University of Maryland sophomore Blake Green has never gotten a flu shot. But this year, amidst an increased amount of flu cases in the state, she's thinking about it.

​"I'm definitely mo​re cautious about touching on everything, opening doors," the behavioral and community health major said. "I wash my hands a lot more during the winter, so I'm just trying to make sure I stay healthy.​"

The CDC has reported that flu activity this year has reached the highest level since the swine flu pandemic nearly a decade ago, with about 6 percent of emergency room and clinic visits attributed to flu-like illnesses. At least 37 children and thousands of adults have died nationwide due to the flu this year.

Even though Maryland is among 39 states reporting high numbers of flu cases, according to a CDC report, the University Health Center hasn't seen an uptick in patients with flu-like illnesses or given out more than its typical number of flu shots to date.

The Health Center saw 31 individuals with flu-like illnesses in January — about 1 percent of the month's visits — compared to 37 visits in the same time period last year, health center Director David McBride wrote in an email. But now that the semester has begun, he said he expects to see more flu activity, simply because "more people on campus equals more illness​."

​As of Tuesday morning, the health center had given nearly 4,500 flu shots and had to order more. McBride said this number is in keeping with those of the past "several years."

This season, the predominant strain is H3N2, according to The New York Times, and this year's vaccine protects most strongly against H1N1, an H3N2 and a B/Victoria lineage strain.

The H3N2 strain is difficult to protect against, however, because it has a tendency to mutate faster than other strains.

Information studies graduate student Mayanka Jha said she really liked when this university sent notifications promoting the flu shot.

"It's been so much on [the] news so I think to be on the safe side, everyone should take one," she said of the vaccine.

Jha said she got a flu shot last week at CVS, though she doesn't know anyone who's been severely affected by the virus.

A University of Maryland-led study indicated that the flu may be spread simply by breathing, not by sneezing or coughing.

People who have the flu generate infectious aerosols, or tiny droplets that remain airborne for a long time, particularly during the first days of the sickness, even when they aren't coughing, lead researcher Donald Milton said in a press release.

People with the flu should avoid classrooms, dining halls and social activities until the fever has been gone for 24 hours, McBride wrote.

If one does catch the flu, it's also important to drink plenty of fluids and take fever reducers like acetaminophen, naproxen or ibuprofen, but not aspirin, McBride wrote. Using aspirin for viral infections like the flu increases the odds of developing Reye's syndrome, which causes swelling in the brain and liver, according to the Mayo Clinic.

Junior computer science major Andres Garcia said hearing about how the flu is worse this year worries him, particularly because he's read about superbugs, bacteria resistant to antibiotic drugs. The flu, on the other hand, is a virus.

"I'm about to [get vaccinated]," he said. "I got an email from my doctor, so I'll probably do that within the next weeks."

During the week ending Jan. 20, the most recent data available, influenza-like illness intensity was classified as "high" and there was "widespread" geographic activity of the flu, according to the Maryland Health Department. The week ending in Jan. 6 was the last to have a "low" intensity level, though the previous week also had a "high" level. Activity level has been "widespread" since about mid-December.

The CDC recommends an annual vaccination for everyone over the age of six months.

A Frederick woman — Colleen Magrann — died of the flu Jan. 24. She was the first Maryland flu casualty of the year, and deaths due to the virus have also been reported in Pennsylvania, Delaware and Virginia. Some Maryland hospitals, including six in Montgomery County, have implemented visitor restrictions aimed at reducing the spread of the virus.