The flu is racing across nearly 30 U.S. states and it's leaving a deadly trail 
 
 Melissa Roberts, left, administers a flu vaccine to Kelly Ternes at the Okaloosa County Health Department in Fort Walton Beach, Fla., Dec. 20, 2012. (Photo: Nick Tomecek, AP) Story Highlights Eighteen children have died, over 2,200 people hospitalized so far 
 
 Flu is widespread throughout the U.S. 
 
 Nearly 30 states have flulike activity 
 
 Chances are that you or someone you know has been chained to the bed recently with fever, fatigue, sore throat and muscle aches. 
 
 That's because the current flu season is turning out to be a bad one, affecting more people than usual, starting earlier and covering a broader geographical area. Government health experts say 18 children, under age 18, have died because of the seasonal flu and 2,257 people had been hospitalized with flu symptoms through the end of 2012. 
 
 "The sense that everybody has is that there's been an extremely rapid increase in influenza," says Trish Perl,co-leader of a flu study encompassing about 100 clinics in several cities. She is also an epidemiologist for the Johns Hopkins Health System in Baltimore. "It has been relatively widespread across the United States." 
 
 The public should be concerned, says Gregory Poland, professor of medicine and infectious disease at the Mayo Clinic in Rochester, Minn. 
 
 "A decade ago, when we had widespread circulation (of the seasonal flu), we had 70,000 deaths in the U.S.," says Poland, who directs Mayo's Vaccine Research Group. 
 
 "We have this cultural thing in the U.S. about, 'Oh, it's just the flu.' I was telling a group yesterday, imagine in October I said, 'We expect a virus to be circulating in the U.S. and it will kill 30- or 40,000 Americans.' Can you imagine the panic that would ensue?" 
 
 For the fourth week in a row, the proportion of people seeing health care providers for flulike illness is above the national baseline, and jumped from 2.8% to 5.6% in that time, according to the Centers for Disease Control and Prevention in Atlanta. Last season's proportion peaked at 2.2%, the CDC reports. 
 
 Twenty-nine states plus New York City are now reporting high flulike activity, up from 16 states the week before, the CDC says. Forty-one states reported in the last week of December that flulike activity was widespread geographically, with that number up from 31 states the week before, according to the CDC. 
 
 During the last week of 2012, 7% of all deaths reported in 122 U.S. cities were due to pneumonia and the flu, according to the CDC. That figure is just below the epidemic threshold of 7.1% for the last week of the year. 
 
 The medical industry is concerned because this is the earliest flu season the U.S. has seen in the past 10 to 12 years, says Michael Jhung, an epidemiologist and influenza expert at the CDC. 
 
 Flu season usually peaks in January and February, according to the Flu.gov website maintained by the Department of Health and Human Services. 
 
 The predominant type of flu that is circulating is H3N2 Influenza A virus, which is making up 76% of the viruses reported, according to the CDC. 
 
 The outbreak has strongly affected the East and the South and is spreading westward, Poland says. 
 
 Perl reports from her studies that initially health professionals were seeing a lot of Influenza B, but now they are seeing mostly A as well as other respiratory illnesses, including respiratory syncytial virus or RSV. 
 
 H3N2 flu seasons tend to be more severe, Poland of the Mayo Clinic says. 
 
 On the ground, the outbreak has sent more people to doctors and hospitals with flu symptoms. 
 
 For instance, in Minnesota, 600 people were hospitalized because of the flu and four people died, Poland says. Among those who died was an otherwise healthy 17-year-old boy who was visiting the Twin Cities area from Texas, according to Poland. 
 
 The professor said he's hearing similar stories from colleagues around the country of people who are generally healthy being hit hard. 
 
 In Indiana, seven deaths have been associated with influenza, two in people younger than 18. 
 
 "It's not too late to get vaccinated, and the CDC encourages everyone who hasn't been to do so soon," Jhung says. 
 
 Enough vaccine has been produced and distributed so that everyone who wants a shot should be able to get one. He urges, though, that if people run into delays because of a run on vaccine, not to be discouraged. 
 
