The last major global outbreak of disease before the COVID-19 pandemic declared in 2020 was the influenza pandemic (H1N1) of 2009. The H1N1 outbreak was the first pandemic of the 21st century. The disease was initially detected in February 2009 in Mexico and subsequently spread to other parts of that country. By April it had reached the United States. As infected persons traveled from Mexico and the United States to other parts of the world, the outbreak expanded. In June 2009 the World Health Organization (WHO) declared the outbreak a pandemic.
The total number of deaths from the H1N1 pandemic was between about 150,000 and 575,000, according to the U.S. Centers for Disease Control. While this was substantially lower than the total number of deaths from previous influenza pandemics—such as the 1968 outbreak of Hong Kong flu, which caused more than 750,000 deaths, and the influenza pandemic of 1918–19, which claimed the lives of an estimated 25 million to 50 million people—the rate at which H1N1 spread globally was unprecedented. Its rapid global dissemination was attributed to the high rates of passenger travel that characterize the modern era.