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"The mild flu seasons we've had the past two years, plus so much attention to new illnesses like SARS and West Nile virus, might make it easy to be complacent about influenza, but that would be a mistake," said Dianne Mandernach, commissioner of the Minnesota Department of Health.

Influenza claims an average of 36,000 lives annually in the United States. In Minnesota, hundreds of people, young and old, are hospitalized each year due to complications of influenza.

Influenza is one of the leading causes of death for people 65 and older, and children under two also have high rates of hospitalization. "It's unacceptable that so many people die and suffer as a result of influenza, when there is a simple protective measure," said Kris Ehresmann, chief of the Immunization, Tuberculosis, and International Health section of the Minnesota Department of Health. "The best way to prevent influenza is to get vaccinated...every year."

It's especially important for Minnesota residents who are most at risk of complications from influenza to get their shots in October so they can develop full immunity from the vaccine before flu arrives here. Flu cases in Minnesota can peak as early as December or as late as April. In general, "flu season" in Minnesota runs from November through May.

Those at highest risk include:

*Anyone 50 years of age or older;

*Residents of nursing homes and other long-term care facilities;

*Anyone over six months of age with a chronic condition of the heart, circulatory system, or respiratory system, including asthma;

*Anyone over six months of age who has been hospitalized or required ongoing medical attention during the past year for a chronic metabolic disorder (such as diabetes), kidney problems, a blood disorder, or immune system problems (such as HIV infection, or an immune system suppressed by medication, chemotherapy, or radiation treatment);

*Children and teenagers who are receiving ongoing medical treatment with aspirin, which could place them at risk of developing Reye Syndrome if they get the flu;

*Women who are more than three months pregnant during flu season;

*All children six to 23 months of age, even if healthy.

Children under six months of age cannot receive the flu vaccine, so parents of babies younger than six months should vaccinate themselves and other children living in the house to keep the baby from catching the flu.

A nasal spray vaccine for influenza, available for the first time this year, is an option for healthy people between five and 49 years, but it is not recommended for people in the high-risk groups, state health officials said.

Supplies of vaccine are plentiful this year, health officials noted. Two years ago, a variety of factors led to temporary shortages or delays in supplies of the vaccine, which may have kept many people from getting their shots.

Fortunately, influenza has been mild the past two years. "The potential for many more cases is there, especially if people do not get vaccinated," Ehresmann said. "We can't predict how severe the flu season will be this year, but there are some indications that this year's virus may produce a more serious outbreak this year."

Flu shots or vaccines have to be given annually. The vaccine is reformulated every year to protect against those strains of influenza that are most likely to be in circulation during the upcoming flu season. Those strains this year are an A New Caledonia-like virus, an A Panama-like virus, and a B Hong Kong-like virus.

The symptoms of influenza - which tend to come on suddenly - can include a sore throat, coughing, fever, headache, muscle aches, and fatigue. People who become severely ill with influenza-like symptoms should see a physician.

While Minnesota has the highest rate in the nation (77 percent) for vaccination among people age 65 and over, coverage for people in other age groups is considerably lower. Among Minnesotans age 50-64, the rate is 43.9 percent.

Nationally, the estimated vaccination coverage among adults aged 18-64 years with high-risk conditions was 29 percent for the 2000-01 season, according to a study published in the Journal of the American Medical Association.

Flu shots can be obtained through health care providers or at special clinics. Dates and locations of clinics can be found on the health department's influenza website at: www.health.state.mn.us.