W.H.O. May Raise Alert Level as Swine Flu Cases Leap in Japan (来源：英语学习门户网站EnglishCN.com)

By DONALD G. McNEIL Jr.
Published: May 17, 2009

The number of swine flu cases in Japan soared over the weekend, raising the likelihood that the World Health Organization will soon have to raise its pandemic alert level to 6, the highest level.

On Sunday, the assistant principal of a school in Queens died after being hospitalized with swine flu. It was the sixth flu-related death in the United States and the first in New York State.

In Japan, authorities ordered more than 1,000 schools and kindergartens in and near the cities of Kobe and Osaka to shut down. There were no confirmed cases in Tokyo.

Until Friday, Japan thought it had contained the virus after finding four infected people who had visited North America and flown home. It quarantined them and 50 other passengers, began sending medical workers to meet each flight arriving from North America to take temperatures of those on board and told visitors they would need to have their temperatures recorded daily.

But on Saturday, the authorities confirmed that a 17-year-old student in Kobe who had not been overseas was infected; as of Sunday evening, the number of recorded cases rose to 93 throughout Japan.

Kobe residents rushed to hospitals, where doctors in biohazard suits checked people for fever in tents set up in parking lots, Agence France-Presse reported. Transit workers and supermarket employees began wearing masks.

Japan is well known in public health circles for being exceptionally nervous about flu; it has an aging population and a national obsession with cleanliness that makes even Switzerland look messy.

Masks are common on subways because it is considered rude to lack one if you are sneezing. Before the outbreak began last month, Japan used about 60 percent of the world’s Tamiflu stock.

If the World Health Organization finds sustained community transmission — that is, infections between people with no connections to travel from North America — it will presumably raise its pandemic alert level to 6, because Japan is outside the W.H.O. Americas region. The alerts, by definition, measure a new virus’s spread, not its lethality. The lethality can vary from country to country, depending on viral mutations, how prepared each country is, what other diseases its population has, and other factors.

Turkey, India and Chile also reported their first swine flu cases over the weekend.

The patient in Turkey was an American heading to Iraq. India’s case was that of a 23-year-old who arrived in Hyderabad from New York. Chilean officials reported that two of its citizens — two women, 25 and 32 years old — were found to have the flu after returning from a trip to the Dominican Republic.