Flu season started with a bang this year, ahead of schedule and stronger than usual.

The season arrived earlier than it has since 2003, and two people in Pierce County have died of the flu, according to the Tacoma-Pierce County Health Department.

The peak of the flu season is typically later, from January to March, but local hospitals and pharmacies have seen increased volume and demand for treatment since mid-December.

The premature spike in flu patients this year is a nationwide trend.

“This year it hit earlier, and very hard right at the beginning – unfortunately, during the holidays, when there was plenty of opportunity for the flu virus to spread,” said Mary O’Brien, a physician at MultiCare Gig Harbor Urgent Care.

One hundred seventy-three flu cases were identified in the first week of January, from patients tested at MultiCare facilities around the Puget Sound region. Last year, the health system averaged 47 flu cases per week during the season’s typical high point in March.

O’Brien said patients of all ages had gone to urgent care for flu treatment.

“It was an equal-opportunity virus,” she said.

The same has been true at St. Anthony Hospital, where associate administrator Kay Bay estimated there has been a 15 to 20 percent increase in volume, both in the emergency department and with in-patient care, over most years.

“We just don’t usually see this kind of impact until at least February,” Bay said.

Bay said the St. Anthony staff has had to adjust to compensate for the high number of flu patients.

“The staff has done a phenomenal job of manipulating the schedule, covering for one another and splitting shifts,” Bay said.

MultiCare increased its staff early on in the season, O’Brien said, in an attempt to combat the flu outbreak. Extra nurses and assistants have been brought in to help move patients through the hospital more quickly.

“There’s nothing worse than being sick and then having to sit around and wait,” O’Brien said.

MultiCare staff members also have been asking all incoming patients if they have been vaccinated against the flu this year, and they’ve offered a vaccine if the patients hadn’t had one.

St. Anthony has offered flu shots to some patients since September, if it was deemed necessary following a screening process.

This flu season also has seen an uptick in post-influenza complications, including pneumonia. Groups normally at greater risk for the flu, such as children, seniors or people who have pre-existing medical problems, including diabetes, asthma or heart disease, are most at risk for such complications.

Other viruses, including a gastrointestinal virus that can cause intense nausea, have been seen at a higher rate this season, Bay said.

Both medical centers have been prescribing antiviral medications, such as Tamiflu, to high-risk individuals. Antivirals can shorten the course of a virus and make it less likely that the patient will develop complications. It is recommended that a high-risk patient start an antiviral course within 24 to 30 hours of coming down with the flu, O’Brien said.

Antiviral medications also are available through primary care providers.

“For some patients, they truly can be life-saving,” Bay said, citing those who have chronic respiratory conditions as an example of a group at risk for complications from a longer bout with the flu.

The flu increase, and its coverage in the media, have also led to more traffic at pharmacies which provide flu vaccinations.

“It’s been busier, because of the outbreak on the news,” said Ken Cox, a pharmacist at Safeway on Point Fosdick Drive NW.

Lisa Meisner, a pharmacist at the Point Fosdick Drive Rite Aid, reported the same.

“With the news reports over the past few weeks, there’s definitely been a surge more than we usually see,” she said.

In addition to injections, Meisner said her pharmacy was offering anti-flu nasal spray, another way to vaccinate against the flu. The spray is available for people ages 2 to 49 without other medical conditions.

Women who are pregnant cannot use both the spray, because it carries a live flu virus, or receive a flu shot, because of state law that prohibits injections with preservatives for expectant mothers.

“Unfortunately, we have that at-risk population that we can’t serve right now,” Meisner said. “Everyone else is good to go.”

O’Brien stressed that flu shots, which contain traces of the flu virus, can’t transmit the flu, although, because they can take two weeks to take effect, people can still get sick after they are vaccinated.

She said this year’s high number of flu patients underscores the importance of getting a flu shot, especially because many of her patients this year have come from typically low-risk groups.

“Often, those are the people who don’t get vaccinated,” O’Brien said. “Those are the people from whom we hear, ‘Oh, I never get the flu.’ ”