As the number of H1N1 influenza cases in the region steadily grows, the emergency room at Children's Hospital has become inundated with children with fevers, coughs and sore throats.

"We're certainly overwhelmed," Dr. Rick Saladino, chief of Pediatric Emergency Medicine at Children's, said in reference to the illness known as swine flu. "We learned from what occurred [during winter months] in the Southern Hemisphere that it's an eight- to 12-week cycle, and we're only three to four weeks into it. So it might get worse."

On a typical day at Children's, 180 children show up at the Emergency Department for treatment of various problems. But recently, the department has seen as many as 310 children a day, with 30 percent having flu-like symptoms most assuredly caused by H1N1, Dr. Saladino said.

The hospital has established a separate clinic at Children's in the floor above the emergency room to help process the glut of cases. Masks are distributed to people who request them.

"In the vast majority of cases, this is an illness with mild to moderate symptoms," Dr. Saladino said. "Therefore, most cases can be managed at home."

He said parents with ill children should deal with flu-like symptoms as they have in the past. If a child already has asthma, heart problems or a compromised immune system, and especially if breathing problems occur, then they should seek medical treatment, he said.

Health officials said the virus, prevalent statewide, is affecting mostly children and young adults.

"Ninety-nine percent of what we're seeing in the state is H1N1. It is not the seasonal flu that's circulating in the state right now," said Holli Senior, deputy press secretary for the state Department of Health.

Guillermo Cole, spokesman for the Allegheny County Health Department, said the adult cases of H1N1 have also not been severe.

"Many people with H1N1 are not even seeking treatment it is so mild," Mr. Cole said. "We do have people going to emergency rooms and doctors' offices, but we do not have a lot of severe illness."

Since April, the county Health Department has been monitoring H1N1 cases that reach the emergency rooms of eight local hospitals.

Mr. Cole said more than 10 percent of all emergency room visits this week involved people with flu-like symptoms, including fever and either a cough or sore throat that's indicative of H1N1.

It represents the highest percentage of flu cases since the H1N1 outbreak last spring and exceeds the percentage of emergency-room visits during the peak of the seasonal flu last February, when 6 percent of emergency-room visits involved the flu, Mr. Cole said. But he noted that last winter's flu season was a mild one.

The state Health Department began distributing doses of H1N1 vaccine statewide last week, but has only received 400,000 of 900,000 anticipated doses, to date. Children 6 months to 24 years old, pregnant women and people 25 to 64 who face medical complications if they get the flu should receive the vaccine.

"We realize there has been a delay in production of the vaccine and all the states are facing the same problem," Ms. Senior said.

Children's Community Pediatrics -- a network of 28 pediatric practices in Western Pennsylvania affiliated with Children's Hospital -- is experiencing "a high call volume" due to the flu season, the hospital reported.

CCP is asking patient families to utilize its Web site -- www.cc-peds.net -- regarding H1N1 flu immunization availability and only to call the office after availability has been determined.

The Web site is being updated daily.

As of yesterday, the hospital reported that the following CCP offices have H1N1 vaccine available: CCP-Allegheny, CCP-Bass Wolfson (Cranberry and Squirrel Hill locations), CCP-HealthQuest Pediatrics, CCP-Kittanning, CCP-GIL (Murrysville location), CCP-Jeannette, CCP-Mt. Lebanon, CCP-Natrona Heights and CCP-Waterdam.

Dr. Saladino stressed that fear is not a reason to avoid getting the vaccine. Most people experience very mild symptoms, if any at all.

n Swine flu is causing unprecedented illness for so early in the fall and the government warns that vaccine supplies will be even more scarce than expected through this month.

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