 "People … may have to go to more than one pharmacy," Jhung says. 
 
 Perl says the outbreak also is a good opportunity for the public to remember that hand-washing and use of sanitizing gels can reduce infection rates by 30%. 
 
 "It's an opportunity for us to reinforce those basic things your mom always told you," she says. 
 
 While health experts advise people to get the flu vaccine and use hand sanitizer, some research shows children who attend daycare or tend to be exposed to more allergens may build up stronger defenses. VPC 
 
 Contributing: Tim Evans, The Indianapolis Star 
 
 Read or Share this story: http://usat.ly/UwBwcC ||||| Continue reading the main story Percentage of visits to doctors and hospitals for “influenza-like illness” % 7 6 5 4 3 2 1 0 2014 Nov. Dec. Jan. Feb. March April 2010–2011 
 
 2009–2010 
 
 "Swine Flu" 
 
 2012–2013 Percentage of visits to doctors and hospitals for “influenza-like illness” % 7 6 5 4 3 2 1 0 2014 Nov. Dec. Jan. Feb. March April 2009–2010 “Swine Flu” This Year’s Flu Is Outpacing Those From Recent Years Flu season has just started, but the rate is higher than the rates from any recent December. Continue reading the main story Continue reading the main story 
 
 At Nazareth Academy, a Catholic high school just outside Chicago, a full quarter of the 780 students were out with the flu in early December, along with more than a dozen teachers. Officials at the school closed it for two days and disinfected the property. 
 
 The principal, Deborah Tracy, said it was the first time in her 15 years there that such a measure had been necessary. “It just really was unprecedented for here,” she said. 
 
 Nationwide, we’re on track for a nasty flu season, with both a large number of cases and many severe ones that require hospitalizations, according to the Centers for Disease Control and Prevention. It declared an influenza epidemic this week, a status achieved at some point nearly every year, though not usually this early in the season. Twenty-two states and Puerto Rico are reporting high flu intensity. In some parts of the country, flu infections have outpaced those from each of the last few years, according to data from the C.D.C. 
 
 Google Flu Trends, which measures flu intensity using search terms, shows a similar pattern of high flu activity. 
 
 The worrisome outlook is the result of a confluence of factors: an early start to the flu season, with more people sick in December than usual; a strain that tends to make people sicker; a relatively low vaccination rate; and a mismatch between this year’s flu vaccine and the virus that’s making people sick. 
 
 “We’re already above the peak that we saw last year, and we’re increasing,” said Dr. Michael Jhung, a medical officer at the Influenza Division of the C.D.C. who predicts it will be several more weeks before flu infections peak. 
 
 The C.D.C. tracks flu deaths, hospitalizations and the percentage of doctors’ visits for flulike illness. The detailed, public data make it easy to watch the flu take off this year. Google Flu Trends tells a similar story, although its algorithm has been criticized for overestimating the prevalence of the flu. But it has also been endorsed by epidemiologists and published in medical journals, and a new Google flu tool allows you to look at the misery down to the level of the city. 
 
