Flu season is off to an early start in Maryland with health officials reporting Tuesday that the state already has 11 confirmed cases.

“We don’t know yet whether flu activity this early indicates a particularly bad season on the horizon,” said Maryland Health Secretary Robert R. Neall in a statement. “Still, we can’t emphasize strongly enough — get your flu shot now. Don’t put it off.

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"The vaccine is widely available at grocery stores, pharmacies and local health clinics, in addition to your doctor’s office.”

The U.S. Centers for Disease Control and Prevention recommends everyone older than 6 months get a flu shot.

The cases in Maryland, reported since Sept. 1, are mostly subtype A with some subtype B. The vaccine this year protects against both influenza subtypes.

The flu is high contagious and lands thousands of people in the hospital in the state each year. Last year, there were 3,274 flu-linked hospitalizations and 82 related deaths, including four youths.

Hospitals can test in the lab to confirm flu cases. But reporting of cases overall, including people with flu-like symptoms, is done largely voluntarily in the state. Many cases are not recorded, especially among those with mild cases who recover at home.

Health officials warn that the flu should be taken seriously because of the high number of people who end up hospitalized with serious complications such as pneumonia. Children and seniors are especially vulnerable, as well as people with compromised immune systems and pregnant women.

The virus is spread through sneezing and coughing and contact with contaminated surfaces. Symptoms usually begin one to four days after exposure and include fever, body aches, fatigue, coughing and sore throat.

“The best way to protect yourself and your family is to get a flu shot," Deputy Secretary for Public Health Fran Phillips said in a statement. “Getting vaccinated every year is important because the strains change over time. Also, keep in mind that it takes about two weeks after being vaccinated before the body’s full immune response kicks in.”

Officials recommend covering your mouth when you cough or sneeze and washing hands frequently.

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