Declarations of a Public Health Emergency

The Secretary of the Department of Health and Human Services (HHS) may, under section 319 of the Public Health Service (PHS) Act determine that: a) a disease or disorder presents a public health emergency; or b) that a public health emergency, including significant outbreaks of infectious disease or bioterrorist attacks, otherwise exists.

Duration and Notification: The declaration lasts for the duration of the emergency or 90 days, but may be extended by the Secretary. Learn More >>

Title	Disaster Type	State Territory	Signed Date
Determination that a Public Health Emergency Exists in the State of Hawaii as a Result of the Severe Storms, Flooding, Landslides, and Mudslides	Severe Storms, Flooding, Landslides, and Mudslides	Hawaii	April 21, 2026
Determination that a Public Health Emergency Exists in the Commonwealth of the Northern Mariana Islands and the Territory of Guam as a Result of the Consequences of Typhoon Sinlaku	Typhoon	Northern Mariana Islands	April 17, 2026
Renewal of Determination that a Public Health Emergency Exists Nationwide as a Result of the Continued Consequences of the Opioid Crisis on December 15, 2025	Opioid Crisis	Nationwide	March 16, 2026
Determination that a Public Health Emergency Exists in the State of Washington as a Result of the Consequences of Severe Storms, Straight-line Winds, and Flooding	Severe Storms, Straight-line Winds, and Flooding	Washington	December 23, 2025
Renewal of Determination that a Public Health Emergency Exists Nationwide as a Result of the Continued Consequences of the Opioid Crisis on December 15, 2025	Opioid Crisis	Nationwide	December 15, 2025
Renewal of Determination that a Public Health Emergency Exists Nationwide as a Result of the Continued Consequences of the Opioid Crisis on September 18, 2025	Opioid Crisis	Nationwide	September 18, 2025
Determination that a Public Health Emergency Exists in the State of Texas As a result of the consequences of severe storms, straight-line winds, and flooding	Severe Storms, Straight-line Winds, and Flooding	Texas	July 8, 2025
Renewal of Determination that a Public Health Emergency Exists Nationwide as a Result of the Continued Consequences of the Opioid Crisis on June 18, 2025	Opioid Crisis	Nationwide	June 18, 2025
Renewal of Determination that a Public Health Emergency Exists in Georgia as a Result of Hurricane Helene	Hurricane Helene	Georgia	June 12, 2025
Renewal of Determination that a Public Health Emergency Exists in Georgia as a Result of Hurricane Helene	Hurricane Helene	Georgia	March 21, 2025
Renewal of Determination that a Public Health Emergency Exists Nationwide as a Result of the Continued Consequences of the Opioid Crisis on March 18, 2025	Opioid Crisis	Nationwide	March 18, 2025
Determination that a Public Health Emergency Exists in the State of California as a Result of the Continued Consequences of Wildfires	Wildfires	California	January 10, 2025
Renewal of Determination that a Public Health Emergency Exists As a Result of the Consequences of Hurricane Helene in the States of Georgia, North Carolina, and Tennessee	Hurricane	Georgia	December 27, 2024
Renewal of Determination that a Public Health Emergency Exists Nationwide as a Result of the Continued Consequences of the Opioid Crisis on December 20, 2024	Opioid Crisis	Nationwide	December 20, 2024
Determination that a Public Health Emergency Exists As a Result of the Consequences of Hurricane Milton in the State of Florida	Hurricane	Florida	October 8, 2024
Determination that a Public Health Emergency Exists As a Result of the Consequences of Hurricane Helene in the States of Tennessee and South Carolina	Hurricane	South Carolina	September 30, 2024
Determination that a Public Health Emergency Exists As a Result of the Consequences of Hurricane Helene in the State of North Carolina	Hurricane	North Carolina	September 28, 2024
Determination that a Public Health Emergency Exists As a Result of the Consequences of Hurricane Helene in the State of Georgia	Hurricane	Georgia	September 27, 2024
Determination that a Public Health Emergency Exists As a Result of the Consequences of Hurricane Helene in the State of Florida	Hurricane	Florida	September 26, 2024
