Raleigh, N.C. — Nine North Carolina residents died of influenza last week in what is the deadliest week so far this season for the illness in the state, public health officials said Thursday.

Still, the number of people visiting physician offices, hospital emergency rooms and local health departments across North Carolina with flu-like symptoms continues to drop. Only 3.8 percent of the patients reported flu-like illnesses, down from 5.4 percent the previous week and 9.1 percent two weeks ago.

In addition to the nine deaths last week, five earlier deaths have also been linked to the flu, bringing the total number of flu-related fatalities this season to 31. Twenty-eight of those deaths involved people age 50 or older.

On average, about 24,000 Americans die each flu season, according to the CDC.

Flu usually doesn't blanket the country until late January or February, but it is already widespread in more than 40 states, including North Carolina.

The early onslaught has resulted in a spike in hospitalizations, prompting hospitals to take steps to deal with the influx and protect other patients from getting sick, including restricting visits from children, requiring family members to wear masks, and banning anyone with flu symptoms from maternity wards.

WakeMed, Duke University Health System hospitals and Cape Fear Valley Medical Center are among the hospitals that now prohibit people younger than 18 from visiting patients.

More than 128 million doses of flu vaccine have been distributed nationwide, which is nearly 95 percent of the amount that manufacturers planned to make this year, officials said.