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Even though the flu season is off to an early start this winter, health officials say it's still not too late to get a flu shot.

(Toby Talbot/The Associated Press)

Patients are streaming into Portland-area emergency rooms with the flu season ramping up to be a bad one.

"It's one of the worst seasons in the past three or four years," said Dr. Ann Thomas, head of the flu team at Oregon Public Health Division. "We're seeing more cases, and we've admitted more people to the hospital."

Since the season kicked in, 179 people have been hospitalized in Multnomah, Washington and Clackamas counties and at least seven people have died.

And the season is young. Usually, the flu virus peaks in Oregon in late February and early March. But the metro area saw the first flu-related hospitalizations this season in November. The number shot up in December, with 20 people admitted to area hospitals with flu symptoms the second week of the month, 67 hospitalized the third week and 81 admitted the week ending Saturday, Dec. 28.

Thomas said Oregon has not seen a spike like that in years.

"They rarely take off until after the first of the year," she said. "We can't tell why it's happening so early this year."

So far, emergency rooms are coping, though they're busier than usual.

The flu

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"This time of year tends to be slower but it hasn't slowed down that much," said Dr. Dan Handel, clinical operations director of the emergency department at

. "But we're not overwhelmed."

Some of those hospitalized have died, with Legacy Health reporting three flu-related deaths, and two each at OHSU and Providence.

The fatalities include a pediatric patient, at least two senior citizens and at least two people in their 30s or 40s.

Usually, the flu virus hits the elderly the hardest. But this season, H1N1 is causing the most suffering, accounting for 97 percent of confirmed tests at Oregon public health labs.

"H1N1 hits young, healthy people," said Dr. Mark Crislip, chief of infectious diseases at Legacy Health.

The reason has to do with history. The H1N1 strain caused the worldwide flu pandemic in 1918-19 and then lingered until the mid-50s, when it disappeared. Those born up to the mid-50s were likely exposed to the virus.

"The presumption is that old people (now) have some residual immunity that protects them against the flu," Crislip said.