Unfortunately, we do not all get to welcome spring with the same feeling of joy… For some of us, the spring months mean the arrival of certain allergies. Pollen the powder found in flowers, is the number one cause of this situation. A spring allergy manifests itself in such symptoms as a runny nose, constant sneezing, watery eyes, itchy and inflamed skin, coughing, difficulty breathing and a wheezy chest.

Dr. İlkay Keskinel from the Department of Pulmonary Diseases at Memorial Suadiye Medical Centre describes allergies as “the body’s acute reaction to environmental factors that are not considered harmful”.

The substance that causes allergic reactions in people who are susceptible is called an ‘allergen’. In people with a genetic tendency, environmental factors can bring on an allergic reaction.

Pollen allergies

In springtime, the wind carries pollen through the air, spreading it over a large area. This powder is in fact the male seeds of plants. Generally speaking, the large pollen in colorful fragrant flowers is transported by insects that are attracted to the plants. As it is not dispersed in the air, it is unlikely to cause allergies. But small pollens, because they are carried in the wind, can cause an allergic reaction in people situated miles away from the actual plant.

Lecturer Prof. Dr. Ahmet Rasim Küçükusta from the Department of Pulmonary Diseases at Cerrahpaşa Faculty of Medicine states that pollens from trees such as alder, hazelnut, olive and poplar and from plants like timothy grass, mugwort, barley, wheat, oat and rye are the most allergenic.

Allergies tend to be caused by tree pollens from February to May, plant pollens between May and June, and weed pollens from mid-summer until autumn. The amount of pollen in the air is greater in the morning. People suffering from pollen allergies are more at ease on rainy days as a result of reduced levels of pollen in the air, while the diffusion of pollen increases on hot and windy days.

Hay fever

Pollen can trigger symptoms of hay fever (allergic rhinitis). Patients suffering from hay fever may think they are experiencing a microbial respiratory tract infection. If symptoms persist for more than 1-2 weeks, one should see a doctor. The first step in protecting oneself against hay fever is to find out which type of pollen one is allergic to. This is done through quick, easily administered skin tests and sometimes blood tests. Once the cause of the allergy is determined, the patient needs to stay well clear of it. Anti-allergy medications may be used in treatment. When appropriate, treatment with injections may also help in reducing symptoms.

Asthma in spring

Asthma is a chronic disease that occurs as a result of the tightening of our airways, the bronchi, in reaction to certain stimuli. Both environmental and genetic factors cause asthma. There are many different types of asthma but the two main types are allergic asthma and non-allergic asthma.

Asthma, whose symptoms include shortness of breath, coughing, phlegm expectoration and chest tightness, can often be triggered during springtime by the increase of pollen in the air. Complaints from asthma patients suffering from pollen allergies can increase in the weeks or months during which the pollen to which they are allergic is most prevalent.

The main characteristic of allergic asthma is that the patient is sensitive to one or more allergens (like mites. domestic pets, pollens and moulds). The level of a patient’s sensitivity can be shown with an IgE measurement through skin or blood tests. The first symptoms of allergic asthma are generally experienced during childhood. Allergic rhinitis, eczema, allergy to medication. food allergies and other allergies are commonly found in the patient or their family. Allergic asthma responds well to treatment through medication and injections. The medication used for treating such patients may need to be altered during the spring months.

Beware of cross-allergies!

Some people are allergic to pollen. These people may have an allergic reaction to plants in the same family as the plants they are sensitive to. This is called a ‘cross-allergy’. For example, people who are allergic to pollen produced by the birch tree may experience itching in their lips and palate when eating apples, pears, carrots celery and tomatoes.

Where to escape from immediately?

In streets lined with tall buildings, the surface of the buildings attracts pollen because of static energy. On the other hand, very little pollen is found by the sea. Much research shows that air pollution increases peoples’ sensitivity to pollen. People living in areas where traffic is heavy and where they are exposed to diesel particles and polyaromatic hydrocarbons (PAH) develop sensitivity to pollen more easily.

