The World Health Organization updated Thursday the number of laboratory-confirmed cases of swine influenza to 154 cases, including eight deaths.

Late Wednesday the health agency had raised its pandemic influenza alert to Phase 5, just one below the highest, in light of evidence showing sustained human-to-human transmission in communities in the United States and Mexico.

WHO has not ruled out that it will raise the level once more, but said while the disease was spreading, it had not yet pinned down the nature of the virus. It caused mild disease in most cases but had also shown itself to be fatal.

In the United States, across ten states, there were 91 cases and one death of a toddler in Texas. Canada had 13 cases in four provinces and Mexico was reporting 26 confirmed incidents including seven deaths.

Spain had 10 confirmed cases, including one case of community spread, with the rest in people who returned from Mexico, where the outbreak is believed to have started.

Other countries with confirmed cases included Britain, New Zealand, Germany, Israel and Austria.

Countries were reporting some higher numbers while others, not on the WHO list yet, said they had confirmed cases, including Switzerland, the host country of the WHO.

Meanwhile, the International Federation of the Red Cross and Red Crescent Societies (IFRC) said it was appealing for 4.4 million dollars to respond to the outbreak.

The federation, which unites all national societies, said it was ready to mobilize hundreds of thousands of volunteers across the globe should the need arise.

The Mexico Red Cross had already activated its volunteer network and they were going to communities to educate and inform about hygiene and other prevention measures people could implement to protect themselves from infection.

"The number of volunteers is increasing by the hour," said Tammmam Aloudat, a health expert with the IFRC. In Mexico they were "active in communities by spreading messages, doing surveillance support and also handling the transport of patients."

He noted that those most at risk were people who were uninformed about personal health and those living in poor, crowded areas where sanitation networks were dirty and insufficient.

Like the WHO and private sector drug companies, the IFRC said the world was better prepared then ever for a possible pandemic due to steps taken following the avian flu outbreak earlier this decade, primarily the preparation of national action plans.