Highly pathogenic H5N1 animal infections were discovered in 1996, and the first human cases were reported a year later, but the disease only emerged as a real threat after a second wave of infections in 2004. See WHO, H5N1 Avian Influenza: A Timeline. 2006 May 8; available at http://www.who.int/csr/disease/avian_influenza/timeline.pdf.

Id.; Chan Margaret Director General, WHO. World Now at the Start of 2009 Influenza Pandemic. 2009 Jun 11; (transcript available at http://www.who.int/mediacentre/news/statements/2009/h1n1_pandemic_phase6_20090611/en/index.html). The WHO pandemic levels do not reflect a measure of disease severity, but rather the degree of transmissibility and extent of global spread. Phase six is the highest level, indicating that there is human-to-human spread of the virus in multiple WHO regions. See WHO. [last visited Nov. 8, 2009];Current WHO Phase of Pandemic Alert. http://www.who.int/csr/disease/avian_influenza/phase/en/index.html.

See, e.g., Homeland Security Council. National Strategy for Pandemic Influenza. 2005 Nov; available at http://flu.gov/professional/federal/pandemic-influenza.pdf. as a comprehensive description of the readiness efforts CDC. Community Strategy for Pandemic Influenza Mitigation. 2007 available at http://www.flu.gov/professional/community/commitigation.html.WHO. Nonpharmaceutical Interventions for Pandemic Influenza, International Measures. Emerg Infec Dis. 2006;12:81.Andrulis Dennis P, et al. Preparing Racially and Ethnically Diverse Communities for Public Health Emergencies. Health Aff. 2007;26:1269.Katz Aaron, et al. Preparing for the Unknown, Responding to the Known: Communities and Public Health Preparedness. Health Aff. 2006;25:946.

See, e.g., Kass Nancy E. An Ethics Framework for Public Health and Avian Influenza Pandemic Preparedness. Yale J Biol and Med. 2005;78:235.Ethics Subcommittee of the Advisory Committee to the Director, Centers for Disease Control and Prevention. Ethical Guidelines in Pandemic Influenza. 2007 Feb 15; available at http://www.cdc.gov/od/science/phethics/panFlu_Ethic_Guidelines.pdf.Berlinger Nancy, Moses Jacob. Bioethics Backgrounder: Ethical Decisionmaking During An Influenza Pandemic. 2007 Nov; available at http://www.thehastingscenter.org/pdf/Pandemic-Backgrounder-The-Hastings-Center.pdf.Uscher-Pines Lori, et al. Hastings Center Report. Jul-Aug. 2007. Planning for an Influenza Pandemic: Social Justice and Disadvantaged Groups; p. 32.Gostin Lawrence O, Berkman Benjamin E. Isolation, Quarantine, Border Control and Social-Distancing Measures. 2008 available at http://www.who.int/csr/resources/publications/cds_flu_ethics_5web.pdf.Upshur Ross. The Role and Obligations of Health-Care Workers During an Outbreak of Pandemic Influenza. 2008 available at http://www.who.int/csr/resources/publications/cds_flu_ethics_5web.pdf.Archer Robert. Pandemic Influenza Planning and Response – Transnational Issues for Governments. 2008 available at http://www.who.int/csr/resources/publications/cds_flu_ethics_5web.pdf.WHO. Ethical Considerations in Developing a Public Health Response to Pandemic Influenza. 2007 available at http://www.who.int/csr/resources/publications/WHO_CDS_EPR_GIP_2007_2c.pdf.Committee on Modeling Community Containment for Pandemic Influenza. Modeling Community Containment for Pandemic Influenza: A Letter Report. National Academy of Science; 2006. Hoffman Sharona. Preparing for Disaster: Protecting the Most Vulnerable in Emergencies. UC Davis L Rev. 2009;42:1491.University of Toronto Joint Centre for Bioethics. Ethics and Pandemic Influenza White Paper Series. CanPrep White Paper Series. 2009 available at http://www.canprep.ca/CanPREP_WP_Series.pdf. [hereinafter White Paper Series].