Allergy skin tests

Dr. Küçükusta states that the most common method of diagnosis for allergic diseases is skin tests. The allergens to which the patient is sensitive can be ascertained through these tests. Allergy skin tests are a simple, reliable, quick, easily repeatable, low-cost form of diagnosis. These tests should be administered and read by people who have been trained and are experienced in this field.

Before testing is performed, detailed information is obtained from the patient about their illness. Information about allergens that the patient may be exposed to, factors causing their symptoms, the patient’s occupation. Hobbies, household pets and types of pollen found in the area in which they live must be obtained from the patient.

Skin tests are carried out either on an area of the back or on the inside of the forearm. There are two main procedures performed for skin tests. Scratch test [epidermal): A drop of allergen is dripped onto the skin and the skin is then either pricked with a special needle or scratched to allow the allergen to get under the skin’s surface. Intradermal test; the allergen is directly injected under the skin with the use of a thin needle.

Allergy shots

Treatment through allergy shots, or immunotherapy, is the most basic form of treatment against allergies. In immunotherapy, injections of the allergen to which the patient is sensitive are administered in gradually increasing doses. This method does not involve the injection of any type of medication.

Dr. Küçükusta states that immunotherapy is the treatment needed for allergic rhinitis. Many changes occur in the immune system of patients on whom this treatment is performed. Thanks to this, aside from desensitizing the patient to certain allergens, the allergic inflammation in the nose also regresses. As a result, this also relieves the symptoms of rhinitis (runny nose) and reduces relapses, eliminating the patient’s need for medication.

The effect continues post-treatment and lasts for many years or even a lifetime. The success rate is much higher for children, adolescents and in cases where treatment is performed early on in the disease. As well by injection, the treatment can also be introduced into the body orally or in the form of nose drops. The best results are seen in patients between five and 50 years old.

Alternative medical practices that remain outside of classical Western medicine are commonly tried throughout the world. They are increasingly in demand, in spite of all the scientific and technological advances and the miracles worked by medicine. The characteristics of these practices, which are generally called ‘alternative medicine’, can vary widely according to countries’ geographic location and cultural substructure. As for their general features, instead of practices based in scientific proof, as In the case of classical medicine, they usually have roots in folklore; some are learned through master-apprentice relationships and some are formulas that are passed down from generation to generation. Experts stress that whilst alternative methods can be deemed safe administered in the right doses, according to guidelines dictated by the Ministry of Health and under the supervision of a doctor, they can be life-threatening in the hands of ignorant or self-seeking people.

Cardiology specialist Dr. Nevrez Koylan answered our questions on this sensitive topic.

Why do people feel a need for alternative treatments?

People have both negative and positive motivations for opting for alternative treatments. Among the negative motivations are: being unhappy with health practices and medical results; the side effects of medicines and treatments; peoples’ wish to have the final word on their own health (wanting to be free of doctors domination); the overuse of medical technology; and the fact that going to the doctor is time-consuming. The reasons that make these treatments attractive are: the hope of having a full recovery from chronic diseases; the wish to use ‘natural’ products; feeling strong as a person; and the feeling of mental and emotional weli-being.

How much can alternative medicine be trusted?

It is very helpful to divide the topic of reliability into several main sections. The first is the issue of separating alternative medicine from complementary and integrative medicine. The term alternative medicine comes from an understanding that completely rejects existing Western medicine and replaces it with entirely different systems such as Chinese medicine or Native American-shamanistic medicine.

Whereas the terms complementary and integrative medicine should refer to treatments that support existing medical practice. In such practices as herbal remedies or manual treatment, it is useful to correctly evaluate whether the therapy is complementary or alternative. At this point, the dangers of alternative or complementary medicine need to be split into two. The first is direct harm. Which can be the toxic effect of a prescribed herbal remedy, the emergence of new injuries following manual treatment by inexperienced and untrained individuals (the most typical example of which would be Injuries caused by bonesetters) or situations where complementary treatments replace real treatments.

Causing medical treatment to be abandoned altogether. As for indirect harm, it is harm caused to a person without directly resulting in illness. Examples of this are over-reliance on alternative or complementary medicine and, as a result, spending large amounts of money on useless procedures and treatments, the weakening of the immune system through unfounded diets, and mental health breakdowns resulting from placing too much faith in religious healers or Indian medicine, reiki, hypnotism and similar practices.

