The Vermont Department of Health is alerting the state's health care providers, schools and partners and stepping up its public health surveillance efforts as part of the national response to an international outbreak of a novel strain of swine influenza in humans.

While no cases have been identified yet in Vermont, the Centers for Disease Control and Prevention (CDC) has to date reported 20 confirmed cases of swine flu in the United States, including eight cases in New York City. Hundreds of cases have been reported in Mexico.

In the U.S., illness has been relatively mild so far compared to the severe illness reported in Mexico. Vermonters are being advised to stay tuned, and take the following precautions:

* Wash your hands often and well.
* Use alcohol-based hand wipes and gel sanitizers if soap and water are not available.
* Cover your mouth and nose when coughing or sneezing.
* Cough or sneeze into a tissue and then throw it away.
* Stay home from work or school and away from others if you are sick.
* If you need medical attention, call your health care provider first.

"Vermont is ready to respond in the event of a more widespread outbreak and we are in close contact with CDC and public health officials nationwide and in the New England states," said Vermont Department of Health Commissioner Wendy Davis, MD. "We are receiving frequent updates from the CDC and will advise Vermonters if any additional steps are necessary beyond the usual precautions they should take to avoid becoming ill from the regular flu season.

" Swine flu viruses do not normally infect humans (12 cases in the previous four years). CDC has notified state health departments nationwide to look for signs and symptoms of the respiratory disease, and to consider testing patients who have flu-like illness, especially if they have traveled to Mexico or elsewhere in North America where cases have been confirmed.

Symptoms of swine flu are similar to seasonal influenza and include fever, lethargy, lack of appetite and coughing. Some people with swine flu also have reported runny nose, sore throat, nausea, vomiting and diarrhea. Like seasonal flu, swine flu may cause a worsening of underlying medical conditions.

You cannot get swine flu from eating pork or pork products. No special precautions are recommended for anyone who owns a pig or is routinely exposed to the animals.

"Vermont's plan to respond to a more widespread outbreak of influenza will involve multiple state agencies and the entire Vermont health care community," Dr. Davis said. "We are counting on all Vermonters to take all the commonsense precautions to stop germs from spreading, and stay tuned to keep informed."