In China, mask-wearing police cordoned off more hotels on Wednesday, quarantining anyone who came in contact with swine flu patients, no matter how mild their symptoms. Not so in Mexico, where the health secretary encouraged tourists to come relax in their favorite vacation spots despite a growing swine flu caseload.
The global outbreak appears mild, but skittishness is evident. Not long after Switzerland lifted its advisory against travel to Mexico and the United States, the Japanese national women's soccer team canceled a tour to North America, where most swine flu cases have been reported.
And in China, hundreds of people have been quarantined inside hotels, hospitals and homes after they came in contact with several infected plane or train travelers from Canada and U.S. The U.S. Embassy said Americans are among those quarantined. With Cuba, Thailand and Finland reporting their first confirmed swine flu cases on Tuesday all in people who had traveled to Mexico there are now 33 countries reporting an estimated total of 6,080 confirmed swine flu cases, including 3,009 in 45 US states, 2,446 in Mexico and 358 in Canada.
But the death total is relatively low 65, of which 60 were in Mexico, three in the U.S., one in Canada and one in Costa Rica. Health Secretary Jose Angel Cordova said Wednesday that Mexico has tested about 9,000 sick people, working through a backlog of samples taken before and after the virus was identified as swine flu and found that Mexico's dead represents 2.5 per cent of confirmed cases, suggesting the virus is not as deadly as intitially feared. Pneumonia, often brought on by regular seasonal flu, may be much more deadly, Cordova said killing 9,500 people in Mexico last year. The last death from swine flu was on May 7, he said. Cordova also addressed Mexico's hard-hit tourism industry, saying there are "very few" cases in tourist destinations including 7 in Cancun.
"There is no risk for tourists they can return to these relaxing vacation spots," he said.
There is a danger the virus will mutate into something more dangerous perhaps by combining with the more deadly but less easily spread bird flu virus circulating in Asia and Africa, according to experts at the US Centers for Disease Control and Prevention.
Another concern is that it will combine with the northern winter's seasonal H1N1 virus. While not unusually virulent, it was resistant to Tamiflu, and health officials worry it could make the new swine flu resistant to Tamiflu as well.
With swine flu still spreading around the globe, the World Health Organization is warning countries to limit the use of antiviral drugs to ensure adequate supplies.
European countries have been using antiviral drugs such as Tamiflu and Relenza much more aggressively than the U.S. and Mexico, administering them whenever possible in an attempt to contain the virus before it spreads more widely.
Officials from EU and Latin American nations, including Mexico, were meeting in Prague on Wednesday to discuss the threat. A WHO medical expert, Dr Nikki Shindo, said the U.N. agency thinks antivirals should be targeted mainly at people already suffering from other diseases or complications such as pregnancy that can lower a body's defenses against flu.
The CDC also said pregnant women should take the drugs if diagnosed with swine flu even though the effects on the fetus are not completely known.
Pregnant women are more likely to suffer pneumonia when they catch flu, and flu infections have raised the risk of premature birth in past flu epidemics. A pregnant Texas woman with swine flu died last week, and at least 20 other pregnant women with swine flu have been hospitalized in the U.S., including some with severe complications.
For all these reasons, risks from the virus are greater than the unknown risks to the fetus from Tamiflu and Relenza, said Dr. Anne Schuchat of the CDC.
"We really want to get the word out about the likely benefits of prompt antiviral treatment" for pregnant women, she said. Mexico now gives Tamiflu to anyone who has had direct contact with a person infected with swine flu, Cordova said. And now that schools are back in session, authorities plan to give it to any children who show symptoms and are suspected of being infected. In Mexico's Baja California state, on the US border, 5,689 children were turned away from schools when classes resumed because they had symptoms like runny noses, headaches or sore throats, the state education department reported Tuesday.
Swiss pharmaceuticals company Roche Holding AG announced it was donating enough Tamiflu for 5.65 million more people to WHO. A further 650,000 packets containing smaller doses of the drug will be used to create a new stockpile for children.
Mexican authorities had enough Tamiflu for 1 million people at the start of the outbreak and have received more, building reserves of 1.5 million courses.