Washington - Kathleen Sebelius was approved by the US Senate as health secretary Tuesday, completing President Barack Obama's cabinet just shy of 100 days into his administration.

Sebelius, currently the governor of Kansas, will take over the Health and Human Services Department amid a growing swine flu outbreak in neighbouring Mexico and in the United States.

There were 64 confirmed cases of swine flu Tuesday in five US states, with the largest outbreak in New York. California has declared a state of emergency.

More than 150 people have died in Mexico of an influenza-type illness, including 20 confirmed swine flu fatalities.

Sebelius will be charged with shepherding Obama's wider health- care reform plans through the US Congress. The long-running debate over extending health insurance to more Americans and lowering US health-care costs looms as one of the most difficult and divisive issues of Obama's administration.

Sebelius' confirmation had been stalled over questions about her personal tax records, an issue that has dogged a number of Obama's nominees. She was approved Tuesday by a 65-31 vote in the Senate.