In the last three days 125 cases of infection with the A-H1N1 flu virus have flared up in Japan, starting at a a school in Kobe. There are fears this could be an independent outbreak, different to the one in Mexico that started the pandemic scare.Japan’s first cases occurred at the start of the month but they all concerned travellers just back from Canada. The outbreak may mean the virus is about to extend its reach and go worldwide, with unknown consequences, particularly if it mutates again. On May 18 the World Health Organisation said there were nearly 9,000 infections globally, in 40 countries. The only fatalities have been in the Americas. The flu reared its head in Mexico back in March, and spread rapidly. Mexico has over 3000 cases, and 68 people have died. It is feared the virus’s deathtoll could mushroom if health authorities do not manage to contain it and break its reproductive cycle. Illness respects no borders. The US knows that. It now has nearly 5,000 cases and four deaths, the most recent this Sunday, the headmaster of a New York school. The city has become the virus’s second home outside of Mexico, and the WHO is extremely vigilant says Emergency Committee president John Mackenzie: “On April 29 and in view of the urgency of the matter, the director-generals sought their views to changing from pandemic phase 4 to pandemic phase 5 characterised by community level transmission in at least 2 countries in one WHO region, this of course being North America.” Some countries like Russia have advised people not to go to North America and Mexico, or even Spain. But that would be an unnecessary precaution says this Spanish doctor: “We haven’t had a Spanish outbreak, not in schools, hospitals or homes. The infection is not gaining ground in Spain, and we can clearly say the risk of infection is zero.” On hearing that Moscow lifted its travel warning, and will respect the WHO’s decision not to limit passenger or goods transport…for now.