A widespread flu outbreak in Pennsylvania this year is already affecting Butler County weeks ahead of the illness's predicted peak.

From the end of September through Dec. 14, there were 6,938 influenza cases reported from 65 of Pennsylvania's 67 counties, according to the Pennsylvania Department of Health.

The rate of cases puts the state into the highest Centers for Disease Control and Prevention category of flu activity: a widespread outbreak classification. Pennsylvania joins 22 other states in hitting the widespread outbreak designation.

Butler County doctors reported 45 of those cases, although the true figure is much higher, according to Dr. Jerome Scherer of Butler Health System. Patients who are able to be diagnosed without lab testing are not added to the state's count.

Scherer alone has handled about five cases already this season. The nation appears to be hitting flu season early and hard, he said.

“I've been seeing them for over three weeks,” Scherer said. “It's definitely much earlier this year.”

The CDC operates a flu forecasting program that attempts to predict spikes in flu activity throughout the nation's 10 U.S. Department of Health and Human Services regions. Pennsylvania is in Region 3 with Delaware, Maryland, Virginia, West Virginia and Washington, D.C.

Most of the forecasts for Region 3 predict a peak in flu activity at the end of January.

However, early cases began in October this year and have picked up faster than in previous years. Scherer said he thinks the worst is yet to come, even though he's already busy.

“I think it's going to get worse and we have a fairly large elderly population here,” he said. “If we can get everyone to get a flu vaccine, that would be really helpful.”

Scherer said he's concerned about misconceptions of vaccines. It's impossible to get the flu from a vaccine, he said, but he repeatedly sees patients who claim that happened to them. The timing is merely a coincidence, Scherer assures them. The vaccine might cause some minor side effects for a day or two, but it can't actually cause the flu.

A third of Scherer's patients refuse the vaccine, he said.

Last season, about 45.3 percent of adults were vaccinated and 62.6 percent of children, according to the CDC.

It's never too late to get the shot, Scherer said.

Catching the flu can be serious, especially among children and the elderly. Nationwide, this season has already brought 1,300 flu-related deaths.

Seven deaths this season were flu-related in Pennsylvania, according to the Department of Health. Six of the deaths were among citizens age 65 and over. The seventh was between age 50 and 64.

Statewide, 144 flu-related hospitalizations have occurred this season.

Along with a vaccination, Scherer suggests people can stay healthy by frequently washing their hands and avoiding touching their faces.

He said he switched from wearing contacts to glasses, so that he'd touch his face less often.

Scherer also takes a vitamin C and zinc supplement daily to fight contagion, but he said those recommendations are only anecdotally proven and lack scientific proof.

Still, the doctor of 35 years hasn't caught the flu in a decade, despite treating flu patients every year.

“Now you've jinxed me,” Scherer said.

A 2012 study published in the International Journal of Health Geographics examined the annual economic costs associated with influenza on the county level in 3,143 U.S. counties. The median cost to a county economy was $2.47 million.

That's why so many insurance companies and businesses offer free flu shots, Scherer said. The vaccine can keep workers on the job.

If someone in your office comes down with the flu, be on guard if they return to work before their fever goes down, said Scherer. A common surgical mask that's available at any pharmacy is a suggested courtesy to wear if you believe you might still be contagious, he said.

The Department of Health keeps an archive of lab-confirmed flu case data for each county in the state.

In the 2017-18 flu season, Butler County had 1,514 confirmed flu cases.

In 2016-17, Butler County had 920.

In 2015-16, the county had 1,359 cases, while it had 1,286 in 2014-15.