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Government officials have declared a public health emergency in connection with the swine flu outbreak that has killed dozens in Mexico and sickened 20 in the U.S., said the nation’s director of Homeland Security Sunday.

Secretary Janet Napolitano also said border agents have been directed to begin passive surveillance of travelers from affected countries, with instructions to isolate anyone who appears actively ill with suspected influenza.

The number of cases confirmed in the United States by the federal Centers for Disease Control and Prevention is now 20, including eight New York City high school students. Other cases are in Ohio, California, Texas and Kansas. Patients have ranged in age from 7 to 54.

Government health officials expect to see more cases of swine flu here, including possibly serious infections, a senior CDC official said.

“We expect there to be a broader spectrum of disease here in the U.S.,” said Dr. Anne Schuchat, interim deputy director for the agency’s Science and Public Health Program. “I do fear that we will have deaths here.”

Napolitano said the emergency declaration is a warning, not a notice of imminent danger, similar to preparing for a hurricane.

"I wish we could call it a declaration of emergency preparedness,” Napolitano said.

Dr. Richard Besser, acting director of the CDC, said that compared to cases in Mexico, “what we’re seeing in this country is mild disease,” noting that the U.S. cases would not have been detected without increased surveillance.

CDC officials said they don’t yet have basic information about how the virus spreads, including how many cases each primary case might create, or how long it might take for them to be infected. However, agency officials believe the virus is spreading person-to-person. In the U.S., all the patients have recovered and only one patient was hospitalized.

Besser said he still can’t say why cases in U.S. are so much milder than the deadly cases in Mexico. There, the disease has killed up to 86 people and likely sickened nearly 1,400 since April 13.

“The real important take away is that we have an outbreak of a new infectious disease that we’re addressing aggressively,” Besser said.

The incubation period for the virus is 24 to 48 hours, health officials said. President Barack Obama recently traveled to Mexico but the president’s health was never in any danger, said John Brennan, Assistant to the President for Homeland Security.

The president has received regular briefings from advisers on the swine flu outbreak and the White House readied guidance for Americans.

“The government can’t solve this alone; we need everybody to take some responsibility,” Napolitano said.

Besser urged Americans to practice frequent handwashing and to stay home if they feel sick. “If your children are sick, have a fever and flu-like illness, they shouldn’t go to school.”

Schuchat said symptoms that would trigger alarm include h igh fever, cough, sore throat, muscle aches, vomiting and diarrhea. But she cautioned those could also be signs of any number of respiratory diseases.

“There’s not a perfect test right now that will let a person, a member of the public or a doctor, know,” she said.

U.S. to screen travelers at borders
The U.S. will begin screening travelers at the nation’s borders and isolating people who are actively ill with suspected influenza, Napolitano said. No travel restrictions are issued currently, but that could change, she said.

CDC officials said Sunday they would begin handing out “yellow cards” at airports with information about signs, symptoms and ways to reduce the chance of acquiring the virus.

Health officials said the facts of the outbreak don’t yet warrant testing or quarantine of travelers from Mexico, but that that could change if the situation gets worse.

Anne Schuchat reiterated that the outbreak can’t be contained.

“We cannot stop this at the border,” she said, adding: “But we think there’s a lot we can do to limit the impact on health and to slow transmission.”

“We think that slowing transmission can have an impact on health,” she said.

Officials said Sunday they are considering whether to begin manufacture of a vaccine.

“At this point, there is not a vaccine for this swine flu strain,” Besser said.

Deaths in Mexico
Symptoms in the eight newly confirmed cases in New York have been mild, said Health Commissioner Thomas Frieden. City health officials said more than 100 students at the St. Francis Preparatory School, in Queens, recently began suffering a fever, sore throat and aches and pains. Some of their relatives also have been ill.