 Continue reading the main story Flu Intensity Is Already High in 22 States and Puerto Rico The Centers for Disease Control and Prevention measures flu intensity on a scale of 1 to 10, based on the number of people visiting doctors and hospitals with flulike symptoms. The flu season usually peaks in February. Alabama 10 Oct. Dec. Arkansas 10 Oct. Dec. Florida 10 Oct. Dec. Georgia 10 Oct. Dec. Idaho 8 Oct. Dec. Illinois 10 Oct. Dec. Indiana 10 Oct. Dec. Kansas 10 Oct. Dec. Kentucky 9 Oct. Dec. Louisiana 10 Oct. Dec. Maryland 10 Oct. Dec. Minnesota 10 Oct. Dec. Mississippi 10 Oct. Dec. Missouri 10 Oct. Dec. New Jersey 10 Oct. Dec. N.C. 10 Oct. Dec. Ohio 8 Oct. Dec. P.R. 10 Oct. Dec. S.C. 10 Oct. Dec. Texas 10 Oct. Dec. Utah 9 Oct. Dec. Virginia 10 Oct. Dec. Wisconsin 10 Oct. Dec. Alabama 10 Oct. Dec. Arkansas 10 Oct. Dec. Florida 10 Oct. Dec. Georgia 10 Oct. Dec. Idaho 8 Oct. Dec. Illinois 10 Oct. Dec. Indiana 10 Oct. Dec. Kansas 10 Oct. Dec. Kentucky 9 Oct. Dec. Louisiana 10 Oct. Dec. Maryland 10 Oct. Dec. Minnesota 10 Oct. Dec. Mississippi 10 Oct. Dec. Missouri 10 Oct. Dec. New Jersey 10 Oct. Dec. N.C. 10 Oct. Dec. Ohio 8 Oct. Dec. P.R. 10 Oct. Dec. S.C. 10 Oct. Dec. Texas 10 Oct. Dec. Utah 9 Oct. Dec. Virginia 10 Oct. Dec. Wisconsin 10 Oct. Dec. 
 
 Columbia, S.C., for example, is suffering one doozy of a season, according to the Google data. Dr. Helmut Albrecht, the chief of infectious disease at the University of South Carolina, confirms as much. “We call it a bad flu season when 5 to 6 percent of our emergency room visits are for flulike illness,” he said. “We are between 17 and 20 percent.” 
 
 Dr. Anna-Kathryn Rye, the director of pediatric infectious diseases at Palmetto Health Children’s Hospital, says flu infection rates among children are two to three times what she sees in a typical year. She said her pediatrician friends had posted on Facebook “that they are tired, and can’t wait for the flu to go away.” 
 
 “They are busy, and they are overbooked,” she said. “They have seen a lot of kids — and they all have the flu.” 
 
 Photo 
 
 For most people who catch it, influenza is unpleasant but not serious. But the disease can cause as many as 40,000 deaths a year, primarily among older people and those with compromised immune systems. The flu that’s circulating this year is a type called H3N2, which tends to spread widely and can cause serious illness. 
 
 Right now, the flu is spreading fastest in the Southeast and the Midwest. Dayton, Ohio, and Knoxville, Tenn., are some of the places experiencing intense flu seasons, according to the Google data. But because the flu tends to move around the country, places that have been spared so far may just end up with more sick people next year. 
 
 Doctors know more than ever about where the flu is and how fast it is spreading, but Dr. Jhung said the medical system still had not made much headway in reducing the toll of influenza. Though the C.D.C. now recommends vaccination for everyone older than 6 months, vaccinations remain at less than 50 percent of the population. With so few people protected, it’s still relatively easy for the virus to spread each year; there are lots of susceptible people, and the airborne virus moves around quickly. 
 
 This year, that problem may be worse than usual. Though the vaccine includes an H3N2 flu, the strain it targets isn’t a perfect match for the one that’s going around. That means that the vaccine is less effective than normal. Ideally, with a weaker vaccine, you’d want more people to be inoculated. But some people, hearing the message about the vaccine’s limited effectiveness, may have skipped it this year. There are other flu strains circulating, too, and people who don’t get a shot may be at risk of catching another variety as well. 
 
 Flu seasons wax and wane, Dr. Jhung said, but the intensity of a flu season typically depends more on the particular bug in a given year than anything else. Two years ago, another H3N2 virus was prevalent, and the flu season was also quite severe. Last year was milder, in part because a different flu strain predominated. ||||| Breaking News Emails Get breaking news alerts and special reports. The news and stories that matter, delivered weekday mornings. 
 
 / Updated By Maggie Fox 
 
 Flu activity increased “sharply” across the U.S. last week, and the virus is still widespread in all states except Hawaii, federal health officials said Friday. 
 
 At least four different strains of influenza are making people sick, the Centers for Disease Control and Prevention said. Flu vaccines are designed to protect against three or four of the strains but work poorly against the most common strain circulating, called H3N2. 
 
