Businesses need to figure out worker-friendly policies that still allow them to operate effectively as the regular flu season meets an already-circulating H1N1 outbreak, according to Utah's top health official.

The challenge for the entire state is "to be alert and informed, but not afraid — to not blow this out of proportion," said Dr. David N. Sundwall, director of the Utah Department of Health, speaking Tuesday at the fifth annual "Ready Your Business Conference" in Salt Lake City, sponsored by the Division of Homeland Security, Salt Lake Chamber and Utah Health Department.

The virus that appeared last spring, H1N1, was "a new, novel virus," which is "why all the fuss," he said. And while most of the illness it sparked was mild, there's no guarantee it will stay that way. Even "mild," it did kill 19 Utahns. Given that as many as 300 Utahns die from regular influenza each year, it could become a harsh season.

Right now, H1N1 activity is "just below the epidemic level," with 34 hospitalizations and no deaths so far this fall. School absenteeism is up, he said. And each of the 52 samples taken from sick patients — testing everyone would be expensive and unnecessary, he noted — came back positive for H1N1.

"We're bracing for a busy season" of dealing with both types of flu, and flu-like activity is already higher than usual for this early, Sundwall said. And businesses could be hard hit if they aren't ready.

Local health departments currently have the first doses of H1N1 vaccine, available as a nasal spray. That's only for healthy people 2 to 49 years old. Children 6 months through age 9 will need two doses of H1N1 vaccine; everyone else only needs one dose. Those with weakened immune systems and pregnant women are high risk but need an injected vaccine, expected in coming days.

The nasal spray will first be given to healthy persons 2 to 24 years old, then healthy health-care workers and adults through age 49 who care for children younger than 6 months. Getting vaccinated is a voluntary thing, he said, but so strongly encouraged that some hospital-employment organizations are requiring it of workers.

And with the federal government bearing the cost, it's the "largest ever mass-vaccination effort," he said.

Steps businesses should take include encouraging "fundamental hygiene," like covering coughs and sneezes and washing hands thoroughly. Employees need to stay home if they're sick (most will be gone only three to five days) and not return until at least 24 hours after their last fever.