Virus traveling faster than information on who's infected

When a swine flu case forced two neighboring Minnesota schools to close, an obvious question arose: Was it a staff member from a shared cafeteria or a student back from spring break?

School officials didn't know. Minnesota health officials wouldn't say. And the absence of information fed a small-town rumor mill that prompted one parent to set the record straight about her daughter's cough.

"I'm sending this to put a rumor to rest," Kim Baumgarten wrote in Thursday's St. Boniface School electronic newsletter, declaring firmly that her seventh-grade daughter "does not have the `Swine Flu.'"

The spreading swine flu virus poses a dilemma for public health officials. They are trying to protect patient privacy while giving enough information to people about a contagion in their midst.

And so far, that's led to different practices in different places:

-In Minnesota, only the barest details are being released - where a suspected or confirmed case is found, if they have a connection to a school and whether the person is recovering.

-In Wisconsin, officials have identified the county and whether cases involve a child or an adult.

-In Massachusetts, the state stayed mum about who contracted the first two cases while local health authorities disclosed that it was two boys who didn't attend public school.

-In Kansas, the age group of those affected was made known.

-In Missouri, officials released the gender and specific age of one probable case and only the location of another likely case.

Health officials say laws prevent them from giving out identifiable information, although a federal medical privacy law contains exceptions for "public health surveillance, or public health investigation or intervention."

Wendy Parmet, an expert on public health law at Northeastern University School of Law in Boston, said managing information in health emergencies like this is a challenge.

"Too little information feeds rumors, feeds distrust," Parmet said. "Too much information may lead to panic and stigma and other real harms."

Parmet added, "There's a lot of potential in this outbreak for discrimination, for stigmatizing those who are ill."

Professor James G. Hodge, Jr. of the Johns Hopkins Bloomberg School of Public Health said context is key.

Knowing that a male young adult is infected in a large city is different than offering the same clues in a town of 3,000 people, he said. And knowing an infant died from the flu matters more than knowing one fell ill.

Hodge, the executive director of the Centers for Law and the Public's Health, said there are risks of patient backlash if authorities say too much.

"They will basically go underground," Hodge said. "It's what happens with HIV. It's what happens with tuberculosis. It's what will happen with swine flu if people believe that their identity will be publicly disclosed because of their pursuit of care or treatment through public health authorities."

In Cold Spring, where St. Boniface and Rocori Middle School were dark Friday for a third day, Rocori's superintendent has worked to assure people that necessary steps are being taken even if the available information is limited.

"I know that the entire issue is frustrating and disconcerting," Scott Staska wrote in a note to parents. "If there were any ability to provide more specific or detailed information, it would help all of us."

Minnesota law allows the health commissioner to give out details to locate a suspected carrier, alert others who are threatened by illness or diminish an imminent threat to the public health.

Minnesota Health Department spokesman Buddy Ferguson defended the amount of information the agency has made public. The state's second probable case was disclosed Friday and more samples are being tested.

"With these cases we've had so far, we're in a position to follow up directly with anybody who had enough contact with the individual where exposure to the illness would be a concern," Ferguson said. "Anytime we need to tell the public something they need to know to protect themselves, yes we will do that."