The United States has declared a "health emergency" regarding an outbreak of swine influenza A (H1N1). As of April 28, 2009, the Centers for Disease Control and Prevention (CDC) confirmed 64 cases of infected individuals in five states (New York, California, Texas, Kansas and Ohio).1 California's governor has activated the California Department of Public Health's Emergency Operations Center. New York's governor has activated its emergency preparedness plan. Cases have been reported in Mexico, Canada, Spain, Scotland and New Zealand. Many in Mexico have died of the flu virus. On Saturday, April 25, 2009, the World Health Organization, upon the advice of the Emergency Committee called under the rules of the International Health Regulations, also declared this event a "public health emergency of international concern." The European Union's health commissioner has urged Europeans to avoid nonessential travel to the United States or Mexico. The CDC, on April 27, also issued a travel warning recommending that people avoid nonessential travel to Mexico.

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