Memo to campers:

Along with bug spray and sunscreen, you might want to pack hand sanitizer this summer.

As the swine flu continues to spread in Minnesota, health officials say the next breeding ground may be summer camps for kids.

Typically, flu season is over long before school ends, but the new swine flu has changed the rules. "It doesn't appear to be waning," said Dr. Ruth Lynfield, the state epidemiologist.

On Friday, the number of confirmed cases of swine flu swelled to 112 statewide, up from 74 the day before, with the number of hospitalized patients nearly tripling to 23, the Health Department reported. Lynfield said she expects the numbers to continue rising as test results come in on a backlog of suspected cases. Last week, new cases were still surfacing at Twin Cities schools, amid scattered reports of high absenteeism.

Yet Lynfield said there will be new challenges when summer camps start to open next week.

"I think the day camp situation will be similar to schools," she said; the state advises anyone with flu-like symptoms to stay home for a week. "What is potentially tough, though, is overnight camps, particularly if kids don't live locally. We can't just say, 'Well, go home for the seven days.'"

Lynfield said her department is scrambling to come up with new guidelines for camps, perhaps sometime next week. But camp operators say they're already taking precautions in case the virus arrives on their doorsteps.

The Minneapolis YMCA has installed hand sanitizers around its day camps and has advised counselors to pack Purell in their backpacks, said Connie Rodosovich, general manager of camping services.

"We are prepared for it," said Rodosovich. She noted that the overnight camps, which typically run one week to three weeks, all have medical personnel on site and that they'll be monitoring campers for flu-like illness. "If they're in remote areas, we would take that camper out, absolutely," she said.

Check on arrival

At the Audubon Center of the North Woods near Sandstone, which runs four- to seven-day expeditions in the wilderness, campers will be checked on arrival, said Katie Kleese, the co-director. "If someone were to show up at the beginning of camp and had flu symptoms, we would send them home," she said. If they get sick in the woods, they'll be "carefully monitored" and the trip may be cut short.

"If they're out on Voyageurs National Park, the best we can do is just bring them home," she said. "If any medical issue comes up, it's a judgment call."

Kleese noted that a Minneapolis school group canceled its trip to Audubon in early May because of a suspected case of swine flu. Now it's rescheduled for the fall.

Camp operators say they're paying more attention to hygiene this year -- washing hands, covering coughs. But coping with sick campers is nothing new. The Girl Scout camp in Hackensack, Minn., for example, has small cabins where girls can be housed temporarily if they fall ill. "We would isolate the child from the rest of the children until they can be picked up," said spokeswoman Tauna Quimby. This year, she said, counselors will be trained to watch for flu symptoms, such as fever, sore throat and cough.

Lynfield said the first line of defense starts at home. "People need to take responsibility and keep the kids home if they're sick," she said. "If that means they come late to camp, so be it."

Maura Lerner • 612-673-7384