RENO -- A 2-year-old Reno area girl who on Wednesday became Nevada's first confirmed swine flu case is "playing like a normal child" at home, an adult cousin of the toddler said at an evening news conference at the Washoe County Health District.
"She has a bit of a cough," Kristina Westerlund said of the girl, who was not hospitalized.
Westerlund said the girl's mother might be ill, though Washoe health officials have not confirmed whether she may have swine flu.
Westerlund is a child care worker at the Fundamentals Preschool, adjacent to the University of Nevada, Reno, campus, where the 2-year-old showed signs of illness Friday. By Sunday, the girl's temperature had risen to 104 degrees, Westerlund said, and the family sought medical assistance.
The preschool, for 22 children ages 2 to 6, was disinfected Wednesday, and medical authorities decided not to close it.
The identities of the girl and her mother have not been released.
Dr. Randall Todd, an epidemiologist for the Washoe County School District, said cases of swine flu can appear anywhere for as yet unknown reasons.
"This is a virus that is spread from person to person," Todd said. "They (the preschool) have done everything they could have done to prevent it."
Todd said the preschool has been open for 15 years and has never had any licensing problems or health concerns.
One of the preschool's owners, Lisa Munson, said at the news conference that one of her own children is enrolled there and that he and another child recently became sick. Both were checked by doctors and found not to have swine flu, she said.
The 2-year-old's case "was quite mild," Dr. Mary Guinan, the acting state health officer, said earlier Wednesday at a hearing of the Assembly Health and Human Services Committee.
But Guinan advised lawmakers that Nevada probably will see additional cases of swine flu in the coming days.
Top state Health Division officials advised people not to be alarmed and told legislators they are prepared to respond.
The state has stockpiled 140,000 treatment courses of Tamiflu and other antiviral medications, and they are on hand in hospitals, pharmacies and other places in Nevada. Officials expect to soon receive 86,000 more treatment courses from the federal Centers for Disease Control and Prevention.
The stockpile should be an ample supply, officials told legislators. Nevada has a population of about 2.8 million.
Dr. Mary Anderson, Washoe County health officer, said the prescription medications only treat the flu, so they should not be taken as a preventive measure.
"Let's not panic," state Health and Human Services Director Mike Willden said at the hearing.
The CDC said early Wednesday that a flu sample sent by Federal Express confirmed that the 2-year-old Reno girl had swine flu, Willden said.
He said the girl's family was not known to travel much.
Clark County School District officials will send a letter home today and Friday notifying families that they are monitoring the swine flu situation and asking people to take precautions such as washing hands frequently and staying home if ill.
School nurses and staff are looking for flu symptoms at school.
"We are being hyper-vigilant," said Diana Taylor, the director of the district's health services.
Taylor said she is staying in daily contact with the Southern Nevada Health District by "phone, fax and e-mail."
School officials will consult with the health district if they think it is necessary to close a school, Taylor said.
"They would have to confirm these are true cases of swine flu," she said.
Officials could close a school within a day, especially if they observe a "clustering," or an outbreak, of cases, she said.
D'Ann Blatt, director of Lit'l Scholar Academy in Summerlin, said she's taking extra precautions just in case.
"We really have to do everything we can to keep it (swine flu) out of our environment," she said. "Because if it gets here, there will be very little we can do about it."
Blatt said she attended what was supposed to be a routine meeting Wednesday morning at the health district. About 100 child care providers showed up for the meeting, ostensibly to talk about childhood immunization.
"Swine flu came up almost immediately," Blatt said.
The group learned about the Northern Nevada case, she said, and they learned that a toddler in Texas had died.
This concerned Blatt enough that she immediately implemented mandatory hand washing for anyone who enters the facility, workers and children included. She said she "encourages" parents to do so but can't make them.
She also has revised the employee handbook to require those who have flu symptoms to bring a doctor's note before they will be allowed back to work. They will not be penalized for missing work, Blatt said.
"We need to take this seriously," she said.
In addition, she said, the staff janitor is cleaning surfaces in the academy, such as light switches, more extensively and frequently than normal.
Brian Labus, senior epidemiologist with the Southern Nevada Health District, said the agency is working with school and day care officials on what should be done if a case is identified.
"The whole situation is evolving rapidly," Labus said, and the advice from the CDC "is changing every day."
"A course of action will be taken on a case-by-case basis," he said.
Labus noted there are always unintended consequences when a school is closed. Do kids treat it as a snow day and hang around with other kids and spread it?
Someone can be contagious and show no symptoms, he said.
"Whatever we do, we have to make sure it's reasonable and the best course of action," Labus said.
The only way people can get Tamiflu or other antiviral medications is through a doctor's prescription. There is no vaccine for the current swine flu, and seasonal flu vaccines are not being used.
Luana Ritch, chief of planning and response for the state Health Division, said Nevada doctors so far are using their own supplies of antiviral medications.
There can be charges for these prescriptions, but if state or federal stockpiles are used, only an administrative cost would be charged.
Review-Journal writers Jim Haug, Richard Lake and Paul Harasim and The Associated Press contributed to this report. Contact reporter Ed Vogel at firstname.lastname@example.org or 775-687-3901.