On Sunday, 26 April 2009, the secretary of the U.S. Department of Health and Human Services declared a public health emergency in response to the outbreak of H1N1 influenza (known as swine flu) in the United States. Through an analysis of state and local health department Web sites, we determined whether departments were able to provide online information to their constituents within twenty-four hours of the declaration. The overwhelming majority of state health departments, and more than half of health departments participating in the Cities Readiness Initiative — but only a quarter of smaller, local health departments — were successful in doing so.
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