Renewal of Determination that a Public Health Emergency Exists Nationwide as a Result of the Continued Consequences of the Opioid Crisis on September 19, 2024	Opioid Crisis	Nationwide	September 19, 2024
Determination that a Public Health Emergency Exists As a Result of the Consequences of Hurricane Francine in the State of Louisiana	Hurricane	Louisiana	September 12, 2024
Determination that a Public Health Emergency Exists As a Result of the Consequences of Hurricane Debby in the States of Georgia and South Carolina	Hurricane	Georgia	August 7, 2024
Determination that a Public Health Emergency Exists As a Result of the Consequences of Hurricane Debby in the State of Florida	Hurricane	Florida	August 6, 2024
Renewal of Determination that a Public Health Emergency Exists in the State of Hawaii as a Result of the Continued Consequences of Wildfires (August 1, 2024)	Wildfires	Hawaii	August 1, 2024
Determination that a Public Health Emergency Exists As a Result of the Consequences of Hurricane Beryl in the State of Texas	Hurricane	Texas	July 12, 2024
Renewal of Determination that a Public Health Emergency Exists Nationwide as a Result of the Continued Consequences of the Opioid Crisis on June 25, 2024	Opioid Crisis	Nationwide	June 25, 2024
Renewal of Determination that a Public Health Emergency Exists in the State of Hawaii as a Result of the Continued Consequences of Wildfires (May 2, 2024)	Wildfires	Hawaii	May 2, 2024
Renewal of Determination that a Public Health Emergency Exists Nationwide as a Result of the Continued Consequences of the Opioid Crisis on March 25, 2024	Opioid Crisis	Nationwide	March 25, 2024
Renewal of Determination that a Public Health Emergency Exists in the State of Hawaii as a Result of the Continued Consequences of Wildfires (February 2, 2024)	Wildfires	Hawaii	February 2, 2024
Renewal of Determination that a Public Health Emergency Exists Nationwide as a Result of the Continued Consequences of the Opioid Crisis on December 21, 2023	Opioid Crisis	Nationwide	December 21, 2023
Renewal of Determination that a Public Health Emergency Exists on the State of Hawaii as a Result of the Continued Consequences of Wildfires (October 31, 2023)	Wildfires	Hawaii	October 31, 2023
Renewal of Determination that a Public Health Emergency Exists Nationwide as a Result of the Continued Consequences of the Opioid Crisis on September 26, 2023	Opioid Crisis	Nationwide	September 26, 2023
Determination that a Public Health Emergency Exists As a Result of the Consequences of Hurricane Idalia in the State of Georgia	Hurricane	Georgia	September 12, 2023
Determination that a Public Health Emergency Exists As a Result of the Consequences of Hurricane Idalia in the State of Florida	Hurricane	Florida	August 30, 2023
Determination that a Public Health Emergency Exists on the State of Hawaii as a Result of the Continued Consequences of Wildfires	Wildfires	Hawaii	August 11, 2023
Renewal of Determination that a Public Health Emergency Exists Nationwide as a Result of the Continued Consequences of the Opioid Crisis on July 7, 2023	Opioid Crisis	Nationwide	July 7, 2023
Determination that a Public Health Emergency Exists in the U.S. territory of Guam as the Result of Typhoon Mawar	Typhoon	Guam	June 2, 2023
Renewal of Determination that a Public Health Emergency Exists Nationwide as a Result of the Continued Consequences of the Opioid Crisis on March 31, 2023	Opioid Crisis	Nationwide	March 30, 2023
Determination that a Public Health Emergency Exists in the State of Mississippi as the Result of Severe Storms, Straight-Line Winds, and Tornadoes	Severe Storms, Straight-Line Winds, and Tornadoes	Mississippi	March 27, 2023
Renewal of Determination that a Public Health Emergency Exists As a Result of the Continued Consequences of the Coronavirus Disease 2019 (COVID-19) Pandemic on February 9, 2023	COVID-19	Nationwide	February 9, 2023
Renewal of Determination that a Public Health Emergency Exists As a Result of the Continued Consequences of the Coronavirus Disease 2019 (COVID-19) Pandemic on January 11, 2023	COVID-19	Nationwide	January 11, 2023
