MEXICO CITY (AP) — Swine flu extended its reach through Europe and Latin America, with at least five countries reporting new cases on Sunday. Health experts were investigating a case of the virus jumping from a person to pigs, trying to determine if the disease was reaching a new stage.
Hong Kong kept 350 people under quarantine in a hotel as a precaution even though no new swine flu infections appeared in Asia.
So far the swine flu epidemic has killed 19 in people in Mexico and one toddler in the U.S. and has spread to 18 countries worldwide — but experts believe the actual spread is much wider.
Mexico's health secretary said 11 people were suspected to have died from the virus in the previous 24 hours. The alarming news came after the epidemic's toll in Mexico appeared to have been leveling off.
The global caseload was nearing 800 and growing — the vast majority in Mexico, the U.S. and Canada. Colombia on Sunday reported South America's first confirmed case of swine flu a day after Costa Rica reported the first in Central America.
The Spanish Health Ministry said the country now has 20 confirmed cases of swine flu — making it the European nation hardest hit by the virus.
But just over a week into the outbreak, the virus largely remains an unpredictable mystery.
Hong Kong — which was criticized for delaying quarantine measures during the SARS outbreak — sealed the downtown Metropark Hotel, where a sickened Mexican tourist had stayed, trapping 350 guests and employees inside.
About a half dozen police officers wearing masks guarded the hotel Sunday, even though all those at the hotel were reported to be healthy. One guest said he walked on the stairs for exercise and to alleviate boredom.
"It's highly inconvenient. That's what's affecting people, because it took us by surprise," said 45-year-old Kevin Ireland, who was on a business trip from New Delhi, India.
Scientists warn that the virus could mutate into a deadlier form.
"Influenza is unpredictable," said Dr. Tim Uyeki, an epidemiologist at the U.S. Centers for Disease Control and Prevention who has worked on SARS and H5N1 bird flu outbreaks. "There are so many unanswered questions. This is a brand new virus. There's so much we don't know about the human infectious with this virus."
Right now, one of the biggest hurdles is a lack of information from Mexico. A team of international and Mexican virus sleuths is trying to piece together an epidemiological picture of who's dying and where transmission began, while also uncovering just how it's attacking people with severe illness. But details are emerging slowly.
Late Saturday, Mexico's confirmed swine flu cases jumped by about 25 to 473, including the 19 deaths. A Mexican toddler also died in Texas days ago, for a worldwide total of 20.
President Barack Obama urged caution.
"This is a new strain of the flu virus, and because we haven't developed an immunity to it, it has more potential to cause us harm," Obama said. Later, he spoke with Mexican President Felipe Calderon to share information.
Pablo Kuri, a Mexican epidemiologist, said three of the dead were children: a 9-year-old girl, a 12-year-old girl and a 13-year-old boy. Four were older than 60. The other nine were between 21 and 39 — unusual ages for people to die from flu because they tend to have stronger immune systems.
Although most of the dead were from the Mexico City area, they came from different neighborhoods in the metropolis of 20 million, and there were no similarities linking their medical backgrounds.
One theory for the deaths is that perhaps they sought treatment too late — falling sick an average of seven days before seeing a doctor. Many of the sick around the world were people who had visited Mexico, including 13 of Britain's 16 cases.
The World Health Organization earlier announced that a pandemic was imminent, but it has decided against declaring a full pandemic alert. Still, that doesn't mean people can relax, said Dr. Mike Ryan, WHO's global alert and response director.
"These viruses mutate, these viruses change, these viruses can further reassort with other genetic material, with other viruses," he said. "So it would be imprudent at this point to take too much reassurance" from the small number of deaths.
In the Canadian province of Alberta, health and agriculture officials said about 220 pigs on a farm were quarantined after being infected by a worker who had recently returned from Mexico. They stressed that swine viruses are common in pigs, and there was no need for consumers to stop eating pork as long as it's handled properly and cooked thoroughly.
The pigs are all recovering in the first documented case of the H1N1 human flu being passed to another species.
In Baghdad, Iraqi officials killed three wild boars at Baghdad's zoo because of swine flu fears, even though health experts say the virus is not transmitted by pigs. Iraq has no documented cases of swine flu.
Associated Press writers Juan Carlos Llorca and David Koop in Mexico City contributed to this report.
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