and Gujarat Andhra Pradesh Researchers of MIT have claimed that the swine flu has mutated in India to a more virulent version with changes in Hemagglutinin protein, contradicting earlier research by Indian researchers. There was another outbreak in India in 2017. The states of Maharashtra and Gujarat were the worst affected. Gujarat high court has given Gujarat government instructions to control deaths by swine flu. 1,090 people died of swine flu in India in 2019 until August 31, 2019. 2015 Nepal Swine flu outbreaks were reported in Nepal in the spring of 2015. Up to April 21, 2015, the disease had claimed 26 lives in the most severely affected district, Jajarkot in Northwest Nepal. Cases were also detected in the districts of Kathmandu, Morang, Kaski, and Chitwan. As of 22 April 2015 the Nepal Ministry of Health reported that 2,498 people had been treated in Jajarkot, of whom 552 were believed to have swine flu, and acknowledged that the government's response had been inadequate. The Jajarkot outbreak had just been declared an emergency when the April 2015 Nepal earthquake struck on 25 April 2015, diverting all medical and emergency resources to quake-related rescue and recovery. 2016 Pakistan Seven cases of swine flu were reported in Punjab province of Pakistan, mainly in the city of Multan, in January 2017. Cases of swine flu were also reported in Lahore and Faisalabad. 2017 Maldives As of March 16, 2017, over a hundred confirmed cases of swine flu and at least six deaths were reported in the Maldivian capital of Malé and some other islands. Makeshift flu clinics were opened in Malé. Schools in the capital were closed, prison visitations suspended, several events cancelled, and all non-essential travel to other islands outside the capital was advised against by the HPA. An influenza vaccination program focusing on pregnant women was initiated thereafter. An official visit by Saudi King Salman bin Abdulaziz Al Saud to the Maldives during his Asian tour was also cancelled last minute amidst fears over the outbreak of swine flu. 2020 G4 EA H1N1 publication G4 EA H1N1, also known as the G4 swine flu virus (G4) is a swine influenza virus strain discovered in China. The virus is a variant genotype 4 (G4) Eurasian avian-like (EA) H1N1 virus that mainly affects pigs, but there is some evidence of it infecting people. A peer-reviewed paper from the Proceedings of the National Academy