While Utah now has nine probable cases of the new H1N1 flu, health officials continued to stress Friday that the illnesses are mild and residents should not be alarmed.

On Friday, the state health department announced four new "probable" cases, bringing the total to nine, with six in Summit County, two in Salt Lake County and one in the Weber-Morgan Health District. There's a 95 percent chance those cases will be confirmed, they said.

As of Friday night, Summit County had not heard whether one of its six cases has been confirmed by the federal Centers for Disease Control (CDC) and Prevention in Atlanta, as expected.

None of the nine Utah patients has been hospitalized, noted state health executive director David Sundwall. And their symptoms look like seasonal flu: muscle aches, fatigue, fever.

"We want people to go on with their lives," he said. "While it's a novel virus, it's not a novel illness."

Andy Pavia, division chief of pediatric infectious diseases at Primary Children's Medical Center, said it is possible this spring's swine flu outbreak will remain mild. But if history holds true, the strain could return in a more virulent fashion in the fall, he added.

Sundwall explained that the reason officials are concerned -- he is in daily contact with the CDC and local health departments and has an operations center running seven days a week -- is because the flu strain is new. There is no vaccine, though one is in the works, and people don't have an immunity to it.

The state's first probable cases were detected in three elementary- and middle-school students in Summit County, where Park City Superintendent Ray Timothy opted late Wednesday to temporarily close the district's eight campuses. The students' test results are all expected to be back by Monday.

With the county now facing a total of six probable cases, there will be no services this weekend for members of The Church of Jesus Christ of Latter-day Saints, Sundwall said.

The antiviral medications oseltamivir and zanamivir, marketed as Tamiflu and Relenza, are thought to reduce the severity of the flu or prevent its onset. But Utah doesn't have enough on hand if the virus turns out to cause a serious epidemic.

In a 2008 report, the U.S. Department of Health and Human Services said Utah should purchase 247,000 doses of antiviral medications. State and local government entities have purchased around 55,000. It would take at least $2.5 million to buy the rest of what Utah should have.

But that amount would only be necessary in a 1918-style pandemic, which is not the current situation, noted state health department spokesman Tom Hudachko.

Before the new outbreak, Rep. Paul Ray, R-Clearfield, was going to sponsor a bill earlier this year to buy $1 million worth of antivirals, but he backed off due to state budget cuts.

He said Friday he remains comfortable with the supplies Utah has -- particularly because Utah received another 87,000 doses this week from federal supplies. But if things change, he says he may seek money during a special legislative session to buy more.

"We have to see how it really explodes," he said. "I'm not sure the H1N1 is going to be the full pandemic."

Nevertheless, there will be rationing.

The state health department on Friday said local health departments can now start using the stockpile. And it finalized guidelines on how those taxpayer-funded medications should be used. Hudachko said local health departments -- which are ultimately in charge -- will be advised to follow CDC guidelines.

The CDC says antivirals should be considered for confirmed or probable cases of the new flu, with priority given to hospitalized patients and those at risk for complications. They also recommend it be given to prevent illness to certain health care workers and to probable or confirmed cases' household contacts who have chronic illness, are over 65 or under 5.

The drugs require a prescription. Pharmacies don't have to follow those guidelines in dispensing their stocks, and some report Utahns are stocking up on the antivirals "just in case." But some pharmacies are also running low or are out of the drugs and are having difficulty getting new supplies, which could force them to turn to health departments.

Gary House, director of the Weber-Morgan Health District, said pharmacies that dispense the government-funded supplies cannot charge for them, which may make pharmacists less eager to participate.

"We're going to appeal to their sense of doing what they can to help people during a severe disease," he said.

And while he will advise them to use the government stockpile as the CDC recommends, he knows that may not happen. "I can't control what happens between the doctor and the patient," he said.

hmay@sltrib.com