Though a Carolinas case hasn't been reported, Mecklenburg's top health official plans to issue a letter this morning advising doctors and hospitals to take no chances and treat suspected swine flu patients aggressively with anti-viral medication.

Local hospitals aren't able to test for the specific flu strain, which is newly discovered.

But doctors can rely on their observations and medical tests to rule out other possibilities.

"Physicians are asked to keep a high index of suspicion for swine flu in patients with respiratory symptoms who have recently traveled to" places where it's been reported, said Stephen Keener, the county's medical director, in an e-mail accompanying a draft of the letter.

Dozens of deaths in Mexico and 20 nonfatal U.S. cases have health officials worried because otherwise healthy people appear to be dying, N.C. Health Director Jeffrey Engel told the Observer on Sunday.

They worry the new strain has the potential to bloom into a global pandemic because humans haven't built up immunity.

On the positive side, Tamiflu and Relenza – two anti-viral flu treatments – are effective against the new strain, he said. The treatments are available from physicians.

And North Carolina has a stockpile of 660,000 treatments from two years ago when the General Assembly started planning for a flu pandemic, Engel said. "I think that's reassuring," he said.

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