Renewal of Determination that a Public Health Emergency Exists Nationwide as a Result of the Continued Consequences of the Opioid Crisis on December 22, 2022	Opioid Crisis	Nationwide	December 22, 2022
Renewal of Determination that a Public Health Emergency Exists Nationwide as a Result of the Continued Consequences of an Outbreak of Monkeypox	Mpox	Nationwide	November 2, 2022
Renewal of Determination that a Public Health Emergency Exists As a Result of the Continued Consequences of the Coronavirus Disease 2019 (COVID-19) Pandemic on October 13, 2022	COVID-19	Nationwide	October 13, 2022
Determination that a Public Health Emergency Exists As a Result of the Consequences of Hurricane Ian on the State of South Carolina	Hurricane	South Carolina	September 30, 2022
Renewal of Determination that a Public Health Emergency Exists Nationwide as a Result of the Continued Consequences of the Opioid Crisis on September 29, 2022	Opioid Crisis	Nationwide	September 29, 2022
Determination that a Public Health Emergency Exists As a Result of the Consequences of Hurricane Ian on the State of Florida	Hurricane	Florida	September 26, 2022
Determination that a Public Health Emergency Exists As a Result of the Consequences of Hurricane Fiona on the Commonwealth of Puerto Rico	Hurricane	Puerto Rico	September 20, 2022
Determination that a Public Health Emergency Exists Nationwide as the Result of the Consequences of Monkeypox	Mpox	Nationwide	August 4, 2022
Determination that a Public Health Emergency Exists in the Commonwealth of Kentucky as the Result of the Severe Storms, Flooding, Landslides, and Mudslides	Severe Storms, Flooding, Landslides, and Mudslides	Kentucky	August 2, 2022
Renewal of the Determination that a Public Health Emergency Exists Nationwide as the Result of the Continued Consequences of Coronavirus Disease 2019 (COVID-19) Pandemic on July 15, 2022	COVID-19	Nationwide	July 15, 2022
Renewal of Determination that a Public Health Emergency Exists in the State of New Mexico as the Consequences of Wildfires and Straight-line Winds	Wildfires and Straight-line Winds	New Mexico	July 1, 2022
Renewal of Determination that a Public Health Emergency Exists Nationwide as a Result of the Continued Consequences of the Opioid Crisi on June 30, 2022	Opioid Crisis	Nationwide	June 30, 2022
Determination that a Public Health Emergency Exists Nationwide as the Result of the Continued Consequences of Wildfires and Straight-line Winds	Wildfires and Straight-line Winds	New Mexico	May 9, 2022
Renewal of the Determination that a Public Health Emergency Exists Nationwide as the Result of the Continued Consequences of Coronavirus Disease 2019 (COVID-19) Pandemic on April 12, 2022	COVID-19	Nationwide	April 12, 2022
Renewal of the Determination that a Public Health Emergency Exists Nationwide as the Result of the Continued Consequences of the Opioid Crisis on April 1, 2022	Opioid Crisis	Nationwide	April 1, 2022
Renewal of the Determination that a Public Health Emergency Exists Nationwide as the Result of the Continued Consequences of Coronavirus Disease 2019 (COVID-19) Pandemic on January 14, 2022	COVID-19	Nationwide	January 14, 2022
Renewal of the Determination that a Public Health Emergency Exists Nationwide as the Result of the Continued Consequences of the Opioid Crisis on January 3, 2022	Opioid Crisis	Nationwide	January 3, 2022
Renewal of the Determination that a Public Health Emergency Exists Nationwide as the Result of the Continued Consequences of Coronavirus Disease 2019 (COVID-19) Pandemic on October 15, 2021	COVID-19	New Mexico	October 15, 2021
Renewal of the Determination that a Public Health Emergency Exists Nationwide as the Result of the Continued Consequences of the Opioid Crisis on October 6, 2021	Opioid Crisis	Nationwide	October 6, 2021
Determination That A Public Health Emergency Exists as the Result of the Consequences of the Remnants of Hurricane Ida in New York and New Jersey	Hurricane	New Jersey	September 3, 2021
Determination That A Public Health Emergency Exists as the Result of the Consequences of Hurricane Ida in Louisiana and Mississippi	Hurricane	Louisiana	August 30, 2021
