Two 26-year-old male rugby players were confirmed as Malta's first official swine flu victims on Wednesday night with two more people testing positive yesterday.

The four infected people formed part of a group of 23 rugby players and friends who went on a three-day visit to Spain.

The group arrived in Malta on a Ryanair flight from Girona on Tuesday morning, with one of the victims already showing symptoms of the illness on Monday.

The health authorities yesterday carried out tests on 13 other members of the group, including another passenger on the plane, who showed symptoms of the disease. Of these, only two were found to have swine flu.

All victims were treated at home with Tamiflu and asked to remain indoors. Their immediate family were also under voluntary quarantine as a precautionary measure. Family members were also prescribed Tamiflu to limit the spread of the disease in its early stages.

The Times yesterday spoke with the two first victims and both were in good spirits and feeling much better.

"I just have a cough and the fever has gone away," the first victim said.

He felt sick on the last day of the trip on Monday, suffering from a blocked nose and fever.

"I was practically in bed all day on Monday but then I had to travel throughout the night to catch the flight back to Malta. I was ill all Tuesday and on Wednesday my friend phoned me and told me to get tested for swine flu after he also had flu-like symptoms," he said.

His friend confirmed that he started coughing on Tuesday after arriving in Malta.

"By the evening I had fever and on Wednesday, when I called my doctor, he referred me to the health authorities to be tested for swine flu. It was not that bad and I wanted to go to work but I was advised to stay at home until the results were out," Malta's second official victim said.

He was "surprised" and "shocked" on learning that he had swine flu, given that they were the first people to bring the disease to Malta.

"I am taking tablets and so are my family. We are house-bound but I'm feeling fine. I'm not even confined to bed. I have a sore throat and sometimes the fever appears. The symptoms are not much different from normal influenza," he said.

The first two cases were confirmed by the health authorities on Wednesday evening. Throughout the night all those in the group were contacted and tests were carried out yesterday on those who had flu-like symptoms.

The Parliamentary Secretary for the Elderly and Community Care, Mario Galea, said the arrival of swine flu did not take the health authorities by surprise because it was always a question of "when" rather than "if" the flu would reach Malta.

Malta had so far been the only EU country without a swine flu case.

"There is no need for alarm; we are well prepared. Life has to go on as normal," Mr Galea said.

Flanked by the Director General of Health, Ray Busuttil, and the Director of Health Promotion, Charmaine Gauci, Mr Galea urged the public to be vigilant by adopting basic hygiene measures such as frequent washing of hands and the immediate disposal of tissues.

Mr Galea has headed the government's plans to tackle any possible outbreak including the provision of medicines and the allocation of a special section at Mater Dei Hospital.

His secretariat was further granted €3.5 million about three months ago to finance an information campaign and purchase more antiviral supplies, antibiotics, protective gear for hospital workers and the stockpiling of alcohol-based hand rubs.

Mr Galea said last month that Malta's antiviral supplies were being increased after the government ordered 10,000 courses of the antiviral Relenza.

The health authorities have enough anti-virals to treat up to 25 per cent of the population, an amount expected to increase by a further 10 per cent.

Swine flu has shown to be responsive to both Tamiflu and Relenza, which are expected to be the first line of defence before a vaccine against the virus is available.

Dr Busuttil said that, according to the current clinical scenario, a vaccine would possibly be available by January.

Swine flu has spread across the world. More than one million people in the United States alone may have been infected with the new flu and a global pandemic alert was activated by the World Health Organisation.

According to the European Centre for Disease Prevention and Control there were 81,700 confirmed cases and 339 deaths worldwide up to 5 p.m. yesterday.

The victims have often been found to have had underlying health problems.

In the EU, there were 9,453 confirmed cases and only four deaths.

The UK, the worse hit EU country, yesterday announced a change in strategy after acknowledging that the virus could no longer be contained.

The change means that treatment will no longer be given to the close contacts of those infected and laboratory testing will no longer be done to confirm all cases.

Factbox - Swine flu

Swine flu is caused by the influenza virus A(H1N1) and everybody can contract the disease. There is no vaccine for this virus.

What are the symptoms?

Symptoms are similar to normal influenza and include fever, coughing, blocked or runny nose and sore throat. Other symptoms may include muscle aches, headaches, vomiting and diarrhoea.

How is it spread?

Airborne droplets spread by coughing and sneezing are the most likely way of spreading the disease. However, influenza can also be contracted after a person touches anything that has been handled by a sick person and then touches nose, eyes or mouth.

How do you minimise risk?

Frequent hand washing, regular cleaning of surfaces and covering one's mouth when coughing or sneezing can go some way to help stem the spread of disease.

Doctors urge the use of tissues rather than handkerchiefs. Tissues should be discarded immediately and not left lying around.

ksansone@timesofmalta.com