SEATTLE -- With the federal government saying this year's

flu outbreak has spread to all 50 states, Washington's Health

Department is asking health-care providers to save any remaining

vaccine for those who need it most.

Those at highest risk for complications from flu include the

elderly, children under 2, people with chronic medical conditions

and women in the second and third trimester of pregnancy.

"The way we look at it, and the CDC (Centers for Disease

Control and Prevention) agrees with us, is that the healthy people,

the young to middle-aged, are the least likely to suffer flu

complications, so the ones most likely to suffer complications

should have it," Department spokesman Donn Moyer said Friday,

noting that the disease is considered widespread in Washington.

The Health Department guidelines on vaccine use are only

recommendations. Final decisions are left to providers and

patients.