The head of the World Health Organization, Margaret Chan, yesterday suggested the swine flu pandemic alert would eventually move to its highest level.

But the woman in charge of the global fight against the H1N1 outbreak said a move to level six should not be taken as a cause for panic.

“Level six does not mean, in any way, that we are facing the end of the world. It is important to make this clear because [otherwise] when we announce level six it will cause unnecessary panic,” she told Spain’s El País newspaper.

Officials from the United Nations and the WHO later insisted that there were no imminent plans to raise the alert level. But they agreed that going to the highest level could be an eventuality.

Raising the alert level to six would mean that a global pandemic was in full effect. However, the officials emphasised that a pandemic did not necessarily mean the disease was particularly deadly.

And in a video link with the UN, Chan appeared to attempt to allay fears, adding: “We are not there yet.”

The Financial Times also reported that Chan, who recently raised the threat of a pandemic to level five, had suggested a move to level six was likely. She warned that the real blow might come if a second wave of cases swept across the globe at the start of the winter flu season.

“If it’s going to happen, it would be the biggest of all outbreaks the world has faced in the 21st century,” she said.

The UN secretary general, Ban Ki-moon, said: “Let us remember that even if the WHO does declare phase six, a pandemic, that would be a statement about the geographic spread of the virus, not its severity.”

Spain remains the European country with the most cases of swine flu. By yesterday there were 54 reported cases, including four people who were infected in the country. The outbreak has raised concerns over its potential impact on tourism.

Swine flu cases reached 1,085 worldwide, spreading to 21 countries and every major region of the U.S., health officials said. The symptoms, no more serious than those of seasonal flu, may worsen as seasons change.

In the U.S., the H1N1 virus has been confirmed by laboratory tests in 286 patients in each of nine regions tracked by the U.S. census, according to the U.S. Centers for Disease Control and Prevention in Atlanta. The disease, most active in Canada, Mexico and the U.S., has been confirmed in Central America, South America, Europe, the Middle East, Asia and New Zealand.

The World Health Organization said it’s bracing for the possibility the disease will worsen despite signs the virus may be no worse than seasonal flu. As the outbreak eases in Mexico, where it struck hardest, health officials are focusing on the Southern Hemisphere, where flu season will likely begin before a swine flu vaccine is available.

“That part of the world will be heading into the winter months,” Keiji Fukuda, the World Health Organization’s assistant director-general for health, security and environment, said today at a news conference in Geneva. “We’re really trying to get a handle on how far has this virus spread out and how much has it established itself in different parts of the world.”

The U.S. CDC reported 286 cases in 36 U.S. states, with one death. The number of people with flu in the U.S. is increasing when the normal flu season would be ending, the CDC said. At least 533 schools in 24 states were closed today, shutting out about 330,000 students, according to the U.S. Department of Education.

Mexico Peaks

Mexico’s outbreak probably peaked last week and patients are responding well to antiviral treatments, Health Minister Jose Cordova said yesterday. The virus has been confirmed in 23 of Mexico’s 31 states and the capital district.

“Mexico is trying to return to normalcy as soon as possible,” President Felipe Calderon said yesterday, adding that it was too soon to tally the economic cost. “We are going to win this battle.”

St. Francis Preparatory School in New York, where more than 1,000 students were likely infected, reopened today after being closed since April 27. New York has 73 confirmed cases of swine flu, though it stopped testing everyone suspected of having the illness, said Thomas Frieden, the city health commissioner, at a news conference today.

More Cases

“It is no more severe, from everything we have seen, than seasonal flu.” Frieden told reporters at St. Francis, in the New York borough of Queens.

Declaration of a pandemic is imminent, the World Health Organization said over the weekend. The WHO raised its six-tier alert to 5 on April 29 and a further elevation would signal a pandemic, alerting governments to carry out plans to curb the disease.

