The United States stepped up preparations for a possible swine flu epidemic, and Canada confirmed its first cases on Sunday as researchers worked to determine how contagious the virus could be.

Keiji Fukuda, the assistant director-general of the World Health Organization, called the outbreak "serious" on Sunday. Researchers are still trying to determine how easily the virus is transmitted person to person and it's too early to predict whether there will be a mild or serious pandemic, said Fukuda.

Dr. Alejandro Macias, an epidemiologist and adviser to the federal Ministry of Health, told CNN en Español that the official death toll was at 86. Macias said five more deaths in Mexico City had been reported to federal authorities by local authorities in the city.

Earlier, Mexican President Felipe Calderon said 81 deaths were suspected to be from the outbreak and 374 people remained hospitalized. Another 929 people have been examined and sent home, he said.

"These people have shown up at some medical institution in the country with respiratory symptoms that required to be studied and diagnosed," he said.

Mexico City closed all of its schools and universities until further notice because of the virus, and troops passed out filter masks outside the National Cathedral on Sunday morning. No masses were scheduled at the cathedral, but dozens of worshippers put on masks and went inside the church to pray on their own.
Public Health Emergency
According to the World Health Organization, a public health emergency is an occurence or imminent threat of illness or health conditions caused by bioterrorism, epidemic or pandemic disease, or highly fatal infectious agents or toxins that pose serious risk to a significant number of people.

At a White House news conference Sunday, Homeland Security Secretary Janet Napolitano said the emergency declaration is standard procedure -- citing that one was declared for the inauguration and for recent flooding.

Mexican Finance Minister Augustin Carstens said Sunday that the World Bank was lending Mexico $205 million to deal with the outbreak. "We are getting an immediate loan of $25 million for the requisition of medicines, medical equipment and epidemiological equipment and in addition, $180 million to build up strategic operational and institutional capacities to deal with this issue," he said.

Russia announced it is banning meat imports from Mexico and the southern United States due to the outbreak of swine flu, the Interfax news agency reported. Passengers arriving in Russia from Mexico and the United States also will be screened for swine flu, the news agency reported, by having their temperatures taken upon arrival.

Canada confirmed six cases of mild illnesses on Sunday, and the United States reported 20. Meanwhile, Spain, Israel and New Zealand were investigating possible but unconfirmed cases.

In Washington, the head of the Centers for Disease Control said 20 cases had been confirmed in five U.S. states by noon Sunday. The largest number of cases was in New York, where the CDC confirmed cases in eight students at a preparatory school in that city, Mayor Michael Bloomberg said Sunday.

Another seven cases have been confirmed in California, two each in Kansas and Texas and one in Ohio, said Dr. Richard Besser, the CDC's acting director. Only one person has had to be hospitalized, but Besser said authorities are likely to see "a broader spectrum of disease" in the days ahead.

"Given the reports out of Mexico, I would expect that over time we're going to see more severe disease in this country," he said.

Canada's chief public health officer, Dr. David Butler-Jones said the symptoms seen there -- headaches, fevers, coughs and muscle aches -- were mild by the standards of serious flu cases. But he added, "It's still pretty miserable."

The U.S. government declared a public health emergency -- a step Homeland Security Secretary Janet Napolitano said "sounds more severe than really it is."

"This is standard operating procedure and allows us to free up federal state and local agencies and their resources for prevention and mitigation," she said.

The outbreak "is of great concern to the White House," said White House spokesman Robert Gibbs, but, he added, "It's certainly not a time to panic."

"If you're sick, stay home, get treatment, go see a doctor," Gibbs told reporters. "The government is taking all the steps it needs to and must do to take the precautions to deal with whatever size and scope we may be facing," he said.


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