As the number of H1N1 influenza cases increased around the world, dioceses are suggesting ways that pastors can alter certain practices within the celebration of Mass in an effort to prevent the spread of the highly contagious virus.

The swine flu is transmitted when an infected person coughs or sneezes around others. It can also be spread when a person touches a surface contaminated with the virus and then touches his or her eyes, nose or mouth.

In a memo to pastors, parish administrators, parish life directors and school principals in the Archdiocese of Los Angeles, Msgr. Royale Vadakin, moderator of the Curia and Vicar General, recommended that parish leadership evaluate distribution of the Eucharist under both species, and the form in which the Sign of Peace is offered at liturgy.

"These decisions are best left to individual parishes," Msgr. Vadakin wrote. He also suggested that in the Prayer of the Faithful, parishes add petitions for those who have died or who suffer from the swine flu, and for the ability to contain and control the swine flu pandemic. Examples:

"For everyone affected by the recent flu outbreak, may we grow in our awareness of our frailty in living together, and extend consolation through prayer and concern, we pray to the Lord…."

"For those who are gravely ill due to the recent medical outbreak, may Jesus the good shepherd be their healer and their source of comfort and strength, we pray to the Lord…."

Other precautions could be observed by parishes and schools based on their individual needs. Parish and school leadership was further encouraged to observe precautions about handwashing and other issues, such as care in sneezing and coughing.

Msgr. Thomas Welbers, pastor at Our Lady of the Assumption Church in Claremont and a member of the Archdiocesan Liturgical Commission, offered some suggestions regarding the Lord's Prayer and the Sign of Peace, times during the liturgy at which contact with other individuals is often made.

---With regard to the Lord's Prayer, he pointed out, "this gesture is not 'holding hands,' but the kind of joining together that people of faith instinctively do when praying before meals. The liturgy is insistent that this is not a time of private prayer --- we say 'Our Father,' not 'My Father.' Direct hand-to-hand contact could, perhaps, be mitigated by placing your hand on each others' wrist or forearm, and linking together that way."

---Regarding the Sign of Peace, the early traditional form of the ritual, Msgr. Welbers said, "was not a handshake --- although I prefer the term 'handclasp' as better expressing the dignity of the gesture at Mass --- but an embrace. It might be preferable to consider simply touching one another's shoulders in a simple and modest embrace or hug rather than taking their hands. The liturgical directives do not specify the gesture to be used in the sign of peace, so we are free to share the Sign of Peace in whatever way each person finds appropriate."

Msgr. Welbers further emphasized that "there is no virtue in coming to Mass sick, and giving whatever you have to others. If you are sick you are dispensed from any obligation to come to Mass --- especially if you feel that you are in the highly contagious first few days of major symptoms."

Spiritually, he said, it would be important to engage in personal prayer at that time, "especially by reading and meditating on the Sunday Scripture readings and by praying for all your sisters and brothers in our parish community. In taking care of yourself, you are also showing your love and care for others."

As for drinking the Precious Blood from the cup others have used, "the Centers for Disease Control has consistently regarded the shared Communion cup as a relatively low risk practice in the spread of disease," Msgr. Welbers said. "There is no record of any case of the transmission of any disease that has been linked to the shared Communion cup, either in the Catholic Church or in other Christian churches that distribute Communion in this way."

A random check of parishes in the archdiocese found some distributing the cup as usual, and others halting its distribution for the time being, but all urging parishioners to exercise habits of good hygiene.

The U.S. Conference of Catholic Bishops' Secretariat of Divine Worship posted on its Web site a list of questions and answers associated with how the church should modify the celebration of the liturgy as a result of the outbreak of swine flu. (See http://usccb.org/liturgy/swineflu.shtml.)

In previous times of influenza outbreak, bishops have altered liturgical practices such as the distribution of Communion and the exchange of the sign of peace to avoid the spread of contagion, the document noted.

To limit the spread of the swine flu virus, the Secretariat of Divine Worship advised priests, deacons and extraordinary ministers of Communion "to use an alcohol-based anti-bacterial solution before and after distributing holy Communion."

Ministers and pastors should also ask parishioners not to receive from the cup if they feel ill, it said.

Individual bishops may decide whether they feel it is necessary to change such practices during the celebration of the liturgy within their diocese. However, the Secretariat of Divine Worship does not believe that widespread liturgical adaptations are necessary at this time to prevent the spread of the swine flu.

The Secretariat of Divine Worship has asked that diocesan offices provide any available information about local conditions regarding illness and the influenza outbreak.

Symptoms of the swine flu are similar to those of the common flu and include fever, runny nose, sore throat, body aches, fatigue, lack of appetite, nausea, vomiting and diarrhea.

Continuously updated information about the swine influenza virus is available online from the Centers for Disease Control and Prevention at http://www.cdc.gov/flu/. Mike Nelson and Catholic News Service contributed to this story.