The Church has instructed parishioners not to receive Holy Communion by mouth in an attempt to contain the spread of swine flu in Malta.

The decision was taken by Archbishop Paul Cremona and Gozo Bishop Mario Grech following consultation with the health authorities, a spokesman for the Curia said.

The message was passed on to the congregation through a circular read in churches around Malta and Gozo during Mass.

Health Director General Ray Busuttil said the directive was intended to reduce the risk of priests carrying the virus from one person to another.

The authorities yesterday confirmed another four separate cases. Two cases involve an 18-year-old man and a 19-year-old woman who are on holiday. Another two Maltese youths were confirmed to be carrying the flu after returning from their holidays in Cyprus.

The health authorities said all those who had contracted the influenza - there are now 16 confirmed cases in all after the status of two of those previously diagnosed was downgraded to "probable" yesterday - were recovering well.

Even the 18-week-old British boy who was admitted to Gozo General Hospital with a chest infection after contracting swine flu was discharged yesterday evening.

An Air Malta aircraft operating the London Gatwick to Catania route was yesterday delayed for nearly three hours at Catania airport. The delay was a result of a health procedure to disinfect the aircraft in cooperation with the Sicilian health authorities after two Italian passengers were reported sick during the flight.

The passengers were medically examined by the Sicilian medical authorities, and following laboratory tests in Palermo, it was confirmed that the passengers were suffering from the H1N1 virus.

Although the Air Malta operating crew do not have flu symptoms, the Sicilian authorities requested the crew to remain in Catania until the examination tests of these passengers are issued.

The authorities yesterday called on people who believed they contracted swine flu not to go to Mater Dei's Emergency Department or other clinics but to contact their family doctor or call the helpline 2132 4086. They said all those who had been confirmed to be suffering from swine flu had been quarantined.

Dr Busuttil said there was no public health reason to cancel mass events, like Wednesday's Isle of MTV concert. "We are still urging people to take the necessary precautions," he said, adding that Spain, where cases of H1N1 influenza were rampant, did not cancel the U2 concerts.

He also said that there was no reason to scan people entering the island since those who are asymptomatic could be carrying the virus.

In Gozo, where two cases were confirmed last Friday, there were mixed reactions to the swine flu outbreak, though some people who spoke to The Sunday Times yesterday expressed concern.

Paul Cassar from Victoria said he was being extremely careful and was washing his hands even more regularly.

"I think it's important to use disposable glasses when going to a bar," he said.

Tourist guide Angela Theuma said she would wear gloves and a mask if it was not too much of an inconvenience.

"I wash my hands regularly, but sometimes water is not readily available," she said the woman.

Mariella Vella from Ghajnsielem and Rachel Cardona Victoria were both concerned about the infection. "I bought disinfectant as soon as I heard that there were cases in Gozo," Ms Cardona said, adding that she constantly washes her young son's hands.

In contrast, George Vassallo from Victoria and Simon Schembri from Gharb believe the fuss over swine flu is blown out of proportion. "It is a gimmick by pharmaceutical companies to make money," Mr Schembri said.

However, both admitted they were washing their hands more regularly.

Timeline: swine flu in Malta

Monday, June 29: A 26-year-old male rugby player develops flu-like symptoms including fever while on holiday with a group of friends in Spain.

Tuesday, June 30: The rugby group arrives back in Malta at 9 a.m. on a Ryanair flight. Another 26-year-old male rugby player forming part of the group falls ill and develops fever by the evening.

Wednesday, July 1: The second victim calls in his doctor, who suggests tests for swine flu. Both men are tested by the health authorities. At 10 p.m. both are confirmed to be suffering from swine flu and efforts are made to contact the other members of the group.

Thursday, July 2: The health authorities officially announce that Malta registered its first two swine flu victims and another 13 individuals were being tested. By the evening, the number of victims rises to four.

Friday, July 3: The first two victims of swine flu tell The Times they were responding well to medication and were in high spirits. The number of confirmed swine flu victims shoots up to 16, an 18-month-old baby being among the new cases. The baby and another victim are UK citizens.

Saturday, July 4: Two British nationals and two Maltese youths test positive for swine flu as two of those confirmed on Friday have their status downgraded to "probable". The Church issues instructions to priests for people to receive Holy Communion by hand. The Health Department said a large number of people went to the Mater Dei Hospital Emergency Department overnight asking to be tested for swine flu. The spokesman explained that this disrupted the operations of the department and increased the potential of the virus to spread.

Data confirmed by Health Department at 4 p.m. yesterday.