Hundreds of patients with flu-like illness have crowded emergency rooms at Twin Cities hospitals this week, the latest sign of an early and aggressive start to the influenza season.

East metro hospitals briefly closed their emergency rooms and diverted ambulances to other hospitals, and Regions Hospital in St. Paul converted a clinic into an overflow area so it had room for all of its ER patients.

Regions had 29 cases of flu-like illness in its ER on Thursday, and more than 100 cases since Monday. Children’s Hospital in St. Paul reported 215 patients on Sunday, a record 24-hour volume, due in large part to flu cases. Children’s Hospital in Minneapolis set an ER record the following day.

“Flu is here,” said Patsy Stinchfield, an infectious disease expert for Children’s. “It has hit hard.”

Some of the surge is due to patients who are acting based on caution or because of news reports of a harsh flu season, officials said, and are at low risk for serious complications.

But Regions also has filled its inpatient beds with high-risk patients with breathing problems and other complications, said Dr. Bjorn Peterson, a Regions ER physician. “We’re not necessarily seeing any more people in the ER than we normally would,” Peterson said. “It’s just that we don’t have anywhere to move them. … It’s just backed up throughout the system.”

The Minnesota Department of Health on Thursday declared flu widespread in the state, and reported 185 flu-related hospitalizations as of Dec. 6. While that designation is normal in most flu seasons, it typically doesn’t occur until January — after the traditional holiday germ-swapping at family gatherings and end-of-year parties.

The state also reported 19 schools with flu-like outbreaks last week. Stinchfield said she has heard reports of more than 80 schools making such announcements this week, but the exact count won’t be known until the state Health Department’s next flu report on Dec. 18.

Tracy Holtan of Edina has been worried all week about her 13-year-old daughter, Isabella, whose symptoms included severe dizziness and at one point delirious speech. She took her daughter Tuesday to the University of Minnesota children’s hospital.

“As we were sitting in the waiting room,” Holtan said, “Bella said it felt like the room was spinning and she felt the worst she had ever felt.”

Alternatives to the ER

Holtan urged the doctors to conduct a flu test — which isn’t routine because the result doesn’t necessarily alter the way doctors will treat the symptoms — and said it ended up positive for influenza A. Her daughter’s fever has broken, but she remained weak and coughing on Friday.

“Bella is my third and youngest child so I’ve seen almost everything,” Holtan said. “I’d never seen anything like this.”

Because of the ER backlog, doctors are encouraging people at lower risk of flu complications to consider alternatives for care. That includes nurse hot lines and online clinics such as HealthPartners’ Virtuwell, where patients can get expert advice without exposing others to the virus.

While antibiotics can treat bacterial strep infections, there are no comparable medications for viral influenza infections. One option is the drug Tamiflu, but it must be given within the first three days of illness and it is generally conserved for people at higher risk of complications from infection — a group that includes the elderly, children 2 and younger, and adults with chronic illnesses.

“For everyone else, you really just need to try to ride it out at home — as miserable as you might be,” Peterson said.

Part of the problem this season is that an A strain of influenza that is circulating is poorly matched to the vaccine, and is also known to cause more severe illnesses, particularly in the elderly and in young children.

But Stinchfield noted that the vaccine is still available and offers some protection. “If (people) haven’t gotten the vaccine yet, it’s not too late at all.”