“While we’re not out of the woods yet, we are seeing some encouraging signs,” said Richard Besser, acting chief of the U.S. Centers for Disease Control and Prevention in Atlanta, in a conference call today. “Here in the United States, we’re at the very end of our flu season. There aren’t a lot of other flu viruses around that it’s competing with. What happens when it goes into countries where there are other viruses circulating?”

Besser said the U.S. strategy to close schools with suspected cases doesn’t effectively halt the virus’ spread once it becomes established in an area. The CDC is evaluating whether to change its advice to schools, he said.

New Cases

The WHO, a Geneva-based agency of the United Nations, today added Colombia and El Salvador to the list of countries with confirmed cases. The other nations are Austria, Canada, Costa Rica, Denmark, France, Germany, China (Hong Kong), Ireland, Israel, Italy, Mexico, the Netherlands, New Zealand, South Korea, Spain, Switzerland, the U.K., and the U.S.

Canadian health officials on May 2 reported the world’s first known case of swine flu jumping to pigs from a human, probably after a farm worker in the province of Alberta became ill during a trip to Mexico. Hundreds of pigs on the farm showed symptoms of the same H1N1 strain in humans and were recovering, according to the Canadian Food Inspection Agency.

Pigs are an ideal breeding location for new forms of the flu, and further genetic scrambling can result in deadlier forms of the new swine flu, said Nancy Cox, chief of the flu division at the Center for the Immunization and Respiratory Disease at the Atlanta-based CDC.

Mixing in Pigs

The animals serve as a “wonderful mixing vessel” for bird, human and swine viruses, Cox said. The process of two viruses merging to form a new virus can also take place in humans.

Even if swine-flu symptoms are mild, the ease with which the new virus spreads among a world population makes it a threat, health officials said.

Data so far suggest the virus is striking younger patients than is typical for influenza, and younger patients than usual are entering hospitals, said Anne Schuchat, a scientist at the CDC. “Very few” patients with swine flu are older than 50, and the median age is 17. It’s possible that older people have greater immunity, she said.

The three main seasonal flu strains — H3N2, another form of H1N1, and type-B — cause 250,000 to 500,000 deaths a year globally, according to the WHO. The new flu’s symptoms are similar: aches, coughing, and fever. The CDC says people with the swine flu are more likely to have diarrhea.

Pandemic Threat

The world is now closer to another influenza pandemic than at any time since 1968, when the last of the previous century’s three pandemics occurred, world health experts said. The WHO hasn’t had a phase 6 alert since it introduced the six-level system in 2005. Before last week, the warning had been at phase 3 since 2007, when it was elevated for an outbreak of avian influenza, according to the WHO Web site.

The new flu strain has now struck more people than the H5N1 avian influenza that emerged in 2003. That illness killed more than half of the 421 who contracted the malady worldwide. Unlike swine flu, it didn’t spread from person to person.

The Spanish flu of 1918, another version of bird flu, killed as many as 50 million people in one of history’s deadliest outbreaks.

The U.S. is hastening production of its annual flu shots based on strains identified before the H1N1 outbreak, said Kathleen Sebelius, who was confirmed as the U.S. Health and Human Services secretary last week. That will make capacity available if vaccines are needed for swine flu, she said.

Batches of seed virus are being developed for potential vaccine production, according to the WHO. Sanofi-Aventis SA of Paris, Baxter International Inc. of Deerfield, Illinois, and GlaxoSmithKline Plc of London, are talking with world health authorities about producing shots, the agency said.

Authorities advised hand-washing, hygiene and staying home if sick as the most effective ways to control the outbreak. The WHO and CDC said closing borders or killing animals are costly steps that wouldn’t slow the spread of flu.

WASHINGTON (Reuters) – The new H1N1 swine flu has infected 286 people in 36 U.S. states and it is likely to spread to every state, the U.S. Centres for Disease Control and Prevention reported on Monday.

Most cases remain mild but 35 have been hospitalized, the CDC’s acting director, Dr. Richard Besser, told a news conference. A toddler who died in Texas last week remains the only death in the United States so far.

