2018 thus far has had a bad case of the flu, and the Center for Disease Control (CDC) reported that this season is especially intense. The flu has already spread throughout the country and claimed a number of lives, including 20 children.

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Two of the main ways the CDC gauges how bad a flu season will  be are through looking at the proportion of people who go to their doctors for treatment and the rate at which people are being hospitalized. The rate of people rushing to see their doctors has already hit 5.8 percent, which is about as high as the number gets during the peak of the flu season, reported NPR. According to the CDC, the rate of hospitalization has almost doubled within the last week to 22.7 for every 100,000 hospitalizations.

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“Flu is everywhere in the U.S. right now,” said Dan Jernigan, director of the CDC’s influenza division, according to NPR. “There’s lots of flu in lots of places.”

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The outbreak has caused a number of schools to be closed in Alabama, Idaho, North Carolina, Tennessee and Texas. The CDC said that high flu activity has been reported in Alabama, Arizona, Arkansas, California, Colorado, Georgia, Illinois, Indiana, Kansas, Kentucky, Louisiana, Mississippi, Missouri, Nebraska, Nevada, New Jersey, New Mexico, Ohio, Oklahoma, Oregon, South Carolina, Texas, Virginia, Washington, West Virginia, Wyoming and New York City.

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This year’s most common strain is influenza H3N2, which the CDC reported as more severe compared to other strains. Although it has not been very prevalent in the past couple of years, when this strain occurs it causes more cases in general as well as more hospitalizations and deaths.

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The CDC does not recommend the use of nasal spray for the 2017-2018 season with an injectable shot being the only recommended prevention method. For the first time, the vaccine is cell-grown as opposed to egg-grown, meaning the viruses were grown inside of animal cells. A study in Australia found that the vaccine may only be 10 percent effective against this year’s flu, but Dr. Daniel B Jernigan, director of the Influenza Division in the National Center for Immunization and Respiratory Disease (NCIRD) at the CDC, said that this estimate does not necessarily apply to the U.S.

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“The 10 percent is a very low estimate that came out of Australia over their season last summer,” he said, according to ABC News. “The same kind of virus that we had last year was around 30 percent to 33 percent effective for the H3 component. It’s actually more effective for the other parts of the vaccine that are trying to prevent the other flus circulating.”

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Anyone who thinks they may have the flu is advised to use antiviral drugs within 48 hours of the first symptoms to prevent serious complications, according to ABC News. This is particularly important for those in high risk groups, including children younger than 5 and adults over 65.

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In order to focus more attention on the flu, the CDC delayed their nuclear-preparedness teaching session that was prepared in light of the recent tension between President Trump and North Korea.

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In general it is recommended that those with the flu shy away from school and work to prevent further spreading of the disease. To prevent catching the flu, CDC recommends more frequent hand washing, keeping hands away from the eyes, nose and mouth and regularly disinfecting surfaces and objects that have the possibility of being contaminated.