The number of confirmed swine flu cases in Kentucky jumped to 20 on Wednesday and is likely to increase further as a result of a cluster of more than 20 possible new cases in Madison County.
Altogether, five new Kentucky cases were confirmed Wednesday, raising the total to 20. The new cases included a child at Georgetown's Anne Mason Elementary School. In letters sent home with students, the Scott County Public Schools said workers would clean and sanitize buildings in the district overnight.
The Madison County cluster — the first identified so far in Kentucky — involves more than 20 people at a residential supported living facility, state health authorities said. The facility serves people who are mentally retarded or developmentally disabled.
One resident there has been confirmed to have H1N1 swine flu. But two others at the facility have "probable" cases of swine flu, and about 20 more have flu-like systems, according to Christie Green, a spokeswoman with the Madison County Health Department. The numbers include both residents and staff members, Green said.
State health officials say it's likely that all of those at the facility who have symptoms will turn out to have H1N1 swine flu. Roughly half of the residents have displayed symptoms, officials said.
Dr. Kraig Humbaugh, Kentucky's state epidemiologist, said the new cases are a reason for concern, but not for panic. With flu cases continuing to spread, clusters in close-living situations probably are inevitable, he said.
"There is reason to be watchful. But the good news is that based on the evidence so far, it appears that the severity of this illness may be comparable to seasonal flu," Humbaugh said.
Madison County health officials don't know how residents at the supported living facility might have contracted the flu virus, Green said. But she noted that while residents might not travel frequently, they are in regular contact with their caregivers and families and friends who visit.
Residents live in separate housing units — each unit with three residents plus staffers. But they are together for extended periods each day for group activities. That could increase the chance for flu transmission within the group, health officials said.
"We assume, based on the one confirmed case, that all the cases will turn out to be H1N1," state health department spokeswoman Gwenda Bond said. "In fact, we probably will test only a few more samples, rather than trying to confirm all 20."
All the patients will receive medical treatment as if they have swine flu, she said.
According to Green, the Madison County Health Department and the provider that operates the facility were cooperating to prevent further spread of the flu virus. The joint effort includes providing anti-viral medications to any patients who need it, and "voluntary isolation and quarantine of individuals who are ill or have close contact with others who are ill," according to an announcement from the state health and family services cabinet.
The quarantine could continue for a week or until symptoms resolve, health officials said. All group activities at the residential facility have been canceled.
Some residents developed symptoms early last week. That alerted caregivers, who then contacted health care providers and the county health department.
Test samples from some patients were sent to Frankfort, which led to Wednesday's confirmed case, Green said.
Green said those under quarantine were voluntarily staying in their rooms and using protective measures such as wearing masks.
In addition to the one confirmed case in Madison County, and the child in Scott County, three more flu cases were confirmed in Jefferson County Wednesday, the state health department said.
A complete listing of all cases by county can be found by going to to http://healthalerts.ky.gov.