For these reasons, the most important thing is to never abandon medical treatment and for alternative and complementary therapies to be carried out under the guidance of a trained and informed expert. In many countries complementary and integrative medical practitioners carry out these treatments under the supervision of the health authority and again with certificates obtained from that authority. Unfortunately we are very far from having that in our country.

Should alternative medicine be monitored?

The most effective way to deal with this issue is for the health authority to step in and monitor such practices by determining training and certification standards in the light of scientific data, neither rejecting nor encouraging such therapies. The absence of such an intervention leaves the field open to people who claim to come from China and hang indecipherable Chinese writing on walls around the room, people from Central Asian countries who carry out meaningless rituals saying they are ‘using bio energy”. Underground ozone therapy centres, religious healers and bonesetters.

How right is it for alternative medicine to be a competitor to medical and surgical methods for the treatment of chronic diseases?

Of course it is not. In the case of chronic diseases, one should only make use of the additional benefits of complementary and integrative treatments within certain restrictions. And then only under the guidance of a specialist in that field. There are very beneficial modalities available, provided they are used in the right place and in the right way; these can noticeably improve the quality of life and speed up recovery, if used responsibly.

2 . Overeating
It causes hardening of the brain arteries, leading to a decrease in mental power.

3. Smoking
It causes multiple brain shrinkage and may lead to Alzheimer disease.

4. High Sugar consumption
Too much sugar will interrupt the absorption of proteins and nutrients causing malnutrition and may interfere with brain development.

5. Air Pollution
The brain is the largest oxygen consumer in our body. Inhaling polluted air decreases the supply of oxygen to the brain, bringing about a decrease in brain efficiency.

6. Sleep Deprivation
Sleep allows our brain to rest. Long term deprivation from sleep will accelerate the death of brain cells.

7. Head covered while sleeping
Sleeping with the head covered increases the concentration of carbon dioxide and decrease concentration of oxygen that may lead to brain damaging effects.

8. Working your brain during illness
Working hard or studying with sickness may lead to a decrease in effectiveness of the brain as well as damage the brain.

9. Lacking in stimulating thoughts
Thinking is the best way to train our brain, lacking in brain stimulation thoughts may cause brain shrinkage. Crosswords and Sudoku provide good exercises.

10. Talking Rarely
Intellectual conversations will promote the efficiency of the brain.

We will cover what the condition entails, and discuss different ways to treat the ailment. As always, discuss your options with your doctor before beginning any new treatment regimen.

It is important to understand what Eczema actually is. The term Eczema is actually a blanket one that covers a variety of different skin inflammations. The most common type of Eczema is actually Atopic Dermatitis. This affects children, and usually clears up with age.

Atopic Dermatitis shows up most often in infancy and begins to lessen as the child ages. Eczema may vary from person to person, but usually entails dry, red, itchy patches of skin. The majority of the symptoms will come and go based on external factors.

Many doctors believe that Eczema is actually an abnormal response to the body?s immune system. While there is no current treatment for Eczema, there are a variety of medications aimed at controlling the severity and number of outbreaks.

The key to preventing outbreaks is proper moisturizing. This coupled with avoidance of triggers can help you prevent many Eczema outbreaks. To prevent Eczema you should try the following:

- Moisturize frequently
- Avoid sudden temperature changes
- Avoid overheating
- Reduce stress levels
- Avoid scratchy fabrics
- Avoid harsh soaps and detergents
- Avoid allergens

If you do experience an Eczema flair-up, there are a variety of different treatments that you can try. Many of which can be done at home with over the counter medications. If your case is more sever, you may want to go with stronger prescription medications and treatments. These include:

- Cold compresses
- Lotion applied after a bath
- Over the counter Corticosteroid creams and ointments
- Prescription creams and ointments
- Antibiotics- if it becomes infected
- Antihistamines- to reduce itching
- Prescription medications aimed at targeting immune responses

You will want to discuss your options with your doctor to make sure that you are getting the best possible treatment. It is recommended that you spend some time researching your options online, so that you can be better informed of the situation. Try doing a search using google, yahoo, msn, or one of the other search engines available. You should have no trouble finding lots of valuable information.

