Ohio National Guard moving Tamaflu into highly secure buildings.

In this photo released by the Ohio Department of Health, shipment of Tamiflu vaccine is received and stored by the Ohio National Guard at an undisclosed location Tuesday, April 28, 2009 in Ohio. Laboratory testing shows the new virus is treatable by the anti-flu drugs Tamiflu and Relenza, and the first shipments from a federal stockpile arrived Wednesday in New York City and several other locations in the U.S.. The government was shipping to states enough medication to treat 11 million people as a precaution.

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Comment by truth on April 30, 2009 at 4:30pm

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Swine flu is probably here

• 2 local cases called 'probable'; U.S. has first death• City schools proactive about possible closings•

WHO alert is at Phase 5, one step from pandemic

Thursday, April 30, 2009 3:28 AM

By Suzanne Hoholik

THE COLUMBUS DISPATCH

Adelina Vargas, from Costa Rica, walks through the luggage terminal at Port Columbus on her way to visit friends here. Her doctor told her to wear the mask to protect herself from the flu because she is mildly asthmatic. " border="0">

Jeff Hinckley | dispatch

Columbus Public Health medical director Dr. Mysheika LeMaile-Williams, left, addresses the flu situation at a news conference with city Health Commissioner Dr. Teresa Long, center, and Franklin County Health Commissioner Susan Tilgner.

Click here for an interactive swine-flu map." border="0">

Click here for an interactive swine-flu map.

Swine-flu cases

How possible cases of the new strain of swine flu are classified:

• Suspected: A patient has respiratory problems and one of the following factors: close contact with someone confirmed to have swine flu; travel to a community where there are confirmed cases; or living somewhere where cases have been confirmed.

• Probable: Someone with respiratory problems tests positive for influenza A but negative for the seasonal flu. The person also has traveled to an infected area, such as Mexico.

• Confirmed: A laboratory test done by the Centers for Disease Control shows that a person has swine flu, a respiratory illness that typically includes a fever, cough, runny nose and sore throat.

Source: Columbus Public Health

Complete Coverage

Get more information about the Swine Flu outbreak

9:53 A.M. UPDATE: The probable case of swine flu at Ohio State University involves a male patient, it was learned this morning.

The health situation got worse here and around the world yesterday as the new, deadly strain of swine flu continued to spread.

• The World Health Organization raised its alert level to Phase 5, one step from a pandemic, and the first death was recorded in the United States.

• Local officials yesterday confirmed a probable case involving a Columbus woman and are investigating up to seven suspected cases in Columbus and Ross County. Then last night, Ohio State University sent an e-mail to staff members and students saying an employee of OSU Medical Center was being treated there for a probable case of swine flu. It was not known if the case was among the eight that health officials had referred to earlier.

• And schools, which President Barack Obama said should consider closing if they have cases, were preparing for a pandemic that could keep children out of class.

What makes this flu so alarming is that scientists have never seen this strain, people have no resistance to it, and there's no vaccine.

The fast-changing news has prompted many people who might normally have toughed out flu symptoms to call their doctor or go to hospitals to be tested, especially if they recently have been in Mexico.

"Health providers and hospitals have told us they've been inundated with patients and calls," said Dr. Mysheika LeMaile-Williams, medical director at Columbus Public Health.

At Ohio State University Medical Center, anyone who says they have flu symptoms is given a mask before they enter the emergency room, said Dr. Richard Nelson, vice chairman of emergency medicine.

"If it's determined they have recently been in an outbreak area, then they're placed in respiratory isolation until further testing can be done," he said.

Dr. Medard Lutmerding, an emergency-room physician at Mount Carmel East and West, said those hospitals have sent two or three culture samples to the state laboratory for testing.

Health officials say the public can protect themselves: Wash your hands frequently, cover your mouth when you cough or sneeze, stay home when you or your child is sick, and avoid greeting people with kisses and handshakes.

