US & World

MADRID (AP) ― The State Department is warning U.S. citizens to avoid nonessential travel to Mexico and those who live in Mexico to avoid hospitals or clinics there unless they have a medical emergency.

The department says those who fall ill in Mexico should stay home and call their doctors to avoid exposure to swine flu infection at hospitals.

The department's advice was issued Monday evening. It recaps warnings provided earlier by the U.S. Centers for Disease Control and Prevention and by Mexican authorities in response to the flu outbreak that has claimed scores of lives in Mexico.

The department also warned that U.S. consular offices in Mexico will be affected by the flu outbreak. The travel alert is effective until July 27.

A young man in Spain and two people in Scotland have come down with swine flu following trips to Mexico, health officials said, in what were the first cases reported outside North America. The World Health Organization said it is still awaiting official reports from the U.K. about the Scottish cases.

Russia, Hong Kong and Taiwan said they would quarantine visitors showing symptoms of the virus amid a surging global concern about a possible pandemic.

European and U.S. markets bounced back from early losses as pharmaceutical stocks were lifted by expectations that health authorities will increase stockpiles of anti-viral drugs. The stocks of airlines, hotels and other travel-related companies posted sharper losses.

The virus was suspected in up to 103 deaths in Mexico, the epicenter of the outbreak with more than 1,600 cases suspected, while 40 cases — none fatal — were confirmed in the United States and six in Canada, the WHO said.

"Today we've seen increased number of confirmed cases in several countries," WHO spokesman Paul Garwood told The Associated Press. "WHO is very concerned about the number of cases that are appearing, and the fact that more and more cases are appearing in different countries."

President Barack Obama said the threat of spreading infections is cause for concern but "not a cause for alarm."

The WHO set its pandemic alert level at level 3, which means there is an animal virus that occasionally causes human cases but that doesn't spread well between people. If the WHO raises it to 4 or 5, that signals that the swine flu virus is becoming increasingly adept at spreading between humans. That move could lead governments to set trade, travel and other restrictions aimed at limiting the disease's spread.

In Luxembourg, European Union Health Commissioner Androulla Vassiliou urged Europeans to postpone nonessential travel to parts of the United States and Mexico affected by swine flu, toning down earlier comments referring to all of North America.

"I meant a travel advisory, not a travel ban, for travel to Mexico City and those states in the United States where we have outbreaks" of swine flu, he said.

The EU health commissioner only makes recommendations to the 27 member countries; they must make a final decision to set travel advisories through their foreign ministries.

Dr. Richard Besser, acting head of the Centers for Disease Control and Prevention in Atlanta, said the EU recommendation was not warranted. "At this point I would not put a travel restriction or recommendation against coming to the United States."

Spain's first swine flu case — confirmed by the WHO — was a young man in the town of Almansa who recently returned from Mexico for university studies and is responding well to treatment, said Health Minister Trinidad Jimenez. Neither the young man nor any of the 20 other people under observation for the virus were in serious condition.

Scottish Health Secretary Nicola Sturgeon said tests "conclusively" confirmed swine flu in two people recovering in a hospital in Scotland with flu-like symptoms after a trip to Mexico. She did not say whether the tests showed if it was the same strain of flu that has affected Mexico. Calls seeking further information from Scottish officials were not immediately returned.

WHO spokesman Peter Cordingley singled out air travel as an easy way the virus could spread, noting that the WHO estimates that up to 500,000 people are on planes at any time.

New Zealand was testing 13 students, their parents and teachers who were showing flu-like symptoms after returning from Mexico, said Health Minister Tony Ryall. Israel, France, Brazil, Switzerland and Sweden were also conducting tests.

At Germany's bustling Frankfurt Airport, people suspected of having the disease are being examined before getting off planes, said the health minister for Hesse state, Juergen Banzer. This policy has been in effect since Saturday at continental Europe's second-busiest airport, after Charles de Gaulle in Paris.

Governments in Asia — with potent memories of SARS and avian flu outbreaks — heeded the warning amid global fears of a pandemic.

Singapore, Thailand, Japan, Indonesia, and the Philippines dusted off thermal scanners used during the 2003 SARS crisis and were checking for signs of fever among passengers arriving from North America. South Korea and Indonesia introduced similar screening.

In Malaysia, health workers in face masks took the temperatures of passengers as they arrived on a flight from Los Angeles.

Russia, Hong Kong and Taiwan said visitors returning from flu-affected areas with fevers would be quarantined.

Australian Health Minister Nicola Roxon said pilots on international flights would be required to file a report noting any flu-like symptoms among passengers before being allowed to land in Australia.

China said anyone experiencing flu-like symptoms within two weeks of arrival had to report to authorities.

India will start screening people arriving from Mexico, the United States, Canada, New Zealand, Spain, Britain and France for flu-like symptoms, said Vineet Chawdhry, a top Health Ministry official. It also will contact people who have arrived from Mexico and other affected countries in the past 10 days to check for the symptoms, he said.

Some officials cautioned that the checks might not be enough.

The virus could move between people before any symptoms show up, said John Simon, a scientific adviser to Hong Kong's Center for Health Protection.

Thomas Tsang, controller for Hong Kong's Center for Health Protection, said the government and universities aim to develop a test for the new flu strain in a week or two that will return results in four to six hours, compared with existing tests that can take 2-3 days.

China and Russia banned imports of pork and pork products from Mexico and three U.S. states that have reported cases of swine flu, and other governments were increasing their screening of pork imports.

Indonesia, which was hit hardest by bird flu, said it was banning all pork imports.

Lebanon's agriculture ministry also banned all imports of pork and pork products, excluding some canned products. It also says it will destroy any pork shipments to have entered Lebanon from a country declared infected with the swine flu virus by the WHO or countries with suspected cases.

The CDC says people cannot get the flu by eating pork or pork products.

Germany's leading vacation tour operators were skipping stops in Mexico City as a precaution. The Hannover-based TUI said trips through May 4 to the Mexican capital were being suspended, including those operated by TUI itself and also through companies 1-2 Fly, Airtours, Berge & Meer, Grebeco and L'tur

TUI said other holiday trips to Mexico would continue to operate but would not make stops in Mexico City "for the next few weeks." Japan's largest tour agency, JTB Corp., suspended tours to Mexico at least through June 30.

Russian travel agencies said 30 percent of those planning to travel to Mexico in early May had already canceled.

At Madrid's Barajas International Airport, passengers arriving from Mexico were asked to declare where they had been and whether they had felt any cold symptoms. They were told to leave a contact address and phone number.

"Where we were, there was no real alarm but we followed what was happening on the news and we're a little bit worried," said Spaniard Filomeno Ruiz, back from vacation in Cancun.

Passengers were also urged to contact health authorities if they notice any symptoms in the 10 days following arrival.

In the airport's baggage claim area, ground crews and police wore surgical face masks. Some travelers took precautions even though they had not been in Mexico.

"Nobody has recommended it, but I've put the mask on out of precaution," said Roger Holmes of Britain, who was traveling to Tunisia from Madrid. "I'm not afraid, but it costs nothing to be careful."

(© 2009 CBS Broadcasting Inc. All Rights Reserved. This material may not be published, broadcast, rewritten, or redistributed. The Associated Press contributed to this report.)