Flu season might be in full swing in some parts of the country, but it's getting a late start in Washington and doctors fear the worst may be yet to come.

"We've [seen] relatively low-level activity so far but that's pretty typical for Washington state," said Dr. Elizabeth Meade, Chief of Pediatric at Swedish Hospital.

It's low when compared to the last few seasons. But that is changing. 

"It's hitting right now," Department of Health spokesperson Julie Graham said.

Flu season in the Pacific Northwest is generally slow to follow the east coast. Delayed by a few weeks, the flu season here is projected to peak starting late January. It could last through spring.

The timing of the flu season varies from year to year for unknown reasons. It's also highly dependent on the specific strain of the flu and community immunity; how many of your friends and neighbors are fighting the flu by getting vaccinated. In addition, it's related to social networking (the kind we do in person) and climate. The flu likes cold, dry weather where it can survive and spread. Alternately, it hates heat and humidity which is why we don't have flu season in the summer.

"I think that it's really important for people to know that although we typically recommend getting your shot by the end of October it's still not too late," says Dr. Meade.

At last check, Washington has had 9 flu deaths and 89 hospital visits. Locally, King and Tacoma-Pierce counties health departments are not reporting any flu deaths but have recorded over a dozen hospital visits for flu-like symptoms.

Doctors continue to stress that the best way to protect your kids and family is to get everyone vaccinated. Also, if someone in your house is at risk including young kids and the sick or elderly, make sure you keep an eye out for dangerous symptoms.

"Super high fevers that aren't going away. If you're feeling at all confused or lethargic or you're noticing that you have difficulty breathing a cough it is really painful. Those are all times when it's better to get checked out for the most part," explains Dr. Meade.

If you still haven't gotten the flu shot, do it now because it takes a few weeks to reach maximum effectiveness. Health departments and doctors are basically begging people to get the vaccine to increase that community immunity.

During both the 2017-18 flu season and 2016-17 season, there were around 20 flu-related deaths around this time. There were nearly 300 flu-related deaths last season, according to the Department of Health.

Those flu seasons were a bit out of the ordinary. According to Centers for Disease Control and Prevention, during the 2017-18 season, influenza-like illness activity began to increase in November, reaching an extended period of high activity in January and February at a national level. It remained elevated through March. The flu illness was at or above the national baseline for 19 weeks, making it one of the longest in recent years. 

What is being seen now is a bit more typical, Graham said. 

In the past few weeks, there has been a "significant uptick" in the number of people going to the hospital with flu-like illness, Graham said. Many are testing positive. 

"While we still aren't at a widespread level, it really has begun to pick up," she added. 

It's nearly impossible to tell how severe the flu season is going to be. Many factors play into the severity, including how many people are being vaccinated, and whether a flu vaccine is a good match for the circulating viruses. 

The CDC says, nationally, the average duration of a flu season for the last five seasons has been 16 weeks, with a range of 11 to 20 weeks. 

In the meantime, flu season is really ramping up across the country.

"There are 24 states now that are reporting widespread flu activity," Dr. Meade said. "We've had at least 13 pediatric deaths thus far and the pediatric ones are the ones that we really track the numbers on. And so, we're anticipating that over the next few weeks those numbers are really going to continue to climb here locally,"