Across the county, measures that were put in place before the flu arrived are paying off.
It's the thick of flu season, and, like everywhere else, Washington County has been mobilized for its annual battle of the bug.
At two state prisons, area schools, hospitals and the local jail, efforts are underway to contain the spread of the disease, which is now widespread in 47 states.
"This season started about a month early," said Boyd Wilson, system director for infection prevention with HealthEast, which runs Woodwinds Hospital in Woodbury. "And that's a little bit of a concern about that, because you don't know what that's going to mean for the rest of the season."
The flu arrived with a wallop about three weeks ago, but the intensity seems to have leveled off, he said. A typical flu season, if there is such a thing, usually runs into May before petering out, he said.
"Flu is always out there, and it always seems to be severe," said Connie Waldera, program manager of disease prevention and control with the Washington County Department of Public Health. "We've had a couple of relatively easy years, but I would call this a moderate to moderately severe season."
Waldera and her public nursing staff began preparing for the season well in advance. Stocking up on vaccine was a top priority, and supplies at local clinics in the county have been adequate, she said.
The challenge is educating people on the value of the vaccine and renewing the annual push for simple preventive measures like hand-washing, covering coughs and staying home when ill. With recent easier flu seasons, public health nurses fight complacency, she said.
With so many county employees interacting with the public, including such people as the nursing staff, county workers are strongly urged to get vaccinated, though it's not required. A similar policy is in effect at HealthEast hospitals and clinics.
That also goes for guards at the Washington County jail, who work in close quarters with an average of 150 inmates in a population that has a lot of turnover, said Sue Hedlund, deputy director of Washington County's public health and environment division, who oversees medical care there.
"Whenever there's flu around, we're always on alert," Hedlund said. New inmates also are offered vaccinations. "We can't make them take the vaccination, but we do offer it to them."
Inmates who are booked in -- typically about a dozen each day -- are screened for symptoms, Hedlund said. If they are ill, there are plans in place to isolate them in the jail, away from the healthy population. So far, flu has not been a major problem at the jail this winter, she said.
Nearby, at the two state prisons in Stillwater and Oak Park Heights, which house about 2,000 inmates, flu has not been a problem, according John Schadl, spokesman for the state Department of Corrections. Statewide, there have been 17 confirmed cases of flu-like illnesses across the entire prison population of about 9,500 inmates in 10 facilities.
The department has been vaccinating inmates since last fall in anticipation of the season, he said, targeting those deemed at high risk and offering the shots to anyone else who wanted them. Prison staff members are strongly encouraged to get vaccinated, but it isn't required.
The prison has a carefully laid-out protocol for responding when an inmate gets the flu, Schadl said. They are offered Tamiflu to treat high-risk cases, and sick inmates eat in their cells instead of dining in common areas and can't have visitors. A cellmate of an inmate with confirmed flu symptoms also has to remain in his cell.
The county also consults with school districts on their prevention measures. In the South Washington County Schools, for example, flu cases at four elementary schools reached an "alert" level where parents were notified to take extra precautions, said Barb Brown, school district spokeswoman.
It's part of what appears so far to be a typical flu season, she said, with absences most notable after winter break. That included teachers, and there was a notable spike in the call for substitutes.
This year's outbreak pales by comparison to the H1N1 pandemic of 2009, said Wilson, of HealthEast. But its remnants, and useful lessons, can be seen in hand sanitizer bottles and coughing technique signs that are now commonplace.
"The back-to-basics have kind of become new again," he said.
Jim Anderson 651-925-5039; Twitter: @StribJAnderson