FIGURE A10-4 Epidemic curve of laboratory-confirmed pandemic 2009-H1N1 influenza A cases and deaths by week, South Africa, as of December 15, 2009 (n[cases] = 12,683).

South America, and Europe, with documented cases of local transmission resulting to a close household contact. A week later, on June 27th, an outbreak of H1N1 occurred at a sports event in Johannesburg, where 20 young athletes with ILI were confirmed at NICD as pandemic H1N1. The index case of this cluster was probably an 18-year-old male attending from Zimbabwe, believed to have been infected while in transit (possibly through contact with other travellers). Over the next 2 weeks the number of confirmed cases rose steeply and, on July 13th, a month after the first case was diagnosed, over 100 cases had been confirmed in South Africa. At that stage the majority of cases were identified in the Gauteng province, the province with the largest population (incorporating both Johannesburg and Pretoria) and with the highest international exposure through OR Tambo International Airport in Johannesburg. In conformance with the WHO recommendations