenen crisisrichtlijnen gemaakt en aangepast worden. De vele activiteiten moesten steeds aangepast worden aan de veranderende omstandigheden. De tijd van terugblikken en evalueren is aangebroken. Doel van dit rapport is om de vele gebeurtenissen en maatregelen rond de Nieuwe Influenza A (H1N1)-pandemie vanuit het oogpunt van het Centrum Infectieziektebestrijding op een overzichtelijke wijze chronologisch in kaart te brengen. Het is geschreven voor beleidsmakers en professionals die betrokken waren bij de bestrijding van (de gevolgen van) deze pandemie. Dit rapport werd opgesteld in opdracht van het ministerie van Volksgezondheid, Welzijn en Sport om – naast andere bronnen – als basisinformatie te dienen voor een evaluatie van het beleid rondom de Nieuwe Influenza A (H1N1)- pandemie. Trefwoorden: chronologisch overzicht, Nieuwe Influenza A (H1N1), Mexicaanse griep, varkensgriep, griep, influenza, pandemie, infectieziektebestrijding Page 4 of 152 RIVM Report 215011006 Preface This is the chronological overview of the events and activities that took place during the 2009 H1N1 influenza pandemic that has been drawn up by the Centre for Infectious Disease Control (CIb) of the Dutch National Institute for Public Health and the Environment (RIVM). This chronological overview was written within the framework of the project ‘Evaluating the policy approach to the 2009 H1N1 pandemic’; it was commissioned by the Ministry of Health, Welfare and Sport (VWS). This report is a factual account of the pandemic events and activities in which the CIb was actively involved. Very many people have been involved in the realization of this RIVM report. In particular, we would like to thank the following people for their contributions either as reader, reviser or provider of information. J. van Beek CIb/LIS K van Beers CIb/LCI A. de Boer CIb/BBA M. van Boven CIb/EPI J. Box Box Editing (English translation) N. Burgers VWS R. Coutinho CIb (reader) Ph. van Dalen VWS (reader) S. Dittrich CIb/LIS R. van Gageldonk CIb/EPI G. Haringhuizen CIb/BBA M. Heijnen RIVM CvB (reader) W. van der Hoek CIb/EPI (reader) P. de Hoogh CIb/RCP (reader) L. Isken CIb/EPI (reader) A. Jacobi CIb/EPI H. van den Kerkhof CIb/EPI M. Knijff CIb/EPI M. Koopmans CIb/LIS (reader) M. van der Lubben CIb/BBA (reader) N. van der Maas CIb/EPI A. Meijer CIb/LIS (reader) K. Ottovay CIb/EPI G. Rooij CIb/LCI M. van der Sande CIb/EPI (reader) J. van Steenbergen CIb/EPI N. Troisfontaine VWS L. Vinck CIb/EPI M. de Vries GGD NL J. Wallinga CIb/EPI G. Weijman CIb/RCP (reader) L. Wijgergangs Marlijn Communicatie (reader) J. Woudstra CIb/LCI H. Wychgel RIVM Corporate Communicatie (reader) K. van der Zwan NVI (reader) A great number of different parties were involved in the pandemic, both in the Netherlands and abroad and many preventive and control measures were taken. We would like to thank all those people who were involved before, during and after the 2009/2010 H1N1 pandemic for their efforts. Page 5 of 152 RIVM Report 215011006 Page 6 of 152 RIVM Report 215011006 Contents 1 Introduction 9 2 Actors involved 13 3 Period 1: from March 18, 2009 to June 29, 2009 21 4 Period 2: from April 30, 2009 to June 8, 2009 39 5 Period 3: from June 9, 2009 to June 23, 2009 63 6 Period 4: from June 24, 2009 to August 15, 2009 77 7 Period 5: from August 16, 2009 to November 10, 2009 101 8 Period 6: November 11, 2009 to August 10, 2010 125 9 Research studies and publications from the CIb on the 2009 H1N1 influenza pandemic 141 References 145 Appendix 1 List of Abbreviations 149 Appendix 2 Algorithm for the management of suspect cases of 2009 H1N1 influenza 152 Page 7 of 152 RIVM Report 215011006 Page 8 of 152 RIVM Report 215011006 1 Introduction 1.1 Background The Centre for Infectious Disease Control (CIb) was set up to coordinate – at national level and wherever necessary – the prevention and control of outbreaks of infectious diseases. These outbreaks usually occur at local, regional or supraregional level and hardly ever on a national or international scale. The situation that occurred in 2009 was unusual in this respect: within a few months, the Netherlands was having to deal with the consequences of the worldwide pandemic spread of the H1N1 influenza virus. This virus was totally new and, as such, had never spread in humans before. Because it was presumed that hardly anybody would have effective resistance to this new virus, provisions had to be made for the eventuality of large numbers of people becoming ill with some of these people possibly even dying from the infection. On June 11, 2009, the World Health Organization (WHO) declared that the outbreak had turned into a pandemic. At the onset of the pandemic, the WHO estimated that one in three people worldwide would become ill, with the possibility of some of them becoming seriously ill. Luckily, the flu itself turned out to be relatively mild with symptoms similar to the yearly bouts of seasonal influenza. During the 2009 H1N1 pandemic, many response measures were taken at both national and international levels. Initially, these measures were necessary to get to the bottom of the epidemiology and identify the virus characteristics so that the spread from human to human could be prevented as far as possible. Later on, when it became apparent that containment of the outbreak was no longer feasible, the focus changed to one of mitigating the outbreak – in other words, limiting the consequences of infection. In the Netherlands, the Minister of Health, Welfare and Sport (VWS) bore the responsibility of coordinating the national response to the influenza pandemic.
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