The numbers show just how real the flu is this year.

Four patients who had been diagnosed with influenza have died over the past few weeks at a Decatur, Ala., hospital, al.com reported late last week.

In Santa Rosa County, Fla., a paramedic died of complications from the flu last week, the Northwest Florida Daily News reported. His wife was in serious condition at UAB. Both had been diagnosed with the H1N1 flu virus, family members told the newspaper.

The Centers for Disease Control’s numbers for the week ending Jan. 11 showed that, for the week, the proportion of deaths attributed to pneumonia and influenza (P&I) was above the epidemic threshold, and that there were 10 influenza-associated pediatric deaths nationwide.

As that significant flu activity continues across the country, both state and local health officials are continuing to urge residents to get vaccinated.

According to the CDC, the flu is now widespread in 35 states, including Alabama.

Dr. Jim McVeigh, director of health promotion for the Alabama Department of Health, said the current flu season began early and has been directly linked to at least one death in the state.

“We have to go off of death certificates, and that usually takes a few weeks,” McVeigh said. “There has been one death that the cause was flu, and that was a child from Mobile.”

McVeigh said most deaths associated with the flu are actually caused by pneumonia or other respiratory problems that may or may not have been caused by influenza.

Reports indicate there have been 130 deaths attributed to pneumonia since September. According to published reports, Alabama recorded 856 flu and pneumonia deaths in 2013, with 38 caused by flu and the remainder by pneumonia.

McVeigh said the combination of an early start, coupled with the spread of the H1N1 strain of influenza, has made this flu season especially potent.

Ricky Elliott, an administrator with the health department covering eight counties in south Alabama, said the best way to avoid the flu is still to get vaccinated.

Elliot also said fear of contracting the flu from the vaccination is an unfounded concern.

“You have to do decide that personally, but the flu vaccine doesn’t make you sick,” he said. “It’s not a live virus. The best way we have to protect ourselves is to take the flu vaccine.”

McVeigh said there is still plenty of time for those who have not yet received the vaccination.

“It takes about two weeks before you start building up antibodies,” McVeigh said. “But, just because flu season started early, doesn’t mean that it will end earlier. We’ve had flu seasons that peaked as late as March, although that is unusual. We consider ourselves right in the middle of the flu season right now.”

McVeigh said, while vaccination is the best way to avoid the flu, other important tips include:

• Frequent hand washing;

• avoiding large gatherings of people;

• staying home from school or work is you are sick;

• and, for adults, seeking treatments such as Tamaflu within the first 48 hours of noticing symptoms.

In Covington County, physicians, as well as many area pharmacies, are offering flu vaccinations.