GOLDEN VALLEY, Minn. - Health officials say the flu season is off to an early start in states neighboring Minnesota.

The Minnesota Department of Health doesn’t officially start tracking cases until October, but they are hearing about reports that the illness is already showing up in numbers that are close to what other states like Wisconsin, Iowa and the Dakotas are seeing.

In Wisconsin, officials say from the start of the month through Monday there have been 19 confirmed cases of influenza in the state. Eight people have been hospitalized. In 2016 during this time they only saw five cases.

North Dakota health officials say they have confirmed nine cases so far this month, including four in counties that border Minnesota. Three of them were across from East Grand Forks. The other was near Fergus Falls.

Iowa has also seen “a handful of flu cases” this month,” officials there say.

Minnesotans who wish to be immunized should do so “as soon as possible,” said Health Department spokesman Doug Schultz. Once vaccinated, it takes up to two weeks for the vaccine to reach full effectiveness.

Joe Kurland, a Vaccine Specialist and Infection Preventionist with Children’s Minnesota. He says that they have seen a case or two as well and have heard of a few others in Minnesota.

He recommends that people get the flu as soon as it becomes available. He says experts typically recommend that you get the shot before the end of October.

Kurland says the shot will protect you through the peak months of October through March. However, he says the shot takes about two weeks before it works.

Experts also recommend that for kids between 6 months and 8 years old, if they haven’t had the flu shot before, they should get two shots, one right away and then the second shot about four weeks later. He says this is a standard recommendation.

Also, people who are 65 and older, they should get a “higher dose” shot that will take into account their aging immune system. He says physicians and medical providers should know what this is and should be able to help seniors get it.

Studies over the last few years showed that the nasal spray isn’t as effective as the shot. Therefore, the spray will not be available this year. He says you won’t even be able to get it in the U.S. this year.

As far as this flu season outlook, Kurland says it’s too early to tell but early signs show that the vaccine should be adapt to handle this year’s strains of flu. He says every year scientists try to match the vaccine to the latest strain and he says they were able to get a good match this year.