AUGUSTA — Four more Mainers died in the past week from influenza, bringing the state’s total flu deaths this season to 28, according to numbers released Wednesday by the Maine Center for Disease Control.

There have been no pediatric influenza deaths this season, according to the report.

In Maine and across the nation, the influenza outbreak continues to spread in what experts say is one of the worst years for flu cases.

In the last week, 538 people in Maine tested positive, bringing the statewide total to 2,307 influenza cases.

In Androscoggin County, 50 cases tested positive in the last week, one requiring hospitalization. That brings the county’s season total to 184, with 28 requiring hospitalization.

In Franklin County, there have been 14 new cases in the last week, bringing the total to 88. Of those, three were hospitalized.

In Oxford County, there have been 23 new cases bringing the total to 86, with 30 needing hospitalization.

Central Maine Medical Center is seeing “lots of admissions around this in all age brackets,” Peter Tilney, co-director of the Department of Emergency Medicine, said Wednesday in an email.

Patients are showing symptoms that include fever, malaise, weakness and body aches, Tilney said. The hospital is also seeing patients with secondary infections, some critically ill with pneumonia and the flu.

Dr. Dora Anne Mills, former director of the Maine Center for Disease Control, now vice president of University of New England’s Clinical Affairs, said so far Maine is lagging behind the rest of the country in terms of the outbreak, “but it is heating up.”

People need to remember that every year influenza is a serious infection and a threat to public health, she said. “This season is worse than most.”

Symptoms include severe aches all over, respiratory symptoms and a fever. Unlike a cold or stomach virus, people with influenza feel very weak, Mills said. “You’re down for the count on the couch, a good place to be.”

Those most at risk are younger than 5, 50 or older, pregnant or dealing with chronic disease, such as asthma.

Doctor’s advice:

If you have symptoms, call your doctor, especially people in the high-risk categories listed above. Tamiflu, a prescription medication, helps shorten the duration especially when taken during the first 48 hours.

Getting medical help early is especially important for children, said CMMC’s Tilney. In children symptoms include fast breathing or trouble breathing, bluish or gray skin color, not drinking enough fluids and not producing the normal amount of urine, severe or persistent vomiting, not waking up, or being so irritable that the child doesn’t want to be touched.

Another worrisome sign is if symptoms improve, but then return with fever and a worse cough.

To avoid getting or spreading influenza, wash your hands – often. The virus can live two to four hours on regular surfaces, Mills said. After shaking hands, touching doorknobs or pushing elevator buttons, wash your hands well with soap for 30 seconds, long enough to sing “Happy birthday.” Keep your hands off your face. Don’t touch your eyes, mouth or nose.

How long is someone contagious? People with influenza should stay home and not return to work or school for at least 24 hours after the fever goes away. Those with the flu can infect others from one day before getting sick, to up to five to seven days afterward, Tilney said. Severely ill people, or young children, can spread the flu longer, especially if they still have symptoms.

Get a flu vaccine if you haven’t already. “It’s never too late,” Mills said. The flu shot is 30 percent effective in preventing H3N2, but it also decreases the severity if someone comes down with it, so the vaccine is more powerful than just the 30 percent. Of the children who have died from influenza in past years, “80 percent were unvaccinated,” Mills said.

The influenza going around now is H3N2. “But we might be seeing another peak later in the season with the B virus.” This year’s vaccine is very effective against the B and H1N1 strains, Mills said.

Flu shots protect others. The influenza vaccine not only protects you and your loved ones, but others with whom you come into contact. Anyone walking through the mall who is coming down with influenza  is contagious and poses serious risks to those who are weak, Mills said. If running into someone who, for instance, is undergoing chemotherapy, “you can be like a bullet,” she said.

The influenza season typically runs the length of the professional hockey season — October through April.

Dr. Dora Anne Mills, former director of Maine Center for Disease Control and now vice president of clinical affairs at the University of New England, say to avoid getting influenza, she has gotten a flu shot, thoroughly washes her hands often and does not touch her face. (Sun Journal file photo)