NEW YORK — New York City has closed three schools in response to a swine flu outbreak that has left an assistant principal in critical condition and sent hundreds of kids home with flu symptoms, in a flare-up of the virus that sent shock waves through the world last month.
Mayor Michael Bloomberg said that four students and the assistant principal have documented cases of swine flu at a Queens middle school. More than 50 students have gone home sick with flulike symptoms there, he said. At another middle school in Queens, 241 students were absent Thursday. Dozens more were sick at an elementary school.
The Health Department said the assistant principal is on a ventilator, marking the most severe illness in the city from swine flu to date. The students who have fallen ill in this latest surge of illness appear to be experiencing mild symptoms, similar to routine flu.
The mayor said that the sick assistant principal may have had pre-existing health problems. In many other swine flu cases that turned critical, patients had pre-existing conditions.
Bloomberg said that three locations – all special education schools with more than 4,000 students – would be closed for at least a week because "there are an unusually high level of flulike illnesses at those schools."
"There are documented cases of H1N1 flu at one of them," the mayor said, using the formal name for swine flu.
New York City's first known cases of swine flu appeared in late April, when hundreds of teenagers at a Roman Catholic high school in Queens began falling ill after the return of several students from vacations in Mexico, where the outbreak began.
At first, the virus appeared to be moving at breakneck speed. An estimated 1,000 students, their relatives and staff at the St. Francis Preparatory School fell ill in a matter of days.
City health officials became aware of the outbreak on April 24. The school closed, and health officials began bracing for more illnesses throughout the city.
But the outbreak then seemed to subside. Additional sporadic cases continued to be diagnosed, but the symptoms were nearly all mild. The sick children recovered in short order. St. Francis reopened after being closed for a week.
The middle school with the confirmed cases is two miles from St. Francis.
Dr. Isaac Weisfuse, a deputy commissioner of the health department, said investigators are trying to learn more about why the disease has spread erratically, moving quickly through a few schools but slowly everywhere else.
Schools are a good incubator for illness in general, he said, because space is tight, and youngsters often don't practice the best hygiene.
Across the country, most of the people getting the illness have been young. Some experts have speculated that older people might have some immunity to the virus because of genetic similarities to more common types of flu.
At the start of the flu outbreak in the United States, government health officials recommended that schools shut down for two weeks if there were students with swine flu. But when the virus turned out to be milder than initially feared, the Centers for Disease Control and Prevention dropped that advice but urged parents to keep children with flu symptoms home for a week.
So far, the virus has not proved to be more infectious or deadly than the seasonal flu.
CDC officials said schools may decide to close if there is a cluster that's affecting attendance and staffing.
Meanwhile, a woman in Arizona suffering from a lung condition has apparently become the fourth person in the nation to die with swine flu.
The Maricopa County Health Department reported on Thursday that the woman in her late 40s died last week of what appears to be complications of the new strain of influenza.
Laboratory tests confirmed that the woman was infected with the flu strain. The case would bring the number of swine flu deaths in the nation to four and put the worldwide death toll at 70, with an estimated 6,672 cases in 33 countries.
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