HERE AND NATIONWIDE Flu cases are picking up, and strain is a severe one Health officials encourage people to get vaccinated in this 'problematic' season

The influenza season now underway in Nebraska, Iowa and the rest of the country is turning out to be a rough one.

Numbers of cases recorded in both states, and nationally, continue to increase, likely aided by all of the mixing and mingling of people - and germs - at family gatherings, airports and other public places over the holidays.

Dr. Tom Safranek, Nebraska's state epidemiologist, said the number of cases health officials are seeing is comparable to the peak numbers they've seen in other years - and they're still going up.

"I think we're in for one of our more problematic flu seasons we've seen in recent years," he said.

Iowa officials on Friday reported four more influenza-related deaths, bringing that state's total to six since October. The number of Iowans visiting doctors' offices with flu-like illnesses last week was higher than at last season's peak. Locally, roughly a third of the confirmed cases recorded by Douglas County health officials so far this season came in last week. Douglas County officials also noted an increase in emergency room visits due to flu-like symptoms.

"It's confirming that it's probably a more severe season," said Dr. Anne O'Keefe, senior epidemiologist with the Douglas County Health Department.

Safranek and O'Keefe said they don't believe the bug has plateaued yet, given that cases just started mounting in recent weeks. Whether the return of most area students to classrooms next week will add to the count is difficult to predict, they said, although it's not unheard of.

Meantime, other seasonal bugs, including the common cold, also are adding to the tally of shivering, sneezing and coughing humans.

"Other viral illnesses, this is the time for that to happen," said Dr. Brynn Lastovica, a physician at Nebraska Medicine-Chalco at 168th Street and Giles Road.

Safranek said respiratory syncytial virus, or RSV, also has been showing up in solid numbers. The virus generally causes mild, cold-like symptoms in adults and healthy older children but can be more serious in babies, especially those in certain high-risk groups.

Lastovica said she's seen strep throat and flu in recent days. "I think we're just seeing the beginning of it right now," she said of the flu.

Public health officials warned this fall of the potential for a difficult flu season. Not only did it start roughly a month earlier than it did in the past several years, the predominant strain picked up in lab tests this fall in the United States - and continuing now - is a strain of influenza A known as H3N2. In the past, seasons dominated by that strain have proven worse than others. It's associated in particular with increased hospitalizations and deaths.

The good news is that it's not too late to get a flu shot. While it can take up to two weeks to reach full effectiveness, it can provide some protection from the get-go. And the flu season can continue for months.

"Absolutely, still get the flu shot," Lastovica said.

If you do get the flu, the vaccine can shorten the course of the illness and lower the fever, and even keep you out of the hospital. The vaccine also covers three other strains, any of which could take their turn on top.

Health officials also stress that getting the vaccine can keep us from spreading the flu to those at higher risk, including the very young and the very old.

"If you don't get it for yourself, get it to protect everybody else," said Douglas County's O'Keefe.

The federal Centers for Disease Control and Prevention also issued an alert last week for health care providers, stressing the importance of using antiviral drugs such as Tamiflu as early as possible to treat people who are very ill with flu and those at high risk of serious flu complications.

"It really makes a big difference if you get people on it early in the course of their illness," Safranek said.

Of the latest Iowa deaths, three of the four were 81 or older and one was between age 61 and 80. Three of the four had underlying health conditions or other contributing factors. The state recorded three flu-related deaths during the same period last year, said Polly Carver-Kimm, a spokeswoman for the Iowa Department of Public Health.

Nebraska has recorded eight flu-related deaths this season, Safranek said, all in medically fragile people.

Know the symptoms

You know you're coming down with something. But is it a cold or influenza?

While it can be difficult to tell, Dr. Brynn Lastovica, a physician at Nebraska Medicine-Chalco, said fever and body aches typically are the key symptoms that set flu apart from the common cold.

Indeed, the symptoms of flu can include fever, cough, sore throat, runny or stuffy nose, muscle or body aches, headaches and fatigue. Cold symptoms are usually milder than the symptoms for flu. Someone with a cold is more likely to have a runny or stuffy nose.

To stop the spread, avoid contact with sick people, and stay home if you have a flu-like illness, except to get medical care or necessities.

Some other precautions:

» Cover coughs and sneezes; toss tissues when you're done using them.

» Wash hands often with soap and water; use an alcohol-based gel if soap and water aren't available.

» Avoid touching your eyes, nose and mouth.

» Clean and disinfect surfaces and objects that may be contaminated by the flu or other germs.

Source: U.S. Centers for Disease Control and Prevention