Eczema doesn?t have to be a life sentence. Even though there is currently no cure, there are many different treatment options that you have. By focusing on preventing outbreaks, you can live a relatively Eczema free life. If you have an infant or child that suffers from the condition, you can do a lot to keep them outbreak free. Moisturize frequently, and do your best to prevent them from scratching at their sores. Your doctor can give you an antihistamine if the itching becomes too severe.

These include dysfunctional conditions of the heart, arteries and veins that supply oxygen to life-sustaining areas of the body such as the brain, the heart itself and other vital organs.

These conditions can be caused by a buildup of fatty deposits in the arteries, elevated cholesterol, high blood pressure and poor circulation. Patients with cardiovascular disease are at increased risk for heart attacks, strokes and death.

A healthy diet and regular exercise are important steps in the prevention of cardiovascular disease. In addition, a new and complete heart health product has been developed that combines the known benefits of doctor-recommended, low-dose aspirin with heart health vitamins and other supplements.

These ingredients have been clinically shown to reduce the chances of heart attack and stroke, and may help lower blood pressure and cholesterol levels and help manage other cardio risk factors.

Called CardioEA™ Enhanced with Aspirin, each safety-coated caplet contains 81 mg of doctor-recommended, low-dose aspirin plus a complex of vitamins B6, B12, Folic Acid, L-Arginine and Aged Garlic Extract™ (AGE). It provides heart health-conscious consumers with the opportunity to help manage many of the risk factors that contribute to heart disease with a single daily caplet instead of taking various supplements and aspirin every day.

This is the first in a new category of preventive and wellness products called OTCeuticals™, manufactured by the Alan James Group, a health care-focused consumer products company based in Boca Raton, Florida.

OTCeuticals are vitamins, minerals, herbs and other supplements that are combined with FDA-monographed, Category 1 USP-grade ingredients in rational, safe, effective and convenient combinations.

In addition to CardioEA Enhanced with Aspirin, the Alan James Group’s OTCeuticals pipeline includes products for bone & joint and gastrointestinal health, among others.

CardioEA Enhanced with Aspirin is available in the vitamin section at most major supermarkets, chain drug and discount retailers.

What is new about this type of swine flu?

The World Health Organization has confirmed that at least some of the human cases are a never-before-seen version of the H1N1 strain of influenza type A.

H1N1 is the same strain which causes seasonal outbreaks of flu in humans on a regular basis.

But this latest version of H1N1 is different; it contains genetic material that is typically found in strains of the virus that affect humans, birds and swine.

Flu viruses have the ability to swap genetic components with each other, and it seems likely that the new version of H1N1 resulted from a mixing of different versions of the virus, which may usually affect different species, in the same animal host.

Pigs provide an excellent ‘melting pot’ for these viruses to mix and match with each other.

How dangerous is it?

Symptoms of swine flu in humans appear to be similar to those produced by standard, seasonal flu.

These include fever, cough, sore throat, body aches, chills and fatigue.

It is worth remembering that seasonal flu often poses a serious threat to public health: each year it kills 250,000 – 500,000 around the world.

So far, most cases of swine flu around the world appear to be mild, albeit with diarrhoea more common than it is with seasonal flu.

But lives have been lost in Mexico, and a single death – of a Mexican child – has been confirmed in the US.

How worried should people be?

When any new strain of flu emerges that acquires the ability to pass from person to person, it is monitored very closely in case it has the potential to spark a global epidemic, or pandemic.

The World Health Organization has warned that swine flu could potentially trigger a global pandemic, and stresses that the situation is serious.

However, experts say it is still too early to accurately assess the situation fully.

Currently, they say the world is closer to a flu pandemic than at any point since 1968 – upgrading the threat from four to five on a six-point scale following a meeting on Wednesday.

This means all governments have to mobilise their pandemic flu plans.

However, eight days after the first reports of swine flu cases in Mexico emerged, a World Health Organization official said there was as yet no evidence of the virus spreading in a sustained way outside North America.

