Health officials say they are hoping for the best and preparing for the worst as the threat of the H1N1 flu gets underway this fall.
Minnesota, like the rest of the country, could get hit with a double whammy, with the seasonal flu hitting about the same time H1N1 flu, also called swine flu, is expected to reappear.
Nationwide, federal officials say the H1N1 flu may infect half the U.S. population, and 90,000 people may die.
Michael Osterholm, director of the University of Minnesota Center for Infectious Disease Research and Policy, estimates H1N1 deaths may be end up being closer to half or three-fourths the federal estimates. But, he cautions the strain will hit a wider cross-section of the population than in normal years, particularly younger and healthier adults under the age of 50.
"It's going to be different deaths ... and that changes the picture," Osterholm said in an interview on Minnesota Public Radio News.
Osterholm, a former Minnesota state epidemiologist, stressed the importance of common-sense steps to stop the spread of the flu, including vaccinations, frequent hand-washing, covering a cough, staying home when sick and not sending sick children to school.
"You're going to hear a lot of scare stories. You're going to hear a lot of misinformation" about the vaccine, Osterholm said. "I'm definitely recommending this vaccine from a safety standpoint."
Osterholm said while the vaccine is not an absolute guarantee against the H1N1 flu, experts do expect it will protect about 95 to 98 percent of people.
So far, 263 people have been hospitalized with H1N1 flu in Minnesota, including 18 pregnant women. Seventy percent of those hospitalized were younger than 25 years old. Three people have died, including two children and one elderly person.
State officials have said that this season's vaccination program is going to be confusing for some. The vaccine for the seasonal flu has already started arriving in Minnesota, and it's recommended everyone get the shot, particularly the elderly.
The swine flu vaccine is expected to start arriving in small quantities in the state at the end of September, officials said earlier this week.
The initial doses are going to be for health care workers, pregnant women, young children and people who care for infants.
The state is still developing a plan to distribute the swine flu vaccine, but it will probably be available through the same places that offer the regular flu shot, officials said. It also may be available at some new locations, including obstetrician's offices and schools.
Osterholm said distributing the vaccine will be a challenge for public health officials this season.
"Some people may get as many as three flu shots this season, and that's not going to be easy," he said.
(The Associated Press contributed to this report.)