GALVESTON, Texas -

Public health officials said the flu has killed at least four Galveston County residents.

"We did put something out in mid-December asking providers to report them if they had any," said Galveston County Health District Public Information Officer Kurt Koopmann.

He said it is not mandatory for health care providers to report flu deaths.

He told Local 2, "We have seen a pretty active season. And the activity kind of ramped up sooner than what we normally see. And as of this point, we have had four reported flu deaths."

The Centers for Disease Control said the number of states with reported flu cases are up.  Thirty-five states now report flu cases.  That is up 10 states from the week before.

Health officials said the deaths reported from the flu in Galveston County have ranged in age from 55 to 72.

Despite the spike in cases, infectious disease specialists said this is typical for a flu season.  The dominant strain has been H1N1.