BISMARCK - Last year was a nasty year for the flu in North Dakota.

The 2017-18 flu season was one of the worst seasons in the past 20 years, according to Jill Baber, influenza surveillance coordinator for the North Dakota Department of Health. There were 8,498 reported cases of the flu, an increase from the severe 2014-15 season, which saw 6,439 cases.

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So far this year, there have been six reported cases of the flu in North Dakota, according to latest data from the health department.

Baber said one of the cases was from a person who was on a plane detained at New York's John F. Kennedy International Airport Sept. 5. An Emirates aircraft landed at the airport carrying several passengers and crew members who had flu-like symptoms, according to The Associated Press.

Baber said there was just one person "that we know of" from North Dakota who was on the detained plane and tested positive for the flu. The other five cases that have been reported so far were local to North Dakota.

Six cases at this time of year is "normal early activity season," which typically starts with a handful of cases every week in September or October, Baber said. No outbreaks have been reported yet in North Dakota. The flu season starts in October and runs through May.

The Centers for Disease Control and Prevention called the 2017-18 flu season a "high-severity season," meaning there were high levels of hospitalizations for influenza-like illnesses and "elevated and geographically widespread influenza activity for an extended period." There were 180 pediatrics deaths due to the flu last season.

The flu is unpredictable, and Baber said she's not sure what the upcoming season holds.

"We hope it is not as bad as last season," she said.

Health care facilities are getting stocked with the flu vaccine, which is recommended for everyone 6 months of age and older.

Abbi Berg, vaccines for children program manager with the North Dakota Department of Health's immunization program, said she is aware of some pharmacists and health care providers currently offering the flu vaccine, but efforts typically ramp up after Oct. 1.

The CDC recommends everyone get a flu shot by the end of October, before flu activity increases. However, Berg said people can still get the shot after that time frame and "well into early spring," when flu activity picks up.

"If you haven't gotten a flu shot, it's never too late," she said.

Though the injectable vaccine is preferred, federal health officials have approved the use of a nasal spray flu vaccine this season.

Berg said the nasal spray, called FluMist, was previously approved, but the recommendation was removed two years ago when the CDC's vaccines advisory committee received some data that questioned the nasal spray's effectiveness against the H1N1 strand. The nasal spray may be available in "limited quantities" throughout the state, Berg said.

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