In the wake of a swine flu outbreak, many local parents said they are being very careful in how they discuss the illness with children.

Parents said they are concerned about a possible pandemic because of the close proximity that children share in classrooms and schools. There, colds and viruses are shared fairly easy which is why parents are stressing the importance of hand washing and covering mouths.

"I have two children and there's one that's in daycare. I'm very concerned about the daycare and making sure they're speaking to them about it also," said Bridgitte Collins, of Wheeling.

Federal officials said the flu had been confirmed in four more states with 91 cases nationwide as of Wednesday.

The first confirmed death in the U.S. from swine flu was a 23-month-old Mexican child who died in Houston, officials said.

Wednesday, the World Health Organization raised its pandemic alert to phase 5, indicating widespread human-to-human transmission. The level is just one step below level 6, a full-fledged pandemic.

The symptoms of swine flu are similar to regular human flu -- a fever, cough, sore throat, body aches, headache, chills and fatigue. Some people also have diarrhea and vomiting.

Local parents said they are trying to avoid scaring and worrying their children when it comes to swine flu. Most, if not all, said hygiene has been the key topic when they discuss the situation.

Medical providers said people should take commonsense precautions like covering coughs and sneezes with a tissue or sneezing into their elbow rather than their hand.

People should also wash their hands frequently; if soap and water aren't available, hand gels can substitute. People should stay home if they're sick and keep children home from school if they are.

Health authorities said people who live in places where swine flu cases have been confirmed, or recently traveled to Mexico, and have flulike symptoms, should ask a doctor if they need treatment or to be tested. Allergies won't cause a fever and run-of-the-mill stomach bugs won't be accompanied by respiratory symptoms, a spokesman for the American Academy of Family Physicians said.

Previous Stories: April 28, 2009: Swine Flu Has Valley Residents Concerned April 28, 2009: Some Valley Residents Approve Of Government's Actions On Swine Flu April 28, 2009: Local Couple Cancels Honeymoon Because Of Swine Flu Scare April 27, 2009: Local Travelers Leery Over Swine Flu Outbreak April 27, 2009: Swine Flu Has Local Health Officials On Alert April 27, 2009: Ohio Boy Diagnosed With Swine Flu April 25, 2009: Swine Flu Kills Dozens In Mexico, Spreads Into United States