BOSTON - A virulent strain of flu has reached the continental United States from Alaskan cruise ships, threatening to start the flu season early.
Public health officials already are kicking off campaigns encouraging people to get shots to prevent the disease, the sixth-leading cause of death in the United States.
''Remember when you get your shots, just think to yourself afterwards, it's just one shot for man, one giant leap for public health,'' Massachusetts Public Health Commissioner Howard Koh said Monday.
Flu viruses follow well-worn paths, starting in Asia and heading east. Alaska is usually the first place in the United States to feel their effects, and the viruses then make their way to the western United States and eventually the East Coast, said Dr. Steven Mostow, associate dean of the University of Colorado Medical School and an influenza expert.
Dozens of flu cases were confirmed in Alaska over the summer, and Mostow believes the flu is showing up in the continental United States a month earlier than normal.
Of the several cases reported in the Lower 48 states, four in Colorado have been linked to outbreaks on Alaskan cruise ships. ''The way the boats are set up - eating in large groups, touring in large groups - facilitated the threat of the virus,'' Mostow said.
Mostow believes the virus will reach the East Coast soon - by Thanksgiving in Massachusetts, for example.
The Centers for Disease Control estimates 10 to 20 percent of the population gets the flu every season, with about 20,000 Americans dying from its complications every year. The elderly, residents of nursing homes and people with chronic medical conditions are particularly at risk.
Although new drugs have been shown to be effective against the flu, health officials say the flu vaccination remains the best defense. The vaccine prepared for the 1999-2000 season protects against A-Beijing, A-Sydney and B-Yamanashi strains.
And states are getting more creative in their outreach efforts. Colorado gives flu shots in grocery stores and at football games. In Fort Edward, N.Y., motorists can get a flu shot at a drive-through clinic.
In Atlantic City, N.J., elderly gamblers got their flu shots Monday in the ballroom at Bally's Park Place while slot machines jangled in the next room.
When nurses warned seniors the shot could cause soreness in their arms, many replied they would work it out by pulling the slot machine handle, said Tracye McArdle, health officer for the Atlantic County Division of Public Health.
''They loved it,'' she said. ''They absolutely loved it.''