 Another 10 children were reported to have died from flu, the CDC said, although not all the deaths occurred last week. It can take weeks for states to gather the information and send it to CDC. So far this flu season, 30 children have died from influenza. 
 
 Last season, 110 children died from flu in the U.S. 
 
 Every year, influenza kills between 12,000 and 49,000 people and can send as many as 700,000 people to the hospital, the CDC says. It affects so many people that adult cases and deaths can only be estimated. 
 
 Related: Flu season's coming early, looking tough 
 
 The CDC says this is the worst flu season since the 2014-2015 season. Flu can vary a lot from year to year, and this year it’s spreading actively in all the states at the same time. In other years, it has usually moved in irregular waves, peaking in different parts of the country at different times. 
 
 “We’re seeing flu throughout the entire country,” said Dr. Nicole Alexander-Scott, director of the Rhode Island Department of Health and president-elect of the Association of State and Territorial Health Officials (ASTHO). 
 
 “By every measure – whether it’s by outpatient visits, hospitalizations, laboratory testing - this has been a very early season and a more severe one than recent influenza seasons,” agreed Dr. Karen Smith, director of the California Department of Public Health. 
 
 Related: How about a better flu vaccine? 
 
 Some hospitals are overwhelmed, said Dr. Larry Wolk, Colorado’s chief medical officer. 
 
 “We’ve had well over 2,000 influenza-associated hospitalizations. That’s double our average number of cases we usually see this time of year,” Wolk told reporters in a briefing organized by ASTHO. 
 
 Worried flu patients are flooding emergency rooms and Alexander-Scott said her state health department was trying to steer those who are not suffering emergencies away from emergency departments. Only the urgently sick or injured should be in the ER, she said – others should be calling their own primary care doctors or visiting urgent care clinics. 
 
 Related: Flu might be airborne 
 
 It’s still not too late to get a flu shot, all the officials said. Pharmacies and drug stores reported they still had plenty of supplies, and the CDC predicts flu season will last several more weeks at the least. 
 
 “It may be several months before this flu season ends,” Wolk said. ||||| From the Rocky Mountains to New England, hospitals are swamped with people with flu symptoms. Some medical centers are turning away visitors or making them wear face masks, and one Pennsylvania hospital set up a tent outside its ER to deal with the feverish patients. 
 
 Dr. Meeta Khan wears a face mask as she examines a respiratory patient at the Rush University Hospital emergency department, Thursday, Jan. 10, 2013, in Chicago. Flu season in the U.S. has hit early and,... (Associated Press) 
 
 Registered nurse Michelle Newbury, left, and physician assistant Scott Fillman meet with patients, not pictured, in a tent set up for a people with flu symptoms, just outside the emergency entrance at... (Associated Press) 
 
 A tent is set up for a patients with flu symptoms, just outside the emergency entrance at the Lehigh Valley Hospital Thursday, Jan. 10, 2013, in Allentown, Pa. The Pennsylvania Department of Health designated... (Associated Press) 
 
 Damien Dancy puts masks on his children Damaya, 3, left, and Damien, 7, on Wednesday, Jan. 9, 2013 at Sentara Princess Anne Hospital in Virginia Beach, Va. Hospitals in Hampton Roads are urging patients... (Associated Press) 
 
 Vials of flu vaccine are displayed at Philly Flu Shots on Thursday, Jan. 10, 2013 in Philadelphia. The flu season arrived early in the U.S. this year, but health officials and experts say it's too early... (Associated Press) 
 
 A public health nurse demonstrates drawing flu vaccine from a bottle at the Oklahoma City-County Health Department in Oklahoma City, Thursday, Jan. 10, 2013. Flu season in the U.S. has struck early and,... (Associated Press) 
 
 Physician assistants Scott Fillman, left and Andrew Hunadi meet with patients, not pictured, in a tent set up for a people with flu symptoms, just outside the emergency entrance at the Lehigh Valley Hospital... (Associated Press) 
 
 Flu season in the U.S. has struck early and, in many places, hard. 
 