In Mexico, officials say they hope cases there will continue to decline, but it was clear the outbreak of the never-before-seen strain of influenza was growing elsewhere.

Besser said the virus was so clearly everywhere that the CDC might step down its recommendations to test people so that state and federal health officials could spend their limited time and resources elsewhere.

“We are seeing over 700 probable cases in a total of 44 states,” Besser said. So far, 99 percent of probable cases have, upon further testing, turned out to be the new H1N1 strain, Besser said.

“This likely represents an underestimation of the total number of cases across the United States,” Besser added, because most people with flu-like symptoms — fever, aching muscles and cough — are not even getting tested.

Besser said the CDC was even reconsidering the strategy of closing schools where cases turn up. More than 500 U.S. schools have been closed because of outbreaks.

Schools are closed to protect children, and to keep children from being “amplifiers” who spread an infection in the community. But this virus is looking to be as mild as seasonal flu, which only rarely kills children.

“It appears that the virus is already pretty well established in those communities,” Besser said. “So we are looking at the school closure guidance.”

That does not mean the virus is harmless, he noted. Seasonal flu infects an estimated 30 million Americans every year, about 10 percent of the population, kills 36,000 and puts 200,000 into the hospital.

“People are hospitalized and die every year with seasonal flu,” Besser said. The new virus has killed people in Mexico and can expect to kill elsewhere, as well, he said.

He said he was pleased at how well-prepared state and local officials were for the outbreak — a result of years of planning for pandemic influenza and other disasters that started with the 2001 anthrax attacks, accelerated when H5N1 avian influenza re-emerged in 2003 and kicked into high gear when the response to Hurricane Katrina in 2005 was so poor.

Doctors tracking swine flu in California are investigating a new theory: What if it didn’t originate in Mexico but instead had been floating around the border region for months?

Growing evidence in California suggests that early flu cases had no apparent origin in Mexico. Many of the early California victims — including the first two cases — say they hadn’t traveled to Mexico and had no contact with pigs. Some may have fallen ill before the first Mexicans did.

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Those cases contradict the conventional understanding of how the strain originated. They could also offer important clues about the future trajectory of the disease. Other cases here and in other states, as well as abroad, have clear links with Mexico.

Michael Shaw, associate director for laboratory science for the influenza division of the Centers for Disease Control and Prevention, said the flu theoretically could have appeared first in California, but he cautioned against drawing any conclusions since the strain also exhibited genetic characteristics traceable to Eurasia.

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The first case discovered in California was a 10-year-old boy in San Diego County, who fell ill with a fever March 30.

Health authorities stumbled upon the case by chance. The boy had a throat swab taken at a clinic during a random check, a common procedure by health officials to monitor illness around the U.S.-Mexico border. “We got lucky,” said Chavez.

Tests revealed the flu virus didn’t match any typical human flu subtype. The CDC received samples April 14 and determined the cause to be the now well-known A/H1N1 influenza.

MEXICO CITY —  Mexico’s top epidemiologist says the World Health Organization was slow to react to an outbreak of atypical pneumonia that grew into the swine flu epidemic, and wants a probe.

In a telephone interview with The Associated Press, Dr. Miguel Angel Lezana says he is troubled by the response of the Pan American Health Organization, or PAHO, and its parent organization, the WHO, in the early days of the outbreak.

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Lezana, director of the National Epidemiology Center, says it notified PAHO on April 16 about the outbreak in Mexico, but that action wasn’t taken until eight days later, when the WHO announced the spreading epidemic..

Experts, however, are asking whether the health system in Mexico is up to dealing with the outbreak and whether an earlier response might have prevented its worldwide spread.

“Mexico does not have the kind of measures in place we have in this country,” said Dr. Len Horovitz, a pulmonary specialist at Lenox Hill Hospital in New York. “This virus has been circulating since sometime in March and could involve thousands or hundreds of thousands of people.”

Reports indicate that hospitals around Mexico started seeing a rise in patients complaining of respiratory distress as early as the middle of last month.

