HUNTINGTON -- Local hospitals have issued new guidelines that include masks and separate entrances for people who come to their emergency departments with flu-like symptoms.

The guidelines, aimed at trying to prevent the spread of flu, come after three H1N1, or swine flu, deaths have occurred in Cabell County. Spikes in the number of H1N1 cases in the state have been reported in Cabell, Jackson, Mercer, Monongalia and Wood counties, according to West Virginia Bureau for Public Health spokeswoman Marsha Dadisman.

People with symptoms of flu who visit the emergency department at St. Mary's Medical Center are being asked to use a different entrance, according to Sharon Shaw, manager of public relations at St. Mary's Medical Center.

Shaw said staff posted signs outside the emergency department at St. Mary's indicating the separate entrances on Tuesday. People with flu-like symptoms are asked to enter to the right of the main emergency entrance, through the doors below the Regional Heart Institute sign. Other emergency patients should use the regular emergency room entrance.

Shaw said the change was made to protect visitors from flu exposure. Hospital staff also want to limit the number of people who accompany patients in an effort to reduce crowding.

"We're asking, please, if possible, only one family member bring the sick person," Shaw said.

She said people who enter the flu entrance also will be given masks.

The new guidelines at Cabell Huntington Hospital ask that patients with shortness of breath or chest pains go directly to the information desk and notify hospital staff, according to information from Charles Shumaker, media relations manager for Cabell Huntington Hospital. Patients not suffering from those symptoms should wash their hands using free hand sanitizer, sign in and take a mask to help prevent the spread of germs.

Staff at Cabell Huntington are asking patients in the emergency department to remain patient, and they will be evaluated by medical staff as soon as possible. Patients should not hesitate to ask questions, but remember that they may have to wait to see a physician.

Precautions also continue at other area health care facilities.

Cornerstone Hospital, which is housed on the second floor of St. Mary's, began asking its visitors and staff to wear masks on Monday, according to Chief Executive Officer Dan Dunmyer.

"Were trying to keep (the flu) from spreading any further," he said.

Dunmyer said some staff at the 28-bed hospital have experienced the flu or flu-like symptoms recently.

While masks are being distributed at local hospitals, they are not recommended in community and home settings because no scientific data exists to indicate wearing masks in those settings decreases risks, according to the Centers for Disease Control and Prevention.

Masks also are not recommended by the Cabell-Huntington Health Department, according to Elizabeth Ayers, public information officer.

"It's nothing that we're heavily pushing right now," Ayers said.

Instead, she said the health department continues to advise residents to cover their noses and mouths with a tissue when they cough and sneeze and to wash hands frequently.

"I think if everyone walked around in masks it would scare everybody, and that's not what we're trying to do," she said.

West Virginia's first batch of swine flu vaccine is expected to arrive this week, but the first 10,000 doses will go to hospitals and health care workers to ensure continued treatment for people who fall sick with the H1N1 virus this fall.

Shaw said St. Mary's will begin vaccinating its emergency workers against swine flu on Thursday. The first batch of vaccines will be in nasal spray form.

She said the H1N1 vaccine will be given out using a four-tiered program.

"We will be vaccinating the employees in 'tier one' on Thursday. That group will include staff in the emergency department, Cabell County EMS workers, staff in surgery units and heart units, critical care units and those in our respiratory therapy area," Shaw said.

The next workers to receive vaccines include labor and delivery staff, oncology staff, lab staff, and those involved with direct patient care.

Shumaker said some clinical staff at Cabell Huntington Hospital also were expected to be vaccinated against H1N1 this week.

Dr. Cathy Slemp, the state health officer, estimated that several thousand West Virginians are likely infected with swine flu, but stressed that most will recover. She said 36,000 people die nationwide each year from the seasonal flu, suggesting a fatality rate of 200 or so for West Virginia.

Slemp said she expects more swine-flu vaccine to arrive later this month or in early November, and she said there should be enough for anyone who wants one by January.

Symptoms for both seasonal and H1N1 viruses are similar, including a temperature of 100 degrees or more, cough, sore throat, runny or stuffy nose, body aches, headaches, fatigue, and vomiting and diarrhea in some cases. However, not everyone with the flu will have a fever.

More information is available at st-marys.org or cabellhuntington.org.

The Associated Press contributed to this report.

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