Mexico flu death toll rises

WHO says up to 2 billion could be infected

FLU MEASURES IN MEXICO: Women wearing protective masks carry a bucket of water to clean classrooms as part of their school's disinfection programme in Monterrey, northern Mexico.

Future of H1N1 unclear

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Mexico has confirmed two more deaths from the new H1N1 flu virus pushing the country's toll to 44.

The swine flu virus is spreading slowly in Europe, but China has eased quarantine measures.

The World Health Organisation said up to 2 billion people could be infected by swine flu if the current outbreak turned into a pandemic lasting two years.

WHO flu chief Keiji Fukuda said the historical record of flu pandemics indicates one-third of the world's population gets infected in such outbreaks. Independent experts agreed that the estimate was possible but pointed out that many would not show any symptoms.

But the Mexican government says the worst is over and millions of high school and university students returned to classes as the country got back on its feet after shutting public places last week to avoid spread of the disease.

The new flu, a mixture of swine viruses with elements of human and bird flu, has taken the world to the brink of a pandemic and stoked trade and diplomatic tensions, as China and some other nations quarantined Mexican citizens and products.

Global health officials, who hope their warnings have helped brake the disease's spread, debated whether the swine flu was spreading enough to justify calling it a pandemic.

The Netherlands confirmed a second case of the virus, in a 53-year-old woman who had been in Mexico.

The United States has 896 confirmed cases of the new H1N1 flu in 41 states, the Centers for Disease Control and Prevention said.

Mexico raised its confirmed death toll from the swine flu outbreak to 44 from 42 as results from labs came in of people who had died earlier in the outbreak.

After a five-day business shutdown, the government has let bars, cinemas, restaurants and workplaces reopen.

But visitors to government-run buildings were asked to wear surgical masks and wash their hands with anti-bacterial soap before entering. Restaurants also sanitized diners' hands as they arrived.

"It's obviously a worry for us that after we allow many activities people can forget the (health) recommendations," Health Minister Jose Angel Cordova said.

H1N1, which has killed a woman and a child in the United States but no one else outside Mexico, has reached 24 countries and infected more than 2,000 people, according to data from the World Health Organisation and national authorities.

Sweden and Poland confirmed their first cases on Wednesday.

China began lifting a seven-day quarantine for passengers who had arrived on a flight from Mexico City which included a man who tested positive for H1N1, the Health Ministry said.

The dozens of Mexicans had been caught up in a wider drama about how far governments should go to try to keep the virus from creeping across their borders.

BACK TO NORMAL

Mexicans were relieved to get back to normal.

"It's wonderful," said Ana Maria Ramos, an artist visiting the capital's newly reopened National Anthropological Museum.

While high schools and universities in Mexico that were closed by the epidemic reopened on Thursday, many younger students won't return to class until Monday.

The WHO now finds itself in a bind about how to respond to the spread of a virus whose effects have proved mainly mild.

The UN agency's guidelines state that as soon as the virus starts spreading freely in two regions of the world, its six-point pandemic alert should be raised to the top notch.

With infection numbers rising in Europe, public health experts are struggling to decide whether it is worth sounding the full alarm over H1N1, which is treatable with existing drugs and appears less severe than seasonal flu in most cases.

"It is a judgment call," one WHO official said.

The new virus has confused doctors because it appears to act like common flu but has also killed some young and apparently healthy adults in Mexico. Influenza normally has a much higher death rate for the old, very young and frail.

WHO experts will meet next week to consider whether vaccine makers should switch from seasonal to pandemic flu production in response to the new H1N1 strain.

The flu has prompted around 20 nations to ban imports of pigs, pork and meat products from Mexico, the United States and Canada, which in protest have urged the world not to use the crisis as a reason to create "unnecessary trade restrictions."

"Eating pork is not a danger in terms of getting this infection," Dr Keiji Fukuda, acting WHO assistant director-general, told a news conference in Geneva.

WHO said on Wednesday meat from pigs infected with the new H1N1 virus should not be eaten by humans.

- Reuters