Renewal of the Determination that a Public Health Emergency Exists Nationwide as the Result of the Continued Consequences of Coronavirus Disease 2019 (COVID-19) Pandemic on July 19, 2021	COVID-19	Nationwide	July 19, 2021
Renewal of the Determination that a Public Health Emergency Exists Nationwide as the Result of the Continued Consequences of the Opioid Crisis on Jul,y 7, 2021	Opioid Crisis	Nationwide	July 7, 2021
Renewal of the Determination that a Public Health Emergency Exists Nationwide as the Result of the Continued Consequences of Coronavirus Disease 2019 (COVID-19) Pandemic on April 15, 2021	COVID-19	Nationwide	April 15, 2021
Renewal of the Determination that a Public Health Emergency Exists Nationwide as the Result of the Continued Consequences of the Opioid Crisis on April 7, 2021	Opioid Crisis	Nationwide	April 7, 2021
Determination that a Public Health Emergency Exists in the State of Texas as the Result of the Winter Storm	Winter Storm	Texas	February 17, 2021
Renewal of the Determination that a Public Health Emergency Exists Nationwide as the Result of the Continued Consequences of the Opioid Crisis on January 7, 2021	Opioid Crisis	Nationwide	January 7, 2021
Renewal of the Determination that a Public Health Emergency Exists Nationwide as the Result of the Continued Consequences of Coronavirus Disease 2019 (COVID-19) Pandemic on January 7, 2021	COVID-19	Nationwide	January 7, 2021
Renewal of the Determination that a Public Health Emergency Exists Nationwide as the Result of the Opioid Crisis on October 7, 2020	Opioid Crisis	Nationwide	October 7, 2020
Renewal of the Determination that a Public Health Emergency Exists as the Result of the Continued Consequences of Coronavirus Disease 2019 (COVID-19) Pandemic on October 2, 2020	COVID-19	Nationwide	October 2, 2020
Determination that a Public Health Emergency Exists in the State of Oregon as the Consequences of Wildfires	Wildfire	Oregon	September 16, 2020
Determination that a Public Health Emergency Exists in the State of Louisiana and the State of Texas as a Result of Hurricane Laura	Hurricane	Louisiana	August 26, 2020
Determination that a Public Health Emergency Exists in the State of California as a Result of Wildfires	Wildfire	California	August 26, 2020
Renewal of the Determination that a Public Health Emergency Exists as the Result of the Continued Consequences of Coronavirus Disease 2019 (COVID-19) Pandemic on July 23, 2020	COVID-19	Nationwide	July 23, 2020
Renewal of the Determination that a Public Health Emergency Exists Nationwide as the Result of the Opioid Crisis on July 6, 2020	Opioid Crisis	Nationwide	July 6, 2020
Renewal of the Determination that a Public Health Emergency Exists as the Result of the Continued Consequences of Coronavirus Disease 2019 (COVID-19) (formerly called 2019 Novel Coronavirus (2019-nCoV)) Pandemic on April 21, 2020	COVID-19	Nationwide	April 21, 2020
Renewal of the Determination that a Public Health Emergency Exists Nationwide as the Result of the Opioid Crisis on April 2, 2020	Opioid Crisis	Nationwide	April 2, 2020
Determination that a Public Health Emergency Exists Nationwide as the Result of the 2019 Novel Coronavirus	COVID-19	Nationwide	January 31, 2020
Renewal of the Determination that a Public Health Emergency Exists Nationwide as the Result of the Opioid Crisis on January 24, 2020	Opioid Crisis	Nationwide	January 24, 2020
Determination that a Public Health Emergency Exists as a Result of the Consequences of Earthquakes on the Commonwealth of Puerto Rico	Earthquake	Puerto Rico	January 8, 2020
Renewal of the Determination that a Public Health Emergency Exists Nationwide as the Result of the Opioid Crisis on October 16, 2019	Opioid Crisis	Nationwide	October 16, 2019
Determination that a Public Health Emergency Exists in the State of North Carolina as the Result of Hurricane Dorian	Hurricane	North Carolina	September 4, 2019
Determination that a Public Health Emergency Exists in the State of Georgia as the Result of Hurricane Dorian	Hurricane	Georgia	September 2, 2019
Determination that a Public Health Emergency Exists in the State of South Carolina as the Result of Hurricane Dorian	Hurricane	South Carolina	September 2, 2019
