The swine flu has killed 149 people in Mexico and there are at least 40 confirmed cases in the United States. Tamiflu, the current cases around the country have been relatively mild, meaning it largely hasn't been needed. In many cases patients have been able to recover on their own.

After two suspect cases in South Dakota came back negative, at this point the swine flu does not appear to be in this state, Minnesota or Iowa. But all three states are ramping up efforts a lot.

Sioux Falls mom Jennifer Peterson has been keeping an eye on the swine flu outbreak, and so far she's impressed with the response.

"I think it's a good alert," Peterson says. "I know there was a couple in Kansas so I know it's getting closer."

State health officials in South Dakota, Minnesota and Iowa all say they are paying special attention to residents who have recently returned from Mexico, and each state has also called for increased testing of those with flu symptoms.

"We are now casting a very wide surveillance net to detect this virus in South Dakota," said state epidemiologist Lon Kightlinger. "We may ramp it up or scale it back in the coming days as the situation changes, and this certainly is a fast changing situation."

All three states are also stockpiling anti-virus medications like Tamiflu and Relenza. South Dakota has about 80,000 doses on hand, and that will jump by more than 28 thousand within the week. Iowa officials, say the state has at least 400,000 on hand or on the way. A spokesperson with the Minnesota Department of Health tells KSFY it's stockpile numbers are fluid, until they know more about the severity of the outbreak.

Jennifer Peterson says she's glad the states are taking those steps to prepare. She says it's turned into a teaching experience for her two sons.

"Washing hands, hand sanitzer, no drinking anybody's water bottle," Peterson said.

Even thought the state is busy stockpiling