Now that swine flu has turned up in Maryland, health officials throughout the state are taking extra steps to try to limit the spread of the viral illness before it becomes a pandemic.

A number of counties have set up hot lines to answer residents' questions about swine flu, and officials are closely monitoring the situation.

The measures are being taken as the state awaits definitive test results on eight suspected cases of the illness — four in Baltimore County, three in Anne Arundel and one in Montgomery County. Nationally, the Centers for Disease Control and Prevention confirmed 109 cases of swine flu as of Thursday evening.

The 1,200-student Rockville High School was closed Friday after a student came down with what could be swine flu. Hand-lettered "School closed" signs taped to the doors of the Baltimore Road school greeted those who had not received word of the closing, which was recommended late Thursday by health officials.

Also Thursday, Gov. Martin O'Malley (D) announced formation of an advisory board to assist him and the state Department of Health and Mental Hygiene on the possible swine flu cases in Maryland.

"The members of this advisory board represent some of the best minds in medicine, infectious disease and pediatrics and have already provided invaluable advice and guidance," O'Malley said in a statement. "We fully expect to see more cases of swine flu in Maryland and will continue to provide the public with the latest information possible."

In the Baltimore County cases, two of those ill are members of the same family; one recently traveled to an affected area — possibly Mexico, health officials said. A third Baltimore County case also involved a person who recently went to an affected area, officials said. The fourth case was a woman who presented with flu symptoms.

The Montgomery County case, announced on Thursday, involves a 53-year-old World Bank employee who had traveled to Mexico on business, according to county officials. He now is home and recovered, but his wife, a Montgomery County teacher, and two children have been asked to stay home from school.

School officials notified parents at the affected schools — Takoma Park Elementary, Westland Middle and Einstein High schools — about the situation. They remain open.

In the Anne Arundel cases, a family member of two people who got sick recently returned from an affected area, health officials said.

Two of the cases involve students. One attends Folger McKinsey Elementary School in Anne Arundel County and the other attends Milford Mill Academy in Baltimore County.

In an April 29 letter to parents, Anne Arundel schools Superintendent Kevin M. Maxwell wrote that the Folger school would remain open and would be thoroughly cleaned with disinfectant. He said parents should keep sick children at home.

Also in a letter to parents, Milford Mill Principal Nathaniel Gibson asked parents to call the school if their child is home sick with flu-like symptoms. Officials at both schools are working with their counties' respective health departments to monitor unusual absences.

None of the patients has been hospitalized. The cases have been sent to the CDC for testing, and state officials were awaiting the results Thursday.

Citing confidentiality, health officials declined to release the names of those infected.

"This development is what we have expected and prepared for" since news of the swine flu broke last week, John M. Colmers, secretary of the state's Department of Health and Mental Hygiene, said in a statement. "We are working together with local health officials and health care providers in every corner of the state to detect and respond rapidly to this serious health care concern."

In Baltimore County, officials have coordinated with health care providers on swine flu testing and created an agency hot line to answer residents' questions, said Monique L. Lyle, a spokeswoman for the county health department.

"The main thing that we're doing, that we'll continue doing, is our surveillance" of the swine flu spread, Lyle said.

Anne Arundel health officials have sent out brochures in Spanish to more than 25 churches in the county, said Ellen Jones, a spokeswoman with the county's health department. Anne Arundel also has set up a general information hot line for residents with concerns about swine flu. So far, the county health department has not received many calls, Jones said.

"The most important thing at this point is public information," she said.

In other counties in Maryland, various steps are being taken.

In Montgomery County, officials set up an 8 a.m.-to-5 p.m. weekday hot line for as long as it is needed.

"We're actively talking and working throughout the area," said Department of Health and Human Services spokeswoman Mary Anderson.

Prince George's County Executive Jack B. Johnson held a press conference Thursday afternoon to disseminate the latest flu information from the CDC and the state Department of Health and Mental Hygiene.

The county also is distributing a flu fact sheet to residents and has a link to the CDC's swine flu site on its health department Web page. County health officials also have posted a flu prevention video on their Web site.

Carroll County has established its own flu hot line to answer residents' questions and has posted under the county news tab on the county Web site a message about the importance of washing hands as a preventive measure.

Meanwhile, the state is monitoring hospital emergency rooms and doctors' offices to see if people are coming in with symptoms, which include a fever greater than 100 degrees, sore throat, difficulty breathing, confusion, an inability to eat or drink, and a bluish tinge to the skin, said Fran Phillips, deputy secretary of public health with the Maryland Department of Health and Mental Hygiene.

People should contact their doctor or visit an emergency room, she said.

The state also is using "nontraditional" ways of conducting medical surveillance. For example, several hundred pharmacies have their inventories plugged into a network of computers. State health officials can get a daily report on sales of over-the-counter medications, which might show an increase in respiratory illness, Phillips said.

Maryland has a stockpile of 276,000 doses of Tamiflu, one of four known antiviral medications that is effective against swine flu, said David Paulson, a spokesman for the state Department of Health and Mental Hygiene.

The federal government also plans to release its stockpile of Tamiflu, should it be necessary, he said, and that would mean 200,000 additional doses.

Staff Writer Janel Davis contributed to this report.

-Go to www.cdc.gov/swineflu/index.htm

for the most recent information on swine flu

-For information specific to Maryland, go to: www.swineflu.maryland.gov