 While flu normally doesn't blanket the country until late January or February, it is already widespread in more than 40 states, with about 30 of them reporting some major hot spots. On Thursday, health officials blamed the flu for the deaths of 20 children so far. 
 
 Whether this will be considered a bad season by the time it has run its course in the spring remains to be seen. 
 
 "Those of us with gray hair have seen worse," said Dr. William Schaffner, a flu expert at Vanderbilt University in Nashville. 
 
 The evidence so far points to a moderate season, Schaffner and others say. It looks bad in part because last year was unusually mild and because the main strain of influenza circulating this year tends to make people sicker and really lay them low. 
 
 David Smythe of New York City saw it happen to his 50-year-old girlfriend, who has been knocked out for about two weeks. "She's been in bed. She can't even get up," he said. 
 
 Also, the flu's early arrival coincided with spikes in a variety of other viruses, including a childhood malady that mimics flu and a new norovirus that causes vomiting and diarrhea, or what is commonly known as "stomach flu." So what people are calling the flu may, in fact, be something else. 
 
 "There may be more of an overlap than we normally see," said Dr. Joseph Bresee, who tracks the flu for the Centers for Disease Control and Prevention. 
 
 Most people don't undergo lab tests to confirm flu, and the symptoms are so similar that it can be hard to distinguish flu from other viruses, or even a cold. Over the holidays, 250 people were sickened at a Mormon missionary training center in Utah, but the culprit turned out to be a norovirus, not the flu. 
 
 Flu is a major contributor, though, to what's going on. 
 
 "I'd say 75 percent," said Dr. Dan Surdam, head of the emergency department at Cheyenne Regional Medical Center, Wyoming's largest hospital. The 17-bed emergency room saw its busiest day ever last week, with 166 visitors. 
 
 The early onslaught has resulted in a spike in hospitalizations. To deal with the influx and protect other patients from getting sick, hospitals are restricting visits from children, requiring family members to wear masks and banning anyone with flu symptoms from maternity wards. 
 
 One hospital in Allentown, Pa., set up a tent this week for a steady stream of patients with flu symptoms. But so far "what we're seeing is a typical flu season," said Terry Burger, director of infection control and prevention for the hospital, Lehigh Valley Hospital-Cedar Crest. 
 
 On Wednesday, Boston declared a public health emergency, with the city's hospitals counting about 1,500 emergency room visits since December by people with flu-like symptoms. 
 
 All the flu activity has led some to question whether this year's flu shot is working. While health officials are still analyzing the vaccine, early indications are that it's about 60 percent effective, which is in line with what's been seen in other years. 
 
 The vaccine is reformulated each year, based on experts' best guess of which strains of the virus will predominate. This year's vaccine is well-matched to what's going around. The government estimates that between a third and half of Americans have gotten the vaccine. 
 
 In New York City, 57-year-old Judith Quinones skipped getting a flu shot this season and suffered her worst case of flu-like illness in years. She was laid up for nearly a month with fever and body aches. "I just couldn't function," she said. 
 
 But her daughter got the vaccine. "And she got sick twice," Quinones said. 
 
 Europe is also suffering an early flu season, though a milder strain predominates there. Flu reports are up, too, in China, Japan, the West Bank, the Gaza Strip, Algeria and the Republic of Congo. Britain has seen a surge in cases of norovirus. 
 
 On average, about 24,000 Americans die each flu season, according to the CDC. That's an estimate _ the agency does not keep a running tally of adult flu deaths each year, only for children. Some state health departments do keep count, and they've reported dozens of flu deaths so far. 
 
 Flu usually peaks in midwinter. Symptoms can include fever, cough, runny nose, head and body aches and fatigue. Some people also suffer vomiting and diarrhea, and some develop pneumonia or other severe complications. 
 
 Most people with flu have a mild illness and can help themselves and protect others by staying home and resting. But people with severe symptoms should see a doctor. They may be given antiviral drugs or other medications to ease symptoms. 
 
 Flu vaccinations are recommended for everyone 6 months or older. Of the 20 children killed by the flu this season, only two were fully vaccinated. 
 
