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Swine flu is officially in Juneau.
Health officials announced two confirmed cases Friday, both at the Ethel Lund Medical Center.
One patient was a man in his 30s, the other was a woman in her 20s. Both had only mild symptoms, said Frank Sutton, vice president for hospital services for the Southeast Alaska Regional Health Consortium.
SEARHC also operates the Mt. Edgecumbe Hospital in Sitka, which reported a case Thursday.
The two Juneau cases are among a total of 21 cases of the swine flu, also called novel H1N1, confirmed in Alaska as of Friday evening.
"It's pretty much throughout the state," Sutton said.
Several other cases aboard cruise ships in Alaska are officially attributed elsewhere, depending on where they were first confirmed.
Most of the state's population now lives in cities where the swine flu is thought to be circulating, including its three largest cities, Fairbanks, Anchorage and Juneau. Other cities with confirmed cases include Haines, Skagway, Sitka and Homer.
State epidemiologists trying to track the progress of the virus in Alaska have thought that many of the cases they studied were contracted outside Alaska, though the state's first case in Fairbanks had no travel outside Alaska or any known contacts with any other confirmed cases.
Sutton said the two Juneau cases were difficult to link to definitive sources.
Juneau's male swine flu victim, the man in his 30s, had no known travel outside Alaska, Sutton said.
The woman in her 20s had traveled about two weeks ago, though swine flu is thought to be contagious for only about 10 days.
"That's just outside the normal 10-day incubation period," said Greg Wilkinson, spokesman for the state Division of Public Health.
The latest cases include another Southeast case, in Skagway, for a total of six in the panhandle, though few of the cases are thought to have any possible links to each other.
State public health and SEARHC officials are asking those seeking medical attention for possible flu cases to contact their health care provider before arriving, except in cases of emergency, to avoid infecting other patients in waiting areas.
Those sick with the flu should stay home, except when seeking medical care, and not go to work or school. Sick adults should avoid public activities for at least five days and seven for children.