Swine flu confirmed, Minnesota goes on guard

COLD SPRING, MINN.

Cold Spring, Minn., a town of 3,000 in central Minnesota, found itself in the middle of a global disease outbreak Thursday as schools, city officials and clinics reacted to news that authorities had confirmed the state's first case of the new flu virus that swept out of Mexico last month.

At St. Cloud Medical Group's satellite clinic in Cold Spring, patients who walked in with flu symptoms were asked to don surgical masks and take seats in a separate waiting room. A worried mother alerted neighbors through the St. Boniface school newsletter that, contrary to rumors, her daughter is not the mystery patient. And at Rocori Middle School, a team of janitors prepared to enter the school Friday with disinfectant to scrub down doorknobs, handrails and desktops and other surfaces that might harbor germs.

"It's probably overkill," Superintendent Scott Staska said after a Thursday morning news briefing. "The health people tell us any remnants of the virus laying around are probably long dead. But we'll do a good cleaning just to be sure."

So with patient calm, the town began a carefully choreographed series of precautionary measures that thousands more Minnesotans could face in coming weeks if the novel virus spreads further.

The day began with a morning news conference at which Gov. Tim Pawlenty announced that the Centers for Disease Control and Prevention in Atlanta had confirmed that a flu specimen taken from a patient in Cold Spring was, in fact, the new strain of flu.

As of late Thursday, the state Health Department had tested 126 specimens, with another 23 pending. But all were identified as other types of flu or infections, health officials said.

Officials said Rocori Middle School would close for seven days, through next Tuesday, following CDC guidelines on how long anyone who has the swine flu is believed to be infectious. However, St. Boniface Elementary School told parents later in the day, after an emergency board meeting, that it will reopen Monday, although the 200 students must bring cold lunches. Starting Wednesday, if Rocori Middle School reopens as planned, the parochial school students will resume getting lunches there.

Rocori Superintendent Staska also said he is prepared to close other schools if new cases emerge.

At the moment, however, closing schools is "a precautionary measure," said Kris Ehresmann, director of infectious disease for the Minnesota Department of Health. "As the outbreak develops we will have more information on who is getting sick" and what additional measures might be necessary.

Keeping the schools closed can both prevent infection, and slow the rate of the epidemic if the virus is already in the population, she said.

"If you get a huge peak of disease, it taxes everything," she said. "If you can slow it down and reduce it, that's your goal."

Back in St. Paul, a team of Health Department investigators had returned from Cold Spring and were completing their interviews by phone. On Wednesday they had interviewed the infected patient and her family, and by Thursday they were trying to track down "the concentric circles of others that person came in contact with," said state Health Commissioner Sanne Magnan.

State officials offered no additional clues about the identity of the person with the virus.

However, in the St. Boniface School Weekly Newsletter, a personal note batted down one of several rumors about the person's identity. It included a note from Kim Baumgarten: "I am sending this to put a rumor to rest. My daughter, Keisha Baumgarten (RMS student) does not have the "Swine Flu." Because we traveled earlier this month and Keisha has been sick, some rumors have been out. She has been checked by the doctor and it is 100% negative. ... I feel for the families involved and hope that we treat everyone with respect."

If the outbreak does expand in Minnesota, state officials will be faced with a difficult task -- deciding whether to close more schools, and cancel public events such as concerts and graduations. That, too, depends on how the outbreak evolves, Ehresmann said.

"We'd be looking for a significant number of severe cases where we'd be concerned about the impact," she said. "But you walk a fine line of when that would be beneficial." If transmission is widespread then so-called social containment precautions are not much help. "Then the horse is already out of the barn," she said.

Much might be learned from the disease investigations underway in Cold Spring, she said. It's one of many hundreds going on around the world that will create a profile of the virus, which is now being referred to by health officials as H1N1 novel virus.

Meanwhile, health officials around the world struggled with what to call the new flu. The swine industry objects to the term "swine flu," saying it falsely implies that pork is a risk. The World Health Organization on Monday suggested that it be labeled "North American influenza," in keeping with the tradition of naming influenza pandemics for the regions where they were first identified. The CDC has now started referring to it by its scientific tag, H1N1, but there are many varieties of H1N1 influenza viruses. Minnesota health officials said they would call it H1N1 novel flu, to differentiate it from more typical H1N1 strains.

By afternoon in Cold Spring, some parents apparently were adjusting to their new world, adapting work schedules to accommodate closure of the two schools, with a total of 600 students, and some said they were a little more concerned about health issues after learning that someone in the school district has the virus.

"Well, sure, you get a little twitchy about the swine flu, with what's going on in Mexico," Sharon Schmidt said Thursday afternoon as she walked out of the Supervalu with a cart of groceries and two kids, one who would have been in his seventh-grade class if the school were open.

"Having kids home will be a problem for some parents," she siad. "For me, I'd rather have him under foot and healthy, so it's OK."

Josephine Marcotty • 612-673-7394 Warren Wolfe • 612-673-7253