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But the WHO wasn’t made aware of the situation until a month later. Within a week people in Mexico were dying of flu-like symptoms and two children in California were diagnosed with a new strain of swine flu, believed to be the same strain circulating through Mexico.

Dr. Keiji Fukuda, an assistant director general with the WHO, defended Mexican health officials in a news conference on Sunday, pointing out that the country — which has been hard hit by the global recession and is devoting many of its resources to its war against drug cartels — was in the middle of flu season when the increase in patient load began.

Mexico’s top medical officer voiced optimism Thursday that swine flu has slowed in the nation hardest hit by the virus, but the World Health Organization cautioned there is no evidence the worst of the global outbreak is over.

U.S. authorities are pledging to eventually produce enough swine flu vaccine for everyone but the shots couldn’t begin until fall at the earliest.

Worries about the spread of the virus mounted Thursday as the nation’s swine flu caseload reached 130, and nearly 300 schools closed in communities across the country.

On Friday, the World Health Organization raised its tally of confirmed human cases to 331 from 257.

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The global body says 11 countries have now reported confirmed cases, including Germany, which confirmed Friday the first case of swine flu transmission within the country. This does not include Hong Kong and Denmark, which confirmed cases mid-morning Friday.

Federal officials had to spend much of Thursday reassuring the public it’s still safe to fly and ride public transportation after Vice President Joe Biden said he wouldn’t recommend it to his family.

“There’s not an increased risk there,” Dr. Richard Besser, acting director of the Centers for Disease Control and Prevention, said Friday. “If you have the flu or flu-like symptoms, you shouldn’t be getting on an airplane or you shouldn’t be getting in the subway, but for the general population that’s quite fine to do,” he said.

Clinics and hospital emergency rooms in New York, California and some other states are seeing a surge in patients with coughs and sneezes that might have been ignored before the outbreak.

Scientists were racing to prepare the key ingredient to make a vaccine against the never-before-seen flu strain — if it’s ultimately needed. But it will take several months before the first pilot lots begin required human testing to ensure the vaccine is safe and effective. If all goes well, broader production could start in the fall.

“We think 600 million doses is achievable in a six-month time frame” from that fall start, Health and Human Services Assistant Secretary Craig Vanderwagen told lawmakers.

“I don’t want anybody to have false expectations. The science is challenging here,” Vanderwagen told reporters. “Production can be done, robust production capacity is there. It’s a question of can we get the science worked on the specifics of this vaccine.”

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Until a vaccine is ready, the government has stockpiled anti-viral medications that can ease flu symptoms or help prevent infection. The medicines are proving effective.

Reassurances from top health officials didn’t stop the questions from coming.

An estimated 12,000 people logged onto a Webcast where the government’s top emergency officials sought to cut confusion by answering questions straight from the public: Can a factory worker handling parts from Mexico catch the virus? No. Can pets get it? No.

And is washing hands or using those alcohol-based hand gels best? Washing well enough is the real issue, Besser said. He keeps hand gel in his pocket for between-washings but also suggested that people sing “Happy Birthday” as they wash their hands to make sure they’ve washed long enough to get rid of germs.

The Numbers

In the U.S., 130 cases have been confirmed in 20 states, although state health experts say the count is likely much higher. Among the U.S. cases confirmed by the Centers for Disease Control and Prevention are 51 in New York, 16 in Texas and 14 in California, as well as scattered cases in Kansas, Massachusetts, Michigan, Arizona, Indiana, Nevada, Ohio, Maine and South Carolina.

State officials also confirmed cases in Minnesota, Georgia, New Jersey, Delaware, Utah, New Jersey, Virginia and Colorado. On Thursday night, Illinois health officials announced the number of probable swine flu cases in the state had more than doubled to 41.

About 300 of the nation’s 132,000 schools have closed, including schools on both coasts and in the nation’s heartland. More are likely to shut their doors in coming days. Additionally, high school, college and professional sporting events have been called off nationwide due to increasing fears.

