VANCOUVER, B.C. - On a busy evening in the emergency room of a Vancouver-area hospital, a family with an obviously feverish little boy waits to see a doctor.
It's just days after the World Health Organization warned an outbreak of swine flu was killing people in Mexico and every time the boy coughs - tongue out, mouth wide open - other patients sitting around him at the hospital in suburban Delta, B.C., flinch.
At Toronto's University Health Network - in the city that saw 247 of the 438 cases of SARS to hit Canada in 2003 and all of the 44 deaths - the scene would have played out differently.
Posters at the doors of Toronto General and Toronto Western Hospitals emergency units warn people if they're coming in with a cough, fever or shortness of breath, the triage nurses need to know so a surgical mask can be put on the patient.
"We've had in place for at least five years this screening tool that we apply," said infection control expert Dr. Susy Hota. "It's meant to try and triage people who do have these kinds of symptoms and now we're being very vigilant."
The coughing boy should have raised an alert with staff, according to Dr. David Patrick with the B.C. Centre for Disease Control.
Before any cases of swine flu were discovered in Canada, Patrick said the word went out to care centres in British Columbia reminding them of the practices that have been in place since the SARS outbreak.
"And that is, if you've got somebody with a fever and a cough, keep them separate from other people."
On Tuesday, several more cases of swine flu were announced and health officials across the country say it's likely more cases will be detected.
But it's also the time of year when a variety of flu viruses are swimming through the population.
Canadian flu season is coming to an end, allergy season is starting and the swine flu is emerging - it's a "bad alignment of the stars," said Hota.
She said their emergency wards, which saw more than 70,000 patients in 2006/07, are busier and staff have been preparing for even more people because of swine flu.
"We're also expecting that some people may develop other symptoms that seem similar to flu-like symptoms and might actually be more concerned given what's going on outside," she said.
In Alberta, both physician and emergency room visits are up and residents have been swamping the Health Link phone service asking registered nurses questions.
"This news is all over the world," said Dr. Andre Corriveau, Alberta's chief medical officer of health.
"People are watching several times a day in all the media so there's a heightened level of awareness and concern about this, especially if you've travelled to Mexico. So we're trying to bring things back to perspective."
Dr. Eilish Cleary, New Brunswick's chief medical health officer, said that perspective means getting the information out to the public about not panicking and overwhelming medical offices.
"Canada is probably one of the best places to be in the world right now if you're facing a pandemic. Virus don't respect borders, but what does make a difference to a virus is having healthy communities, healthy individuals and healthy populations and we have that in Canada," Cleary said.
No pandemic has been declared in Canada or elsewhere.
Manitoba's chief medical health officer is concerned people may be over reacting to the flu threat.
"If people overuse our health facilities when they don't need to be there ... it can cause trouble for the health system because it can slow down the system and people who really need health care might have to wait longer," Dr. Joel Kettner told reporters Tuesday.
The World Health Organization has raised its alert warning indicating the likelihood of a pandemic for Mexico, where it's believe the flu started, to a four on a scale of six.
The advice from Canadian health officials is universal for those who have flu-like symptoms: ride out the illness at home, isolate yourself for about seven days, and limit contact with other people.
Hota said only when there's a medical complication, underlying illness, or the flu symptoms start to get worse and breathing becomes a problem should patients contact their doctor or go to hospital.