Duke University Health System has restricted visitation to immediate family members and those over 18 who are healthy in response to rising cases of the flu.

A recent spike in the number of patients afflicted by the flu prompted Duke to take measures to stop the spread of the virus. The limitations were catalyzed by the high rates of infection and abnormally early start to the flu.

Although such restrictions have been instituted in past years, this season’s flu activity is the worst the state has seen in the past decade, according to a North Carolina Department of Health press release published Dec. 21. So far, 14 North Carolina residents have died from the flu—a “very unusual” occurrence, according to the department.

“We would [institute limitations] in any season where we really want to minimize transmission in the hospital,” said Dr. Cameron Wolfe, clinical associate in the infectious disease department of Duke Medicine. “It’s a step you don’t take lightly but it’s certainly something we do at times when the community is sick as a whole.”

Not only has this year’s flu season been more severe, it also struck earlier.

“Typically the flu really only kicks off about now and peaks in the first week or two of February,” Wolfe said. “[This year] we started seeing a big rise in early December, and even by late last week, we saw rates [of flu infections] that are higher than the past four or five years.”

Across the nation, 43 of the 50 states are reported to have “widespread” influenza activity, according to the Centers for Disease Control and Prevention.

Despite the severity of the flu, it is not a new strain like the pandemic H1N1 virus, commonly known as the swine flu, that prompted concerns in 2009, Wolfe said. Still, concern is especially high for the flu to spread in the tightly packed Duke residential halls.

“The best incubation for any virus is the student dormitories,” he said. “Since the flu is a respiratory virus, the only way it enters your system is through an airway or your eyes, often when we rub them with our hands.”

He noted several steps Duke students can take to ensure they stay healthy this winter. For one, washing hands can limit the spread of the flu by destroying the virus that can otherwise live on hands for several hours. Students can also avoid sharing utensils with dorm-mates and covering their coughs. Although the Triangle is already well into the throes of flu season, a vaccine can still be beneficial and provide protection in the coming weeks sincethe immunity it contains is effective against this year’s disease.

“We were able to see it [in Europe and other countries], predict that it would be here, and therefore we were able to put it into the vaccine,” Wolfe explained.

He urged any student who has not yet been vaccinated to get the free shot through the Student Health Center on West Campus.

Kevin Sowers, president of Duke Hospital, and Doug Stokke, assistant vice president for communications at Duke Medicine, could not be reached in time for comment.