Lynchburg, VA - The World Health Organization has raised its pandemic alert for swine flu to the second highest level, meaning it believes a global outbreak is imminent.

Meanwhile, officials say a toddler in Texas has died from the flu and there are more than 90 confirmed cases in ten states, including California, Arizona, Nevada, Texas, Kansas, Indiana, Michigan, Ohio, Massachusetts, and New York. Still no cases in Virginia, but state health officials say it's only a matter of time.

We spoke with Governor Kaine on Wednesday, who says he feels confident about Virginia's abilities to handle an outbreak. The state did extensive preparations in 2006 and 2007 in case of an avian flu epidemic. "Even though the swine flu is different than avian flu the preparation and response steps are exactly the same. The only difference is we don't have a vaccination for the swine flu 'cause it is not ever a type of flu that has ever been seen," Kaine said.

Locally, schools and hospitals are also making plans and preparing for the possibility the virus will make its way here. They say up to this point planning has been easy because, like the governor said, these groups already had a flu pandemic plan in place. The avian flu threat was great practice for the swine flu problem.

Healthcare workers call it the fear of the unknown. Centra Health (web) Director of Infection Control Kathy Bailey said, "It is a new strain of flu, it is a different strain of flu and because it is a combined organism."

But we're still not certain how much it differs from the common influenza virus. At Lynchburg General Hospital, they're prepared to treat swine flu the same as a normal flu bug.  "You know we aren't done with that seasonal flu yet so influenza's that we might get may not necessarily be this new strain," Bailey said. 

We do know the swine flu becomes contagious one full day before the patient shows symptoms, meaning you could infect others before you know you are sick.   Anne Bond-Gentry, the Lynchburg City Schools (web) Coordinator for Student Services, said, "That's pretty amazing and it would be difficult to manage and so it would be really hard."

Lynchburg City schools has met with all school nurses about keeping a close eye on students, but they've had no discussions yet of potential school shut-downs.  "We would follow recommendations given to us from the Department of Education and the Department of Health here,” Bond-Gentry said.

Right now, the health department says you should wash your hands often and stay home if you feel sick. Also, be prepared to answer plenty of questions if you get treated for flu-like symptoms.

"It is very important for healthcare providers to get a travel history, information on what contacts an individual might have had should they come in with flu symptoms," Bailey said.

The Virginia Department of Health is organizing a Call Center for any questions you might have about the swine flu. Beginning Thursday at 8:30 p.m. you can call 877-ASK VDH3. The call center will operate during regular business hours.

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