Nobody knows the full potential impact of a pandemic, but experts have warned that it could cost millions of lives worldwide. The Spanish flu pandemic, which began in 1918, and was also caused by an H1N1 strain, killed millions of people.

There is hope that, as humans are often exposed to forms of H1N1 through seasonal flu, our immune systems may have something of a head start in fighting infection.

However, the fact that many of the victims are young does point to something unusual. Normal, seasonal flu tends to affect the elderly disproportionately.

Is Mexico different?

The death toll in Mexico – where the virus at present seems to producing much more severe symptoms – suggests there may be unusual factors coming into play there.

Some experts have suggested the possibility that other, unrelated viruses may also be circulating in Mexico, making symptoms worse.

This would be unlikely to come into play in the rest of the world.

Alternatively, people infected in Mexico may have sought treatment at a much later stage than those in other countries.

It may also be the case that the form of the virus circulating in Mexico is subtly different to that elsewhere – although that will only be confirmed by laboratory analysis.

The Mexican authorities have downgraded the official death toll from the virus, ordering a new round of more stringent tests.

Can the virus be contained?

The virus appears already to have started to spread around the world, and most experts believe that, in the era of readily available air travel, containment will be extremely difficult.

The World Health Organization says that restricting flights will have little effect. It argues that screening of passengers is also unlikely to have much impact, as symptoms may not be apparent in many infected people.

Can it be treated?

The US authorities say that two drugs commonly used to treat flu, Tamiflu and Relenza, seem to be effective at treating cases that have occurred there so far. However, the drugs must be administered at an early stage to be effective.

Use of these drugs may also make it less likely that infected people will pass the virus on to others.

The UK Government already has a stockpile of Tamiflu, ordered as a precaution against a pandemic.

However, there is concern that if too many people start taking anti-virals as a precaution, it could raise the risk of the virus developing resistance, reducing the drugs’ effectiveness.

What about a vaccine?

It is unclear how effective currently available flu vaccines would be at offering protection against the new strain, as it is genetically distinct from other flu strains.

A new bespoke vaccine is being worked on by scientists in the UK and the US, but it may take months to perfect it, and manufacture enough supplies to meet what could be huge demand.

A vaccine was used to protect humans from a version of swine flu in the US in 1976.

However, it caused serious side effects, including an estimated 500 cases of Guillain-Barré syndrome. There were more deaths from the vaccine than the outbreak.

What should I do to stay safe?

Anyone with flu-like symptoms who might have been in contact with the swine virus – such as those living or travelling in the areas of Mexico that have been affected – should seek medical advice.

But patients are being asked not to go into GP surgeries in order to minimise the risk of spreading the disease to others. Instead, they should stay at home and call their healthcare provider for advice.

Countries around the world have taken varying measures but are mostly stepping up monitoring and issuing advice about travel to Mexico.

In the UK, the Foreign Office is advising against all but essential travel to Mexico.

What measures can I take to prevent infection?

Avoid close contact with people who appear unwell and who have fever and cough.

General infection control practices and good hygiene can help to reduce transmission of all viruses, including the human swine influenza. This includes covering your nose and mouth when coughing or sneezing, using a tissue when possible and disposing of it promptly.

It is also important to wash your hands frequently with soap and water to reduce the spread of the virus from your hands to face or to other people and cleaning hard surfaces like door handles frequently using a normal cleaning product.

If caring for someone with a flu-like illness, a mask may be worn to cover the nose and mouth to reduce the risk of transmission. The UK is looking at increasing its stockpile of masks for healthcare workers for this reason.

In Mexico masks have been handed out to the general public, but experts are sceptical about how useful this is.

May it take some time for a pandemic to strike?

Possibly. The flu virus tends to thrive in cooler conditions, and to struggle in warmer weather.

The initial cases have developed right at the tail end of the winter flu season in the northern hemisphere, so it is possible that the number of infections may only begin to accelerate once the weather turns colder in the autumn.

However, the southern hemisphere is about to enter its winter season and it is possible that the virus will take hold there first.

Is it safe to eat pig meat?

Yes. There is no evidence that swine flu can be transmitted through eating meat from infected animals.

However, it is essential to cook meat properly. A temperature of 70C (158F) would be sure to kill the virus.

