The outbreak began here in early May as Australia was entering its annual flu season, speeding up infections so much that in a month Melbourne was the world's "swine flu capital" with the highest concentration of cases anywhere.

More than 40 deaths and some 16,000 cases later, Australia's experience with A(H1N1) holds valuable lessons for northern countries contemplating the onset of autumn and winter.

"There's no doubt that the lessons learned from Australia will be useful for overseas," said University of New South Wales epidemiologist William Rawlinson.

"What's happening in Australia now and the evidence that the number of cases of swine flu has significantly increased as winter's become colder is exactly what we expect in the northern hemisphere during their winter.

"So certainly lots of people in the northern hemisphere, Europe and the United States, are very interested in what happens here."

Australia's efforts against the virus have ranged from reminding people to wash their hands to closing schools and planning a mass immunisation programme capable of covering the entire population.

Authorities have also been forced to fine-tune their response as the threat has evolved, concentrating efforts on the most vulnerable groups such as pregnant women and those with existing medical problems.

They have also issued warnings to the disadvantaged Aboriginal community and noted with alarm that the disease starting attacking rising numbers of young, otherwise fit, people.

"Australia has seen you do have to change your response and get that message out to the public and the health community," Rawlinson said. "The issues have to be very clear -- otherwise, people get confused.

"As deaths rise and as critical care becomes more important you have to respond to that, and that's one thing we've done very well in Australia."

The Influenza Specialist Group advisory panel said initial measures to stop the virus spreading, such as monitoring at ports and airports and shutting schools, had proved futile.

"It certainly proved that border protection does not work against this type of virus, although that was not unexpected," the panel's chairman Alan Hampson said.

He added that the disease could become more infectious by the northern hemisphere winter. World health experts fear a repeat of the devastating Spanish and Asian influenza pandemics of 1918 and 1958.

"It requires only a couple of points of mutation to acquire additional transmission capacity -- maybe that's what we're seeing now, we just don't know," Hampson said.

"Maybe by the time it gets to the northern hemisphere this virus will be much more able to spread."

Anne Schuchat, a doctor at the US Centres for Disease Control and Prevention, said health experts in the country were gathering information from around the world.

"Whether it's here in the United States or in places like Argentina or Australia, there is a way that we handle any types of medical challenges," she told the Australian Broadcasting Corporation.

With human testing for a swine flu vaccine already underway in Australia, Hampson said northern countries had a big advantage unavailable here going into flu season.

"The northern hemisphere will have a vaccine, which will be a major benefit that we haven't had," he said.

earlier related report
Swine flu's rapid spread leaves health experts on edge
Geneva (AFP) July 26 - Swine flu has swept the globe since its detection in March, now linked to hundreds of deaths, affecting nearly every country and raising concerns over what dangers await as the new virus develops.

The World Health Organisation declared the first influenza pandemic in four decades in June, and the A(H1N1) virus has, in the words of one WHO official, since become "unstoppable."

More than 800 deaths have been linked to the virus, and though the WHO no longer provides figures on the number of infected people worldwide, swine flu has spread to 160 of the organisation's 193 member states.

In addition to the death toll, lives have been disrupted in countless ways, including school closings, changes in church rituals and warnings that vulnerable Muslims should not embark on the pilgrimage to Mecca.

In the United Nations, handshakes are now reserved for meetings between ambassadors.

The great fear among experts is that the virus could mutate into a more virulent form and leave far more damage in its wake.

"There are many questions for which we have no answers," said WHO spokesman Gregory Hartl. "We don't know how the virus will change going forward.

"In the southern hemisphere, we see that it is spreading well but also in the northern hemisphere. The question is what will the virus do during our winter? We do not know."

The virus was first uncovered in Mexico and combines swine, human and avian influenza. Most deaths have been concentrated in the Americas, with the United States, Argentina and Mexico recording the highest number of fatalities.

Amid the winter months of the southern hemisphere, the spread of the virus has gained pace, but even in the north, where summer is in full swing, infections have multiplied.

In Britain, Europe's worst-hit territory, it is estimated that 100,000 people were infected the week before last.

Health experts have found so far that the majority of patients are recovering, even without medical treatment, a week after the appearance of the first symptoms.

The WHO has asked countries to stop systematic testing of all cases, but it has asked health authorities to report irregular symptoms.

"For the moment, we haven't seen any changes in the behaviour of the virus. What we're seeing is a geographical expansion," said Hartl.

In the northern hemisphere, new targeted responses to the flu are beginning to be unveiled.

Britain launched a swine flu hotline to give those who believe they are infected access to anti-viral drugs without seeing a doctor.

France has asked those with flu symptoms to contact their family doctors, who are expected to prescribe flu drugs and masks. It has also placed an advance order for 90 million vaccines, joining other countries like the United States that have ordered stockpiles early.

The development of vaccines is ongoing and Novartis has said clinical trials will start as early as this month.

While a vaccine should be available in September or October, health authorities in the northern hemisphere fear that it would be too late to cope with the rapid onset of winter.

It also remains unclear if one or two injections are necessary to guarantee immunity against the illness, making it difficult to estimate the potential coverage of the production capacity of the vaccine.

Even those who have not contracted the virus have seen their lives affected.

Several Muslim countries have advised against travel to Mecca, where the virus could spread quickly among the masses of pilgrims.

A British bishop advised his diocese to suspend holy water from churches while Anglicans have been told to stop sipping from the same chalice during communion services.

Some Latin-American countries have even stopped greeting people with a kiss and suspended football matches.

On Saturday, a British city council said it was considering using underground burial chambers, currently a tourist attraction, to store the corpses of swine flu victims if the pandemic worsens.

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