The flu season isn't letting up.
The Allegheny County Department of Health reported 31 new cases of influenza Tuesday, bringing the total number of confirmed cases to 591. Experts estimate each reported case represents as many as a thousand unconfirmed illnesses.
"This thing has no signs of losing any steam right now," said county Health Department spokesman David Zazac. "We have seen no plateau in sight where we're starting to level off."
The federal Centers for Disease Control and Prevention said the country hasn't seen the worst of the flu season. Kansas, Kentucky, Nebraska, Washington and West Virginia no longer are listed as having widespread outbreaks of the flu.
Forty-two states -- including Pennsylvania -- are still on the CDC's list.
"If you look at overall data from nationwide surveillance, it doesn't look like it's peaked yet," said Dr. Scott Harper, a flu expert at the CDC in Atlanta. "Nationwide, influenza-like illnesses are still on the rise."
About 40 percent of Allegheny County's flu cases affect people 18 and younger, but the outbreak hasn't caused a significant spike in absenteeism in local schools.
Schools surveyed Monday by the county health department reported no greater degree of absenteeism than usual.
School attendance, though, could change in the coming weeks, said state health department spokesman Richard McGarvey.
"Keep in mind that we just came through a holiday period with less kids in school," McGarvey said. "We'll see what happens in the next week or two."
Zazac said the county health department plans to conduct another survey late in the week to see if school attendance has changed.
Dr. Julia Lear, director of the Center for Health and Health Care in Schools at George Washington University, said there is no data to suggest that schools experience increases in illness as a result of children's exposure to the flu over the holidays.
"Unfortunately, the bringing together of so many children in the enclosed school classroom inevitably means that more children will be exposed to and catch the flu," she said.
She urges schools to make tissues readily available in classrooms to help stem the spread of flu.
Lear also recommends frequent hand-washing for students. She said children should sneeze or cough into their upper arm sleeve, not their hands, if a tissue is not available. She said frequently touched door handles, bannisters and lunchroom tables should be disinfected.
In the Plum School District, spokeswoman Dawn Check said principals have sent home newsletters to parents about precautions to take to prevent the spread of the cold and flu viruses.
Seneca Valley Schools spokeswoman Linda Andreassi said sanitizing frequently touched areas is standard practice in the Butler County district.
"Our cleaning crew does quite a great job of disinfecting classrooms every day -- not just when we have a flu epidemic or any kind of sickness problems," she said. "Those kinds of provisions are already in place here."
Of course, health officials say the best way to prevent the spread of flu is to get the vaccine.
St. Barnabas Medical Center in Richland still has more than 700 flu shots available and doesn't expect to run out, said spokeswoman Kathleen Brenneman.
The hospital has not had the long lines that the national vaccine shortage produced at other sites around town late last year. She said the medical center sometimes goes hours without a single taker.
"We're ready and waiting for them, and nobody's coming," Brenneman said.
