October brings many changes, from the color of leaves to the length of sleeves, but some minds automatically turn toward a hallmark event of the coming months: flu season.

Santa Barbara County is on board with the rest of the country in preparing for this unconventional year, in which millions of doses of vaccine are being distributed for both seasonal flu and H1N1 flu.

The off-season H1N1 flu is widespread in 37 states, including California. The county has seen 24 hospitalized cases as of early October, said Susan Klein-Rothschild, an assistant deputy director with the county Public Health Department. The first case hospitalized was in late June.

There have been two probable H1N1 deaths in the county. A female adolescent with prior medical conditions died Oct. 3 at Santa Barbara Cottage Hospital, and a 4-year-old boy, also with underlying medical conditions, died over the weekend.

According to the Daily Nexus, UCSB’s Student Health Services has seen an unprecedented number of students — about 500 — reporting flu-like symptoms in the past few weeks.

Typically, 36,000 people die each year from seasonal flu, the majority of whom are elderly people. H1N1 flu has affected a different population, with children, young adults and pregnant women proving susceptible. In fact, 58 percent of Santa Barbara’s hospitalized cases of H1N1 have been people younger than 19, according to the Public Health Department.

The Centers for Disease Control and Prevention recommends getting flu vaccinations this year, and Klein-Rothschild concurs. The seasonal flu vaccine is not expected to protect against H1N1.

“I say, get both shots if you’re able,” she said, adding that it’s better not to get sick and not to pass it on to someone who’s more at risk. “Help yourself and help somebody else is my theory.”

The H1N1 vaccine will be available in both shot and nasal spray form. The county has only 4,500 doses of the nasal-spray vaccine, which is being given to healthy children ages 2 to 9. The county expected to get shot vaccines soon, most likely by the first week of November.

There have been worries about a shortage, but Klein-Rothschild said there should be enough for everyone who wants one. However, doses are coming through the federal government — which has paid for all of the vaccines and syringes — and will come in batches on an unknown schedule.

Although the doses are paid for by the federal government, there may be an administrative cost through certain organizations, such as Costco.

The vaccines will be given to people who are most at risk for serious illnesses first, she said.

The shot has the killed virus in it, and is not capable of causing the disease, while the nasal-spray vaccine has live, weakened viruses. At-risk groups shouldn’t get the nasal-spray vaccine, according to the CDC.

The pressure to produce H1N1 vaccine this year has caused some local physicians to have a low stock of seasonal flu vaccine, Klein-Rothschild said.

There have been a number of free seasonal flu vaccine clinics throughout the county, and private organizations provide the vaccine as well. The county-sponsored clinics offer shots to young people with a doctor’s verification of illness and those age 60 or older, and the nasal-spray vaccine for nonpregnant, healthy 2- to 39-year-old people.

The next clinic will be from 1 p.m. to 4 p.m. Tuesday in the Goleta Valley Community Center, 5679 Hollister St.

The CDC recommends taking other preventive measures to avoid the flu, such as washing hands often, avoid touching the face and avoid close contact with sick people.

H1N1 spreads person to person through respiratory droplets from coughing and sneezing, so covering your mouth is essential to avoid contaminating others.

Symptoms of the flu are fever, headache, fatigue, dry cough, sore throat, runny or stuffy nose, muscle aches and sometimes stomach issues. Both flus can cause mild to serious illness, and some people won’t need to seek medical care.

However, the CDC has a list of “emergency warning signs” that should make people get medical care immediately, as well as groups that are more likely to get complications from flu symptoms. At-risk groups are young people, people older than age 65, those with pre-existing medical conditions and pregnant women.

Warning signs (courtesy of CDC):

In Children

» Fast breathing or trouble breathing

» Bluish skin color

» Not drinking enough fluids

» Not waking up or not interacting

» Being so irritable that the child does not want to be held

» Flu-like symptoms improve but then return with fever and worse cough

» Fever with a rash

In Adults

» Difficulty breathing or shortness of breath

» Pain or pressure in the chest or abdomen

» Sudden dizziness

» Confusion

» Severe or persistent vomiting

Antivirals have been used to treat H1N1, but they are used sparingly to avoid mutation of the virus, Klein-Rothschild said. They are typically used for the sickest people, she said.

Though H1N1 hasn’t affected as many people as the seasonal flu, it’s still dangerous, she said. “It’s not even in flu season yet and we’ve had people hospitalized,” she said. “This will make the middle of flu season worse.”

Flu clinics

» 1 p.m. to 4 p.m. Oct. 20, Goleta Valley Community Center, 5679 Hollister Ave.

» 10 a.m. to 2 p.m. Oct. 21, Vista De Santa Barbara, 6180 Via Real in Carpinteria

» 9:30 a.m. to 11:30 a.m. Oct. 22, Cuyama Clinic, 4711 Highway 166 in New Cuyama

» 11 a.m. to 3 p.m. Oct. 24, Wal-Mart Santa Maria

» 1 p.m. to 4 p.m. Oct. 28, Veterans Hall, 941 Walnut in Carpinteria

» 1 p.m. to 4 p.m. Oct. 29, Buellton Senior Center, 164 W. Highway 246

Noozhawk staff writer Giana Magnoli can be reached at gmagnoli@noozhawk.com.

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Giana Magnoli, Noozhawk Managing Editor

Noozhawk managing editor Giana Magnoli can be reached at gmagnoli@noozhawk.com.