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The World Health Organisation is urging the planet to brace for a second wave of the swine flu pandemic as the heavily populated northern hemisphere edges towards the cooler season when flu thrives.
"The WHO is still mobilised and worried," spokesman Gregory Hartl said as the global health watchdog kept an anxious eye on some "mysterious" patterns of illness associated with the new A (H1N1) virus that appeared in April.
Influenza traditionally surges to its peak during the northern autumn and winter.
WHO Director General Margaret Chan warned on Friday that there had been second and third waves in previous pandemics.
"We cannot say for certain whether the worst is over or the worst is yet to come," Chan said in a videotaped address to a symposium on flu in the Asia-Pacific region.
"We need to be prepared for whatever surprises this capricious new virus delivers next," she added.
Some 1,799 people have died since the A(H1N1) was uncovered in Mexico and the United States nearly six months ago, according to the UN health agency.
By comparison, an estimated 250,000 to 500,000 people die around the world every year from seasonal flu, and overall the symptoms of the new pandemic virus have proved to be mild in the great majority of known cases.
However, it has spread swiftly into 177 countries, proving to be more infectious than seasonal flu and more durable through warmer months.
Through a full season in the southern hemisphere, the pandemic strain gradually became dominant.
WHO monitoring showed that it was now on the decline there, except in South Africa, and in some later affected areas of Argentina, Australia and Chile.
Some 182,000 people worldwide are known to have caught swine flu based on laboratory confirmed cases, but the WHO has long advised countries to give up counting; the true number may in the millions, according to some experts.
It is also striking those in a more physically fragile phase of life, such as pregnant women or the chronically ill, as well as those who are obese and younger age groups than usual.
Many of the most severe cases are among 30 to 50 year olds.
WHO officials are also mystified at the "most worrying" characteristic of this flu virus, Hartl explained.
About 40 percent of the most severe or fatal cases occur in people who are in perfect health, he told.
However, he was unable to say how many severe cases had occurred, although they are generally regarded as a small proportion of the outbreak so far.
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