For the most part, health officials say, the symptoms of this flu strain have been mild to moderate, with 170 deaths nationwide, including one in Maryland. Nearly all who have gotten ill have recovered.
But some have been hospitalized, particularly people with underlying medical conditions and already-suppressed immune systems. There have also been cases of otherwise healthy people who have been hospitalized with flu.
"If you get it, you feel like you've been hit by a train," said Dr. Harold Standiford, an epidemiologist at the University of Maryland Medical Center. "But in terms of causing serious illness, we're very fortunate that it has not done that very often.
At the Maryland Department of Health and Mental Hygiene's laboratory, where swabs are being sent to test for the H1N1 virus, technicians are on the lookout for whether the virus is mutating. They are concerned that swine flu could become resistant to Tamiflu (so far there are no reports that it has done so in the United States) or could become more severe. At this point, tests are only being done on swabs from people who are seriously ill.
Seasonal flu in a typical year kills 36,000 people in the United States, primarily the elderly. Children and young adults have been more susceptible to the new H1N1 strain. Some doctors believe that older people might have been exposed to similar strains of flu decades ago and that could be providing some protection.
Seasonal flu tends to peak between December and February, and the state usually stops monitoring for it in mid-May. But this year, Maryland health officials have continued the monitoring program, getting regular reports from private doctors, public clinics and hospitals.
The trend is definitely upward: During the last week in May there were 23 confirmed cases of H1N1; during the last week of June there were 166. There are 578 confirmed cases in Maryland, but some officials say those numbers might be meaningless because there are believed to be thousands of people who have gotten ill but have not been tested for the virus.
At St. Joseph, 174 rapid flu tests were given in the past two weeks and most came back negative. Cunningham said she believes the test "may be inaccurate."
"It's not picking up the cases," she said.
Morrill, the Perry Hall doctor, has had such a hard time getting her patients tested that when she sees someone sick with flu-like symptoms she assumes it is the H1N1 virus and prescribes Tamiflu.
