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WHO boosts pandemic alert level to 4

Ontario probing 10-12 potential cases; P.E.I. investigating 8

Last Updated: Monday, April 27, 2009 | 6:38 PM ET

More countries announced confirmed or suspected cases of the virus linked to the outbreak in Mexico on Monday. More countries announced confirmed or suspected cases of the virus linked to the outbreak in Mexico on Monday. (CBC)The World Health Organization raised its global pandemic alert to Level 4 from Level 3 on Monday, meaning the global health body feels the virus causing the swine flu outbreak can easily transmit between people.

Dr. Keiji Fukuda, the WHO’s assistant director general, confirmed the change during a briefing from Geneva following an emergency meeting of the organization.

Countries should focus their efforts on mitigating the effects of the virus — which the WHO has confirmed has spread to Mexico, Canada, the United States and Spain — because containment is impossible, he said.

However, Fukuda added: "A pandemic is not considered inevitable at this time."

Fukuda said the WHO doesn't recommend closing borders or restricting travel but is encouraging people who are ill to delay travel.

"The deliberations of the emergency committee and the decisions of the director general really reflect a lot of very careful and sober discussion and a number of important considerations," said Fukuda.

Commuters in Mexico City wear surgical masks while riding the subway on Monday. Mexico's government is trying to stem the spread of a deadly strain of swine flu as a new work week begins by urging people to stay home if they have any symptoms of the virus believed to have killed more than 100 people.Commuters in Mexico City wear surgical masks while riding the subway on Monday. Mexico's government is trying to stem the spread of a deadly strain of swine flu as a new work week begins by urging people to stay home if they have any symptoms of the virus believed to have killed more than 100 people. (Eduardo Verdugo/Associated Press)

Despite the WHO's comments, the European Union and the U.S. have advised against non-essential travel to Mexico because of the outbreak of the virus believed to have killed dozens in Mexico. Canada was expected to issue a similar advisory.

The administration of U.S. President Barack Obama said it is already waging a vigorous campaign of prevention, unsure of the outbreak's severity or where it would show up next.

"We want to make sure that we have people where they need to be, equipment where it needs to be and, most of all, information shared at all levels," Secretary of Homeland Security Janet Napolitano told reporters Monday in Washington.

Napolitano said she is working with Canadian and Mexican officials in a "tri-national" approach to the outbreak. Canada's health minister, Leona Aglukkaq, said she has been in touch with her counterparts in Mexico and the U.S.

Mexico raises death toll

The number of confirmed cases rose Monday to 50 in the U.S., the result of further testing at a New York City school. The WHO has confirmed 26 cases in Mexico, six in Canada and one in Spain. All of the Canadian cases were mild, and the people have recovered.

The Mexican government suspects the virus was behind at least 149 deaths in Mexico, the epicentre of the outbreak, with hundreds more cases suspected.

More than 1,900 people have been hospitalized over what Mexican Health Minister José Angel Cordova Villalobos called "grave pneumonia," but 1,070 have since been released. He said health officials expect the number of new cases to rise.

Its first suspected case of swine flu was detected in the southern state of Oaxaca, Villalobos said Monday, but he added it was too early to identify the cause or geographical source.

The Mexican government has also ordered all schools throughout the country closed until May 6.

The majority of the suspected deaths were between the ages of 20 and 50, Villalobos told reporters in Mexico City.

"We are investigating for confirmation on those cases to see if they are, in fact, flu cases," he said.

Spain, Scotland say flu has hit

More countries announced confirmed or suspected cases of the virus Monday.

Health officials in Britain said two cases have been confirmed in Scotland, but a Canadian woman hospitalized in Manchester, England, tested negative for swine flu. The WHO said it is still awaiting official reports from the U.K. about the Scottish cases.

Scottish Health Secretary Nicola Sturgeon said the two confirmed patients are "recovering well."

In Spain, the first patient, a young man who recently returned from Mexico, is responding well to treatment, Spanish Health Minister Trinidad Jimenez said.

Another 17 sick people are suspected of having the virus, but none of the people under observation is in serious condition, the minister told a news conference in Madrid.

"The situation is under control," Jimenez said.

