"Even if you're sick, the best thing in most cases is to stay home," Vitek added. The next choice is seeing your family doctor or a clinic. Emergency room visits should be reserved for those with severe symptoms or a condition that puts them at serious risk.

Health officials have seen great variation among individuals, with one constant: very high temperatures — even in the 104-degree-and-up range — as well as some trouble breathing. Symptoms that should send someone to the hospital include severe difficulty breathing, skin or lips turning blue, seizures and loss of consciousness. If little kids are not eating or drinking for an extended period or cry but produce no tears, indicating dehydration, that's a medical emergency, Vitek said.

Antiviral medications like Tamiflu are not curative and are most effective when administered within two days of symptom onset, although they can reduce symptom severity and shorten slightly both flu duration and how long someone is infectious even when administered later. The best defense against getting flu, said Rolfs and Vitek, is great respiratory-illness hygiene, including diligent handwashing.

Rolfs said he expects the pandemic to continue for a while, but there's no way to predict what it will do. He said some pandemics started mild and grew more severe. Others never got serious. The Centers for Disease Control and Prevention has confirmed more than 17,000 cases of H1N1 nationally, including 45 deaths.

E-MAIL: lois@desnews.com