GRAND FORKS - Not halfway into October and cases of the flu are already occurring around the state, but that isn't a sign we're in for a tough flu season, said an official with the North Dakota Department of Health this week.

"We're seeing clusters of cases popping up here and there," said Jill Baber, epidemiologist with the department's Division of Disease Control.

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"That is normal for this time of year. It doesn't necessarily mean we're going to have a bad season. We could see this little bump and it could go away. Unfortunately, it's very unpredictable."

What is a bit unusual, Baber said, is that "a lot of cases have been working-age adults."

This early in the season health officials usually see more cases in the elderly and child populations.

"It's a good reminder that everybody needs to protect themselves," Baber said.

Possible serious threat

Influenza, a contagious respiratory illness, can cause mild to severe symptoms and, in some cases, can lead to death, health officials say.

Last year, 31 people died in North Dakota as a result of the flu, according to the state health department.

"Nationally, it was the biggest year for deaths," Baber said. "It was a very bad year - the worst year since the '09 pandemic."

But for North Dakota, the 2014-15 season was the worst, Baber said. "It was comparable to last year (nationally) in terms of severity. There were 50 deaths in North Dakota."

Every year, an average of 28,000 North Dakotans are reported as having flu that has been identified by a medical laboratory, according to the state health department.

The actual number of flu cases is likely much higher, since many of those who are stricken do not seek medical care, officials say.

It's also difficult to predict the effectiveness of this season's flu vaccine, which has been slightly modified from the version used for the 2017-18 flu season, said Haley Bruhn, interim immunization program manager for Grand Forks Public Health.

The composition of the vaccine is determined based on knowledge gained from the previous flu season, she said.

Early protection

Because the timing of flu season is difficult to predict, health officials suggest getting a flu shot before the end of October. But it is never too late to get vaccinated - as long as the flu is circulating, vaccination is recommended, they say.

Flu season usually runs from October to May, with peak case numbers hitting between January and March.

Of the 14 cases of lab-identified flu cases reported in North Dakota since Aug. 1, when data collection began, at least one is in Grand Forks County, Baber said.

In northeastern North Dakota, other cases have been reported in Pembina, Cavalier, Rolette, Benson and Griggs counties.

Although flu season typically starts in October, "most often we start to see more serious numbers (of cases) in December and January, usually," Baber said.

"We see cases into May, pretty regularly," she said.

Clinics are busy

Flu shot activity at local clinics has been brisk.

At Grand Forks Public Health, "we've probably given well over 400 vaccinations since we began offering walk-in flu shots Oct. 1," Bruhn said.

Personnel there can bill several insurance entities, she said. They charge $53 per vaccination for uninsured and underinsured adults up to 64 years of age and $85 for a high-dose flu vaccine for those who are 65 and older.

At Valley Health in downtown Grand Forks, about 80 people have dropped in to request the shots, "most of them in September," said Brittany Klockmann, associate director of the clinic.

"We had to order more vaccine," Klockmann said.

Valley Health will bill the individual's insurance company or, if necessary, charge $40 in cash, she said.

Avoiding flu

Most health experts believe that the flu virus is spread mainly by droplets that become airborne when people cough, sneeze or talk. The droplets can land in the mouths or noses of people who are nearby.

Less often, a person might also get the flu by touching a surface or object that has flu virus on it and then touching their own mouth, eyes or possibly their nose.

The best way to prevent the flu is to get a flu shot each year, experts say.

It is recommended that people receive a flu vaccine as soon as it's available, because it takes about two weeks for the body to develop protection against the flu.

The flu vaccine is recommended for everyone who is 6 months old and older. There is no upper age limit. Pregnant women should be vaccinated, Bruhn said.

Parents can protect babies under 6 months of age by making sure that everyone around them has had a flu shot and washes their hands well and regularly, Baber said. "And, don't let people kiss your baby."

Other methods to avoid getting or spreading the flu include washing your hands often, staying at home when you're sick, and avoiding touching your face with your hands.

People don't realize how important it is to stay home when you don't feel well, Baber said, "because even talking puts enough virus in the air to spread the disease. It's just as bad as a cough or sneeze."