Flu misery has continued to spread throughout the Washington area in the past week, hitting the elderly particularly hard, say health officials who are calling the outbreak "widespread" in Maryland, Virginia and the District.

Whether the worst is over or lies ahead is a matter of debate. There are not enough statistics available to decide, according to doctors.

"This is not unlike a flood," said Robert Cates, vice chairman of the Emergency Department at Inova Fairfax Hospital. "Has the river reached its highest point? If it's still raining, you don't know."

While hundreds of people are still coming down with symptoms--dizziness, sore throats, congestion and fever--fewer appear to be heading to emergency rooms for treatment, local hospitals say. In Baltimore last week, state officials ordered 22 hospitals with crowded emergency rooms to add staff and turn away noncritical patients. They were put on "yellow alert." Yesterday, the same institutions were allowed to resume normal operations.

"I just called the [emergency room] and they said today has been the first time in weeks that we haven't been overcrowded," said Karen Infeld, a spokeswoman for Johns Hopkins Hospital in Baltimore.

Robert Bass, Maryland's statewide emergency medical services coordinator, speculated that as publicity about flu has spread, more patients are aware of what they have and are treating themselves or heading to their family doctors.

Jeff Roche, Maryland's acting epidemiologist, said the state is also beginning to see more flu outbreaks in long-term care facilities.

Although health officials in the Washington area report that there are not yet statistics on the number of cases and death rates among the elderly from flu-related illness such as pneumonia, doctors are seeing older people hard hit.

"I remember a shift where I must have laid my stethoscope on five or 10 patients, most of them elderly, and most of them had bacterial infections or pneumonia," said John Howell, chairman of the emergency department at Georgetown University Hospital.

The flu outbreak that has the East Coast in its grip began last month in California and has moved east. Authorities say it involves the influenza A version of the virus--which is included in the vaccine that was widely available last fall.

However, the vaccine prevents infection only 70 percent to 90 percent of the time. In elderly patients, its effectiveness is even lower, but it lessens the severity of the illness, doctors say.

Normally, the winter flu season diminishes by February or March.

People can still get flu vaccine, which takes from one to two weeks to become fully effective. For most people, however, treating the symptoms with rest, plenty of fluids and over-the-counter medicines may be the best course of action, doctors say.