Photo by Bill Green Christa Williams, health specialist for Frederick County Public Schools, reports that all Frederick County school have been supplied with face and nasal masks in case a student comes down with flu symptoms at school. This will protect others until the student is picked up from school.

"It's circulating all over," said Dr. Barbara Brookmyer, Frederick County's health officer, at a news conference Friday. Of flu cases reported nationally, 98 percent are of the H1N1, or swine flu, variety.

Influenza-like illness rates are increasing at schools across the nation.

"What we're seeing here isn't different from a typical flu season," she said. "Maybe it's starting a little earlier."

A swine flu vaccine likely won't be available until mid-October. But when it is, the county health department will have clinics at multiple times and locations to prevent the need to stand in long lines, she said.

Swine flu tends to strike the young and healthy more than older people. That's because people over 64 have likely encountered a similar flu strain and have some resistance. Swine flu seems to be most common among people ages 6 to 24, Brookmyer said.

The virus isn't serious in the vast majority of cases, Brookmyer said. The prescription is lots of rest and fluids. Swine flu, like other influenza viruses, is only a concern when someone who gets the flu already has a compromised immune system from diabetes, heart disease, asthma or other diseases that demand a lot from the immune system.

Because swine flu is already widespread, testing for all cases isn't recommended, Brookmyer said.

"It's assumed if you have the flu, you have H1N1," she said.

Testing is being limited to people who are being hospitalized or who have died after coming down with flu.

So far, no county public schools have reported any cases of swine flu in Frederick County, although two cases have been reported in Washington County. Frederick Memorial Hospital has had one confirmed case since Sept. 1.

"Medicine is part science, part art," she said. "What we have people saying is, 'My doctor diagnosed me with swine flu.'"

Labs are being overrun with tests, which makes it more important that routine flu, even routine swine flu, not be tested.

"What we want to know is, has this virus changed?" Brookmyer said. "Is that why it's more severe?"

School preparation

This fall, schools are the focus of prevention, Brookmyer said.

"The social density is higher there than in offices," she said.

Frederick County schools, government and businesses are giving people the same advice being heard around the world: Wash your hands. A lot. And cough into your sleeve.

Christa Williams, health specialist for Frederick County Public Schools, said schools have hand sanitizers and hand washing stations throughout school buildings.

"We're taking good hygiene education to the schools," she said.

Posters telling students to cough into a tissue or their sleeve are in every classroom. Students who feel any flu symptoms are being asked to stay home.

Schools do have masks, in case a student comes down with flu symptoms at school. A system is in place to separate those children until they're sent home, Williams said at Friday's press conference.

Students may be asked to wear one of the purple masks, and staff members in close contact with the student may also wear a mask, she said.

Schools will likely stay open if cases are reported, but that could change.

"Everything changes from day to day," Williams said. "We've had a few cases of flu so far, and it's common in the community."

But none of those cases has been confirmed as H1N1, however.

Other preparations

Pregnant women, health care providers and anyone who works with children are being asked to get vaccinated as soon as one is available. Pregnant women are considered at high risk. Anyone who comes into close contact with a child 6 months old or younger should also be vaccinated. Babies younger than 6 months cannot be vaccinated.

Frederick Community College has one local student who called the school Tuesday and said his doctor confirmed he has swine flu, said spokesman Michael Pritchard. The doctor said the student probably got the virus while visiting New York City. The student hasn't been to school since becoming ill.

"We have no reports of any outbreaks," Pritchard said. "The health department is telling us it's very difficult to distinguish between seasonal and H1N1 flu. We haven't had any reports of huge numbers of absences."

Mount St. Mary's University, where many students live on campus, has not had any positive test results for swine flu, spokeswoman Linda Sherman said.

"Visits are up a little bit at the Wellness Center," she said. "There's probably a little bit of nervousness. Any little thing, they are coming in."

Resident assistants are encouraging any student with symptoms to get checked. Some students want to tough it out, she said.

"When you're living in close quarters as college students are, that's not a good idea," Sherman said.

Many students said parents tell them to get symptoms checked out right away. The university is encouraging them to get vaccinated, Sherman said.

Seasonal flu vaccinations will be given to students from 9 a.m. to 5 p.m. and 5:30 to 7 p.m. Monday. Staff will get shots Oct. 1.

"We're telling students to get serious about washing their hands," she said. "We've done a lot of prevention. In this age, you need to know what the facts are."

At the Frederick YMCA, where at least 1,000 people a day go for exercise and group activities, hand sanitizers and antibacterial soap are in plentiful supply, as are signs informing members to wash hands frequently, spokeswoman Tammy O'Connor said.

Flu behavior

Flu is a reality every year, especially in the colder months. The flu virus tends to do better when temperatures are down. As a result, people are more likely to get the flu in the coming months. Most people spend more time indoors when it's cold outside, and that adds to the spread of the virus.

Flu is contagious, whether it's swine flu or seasonal flu. Going out in public with a fever, sore throat, cough, body aches, chills and fatigue is a good way to spread flu.

The Centers for Disease Control and Prevention wants anyone with symptoms to stay home for at least 24 hours after the fever is gone without help from medicine.

The current swine flu is called that because the virus is similar to a swine flu that pigs typically get in some parts of the world. But this H1N1 virus is different from the swine flu that pigs in North America get, according to the CDC.

Therefore, the myth that people can get swine flu from being around pigs or eating pork is strictly that: a myth. In fact, swine flu will not pass from pigs to humans through eating pork.

Those most at risk are the only ones who should take antiviral flu medicines to prevent resistant flu from developing, Brookmyer said.

Flu and the fair

According to a recent NPR report, hog farmers are keeping their animals away from people at county fairs. The fear is that the pigs could catch it from people and it would mutate into a new strain.

That's not a concern at the Great Frederick Fair, which starts in a week.

"There's no impact on our event as of this date," said Becky Brashear, executive assistant to the fair.

Brashear said the Maryland Department of Agriculture, which dictates elimination or reduction of animals for livestock shows, has not notified the fair of any such measure. In fact, the swine entry for the fair is up over last year, Brashear said.

"We put our animals through two or three checks and balances and we follow a whole outline of animal health protocol, not only for the safety of the animals but also for the spectators," she said.

But labeling the H1N1 virus swine flu is costing the pork industry several billion dollars,--according to the National Pork Producers Council.

The nearly 2-year-old economic crisis has put some producers out of business as the pork industry has lost more than $4.6 billion in equity over the past two years, the NPPC said.