With more influenza illnesses spreading across the country, Minnesota health officials said Monday they expect the state’s caseload to increase as people travel during the holiday season.

The Centers for Disease Control and Prevention (CDC) in Atlanta said late last week that recent increases in flu activity “have signaled the start of the 2018-2019 influenza season.”

High or moderate flu activity is being reported in New York City and 11 states, with the worst outbreaks in Colorado and Georgia.

“The chance that our influenza activity will pick up after the holidays is certainly very likely,” said Kris Ehresmann, director of the infectious disease division at the Minnesota Health Department. “It is a great opportunity for mixing and sharing germs.”

So far, 69 Minnesotans have been hospitalized with influenza, a pace that lags last year’s season, which was among the worst in the past eight years.

Clinics are seeing a spike in people with influenza-like illnesses, which can include those infected with the flu virus as well as those with upper respiratory infections. Among clinics that report data to the state, 2.8 percent of all outpatient visits were for flu-like symptoms.

“We have definitely started to see flu increase as well as all the other sinus, viral and respiratory infections,” said Jen Schomaker, a nurse practitioner and care delivery supervisor at virtuwell.com, an online clinic owned by Bloomington-based HealthPartners.

“Especially over this weekend we are starting to see the uptake of people traveling and seeing family and sharing those germs,” she said.

The influenza virus can spread by air as well as touching infected surfaces.

“In the short term, the best thing to do is make sure that you are washing your hands, trying to get rest and trying to take care of yourself,” Schomaker said.

The flu typically comes on fast, with a fever, headache, chills, muscle aches and fatigue. Colds tend to develop slowly and last longer with many of the same symptoms, but usually not a fever.

“Both are viruses, so there are no antibiotics that are going to take care of the common cold or the flu,” said Schomaker. An antiviral, such as Tamiflu, can help relieve the symptoms of flu and is recommended for young children, the elderly and those with weakened immune systems.

Flu has the potential for serious complications, which is why health officials recommend that everyone over the age of 6 months get a flu shot.

Last year, 62 percent of Minnesota children from six months to 17 years received the flu shot.

“It is still not where we want to be and when you talk about pediatric deaths we want to make sure that we get kids protected,” said Ehresmann.

Last year Minnesota saw 435 flu-related deaths, which was the most in several years. Five pediatric deaths were among those.

In addition, nearly 6,300 people were hospitalized last season because of the flu, compared to 3,700 in the previous season.

Each flu season is different, with most deaths last season occurring in late January. In the previous season, the number of deaths spiked after February.

So far this season, 20 outbreaks have been reported in schools and just one outbreak among long-term care facilities.