Trevor Hughes

USA TODAY

DENVER – Flu cases are spiking on both coasts, while the middle of the United States has so far seen little activity, according to federal officials.

New York City and New Jersey in particular are being hit hard compared to other areas. Oregon is also seeing a high level of flu symptoms, said federal epidemiologist Lynnette Brammer.

Across Middle America, relatively few flu cases are being reported, except in Oklahoma. Ten states are reporting high levels, as is Puerto Rico, based on reports collected by local health officials and compiled weekly and released Friday morning by the federal Centers for Disease Control Control and Prevention. Laboratory-confirmed tests show a significant spike in infant flu cases, the CDC reported.

“Activity has started to go up pretty dramatically, but there’s still time for people to get vaccinated and build up immunity,” Brammer said.

This is typically the time of year when flu cases begin rising dramatically. Doctors’ visits for flulike symptoms are already ahead of last season, although still well behind the 2014-2015 season, one of the worst in a decade. In that season, experts blamed a strain that hit the elderly and very young hard, along with a less-effective vaccine. Last week was the third consecutive week in which reported flu-like illnesses were above the national baseline.

Brammer said while it’s too early to tell if the annual flu vaccine is effective, it closely matches the strains of flu commonly in circulation, which suggests it will be effective. The flu vaccine changes each year, based on predictions by epidemiologists about what specific strains will emerge in the subsequent months.

That’s the message Dr. Keri Peterson has been repeating to her patients. Peterson, an internist at Lenox Hill Hospital in New York City, said she’s seeing increasing numbers of people coming in with preconceived – and often misplaced — notions about vaccines and the danger posed by flu. The flu typically kills at least 100 infants annually, and tens of thousands more adults.

“I think people are using Dr. Google, seeking information on their own, and finding results that gear toward their way of thinking,” she said. “I think that people have more access to information, but that it may not be accurate.”

The flu kills people every month of the year, and about 6% of all deaths nationwide were flu or pneumonia related last week. The exact number of deaths caused by flu are not tracked because not every local health department reports them to the CDC. Nine people have been confirmed killed by the flu in Washington state, officials said this week.

In Washington state's King County, the number of flu cases at emergency rooms is the highest it's been in five years, says county epidemiologist Dr. Jeff Duchin, and Snohomish County says the number of hospitalizations has been doubling each week since early December.

In Thurston County, the overloaded emergency rooms prompted health officials at Providence St. Peter Hospital to activate a 'Disaster Medical Control Center' for the first time in 10 years. It's an emergency measure that's usually only used during mass casualty incidents.

"We were in a situation where in Thurston County, our two hospitals were saturated, we were at capacity, and could no longer take care of patients safely — ambulance patients, there was nowhere to put them," said Malloree Fontanilla, who is a registered nurse in the Emergency Room.

Contributing: KING-5 TV