The human swine flu outbreak continues to grow in the United States and internationally. Today reports additional cases of confirmed swine influenza and a number of hospitalizations of swine flu patients. Internationally, the situation is more serious also, with additional countries reporting confirmed cases of swine flu. In response to the intensifying outbreak, pandemic alert level has been raised to Phase 4. A Phase 4 alert is characterized by confirmed person to person spread of a new influenza virus. The increase in the pandemic alert phase indicates that the likelihood of a pandemic has increased.