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Swine Flu Poses Holiday Puzzle

ATLANTA -- Health officials say swine flu cases appear to be declining throughout most of the U.S., but the specter of Thanksgiving gatherings makes it hard to predict what will happen next. The Centers for Disease Control and Prevention said Friday that reports of swine flu illnesses were widespread in 43 states last week, down from 46 the week before.

CDC officials also say reports have been increasing in a few states, including Maine and Hawaii. They say it's hard to know whether the epidemic has peaked, and many people will be gathering -- and spreading germs -- next week at Thanksgiving.

Tamiflu Resistance Seen

In other developments, four North Carolina patients at a single hospital tested positive for a type of swine flu that is resistant to Tamiflu, health officials said Friday. The cases reported at Duke University Medical Center over six weeks make up the biggest U.S. cluster seen so far.

Tamiflu is one of two flu medicines that help against swine flu, and officials have been closely watching for signs that the virus is mutating, making the drugs ineffective.

More than 50 resistant cases have been reported in the world since April, including 21 in the U.S. Almost all in the U.S. were isolated, officials with the Centers for Disease Control and Prevention said.

Quarantines Fall Short

Health experts say extraordinary measures against swine flu -- most notably quarantines imposed by China, where entire planeloads of passengers were isolated if one traveler had symptoms -- have failed to contain the disease.

Despite initially declaring success, Beijing now acknowledges its swine flu outbreak is much larger than official numbers show.

China's Health Ministry said Thursday it will punish officials who under-report cases of swine flu after a prominent doctor said he believes the true number of swine flu deaths is being covered up. China's official count of nearly 70,000 reported illnesses with 53 deaths is dwarfed by estimates of millions of cases with nearly 4,000 deaths in the U.S., with about a third of China's population.

Norway Strain Investigated

The World Health Organization said Friday it is investigating samples of variant swine flu linked to two deaths and one severe case in Norway, but that so far the significance of the mutation is unclear.

Norway's Institute of Public Health announced Friday that the mutation "could possibly ... cause more severe disease" because it infects deeper airway tissue.

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