Three more probable Kentucky swine flu cases were identified Friday afternoon in Louisville and Northern Kentucky, state health officials said.
Details were sketchy, but officials said the patients are a University of Louisville student, a child from Louisville, and a young woman from Kenton County.
According to an e-mail distributed to the U of L student body by university Provost Shirley Willihnganz, the student does not live on campus and has had "limited contact with other students, faculty and staff" since being seen at the university's Student Health Center.
According to the e-mail, anti-viral medication has been provided to anyone suspected of having come in contact with the student. U of L has developed a Web site to provide updates on the flu and tips on prevention.
Neither of the new adult patients is in the hospital, officials in Frankfort said. Information on the child's status was not immediately available.
The new cases were identified Friday afternoon through preliminary tests on samples from the three patients. State officials said samples now are being forwarded to the federal Centers for Disease Control and Prevention in Atlanta for analysis to determine whether actual swine flu is present.
The new probable cases are the first reported in Kentucky since Monday. Those new cases, combined with confirmations on some previously reported cases, leave the state with a current total of five probable cases and three confirmed cases, officials said.
Dr. William Hacker, Kentucky's public health commissioner, had said earlier Friday that the state might be able to cut back its flu monitoring and prevention efforts next week if no new problems appeared.
It was unclear how the new cases might affect that decision.
Hacker said in a prepared statement Friday afternoon that Kentuckians should continue to practice good hygiene — regular hand washing, covering coughs and sneezes, monitoring themselves for symptoms, and staying home if they're sick. Such steps can offer a hedge against further spreading flu.
Officials said the precautions are particularly important for Kentuckians who recently visited Mexico or other areas where swine flu has been reported.
Hacker said the state Department for Public Health will remain on a high level of alert over the weekend and "reassess things next week."
"If things do appear to be slowing down and the need for our support lessens, we might be able to cut back on our intense staffing," he said.
The state health department has been monitoring cases, testing patient samples and answering public questions almost around the clock since swine flu surfaced two weeks ago.
The Lexington-Fayette County Health Department said its swine flu hotline has received almost 600 calls during the period. But Fayette officials said Friday they might scale back the phone service next week if conditions warrant. The hotline, (859) 288-7729, will still be monitored during the weekend, officials said.
Hacker had cautioned earlier Friday that Kentucky might well see some more probable flu cases, given trends in other states.
However, public concern over swine flu has appeared to wane nationally as flu stories slipped off the front pages of many newspapers and some news reports have begun to question whether the whole situation was overblown.
But Hacker, like other public health officials, insists that the health response has been proper — even if it turns out that the flu threat is less serious than initially feared. Medical experts must move quickly when epidemics threaten, he said.
"If we are slow and things take a serious turn, we're accused of underresponding and not paying attention," he said. "But if we act aggressively, as we did in this case, and events turn out to be mild, we can be accused of overreacting. We have to err on the side of public safety."
Experts initially feared the influenza A H1N1 swine flu virus would be both highly contagious and dangerous. But U.S. flu cases generally have been mild, despite two deaths. And experts say the spreading of the virus seems to fade after going through one or two individuals.
But strains of influenza A caused three world flu pandemics during the 20th century: 1918, 1957 and 1968. The 1957 and 1968 outbreaks were considered mild, but the 1918 flu killed more people than World War I did.
"Historically, influenza A has been unpredictable, and we have to respect it greatly," Hacker said.
Health officials say that most of the Kentuckians previously identified with probable or confirmed swine flu have not been hospitalized and "have recovered or are recovering."
The one exception has been a Bowling Green area woman who was hospitalized with confirmed swine flu in Georgia more than a week ago. Kentucky officials said Friday that she is improving, but they were not sure whether she is still in the hospital.
The other confirmed cases involve a Lexington man and a young man from Daviess County.
Kentucky health officials still are awaiting confirmation on two previous suspected cases in Hardin and Montgomery counties.
Hacker says national health officials remain concerned that the swine flu virus still could mutate over the summer and return in a more contagious and dangerous form this fall and winter.