It can start with a bit of a headache, a tired and achy feeling, a slight cough. Within hours, the mild discomfort explodes into a hit-by-a-Mack-truck sickness, with fever, chills, painful body aches and coughing so violent it can break ribs.

Welcome to flu season.The season appeared to start early this year, but is expected to peak this month and next. The illness is hitting hard: Flu is widespread in Pennsylvania, according to the state Department of Health. So many people have flocked to hospitals with flu-like symptoms. Lehigh Valley Hospital has set up tents at its Salisbury Township campus to handle the overflow.Last week, flu-related illnesses accounted for 3 percent to 40 percent (median 4.7 percent) of all emergency department visits reported by sentinel hospitals, according to the website. Between Oct. 2 and Jan. 5 there were 87 cases diagnosed in Carbon County, 89 in Monroe County, and 132 in Schuylkill County, according to the Department of Health.Health officials point out that these are only a fraction of the actual number of cases - most people showing up at doctors' offices and hospitals with flu-like symptoms are not tested for the virus."We estimate that between 5 and 10 percent of the population gets the flu each year, which for Pennsylvania represents 600,000-1.3 million persons annually. The CDC estimates suggest that 180-2,000 Pennsylvanians die of flu-related complications every year, with most of these deaths occurring in those over 65 years of age," the state Department of Health website says.The illness is not to be taken lightly. Complications of flu can include bacterial pneumonia, ear infections, sinus infections, dehydration, and worsening of chronic medical conditions, such as congestive heart failure, asthma or diabetesSo far in Pennsylvania, 22 people have died from flu. Locally, two deaths have been attributed to the flu, an 80-year-old woman who died at St. Luke's Miners Memorial Hospital, Coaldale, and an infant at Lehigh Valley Hospital, Lehigh County.Flu vaccinesCDC findings suggest that this season's vaccine so far is reducing the risk of having to go to the doctor for influenza by about 60 percent for vaccinated people.Health care providers urge people to get vaccinated against the flu. The vaccines are typically available at drug stores and from one's family physician. However, some local chain drug stores have been running short on the vaccines.Blue Mountain Health System is offering free flu shots to those over age 13, available by appointment only with its Workforce Wellness department. The department can be reached by calling (610) 377-7269, said spokeswoman Lisa Johnson.St. Luke's Miners Memorial Hospital, Coaldale, Kathy Matika, manager of Infection Prevention and Employee Health, and spokeswoman Denise Rader said that vaccines are available at the St. Luke's University Health Network's off-site facilities in Nesquehoning (570) 669-9787, Hometown (570) 668-6111, and McAdoo (570) 645-1880.People are asked to call the centers, and ask if the vaccines are available for adults or children. The vaccines are free for under or uninsured children. Adults are asked to check with their insurance providers. Rader advises people to check first with their primary health care provider for the vaccine. If they don't have a primary care physician, the centers are accepting new patients.Stop the spreadIt's important to get the vaccine, and to follow recommended safety procedures to avoid spreading the illness.According to the CDC, you may be able to pass on the flu to someone else before you know you are sick, as well as while you are sick. Most healthy adults may be able to infect others beginning one day before symptoms develop and up to five to seven days after becoming sick. Some people, especially young children and people with weakened immune systems, might be able to infect others for an even longer time.Local hospitals are imposing restrictions on visiting. Blue Mountain Health System's nursing and rehabilitation center, The Summit at Blue Mountain, is currently closed to visitors. No children under age 12 are permitted to visit patients in Gnaden Huetten and Palmerton hospitals, and adult visitors are asked to wear disposable respiratory masks.St. Luke's Miners Memorial Hospital has no restrictions in place. However, Rader advises people who have flu symptoms or other illnesses to not visit hospital patients.