State health officials announced the first confirmed case Oct. 3: a child in the Washington suburbs. They said it came more than two weeks before the previous season's first case and earlier than any year in the last decade.
Instances of flu-like activity are slowly rising, according to the Baltimore Health Department. Local officials said if enough people get vaccinated, the numbers can remain low. Plenty of vaccine is available in doctors' offices, drugstores and local health department clinics, they said.
"We can't predict when influenza is going to peak," said Dr. Oxiris Barbot, Baltimore's health commissioner. "The point of vaccination is prevention. The best way to prevent a bad outcome, like missed work or school or unnecessary hospitalization or even death, is vaccination."
Barbot said the flu season typically begins sometime in October and can last through May, with a peak in January or February.
The Centers for Disease Control and Prevention recommend everyone over 6 months get a flu vaccine. The flu typically kills thousands of people every year and leads to hospitalization for many more. Seniors, children and those with compromised immune systems are especially vulnerable.
Officials believe this year's vaccine contains the right strains to prevent infection. There are generally three strains included in the vaccine, though this year there is a vaccine with four strains.
There also is a vaccine produced in cells rather than eggs, so those with allergies can still get some protection. And there is a nasal mist for those who prefer not to get a shot and are younger than age 50 and do not have a compromised immune system.
"The overall message is that there are more and more options out there," said Dr. David Blythe, the state epidemiologist. "Everyone over 6 months should choose one."
Officials can't say exactly how many people catch the flu because most people are not tested and many people never even go to the doctor. The state does track those who test positive for a strain and, as of Nov. 16, there have been 88 cases.
The state also uses emergency department visits to track influenza-like illness. There had been 2,911 such cases as of Nov. 16. Blythe said the actual number of people with flu is probably not that high, but close.
Linda Frisch got her shot in mid-November and hopes to remain among the healthy. She's director of grant development for MedStar Health, which operates 10 hospitals in the Maryland-Washington region and requires its 30,000 employees to get a vaccination by Thanksgiving.
"I have a daughter and two grandkids, 2 and 5, who live with us, so it's good all around," Frisch said of getting vaccinated. "It helps me stay healthy, helps my family stay healthy, and the patients and my colleagues too."
MedStar Good Samaritan Hospital's Good Health Center in Northeast Baltimore also offers vaccinations to patients and people from the community in addition to hospital employees.
A recent Gallup poll found the percentage of Americans who report having the flu on any day in the first half of October averaged 2.2 percent, about the same rates in the last two years.
The flu is a virus and can't be treated with antibiotics, but cases caught early can be treated with an antiviral medication that can lessen the symptoms.
The doctors also emphasized that it's a myth that the vaccine causes the flu. But they want people to get vaccinated now because it can take two weeks for it to become effective. A vaccination is needed annually.
The CDC reports that there will be at least 138 million doses of vaccine available this season around the country. Included in them will be the influenza A (H1N1) viruses, influenza A (H3N2) viruses and influenza B viruses.
Officials recommend that those who do get the flu drink plenty of fluids, stay home, cover their mouths when they cough and wash their hands frequently.