Larimer County health officials are worried about the possibility of a flu outbreak at a middle school in Fort Collins.

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About 180 students at Webber Junior High School, or about 20 percent of the student body, were out sick Monday. The school reported that about 60 students were out of school on Wednesday with flulike symptoms and several staff members were also out sick.

The lab tests of two students were positive for influenza type A, and most students are experiencing fever, sore throat, cough, fatigue and some muscle aches, which may be signs of influenza, health officials said.

Other students have been tested but results are not yet available.

In the meantime, principal Sandy Bickel has ordered that all doorknobs, desks and lockers be disinfected daily and that teachers encourage their students to wash their hands.

"Persons who have not been vaccinated for the flu are advised to get their shots now since it takes about two weeks after a vaccination is given for a flu shot to provide protection," said Dr. Adrienne LeBailly, director of Larimer County's Health Department. "Flu season is starting earlier than usual this year."

Health experts say the outbreak underscores the need for vaccinations for people at risk for complications from influenza such as people older than 65, children between 6 and 23 months old, and people with chronic health conditions such as diabetes, asthma, HIV/AIDS and kidney and cardiovascular diseases.

Health care workers and other people who have close contact with those at risk, including parents and caregivers, should also be vaccinated to reduce the risk to people at high risk, health officials advised.

Last year, 767 Coloradoans died from the flu or flu-related complications, such as pneumonia. The state health department said that as of Nov. 1 , there were 17 confirmed cases of the flu and those cases are scattered across the state.

This year's flu vaccine is the same as last year's, which includes three strains of virus, A/Moscow, A/New Caledonia, and B Hong Kong. A new nasal-spray flu vaccine, FluMist, is available in the United States this year. It is a live virus vaccine and is recommended only for healthy people between 5 to 49 years old. It should not be given to high-risk people, infants and young children, pregnant women and people over 50.

Typical flu symptoms include headache, fever, chills, cough, runny or stuffy nose, body aches and fatigue. While intestinal symptoms such as nausea and vomiting occasionally occur during a flu infection, they are uncommon signs of influenza. "Stomach flu" is a misnomer used to describe gastrointestinal illnesses that are caused by organisms other than flu viruses, health officials said.

Most people infected with the flu recover within one to two weeks.

The Larimer County Department of Health and Environment offers $22 flu shots at all of its offices during the regular, walk-in clinic hours.

In Fort Collins, there will be immunization clinics from 9 a.m. to noon on Fridays, from 9 a.m. to noon and 1 p.m. to 3:30 p.m. on Mondays, as well as a special monthly Saturday clinic from 9 a.m. to noon on Nov. 15. In Loveland, immunization clinics are open on Fridays from 9 a.m. to noon and Mondays from 12:30 p.m. to 3:30 p.m., and Wednesday, Nov. 12 from 4 p.m. to 6 p.m. Estes Park immunization clinics are open on Mondays from 1 p.m. to 4 p.m. and Wednesdays from 9 a.m. to noon.

Updated information on flu clinics offered by various providers in Larimer County are recorded on the hot line, 498-670, and on the county Web site.

To find a flu clinic near you, call (888) 692-0269.