JOHNSTON COUNTY - Demand for flu vaccinations here has so far outstripped the county's supply of shots and nasal mists. The Johnston County Public Health Department on Thursday cancelled a flu clinic that was scheduled for this week, saying it had run out of vaccine for both the seasonal and H1N1 flu.

Many people have been anxious to get both vaccines, driven by an early flu season and extensive publicity about H1N1. Last week, about a thousand people turned out for the Health Department's second flu clinic of the season, which offered both H1N1 and seasonal immunization.

Within hours, the department had to turn away people seeking the H1N1 vaccine.

Maggie McDaniels brought her children, Jordan and Alex, for their shots. "It's just in case, because you never know," she said. "They touch who-knows-what."

During the clinic, the Health Department building was crowded with kids and concerned parents; children are considered to be an at-risk group for both kinds of the flu. Young adults are also more vulnerable because they tend to have less natural immunity to H1N1.

Brittany, 20, came for the shots because she is pregnant. "It's just about my baby being healthy," said Brittany, who declined to give her last name.

The clinic started at 2 p.m. last Tuesday, but people were lined up outside at noon, a nurse said. By 5 p.m., department director Dr. Marilyn Pearson and a Spanish-language translator were telling people that no more H1N1 vaccine remained.

Late last week, a news release announced that the department had run out of both kinds of vaccines. By that point, about 1,300 people had been given the H1N1 shots and mists, Pearson said.

She said she expected another shipment this week but was unsure when it would arrive or how big it would be. The news release said that within the next few weeks the department would get enough vaccines to "meet the needs" of the county.

An early start

The H1N1 strain of the flu has already struck many people in the county, causing a wave of flu cases months before the season usually begins. In the first three weeks of October, 375 people with flu-like symptoms came to the emergency department of Johnston Medical Center in Smithfield.

Flu levels are usually much lower this time of year, and do not typically start increasing until November, said Kim Bjurstrom, director of the emergency department.

"In past years, seasonal flu activity typically did not reach its peak in the U.S. until January or February," Bjurstrom said.

The county sends samples from some flu patients to the state Department of Health and Human Services for testing; the vast majority have turned out to be H1N1, Pearson said.

"We suspect that most everybody that has flu-like symptoms has H1N1," Pearson said.

H1N1, sometimes called "swine flu," first made headlines when it broke out in Mexico early this summer. Health officials say it is a concern for several reasons, including its fast and early spread.

The virus has hit young children and pregnant women hard and has affected young adults at a surprising rate.

No one in Johnston County has died of H1N1, but the virus can cause sometimes-fatal respiratory problems in otherwise healthy adults.

Bjurstrom said its impact on younger people, children and pregnant women is a cause for concern. "People have to take it seriously."

In general, H1N1 has not hit North Carolina as hard as other states, she said. In fact, few if any people in Johnston have fallen seriously ill from the virus.

Early numbers about the virus are still emerging. One expert has said the variant probably causes deaths at a lower rate than normal seasonal flu, according to an MSNBC report in September. The New York Times has reported that the H1N1 pandemic is "moderate" in severity.

But given the strain's fast and early spread, the county's hospital and health department are fighting to get a handle on the pandemic early.

At the hospital, new flu-protection rules discourage visitors under the age of 18 and visitors with flu-like symptoms from seeing patients. Those visitors are allowed entrance if they wear a surgical mask, though.

As the county waits on new vaccine supplies, health officials want people to practice good hygeine and be wary of the flu in themselves and others.

"It is a concern because it is causing a lot of illness right now," said Pearson. "There are a lot of people sick, a lot of people out of school."