Officials confirm Phila.-area swine-flu cases

The swine-flu outbreak formally arrived in the Philadelphia region and New Jersey yesterday as officials confirmed nine cases, though all appeared more anemic than epidemic.

None of the nine patients was hospitalized, including a family of three in Burlington County and four University of Delaware students.

Public-health officials continued to urge people to take basic precautions: Wash hands frequently, cover coughs, and stay home from work or school if you have flulike symptoms.

"So far we have been lucky," said Marla J. Gold, dean of the Drexel University School of Public Health. "That doesn't mean the public should become complacent."

The new infections were confirmed as swine flu appeared to be stabilizing in Mexico, the epicenter of the outbreak. Still, the number of confirmed U.S. cases reached at least 118 yesterday. Nearly 300 schools in the United States have been closed to combat the spread of the virus.

Pennsylvania health officials raised the number of probable swine-flu cases to four: three in Philadelphia and one in Montgomery County.

But even as the World Health Organization raised the swine-flu alert to "phase five" - the second-highest level, indicating human-to-human transmission in at least two countries - few cases in the United States were severe.

"Most of the confirmed cases in the U.S. have not caused serious disease," said P.J. Brennan, chief medical officer at the University of Pennsylvania Health System. Another positive sign was that the new virus can be treated with existing antiviral drugs.

Still, said Brennan, an infectious-disease specialist, "the situation is worrisome because it is a novel virus, and it does appear to be easily transmitted."

Emergency rooms in the region have not had a significant increase in flu cases.

"We are preparing for, but not yet seeing, a major problem," said Tom Grace, the point person for disaster preparedness at the Delaware Valley Healthcare Council, which represents hospitals.

"Mostly what we are seeing in our emergency room now are a lot of the 'worried well,' " added Jane Gould, an infectious-disease doctor at St. Christopher's Hospital for Children in Philadelphia.

In addition to the five confirmed cases, New Jersey health officials awaited test results for two other people. State officials said all seven patients had mild flu.

The three Burlington County patients were members of a family that had recently been in Mexico, state officials said. Two - a 14-year-old boy and a 10-year-old girl - are students in the Mount Laurel School District.

The superintendent posted a letter on the district's Web site yesterday stating that "both students have been absent from school throughout the past week and have been deemed 'beyond the communicable stage' by county health officials."

Both have recovered fully, but neither was in school this week, according to the letter.

At a news conference yesterday, Gov. Corzine said, "It is time to be cautious but not alarmed."

At the University of Delaware, attendance was lighter than usual yesterday, officials said.

The 20,000-student campus in Newark remained open, but president Patrick T. Harker urged anyone with symptoms to stay home.

Six new probable cases were identified at the school yesterday, taking the total there to 12 probable and four confirmed cases.

The Delaware health department is reaching out to anyone who had contact with the sick students, including friends and roommates, university spokeswoman Andrea Boyle said. Health officials can be reached at 866-408-1899.

The university canceled all large public gatherings and gave professors discretion to call off classes.

Alfred I. du Pont Hospital for Children in Wilmington and Union Hospital in Maryland have banned some university nursing students from performing clinical rotations, a university faculty leader said yesterday.

"It poses a bit of a problem" for nursing students who need to get their work in, said Amy Nagorski Johnson, faculty senate president and associate professor of nursing.

She questioned the rationale of excluding students who have no symptoms and understand safe medical practices.

Alfred I. du Pont spokesman Jim Lardear said the hospital treats seriously ill children who already have compromised immune systems and must be cautious.

He said only one student had been asked to forgo a rotation, in the blood and bone-marrow transplantation unit, a particularly sensitive area. He said the hospital would help the student make up the work. Union Hospital officials could not be reached.

Even as more U.S cases are confirmed, the new virus is not yet as dangerous as seasonal flu, which causes an estimated 30,000 to 36,000 deaths a year in the United States.

The big question for health officials is why the swine-flu virus seems to have hit harder in Mexico.

Experts said Mexico was not tracking mild or moderately ill patients who get better without medical attention. It has taken samples for confirmatory lab tests only from the sickest and the dead.

"Probably you're seeing just the tip of the iceberg in Mexico," said Phyllis Flomenberg, head of infection control at Thomas Jefferson University Hospital.

Even if this wave of swine-flu cases slows, experts agree that elevating it to a global health emergency is not an overreaction. No one knows whether the virus will fizzle out - or mutate into a threat.

"There is no reason it couldn't recombine with more virulent strains in birds, swine, or humans," said Sonja Gerrard, a University of Michigan virologist. "Is it likely? That's hard to say. It is possible."

Updates and tips for preventing illness at http://go.philly.com/swinefluEndText

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