Flu alert raised as first death in U.S. is reported in Texas

A global swine-flu pandemic is likely, the World Health Organization (WHO) said Wednesday as it raised its alert level to Phase 5, the next-to-highest level in the worldwide warning system.

Phase 5 never has been declared before. Phase 6 means a pandemic is under way. WHO said its decision was based on the continuing spread of swine flu in the United States and Mexico, particularly the increasing numbers of unexplained cases.

"All countries should immediately activate their pandemic-preparedness plans," Dr. Margaret Chan, director-general of WHO, said in Geneva. "Countries should remain on high alert for unusual outbreaks of influenza-like illness and severe pneumonia."

The first death from swine flu in the United States — of a 23-month-old child from Mexico who was being treated in Houston — was reported Wednesday, along with more infections and hospitalizations. The Centers for Disease Control and Prevention (CDC) reported nearly 100 confirmed cases from 10 states, up from 64 cases in five states Tuesday.

State officials in Maine said laboratory tests had confirmed three cases in that state, not included in the CDC count. In addition, there were suspected cases in Washington, Louisiana and Delaware.

The total in Canada rose to 19, from 16. In Mexico, more than 150 people are suspected to have died from the illness, and almost 2,500 are thought to have been infected.

Chan emphasized the need for calm, but spoke as if a pandemic had begun. She also emphasized that flu epidemics tended to take much higher death tolls in poor countries than in rich ones and said her organization and others would need to make special efforts to help poorer nations.

More hospitalizations and deaths are expected in the United States, the CDC Web site said, because the virus is new and most people have no immunity to it.

Dr. Richard Besser, acting director of the CDC, said officials had no way of predicting whether the outbreak would become more serious. "You don't know if this is a virus that will fizzle in a couple of weeks or one that will become more or less virulent or severe in the diseases it causes," Besser said.

He said officials must follow government plans for a pandemic because of that unpredictability.

Some experts, meanwhile, said the current outbreak may not do as much damage as the run-of-the-mill flu outbreaks that occur each winter.

"Let's not lose track of the fact that the normal seasonal influenza is a huge public-health problem that kills tens of thousands of people in the U.S. alone and hundreds of thousands around the world," said Dr. Christopher Olsen, a molecular virologist who studies swine flu at the University of Wisconsin School of Veterinary Medicine in Madison.

In a typical U.S. flu season, between 5 percent and 20 percent of the population becomes ill and about 36,000 people die.

Nonetheless, much of the world was taking drastic — and some said debatable — measures. Egypt on Wednesday ordered all 300,000 pigs in the country be slaughtered, even though there have been no swine-flu cases there and there is no evidence pigs have spread the disease. Britain, with five cases, is trying to buy 32 million masks even though their protective effects against flu are unproven.

Material from The Associated Press and Los Angeles Times is included in this report.