Here, patients with H1N1, better known as the swine flu, have experienced mild symptoms, said Dr. Marilyn Pearson, director of the Johnston County Health Department. But she’s concerned about what might come next. Some health officials expect a more-severe form of H1N1 to take hold next fall.

“If it does get worse in the fall, staffing will be a big issue” for the health department, Pearson said.

She expects more people to line up next fall for the flu shot. More vaccinations — and more H1N1 patients — will mean more paperwork for the health department staff.

The health department gets money from the county, the state, Medicaid and private insurance. This year, the department got about $4.3 million from the county, which made up the bulk of the department’s budget. The state gave less than $1.6 million — about 21 percent of the budget.

Next fiscal year, the department is expecting only slight increases in funding. The department will likely get about $4.4 million from the county and $1.6 million from the state, said Steve Strickland, assistant health director in Johnston. But state funding remains uncertain as lawmakers hash out the details of a tight budget.

“Honestly, I don’t know what to expect from the state at this point,” Pearson said.

As of June 10, the county had reported nine confirmed cases of H1N1. All of the patient samples the department sent for testing a couple of weeks ago came back positive, Pearson said.

At least two of the recent cases involved elementary school children. One student at Wilson’s Mills Elementary and another at Cooper Elementary tested positive. The schools sent out phone messages June 9 telling parents of the confirmed cases and reminded them about precautions, said Terri Sessoms, spokeswoman for Johnston County schools.

Workers disinfected the schools that day, but that would have happened even without the confirmed cases, Sessoms said.

“We’ve been doing that on a regular basis since swine flu ... came under the radar,” she said.

Now, the health department is no longer recommending testing for patients who think they might be sick. Many infected patients are getting better in the 24 to 48 hours it takes for the test results to come back, Pearson said.

“Now that we know it’s in our community, we know it’s milder ... than the seasonal flu,” she said.

As fewer people get tested, Pearson expects the county will have several more cases, but they will not be confirmed.