Two people in Israel who recently returned from Mexico have been quarantined with flu-like symptoms, Israeli health officials said Monday.

Meanwhile, in New Zealand, Health Minister Tony Ryall said 13 people who had just returned from a school trip to Mexico and were showing flu-like symptoms were being tested for swine flu.

Pork imports banned

As more suspected cases are reported, countries around the world are taking action to try to stop the spread of the virus.

Airports in Germany, Singapore, Thailand, Japan, Indonesia, the Philippines, India and Malaysia were to begin screening all airline passengers from North America.

Russia, Hong Kong and Taiwan said visitors returning from flu-affected areas with fevers would be quarantined.

Australian Health Minister Nicola Roxon said pilots on international flights would be required to file a report noting any flu-like symptoms among passengers before being allowed to land in Australia.

China said anyone experiencing flu-like symptoms within two weeks of arrival had to report to authorities.

Several countries, including China, Russia and Ukraine, have also banned imports of pork and pork products from Mexico.

Azerbaijan banned all livestock products from North America while Indonesia and Lebanon announced they will ban most imported pork products.

The U.S. Centres for Disease Control and Prevention says people cannot get the flu by eating pork or pork products.

The term pandemic is a medical description of the way an infectious disease spreads and not an indication of its mortality rate.

Canadian health officials have said flu viruses in general kill about 4,000 people a year in Canada.

With files from The Associated Press
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Swine flu

Swine flu: FAQs
FAQ: How viruses mutate
Map: Confirmed swine flu cases around the globe
Investigating swine flu
Will face masks protect you from the flu?
Citizen Bytes: Swine flu: A report from Mexico
Your Interview: Dr. Donald Low answers your questions about swine flu
Citizen Bytes: Stranded in Mexico: "Canadians, please beware"
Your View: Is the swine flu health alert being overblown?

In Depth

Pandemic preparation: dealing with infectious disease outbreaks
What is a virus?
How viruses mutate
Misconceptions about the flu
Tips for building your immune system
Fighting the flu
The 1918 flu epidemic
CBC Archives: Influenza - Battling the last great virus
CBC Archives: The swine flu fiasco

Stories

13 swine flu cases confirmed in Canada, all mild
April 28, 2009
Obama calls for $1.8B to stem spread of swine flu
April 28, 2009
Mexican farm swine flu's 'ground zero': residents
April 28, 2009
Vancouver Island woman believed to be B.C.'s 3rd case of swine flu
April 28, 2009
Canada's farmers could be battered by impact of swine flu outbreak
April 28, 2009
Several travel companies suspend trips to Mexico
April 28, 2009
Alberta confirms 2 cases of swine flu
April 28, 2009
'Inappropriate' to use antivirals now, public health chief says
April 28, 2009
WHO boosts pandemic alert level to 4
April 27, 2009
Swine flu likely to worsen in Canada, says top health official
April 27, 2009
Canada will monitor, not bar Mexican farm workers
April 27, 2009
Swine flu symptoms spreading beyond Windsor, N.S., campus
April 27, 2009
Health officials confirm 6 cases of swine flu in Canada
April 26, 2009
India, Malaysia issue travel warnings to Canada over swine flu
April 26, 2009
Swine flu outbreak international 'public health emergency': WHO
April 25, 2009
Canadian lab confirms human swine flu cases in Mexico
April 24, 2009
Travel advisory warns of severe respiratory illness in Mexico
April 23, 2009

Video Interviews

CBC's Heather Hiscox interviews Dr. Donald Low with the Ontario Public Health Agency (5:41)
April 28, 2009
Brian Ward, infectious disease specialist at McGill University (7:45)
April 26, 2009
Dr. Andrew Simor, director of microbiology at Sunnybrook Health Sciences Centre (8:41)
April 26, 2009
Steven Corber, former head of disease prevention programs at Pan American Health Organization
April 26, 2009

External Links

The Public Health Agency of Canada's travel warning on Mexico
April 28, 2009
World Health Organization guide: Pandemic Influenza Preparedness And Response
PDF document
Public Health Agency of Canada news release on swine flu
April 26, 2009
Swine influenza: statement by WHO director-general Margaret Chan
April 25, 2009
Swine influenza page from Centres for Disease Control website
April 29, 2009

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