As the weather cools, people start thinking about winter. Time to check your heating system, shake out those thick sweaters and, oh yeah, get a flu shot.

County public health departments in the Northern San Joaquin Valley will begin offering influenza shots as early as today.

At least one epidemiologist said people should consider getting their flu shot sooner than later.

Loring Dales, an epidemiologist with California's Department of Health Services Immunization Branch said the influenza strain that caused so much trouble last year, A/Sydney, started late and hung on well into spring. That means flu season could start early. A/Sydney has already been implicated in an outbreak in Alaska and the Yukon territories last summer.

Health officials usually suggest people get flu shots from mid- to late-October into November. Dales suggested getting a flu shot in early October "for better insurance." It takes about two weeks for the body to build immunity after receiving a flu shot.

Trying to predict whether flu season will be calm or chaotic is a guessing game. But Dales doesn't think this season will mirror last year's.

Last winter, hospitals throughout the state were unprepared for the deluge of patients swamping their emergency rooms. In late December and throughout January, some California hospitals -- including those in Stanislaus, San Joaquin and Merced counties -- were so packed they had to send patients to facilities in other counties.

What happened, explained Dales, was A/Sydney appeared out of the blue, catching everyone off guard.

Every year in early spring, scientists determine what flu strains will go into the vaccine. They look at what flu strains circulate in the southern hemisphere during their winter. They then put those viruses into the vaccine.

Because they saw no evidence of A/Sydney at the time, last year's vaccine didn't provide protection against the strain.

This year's vaccine does.

"We're not in the situation we were in last year. At this point, the flu vaccine looks to be on target," Dales said. "So far, no new strain seems to be sweeping the southern hemisphere. And since this is our second winter with A/Sydney, we won't be in virgin territory. It's not a brand new thing."

This year's vaccination consists of three strains: A/Sydney, A/Beijing and B/Beijing.

County health departments will provide free and low-cost flu vaccines to people 60 and older and others with chronic conditions.

"Influenza weakens the body, which makes older victims more susceptible to other infections," said Dr. Alvaro Garza, Stanislaus County's public health officer. "Without a flu shot, a serious case of flu can develop quickly and worsen rapidly."

Influenza is nothing to sneeze at. Each year in the United States, 26 million to 55 million people get the flu. As many as 40,000 -- mostly the very young and the very old -- die from it.

In addition to the elderly, flu shots are recommended for pregnant women in their second or third trimester during flu season, children on long-term aspirin therapy and those with heart, lung or kidney disease, anemia, diabetes and HIV.

People in close contact with those high-risk groups -- family members or caregivers -- should also get a flu shot, suggested Rebecca Heffner, the infection control coordinator at Memorial Medical Center in Modesto. But people allergic to eggs should not get the vaccination.

There are a few things you can do to keep the flu at bay, Heffner said.

"If you are generally healthy, your body's immune system does a good job of protecting you," Heffner said. "But your body can get overwhelmed if you're stressed, don't eat right or exercise."

The No. 1 protection against flu and cold viruses (and much bacterial crud) is washing your hands. "It's the best way to prevent germs from being transmitted from one person to another," Heffner said.

Vigorously wash hands with soap and water for 10 to 15 seconds to loosen dirt and germs. "It's important to do hand washing, not hand wetting," Heffner said

Hand sanitizers such as Purell can be used in conjunction with hand washing but should not be used as a substitution.

Other tips to reduce the spread of germs:

• Try to avoid touching your eyes, nose and mouth. Most viruses are spread though direct hand-to-mouth, hand-to-eye and hand-to-hand contact.
• Cover your mouth with a tissue when you sneeze or cough, then wash your hands.
• Stay at home when you are sick. If you are sick when you go to work, try not to have other people use your telephone or other objects. Sanitize them with alcohol.

And remember: Getting a flu shot won't prevent you from getting a cold.

Reprinted by permission of Modesto Bee.