The recent H1N1 (swine) flu outbreak demonstrated how rapidly a new strain of flu can emerge and spread around the world. As of June 1, 2009, the H1N1 virus was reported in 62 nations, with nearly 17,500 confirmed cases and more than 100 deaths. The sudden outbreak of this novel flu virus has tested the world's public health preparedness. H1N1 provided a real-world test that showed the strengths and vulnerabilities in the abilities of the United States and the rest of the world to respond to a major infectious disease outbreak. This report examines early lessons learned from the response and ongoing concerns about overall U.S. preparedness for potential pandemic flu outbreak. The first section reviews 10 key lessons based on the initial response to the H1N1 outbreak; and the second section discusses 10 underlying concerns and provides recommendations for addressing serious continued vulnerabilities in the nation's preparedness in the event that H1N1 returns in the fall, either in its current form or as a more virulent strain, or if a different strain of influenza, like the H5N1 (bird) flu, emerges. Overall, the H1N1 outbreak has shown that the investment the country has made in preparing for a potential pandemic flu has significantly improved U.S. capabilities for a large scale infectious disease outbreak, but it has also revealed how quickly the nation's core public health capacity would be overwhelmed if the outbreak were more widespread and more severe.
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