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"You know, some years are mild and some years are tough, and this is a tough year," Green said. "But it's not out of the ordinary."

Santa Rosa Memorial Hospital reported having had eight confirmed cases of flu come in since October, three of them admitted, one to the intensive care unit.

At Sutter Santa Rosa Medical Center, hospital staff has treated eight flu patients in the intensive care unit, including two who have been sent home, spokeswoman Lisa Amador said.

Probably 95 percent or more of those who become ill with flu will have mild to moderate cases, said Green.

But because even the young and healthy can be made severely ill, health officials are urging precautions for everyone, including vaccinations and common-sense health practices like staying home when you're ill, washing hands frequently, covering your cough and avoiding touching your face with anything but clean hands.

Santa Rosa City Schools, Sonoma County's largest school district, has joined the effort, putting out an automated phone call to its 16,000 students Monday night, urging parents of students who show flulike symptoms like fever, cough, body aches, vomiting or diarrhea to stay home, avoid contact with other people and contact a doctor. Students are asked not to return to school until at least 24 hours after the vomiting and fever has ended.

"Healthy people are getting very sick," said Superintendent Socorro Shiels. "Everybody should just be as aware as possible about what is happening."

Sonoma Valley School District officials Tuesday were planning to notify parents to be aware of the differences between cold symptoms and those associated with the flu.

A letter going out is intended to "remind parents to keep their students home if they are not feeling well," said Superintendent Louann Carlomagno.

The Public Health Office maintains information on availability of flu vaccines and other information at www.sonoma-county.org/health/topics/influenza.asp.

You can reach Staff Writers Mary Callahan at 521-5249 or mary.callahan@pressdemocrat.com and Kerry Benefield at 526-8671 or kerry.benefield@pressdemocrat.com.