So where's the swine flu?

Is South Florida catching a break from the H1N1 virus, or is this only a lull before the storm?

Across the nation, flu is making news. On Saturday, President Barack Obama declared a national emergency. Federal health officials say it's widespread in 46 states -- including Florida -- up from 37 a week ago. Schools are closing, football teams are forfeiting games. Churches are doing away with the common cup for Communion.

But in South Florida, Miami-Dade and Broward counties have had only 11 new hospitalizations and one new death in the most recent week reported. No schools have closed. No teams have stayed home. No businesses have stopped work.

``We're seeing small clusters of one or two cases; we don't see the large outbreaks that some other states have reported,'' says Dr. John Livengood, director of epidemiology for the Broward County Health Department. ``I don't know why.''

It might be the weather or the humidity, he says. It might be because South Florida had a large number of cases in the late spring. But don't relax yet, doctors say. There's plenty of swine flu in South Florida.

``We seem to be at a plateau, but it's at a pretty high level,'' says Dr. Rafael Campo, professor of infectious diseases at the University of Miami Medical School.

``Typically at this time of year at the University of Miami Hospital only about 2 percent of ER visits are due to influenza,'' he said. ``Right now it's 15 percent.''

``We're just at the beginning of the regular flu season,'' says Dr. Stan Marks, senior vice president of the Memorial Healthcare System, which runs six hospitals in Broward. ``I expect we will see increases in flu in the U.S. and in South Florida.''

Still, South Florida seems better off than many states.

``We have had many millions of cases of pandemic influenza in the U.S.,'' said Thomas Frieden, director of the U.S. Centers for Disease Control and Prevention. Since April, he said the U.S. has had more than 1,000 deaths and 20,000 hospitalizations. Still, CDC officials repeatedly point out that regular seasonal influenza kills 36,000 and hospitalizes 200,000 in a typical year.

Across the country, 351 schools were closed last week alone due to excess absenteeism. In Wisconsin, the University of Wisconsin football team beat Fresno State even though 40 of its players were sick, some vomiting.

EXPERIMENT

In California, Stanford University hospitals are experimenting with drive-through ``McTriage'' centers in tents in which doctors take patients' pulse and blood samples while they're still in their cars and not contaminating other patients.

It's not that South Florida is exempt. Miami-Dade County has had 350 hospitalizations and 27 deaths since April. Broward has had 74 hospitalizations and 10 deaths. Florida has had 912 hospitalizations and 132 deaths. In the week ending Oct. 20 there were 11 new deaths in Florida in 11 counties, although none in Miami-Dade or Broward counties.

``Since the beginning of the school year, we've had 11 outbreaks in schools or day-care centers,'' said Dr. Fermin Leguen, chief epidemiologist for the Miami-Dade Health Department. ``Maybe 20 cases in a school of 2,000 is not a large number. There's no consideration of closing.''

Leguen has received no reports of outbreaks in correctional institutions, nursing homes, sports teams or businesses. He, too, thinks it might be the weather. This fall, there's been no repeat of the near panic of last spring, when Miami-Dade schools were closing after a single flu case, and hospitals were putting up emergency-room triage tents to keep expected hordes of victims from overwhelming their facilities.

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