The flu season has hit Oregon, and it is not pretty.

More than 1,300 have fallen ill since late September, when state authorities started tracking confirmed flu cases across the state. By the same time last year, there were fewer than 400 confirmed flu cases in Oregon.

Oregon’s not even seeing the worst of it.

Federal health officials say the state has had “moderate” flu activity in the week ending Dec. 7, up from “minimal” and “low” in the prior nine weeks. Washington, on the other hand, is part of a club of states, most of them in the Deep South, that are seeing “high” activity levels.

Five people in Washington have died so far this season. The state’s health officials say the numbers are likely an undercount.

Oregon does not count how many adults die from the flu, Oregon Health Authority spokesman Jonathan Modie said, because people can die of complications caused by the flu, which makes it very difficult, if not impossible, to get accurate numbers.

About 1,300 people have died from the flu nationally, according to the U.S. Centers for Disease Control and Prevention. About 2.6 million have fallen ill, according to the agency, and 23,000 people have been hospitalized.

Symptoms of a flu infection include sore throat, a cough, aches, headaches and a fever. Most people get over an infection within two weeks, at most. But there’s always the chance of worse outcomes. People can get sinus and ear infections, or they can get pneumonia, heart, brain or muscle inflammation or even multiple organ failure.

The flu is particularly dangerous for people over 65 years old, anyone with a chronic medical condition like asthma or diabetes, pregnant women and children less than 5 years old.

Health officials urge people to get a flu shot. They are safe and can help prevent an infection or, if a person gets sick despite a shot, makes the infection less severe.