Gifts may not be the only thing exchanged this holiday season: Influenza has arrived in Utah, and lots of people are sneezing and coughing and feeling genuinely miserable — then passing it on.

So far, 37 people have been hospitalized with severe influenza, which arrived just in time for maximum exposure at area malls, school pageants and family gatherings.

"This is the beginning of the intense flu season," said Susan Mottice, epidemiologist in the Utah Department of Health. "Our sentinel data indicates we have widespread influenza activity."

The map posted and updated weekly at shows a band of elevated flu activity centered mostly along the Wasatch Front.

The Utah County Health Department over the past two weeks has received scattered reports of people testing positive for influenza at doctors' offices and clinics, said spokesman Lance Madigan.

"The flu has definitely arrived in Utah County," Madigan said.

The county's first hospitalization of the flu season was reported last week, he said.

Madigan advises Utah County residents who haven't yet been vaccinated for the flu this season to do so.

"Unlike some areas, we still have flu shots (available)," he said. "Some people think it's too late to get a flu shot, and that's not the case. It's still very useful to get the flu shot and try to nip that in the bud."

"Our volume jumped significantly two weeks ago and again dramatically this week," said Mike Gibbons, nurse manager at the LDS Hospital emergency room.

At Primary Children's Medical Center, they're seeing a definite but expected uptick in influenza and other respiratory illnesses. "We're definitely not peaking yet," said Bonnie Midget, spokeswoman.

University Hospital always sees more flu-like illnesses this time of year, said Chantelle Turner, a hospital spokeswoman, and this week has been no different. It's especially common, she said, when there's a warm spell amid the cold. That tends to boost spread of the illness.

"We're seeing respiratory complaints, fever, etc. There are strep throats and influenza cases," as well as a flu-like illness that tests negative for influenza but includes a high fever, Gibbons said. As for the age of patients, "it's all over the board."

Health officials say the best treatment is prevention in the form of a flu vaccine, still available although you may have to shop around a little, Mottice said. "My advice if you haven't gotten one is: Don't wait any longer."

That's especially important, she said, for those who are planning to go to large family gatherings over the holidays. The risk of giving influenza to someone who's at high risk of complications — including those younger than age 2, those older than 65, pregnant women and individuals with chronic diseases — is especially great this time of year. The health department says people who are sick should skip holiday gatherings completely, for everyone's sake.

Most people who go into the emergency room are not being admitted. Instead, they are given an antiviral that has been proven to reduce symptoms and slightly shorten duration of influenza. But that drug has to be given almost immediately after someone gets the flu in order to have an effect, Mottice said.

Besides getting a vaccine, everyone needs to practice respiratory etiquette, she said. Carefully cover all of your coughs and sneezes with either a tissue (then throw it away) or the inside of your elbow. Wash your hands frequently.

Perhaps the most important thing if you become sick, for yourself and everyone else, is stay home, she said. The Department off Health has urged schools and employers to be supportive of prevention efforts, including not encouraging employees to come to work when they're ill.

Two years ago, the flu season started very early. Last year it got off to a late start. This holiday-time outbreak is actually "right on schedule" for a typical year, although it's too soon to say how severe it will be, Mottice said.

The Centers for Disease Control and Prevention has "typed" only a few influenza-related samples so far this year, but the indications are that the vaccine was targeted correctly. Each year, health experts decide what will make up the vaccine, based on what they see around the world and what they expect to be active during flu season.

Most of the Utah hospitalizations have been in individuals who are at high risk for complications. Most of the flu cases have been associated with type A influenza.

Any count is an automatic undercount, health experts say, because most people don't go to the doctor when they have flu and even when they do, a specimen is not always sent to the lab for confirmation.

To find available vaccine, Mottice recommends calling private providers or local health departments or the immunization hotline, 1-800-275-0659.

Contributing: Jared Page