The five children tested were randomly selected out of the 40 campers that exhibited flu-like symptoms while at camp. The staff said the first case surfaced around June 15. Tests earlier this week found 18 cases of Type A flu virus among the 40 -- four in Taney County and 14 in Stone County. (Kanakuk also has camps next to Lake Taneycomo near Branson.)

A spokesman for the state health department said two of the cases are people from Texas, one is from Arkansas, one is from Florida, and one is from Oklahoma.

“This is not a surprise to us,” said Stone County Health Department administrator Angela Ford. “H1N1 cases have been reported in all 50 states and in more than 100 countries around the world. We knew it would turn up in Stone County eventually.”

The health department activated an H1N1 surveillance system in late April after learning of the new virus. It worked closely with Kanakuk Kamps and the Taney County Health Department to limit the spread of the H1N1 virus from these isolated cases.

“At this time we believe the cases of H1N1 are isolated to one Kanakuk Kamp,” said Ford. “All the children who tested positive for H1N1 have been sent home”.

Kanakuk is carefully screening newly arriving campers and is monitoring the health of campers and staff. According to Doug Goodwin, chief operating officer of Kanakuk Kamps, any camper that develops a fever or other flu-like symptoms will be immediately separated from the other campers, evaluated by a camp physician, and tested for influenza A. If the test is positive the camper will be sent home with his or her parents.

To limit the virus’ spread and cross-contamination, the camp has increased cleaning schedules to ensure surfaces are virus-free. They are also encouraging campers to practice vigilant hand washing.

“We are treating this as we would any other communicable disease,” said Ford. “The mission of public health is to slow and stop the spread of disease, and one of the best ways to do that is good hand washing. It is a proven public health practice, and offers protection against H1N1 and a number of other illnesses.”

So far there have been more than 59,000 cases of H1N1 reported in 105 countries, although most have been reported to be mild. The United States has seen 21,449 cases, including 87 deaths. Seasonal influenza sickens as many as one in 5 Americans every year, causing approximately 200,000 hospitalizations and 36,000 deaths.