The second week in January was the worst single week for flu transmissions in the D.C.-Maryland-Virginia area so far this flu season.

Doctors are saying they are seeing a wide range of flu cases this month, ranging from mild flu symptoms to cases that require lifesaving treatment. In nearby West Virginia, the first pediatric death from the flu was recorded this past week. A six-year-old passed away from influenza, the first pediatric flu fatality in the United States since the infamous 2014-5 flu season.

The parts of the population most vulnerable to flu are the young, the elderly, and the sick. Area hospitals are reporting an above average number of walk-ins for flu symptoms.

In just the second week of January, the Maryland Department of Health reports that 208 people tested positive for the flu. More than 59 percent of all flu hospitalizations in Maryland were for patients over the age of 65. Virginia also saw the highest number of flu cases last week, with the Virginia Department of Health reporting 160 confirmed cases. While that is the highest one-week total in Virginia this year, it is still short of last year’s peak — 200 confirmed cases in a single week in February.

The numbers are even more shocking in the District. In Washington, D.C., there have been 624 confirmed flu cases so far. A whopping 400 of those cases came just during the first two weeks of January.

Flu season can run into February and even March some years, so it’s perfectly normal to see a spike in influenza cases during January. Most severe cases of flu have been tracing back to the H3N2 strain of the virus. This strain of Influenza A has been historically difficult to vaccinate against. This year’s flu vaccine did not cover the H3N2 strain, leading health officials to warn that this year’s vaccine could be only 10 percent effective.

Still, health officials are urging people to get the flu vaccine anyway, even if it’s not protecting against the most prevalent strain. They are starting to see other strains show up that are protected by the vaccine. The reason for this is less about protecting you and more about protecting the vulnerable populations as much as possible.

If you do begin to feel flu symptoms, be sure to stay home from work or school and drink plenty of fluids. Resist the urge to fight through it at work. Not only does that put your co-workers at risk, but it can overtax your own system, making it harder to recover. Many severe flu cases that reach the emergency room stem from dehydration. Getting bed rest and drinking plenty of water, Gatorade, or even Pedialyte can help keep you out of the emergency room and let hospital staff focus more on serious flu cases.

D.C. hospitals have also reported a shortage of saline IV bags in recent weeks. A large percentage of saline bags in the U.S. are manufactured by a company called Baxter. They have a number of manufacturing plants in Puerto Rico designated solely to producing saline IV bags. In the wake of Hurricane Maria, those Puerto Rico factories shut down, leading to a shortage of saline IV bags stateside. With the flu as bad as it is this year, many hospitals were forced to save their bags for important surgeries. This week, Baxter began importing saline IV bags from Mexico to fill the shortage.

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Click here to read more about why health officials recommend the flu vaccine, even if the worst strain isn’t covered this year.