State health and education officials are bracing for the possibility that more students could come down with swine flu at 'Anuenue School in Palolo after a third-grade teacher and a student in a different class became the ninth and 10th people from the Islands to become infected.

"It's not surprising that it's in a school," state health director Dr. Chiyome Fukino said yesterday. "We expected to see this illness. It's in our community. It would not surprise me if it appears in another school."

'Anuenue will remain open and all activities will continue as scheduled.

Four new cases of swine flu were reported yesterday by the Health Department. Three of them — the two at 'Anuenue and another adult on O'ahu — had not traveled recently.

All three are recovering or have recovered at home, health officials said. Household members and other people who had close contact with the victims are being identified, notified and tested if they have symptoms, the health officials said.

The fourth victim is a Maui resident who became infected while in Washington state. That person was hospitalized briefly, has fully recovered and will return home after required isolation, Fukino said.

But the two cases at the Hawaiian language immersion program at 'Anuenue have fired up a debate over whether to close schools that have outbreaks of swine flu.

Tuesday night, health officials called parents of 'Anuenue's 18 third-grade students about the two flu cases at their school.

Yesterday, all 353 students at the school were given a letter from principal Charles Naumu to take home. The letter emphasizes in bold-face print that 'Anuenue will remain open.

FEARS NOT CALMED

Three of Jamie Kaneakua-Rauschenburg's four children attend 'Anuenue, including one in the third-grade class of the teacher who came down with swine flu. She now plans to keep all three children home from 'Anuenue at least a week — or until the swine flu passes.

"I was freaking out," Kaneakua-Rauschenburg said. "I'd rather be safe than sorry. It's worrying because the Department of Health and Department of Education are not on top of what they should be."

She praised Naumu for his letter, but said Tuesday night's call from the Health Department increased her fears instead of calming her down with concrete information.

Kaneakua-Rauschenburg said the Health Department officials told her only that her 9-year-old, daughter, Kawai, a third-grader, "was exposed to influenza."

"I asked whether it was the swine flu and the lady said it was confirmed and asked if Kawai had any symptoms."

Kaneakua-Rauschenburg said she spoke with other parents at 'Anuenue yesterday. She said only those with children in the third grade were aware of the flu outbreak.

"To my surprise, most of the parents didn't know about it," Kaneakua-Rauschenburg said. "I understand they're trying to protect privacy. To me, you've got to warn the parents of the kids so they can watch for symptoms."

INTERNAL GUIDELINES

The Health Department is following internal guidelines in recommending that 'Anuenue stay open, Fukino said. The guidelines only call for a school closure when it has 10 percent overall absenteeism — or 20 percent absenteeism in a particular class from the same illness.

At 'Anuenue, Fukino said, "the threshold has not been reached."

While the teacher and student who were infected do not share the same classroom, "there are common areas — a cafeteria that's common, computer lab, recess areas," Fukino said.

Naumu said yesterday that the school has had plenty of paper towels and hand soap since the swine flu outbreak began. He said cafeteria workers have been reminded to be especially aware of proper sanitation.

'Anuenue's cafeteria also prepares food for three nearby schools — Queen Lydia Lili'uokalani, Jarrett Middle School and King Liholiho — so "we have to be extra careful," Naumu said.

Like Fukino, however, Naumu is prepared for the possibility that another case of swine flu could occur at the school.

"We're trying to do an ounce of prevention," he said. "But I wouldn't be surprised. We're trying our best to avoid that."

The Health Department updates new confirmed cases at 10 a.m. daily at www.hawaii.gov/health (click on H1N1 Swine Flu Information).