Swine flu kills second person in US

A Texas woman with the new H1N1 flu died earlier this week, state health officials said on Tuesday, the second death outside of Mexico, where the epidemic appeared to be waning.

Officials said the woman, who was in her 30s, had other health problems. US health officials have predicted that the swine flu virus would spread and inevitably kill some people, just as seasonal flu does.

Last week a Mexican toddler visiting Texas also died. Mexican officials have reported 29 confirmed deaths.

The World Health Organisation was monitoring the spread of the virus and said 21 countries have officially reported 1490 cases. The United States has 403 confirmed cases in 38 states, the US Centers for Disease Control and Prevention said, with another 700 "probable" cases. Canada has reported 165 cases.

"Those numbers will go up, we anticipate, and unfortunately there are likely to be more hospitalisations and more deaths," US Health and Human Services Secretary Kathleen Sebelius said.

Health officials said the outbreak seemed to be slowing in Mexico, the country hardest-hit by the virus, which is a mixture of swine viruses and some elements of human and bird flu. At the same time, infections were breaking out globally and are expected to spread.

Trade skirmishes over pork worsened, with some countries imposing new restrictions, despite assurances by the United Nations Food and Agriculture Organisation that pork, especially cooked pork, was safe to eat.

The question remained how far the virus would spread and how serious it would be. The WHO remained at pandemic alert level 5, meaning a pandemic is imminent.

"If it spreads around the world you will see hundreds of millions of people get infected," the WHO's Dr Keiji Fukuda told a news briefing.

If it continues to spread outside the Americas, the WHO would likely move to phase 6, a full pandemic alert. This would prompt countries to activate pandemic plans, distribute antiviral drugs and antibiotics and perhaps advise people to take other precautions like limiting large gatherings.

"It's not so much the number of countries, but whether the virus sets up shop in any of those countries like it has here and starts to spread person to person. And given the number of countries that have cases, one would think that eventually that criteria would be met," said acting CDC director Dr Richard Besser.

He and Fukuda said it would be important to watch the Southern Hemisphere, where winter and the flu season are just beginning.

Other pandemics have started with a mild new virus in spring that has come back to cause severe disease later in the year. WHO said it would begin sending 2.4 million treatment courses of Roche AG's and Gilead Sciences Inc's Tamiflu, an antiviral proven effective against the new flu, to 72 nations, including Mexico.

Fukuda said the WHO was still trying to answer the most pressing questions, including why more people have died in Mexico than anywhere else.

"More people have had mild illness than have had severe illness," Fukuda said. "The reasons for that are not clear. I don't think it reflects differences in treatment."

Most of those who have become ill with the new flu, including in Mexico, have recovered with little or no treatment.

The CDC eased recommendations for closing schools in the United States when children or teachers had infections, but advised parents to keep sick children at home to prevent further spread.

Fukuda said it was too soon to say whether a new H1N1 vaccine was needed, but scientists have started to make one. US vaccine experts said it would probably be given as two doses, separately from the seasonal flu vaccine.

Mexico began to return to normal, but a five-day lockdown ordered by the government to try to slow the influenza's spread cast a pall on the normally exuberant Cinco de Mayo celebrations.

Mexican Finance Minister Agustin Carstens said the outbreak could knock as much as half a percentage point off growth this year.

"It's having a big impact on our economy," Carstens said. Mexico was already in recession due to a collapse in US-bound exports. Now its tourism industry is being savaged.

H1N1 continued to spark trade and diplomatic quarrels.

An AeroMexico plane picked up dozens of Mexicans stranded in China after they were quarantined there. Mexican President Felipe Calderon condemned the measure as discrimination against his compatriots.

Singapore also issued orders to quarantine sick travellers.

Mexico told the World Trade Organisation it was "deeply disappointed" by what it called "divisive measures" applied by some WTO members against its pork products.

"Mexico urgently requests all its trading partners to eliminate any restrictive measures established on Mexican products, which are not in accordance with the scientific information available," the government said.

US and Canadian pig and pork exports have also been hit by bans from Russia to Ecuador that rattled the $US26 billion-a-year global pork industry, in which Mexico, the United States and Canada are among top exporters.

-Reuters