With the flu season expected to peak later this month amid a widespread outbreak, the state's health department is urging people to get vaccinated.

From Oct. 1 through Dec. 29, there were 17,349 laboratory-confirmed influenza cases in 66 of Pennsylvania's 67 counties, according to the Pennsylvania Department of Health. The health department attributed nine deaths — all of whom were over age 50 — statewide to the flu.

And in Butler county, the flu is on the rise, according to David Rottinghaus, a doctor with Butler Memorial Hospital who specializes in emergency medicine. Butler County doctors reported at least 207 of the state's confirmed cases, but Rottinghaus said that number is probably higher.

“Anecdotally, reported cases lag behind the number of actual cases being seen,” Rottinghaus said.

As a BMH doctor serving in the medical emergency department, Rottinghaus shared his observations.

“We've seen a palpable rise in the number of cases,” Rottinghaus said. “And that's not just in the hospital; it's at our urgent care and our outpatient.”

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 at least 22 states in hitting the widespread outbreak designation.

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.

“Flu season is definitely ramping up,” Rottinghaus said. “As more people get the flu, the more it gets passed around to other people.”

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

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

The health department suggests the best way to prevent the flu is to get vaccinated each year. Persons age 6 months and older are advised to get the flu vaccine each season. It takes about two weeks for the antibodies from the vaccine to develop protection against infection.

The department of health keeps an archive of lab-confirmed flu case data for each county in the state. Rottinghaus noted that for many healthy adults, catching the flu will be a discomfort and a nuisance, but for the young and vulnerable the flu poses a serious risk.

“The majority of people will recover, but people we worry about are the very young and people with medical problems,” Rottinghaus said.

Those with medical problems such as asthma or cancer, Rottinghaus said, have a higher risk of serious medical complications developing — for example, developing pneumonia — during their sickness.

Rottinghaus and the health department encourage people to practice good hygiene and to get vaccinated. The health department also suggests staying at home if you contract the flu.

Flu season is Oct. 1 through Dec. 29. Here are the confirmed numbers of flu cases in Butler County.2017-18...........1,5142016-17..............9202015-16...........1,3592014-15...........1,286