Determination that a Public Health Emergency Exists in the State of Florida as the Result of Hurricane Dorian	Hurricane	Florida	August 30, 2019
Determination that a Public Health Emergency Exists in the Commonwealth of Puerto Rico as the Result of Tropical Storm Dorian	Tropical Storm	Puerto Rico	August 28, 2019
Renewal of the Determination that a Public Health Emergency Exists Nationwide as the Result of the Opioid Crisis on July 17, 2019	Opioid Crisis	Nationwide	July 17, 2019
Determination that a Public Health Emergency Exists in Louisiana as a Result of Tropical Storm Barry	Tropical Storm	Louisiana	July 12, 2019
Renewal of the Determination that a Public Health Emergency Exists Nationwide as the Result of the Opioid Crisis on April 19, 2019	Opioid Crisis	Nationwide	April 15, 2019
Renewal of the Determination that a Public Health Emergency Exists in California as a Result of the Wildfires	Wildfire	California	January 30, 2019
Renewal of Determination that a Public Health Emergency Exists Nationwide as the Result of the Opioid Crisis on January 17, 2019	Opioid Crisis	Nationwide	January 17, 2019
Renewal of Determination that a Public Health Emergency Exists in the Commonwealth of the Mariana Islands as the Result of Typhoon Yutu (January 17, 2019)	Typhoon	Northern Mariana Islands	January 17, 2019
Renewal of Determination that a Public Health Emergency Exists Nationwide as the Result of the Opioid Crisis on October 18, 2018	Opioid Crisis	Nationwide	October 18, 2018
Determination that a Public Health Emergency Exists in Georgia as the Result of Hurricane Michael	Hurricane	Georgia	October 11, 2018
Determination that a Public Health Emergency Exists in Florida as the Result of Hurricane Michael	Hurricane	Florida	October 9, 2018
Determination that a Public Health Emergency Exists in the Commonwealth of Virginia as the Result of Hurricane Florence	Hurricane	Virginia	September 12, 2018
Determination that a Public Health Emergency Exists in North Carolina and South Carolina as the Result of Hurricane Florence	Hurricane	North Carolina	September 11, 2018
Renewal of Determination that a Public Health Emergency Exists Nationwide as the Result of the Opioid Crisis on July 23, 2018	Opioid Crisis	Nationwide	July 23, 2018
Renewal of Determination that a Public Health Emergency Exists in the Territory of the U.S. Virgin Islands as a Result of Hurricane Maria (September 11, 2018)	Hurricane	Virgin Islands, U.S.	July 12, 2018
Renewal of Determination that a Public Health Emergency Exists in the Territory of the U.S. Virgin Islands as a Result of Hurricane Maria (June 12, 2018)	Hurricane	Virgin Islands, U.S.	June 12, 2018
Renewal of Determination that a Public Health Emergency Exists Nationwide as the Result of the Opioid Crisis on April 20, 2018	Opioid Crisis	Nationwide	April 20, 2018
Renewal of Determination that a Public Health Emergency Exists in the Commonwealth of Puerto Rico as a Result of Hurricane Maria (March 16, 2018)	Hurricane	Puerto Rico	March 16, 2018
Renewal of Determination that a Public Health Emergency Exists in the Territory of the U.S. Virgin Islands as a Result of Hurricane Maria (March 15, 2018)	Hurricane	Virgin Islands, U.S.	March 15, 2018
Renewal of Determination that a Public Health Emergency Exists Nationwide as the Result of the Opioid Crisis on January 19, 2018	Opioid Crisis	Nationwide	January 19, 2018
Renewal ofetermination that a Public Health Emergency Exists in the Territory of the U.S. Virgin Islands and the Commonwealth of Puerto Rico as the Result of Hurricane Maria (December 11, 2017)	Hurricane	Puerto Rico	December 11, 2017
Determination that a Public Health Emergency Exists Nationwide as the Result of the Opioid Crisis on October 26, 2017	Opioid Crisis	Nationwide	October 26, 2017
Determination that a Public Health Emergency Exists in California as the Result of Wildfires	Wildfire	California	October 15, 2017
Determination that a Public Health Emergency Exists in Alabama as the Result of Hurricane Nate	Hurricane	Alabama	October 8, 2017
Determination that a Public Health Emergency Exists in Florida as the Result of Hurricane Nate	Hurricane	Florida	October 8, 2017
