Health officials Tuesday afternoon have confirmed two cases of swine flu in Marin County, which has sickened at least 13 other Californians and prompted the governor to declare a state of emergency. The two confirmed cases in Marin County are the first in the Bay Area.
Local health officials have also identified one probable case of swine flu in Santa Clara County. The Santa Clara County Department of Public Health announced the suspected case Tuesday afternoon. The county lab could not identify the virus as one of the more common strains, so the sample has been sent to state labs for confirmation.
Results will be available in 24 to 48 hours, health department spokeswoman Kris VanTornhout said.
The swine flu has also sickened 45 people in New York City, six in Texas, two in Kansas and one in Ohio since the outbreak began earlier this month.
Gov. Arnold Schwarzenegger declared a state of emergency Tuesday for California in response to the swine flu outbreak that has sickened at least 15 Californians and 54 other U.S. residents.
Testing of Bay Area residents got under way Tuesday.
A state of emergency allows the California Emergency Management Agency to start working with state Department of Public Health to prevent the disease from spreading, governor's spokesman Jeff Macedo said.
As of about 10 a.m., the Alameda County Public Health Department had sent nine nasal swab specimens to the California Department of Public Health for testing, according to Alameda County health department spokeswoman Sherri Willis.
Willis said test results could be available by early Tuesday evening.
The Pleasanton Unified School District sent out an email to subscribers of its e-Connection advising people about symptoms of the swine flu, information from the Centers for Disease Control.
"Please do not send your child to school if he/she has a fever, and keep your child home for 24 hours after a fever without the aid of medicine such as Tylenol or Advil," the e-Connection states. Â "The health and well-being of our students is our top priority, and we are doing everything possible to address the situation."
Jelissa Walker, an infectious diseases nurse at San Ramon Regional Medical Center, said Monday the hospital hasn't had anyone come in with flu-like symptoms, but she's notified her staff to be on the lookout just to be overcautious.
"I put it out to our emergency room that if they see anybody coming in with funky respiratory illnesses, with a fever and maybe some abdominal issues, to just keep me apprised, but we haven't seen anything coming through our doors," she said.
The regular flu season goes from October to the end of April and this year has been relatively minor in the number of cases, which means San Ramon Regional has a healthy stock of Tamiflu, which has effectively been treating swine flu cases.
"We're one of I'd say three or four hospitals in the state that keeps a small stockpile of that," Walker said. "We have an arsenal to treat our patients. We're not concerned about supplying antivirals to them."
If someone were to come into the emergency room with flu symptoms, hospital staff would take a nasal swab from the patient and test it, she said. If it was swine flu, the results would show it was the H1N1 strain and the hospital would send it out for further testing. The patient would be treated, sent home and told to keep isolated for seven days.
Walker said she has told her staff to be aware, especially since some employees are taking vacations to Mexico.
Bernie Revak, manager of ValleyCare Health System's Department of Infection Control and Prevention, said Tuesday the hospital is "constantly monitoring the CDC website, participating in CDC conference calls and receiving up to the date alerts from the local and state Departments of Public Health."
Signs have been posted asking patients and/or visitors to cover their mouths when they cough, maintain careful hygiene and ask for a mask if an individual has a cough or flu-like symptoms, Revak said.
"We are following all recommendations from Alameda County Public Health Department regarding the collection, handling and testing of specimens collected for swine influenza surveillance," Revak added.
ValleyCare, like San Ramon Regional, also has a supply of Tamiflu, Revak said, and it is working with vendors to increase stock levels. The CDC has said it is releasing one-quarter of its antiviral drugs, personal protective equipment and respiratory protection devices to help states with confirmed cases respond to the outbreak.
Axis Health, a nonprofit which operates clinics in Pleasanton, Livermore and Dublin to serve low-income residents, is being advised by the county on what measures to take.
"We have the protocol which is given to us by the Alameda County Health Care Services Agency's public health department," Meena Rijhwani, medical director for Axis, said Monday. "They just want us to be alert, vigilant and see if anybody has a respiratory illness or fever coming from San Diego County; Imperial County; and San Antonio, Texas, who have lived over there or traveled over there or been in contact with anybody with the swine flu to do the testing."
"We have not seen anyone that we suspect (has the swine flu)," she added. Because this is the tail-end of the regular flu season, Rijhwani said Axis gets many patients who come in for treatment of the flu, so that's why they are not testing everyone.
But, she added, patients with flu-like illnesses will be given masks to wear as a precautionary measure to prevent the spread. While the clinics don't have Tamiflu on site, they do write prescriptions and patients can then pick it up at a pharmacy. Should anyone contract swine flu, the county will release Tamiflu immediately to be given out at the clinics.
Swine flu is believed to spread mainly person-to-person through coughing and sneezing. Health officials recommend that people cover their noses and mouths with a tissue when coughing or sneezing, wash hands often with soap and water, and avoid touching eyes, noses and mouths.