Back in 1918, children skipped rope to the rhyme of the time:

"I had a little bird,

Its name was Enza,

I opened the window,

And in-flu-enza!"

Called the "Spanish flu" because it received so much press attention in Spain, the viral pandemic of 1918 to 1919 killed more people worldwide than World War I.

In the United States alone, it's estimated that 675,000 people died from the flu -- 10 times more than the number of Americans who lost their lives in the war.

Eunice Radford was 12 and living in Carroll County when the pandemic hit home.

Now 99, the Montgomery County woman was the youngest of her family's four children. She still remembers, though, when her older brother, Talmage Goad, came down with the flu and was very ill for two weeks.

"He was in Winston-Salem when he got sick," Radford recalled. "He was in a hospital where he could see a cemetery outside his window. He said they was burying people five and six a day."

Radford said her brother had ventured to North Carolina for work when he contracted the flu. Another man who went with him also fell ill and later died from flu complications.

Radford said the pandemic killed many local folks, too.

"Back then doctors came in a horse and buggy," she noted. "We didn't have the medicine that we have now. We were so worried about the flu because it was killing so many."

Radford did not get sick back in 1918. Today, however, she makes sure she gets a flu vaccine every year.

"I got my flu shot and my pneumonia shot, too," she said. "Getting the flu can take a lot out of you."

New River Health District Director Jody Hershey said a pandemic like the one that spread in 1918 is different from seasonal outbreaks of influenza known as inner pandemics.

"In the last 300 years, we've had only 10 influenza pandemics. Three of those have been in the last century," he said, noting that the event of 1918 caused about 50 million deaths worldwide.

"The majority of people died from secondary infections, such as pneumonia."

Normal seasonal flu outbreaks differ from pandemics in that pandemics represent a new viral strain of influenza with no previous exposure.

With a pandemic, Hershey explained, "you get a change in the influenza A virus that causes serious illness and spreads easily."

Hershey said people getting flu shots are protecting themselves from three current common strains of seasonal viral infections. Scientists monitor influenza across the world every year to determine the universal strains, most of which start in Asia.

Unlike last year, this year's supply of flu vaccine appears to be adequate, even though not all private physicians have it in stock.

"We don't see an overall shortage of doses but rather inconsistency in supply and distribution," Hershey said.

He pointed out that the Virginia Department of Health received 200,000 doses this year with 3,500 going to the New River office.

"This may be the highest number of doses ever available in this country," he said, explaining that more and more people are opting for the flu protection.

Hershey said people older than 65 are in the highest risk group for complications, hospitalization and deaths due to flu. Vaccinating the elderly is effective in preventing secondary complications such as pneumonia, he added.

The Montgomery County Health Department is still taking appointments for those who need a flu shot.

Hershey said senior citizens who have not received the vaccine at their doctor's office may call 381-7100 for an appointment. Those who are late getting a shot, shouldn't worry, though.

"There's still ample time to receive the vaccine," Hershey said, explaining that many doctors are receiving supplies in phased shipments. "We here in Virginia have the highest influenza rates in January and February. Flu shots can still be very effective in December and January."

Hershey recommended that senior citizens keep three words in mind when scheduling their yearly flu shots:

"Patience, persistence and cooperation -- that's what's needed."

Area senior centers and volunteer programs offer a variety of services, including crafts, dinners, seminars, picnics and trips.

Most have newsletters and calendars listing monthly services and happenings. Contact each center for information.

Blacksburg Senior Programs: Blacksburg Community Center, 725 Patrick Henry Drive. Joy Herbert, 961-1134.

Christiansburg Senior Center: 1600 N. Franklin St. Tammy Caldwell, 382-2349.

Floyd RSVP: 323 Floyd Highway, PO Box 849. Judy Weitzenfeld, 745-2105.

Giles County Senior Center: 1320 Wenonah Ave., Pearisburg. Faith Plummer, 921-3924.

Giles County RSVP: 1410 Wenonah Ave., Pearisburg. Chris Blankenship, 921-2037.

Montgomery County and Radford RSVP: Health and Human Services Building, 210 Pepper St., Christiansburg. Angela Little, 382-5775.

Pulaski County RSVP: 106 N. Washington Ave. Ava Stilwell, 980-3969.

Pulaski Senior Center: 106 N. Washington Ave. Barbara Tate, 994-8627.

Radford Senior Center: 200 George St. Audrey Caldwell, 731-5517.

Senior shorts

Flu shots: Available by appointment at the Montgomery County Health Department. $28. Medicare, Medicaid and Anthem insurance accepted. 381-7100.

Free smoke detectors: Offered by Montgomery County fire departments to anyone who needs them. Call your local fire department or Neal Turner, Montgomery County emergency service coordinator, 394-2146.

Game day: Tuesday, 2 to 3:30 p.m., New River Community Action, Floyd. 745-2105.

Country line dancing: Thursdays through Dec. 8, 2 to 3 p.m., Blacksburg Community Center activities room. No class Thursday. Open to singles and couples and offered by Sapphire Ballroom Dance Center. 961-1134.

