A woman who traveled to the United States and Canada is the first verified case of the H1N1 flu in Latvia, the Public Health Agency in Rīga has announced.

The woman returned to Latvia on June 21 on a Berlin to Rīga flight on airBaltic, the agency said in a June 23 press release. The woman exhibited symptoms on the flight and was hospitalized as soon as the flight landed.

The agency has recommended that passengers who were on the flight monitor their health during the next five days. Symptoms of H1N1, according to the World Health Organization (WHO), are flu-like and include fever, cough, headache, muscle and joint pain, sore throat and runny nose. If such symptoms are observed, a spokesperson for the Latvian agency said, the person should contact their family physician or the Public Health Agency’s epidemiologist at +371 67271738.

Health officials were prepared for this first case in Latvia, the agency said in the press release. The agency has notified German officials of the case so they can organize assistance for passengers who traveled with the woman from Canada to Germany.

WHO on June 11 labeled the spread of the virus as a pandemic.

“Globally, we have good reason to believe that this pandemic, at least in its early days, will be of moderate severity,” WHO Director-General Margaret Chen said in a statement. “As we know from experience, severity can vary, depending on many factors, from one country to another. On present evidence, the overwhelming majority of patients experience mild symptoms and make a rapid and full recovery, often in the absence of any form of medical treatment.”

According to WHO, a total of 52,160 cases of H1N1 have been reported around the word as of June 22. In all, 231 people have died as a result of the virus. No cases of the virus have been reported in Lithuania, but Estonia has had five. The United States, Mexico and Canada remain the top three countries in the number of infections.

Prime Minister Valdis Dombrovskis has apologized to the Latvian people for the serious tests they will have to endure as the country struggles to emerge from its economic crisis and avoid bankruptcy.

At the same time, the prime minister said in a statement released June 18, conflict will not solve the problem. The announcement came as several hundred people gathered in the Esplanade in downtown Rīga for a demonstration organized by the Free Trade Union Confederation of Latvia (Latvijas Brīvo arodbiedrības savienība, or LBAS) to protest the effects on workers of deep cuts to the national budget.

“Even though during the so-called ‘fat years’ I have not worked in the government coalition,” Dombrovskis said in his statement, “at this moment I wish to apologize to the people of Latvia for the situation and for the tests that we all will have to endure.

“I recognize that I cannot promise well-being tomorrow at lunchtime,” he continued, “but I know I am doing all that is possible to stop Latvia’s heavy fall.”

The Saeima on June 16 approved LVL 500 million in cuts to this year’s budget, which government leaders hope will clear the way for a package of international loans to be released to the country. Without the money, Dombrovskis said in his statement, the government by August will not be able to make salary, pension and other payments.

The sweeping cuts to the national budget have claimed their first political casualty. Health Minister Ivars Eglītis stepped down June 17 to protest what a 10 percent decrease in his ministry’s budget will mean to health care in Latvia.

“This is a decisive time for our nation, and we do not have many options,” the prime minister said in his statement. “Latvia faces bankruptcy, from which we can save ourselves only by sharply reducing state expenditures and hoping for the international loan.”

The other option would be to slash the budget even further, thereby putting even more pressure on society, Dombrovskis said.

Latvia’s national budget now foresees spending LVL 4.6 billion this year. The budget will have to be cut by another LVL 500 million in 2010 and again in 2011, officials have said.

The trade unions understand the need for cuts to state spending, LBAS Chairman Pēteris Krīgers said in a press release announcing the June 18 demonstration.

“But we know that there are different ways to save, with an eye toward development or without it,” Krīgers said. “Even while saving it is possible to make new jobs and create new opportunities. Latvians have always survived thanks to their capacity to work. That is why we should be given the opportunity to work!”

In a speech before the Saeima, President Valdis Zatlers admitted the country’s leaders have not been prepared to deal with the crisis.

“In my opinion,” the president said, according to a transcript of his speech, “we must all not only acknowledge, but also accept responsibility for the fact that our decisions often have been incorrect, actions have been incorrect, we have lacked political will, lacked economic and management far-sightedness, we have badly run our country.”

He urged members of parliament to work even through the summer to address the next phase of budget cuts and to involve the public in the decision-making process.

Latvia’s Health Minister Ivars Eglītis has resigned, saying he will not be responsible for what cuts in the government budget will mean to medical care in the country.

Eglītis, a member of the People’s Party (Tautas partija), announced his resignation June 17, a day after the Saeima approved a sweeping LVL 500 million reduction in the national budget. He is the first minister to leave the coalition government headed by Prime Minister Valdis Dombrovskis.

A significant portion of the cuts—LVL 45 million—is to come from the Ministry of Health and will require changes to health care delivery. The amended national budget now foresees spending LVL 4.6 billion, but taking in just LVL 4 billion. The health ministry’s revised budget anticipates spending LVL 453 million this year.

“Without creating the social protection system for those patients to whom the lack of money already forbids to receive timely and qualitative medical help, further health budget cuts were not acceptable because those are disproportionate to the social responsibility of the sector,” Eglītis said in a statement released by the health ministry. “As (a) doctor and health care specialist I cannot accept that.”

Dombrovskis has accepted Eglītis’ resignation.

“In this crisis situation the minister for health has chosen the easiest way as it is clear that the health care system is facing a process of complicated, urgent and essential reforms,” Dombrovskis said in a prepared statement. “The decision will require political will and determination, and conviction that the end result is adequate for such a health care model which should already have been introduced some years ago. If the minister honestly admits to be unable to manage these reforms, his resignation is sensible and acceptable.”

Dombrovskis also said he is awaiting the People’s Party’s recommendation on who should replace Eglītis.

After a meeting with the prime minister, President Valdis Zatlers told a press briefing that Latvia needs a health minister who is confident in their abilities.

“And this minister must be found as soon as possible,” Zatlers said. “I would even say today, so he could start work tomorrow.”