1. The WHO has kept the pandemic alert level at 5, because so far community-level transmission has been restricted to only one WHO region, meaning North America. Twenty countries have 1,025 documented cases of H1N1 flu with 26 deaths. 2. In Mexico, 40-50% of cases experienced diarrhea. Keep this is mind if you suspect a case. 3. South Carolina is ranked sixth, with 15 confirmed cases, out of 279 in 36 states. So far, still only one reported death. Let's hope the low death rate continues. 4. In my practice, I did not see anyone with symptoms consistent with swine flu. 5. Swine flu is slowly spreading. Take precautions! I have spoken with three business travellers who basically thought it was stupid to wear a mask in the airport and on the planes. I hope more people do not think this way.