Aches. Chills. Fever. The wet noodle feeling that sets into your bones and makes you want to never get out of bed again.
The first flu cases are starting to crop up in doctor offices and clinics in the Tri-Cities, but health officials say it's not too late to get vaccinated to avoid getting sick.
Public health officials traditionally have believed flu season started sometime around January, but the 2009 H1N1 swine flu pandemic changed how the disease is perceived, said Heather Hill, communicable disease program manager for the Benton-Franklin Health District.
"We used to think September, October, November-ish was a little early, but the testing that was done throughout the year during the H1N1 outbreak taught us that sometimes the flu could be here all year round," she said. "It just peaks in the winter and spring months."
Hill said plenty of adult vaccine is available at the health district and at doctor offices.
This year's vaccine is a cocktail of three strains of flu virus, including H1N1. No separate H1N1 vaccine is needed this year. The state Department of Health recommends everyone older than 6 months receive the flu vaccine.
"The most important step to prevent the spread of flu is to get vaccinated each season," said Secretary of Health Mary Selecky in a written statement. "Even healthy kids and adults can get very sick. They can spread it to their family, friends and people in the community."
The department provides flu vaccine for children and adults younger than 19. The department ordered about 480,000 doses this year.
Hill said the state sends the child vaccine to health care providers, who are not allowed to charge for the vaccine but can charge for the office visit or an administration fee.
But the child vaccine doesn't arrive all at once -- delivery to providers is spread out during the flu season. Parents should check with their doctor or pediatrician to find out if they have the vaccine in stock, Hill said.
Seniors can go to the Benton-Franklin Health District to get a high-dose flu vaccine, a new formula designed for people over 65, whose bodies generally don't respond as well to vaccinations.
Hill said the senior vaccine is the same one given to everyone else, but it's four times stronger to cause a greater immune response.
Because it's new, health officials don't yet know if the high-dose vaccine for seniors will save more lives or prevent more people from getting sick.
The health district offers vaccinations by appointment. Call 460-4200 to schedule.