Butler County has the 17th highest number of documented flu cases out of 67 counties in the state so far this year.

The county has seen 377 documented cases as of Jan. 13, according to the Pennsylvania Department of Health's website, and the flu could be hitting harder than the statistics show.

“These case counts represent only a fraction of the actual burden of illness due to influenza occurring in the commonwealth at any given time,” the website said. “This is because most persons with influenza do not go to the doctor or are not tested or reported.”

The flu presents trouble, especially to the elderly. The data also show that 32 people died this year from influenza, the majority of which were over age 65.

“It is estimated that 5 to 20 percent (600,000 to 2.4 million) of Pennsylvanians get the flu each year, and 120 to 2,000 die from complications of influenza,” the website said.

Dr. David Rottinghaus, an emergency medicine specialist at Butler Memorial Hospital, said in a previous interview that this year's flu symptoms have appeared in the forms of fever, respiratory problems, muscle aches and sore throats.

“We really want people, if they feel their symptoms are severe enough, to come for an evaluation,” he said.

Local schools are particularly attentive to symptoms in their students, according to Joan Timko, a certified school nurse of both Slippery Rock high and middle schools.

Timko said fever is the best indicator of when to send a child home for flu-like symptoms because other symptoms coincide with other winter illnesses.

“Congestion is something that you see all the time. A cough is something we see all the time,” she said. “We kind of look for that constellation of symptoms.”

She said through out the district, nurses may have to send home an average of two students per week due to fever or other flu-like symptoms. But, she said these numbers are similar to previous years.

“We have not had an unusual rate of complaints from students,” Timko said. “We have not had any increase in our absentee rate.”

Cyndi Jones, the nurse at the Freeport high and middle schools, said she does not track the number of confirmed cases but has noticed some increase in certain symptoms.

“They have symptoms consistent with the flu,” Jones said.

She said body aches coupled with cold symptoms and chills with or without a fever are the complaints that cause her to think “flu.”

Jones guessed that she has seen an increase of 2 to 5 percent in flu symptoms over last year.

Representatives from the Centers for Disease Control and Prevention confirmed that this year's staggering numbers are partially due to the prevalence of the Influenza A H3N2 strain and the country could experience an extended peak during this season.

“These viruses are often linked to more severe illness, especially among children and people age 65 and older,” Dr. Brenda Fitzgerald, director of the Center for Disease Control, said in a news release Jan. 12. “While our surveillance systems show that nationally the flu season may be peaking now, we know from past experience that it will take many more weeks for flu activity to slow down.”

Another problem of the H3N2 strain is that it reduces the effects of vaccinations which for most strains hover around 40 percent effective, according to Dr. Dan Jernigan, director of the influenza division in CDC's National Center for Immunization and Respiratory Diseases.

“Our information so far suggests that vaccine effectiveness against the predominant H3 viruses will probably be somewhere around what we saw in the 2016-2017 season, which was in the 30 percent range,” Jernigan said.

Despite the reduced effectiveness, Dr. John Love, a member of the infectious disease group at Butler Memorial Hospital, said people need to continue routine vaccinations and practice good hygiene to prevent the spread of the virus, especially to the young, elderly and those with chronic conditions.

“Sometimes they get it right, sometimes not. But there's very little risk and very little harm in getting a flu shot,” Love said. “Even if it's 50-percent effective, it's a win.”