Engle says he's awaiting confirmation on four suspected cases in Craven County. He says a student likely has the virus. The concern is forcing a Havelock Elementary School to close its doors for the rest of the week.
Officials are still investigating how they could have gotten the disease.
The number of swine flu cases is increasing, but the virus may not be as strong as initially feared. There are now 339 confirmed cases in the U.S. and more than 1,300 are sick around the world.
So far, North Carolina health officials have received 413 samples; one case has been confirmed, six are awaiting confirmation, 65 samples are pending and 320 have tested negative.
"This is a process that is not necessarily quick," DHHS Secretary Lanier Cansler said. "It could go on for weeks or even months and making certain that we are vigilant in following it and protecting ourselves from this illness, is going to be important."
No one in North Carolina, who is suffering from the illness, has been hospitalized. Officials say they are afflicted with flu-like symptoms.
Despite the new cases, many health experts say there are signs the threat is leveling off. The diminishing threat has the state scaling back its response. But hospitals are still seeing an uptick in patients afraid they have the swine flu.
At Wake Med in Raleigh the emergency department is flooded with people reporting respiratory problems, fevers, flu-like systems.
The actual number of possible flu cases last week in comparison to the same week last year at all 5 of their centers is up 50 percent.
At UNC hospitals, at least 20 patients on Sunday alone reported similar concerns.
Officials say the difficulty is figuring out who has seasonal flu and who has swine flu. But the state lab will no longer test every possible case.
"Patients will be tested for H1N1 only if they are actually hospitalized," said Barb Bisset with the Wake Med Emergency Services Institute.
It was running a hundred tests a day, and local health departments had to enforce mandatory isolation that will now be voluntary.
Govenor Bev Perdue is urging North Carolina residents and visitors to do what "we need to do to protect ourselves."
As always, health officials say to wash your hands and sneeze or cough into your shoulder or arm to protect from spreading germs.
Health Officials hope people will keep these practices up, especially while they study the swine flu.
"I suspect in 6 months we'll fully understand the novel H1N1 outbreak," Engel said. "Of course we may be in the second wave in 6 months, but that's why decisions are being made now to scale up vaccine."
"If an individual develops shortness of breath, any trouble breathing, if they cannot be controlled through the normal means and if they have sudden dizziness or confused they should seek emergency care for that," Bisset said.
But for basic symptoms --cough, sore throat and fever-- health officials say it's best to stay home and stay away from crowds, especially crowds in an emergency department.