The mainland has confirmed its fifth case of swine flu - a 21-year-old male student who just returned to Beijing from studies in Canada - according to a statement published on the Ministry of Health's website yesterday. This is also the second confirmed case of the swine flu in Beijing. The patient, who studies in a Toronto-based university, arrived in the capital on Air Canada flight 031 from Toronto on Saturday. He developed flu symptoms three days later and checked himself into a Beijing hospital on Tuesday. He tested positive for swine flu yesterday and was transferred to Beijing Ditan Hospital for medical treatment. So far, all five of the confirmed cases of swine flu on the mainland have been people returning from North America. The mainland has expanded its swine flu monitoring network - a strategic change in the face of a rise in the number of imported cases. The Ministry of Health issued a notice requiring provincial capitals and cities with huge populations, numerous migrants or international ties to establish laboratories to monitor swine flu and seasonal flu, and designate a big hospital in each city where patients would be treated, according to a directive posted on the ministry's website. The designated hospital must collect respiratory samples of those who were taken there to be treated for pneumonia, on top of collecting 20 to 30 respiratory samples of the flu outpatients to be sent to the lab for testing. 'This is to expand the scope of the monitoring, increase monitoring capacity and improve the monitoring network so that imported cases of A/H1N1 flu can be promptly discovered,' the notice said. Zeng Guang, chief epidemiologist at the Centre for Disease Control and Prevention, said the directive signified an adjustment in mainland strategy, from fighting the disease with strict border controls to 'doing the utmost to strengthen flu monitoring across the country'. Three of the mainland's previous four confirmed swine flu sufferers, all imported cases, showed no flu symptoms when crossing the border. Hundreds of people were later put under medical observation for being in close contact with them, such as sharing the same vehicle or hotel. The first two confirmed cases - one in Chengdu , Sichuan and the other in Jinan , Shandong , have been discharged from hospital. The third case, in Beijing, and the fourth, in Guangdong, remained in stable condition with normal body temperatures, but were still being treated. Asked why it took Guangdong almost three days to report a suspected case when Guangzhou could get viral test results in three hours, authorities said they had conducted 16 tests to make sure the patient was A/H1N1 positive because the original two tests came back negative, the Shenzhen Economic Daily reported. A previously reported suspected case, a 42-year-old Italian female tourist who had travelled to Tibet via Nepal, was confirmed to be suffering from seasonal flu, the ministry said. She had been put under hospital quarantine in Zhangmu town on Saturday.