Like clockwork, flu season inevitably unfolds from October to May each year. But just what kind of flu, how many people will be infected, and the severity of each flu season are far from predictable.

Delmar Little, respiratory surveillance coordinator for the Georgia Department of Public Health (DPH), makes it his business to try to stay one step ahead of this cagey viral foe by tracking when and where it pops up around the state. Keeping tabs on the flu is not as easy as one might think.

"Flu is a weird disease," Little said. "In most acute diseases we think of, people get sick really fast, and it's easy to tell that they're sick. With the flu, most people feel like it will go away, so they don't go to the doctor's office. It makes surveillance difficult."

Surveillance is important for guiding flu prevention efforts, like doling out flu shots, something public health officials are thinking about during National Influenza Vaccination Week, now through Dec. 8. A flu vaccination is still one of the best ways to prevent seasonal flu and the Centers for Disease Control and Prevention (CDC) recommends everyone age 6 months and older gets a flu shot each year.

This year, public health officials have a new vaccination tool to keep flu at bay. On Nov. 20, the U.S. Food and Drug Administration announced the approval of Flucelvax, a seasonal flu vaccine made using cultured animal cells instead of fertilized chicken eggs. The advantages of a vaccine produced this way include the ability to maintain an adequate, readily available supply and the ability for a faster start-up in vaccine production in the event of a flu pandemic, the agency said in a statement.

Even as scientists improve flu vaccination, many people are still unaware of the importance of flu vaccines or are just unwilling to get one, a fact that makes Little's surveillance of Georgia's flu cases more challenging and important.

"Once we get confirmation [of a case of the flu], our biggest concern is to work with the local entities to start precaution measures," Little said, such as making sure people wash their hands or vaccinating those who haven't gotten a flu shot.

Little and his team rely on an array of tools to identify cases of the flu. They compile lab test results "to characterize what's actually circulating, to see if it's actually a new virus," Little said. They monitor data from 28 different Georgia hospitals to see how many people report flu symptoms, a system which helped officials battle the H1N1 flu pandemic in 2009.

One of the most important tools is the Influenza-like Illness (ILI) Network, a system of 82 physicians around the state who report how many patients they see who have an illness that resembles the flu -- a fever of 101 degrees and a cough or sore throat.

In 2011, the ILI network reported more than 17,800 cases of flu-like illnesses around the state; after testing almost 14,000 cases, 692 cases were detected with a positive lab test result. As far as flu goes, it was a pretty light year.

Little said he sees his job as something of a flu news service.

"Folks don't have time to pay attention to whether there's a lot or not a lot of flu out there," he said. "It's our job to make sure people are aware of what's out there and how to protect themselves."

To keep up with flu and vaccination news from DPH, visit http://health.state.ga.us/programs/immunization/flu.asp 

-Story by Carrie Gann, DPH Communications