Hawaii is the only state that as yet has suffered just one wave of swine flu, state Epidemiologist Sarah Park told colleagues at a recent National Preparedness Summit in Atlanta.

“;They all talked about two waves. It's important for us not to let our guard down,”; said Park, chief of the state Health Department's Disease Outbreak Control Division.

A Central California county with a population slightly smaller than Hawaii's had 70 deaths, she said. “;We really dodged a bullet.”;

Thirteen deaths related to the H1N1 virus were reported in Hawaii between June and January. Most had underlying medical problems.

Park said she and her counterparts from across the nation shared “;a collective sigh of relief”; at the summit because they had feared a 1918-type pandemic. The so-called Spanish flu killed 675,000 Americans and 30 million to 40 million people worldwide.

The H1N1 pandemic “;turned out to be pretty mild,”; she said. “;But all the states agreed this was a wake-up call across all sectors and to the public, as well.

“;A pandemic, no matter the severity, can cause problems and burdens. A lot of things can be improved upon. In a way it was a good drill. It taught us what works and what doesn't.”;

There is “;plenty of room for improvement”; to prepare for infectious diseases that might come here, she said.

Flu vaccine is still being distributed to providers who request it, although the demand has dropped off in recent months, she said.

People shouldn't take for granted that they won't get a flu bug, she said. “;If you have access to vaccine in a physician's office or pharmacy, why not take it?”;

Park said she views vaccines like car or home insurance people get “;just in case ... so you don't have to think about potentially getting ill and having to take off from work.”;

Hawaii's first three H1N1 cases were confirmed last May. “;This thing hit us in late spring and early summer when all of us, on the mainland and here, should not have seen anything,”; Park said. “;We have year-around flu here, but at low levels.

“;Technically, this would be our traditional flu season time,”; she said. “;We can't forget flu is unpredictable. We don't know what is around the next corner.”;

The 2009 H1N1 virus is the predominant virus circulating, but Park said, “;We're not hearing it's too bad in terms of respiratory illnesses. ... It looks like we're pretty good right now.”;

Children under age 10 who had one shot of H1N1 vaccine must have a second dose, but only about one-fourth of kids who received the first dose are getting the second one, she said.