Cover your cough, get out the hand gel, and — if your doctor says so — get a flu shot if you have not done so already. The flu virus is spreading here and across the country.

According to the national Centers for Disease Control and Prevention, Rhode Island is one of 44 states reporting widespread activity as of Feb. 9. People are flocking to local emergency rooms, walk-in clinics, and doctor’s offices.

“We’ve had 164 patients come into the emergency department between January 27 and February 17,” said Rhode Island Hospital spokeswoman Nancy Cawley.

Miriam Hospital in Providence reported a similar spike.

“We’re having a huge surge, all of a sudden,” said spokeswoman Megan Martin. “The past three years haven’t really been that big, but this year there’s a lot of flu.” She added, “It started getting steady in January, and from mid-January to February we started to see a big pick-up. Most aren’t admitted” to the hospital. The sickest are generally getting intravenous fluids “and going home.”

According to the CDC, a standard treatment is antiviral drugs, particularly in severe cases. Secondary bacterial complications are often treated with antibiotics. The rest is tried-and-true common sense: bed rest and drinking a lot of fluids. People are encouraged to use hand-gel sanitizers and cover their mouths when they cough, to protect others.

Dr. David R. Gifford, the state health director, said the past two weeks have been marked by “a significant increase in individuals with influenza-like symptoms, and people testing positive for influenza. We reported to the CDC [Centers for Disease Control] that we’re seeing influenza widespread throughout the state.”

Gifford said the Health Department monitors emergency rooms, clinics, hospitals, schools, nursing homes and other locations for confirmed flu cases or flulike symptoms. It is “general surveillance,” not a track of individual cases.

Some of the increase may be attributed to a less-than-perfect match of this year’s flu vaccine to the current strains of flu virus. And some may just be the cyclical nature of the virus, said Gifford.

The CDC tracks yearly data and looks at the match of the vaccine and circulating strains of influenza, and bases that year’s formula “on what are the most likely strains of influenza,” said Gifford. (This year’s formula was chosen one year ago, according to the CDC Web site, www.cdc.gov).

By design, of the three strains contained in a trivalent vaccine, “one is most perfect match; one is 50-50 match; and one is a poor match. What we are tending to see in Rhode Island and across the country is the strain that has the 50-50 match,” Gifford explained.

Regardless, the vaccine will still have some effect, said Gifford. If you have had a shot, he said, “you may still get the flu, but it will be shorter in duration.”

“What we’re seeing is that those who got the vaccine, the symptoms are lasting three to five days,” compared with the average 7 to 10 days, said Gifford. “It’s too early to say whether they are having symptoms of less severity.”

He also said that getting a yearly flu shot can build immunity over the long run.

“In the last few years we’ve had very mild years of influenza,” said Gifford, but the outbreaks tend to follow cyclical patterns of rise and fall. During those times, “people get complacent and we started seeing the vaccination rates going down,” he said. “This is a reminder that you can’t predict” the level of flu in any given year.

“Even when some strains aren’t picked [for the vaccine], there is still some cross-reactivity. That’s an important message. People think, ‘Oh the vaccine doesn’t match, why get it?’ Getting it every year helps build your immunity.”

He said there is still vaccine available and for those in high-risk categories, and children, it is not too late to get a shot. Vaccinating children “is really important,” he said.

Gifford said, “People joke how daycare centers are like little petri dishes” for incubating a virus, and there may be some truth to that. “There is growing data to suggest that [children] are the vehicle for how a lot of these viruses, particularly influenza, get spread around.”

Now that it’s school vacation week, he encouraged parents to get shots for their children.

The Health Department generally urges people to get flu shots if they are 50 years or older; have chronic cardiovascular or pulmonary disorders, including asthma; have a chronic metabolic disease (including diabetes) or immunosuppressive or immunodeficiency disorder; have a medical condition that can cause breathing problems; are pregnant, or are a health-care worker involved in direct patient care. Children between the ages of 6 months and 5 years are also encouraged to get a flu shot. A quick poll of local emergency rooms and walk-in clinics suggests that many are on flu overload.

“We’re very, very busy now with [people with] flulike symptoms,” said Christine St. Hilaire, administrator at the East Providence Medical Center. She said that increase has been over the past two weeks, and is a “complete mix” of every age group, but especially children and the elderly.

“They’re being treated with a variety of medications,” and told to rest and drink plenty of fluids.

“Oh my goodness, we’re seeing a lot of folks,” said Dr. Daniel Halpren-Ruder of the Urgent Medical Care walk-in clinic in Smithfield. Some have “flulike symptoms,” and others are testing positive for flu viruses, he said.

“My gut feeling is, and I don’t keep exquisite numbers, that we’re about 10 or 15 percent more” in flu cases this year, said Halpren-Ruder. The clinic is now seeing 75 to 80 patients a day, over the usual 55 to 60 patients.

He attributes “the vast majority of that incremental number” to flu.

Asked about this year’s less-than-perfect match of flu vaccine to flu strain, Halpren-Ruder said, “It’s a best guess by some very good minds, and it is still is a best guess. The virus is free to morph — and often does morph … so we do the best job we can but it’s a really a crapshoot as to whether they get it right. They get it right about 90 percent of the time, or 80 percent of the time.”

That, he said, “is not bad.”

The Rhode Island Department of Health is still offering flu shots. For information call (800) 942-7434, or visit the Web site, www.health.ri.gov.

VNA of Care New England will be holding two additional flu clinics, open to the public, on Tuesday, Feb. 26 from 9 – 11 a.m., at the Coventry Senior Center, 50 Wood St.; and in Warwick on March 5 from 1-3 p.m. at the Pilgrim Senior Center, 27 Pilgrim Parkway. For information, call (401) 737-6050.

kziner@projo.com