Flu season is here, and the biggest concern now is who might get it.

Dr. Melanie Miller, a pediatrician, said this week: "We have been inundated by concerned parents. There are a lot of panicking parents out there."

For the moment, the main challenge to health care providers is education rather than treatment.

On Monday, Dr. Miller saw 35 patients between 8 and 11 a.m. "Our phone is ringing off the hook. It started getting incredibly busy in the last two weeks. Parents are worried that their child with a cough might have the flu," she said.

Not necessarily. "A child who is coughing a lot but doesn't have a fever most likely doesn't have the flu," Dr. Miller said. "A fever is when the temperature is above 100 degrees. Ninety-nine degrees is not a fever. Every child with a cough should be watched to see if they develop a fever."

There could actually be more harm than good in bringing a relatively healthy child into a doctor's waiting room. "The worst thing you could do is bring a sick child with only a few symptoms into a waiting room. They could get really sick, and the wait is long."

As far as she knows, there has been but one confirmed case of the flu on the Island to date this season. "We have run a lot of negative tests," she said. The one confirmed case was a person in his or her twenties.

Dr. Michael Jacobs operates a walk-in clinic in Vineyard Haven, and he and his nurses are busy. "My sense is that we are not seeing a major increase in winter illnesses. There usually are a lot of viral upper respiratory cases in the winter," he said.

Across the nation there is plenty of news about influenza. "The news is raising everyone's concern," Dr. Jacobs said, "but to be alarmed is unnecessary."

Dr. Henry Nieder said: "Unless there is a serious complication connected with influenza, all a doctor is going to do is send you home with the suggestion to take lots of fluids, rest and use over-the-counter medications to control the fever." He recommends that people not take aspirin to control fever.

Donna Enos, an infection control nurse at the Martha's Vineyard Hospital, said they've seen some cases at the hospital but nobody has been admitted. "It is the typical flu," she said.

"I think people misunderstand what the flu is or what a cold is," she said. A flu is body aches, a cough and a fever. As for prevention, Ms. Enos said, "The old standby I offer is to wash your hands, have good hygiene. Cover your mouth when you cough. If your kids get sick, keep them home."

Keeping a sick child at home isn't only good for the child, it is good for his classmates.

"There is not much more you can do," she said.

Dr. Miller said: "Grandma was right - chicken soup does help. Hot chicken soup is good. Any liquid is good without caffeine, and lots of rest."

And if there are children at serious risk, there are treatments available.

Preparations for the flu season began last April at the Visiting Nurse Service of Martha's Vineyard Community Services Inc. Linda Leonard, a nurse, has been administering flu vaccine for years. "We knew there were going to be cutbacks from the state so we began the process last April of ordering additional vaccine to cover those people we have vaccinated in the past."

So far the agency has vaccinated 1,300 people on the Island. They also gave pneumococcocal immunizations (known as the pneumonia shot) to 66 high-risk people.

Kathleen Rose, president and chief executive officer of the Vineyard Nursing Association, said they have immunized more than 600 people. "We began immunizing in November and we have used up all the vaccine that we have available. We got some from the state and we got some of our own. I think it is unlikely that there will be much more vaccine available. What is found will be directed to those at high risk."

Mrs. Rose said they are frequently talking to people about what makes illness worthy of attention from a professional. "If people develop a respiratory difficulty beyond a cough, dehydration or worsening of a chronic medical condition like diabetes or asthma, they should see a physician," she said.

"As a home care agency we are vigilant about helping patients with chronic problems," she said. "I am not aware that we have seen flu as of yet."

Flu shots being offered provide resistance to three flu strains: A-Panama, A-Moscow and B-Hong Kong.

The most worrisome version of influenza circulating the mainland is known as the A-Fujian virus. Mrs. Leonard said: "One of the strains we gave you, A-Panama, is similar enough to provide some protection against the A-Fujian virus."

Mrs. Leonard said: "I have worked with Community Services for five years and I have been doing public health for 20 years on the Island. I think this season is pretty routine. I just think the media has heightened awareness." Anticipating a shortage of vaccine, she said, an extra effort was made this year to identify those at high risk, who could benefit most from the vaccine. "We really screened out people who did not need the vaccine this year because I knew we had a problem."

It takes about two weeks for a flu shot to be effective. "That is why we begin in October," Mrs. Leonard said. "Flu season runs from December through March. We won't see a peak here until February."

Dr. Miller said she hopes increased public awareness about flu season will be beneficial. "The biggest thing I'd like to pass on is that kids who are sick should be kept away from other kids. That is the best prevention. If you take a child into the grocery normally, don't do that now. There might be someone coughing or sick, particularly in the health aisle. Stay away from that aisle."

Mrs. Rose said: "Don't give aspirin to teenagers and children, there is a complication that might arise."

Mrs. Enos said: "The old standby is to wash your hands."

Two government web sites are especially helpful for up to date information on the flu:

The Center for Disease Control: www.cdc.gov/nip/Flu/Public.htm

Massachusetts Department of Public Health: www.state.ma.us/dph/cdc/epii/flu/FLU1.htm

Dr. Nieder said: "A great majority of the people will get over influenza without a doctor. It is true the first few days, you feel terrible. You feel much more ill than you do with a cold. But as long as you take in fluids and take Tylenol or an acetaminophen painkiller, then you will probably do fine. We worry most about people who are elderly or have other underlying illnesses, and very small children."