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SIOUX CITY | The flu is back in Siouxland, but health officials say the impact so far hasn't been as severe and widespread as it is in much of the country.

The Iowa Department of Public Health reports that 295 cases of influenza have been confirmed so far in the state. Influenza A (H1N1) is the predominate strain circulating.

About two-thirds of all laboratory-confirmed cases of influenza occurred in people 5 to 49 years of age. That group also accounted for most of the 57 hospitalizations in the state, according to the health department.

Tyler Brock, a Siouxland District Health Department deputy director, said influenza isn't a reportable disease so he doesn't know exactly how many people in Woodbury County have been sickened with the virus. Symptoms include fever and body aches as well as cough, sore throat, runny or stuffy nose and headache.

"We're starting to get reports of some activity," he said.

Mike Unger, a physician assistant who practices at UnityPoint Health Sunnybrook Medical Plaza, said he recorded his first positive influenza test of the season on Tuesday.

"It's been little or non-existent here in the family practice setting so far," he said of the flu.

Unger said Iowa isn't in the clear, however, as flu season generally doesn't ramp up in the state until February or early March.

Joan Rothwell, manager of Infection Control for Mercy Medical Center -- Sioux City, said the hospital's lab saw an increase in positive influenza tests over the past week. Nine cases have been confirmed since Jan. 1. She said Mercy-affiliated clinics, which do their own testing onsite, have also recorded influenza cases.

"What we're seeing is predominately young adults or children, which kind of goes along with what they're seeing nationwide," she said.

According to Brock, just about every strain of influenza has been recorded this year, although the H1N1 flu virus is the most common strain being spread locally. The virus, which caused a worldwide pandemic in 2009, is now a human seasonal flu virus that also circulates in pigs.

"It's completely covered in the vaccine, so people who get vaccinated are being immunized against that strain," he said of H1N1.

WORST YET TO COME

How do you distinguish a cold from respiratory flu?

Unger said an extremely sudden onset of symptoms, high fever and body aches, are classic signs. Patients may feel like they've "been hit by a Mack truck," he said.

"If you've had cold symptoms for the last week and you think you're getting the flu, it's most likely just a common cold," he said.

Typically, Brock said, infants and the elderly are hit hardest by influenza, but this year he said older children and young adults are being targeted by the virus.

A few children and older adults have been hospitalized at Mercy, Rothwell said.

"It always affected the very young and the very old worse, but that's not what this is necessarily so far. That was fairly typical of the H1N1 in 2009," Brock said. "Because this strain is what's being circulated most widely now, it's no surprise that it's also kind of disproportionately affecting the young and the middle-aged adults."

Unger said patients with respiratory symptoms they suspect could be related to the flu must seek treatment within 48 hours of onset if they hope to benefit from Tamiflu, an antiviral. Unlike antibiotics, he said this medication makes it more difficult for the virus to grow and spread, but it doesn't kill it.

"Your immune system has to kill that virus. The medicine just makes it more difficult for it to multiply, so it's easier for your body to kill the virus," he said. "If you don't get it started in the first 48 hours it's ineffective."

It's not too late to get vaccinated against influenza. Unger said it generally takes a couple weeks to build up an immunity to the virus after receiving a flu shot.

"The key is not to panic. The key is to get vaccinated," he said. "If we're gonna get hit we haven't hit that time yet. The worst is yet to come."

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