GENEVA/TOKYO – The new flu strain is spreading widely in the United States and Japan and is likely to circulate worldwide, health officials said on Monday.

The H1N1 flu outbreak has put the world on the brink of a pandemic and ministers and experts were meeting in Geneva to discuss how to fight the virus with vaccines and drugs.

The outbreak is not over, senior U.S. official Richard Besser said at the World Health Organization's (WHO) World Health Assembly.

Japan confirmed on Monday that 125 people, many of whom had not been abroad, had been infected with the new strain after New York recorded its first death from the virus and Chile reported its first two cases.

Forty countries have confirmed cases of the strain, a mix of swine, human and avian viruses, the WHO said.

The WHO raised its global pandemic alert level last month to 5 on a 6-point scale in response to the spread of H1N1 in North America, which has had 95 percent of the nearly 9,000 confirmed infections to date.

Almost all the 74 deaths have been in Mexico. However, mostly people have only had relatively mild symptoms and there has been no decision yet on raising the alert level to six.

Besser, the head of the U.S. Centers for Disease Control and Prevention, said there was widespread transmission in the United States, although he said the virus was not highly virulent for now.

Our best analysis suggests that this novel H1N1 virus is likely to circulate worldwide, similar to other seasonal flu viruses, he told a high-level meeting at the WHO's assembly.

Delegates, including Mexico's Health Minister Jose Angel Cordoba, were discussing how best to respond to the virus.

They will seek an agreement on how samples of the virus should be handled and shared with pharmaceutical companies working to develop vaccines to fight the strain.

However, rich and poor countries remain at odds over whether the biological material can be patented. The meeting will also discuss poor countries' needs for antiviral drugs like Roche's Tamiflu and GlaxoSmithKline's Relenza and any vaccines developed to confront the strain.

We are all under pressure to make urgent and far-reaching decisions in an atmosphere of considerable scientific uncertainty, Margaret Chan, director-general of the U.N. agency told the assembly.


The WHO said on Sunday it was watching the situation in Japan closely, but that it was not clear whether the outbreak, the largest outside the Americas, would trigger the declaration of a full pandemic.

Under WHO rules, signs that the disease is spreading in a sustained way in a second region of the world would prompt a declaration that a full pandemic is under way. Other large clusters have been seen in Spain and Britain, WHO said.

A WHO designation of phase 6 flu would put countries on even higher alert about the flu strain and give more impetus to pharmaceutical efforts to create drugs and vaccines to fight it.

Chan and U.N. Secretary-General Ban Ki-moon will meet top pharmaceutical executives on Tuesday to discuss their ability to make vaccines to fight the strain.

Japan's prime minister, Taro Aso, recorded a video message urging people to wash their hands, gargle and wear face masks to help halt the spread of the disease.

Experts say that if you receive timely treatment, this new flu is not something to be afraid of, Aso said in the message.

Most of Japan's new infections were among high school students in the western prefectures of Hyogo and Osaka who had not traveled abroad, the Health Ministry said.

Schools and kindergartens were closed across the two areas but local governments advised businesses to operate as usual.

Kiosks at some stations in the region were closed, and a festival in the city of Kobe that usually attracts tens of thousands was canceled.

It could have a notable effect on Japan. In the case of Mexico, officials there say their outbreak reduced gross domestic product by 0.5 percent, John Lipsky, International Monetary Fund first deputy managing director, said in Tokyo.

Chile's health minister confirmed on Sunday the country's first cases of the flu in two Chilean women who had returned from a trip to the Dominican Republic.

The women, aged 25 and 32, were receiving treatment in hospital and the government was contacting other people who had traveled on the same flight, Health Minister Alvaro Erazo said.

In New York, a school principal died from the new flu on Sunday, marking the city's first death from the virus.

Several schools have been closed in the New York borough of Queens after students and staff were infected.

Mainland China also confirmed its first case in the capital at the weekend.