For Immediate Release:
Please contact:
Terry Krohn, Amy Elwood or Kerrey Miller
Two Rivers Public Health Department
701 4th Avenue, Suite 1
Holdrege, NE 68949
308-995-4778
1-888-669-7154
April 27, 2009

H1N1 Update from Two Rivers Public Health Department
The World Health Organization has raised its pandemic alert for swine flu by one level to
phase 4, two steps short of declaring a full-blown pandemic. WHO says the phase 4
alert means sustained human-to-human transmission is causing outbreaks in at least
one country. It signals a significant increase in the risk of a global epidemic, but doesn't
mean a pandemic is inevitable.

U.S. officials also advised Americans against most travel to Mexico as a swine flu virus
that began there spread to the United States and beyond. With 40 cases now confirmed
in the United States, Dr. Richard Besser, acting director of the Centers of Disease
Control and Prevention (CDC), said that so far the disease in the United States seems
less severe than the outbreak in Mexico, where more than 1,600 cases have been
reported and where the suspected death toll has climbed to 149. No deaths have been
reported in the U.S, and only one hospitalization. The confirmed cases in the United
States announced on Monday were double the 20 initially reported by the CDC. Besser
said this was due to further testing — not further spreading of the virus — in New York at
a school in Queens, bringing the New York total to 28. Besser said other cases have
been reported in Ohio, Kansas, Texas and California. "From what we understand in
Mexico, I think people need to be ready for the idea that we could see more severe
cases in this country and possibly deaths," he said. "That's something people have to be
ready for and we're looking for that. So far, thankfully, we haven't seen that. But we're
very concerned and that's why we're taking very aggressive measures."
Nebraska Public Health officials at the state and local level are working closely with the
CDC and their local hospitals, medical clinics, schools and media to closely monitor
swine flu, provide up to date information, limit the potential spread of disease and reduce
the effects on the health of the people of Nebraska.

Two Rivers Public Health Department would like to remind you that there are everyday
actions you and your family can take to stay healthy:

• Cover your nose and mouth with a tissue when you cough or sneeze. Throw the
tissue in the trash after you use it.
• Wash your hands often with soap and water, especially after you cough or
sneeze. Alcohol-based hand cleaners are also effective.
• Avoid touching your eyes, nose or mouth. Germs spread that way.
• Influenza is thought to spread mainly person-to-person through coughing or
sneezing of infected people.
• If you get sick, please stay home from work or school and limit contact with
others to keep from infecting them.
• Limit or avoid contact with people that are ill.
Please contact your medical provider if you or any of your close contacts recently
traveled to Mexico, southern California or Texas and you develop symptoms of influenza
which includes a temperature of over 100 degrees with a cough or sore throat.
Headache, body aches, fatigue may also be present. Occasionally vomiting and
diarrhea have also been reported. Your medical provider will determine if testing and
treatment are needed.
Information on Swine Flu will continue to change rapidly as more information is acquired.
Please pay close attention to new information and recommendations from the Centers
for Disease Control – www.cdc.gov/swineflu, the Nebraska Department of Health and
Human Services – www.hhs.ne.state.us and Two Rivers Public Health Department –
www.tworiverspublichealth.com - 1-888-669-7154 or 995-4778 and your local media.
####