SHOT MAY NOT BE FLU CURE-ALL; OFFICIALS FEAR RESISTANT STRAIN.

Byline: Michael Coit Daily News Staff Writer

With the first confirmed case of influenza in Los Angeles County, public health officials warned Tuesday that the Type A virus identified might not be covered fully by the vaccine.

The county, state Department of Health Services and the federal Centers for Disease Control and Prevention will examine a sample taken Christmas Eve from the first confirmed case of the flu in Los Angeles County, a 17-year-old boy from West Los Angeles.

Doctors believe that the boy became sick with the A/Sydney strain, which is covered by the vaccine. But they cautioned that the virus may have mutated even slightly, which means people sick previously with Type A could fall sick again, doctors said.

``Because it can keep changing, you can be infected by a flu which your body has never seen before,'' said Dr. Loring Dales of the state Department of Health Services' communicable disease division. ``You can have full-blown influenza, and you just feel like you've been hit by a truck.''

The good news, however, is that some doctors are predicting a fairly mild influenza season because it has started later than usual.

``We expect the brunt of the flu season to be coming in the next two to four weeks. I don't think it's going to be a particularly heavy season,'' said Dr. Pamela H. Nagami, staff physician for internal medicine and infectious diseases at Kaiser Permanente Medical Center in Woodland Hills.

Nagami also believes that the vaccine in use will be effective.

``We think it's a good match this year. Last year was one of those rare years where the vaccine was missing a key strain,'' Nagami said.

Last year, the vaccine did not include the A/Sydney strain of the virus, but this year it includes that strain and both the A/Beijing and B/Harbin strains.

County health officials believe Los Angeles' first case is A/Sydney because that strain is turning up in most of the California cases, as compared with the B/Harbin strain in the Northeast, said Dr. David Dassey, deputy director of acute communicable disease control for the county Department of Health Services.

Confirming the type of influenza virus is important particularly because Type A strains tend to produce more severe illness, Dassey said.

``People are sicker longer and are more likely to develop the complication of pneumonia,'' he said.

Flu shots recommended

Doctors recommend that the elderly and young adults and children with chronic illnesses get flu shots, because influenza can be deadly for them or they can develop serious complications.

And there still is time to get a flu shot. ``Although it's getting late, it's still not too late,'' Dales said.

Health officials advise people with symptoms including fever, cough, headache, muscle ache and fatigue to stay home during the first three to five days of illness. The recommended treatment is to eat lightly and drink plenty of fluids.

People should contact their doctor if they encounter severe symptoms or have chronic illness or heart disease. Influenza can be deadly, killing 10,000 to 30,000 people annually, health officials said.

The antiviral drugs amantadine or rimantadine are available with a prescription for adults, and can shorten the duration of the disease and lessen its ability to be transmitted, doctors said.

Aspirin substitutes are advised for children to control fever.

`Tip of iceberg'

With school out, health officials don't have one reliable measure of the depth of flu - absentees from school.

The seven confirmed cases in the state so far likely are only the ``tip of the iceberg'' because many doctors do not participate in the national influenza reporting system overseen by the federal Centers for Disease Control and Prevention, Dales said. But he said those few cases are a good indicator.

``What we haven't seen is any evidence of outbreak activity. No health department is telling us they are getting calls from doctors or medical facilities saying cases are just pouring in,'' he said. ``But of course, if it is going to happen, it would happen about now.''

Dales noted that the lack of flu outbreaks among the elderly is a sign of the vaccine's effectiveness.

``In places like nursing homes and senior citizen residences where usually everyone gets a flu shot, we're getting no reports of clusters of cases. I think it's having an effect. It keeps flu from reaching the high-risk people,'' he said.

HOW TO AVOID THE FLU

Public health officials warn that influenza is highly contagious - and the season is just beginning. They offer the following tips:

Wash your hands often, and keep them away from your nose and eyes.

Get plenty of rest.

Use disposable facial tissues.

Don't share glasses, dishes, silverware or towels with family members.

Clean your telephone receiver regularly.

Stop smoking. It taxes your immune system and your lungs.

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BOX: HOW TO AVOID THE FLU (see text)