 ___ 
 
 AP Medical Writer Maria Cheng in London contributed to this report. 
 
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 Online: 
 
 CDC flu: http://www.cdc.gov/flu/index.htm ||||| CLOSE Researchers have developed a new way to predict the severity of the flu season "significantly earlier" than in the past. Buzz60 
 
 In this Sept. 16, 2014, file photo, a sign in a Walgreen store in Indianapolis tells customers about its flu shot services. (Photo: Darron Cummings, AP) 
 
 Flu season has arrived early to North America this year, and it may end up being a doozy. 
 
 Cases of flu tend to ramp up mid- to late-December and peak in January or February, according to Paul Sax, an infectious disease physician at Brigham and Women’s Hospital in Boston. But this year, things are different. 
 
 The Center for Disease Control and Prevention releases a weekly flu report where it tracks flu activity across the country. This year, the percentage of patients reporting flu-like symptoms reached the threshold of 2.2% by late November, an indication that flu season has started. 
 
 Not only has flu season arrived early, but the U.S. may be particularly hard-hit. It’s difficult to make predictions about how a flu season will play out, as flu viruses are wildly unpredictable. But the Southern Hemisphere experienced an especially bad season over the summer (their winter), with Australia reporting record-high numbers of influenza cases and a higher-than-average number of hospitalizations and deaths. 
 
 There are a several different strains of flu viruses, and the main culprit in Australia was a strain called H3N2. However, the flu vaccine was only 10% effective against that strain, meaning it reduced a person’s risk of infection by 10%, according to a paper published in the public health journal Eurosurveillance. 
 
 That same strain, H3N2, was the most common strain of virus in North America last season, and is likely to be this year as well. Experts worry because the H3N2 portion of the vaccine used here in the U.S. is identical to the one used in Australia. 
 
 While 10% seems low, “flu vaccines are usually only about 40% to 60% effective in the best of years,” said Martin Hirsch, an infectious disease physician at Massachusetts General Hospital in Boston and the editor-in-chief of the Journal of Infectious Diseases. 
 
 There are two major things that could contribute to this. 
 
 “It can be due to a change in what’s circulating in the human population, or a change in the vaccine that leads to a mismatch” between the virus and the vaccine, Hirsch said. 
 
 Circulating influenza strains may mutate after the World Health Organization decides what should go into that year’s vaccine. Or the vaccine itself may mutate while it is being grown — currently, vaccines are grown in eggs, but many experts don’t think that’s ideal as the vaccine virus tends to undergo mutations to adapt to growing in an egg. 
 
 But that doesn’t mean you shouldn’t go out and get your flu vaccine, Hirsch cautions. 
 
 “Even if the vaccine is only 10% effective against H3N2, the vaccine does protect against other strains that are circulating,” he said. “The most important thing is still to get your flu vaccine.” 
 
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– As predicted, this year's flu season is already a doozy: It features a more severe strain, it started earlier, it's hitting more people, and it has affected a wider swath of the country than usual, USA Today reports. Flu season started earlier this year than it has in the past 10 to 12 years, and by the end of 2012, 18 children had died and 2,257 had been hospitalized as a result. And things could get much worse: One Mayo Clinic expert recalls that "a decade ago, when we had widespread circulation [of seasonal flu], we had 70,000 deaths in the US." The proportion of people with flulike symptoms and the states reporting such illnesses are both on the rise, and a flurry of local stories today illustrate the problems in various states: There's quite an abundance, but here's a sampling: Flu cases spiked in New Jersey last month, the Star-Ledger reports; the state has seen about twice the number of flu-related ER visits as it did last year. In Chicago, some ERs are actually turning away patients because they're so overwhelmed with flu cases, CBS Chicago reports. In Cleveland, medical centers are limiting visitors in an effort to control the spread, Fox 8 reports. And in Florida, even people who got a flu shot still got sick, ABC News reports. NPR explains that this is a common problem, since the vaccine is only 60% effective—plus it takes about two weeks to kick in, and doesn't necessarily cover all strains of the virus.