During the Ashland Christmas parade, the flu stopped the music for several Ironton High School band members.

"There's been a lot out. It makes it hard when you're preparing and it's hard to keep track of who's covered what," said band director Bill Rath.

Enough band members apparently recovered over the Thanksgiving holiday for the Ironton Christmas Parade the next week, and the band was lucky that the flu did not seem to strike several members of one section, Rath said. Still, he found it quite odd that the flu is already hitting hard this early in the year.

Before the first snowflake hit the ground, emergency rooms are already full with flu sufferers. Still early in the season, local health care facilities have experienced a large increase in flu sufferers - far more than normal.

"The experts have predicted a bad year, and it's already started out that way," said Kathy Cosco, media and community relations manager for Cabell Huntington Hospital.

Workers in the Cabell Huntington laboratory have positively identified 161 flu cases, Cosco said. This includes 54 cases that arrived in the emergency room and outpatient offices that use the lab. Internally, the hospital is providing its employees with free flu shots so those who are taking care of the public stay healthy themselves. The Cabell Huntington Health Department, which is next door to the hospital, is also offering free flu shots.

At King's Daughters Medical Center in Ashland, Ky., flu cases are on the rise. Julie Marsh, public relations specialist for the hospital said the emergency room is experiencing a significant increase in people arriving with flu-like symptoms. Confirmed cases at the hospital have increased by approximately 60 percent.

St. Mary's Medical Center in Huntington, W.Va., diagnosed 96 flu cases in November, a sharp increase from what the hospital normally sees this time of year, said Dan Londree, a spokesperson for the hospital. St. Mary's, like many other health care facilities, offers a rapid flu test, but it is currently experiencing a shortage because many people believe they may have the flu.

"The cases are way up, and we're definitely seeing it earlier," Londree said.

At Our Lady of Bellefonte Hospital, approximately 30 percent of all diagnoses made in the main hospital's emergency room and urgent care center in Ironton are the flu, said Michael Stautberg, vice-president for external affairs. Like other facilities, OLBH is offering free vaccines to employees,

available at the hospital's outreach centers. In the emergency room, temporary partition walls have been set up to separate possible flu sufferers from other patients.

One nearby hospital has been immune to the virus - so far. As of Saturday, Southern Ohio Medical Center in Portsmouth has not had any confirmed flu cases, said Jason Lovins, hospital spokesperson. However, that may change soon, he said.

One reason behind this outbreak could be that the influenza strain the medical community predicted would strike during this season was not the strain that has struck or is a mutated version of the strain, said Dr. Lee Bowman, a physician at the Our Lady of Bellefonte Hospital Urgent Care Center in Ironton.

However, numbers may not be entirely accurate. These reported flu cases, Bowman said, could be the result of misdiagnosis by health care personnel or by patients believing they have the flu and subsequently telling health care workers. At the urgent care center, most seasonal illnesses observed have been ones such as bronchitis rather than viral ones. The only way to determine if someone has the flu is through a throat or nasal swab that will diagnose the disease quickly or by a viral culture. Because of the length of time involved to make a diagnosis with a viral culture, most flu symptoms are over by the time it would be diagnosed, Bowman said. Flu symptoms generally last for 3 to 7 days, he said.

The usual mode of flu transmission, Bowman said, is hand contact. During the Christmas shopping season, many people are touching the same items in stores. Other public items such as doorknobs may possibly be contaminated. Once the virus reaches a surface, it will stay there for four hours.

Bowman recommended frequent handwashing for both flu sufferers not wanting to contaminate others and those not wanting to end up with the virus. Face masks that were successful in preventing SARS infections earlier this year will probably not be helpful in preventing the flu, Bowman said.

Even though another strain of flu or a mutated strain may be causing this outbreak, Bowman said getting the flu vaccine is still useful because this flu season may last well into March or April. He also recommended seeing a physician when one suspects they have the flu because certain prescription medications, when given early enough, will decrease flu symptoms by about 50 percent. If diagnosed, Bowman recommended self-isolation.

"And you can't drink enough water," Bowman said. "You probably need a half gallon to a gallon a day."

While the Ironton City Health Department has run out of flu vaccines, the Lawrence County Health Department still has a few left. An employee at the department said 250 more doses have been ordered. The vaccines cost $10 and they are free to Medicare and Medicaid recipients as long as the recipients present their cards.