Mexico suspected flu toll soars

As many as 149 people in Mexico are believed to have been killed by swine flu as cases of the virulent disease continue to rise around the world.

The Mexican health minister announced the suspected death toll, saying the victims were aged between 20 and 50.

Cases of swine flu have been confirmed in the US, Canada and Spain. Scotland confirmed two cases on Monday evening.

The World Health Organization (WHO) late on Monday raised its pandemic alert level from three to four.

This means its experts believe the virus is showing a sustained ability to pass from human to human, and is able to cause community-level outbreaks.

SWINE FLU Swine flu is a respiratory disease thought to spread through coughing and sneezing Symptoms mimic those of normal flu - but in Mexico more than 100 people have died Good hygiene like using a tissue and washing hands thoroughly can help reduce transmission Swine flu cases confirmed in UK Q&A: What is swine flu? 'I couldn't get out of bed'

UN Secretary-General Ban Ki-moon earlier warned that the virus "could cause a new influenza pandemic".

"It could be mild in its effect or potentially be severe," he said.

"We don't know yet which way it will go, but we are concerned that in Mexico most of those who died were young and healthy adults."

The United States and the European Union have urged people to re-think any travel plans to Mexico.

Mexico quake

Mexico's Health Minister Jose Angel Cordova said on Monday the suspected death toll from swine flu had now risen from just over 100 to 149. Of that number, 20 have been confirmed as swine flu.

The BBC talks to people in Mexico City about the flu outbreak. In pictures

"We're in the decisive moment of the crisis, the number [of deaths] will continue rising," he told a news conference.

Mr Cordova said nearly 2,000 people had been hospitalised since the first case of swine flu was reported on 13 April, but half had now been allowed home.

Schools nationwide are to remain closed until 6 May as the country attempts to grapple with the outbreak.

As Mr Cordova spoke, Mexico City - where the outbreak is centred - was rocked by a 5.6-magnitude earthquake. It shook tall buildings and led to evacuations, but there have been no reports of damage or injuries.

Travel advisories

The US confirmed a further 20 cases of swine flu in New York - bringing the current number of cases in the country to 40.

SPREAD OF VIRUS Mexico: 20 confirmed cases (Mexico puts suspected deaths at 149) United States: 40 confirmed cases Canada: 6 confirmed cases Spain: 1 confirmed case UK: Scotland says tests confirm 2 cases Israel, Brazil, Guatemala, Peru, Australia and New Zealand: Suspected cases being tested

The rise was entirely due to further testing of pupils at a school in Queens, Dr Richard Besser, acting director of the US Centers of Disease Control and Prevention (CDC), said.

Of the other cases reported - in Ohio, Kansas, Texas and California - only one person had been hospitalised and all had recovered, he added.

However, he warned that a new US travel advisory was being prepared suggesting "non-essential travel to Mexico be avoided".

Earlier, US Secretary of State Hillary Clinton urged "caution" for US nationals planning to visit Mexico, saying officials were taking the issue "very seriously".

EU Health Commissioner Androulla Vassiliou said that in her personal opinion people should "try to avoid non-essential travel" to areas where people are known to have been infected.

US President Barack Obama, in a speech to US scientists, said the cases were a cause for concern but not alarm.

He said the declaration of a public health emergency was a "precautionary tool" to ensure that all the necessary resources were available "to respond quickly and effectively".

Vigilance

Swine flu officially arrived in Europe on Monday, when tests confirmed that a young man in Spain and two people in Scotland - all of whom had recently returned from Mexico - had the virus. They were said to be recovering well.

WHO PANDEMIC ALERT PHASES Phase 1: No viruses circulating among animals causing infections in humans Phase 2: Animal influenza virus causes infection in humans, and is considered potential pandemic threat Phase 3: Influenza causes sporadic cases in people, but no significant human-to-human transmission Phase 4: Verified human-to-human transmission able to cause community-level outbreaks. Significant increase in risk of a pandemic Phase 5: Human-to-human transmission in at least two countries. Strong signal pandemic imminent Phase 6: Virus spreads to another country in a different region. Global pandemic under way Life at centre of the outbreak Swine flu: Your experiences In pictures: Swine flu

In Canada, six cases have been recorded at opposite ends of the country, in British Columbia and in Nova Scotia.

Tests are also being carried out on individuals or groups in New Zealand, Australia, Brazil and Israel who fell ill following travel to Mexico.

In almost all cases outside Mexico, people have been only mildly ill and have made a full recovery.

Health experts say the virus comes from the same strain that causes seasonal outbreaks in humans. But they say this newly-detected version contains genetic material from versions of flu which usually affect pigs and birds.

There is currently no vaccine for this new strain, but severe cases can be treated with antiviral medication.

The WHO is advising all countries to be vigilant for seasonally unusual flu or pneumonia-like symptoms among their populations - particularly among young healthy adults, a characteristic of past pandemics.

A number of countries in Asia, Latin America and Europe have begun screening airport passengers for symptoms, while Germany's biggest tour operator has suspended trips to Mexico.

Several countries have banned imports of raw pork and pork products from Mexico and parts of the US, although experts say there is no evidence to link exposure to pork with infection.

Shares in airlines have fallen sharply on fears about the economic impact of the outbreak.

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