Like our mild winter, the flu bug here and elsewhere in the nation is keeping a low profile.
At least for now.
Influenza generally peaks in February. Cases could easily begin to pile up in the weeks ahead.
"We really have not had flu season yet," said Dr. Anthony J. Billittier IV, health commissioner in Erie County.
Nationally, the Centers for Disease Control and Prevention report widespread cases in only three states. New York is one of 18 states reporting sporadic flu activity, with cases identified in Erie, Genesee, Niagara, Chautauqua and 16 other counties.
Of course, that doesn't mean there isn't an unsavory assortment of respiratory and stomach illnesses caused by other viruses keeping people home in bed.
Kristin Brown came down with her first bad cold of the season last month, one of those chills, sore throat, runny nose, achy experiences that takes over the body for a few miserable days.
"It was horrible. My head felt as though it would explode," said Brown, a quality information manager at Univera Healthcare.
Dr. Richard Schifeling and his colleagues are seeing a lot of upper respiratory illnesses but not much flu.
"People are showing up with the usual coldlike symptoms. If you have the flu, you usually know it. It can be pretty severe," said Schifeling, director of the primary care medical center at Buffalo General Hospital.
One of his challenges is convincing patients who want antibiotics that the drug, whose overuse has led to antibiotic-resistant infections, fights illnesses caused by bacteria and and not those from viruses.
The flu is caused by viruses that come in different forms each year, which is why vaccines have to be changed. It appears as though the influenza viruses found this year match those in the vaccine, the CDC reported.
Flu can be a more prolonged illness than a cold and generally takes the form of fevers, muscle aches and headaches. It also can lead to complications, most commonly pneumonia.
Each year, more than 200,000 Americans are hospitalized from flu complications, usually the elderly and individuals with chronic illnesses, and about 36,000 people die, according to the CDC.
A record number of flu vaccine doses -- 115 million -- were distributed this year.
Some private physicians still have doses on hand. But the major public vaccination programs in this region have ended, except for one conducted by the Chautauqua County Health Department.
Antibodies that provide protection against illness develop in the body about two weeks after vaccination. Although doctors consider October, November and December the best time to get vaccinated, they say a shot later in the season still can provide protection.
"There's certainly a benefit. The fact that we're not seeing much flu doesn't mean an outbreak won't occur," said Dr. Richard Judelsohn, Erie County's medical director and a managing partner of Buffalo Pediatrics Associates.
Other than the amount of flu produced, the biggest change this year was in the vaccination recommendation for children.
Experts suggest healthy children six months through age 5, as well as their close contacts, get a flu vaccine. This is an expansion from last year's recommendation to include children age 2 to 5.
Judelsohn said the expanded recommendation is a good idea because studies have shown that children are super-spreaders of viruses. But he said fulfilling the recommendation is a challenge because pediatricians tend to vaccinate only those children who come into the office during the months when flu vaccine is offered.
Flu viruses generally spread through coughing or sneezing. Or people may handle something with flu viruses on it and then touch their mouth or nose.
As a result, physicians advise patients to stay home and practice respiratory etiquette. This means covering the nose and mouth when coughing or sneezing, using tissues and frequently washing hands.
"The best way not to get a cold or flu is to prevent its spread," said Billittier. "That's a message we have to keep hammering away at."