Local healthcare providers are seeing a spike in influenza cases, as numbers across the state have doubled in the last two weeks.

North Dakota Department of Health officials Thursday reported 156 confirmed cases. Burleigh and Morton counties combined for only five, but area healthcare providers say cases are on the rise. Medcenter One Health System officials said their numbers doubled this month, while a doctor at St. Alexius Medical Center said he is seeing about two cases a day.

State health officials expect cases to continue to rise through the rest of the month.

"People travel over Christmas and pick the flu up and bring it back here," said Dr. Tom Magill, St. Alexius emergency room doctor. "People are out and about. That's when it tends to spread."

Vaccine eligibility restrictions are expected to further loosen in some areas of the state because the health department is purchasing public health sector vaccine and redistributing it, Magill said. Grand Forks is the only confirmed area expected to receive the vaccine.

"Right now that's the only request we've had," said Larry Shireley, state epidemiologist.

Healthy people who want a flu shot should contact their local health provider to see if vaccine is available, Shireley said.

Bismarck-Burleigh Public Health has vaccine, but it's limited to people with underlying medical conditions, pregnant women, people 50 and older, children 6 to 23 months, caregivers and those who live with high-risk people. Director Paula Flanders said FluMist is available for healthy people ages 5 to 50.

Custer District Health in Mandan ran out of its 1,000 vaccine doses in December.

Custer and Bismarck-Burleigh held their first shot clinics in December after receiving more vaccine. Prior to that, flu shots were only available through private healthcare because of a severe shortage that hit when British officials shut down a vaccine provider.

Flanders was surprised that a majority of people vaccinated at the clinics were eligible before, but forwent their shot to make sure there was enough for others.

"People really start thinking if they haven't gotten the flu by now they don't need to be vaccinated, although the North Dakota flu season is just starting to pick up," Flanders said.

North Dakota's flu season typically peaks in January or February, Shireley said. Last year, the state had 1,663 confirmed cases and 400 influenza-related deaths, with the season peaking in December.

Magill said most people he has seen have symptoms including high fevers, sore throats, coughing and body aches. People with those symptoms should take precautions against spreading the illness, such as washing their hands, covering their mouths and noses and staying home.

"Once you start seeing the cases it will start spreading," Magill said. "You start seeing more and more of it as more people start getting affected."