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But those numbers do not include all the people who have had the flu, as many do not see a doctor when sick. Each of New Jersey's 21 counties are on high alert.

The local flu watch activity level is set at Level 3, localized with at least one ongoing laboratory-confirmed influenza outbreak in an institution.

Hawkinson said it's a good move. "If they have an extremely high fever and especially if they're not getting better to definitely seek medical care". "Then they shouldn't experience any complications".

The health department said all deaths are under investigation and it was not known if some of those who died had underlying medical conditions.

This year's strain, H3N2, seems to be particularly hard-hitting.

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By comparison, the same vaccine was used last season and found to be 42 per cent effective in preventing cases of H3N2.

The cold winter in many parts of the country may also have played a role, keeping people indoors and helping flu bugs to spread, said Dr. David Weber, a University of North Carolina flu expert. While you are protected there are still strains that could harm you this season. "For more information about where to get vaccinated, New Yorkers can call 311, visit nyc.gov/flu, or text "flu" to 877877".

This outbreak is particularly hard. This season will be longer than a year ago as it has not peaked.

Parents and caregivers should be tired about spreading the disease to children and the elderly. They're normally passed through animals like wild birds as we saw in the the 2009 bird flu epidemic.

"The influenza season is far from over, and it is not too late to get the flu shot", the health department said in a statement. Wash your hands thoroughly with warm water and soap and cover your coughs and sneezes with tissues to prevent yourself from spreading the flu to others.

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Fisher said to be aware of touching door handles, phone receivers and the like, after someone with the virus has touched it.

Avoid touching your eyes, nose and mouth.

"The flu is a serious disease". Last week, 42 states reported high patient traffic for the flu, up from 39. "This is a very hard season". They are also asking those who are sick to wear a mask before entering their buildings.

And there are some signs the flu season will continue to get worse. "There's so much flu in the crowded emergency rooms". It is recommended for everyone over the age of 6 months. "It's worse for younger children or those with any underlying problems - asthma, heart problems, diabetes", she said. Can you get it again?

Over-the-counter medicines do "very little", Fisher said. The fever should be gone without the use of fever-reducing medications. The nation's season has already crossed the 10-week threshold and there are indications that there are many more weeks ahead.

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