Twenty-eight probable cases of swine influenza A (H1N1), also known as swine flu, have been identified in King County through the Washington State Public Health Laboratory.

"We know that the H1N1 virus is circulating widely and the disease has proven to be relatively mild, so we believe that many cases are not being formally diagnosed," said Dr. David Fleming, Director and Health Officer for Public Health Seattle and King County. "We need to find new ways to reduce infections besides focusing on diagnosed, probable cases. We will no longer recommend school closure when we have just one or two probable cases in a school. Instead, we will recommend symptom checks at home and school."

In the coming week, Public Health will work closely with school districts to support this new approach to reduce infections in schools. Instead of closing a school when there is a probable case, Public Health is recommending that parents carefully check their children before school for signs and symptoms of the flu. If symptoms are present, they should not send their children to school. Schools should monitor children and conduct symptoms checks. If they find children with symptoms of the flu, those children should be sent home.
School staff and faculty should assess themselves for symptoms of influenza.

"Our parents are at the front lines of stopping the spread of infection," said Fleming. "We are urging all parents to assess their kids every morning to see if they're sick, and keep them home if they are. In addition, we will be working with schools across King County to help them identify if children are ill so that sick students are sent home before they expose other children."

There appears to be very limited demand for the antiviral drug Tamiflu to treat patients who have severe illness. However, Public Health is launching a strategy to make sure that adequate and accessible supply exists in the community for every patient with a prescription that is in need of this medication.

While there is plentiful supply of Tamiflu in King County, distribution may be slightly backlogged. Public Health will distribute Tamiflu to any hospital that requests it, and it is identifying sites throughout the county so Tamiflu can be dispensed to patients who cannot find it in their local pharmacies.

Public Health is recommending that readers do not seek medical care if you are not ill or have mild symptoms for which you would not ordinarily seek medical care. If you have more severe symptoms of fever, cough, sore throat, body aches or are feeling more seriously ill, call your health care provider to discuss your symptoms and if you need to be evaluated. Your health care provider will determine if a test is appropriate, based on guidelines from Public Health.

Public Health will continue to work with health care providers to test flu patients who develop severe illness or are associated with clusters of other sick people, but does not currently recommend testing for all flu patients.

If the following flu-like symptoms are mild, medical attention is not typically required: runny nose or nasal stuffiness; low-grade fever for less than three days; mild headache; body aches and mild stomach upset.

The CDC has determined that the swine flu virus H1N1 is contagious and is spreading from person to person. Symptoms of swine flu include a fever of more than 100 degrees, coughing, joint aches, and, in some cases, vomiting and diarrhea.

Public Health has a Flu Hotline for the public at 877-903-KING (5464), staffed from Monday to Friday, 9 a.m. to 5 p.m. Interpreters are available.