Determination that a Public Health Emergency Exists in Mississippi as the Result of Hurricane Nate	Hurricane	Mississippi	October 8, 2017
Determination that a Public Health Emergency Exists in Louisiana as the Result of Hurricane Nate	Hurricane	Louisiana	October 8, 2017
Determination that a Public Health Emergency Exists in the Territory of the U.S. Virgin Islands and the Commonwealth of Puerto Rico as the Result of Hurricane Maria	Hurricane	Puerto Rico	September 19, 2017
Determination that a Public Health Emergency Exists in South Carolina as the Result of Hurricane Irma	Hurricane	South Carolina	September 8, 2017
Determination that a Public Health Emergency Exists in Georgia as the Result of Hurricane Irma	Hurricane	Georgia	September 8, 2017
Determination that a Public Health Emergency Exists in Florida as the Result of Hurricane Irma	Hurricane	Florida	September 7, 2017
Determination that a Public Health Emergency Exists in the Commonwealth of Puerto Rico and the Territory of the U.S. Virgin Islands as the Result of Hurricane Irma	Hurricane	Puerto Rico	September 6, 2017
Determination that a Public Health Emergency Exists in Louisiana as the Result of Hurricane Harvey	Hurricane	Louisiana	August 28, 2017
Determination that a Public Health Emergency Exists in Texas as the Result of Hurricane Harvey	Hurricane	Texas	August 26, 2017
Renewal of Determination that a Public Health Emergency Exists as a Consequence of the Zika Virus Outbreak (April 28, 2017)	Zika Virus Outbreak	Puerto Rico	April 28, 2017
Renewal of Determination that a Public Health Emergency Exists as a Consequence of the Zika Virus Outbreak (January 31, 2017)	Zika Virus Outbreak	Puerto Rico	January 31, 2017
Renewal of Determination that a Public Health Emergency Exists as a Consequence of the Zika Virus Outbreak (November 4, 2016)	Zika Virus Outbreak	Puerto Rico	November 4, 2016
Determination that a Public Health Emergency Exists in Puerto Rico as a Consequence of the Zika Virus Outbreak	Zika Virus Outbreak	Puerto Rico	August 12, 2016
Determination that a Public Health Emergency Exists in New York as a Consequence of Hurricane Sandy (Renewal)	Hurricane	New York	January 25, 2013
Determination that a Public Health Emergency Exists in New Jersey as a Consequence of Hurricane Sandy	Hurricane	New Jersey	November 1, 2012
Determination that a Public Health Emergency Exists in New York as a Consequence of Hurricane Sandy	Hurricane	New York	October 31, 2012
Determination that a Public Health Emergency Exists in Missouri as a Consequence of Severe Storms and Tornadoes in the Area (Renewed February 15, 2022)	Severe Storm and Tornado	Missouri	February 15, 2012
Determination that a Public Health Emergency Exists in Missouri as a Consequence of Severe Storms and Tornadoes in the Area (Renewed November 18, 2011)	Severe Storm and Tornado	Missouri	November 18, 2011
Determination that a Public Health Emergency Exists in Missouri as a Consequence of Severe Storms and Tornadoes in the Area (Renewed August 19, 2011)	Severe Storm and Tornado	Missouri	August 19, 2011
Determination that a Public Health Emergency Exists in Missouri as a Consequence of Severe Storms and Tornadoes in the Area	Severe Storm and Tornado	Missouri	May 23, 2011
Flooding in North Dakota: Determination That a Public Health Emergency Exists (renewed on April 8, 2011)	Flood	North Dakota	April 8, 2011
2009 H1N1 Flu Outbreak: Determination that a Public Health Emergency Exists (Renewal)	H1N1 Flu Outbreak	Nationwide	March 22, 2010
Flooding in North Dakota: Determination That A Public Health Emergency Exists (renewed on March 18, 2010)	Flood	North Dakota	March 18, 2010
2009 H1N1 Flu Outbreak: Determination that a Public Health Emergency Exists (Renewal on December 28, 2009)	H1N1 Flu Outbreak	Nationwide	December 28, 2009
2009 H1N1 Flu Outbreak: Determination that a Public Health Emergency Exists (Renewal on October 1, 2009)	H1N1 Flu Outbreak	Nationwide	October 1, 2009
2009 H1N1 Flu Outbreak: Determination that a Public Health Emergency Exists (Renewal on July 24, 2009)	H1N1 Flu Outbreak	Nationwide	July 24, 2009
2009 H1N1 Flu Outbreak: Determination that a Public Health Emergency Exists	H1N1 Flu Outbreak	California	April 26, 2009