Ecuador's President Rafael Correa was under medical observation after it was confirmed that one of his ministers and two people on his security team contracted swine flu, officials said.
"Everyone who has been in close contact (with the infected people) is under observation in case they become symptomatic, including the President," Health Minister Marcelo Aguilar said.
Among his inner circle, Correa's Policy Minister Ricardo Patino, security chief and a guard all came down with A (H1N1). Patino is in hospital and stable, the Health Ministry said.
Correa, just sworn in for a second four-year term, was not in isolation, as he has not been asymptomatic, authorities said.
Ecuador has seen at least 19 people die of the disease, and has more than 900 confirmed cases in a country of almost 14 million people.
This week authorities confirmed Costa Rica's President Oscar Arias, a Nobel Peace Prize winner and mediator of the Honduran political crisis, was in good spirits as he fights the swine flu at home.