Nebraska’s chief medical officer says federal tests have confirmed the first case of swine flu in the state. It involves a California man in his 40s who’s vacationing in the Omaha area. Health officials have said the infection ultimately will be reported as a California case because the CDC counts cases of infectious disease by residence.

Wisconsin Gov. Jim Doyle declared a public health emergency after two more probable cases of swine flu were identified in Wisconsin Thursday.

In a news release Thursday, Dr. Joann Schaefer also said two more probable cases in Nebraska have been detected.

Thirty-nine Marines were confined to their base in California after one came down with the disease. The WHO has raised the total number of confirmed cases worldwide to 236.

And a pediatrician in Washington state saw 22 patients with flu-like symptoms before she developed serious symptoms and went to the emergency room.

The Pennsylvania Department of Health says it continues to find people who it considers to be probable swine flu cases. It is investigating three new possible cases.

Illinois health officials say the number of probable swine flu cases in the state has more than doubled to 41.

Virginia officials say they have turned up two confirmed cases of swine flu in the state. In both cases, the patients – who have since recovered – had traveled to Mexico.

A security aide helping with arrangements during President Barack Obama’s recent trip to Mexico became sick with flu-like symptoms and three members of his family later contracted probable swine flu, the White House said Thursday.

The disclosure from press secretary Robert Gibbs comes days after the White House played down risks to the U.S. delegation on the two-day trip that started April 16. Gibbs remained steadfast that the president was never at risk of contracting the flu, which has quickly spread across the globe.

It was also learned that a Mexican toddler who visited Texas with his family and died Monday night in Houston, spent a day with his family shopping at a huge Houston indoor mall the day before he began to show symptoms, said Cameron County Judge Carlos Cascos, who interviewed the boy’s family.

Slippery Rock University will hold a separate graduation for 22 students who recently returned from Mexico.

So far, the students are in good health, but school officials fear they could have been exposed to the swine flu. Commencement falls in the middle of an incubation period during which the students have been advised to limit contact with others.

The students were in Mexico completing their student-teacher requirements. The flu’s spread prompted schools to close there and the students returned Tuesday, two days early. Saturday’s ceremony for the students will be private. In all, the school is awarding more than 1,300 diplomas.

Meanwhile, the World Health Organization said it plans to no longer call the deadly flu “swine flu” to avoid confusion over the risk from pigs and eating pork. Health officials have stressed repeatedly that the disease is being transmitted human to human and that there is no risk from eating pork.

WHO spokesman Dick Thompson says the name change comes after the agriculture industry and the U.N. food agency expressed concerns that the term “swine flu” was misleading consumers and needlessly causing countries to order the slaughter of pigs.

He told reporters in Geneva “we’re going to stick with the technical scientific name H1N1 influenza A.”

Several countries have put a ban a pork imports. Egypt went as far as to slaughter several thousand pigs, and hog futures fell for the sixth time in seven sessions on Thursday because of continued speculation that people will stop eating pork.

On Wednesday, the WHO boosted its alert level to one level below a full-fledged pandemic. The new Phase 5 alert, indicating a pandemic could be imminent as the virus spread further in Europe, prompted Mexico to announce the partial May 1-5 shutdown, Mexican Health Secretary Jose Cordova said late Wednesday.

“It’s a mixed pattern out there,” Fukuda said. “What’s happening in one part of the country is not necessarily what’s happening in another part of the country.”

The virus, a mix of pig, bird and human genes to which people have limited natural immunity, has also spread to Canada, New Zealand, Britain, Spain, Israel and Austria.

The U.S., the European Union and other countries have discouraged nonessential travel to Mexico. Some countries have urged their citizens to avoid the United States and Canada as well. Health officials said such bans would do little to stop the virus.

WASHINGTON — A security aide helping with arrangements during President Barack Obama’s recent trip to Mexico became sick with flu-like symptoms and three members of his family later contracted probable swine flu, the White House said Thursday.

