The Pennsylvania Department of Health announced Monday that flu is now widespread in the state and has caused five deaths.

Rachel Levine, secretary of health, urged people to get flu shots. She said that is especially important before families gather for the holidays, as it takes two weeks for the vaccination to become fully effective.

The flu vaccine is recommended for everyone above the age of 6 months.

As of Nov. 30, there had been 2,667 laboratory-confirmed cases of flu in the state, but not all cases are reported.

Influenza is a viral illness that typically comes on suddenly. Symptoms include fever, headache, fatigue, dry cough, nasal congestion, sore throat, and body aches.

According to the U.S. Centers for Disease Control and Prevention, flu activity has been elevated for the last month and is increasing.

The New Jersey Department of Health is reporting moderate but increasing flu activity, with one fatality last month.

A CDC chart of patient visits for flu-like illnesses shows the season seems to be off to an earlier start than in recent years. Reports of influenza-like illnesses are highest in the south and still relatively low in the northeast.