As Utah awaits test results to know whether it has its first confirmed case of swine flu, schools are monitoring absences and scrubbing doorknobs, bathrooms and desks. Day care centers are pushing hand washing. And parents are on notice: Children with flulike symptoms should stay home.

But despite advice from President Barack Obama that health officials should "strongly consider" automatically closing affected schools once they have a suspected or confirmed case, most Utah public health officials have decided to go their own way.

"In the United States, the severity [of illness] is just not there," said Dagmar Vitek, medical director of the Salt Lake Valley Health Department. "When you think about seasonal influenza and you say I have one case of seasonal flu at school, are we going to close the school? The answer of course is no. That's why we're struggling with the [federal] recommendations, which are quite severe."

That could change, based on what health officials find out about Utah's first "probable" case of swine flu. The state announced Wednesday that its Public Health Laboratory couldn't identify the strain of flu of one of the 40 influenza cases it is testing. It sent the sample to the Centers for Disease Control and Prevention and should know results by Friday.

The state said it will not release any information about the patient for now.

In a pandemic, health officials have broad powers. They can commandeer schools for use as emergency clinics and order the closure of schools, churches and businesses where outbreaks occur. It will be up to local health departments to decide whether to close them.

The state health department is sending out letters to schools and preparing letters to send to parents, alerting them to the possibility of closures and urging them to plan for what they would do.

It is sure to send ripple effects for working families and area businesses.

"What do parents do? What do I do with my kids if I have to work?" asked Jordan School District spokeswoman Melinda Colton. "It's a very complex issue."

For over a year, health officials have been working with chambers of commerce and large employers to improve preparedness plans.

And in one corporation's opinion, the best plans include flex-time for employees.

Zions First National Bank has a "business continuity" group tasked with keeping the bank and its branches open and functioning in an emergency, said the bank's spokesman Rob Brough.

Should employees fall ill or find themselves without child care, Zions triggers a plan that might include rotating schedules for branch workers and telecommuting for office staff, he said. "The goal is to serve our clients while doing everything possible to protect them and our employees."

State health department spokesman Tom Hudachko said the state urges other businesses and parents also to plan.

"A top priority should be limiting sickness and death, and if it means that at some point kids can't go to school or day care and parents can't go to work, we would hope for cooperation from the community," he said.

Day care centers also would be subject to closure, and could bear the brunt of school shutdowns as parents hunt for baby-sitting alternatives.

Johnny Anderson, president of the Utah Private Child Care Association, said there are no standards dictating how providers respond. But Anderson said his center wouldn't take on extra kids.

"We'll accommodate kids who are already enrolled in our after-school programs as long as they're symptom free," said Anderson. "But we don't have the capacity to take on a bunch of new kids at once. Nor would we want to expose our clients to unnecessary risk."

Low-wage workers and poor families are particularly vulnerable in times of crisis.

"Anytime we have to close, it's a really big deal. We try to avoid it, because our families don't have options," said Erin Trenbeath-Murray, director of Salt Lake CAP Head Start, a preschool catering to low-income children. "Many of our parents are uninsured and don't have the luxury of picking up the phone and calling a doctor or paying for a sitter."

Her school is monitoring for children who have been out of the country and report symptoms, advising parents to seek care at emergency rooms.

The CDC recommends schools with confirmed or suspected cases close for a week and reopen if no additional confirmed or suspected cases are identified among the school population.

Utah's pandemic influenza game plan, written before the new flu strain spread from Mexico to eight other countries -- killing a suspected 159 people in Mexico with eight confirmed -- calls for closing schools. But it's based on the severity of the flu -- essentially how many people it kills in Utah, with the understanding that regular, seasonal flu kills people every year.

David Sundwall, executive director of the state health department, called the CDC's school closure formula "harsh" and Utah's more "nuanced."

"You'd want to know how sick they really are. Have there been other cases in the vicinity of nonschool children who were either having fatal illnesses or serious illness?" he said Tuesday.

Salt Lake County's Vitek said health officials probably wouldn't close a school if there were "one isolated case." But if the virus appeared to have spread in the school, it would be shut down.

She said the health department would discourage mass gatherings of even healthy children whose school has been closed. But groups of up to six would probably be safe.

And she expected that if the health department opted against closing a school, parents would be notified that swine flu had struck.

But for now, the focus is on preventing an outbreak from happening in the first place.

Working with school districts, local health departments have sent alerts to principals and parents, advising them to watch for symptoms.

Schools are stockpiling soap, hand sanitizer, tissues and face masks and are readying isolation rooms, which are used as waiting areas for infected children in need of a ride home, said Lisa Robinson, educational support services coordinator at Jordan School District.

Student and staff travel to destinations with high rates of infection might be canceled.

But perhaps the most important strategy being deployed is something that most preschoolers and kindergarteners practice every day -- frequent and vigorous hand washing.

"It sounds so simple, but it's effective in helping to stop the spread of germs," Hudachko said.

kstewart@sltrib.com

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