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SIOUX CITY | About 40 people suffering from cough, runny nose and fever walk through the doors of Siouxland Community Health Center daily. Chief medical officer Michael Piplani said only a handful of them test positive for the influenza virus.

Piplani said there are a lot of viruses circulating in the community that cause flu-like symptoms, but aren't related to influenza. Human parainfluenza viruses (HPIVs) cause an infection in the upper or lower respiratory areas of the body.

"It gives you a low-grade fever and you cough a lot, but it's not the flu," he said. "The flu can be devastating at times. It's just not that bad or in that family."

Influenza activity is increasing in the state, but remains regional, according to the Iowa Department of Public Health. Flu activity across the country is widespread in 41 states.

The Iowa State Hygienic Laboratory has confirmed 452 cases of influenza so far this season. In mid-January, 295 cases had been confirmed. The 2009 H1N1 virus is the predominate strain circulating.

On Jan. 14, the health department reported Iowa's first influenza-related pediatric death of the season. Several adult deaths in the state are also thought to have been caused by the virus.

Leslie Heying, UnityPoint Health - St. Luke's public relations coordinator, said both the hospital's emergency room and clinic providers have seen an increase in influenza cases since mid-January, particularly in patients who haven't received a flu shot. Influenza-related hospitalizations, she said, haven't increased substantially.

Alison Benson, director of communications and community engagement for the Sioux City Community School District, said influenza is being reported across the district, but she said there hasn't been a spike in cases at any one building to cause concern. When more than 10 percent of students are ill at one time in a single building, the event needs to be reported to the health department.

Piplani said influenza symptoms in Siouxland seem to be "a little milder" and center around a cough. Mainly adults ages 20 to 50, he said, are testing positive for the virus.

"I think a lot of people are coming in, but I haven't heard of people totally waylaid," he said.

Patients who test positive for influenza and see a doctor within 48 hours of symptom onset can receive Tamiflu, which remains in good supply, Piplani said.

"They say it hits like a truck," he said of the flu. "In the morning you felt fine and in the afternoon you felt miserable, so when the symptoms come on really fast like that you want to get in as soon as possible so they can get that Tamiflu in you."

It's not too late to get the influenza vaccine either, according to Piplani. Flu season doesn't generally peak in Iowa until February or March.

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