BY MEREDITH GOAD

Portland Press Herald

The swine flu pandemic, which caused the closure of an elementary school in Maine last spring, has spread to youth summer camps, the state's top health official announced Tuesday.

Nine cases of the H1N1 virus have been identified at four summer camps in Cumberland, York, Oxford and Lincoln counties, according to Dr. Dora Anne Mills, director of the Maine Center for Disease Control and Prevention. All of the cases involve camp counselors who were tested for the virus and isolated.

All youth camps are licensed by the state, Mills said, so health inspectors are working closely with them to be sure they know how to screen for H1N1 and isolate any campers who come down with symptoms, such as a fever and sore throat with coughing or sneezing.

The state has also sent out mailings to camps that might not have Internet access.

During the early days of the pandemic in April, state officials closed Kennebunk Elementary School after a student came in contact with someone who had swine flu. Mills said she doesn't envision any of the summer camp facilities closing at this point, and said she feels no qualms about sending her own children to camp.

"I do want people to feel safe to send their children to camp in Maine," she said. "We've been in close contact with them, and they're doing everything to make sure that those kids are safe."

Mills also announced that this year, for the first time, the state will be offering free seasonal flu vaccinations in Maine schools. So far, 120 schools have signed up, which covers 70,000 students.

The seasonal flu vaccine does not appear to protect against H1N1 itself, but it can bolster overall health so that the immune system has a better chance of fighting off the virus.

Mills said 72 cases of H1N1 have been identified in Maine, including 16 out-of-state residents, many of whom are spending their summer here. Only five people have been hospitalized, and all but one of the hospitalized patients have been discharged.

Geographically, the virus is mostly in southern Maine, but appears to be working its way into inland areas.

Maine is seeing trends similar to what's happening in other states, Mills said. The virus is primarily hitting children and young adults, rather than older adults, which is the opposite of what happens with seasonal flu. More than half of the confirmed cases are in people younger than 25.

In southern New England and the rest of the United States, the infection also seems to be disproportionately affecting pregnant women.

"There have been several deaths across the country amongst pregnant women," Mills said. "We are reaching out to health care providers in settings where pregnant women are taken care of to make sure they know the precautions they can take and that if they come down with symptoms, they are put on antiviral medications such as Tamiflu right away."

The state is also keeping an eye on homeless and domestic-violence shelters, day-care centers, correctional facilities and other places where there are close quarters and the flu can spread quickly.

Anyone who has symptoms of the flu, or who knows someone with symptoms, should presume that they have H1N1, Mills said, because it's the predominant strain being seen in Maine right now.

Mills said it's "very odd" to be talking about influenza during the summer.

"They've been tracking influenza for the 13 years I've had this job, and for many years before that, and we've never seen influenza in the summertime like this," Mills said. "This has been seen, though, in the prior three (flu) pandemics of 1968, 1957 and 1918."

In each of those pandemics, the flu started out mild in the spring, worsened in the fall and winter, and affected young people and pregnant women disproportionately.

The H1N1 virus has been reported in all 50 states and 74 countries. There have been five deaths in other New England states -- three in Connecticut and one each in Massachusetts and Rhode Island.

Mills urged Mainers to continue practicing "respiratory etiquette," especially if they are going to be attending a summer gathering such as a family reunion, wedding or barbecue: Cover coughs and sneezes, wash hands frequently, and if you are sick, stay home.

"The aerosolized particles from sneezes can actually travel 100 miles per hour, and water particles can actually travel 6 feet," Mills said. "So if you're within 6 feet of a sneeze and somebody has not covered their sneeze, you are very likely to come down with H1N1 if that sneeze has H1N1 in it."