"A virus like this is going to travel and change, and that may change the recommendations we have," said Susan Tilgner, Franklin County health commissioner. "Common-sense awareness is what we need people to follow."

Phase 5

Swine flu has now spread into 11 U.S. states and deeper into Europe, causing the World Health Organization to raise the alert to Phase 5, suggesting that a pandemic is imminent.

"It really is all of humanity that is under threat during a pandemic," WHO Director General Margaret Chan said in Geneva. "We do not have all the answers right now, but we will get them."

It was the first time the WHO had declared a Phase 5 outbreak, the second-highest on its threat scale, indicating a pandemic could be imminent. The swine flu has now been reported on four continents.

The flu has killed at least 160 people in Mexico, and it claimed its first victim in the U.S. -- a Mexican toddler who was visiting Texas.

Federal and state health officials confirmed 93 cases of the swine flu in 11 states, including one case in Ohio. Five people have been hospitalized.

At Phase 5, world health leaders want governments to be on alert for unusual outbreaks, work for early detection and treatment of known cases, and control infection in all health facilities.

"Influenza viruses are notorious for their rapid mutation and unpredictable behavior," said Chan of the WHO.

"What we still don't know is what this virus will do," said Dr. Richard Besser, acting director of the Centers for Disease Control and Prevention. "We expect to see more cases, additional hospitalizations and, unfortunately, we expect to see more deaths."

Senators questioned Homeland Security Secretary Janet Napolitano yesterday about her decision not to close the border, action she said "has not been merited by the facts."

Local cases

No cases have been confirmed in central Ohio, but a Columbus woman who recently traveled to Mexico is considered a probable case, officials said.

State health officials have sent a culture sample from the woman to the CDC in Atlanta to determine whether she has swine flu. This testing could take up to 96 hours.

The woman is at home now and so are co-workers with whom she had contact.

Columbus health officials also are investigating four to five suspected cases of the swine flu, said Dr. Teresa Long, city health commissioner. Ross County officials are investigating two suspected cases there.

Ohio State's statement last night said the probable case there involves an employee who contracted the virus outside the workplace and was being discharged from the medical center. The swine-flu diagnosis still must be confirmed by the CDC, the e-mail said.

Ohio's only confirmed case of swine flu involves a 9-year-old boy in Elyria. State officials said he's recovering at home.

Local health leaders yesterday asked the Franklin County Emergency Management & Homeland Security Agency to activate the county's Emergency Operations Center and the Joint Information Center.

Meanwhile, the state received its portion of federal stockpiled items for a pandemic: gowns, masks, gloves, other protective gear and antiviral medications that can treat the virus. Laboratory testing has shown the new virus is treatable by the anti-flu drugs Tamiflu and Relenza, of which there are no shortages.

"We think we are doing the right things, taking the right steps to try to mitigate the spread of this disease," Gov. Ted Strickland said.

Schools

The World Health Organization said the disease could be contained by closing schools and public places and by banning or restricting mass gatherings.

Epidemiologists say the idea is simple: If you keep people who have the virus away from others, you can stop the chain of transmission.

President Obama said schools with confirmed or suspected cases should "strongly consider temporarily closing so that we can be as safe as possible."

He also advised parents to think about contingency child-care plans.

Eight states closed schools yesterday, affecting 53,000 students in Texas alone.

Preparing for a possible shutdown if swine flu spreads here, Columbus City Schools administrators are creating work-at-home packets for students.

The district is planning to do everything it can "to continue education for our children" in a worst-case scenario in which schools would have to close, Superintendent Gene Harris said. That includes allowing students to do some coursework online.

As a precaution, staff members or students who have a fever of at least 101.5 degrees will be reported to the city's health department, district spokeswoman Kim Norris said.

"We have 94 nurses here in our district," Norris said. "Now, more than ever, they are in constant, immediate contact with the Columbus health department."

Dispatch reporters Randy Ludlow, Mark Niquette and Jennifer Smith Richards contributed to this story. Information from the Associated Press also was used.

shoholik@dispatch.com