Experts are also stressing that this is now a disease which is being passed between people.

The World Organisation for Animal Health said culling pigs, as Egypt has proposed, was therefore “inappropriate” as a measure to stop swine flu spreading.

It added there was no evidence of infection in pigs, nor of humans acquiring infection directly from pigs.

What about bird flu?

The strain of bird flu which has caused scores of human deaths in South East Asia in recent years is a different strain to that responsible for the current outbreak of swine flu.

The latest form of swine flu is a new type of the H1N1 strain, while bird, or avian flu, is H5N1.

Experts fear H5N1 holds the potential to trigger a pandemic because of its ability to mutate rapidly.

However, it has so far remained very much a disease of birds.

Those humans who have been infected have, without exception, worked closely with birds, and cases of human-to-human transmission are extremely rare. There is no suggestion that H5N1 has gained the ability to pass easily from person to person.

Where can I get further advice?

Further information and advice on swine flu can be found at websites of leading health and research organisations around the world. The World Health Organisation gives background information on the virus.

The UK’s government services website is carrying regularly updated health and travel information. The Health Protection Agency advises the public about what to do if returning from an affected area. NHS Choices outlines how swine flu is different from other flu.

The US government’s Centre for Disease Control is counting the number of cases in the US.

You can also track the spread of swine flu reports using unofficial sources. Google is mapping search term data as an indicator of flu activity both across the US down to state level and in Mexico. Healthmaps maps viruses using news reports. Social media guide Mashable lists a range of ways to track the virus .

Information and links to useful websites are being shared on Twitter, the micro-blogging service, while social networking website Facebook is tracking swine flu discussion amongst users.

Further questions from our readers have been answered by a UK-based expert.

How swine flu outbreak emerged?

- Flu viruses mutate over time causing small changes to proteins on their surface called antigens. If the immune system has met a particular strain of the virus before, it is likely to have some immunity; but if the antigens are new to the immune system, it will be weakened.

- The influenza A virus can mutate in two different ways; antigenic drift, in which existing antigens are subtly altered, and antigenic shift, in which two or more strains combine. Antigenic drift causes slight flu mutations year on year, from which humans have partial, but not complete, immunity. By contrast, the new strain of H1N1 appears to have originated via antigenic shift in Mexican pigs

- The name “swine flu” is a slight misnomer as it is believed pigs acted as a mixing pot for several flu strains, containing genetic material from pigs, birds and humans. Most humans have never been exposed to some of the antigens involved in the new strain of flu, giving it the potential to cause a pandemic.

- The new virus has made the jump from pigs to humans and has demonstrated it can also pass from human to human. This is why it is demanding so much attention from health authorities. The virus passes from human to human like other types of flu, either through coughing, sneezing, or by touching infected surfaces, although little is known about how the virus acts on humans.

Swine flu – the basics

- Symptoms usually similar to seasonal flu – but deaths recorded in Mexico

- It is a new version of the H1N1 strain which caused the 1918 flu pandemic

- Too early to say whether it will lead to a pandemic

- Current treatments do work, but there is no vaccine

- Good personal hygiene, such as washing hands, covering nose when sneezing advised

Flu pandemics

- 1918: The Spanish flu pandemic remains the most devastating outbreak of modern times. Caused by a form of the H1N1 strain of flu, it is estimated that up to 40% of the world’s population were infected, and more than 50 million people died, with young adults particularly badly affected

- 1957: Asian flu killed two million people. Caused by a human form of the virus, H2N2, combining with a mutated strain found in wild ducks. The impact of the pandemic was minimised by rapid action by health authorities, who identified the virus, and made vaccine available speedily. The elderly were particularly vulnerable

- 1968: An outbreak first detected in Hong Kong, and caused by a strain known as H3N2, killed up to one million people globally, with those over 65 most likely to die.

Its most recent figures show 506 people have been infected in Mexico and 160 people have been infected in the United States, the two countries most affected by the virus widely known as swine flu. There has also been one U.S. death, identified by authorities there as a Mexican infant.

