The much talked about Influenza A/H1N1 virus, a never-before-seen, rapidly spreading swine flu strain has so far spared all but one tribal community. The Tohono O’odham Nation in the Arizona Sonora Desert reported four cases, all children, and all are recovering. A suspected case that closed a tribal campus at the Confederated Tribes of the Grand Ronde in Ore. was not the H1N1 strain.

The Havasupai Tribe, whose village in the Grand Canyon flooded last August, put off reopening to June 1, disappointing hundreds of would-be visitors. “We’re a small, isolated community,” said Vice Chairman Matthew Putesoy. “People come from all over the world to visit, and even though we’ve lost our economy, we couldn’t take the risk.” It’s the first time the canyon has closed since the early 1900s.

Photo courtesy The National Institute of Allergy and Infectious Diseases Pictured is a closer look at the virus.

The U.S. has declared a state of emergency, and health officials say flu cases are likely to grow in coming days. The World Health Organization alert level remains at Phase 5, a strong indication that a pandemic is imminent and the time to implement planned mitigation measures is short. Even though most cases of the flu have been mild, the WHO is warning against over confidence.

Dr. John Redd, branch chief of the Division of Epidemiology, said IHS is responding aggressively. “I’ve been on the job for 11 or 12 days. We activated our emergency coordination center early on, and all of the tribes have put their emergency response plans into action. We feel the response has gone very well.”

Dr. Julia Wong, a physician with the Portland, Ore. Native American Rehabilitation Service said non-IHS medical providers are coordinating with state and local governments to provide services. “We are on our own,” said Jennifer Lagergren of the Chinook Nation, a non-federally recognized tribe in Washington State. “We live more close together with each other, with our children, our elders.” She worries that if the flu virus reaches them, it will spread fast.

Flu experts are struggling to predict how dangerous this new strain will be. During the swine flu threat of 1976, government programs rushed to vaccinate nearly 25 percent of the population. Only 200 came down with the flu, but 500 people developed Guillain-Barre syndrome, a rare neurological disorder that causes temporary paralysis; 25 died. It cost the government their credibility, and millions of dollars in damages. But memories of the 1918 Spanish flu – that affected Native Americans and Alaskan Natives especially hard – is a harrowing reminder that novel strains of human-to-human transmissible swine flu can turn into human plagues. According to the Centers for Disease Control, this new swine flu strain lacks the genes that made the 1918 pandemic so deadly.

Nor is this flu particularly virulent. “It’s just that it’s a new strain and the human population hasn’t built up a resistance,” said CDC spokesperson Karen Hunter. She said 36,000 deaths a year are flu-caused and the CDC is not expecting this flu to exceed that; there are concerns that this strain could mutate and return in a more virulent strain.

Mexican authorities first noticed a higher than usual number of respiratory illnesses in mid-March. In early April, the CDC was investigating cases in California and Texas. They made an official announcement April 24. As of this report, the flu had spread to 41 states and 22 countries. Since the virus broke, there have been two deaths in the U.S. A toddler whose family was visiting Texas from Mexico and a woman, with underlying health issues. Officials have not confirmed her death was caused by H1N1 but was linked to it. Newsweek reported that in 2005 a Wisconsin teenager who butchered pigs came down with an H1N1 swine flu virus, the first part of an evolutionary tree that has led to this current strain. But whether or not this is a pig virus, eating pork won’t infect anyone.

Flu is caused by the airborne spread of droplets and everyday actions; avoiding contact with someone who is sick can keep you healthy. Symptoms are usually fever, cough, sore throat, headaches or muscle aches, fatigue and occasionally vomiting and diarrhea. If you or someone in your family has symptoms, seek medical care. Young children may not have typical symptoms, but may show signs of low activity and have difficulty breathing.

Photo courtesy South Dakota State Historical Society-Archives An unidentified sick man is being cared for. While it is not known if the sick person had the Spanish Flu prevalent in 1918, the time period of the photo is correct.

The CDC and IHS are asking those with respiratory illnesses to stay home from work or school to avoid spreading infection. Protect yourself by washing your hands thoroughly and frequently with soap or an alcohol-based hand sanitizer, practicing social distancing – keeping distance between you and those who are sick, and using tissues or sneezing into your elbow to keep from sending germs airborne.

Two anti-viral medications, Tamiflu and Relenza, are effective treatments for those with serious illness if used early. Redd said IHS maintains their own supply of the drugs. If those are depleted, then drugs from the Strategic National Stockpile are distributed by the states to medical facilities.

So far, the U.S. Education Department said at least 533 schools have closed, affecting nearly 300,000 children. The Red Cross Web site calms worried families by saying that knowing what to expect, how to prepare and where to find needed information and support can increase resilience, decrease stress and minimize the impact on those affected. Information on pandemic preparedness is available at www.pandemicfluandyou.org.

Advice for parents on talking to children about H1N1 Flu is also available online.

The CDC and the federal government’s consolidated pandemic influence Web site, are good sources of information about the flu. Or call the CDC’s toll-free hotline (800) CDC-INFO, or (800) 232-6348 for the hearing impaired.