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Minnesota health experts say flu threat real, but 'don't panic'

DULUTH - The mutant variation of swine flu that's spreading across Mexico and the U.S. is reason for concern in the Northland but not reason to panic, a Duluth-area expert said Sunday.

"Let's prepare, not panic," said Dr. Linda Van Etta, epidemiologist and infectious disease expert for St. Luke's hospital in Duluth. "But when the government releases 20 percent of the emergency stockpile of [flu medicine] it's time to take this seriously."

The U.S. government on Sunday declared a "public health emergency" over the flu outbreak and ordered 12.5 million doses of antiviral medications released to states.

So far, there have been no confirmed cases in Minnesota or Wisconsin and none of the U.S. cases has been fatal.

But Van Etta, who served on the Minnesota Department of Health's pandemic advisory committee, said the expanding swine flu outbreak has all the earmarks of a pandemic in which 30 percent to 40 percent of the population could become infected: It's a strain never before seen, has spread rapidly over large areas and is spreading directly from humans to humans.

"It's got all the characteristics. The odds are very good this is the first pandemic of the 21st century," Van Etta said. "Keep our finger's crossed that this will be a mild one. But, like we've been saying for five years now, prepare for the worst."

The new virus is called a swine flu, though it contains genetic segments from human and bird viruses, as well as from pigs from North America, Europe and Asia. Health officials had seen combinations of bird, pig and human virus before -- but never such an intercontinental mix, including more than one pig virus.

More disturbing, this virus seems to spread among people more easily than past swine flus that have sometimes jumped from pigs to people.

Van Etta suggests not traveling to Mexico, staying away from sick people and stocking up on necessities such as food and medicine.

She also backs a U.S. government recommendation to have face masks on hand.

And, most of all, wash your hands and cover your sneeze.

Van Etta already has warned her hospital to take precautions to protect staff from possibly infected people and to isolate potential flu victims immediately.

The disease, which seems to have spread from Mexico, has been confirmed in 20 people in New York, Kansas, Texas, Ohio and California as well as several students in New Zealand and newly reported cases in Nova Scotia, Canada.

Unlike seasonal flu versions, which affect mostly the very young and very old, the swine flu variation also is likely to afflict an unusually high number of people age 20-40, Van Etta said, because of an inflammation that occurs in the respiratory system.

All of the U.S. confirmed cases have been mild and only one person remains hospitalized. But up to 86 people have died in Mexico.

The Minnesota Department of Health last Thursday first asked hospitals and physicians to submit specimens for testing if they suspect a serious case of any flu. Of 12 cases tested, none were the swine flu variation.

Minnesota has stockpiled flu treatment medicines, as has the federal government, Dr. Ruth Lynfield, Minnesota state epidemiologist, said Sunday.

"We are taking the emergence of this unusual flu strain very seriously, and we are working very closely with national and local partners to characterize this outbreak," Lynfield said Sunday in a statement.

Van Etta said Northland residents shouldn't take solace in being somewhat isolated.

"We live in a global society. If this is a pandemic, it won't matter what part of the country you are in. ... How many people know someone who has been to Mexico this winter?" she said.

Van Etta noted that there have been at least three major pandemics in each of the past three centuries, including the 1918 outbreak that killed between 20 million and 100 million people.

"The thing to remember is that even in 1918, 98 percent of people lived through the pandemic. We have to put it in perspective," Van Etta said.

In the worst-case scenario, Minnesota experts estimated that 750,000 Minnesotans could become sick in a major flu pandemic and that 150,000 could need hospitalization, which could be a problem because the state has only 16,000 hospital beds.

If the outbreak expands in the state, authorities will decide what steps to take to prevent the spread, including closing schools, banning social events and even ordering people to keep at least 36 inches apart when in public, Van Etta noted.

By odd coincidence, the ethics of which flu-stricken Minnesotans get priority treatment and medicine during a pandemic is the subject of an already scheduled public health conference Saturday in Duluth.

"I've been saying the odds of a flu pandemic at some point are 100 percent," Van Etta said. "We thought it would probably be the [bird] flu variation, but we've also said it could come out of left field like this one has."