Earlier on Sunday, WHO had said there were 397 infections in Mexico and 16 deaths there. The U.N. agency said its figures changed because of “ongoing testing of previously collected specimens” and not new reported infections.

Mexico has revised down its estimate of as many as 176 suspected H1N1 deaths after receiving dozens of negative test results. Mexican authorities said on Saturday out of more than 100 suspected deaths from the strain, 19 have been confirmed.

The WHO has also confirmed flu infections, without deaths, in the following countries:
Austria (1),
Canada (70),
Hong Kong – China Region (1),
Costa Rica (1),
Denmark (1),
France (2),
Germany (6),
Ireland (1),
Israel (3),
Netherlands (1),
New Zealand (4),
South Korea (1),
Spain (13),
Switzerland (1),
Britain (15).

Mexico was approved for $3 billion in international loans to fight the swine flu crisis, as the country began a five-day shutdown on Friday to try to halt the spread of the virus. As nations worldwide stepped up safety measures following a World Health Organization, or WHO, warning that a global pandemic may be imminent, Mexican officials said the rapid spread of the H1N1 virus could be slowing, reported Agence France-Presse.

But Mexico’s chief epidemiologist accused the WHO of being slow to respond to the country’s warning about a health crisis that turned into a global swine flu scare. He called for an investigation.Dr. Miguel Angel Lezana told The Associated Press late Thursday that his center alerted the Pan American Health Organization on April 16 about alarming occurrences of flu and atypical pneumonia in Mexico. But no action was taken until eight days later when the World Health Organization said it was “very, very concerned” the outbreak could grow into a pandemic.

“It seems it should have been more immediate,” Lezana, director of the National Epidemiology Center, told AP in a telephone interview.

13 confirmed cases

WHO officials said Friday the health body had been informed on about April 9 of unusual cases of “suspicious influenza” from Mexico that had begun in late March, but that U.S. and Canadian laboratories identified the virus on April 24, when the organization responded rapidly. Health authorities said they have confirmed 300 swine flu cases and 12 deaths due to the virus. Worldwide, 13 countries have confirmed cases. The latest were Denmark and Hong Kong – where a traveler from Mexico accounted for the first verified case on the Asian continent. Canada, New Zealand, Britain, Germany, Spain, Switzerland, the Netherlands, Israel and Austria also have confirmed cases.

Across Mexico’s border, the number of confirmed swine flu cases in the United States rose to 130 Thursday. Hundreds of schools shut their doors. The only confirmed U.S. swine flu death so far was a Mexican toddler who succumbed in Texas. The swine flu outbreak penetrated over a dozen states and even touched the White House, which disclosed that an aide to Energy Secretary Steven Chu apparently got sick helping arrange President Barack Obama’s recent trip to Mexico but that the aide did not fly on Air Force One and never posed a risk to the president. The Washington Post identified the aide as Marc Griswold, a former Secret Service agent who was doing advance work for Chu. It said that Griswold has complained about the infection placing his family in an awkward position with family and neighbors.

U.S. authorities were pledging to eventually produce enough swine flu vaccine for everyone who needs it but the shots couldn’t begin until fall at the earliest. The U.S. swine flu caseload passed 100, and nearly 300 schools closed in communities across the country. Federal officials had to spend much of the day reassuring the public it’s still safe to fly and ride public transportation after VP 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.

$3 billion in loans

In Washington, the Inter-American Development Bank said it would approve $3 billion in loans for Mexico, which was already struggling from the global financial crisis. Mexican authorities, meanwhile, cancelled the traditional gatherings of workers to celebrate May Day, as the restaurants, bars, tourist sites and other public venues remained closed in the capital and elsewhere. “Stay at home with your family,” President Felipe Calderon said in an address to the nation.

The WHO said it would not as yet invoke the highest health threat level – what it calls Phase 6, meaning a worldwide pandemic is under way – but kept it at phase five, indicating a pandemic is imminent. The WHO’s acting assistant director Keiji Fukuda said the virus was behaving like a typical influenza virus, meaning there could be an increase in cases in the southern hemisphere, which is about to enter winter. Elsewhere authorities tightened travel restrictions and took other measures to keep the virus from spreading. Singapore invoked health orders not used since the SARS crisis, ordering anyone arriving from Mexico to be quarantined for one week, as Israel began airport health inspections for those coming from Mexico. Argentina and Cuba have suspended flights to Mexico.

