Six probable swine-flu cases identified in Washington

Six probable cases of swine flu have been identified in Washington state -- three in King County, two in Snohomish County and one in Spokane County, public-health officials announced Wednesday night.

In King County, the patients are an 11-year-old boy who attends Madrona K-8 in Seattle; a 33-year-old woman who is a primary-care physician; and a 27-year old man, all of Seattle.

In Snohomish County, the cases include a woman and a 6-year-old boy. The Spokane case was identified only as an adult male.

Health authorities said they expected to confirm the results of the tests within the next few days.

"Swine flu appears likely to have arrived in Washington and Seattle," said Dr. David Fleming, director of Public Health -- Seattle & King County.

Seattle Public Schools planned to open as usual today. Spokeswoman Patti Spencer said the district is taking guidance from public-health officials about what steps schools should take.

The district sent a phone message to all families Wednesday night to let them know there has been a suspicious flu case at Madrona K-8 and that the student involved had not attended school while he was contagious. The district e-mailed staff as well.

Seattle and other area districts are reminding staff and students to be extra-vigilant about washing their hands, covering their mouths while coughing and staying home if ill.

"The best thing schools can be doing is re-emphasizing good, common-sense measures," said Martin Mueller, an assistant superintendent at the Office of Superintendent of Public Instruction.

Health authorities released at least a few details about the three Seattle patients, all of whom are improving. None had been in Mexico recently:

• The 11-year-old boy felt fine Friday but Monday had a fever, cough and sore throat. His mother kept him home from school, and he was later hospitalized, Fleming said.

• The primary-care physician has a husband and two children who are showing symptoms but all are improving. The health department is working with her workplace to notify her patients, Fleming said.

• The Seattle man, who lives alone, had a fever and cough.

Little was known Wednesday evening about the cases in the other two counties.

Health officials said it will take a few days for the U.S. Centers for Disease Control to confirm whether these are indeed cases of swine flu.

Chances are high they will be, said Dr. Tony Marfin, state epidemiologist. During the past two weeks, more than 95 percent of suspected samples sent to the CDC from around the nation have been confirmed as swine flu, Marfin said.

Since swine flu emerged as a global public-health emergency a week ago, doctors and hospitals said they have been running more influenza tests, seeing increasing numbers of patients they call the "worried well."

"They have a cold, and they're worried they have swine flu,"said Dr. Yuan-Po Tu, medical director of The Everett Clinic's walk-in clinics.

State health officials have been asking medical providers to send all samples testing positive for influenza A to the state lab in Shoreline to determine its subtype.

Officials realized around 6 p.m. Wednesday that they had probable swine-flu cases on their hands when the six samples tested negative for both of the two human influenza A strains, H1N1 and H3N2. That left the likely possibility that they were seeing the new swine strain of H1N1.

Next week, the state lab expects to receive from the CDC the reagents needed to run the confirmation test itself. That could cut down the confirmation time to about a day.

Two antiviral drugs, Tamiflu and Relenza, appear effective against swine flu. Over the next several days, Washington expects to receive 230,000 five-day courses of Tamiflu from the federal stockpile. Marfin said that's about 25 percent of the supply allocated to the state by the federal government.

Marfin said the drugs will be kept in stock only as precaution and will not be handed out yet.

"There is no plan for mass distribution," he said.

Marfin emphasized that residents do not need medical care for mild flulike symptoms.

"People should go to the hospital when they are ill" and not simply to seek a flu test, Marfin said.

So far, swine flu has been much less deadly than avian flu, the focus of much pandemic planning until now.

Avian flu has killed more than 60 percent of the 421 people infected with it worldwide, primarily in Vietnam and Indonesia.

But swine flu spreads among humans far more easily than avian flu. It's spread much the same way as seasonal flu: through large respiratory droplets from sneezes and coughs, and to lesser extent from infected surfaces.

King County has enough Tamiflu on hand to treat 190,000 people infected or exposed to swine flu.

Authorities stressed that the risk of infection for any one person is not great.

"The risk of getting swine flu in Washington is low. And the risk of getting seriously ill is extremely low," said Dr. Jeff Duchin, director of communicable-disease control for Public Health -- Seattle & King County.

Kyung Song: 206-464-2423 or ksong@seattletimes.com