Flu season is back with a vengeance.

Health officials warned Monday that suspected flu cases have jumped in five southern states, and the primary strain circulating tends to make people sicker than normal, particularly the elderly.

“It looks like it’s shaping up to be a bad flu season, but only time will tell,” said Dr. Thomas Frieden, director of the Centers for Disease Control and Prevention (CDC).

The good news is that the nation seems fairly well prepared, said Frieden. More than a third of Americans have been vaccinated, and the vaccine formulated for this year is well-matched to the strains of the virus seen so far, CDC officials said.

Higher than normal reports of the flu have come in from Alabama, Louisiana, Mississippi, Tennessee and Texas. A rise like this usually doesn’t occur until after Christmas. Flu-related hospitalizations are also rising earlier than usual, and there have already been two deaths in children.

According to the CDC, only 40 percent of Latinos received their shot last season. Not only does the CDC report that up to 9.5 million Hispanic-Americans will get the flu in an average year, it also indicates there are 9 million with diabetes, making them prone to infection.

It’s not clear why the flu is showing up so early, or how long it will stay.

“My advice is: Get the vaccine now,” said Dr. James Steinberg, an Emory University infectious diseases specialist in Atlanta.

The last time a conventional flu season started this early was the winter of 2003-04, which proved to be one of the most lethal seasons in the past 35 years, with more than 48,000 deaths. The dominant type of flu back then was the same one seen this year.

However, there are some differences.

In 2003-04, the vaccine was poorly matched to the predominant flu strain. There’s more vaccine now, and vaccination rates have risen for the general public and for key groups, such as pregnant women and health care workers.

An estimated 112 million Americans have been vaccinated so far, said the CDC. Flu vaccinations are recommended for everyone 6 months or older. On average, about 24,000 American die each flu season.

Flu usually peaks in midwinter. Symptoms can include fever, cough, runny nose, head and body aches and fatigue. Some people also suffer vomiting and diarrhea, and some develop pneumonia or other severe complications.

Based on reporting by The Associated Press.

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