Two Confirmed Cases of H1N1 in Va.

Two Virginia adults -- a man in the eastern part of the state and a woman in the central part -- are the state's first two confirmed cases of swine flu, Virginia officials confirmed late Thursday.

"Both of the individuals had traveled to Mexico," said Gov. Timothy M. Kaine during a press briefing Thursday night.

"Both had mild illnesses that would essentially be the equivalent of the seasonal flu. But because of all the news surrounding H1N1, they did contact health-care providers. After testing, it was determined they did have H1N1," said Kaine, referring to the swine flu by its technical name, H1N1 influenza A.

For privacy reasons, officials would not be more specific about the localities where the two people live, nor provide ages or any other identifying information. Neither had to be hospitalized, and both have recovered, Kaine said.

Health officials said an appropriate epidemiological investigation was done of people who had contact with the man and woman.

"I can clearly tell you that they both followed the [Centers for Disease Control and Prevention] guidelines, that we thoroughly investigated family and contacts, and there were no schools involved, which is an important question for people," said Dr. Karen Remley, state health commissioner

"We are following public health guidelines and feel we have a very safe situation," Remley said.
Kaine emphasized that there are likely to be more cases, and he urged people to follow recommendations to stay home if they are sick, to cover their mouth and nose when sneezing or coughing, and to wash their hands often.

"What we have been saying in the last week is real," Remley said. "We really want people to follow those public health guidelines.

"Both of these individuals came home and stayed home," Remley said, emphasizing that they were mindful of not spreading infection. "They did exactly what the CDC asked them to do. They said, 'I am going to stay home and recover.' They talked to us."

Both of the Virginia residents who had the swine flu were described as fairly healthy before getting the flu.

One thing that worries health officials about this flu is that unlike seasonal flu that typically sickens the very young and very old at higher rates, the swine flu is making younger healthy adults sick.

The virus is spread person-to-person, and a person can be infected and spread the infection before having symptoms.

The antiviral drugs Tamiflu and Relenza can lessen the severity of symptoms and shorten the course of the illness.

In Mexico, where there have been as many as 168 suspected flu deaths, the illness seems deadlier. But that raises the questions of whether the virus is simply deadlier there, whether there are some other environmental risk factors, or whether there are simply many more undocumented or unrecognized infections.

"To me the big mystery is still why the deaths in Mexico," Dr. Richard P. Wenzel, an infectious disease specialist at Virginia Commonwealth University, said in an interview earlier Thursday.

Virginia is continuing its policy of only reporting confirmed cases. By early next week, the state labs should have on hand testing kits that allow faster turnaround of test results. Right now, the tests are sent to the CDC labs in Atlanta for confirmation.

The state is also operating a hot line and Thursday got more than 700 calls, including callers from other states, Kaine said.

"It's the anxiety about the course the disease is taking, which hasn't been seen before, and for which there is no vaccine, that creates the need for caution," Kaine said.