The World Health Organization (WHO) has raised its alert level over swine flu from three to four - two steps short of declaring a full pandemic. WHO Assistant Director General Dr Keiji Fukuda said it signalled a "significant step towards pandemic influenza", but added "we are not there yet".
Mexico earlier said it believed 149 people had now died from the swine flu outbreak - only 20 cases are confirmed.
Other, milder, cases are confirmed in the US, Canada, Spain and Britain.
The WHO's decision to raise the alert level to four came after an emergency meeting of experts, brought forward by a day because of concerns over the outbreak.
WHO PANDEMIC ALERT PHASES
Phase 1: No viruses circulating among animals causing infections in humans
Phase 2: Animal influenza virus causes infection in humans, and is considered potential pandemic threat
Phase 3: Influenza causes sporadic cases in people, but no significant human-to-human transmission
Phase 4: Verified human-to-human transmission able to cause community-level outbreaks. Significant increase in risk of a pandemic
Phase 5: Human-to-human transmission in at least two countries. Strong signal pandemic imminent
Phase 6: Virus spreads to another country in a different region. Global pandemic under way
"What this can really be interpreted as is a significant step towards pandemic influenza. But also, it is a phase that says we are not there yet," Mr Fukuda said.
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