Christmas project: RSVP of Montgomery County and Radford needs volunteers to provide supplies and fill tote bags for the 120 residents of Kroontje Health Care Center. Bags must be returned by Dec. 14. 382-5775.

Holiday potluck: Nov. 30, 11 a.m. to 1 p.m., Jacksonville Center community room, Floyd. Rides available. 745-2105.

Green Valley Book Fair and Shenandoah Family Market: Nov. 30. Departure from the Blacksburg Senior Center at 9 a.m. Return by 6 p.m. $8, town residents; $16, nonresidents. Meals extra. 961-1134.

RSVP holiday appreciation party: Dec. 6, 2 to 4 p.m., St. Paul's United Methodist Church, Main Street, Christiansburg. Voting for new advisory council members will be held. 382-5775.

Trip to the Barter Theatre: Dec. 7. Departure from the Blacksburg Senior Center at 9:15 a.m. for a 2 p.m. performance of "Miracle on 34th Street" at the Abingdon theater. Lunch at Nancy's Fancy's at 11:30 a.m. Return to center at 7 p.m. $48, includes transportation, lunch and theater ticket. $10 addition for those who aren't Blacksburg town residents. 961-1134.

NRV Christmas luncheon: Dec. 7, 11:30 a.m. to 3 p.m., Muse Hall banquet room, Radford University. Catered luncheon, prizes, dancing and music by Pete Blackburn and Sam Moore. $15. Registration accepted at local recreation departments.

Historic Fredericksburg: Dec. 10-12. Trip sponsored by the Blacksburg Senior Center. Christmas candlelight tours of historic homes. Show at the Riverside Dinner Theater, visit to Stratford Hall, lunch at Stratford's Plantation Dining Room, tours and shopping in downtown Fredericksburg, dinner at Claibourne's. Fees based on single or double room occupancy. 961-1134.

Personal training and fitness classes: Available at the Blacksburg Senior Fitness Center. Registration is ongoing for Personal Training, Fit over Fifty, Healthy Backs, Pilates for Seniors and Stretch, Balance and Tone classes. Fees vary. Free orientations to the fitness center available by appointment. 961-1134 or 961-1149.

Card games: Bridge is offered Mondays, 10 a.m., and canasta is offered Mondays, 1:30 p.m., at the Radford Senior Center. 731-5517.

Quilting: Tuesdays, 10 a.m., Radford Senior Center. 731-5517.

Badminton: Wednesdays, 10:10 a.m. to noon, Blacksburg Community Center. Open play for all adults. Free. 961-1880.

Bingo: Wednesdays, 10 a.m., New River Valley Mall community room, Christiansburg. 382-6346.

Blood pressure clinics: First Fridays, 9 to 10 a.m., and third Thursdays, 10 a.m. to noon, in the Betty Craig Activity Room of the Radford Senior Center. Blood sugar screenings also offered at the Friday clinic. 731-5517.

Easy motions: Less strenuous exercise class. Mondays, Wednesdays and Fridays, 9 a.m., Christiansburg Recreation Center multipurpose room 2A. Doctor's note and registration required, 382-2349.

Walking club and exercise class: Walking club will not meet Thursday and Friday and exercise class will not meet this week because of the Thanksgiving holiday. 994-8627.

Fun & Fit Fridays: 8 a.m. to noon, at the Blacksburg Senior Center. Billiards, table tennis, shuffleboard, basketball free throws, Frisbee, croquet, horseshoes, bocce and planned outings for other activities. Registration not required. No programs during holiday weeks. 961-1134.

Novice Knitters: Mondays, 2 to 4 p.m., Blacksburg Senior Center social room. Informal group works on a variety of needle projects. Free. 961-1134.

The Funeral Consumers Alliance of the Virginia Blue Ridge: Volunteer consumer-rights advocacy group provides information about options available for funeral and other end-of-life arrangements, www.funerals.org/fcavbr. 953-5589.

Gospel Singing: Public invited monthly for gospel singing of old hymns on the following schedule: first Tuesdays, 10 a.m., at the Christiansburg Recreation Center senior activities area; and first Wednesdays, 2 p.m., at Wheatland Retirement Center, Christiansburg. Musicians and singers welcome. Mary Dotson, 382-8543.

Intrepid USA Healthcare Services: Provides free in-home evaluations to determine whether an individual qualifies for professional home-care services such as home health aid, medical social workers and physical therapy under Medicare, Medicaid or other insurance. 961-5464 or (888) 416-1428.

H2U: Seniors 50 and older may receive national and local benefits from membership in the Montgomery Regional Hospital Chapter. Betty Jahn, 953-5291.

New River Valley Agency on Aging: Services include the Virginia Insurance Counseling and Assistance Program, which provides counselors to answer questions about Medicare, Medigap, insurance, prescription drugs and medical bills. (866) 260-4417 or 980-7720.

Insurance assistance: Offered second Tuesdays at the Blacksburg Senior Center and second Wednesdays at the Christiansburg Recreation Center. Bob Gribben, a certified counselor, assists with the new Medicare Part D program and other programs. To schedule appointments at other times, call 382-5775.

Viva Club: Offers health screenings, insurance assistance and physician referral. 731-2572.