Only three cases of the H1N1 influenza strain have been confirmed in Northeastern Minnesota so far, but that doesn't mean area residents should get complacent.
Confirmed cases represent a small fraction of the total cases, health officials say.
The state recorded its first death from the flu strain last week, officials said Monday. A child from the Twin Cities area died late last week after a brief hospitalization.
State medical epidemiologist Aaron DeVries said the child had multiple medical conditions before falling ill. Lab tests confirmed the H1N1 swine flu virus.
Statewide, 274 cases of swine flu have been confirmed. The three cases in Northeastern Minnesota equate to just 1.1 percent of the total.
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"But that's just the tip of the iceberg," said Dr. Johan Bakken, a specialist at St. Luke's Infectious Disease Associates. Bakken said under state guidelines the only people who are tested for swine flu are people who are sick enough to be hospitalized.
Health providers lack the resources to provide this testing locally and must instead send cultures to Minnesota Department of Health laboratories in the Twin Cities.
"We're all assuming there are more cases than the numbers indicate," said Dr. Timothy Burke, an infectious disease specialist for SMDC Health System.
"The fact that there have not been a lot of confirmed cases of H1N1 in northeast Minnesota doesn't mean the flu is not there, just as having a large number of confirmed cases in another area doesn't mean it is necessarily a hot spot," said Buddy Peterson, director of communications for the Minnesota Department of Health. "You have to assume it's everywhere."
Peterson said monitoring efforts are more intense in the metro area, where health officials have set up "sentinel clinics" to more closely track the spread of the illness.
Bakken pointed out that people throughout the state continue to seek treatment for flu-like illnesses at a time when the seasonal illness usually has fizzled.
Typically the first flu cases emerge in October or November and fade away by February or March.
U.S. health officials were tracking nearly 18,000 confirmed or probable swine flu cases in the country as of Friday, including 45 confirmed deaths. The World Health Organization's global count approached 36,000 cases in 76 countries on Monday, including 163 deaths.
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Dr. Ruth Lynfield, the state epidemiologist, said most cases are mild but the illness can be grave for people with underlying health problems. That's got health officials keeping close tabs on the situation.
"This flu is very widespread, and we expect to see many more cases across the state," Lynfield said in a prepared statement.
Flu symptoms include a fever plus a sore throat, achy muscles or an unproductive cough. Some H1N1 flu victims also have developed diarrhea.
Officials are urging people to take basic precautions, such as washing hands frequently, covering coughs and staying home when sick. People with health problems should call their medical provider if they develop fever, cough or a sore throat.
