Although it is late in the 2018-18 flu season and total weekly influenza cases have begun to decrease, the Division of Public Health announced April 4 that flu activity in Delaware and across the U.S. remains elevated with an increase in the number of influenza A viruses circulating over the past month.

H3N2 viruses are typically associated with more severe illness in older adults, and while anyone experiencing flu-like symptoms should seek treatment quickly, it is especially important for individuals 65 years and older to do so.

As of March 23, there have been 5,854 laboratory-confirmed cases of influenza in Delaware during the 2018-19 season, 943 of which required hospitalization. These numbers reflect only lab-confirmed cases and the actual number of influenza cases in the state is likely much higher. While this year’s influenza case total is much lower than the 9,051 cases reported during the 2017-18 season — the highest total since record-keeping began in 2004 — the 2018-19 season is now the second-highest on record.

As the total number of flu cases continues to climb, so do flu-related fatalities. This season, 20 Delawareans have passed away as a result of flu-related complications. All 20 were infected with influenza A and all had underlying health conditions or suspected health complications. Their ages ranged from 41 to 90 years old.

Nationally, the Centers for Disease Control and Prevention reported that flu illness peaked in February, but remains high for this time of year with 34 states, including Delaware, and Puerto Rico reporting widespread flu illnesses. The CDC expects flu activity to remain elevated for weeks. Levels of flu-like illness in the U.S. have been at or above baseline for 18 weeks so far this season, on track for a relatively long season, possibly exceeding the previous five-year high of 20 weeks. In terms of severity, the CDC estimates that so far this season there have been as many as 508,000 flu hospitalizations and 46,800 deaths.

Flu vaccines are still available at State Service Centers, primary care providers and specialists, pharmacies, and some grocery stores. To find participating stores, enter zip code in the CDC’s flu vaccine finder at cdc.gov/flu. For more information about the flu, visit flu.delaware.gov or call 800-282-8672. The CDC recommends use of any licensed, age-appropriate influenza vaccine, including inactivated influenza vaccine, recombinant influenza vaccine or live attenuated influenza vaccine. For questions about which vaccine is best, talk to a doctor or other health care professional.

Flu shots are available at DPH clinics located within the State Service Centers:

— Porter State Service Center, 509 W. 8th St., Wilmington. For all ages 9 and older. Walk-ins are welcome from 8 a.m. to noon and 1 to 4:30 p.m. Mondays through Fridays.

— Hudson State Service Center, 501 Ogletown Road, Newark. For all ages, including children age 6 months and older. Call 283-7587 (choose option 2) to make an appointment Monday through Friday.

— Williams State Service Center, 805 River Road, Dover. For all ages, including children age 6 months and older. Call 857-5140 to make an appointment from 8 a.m. to 3:30 p.m. Mondays through Thursdays.

— Milford State Service Center - Riverwalk, 253 N.E. Front St., Milford. For ages 9 years and older. Call 424-7130 to make an appointment from 1 to 3 p.m. Mondays and 9 to 11 a.m. Wednesdays.

— Anna C. Shipley State Service Center, 350 Virginia Ave., Seaford. For all ages, including children age 6 months and older. Walk-ins welcome from 8:30 a.m. to 4 p.m. Mondays through Fridays. Call 628-6772.

— Adams State Service Center, 544 S. Bedford St., Georgetown. For all ages, including children age 6 months and older. Walk-ins welcome from 9 to 11 a.m. Thursdays only.

For more about flu surveillance in Delaware, visit dhss.delaware.gov/dph/epi/influenzawkly.html.

In addition to getting a flu vaccine and taking antiviral medication, DPH recommends:

— Practice social distancing if exhibiting cold or flu-like symptoms.

— Wash hands frequently with soap and water or use alcohol-based hand sanitizers.

— Cover sneezes and coughs with a tissue, and dispose of tissues immediately; if no tissue is available, sneeze or cough into inner elbow.

— Stay home if sick until free of fever for 24 hours — with a temperature of less than 100 degrees Fahrenheit, without the use of fever-reducing medications for at least 24 hours.

Social distancing means that those sick with the flu should stay home from work, school and other gatherings and not return until they have been free of fever — with a temperature less than 100 F without the use of fever-reducing medications for at least 24 hours. They should avoid close contact with well people in the household, and stay hydrated by drinking plenty of water and other clear liquids. Over-the-counter medicines can provide symptom relief, but if influenza is suspected, call a doctor, as they may decide to provide antiviral medications to help hasten recovery and prevent serious complications. This is particularly important for those who feel very sick, are pregnant or have chronic medical conditions.

Flu symptoms come on suddenly and include fever, cough, sore throat, runny or stuffy nose, headaches and body aches, chills and fatigue. Some get complications including pneumonia, bronchitis and sinus and ear infections. People with pre-existing health conditions such as diabetes and asthma are more susceptible to catching the flu.

For more about the flu, visit flu.delaware.gov or call DPH at 800-282-8672.