( CNN ) -- Five more states reported widespread flu activity during the second week of January , according to the Centers for Disease Control and Prevention , bringing the total to 40 states . Only 10 states are not yet reporting widespread activity : Alabama , Arizona , Florida , Hawaii , Iowa , Massachusetts , Mississippi , New Hampshire , South Carolina and Vermont . `` Widespread '' means that more than 50 % of geographic regions in a state -- counties , for example -- are reporting flu activity . The designation addresses the spread of the flu , not its severity . However , the number of states experiencing a high proportion of outpatient visits to health care providers for flulike illnesses is 14 -- Alabama , Arkansas , Idaho , Kansas , Louisiana , Mississippi , Missouri , Nevada , New Mexico , Oklahoma , Oregon , Tennessee , Texas , and Virginia -- down from 20 in the previous week . Ten children died from complications of the flu last week , bringing the pediatric death total for the season to 20 . The CDC does not have data on the number of adult flu deaths . Experts estimate the number of flu-related deaths range from as low as 3,000 to as high as 49,000 people each year . Typically , the flu season begins in the winter months and peaks in January or February , according to the CDC . But it 's way too early to know if flu has peaked yet this year . `` As typical of a flu season , some areas are being harder hit than other areas , '' said CDC spokesman Tom Skinner . H5N1 kills first person in North America . One of those areas is California . Dr. Gil Chavez , deputy director for California 's Center for Infectious Diseases , said 45 people under the age of 65 have died during the 2013-2014 flu season , which began in September . This includes two deaths in children . `` An additional 50 deaths are currently being investigated and are likely to be confirmed next week , '' Chavez said . He said that a year ago , only five deaths had been reported at this time ; there were only 106 flu deaths during the entire 2012-2013 flu season . `` H1N1 is the predominant virus circulating , and we do know when H1N1 predominates , there appears to be more fatalities , '' Chavez said . `` We seem to have a predominance of a more deadly strain . '' H1N1 is the same virus that caused a pandemic in 2009 , Dr. Michael Jhung , a medical officer in the CDC 's flu division , has said . It was dubbed swine flu because it was being seen for the first time in humans . Since then , `` it 's established itself very nicely in the human population , '' Jhung said . H1N1 has been seen every season since 2009 in people and is no longer referred to as swine flu . The strain is so common that it was included in this year 's vaccination , he said . Adult flu deaths are not required to be reported to the CDC , but the government agency must be notified of any flu deaths in children . However , after H1N1 first surfaced , California health officials determined this was not enough . Chavez said the lesson learned then was that `` we needed a better way to determine the impact [ of flu ] on the community . So we in California made the decision to make deaths due to influenza in individuals under 65 mandatory to report . '' What consumers need to know is that it 's not too late to take steps to protect yourself from getting the flu , said Dr. Susan Rehm , medical director for the National Foundation for Infectious Diseases . `` People who are young and healthy should be aware that they may get the flu and it could be serious , '' Rehm said . One of the reasons people often say they do n't get the flu vaccine is because they do n't get sick . That excuse does n't hold up , she said . In addition to getting the vaccine , which can prevent flu -- or at least lessen symptoms , washing your hands frequently and staying home when you 're sick can help you get through the flu season . Doctors recommend using antivirals within the first two days of experiencing any flulike symptoms . Does cold weather cause colds ? CNN 's Ashley Hayes contributed to this story .
40 states reported widespread flu deaths during the second week of September . H1N1 is the predominant strain circulating , which is a deadlier strain . It 's not too late to take steps to protect yourself from catching the flu , says Professor Susan Rehm .