Fewer patients with severe flu symptoms were also checking into hospitals, suggesting the infection rate of a flu that has spread to Europe and Asia was declining.

The World Health Organization said on Saturday 15 countries have reported 615 infections with the new flu virus A-H1N1, widely known as swine flu.

Italy later confirmed its first case, a man in the Tuscany region who returned from Mexico on April 24. He has recovered.

Almost all infections outside Mexico have been mild. The only death in another country has been a Mexican toddler who was taken to the United States before he fell sick.

The U.S. Centers for Disease Control and Prevention agreed the outbreak may not be as severe as it looked a few days ago, citing many mild cases that were not immediately noticed.

For Mexicans – spending a second weekend stuck indoors with stores and businesses shuttered across the country and the capital, Mexico City, devoid of its lively restaurants, bars, cinemas and museums – the data is cheering.

Health Minister Jose Angel Cordova acknowledged the numbers were encouraging but cautioned it was too early to say Mexico had control of the flu.

“For now it’s unpredictable,” Cordova said late on Friday. “We need more days to see how it behaves and whether there is really a sustained decline so we can conclude that it’s going down.”

The new virus is only the third infectious disease experts regard as having pandemic potential in the past 10 years.

It has world health experts racing to work on a vaccine and is wreaking havoc with a travel industry that flies hundreds of thousands of people to and from Mexico each week.

China suspended flights to Mexico after Hong Kong authorities on Friday confirmed a Mexican man who flew via the Chinese mainland was infected with the flu strain.

Hotel guests quarantined

Police in surgical masks quarantined 200 guests and 100 staff inside a Hong Kong hotel where the Mexican, 25, had been staying, saying they would be confined for a week.

“They said everybody needed to go back to their rooms. I don’t want to go to my room because I want to be out,” an Australian man at the hotel told a TV reporter by telephone.

Hong Kong was badly hit by the SARS virus in 2003 and has had many episodes of H5N1 bird flu for more than a decade.

The Asian Development Bank said on Saturday it was prepared to provide assistance to countries in the region to cope with the possible spread of flu, as it did during the SARS outbreak.

Several European countries have confirmed cases of the virus. The United States has been hit with 145 cases in 22 states, sending demand shooting up for antiviral medicine.

In Panama, police detained an American who ran away from a hospital that was testing him for the flu.

Mexico has released a confusing batch of flu data in recent days but public hospitals have noted a steady drop in patients turning up with fevers, suggesting the infection rate may be declining as the nation dons face masks and hand gel.

“There are very few deaths worldwide,” said Marcelo Musi, a salesman shopping for vegetables in Mexico City, where residents weary of masks, hand sanitizer and frightening headlines clutched at signs of an end to the crisis. “If there are no more cases, they say things will get better.”

President Felipe Calderon ordered non-essential businesses to close for five days from Friday, extending a three-day holiday weekend over Monday and Tuesday.

Analysts say the move will further dent negative economic growth this year.

Countless families were devastated at having their long weekend ruined as restaurants, bars, playgrounds and parks that hold outdoor “cumbia” dances all stayed closed.

Cordova said of 159 files on suspected flu deaths, tests showed 58 died of other causes. He said 16 deaths are confirmed as caused by the H1N1 flu and 85 are being tested.

Dr. Frank Plummer, the lab’s scientific director, said scientists will test to see if the flu shot will protect animals from swine flu since the annual shot already contains H1N1 human flu virus. Plummer said there are still many unknowns about human swine flu, but said genetics or environmental factors could help to explain why Mexico seems to be experiencing a more severe form of swine flu than seen in Canada and the U.S.

Winnipeg’s lab has done most of the testing of swine flu samples from Mexico.

Plummer said he’s had a good working relationship with Mexican health officials through the Canadian-led Global Health Security Action Group, which is why Mexican authorities approached the Winnipeg lab for help diagnosing samples on April 17.

Plummer said Friday it would take scientists at least six months to develop a vaccine.