The disclosure from press secretary Robert Gibbs comes days after the White House played down risks to the U.S. delegation on the two-day trip that started April 16. Gibbs remained steadfast that the president was never at risk of contracting the flu, which has quickly spread across the globe.

The employee, who was not named by the White House, is an aide to Energy Secretary Steven Chu and helped plan security for part of the administration’s Mexico trip.

“This individual never flew on Air Force One,” Gibbs said. “He was asked specifically if he ever came within 6 feet of the president, and the answer to that was no.”

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The aide arrived in Mexico on April 13, Gibbs said, and became ill on April 16. He developed a fever on April 17, the day Obama left Mexico for the Summit of the Americas in Trinidad and Tobago. The person in question flew back commercially to Dulles on a United flight on April 18; Gibbs had no details yet on whether people on that flight have been notified.

“Obviously we’ll do everything in our power to ensure that what can be done to alert them will be done,” he said.

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The man visited his brother on April 19 and his nephew became ill. In the next two days, the aide’s wife and son also became ill, Gibbs said.

Gibbs said the three members of the aide’s family are being tested to see if they had the same strain of swine flu that is threatening to become a pandemic. More than 100 cases have been confirmed within the United States.

Gibbs said the aide is listed as a suspected case of the virus. He returned to work on Thursday.

“The original patient tested negative likely because so much time had elapsed since the onset of his own symptoms that they would not show up in the test,” Gibbs said.

“All four individuals experienced only mild symptoms, and all four have recovered,” he said.

The aide worked on Chu’s security detail and went ahead to prepare for the trip. He attended a dinner with Obama on April 16 but Gibbs said the aide never was close enough to Obama to put the president at risk.

Obama has had no symptoms of the virus and doctors see no need to conduct any tests on his health, Gibbs said.

He also said the energy secretary hasn’t experienced any symptoms.

Asked about others involved in the U.S. delegation to Mexico City, Gibbs said no one else has gotten sick.

The White House declined to release the aide’s identity, citing privacy concerns.

More than 100 schools from New York to California have closed down affecting 65,000 students as health and government officials raced to stop the spread of swine flu.

Swine flu continued its spread across the United States Thursday, with at least 109 cases confirmed in more than a dozen states.

Meanwhile, the World Health Organization said it plans to no longer call the deadly flu “swine flu” to avoid confusion over the risk from pigs and eating pork. Health officials have stressed repeatedly that the disease is being transmitted human to human and that there is no risk from eating pork.

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WHO spokesman Dick Thompson says the name change comes after the agriculture industry and the U.N. food agency expressed concerns that the term “swine flu” was misleading consumers and needlessly causing countries to order the slaughter of pigs.

He told reporters in Geneva “we’re going to stick with the technical scientific name H1N1 influenza A.”

Several countries have put a ban a pork imports. Egypt went as far as to slaughter several thousand pigs, and hog futures fell for the sixth time in seven sessions on Thursday because of continued speculation that people will stop eating pork.

Among the U.S. cases confirmed by the Centers for Disease Control and Prevention are 51 in New York, 16 in Texas and 14 in California, as well as scattered cases in Kansas, Massachusetts, Michigan, Arizona, Indiana, Nevada, Ohio, Maine and South Carolina.

On Thursday, state officials confirmed cases in Minnesota, Georgia, New Jersey and Colorado.

Nebraska’s chief medical officer says federal tests have confirmed the first case of swine flu in the state. It involves a California man in his 40s who’s vacationing in the Omaha area. Health officials have said the infection ultimately will be reported as a California case because the CDC counts cases of infectious disease by residence.

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In a news release Thursday, Dr. Joann Schaefer also said two more probable cases in Nebraska have been detected.

Thirty-nine Marines were confined to their base in California after one came down with the disease. The WHO has raised the total number of confirmed cases worldwide to 236.

About 100 of the nation’s 132,000 schools have closed. But they include schools on both coasts and in the nation’s heartland, and more are likely to shut their doors in coming days. Texas officials just suspended all public high school sports — smack in the middle of baseball season.

