ST. PAUL, Minn. — Parents wondered who to blame when two schools in their small town closed because one school had a probable case of swine flu.
Was the virus introduced by a staffer at the cafeteria both student bodies use? Was the patient a student who could have picked up the bug on spring break?
Officials of Rocori Middle School and of nearby private St. Boniface School in Cold Spring didn't know. And Minnesota health officials wouldn't say.
The absence of information led one parent to set the record straight about her child'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 daughter "does not have the 'Swine Flu.'"
By Thursday, officials said the state's first confirmed case of swine flu was a person with ties to Rocori Middle School. The patient was expected to recover.
Additional information, however, was limited.
The virus poses a dilemma for public health officials trying to balance the need to protect patient privacy against giving out sufficient details to inform the public about a contagion.
States are dealing with the dilemma in various manners:
• Minnesota states only where a suspected or confirmed case is found and whether the person is recovering.
• Wisconsin officials have identified the county involved and whether each case involves a child or an adult.
• Massachusetts stayed mum about who contracted that state's first two cases, while local health authorities said they involved two boys who didn't attend public school.
In Mexico, the center of the outbreak, federal authorities initially gave only overall numbers of cases and deaths. However, they've begun to break down the deaths by the victims' age, sex and home state, and on Sunday, the health ministry did the same for cases that were not fatal.
Health officials say laws prevent them from giving out identifiable information, although a federal 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 health emergencies like this pose a challenge.
"Too little information feeds rumors, feeds distrust," Parmet said. "Too much information may lead to panic and stigma."
Context is key, said James G. Hodge Jr., a Johns Hopkins Bloomberg School of Public Health professor. Knowing that a young man is infected in a city is different from knowing that about a town of 3,000, he said.
Hodge said there are risks of patient backlash if authorities say too much. "They will basically go underground," he said.
Minnesota Health Department spokesman Buddy Ferguson defended the amount of information his agency has made public. The state's second probable case was disclosed Friday.
"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.
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