Of particular concern is New York City’s outbreak, with 51 confirmed cases and tests under way on three probable ones outside the city. City Health Commissioner Thomas Frieden said Wednesday that all those with confirmed cases are recovering, but two more city schools closed because of suspected cases — in addition to a Queens Catholic school with a large outbreak.

Mayor Michael Bloomberg said the city plans to announced new cases Thursday.

It was also learned that a Mexican toddler who visited Texas with his family and died Monday night in Houston, spent a day with his family shopping at a huge Houston indoor mall the day before he began to show symptoms, said Cameron County Judge Carlos Cascos, who interviewed the boy’s family.

In response to an intensifying outbreak in the United States and internationally caused by a new influenza virus of swine origin, the World Health Organization raised the worldwide pandemic alert level to Phase 5 on April 29, 2009. A Phase 5 alert is a “strong signal that a pandemic is imminent and that the time to finalize the organization, communication, and implementation of the planned mitigation measures is short.”

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The United States Government has declared a public health emergency in the United States. CDC’s response goals are to reduce transmission and illness severity, and provide information to help health care providers, public health officials and the public address the challenges posed by this emergency. CDC is issuing and updating interim guidance daily in response to the rapidly evolving situation. CDC’s Division of the Strategic National Stockpile (SNS) continues to send antiviral drugs, personal protective equipment, and respiratory protection devices to all 50 states and U.S. territories to help them respond to the outbreak. The swine influenza A (H1N1) virus is susceptible to the prescription antiviral drugs oseltamivir and zanamivir. In addition, the Federal Government and manufacturers have begun the process of developing a vaccine against this new virus.

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The World Health Organization says the outbreak of swine flu in North America has “pandemic potential” because it can spread from human to human.

What flu pandemics are and how they might be stopped or slowed down:

— New forms of flu virus often appear first in livestock, particularly poultry and pigs. The vast majority of these animal viruses do not cross over to humans.

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— Flu pandemics occur when a strain of the flu virus mutates into a new form that can spread from human to human and to which people have no natural immunity.

— The new strain will most likely spread through the air, by coughing and sneezing in the same way as seasonal flu.

— Because there is no widespread immunity to the new strain, its effects are worse than normal flu. It is also difficult to predict which age groups will be worst hit by a pandemic strain.

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— Until now, scientists have been most concerned the H5N1 bird flu would mutate into a pandemic strain. Since 2003, over 100 people have contracted a deadly strain of H5N1 and more than half of them have died. So far this strain does not appear to spread easily from human to human.

— Flu pandemics usually occur a couple of times each century, but the timing is unpredictable. Serious pandemics occurred in 1918 (Spanish influenza); 1957 (Asian influenza); and 1968 (Hong Kong influenza). According to WHO, the 1918 pandemic killed between 40 million and 50 million people worldwide, making it one of the deadliest epidemics in human history.

— Once a full-scale pandemic breaks out, WHO will raise its alert level to phase six.

— Countries may take measures such as border closures and travel restrictions to delay arrival of the pandemic, but would probably not be able to stop it.

— Widespread air travel means a pandemic would likely circle the globe in the space of three months, according to WHO.

— Most countries would not have enough supplies of anti-viral drugs to treat the entire population. A vaccine would also not be available immediately, and production of sufficient quantities would take some time. Rich countries would likely fare better than poor because they are able to buy large quantities of precious medicines at asking price.

— One of the biggest problems during a pandemic would be treating the large numbers of people who fall ill. Hospital staff would also be affected, reducing the number of health workers able to treat patients. For this reason many countries have declared that health workers would be the first to receive anti-virals.

— Death rates during a pandemic depend on the number of people infected, the vulnerability of the population, how lethal the virus is, and measures taken to stop the outbreak. WHO estimates that a pandemic would kill between 2 million to 7.4 million people, but these figures are based on modeling studies and are not considered precise.

— Aside from the health effects, economic damage would likely be one of the worst effects of a pandemic as workers stay at home and consumption and trade plummet.