Knox County has seen a dramatic spike in confirmed influenza cases, particularly in the past week, according to the Maine Center for Disease Control and Prevention.

Since Oct. 1, there have been 118 flu cases confirmed in Knox County, with 56 people hospitalized. This is almost as many as for the entire 2016-2017 flu season and more than in the 2015-2016 flu season.

Most of the cases in Knox County have occurred in the past week. For the week ending Jan. 20, there were 51 positive cases of influenza confirmed in Knox County. Sixteen people required hospitalization. Only Cumberland and York counties saw more cases.

There were 33 new cases confirmed in Knox County for the week of Jan. 13, in which 26 people required being admitted to a hospital.

For the week of Jan. 6, there were 15 new cases, with seven people going to the hospital.

A week earlier (week ending Dec. 30), there were seven new cases, with four people hospitalized. And for the week of Dec. 23, two new cases were confirmed, with one going to the hospital.

And for the week of Dec. 16, there were two new confirmed cases, with no one requiring hospitalization.

Statewide, there have been 1,749 confirmed cases, with 429 people being admitted to hospitals. There have been 22 deaths statewide this winter from influenza, according to the CDC. Five of those deaths occurred during the past week. None of the deaths in Maine has involved a child, according to the CDC.

The average age of people diagnosed with the flu in Maine is 50 and the average age of those hospitalized is 63, the Maine CDC said.

The flu season this year has seen far more cases than in an average year. The flu season generally runs from October through May, but can vary from year to year.

The number of people admitted to hospitals is already more than for the entire 2015-2016 season, when there 2,397 confirmed cases and 397 hospitalizations. In Knox in 2015-2016 there were 88 confirmed cases, with 22 people being hospitalized.

For 2016-2017, there were 5,885 cases for the entire season, with 1,151 people hospitalized. In Knox County, there were 178 cases, with 84 hospitalizations in 2016-2017.

This latest outbreak comes 100 years after the worst influenza outbreak in world history. The great 1918 Pandemic claimed the lives of between 20 million and 50 million people across the world. In the United States, 575,000 people died from influenza in 1918. The estimated toll in Maine was 5,000.

A flu pandemic, such as the one in 1918, occurs when an especially virulent new influenza strain for which there’s little or no immunity appears, according to the U.S. Centers for Disease Control.

Since 1918, there have been several other influenza pandemics, although none was as deadly. A flu pandemic from 1957 to 1958 killed around 2 million people worldwide, including some 70,000 people in the U.S., and a pandemic from 1968 to 1969 killed approximately 1 million people, including some 34,000 Americans. More than 12,000 Americans perished during the H1N1 (or “swine flu”) pandemic that occurred from 2009 to 2010, according to history.com.

Rockland was hard-hit by the 1918 Pandemic, with hundreds taken ill each week soon after the start of the outbreak. Deaths mounted by the week.

The Courier reported in the Sept. 27, 1918, edition that unlike the rest of New England, Rockland had avoided the throes of the influenza, also known then as the Spanish grippe.

"The doctors report a number of severe colds, but this is not to be wondered at in view of the strenuous and unusually severe fall weather," the article stated.

But only a week later, the view had dramatically changed, with 250 new cases reported in the Rockland area.

"In common with every other New England community this city now has a considerable amount of the pandemic known as Spanish influenza or grippe," according to the article.

Two residents of Rockland and a third a young man from New York who was visiting the area died that week from the flu. The sick bay at the Naval Training Center was at capacity, and an overflow hospital had been set up at the Rockland YMCA (which was located on Limerock Street by where the Custom Street parking lot is now.

The Board of Health ordered the closure of schools, churches, theaters, dance halls and other places of public gathering, including the public library. Restaurants, pool halls and soda fountains were exempt from the closure order.

The Narragansett Hotel was converted in mid-October to an emergency hospital to treat patients, as the number of new cases reached 450 that week.

Undertaker Burpee reported he was handling the funerals of 10 people that week who had died from influenza. There were numerous obituaries of people who had succumbed to the flu, including a Navy recruit, a nurse, a young woman and a young husband, who was being held prior to his trial for allegedly murdering his wife.

By November, the Courier reported that the outbreak had passed and only a few new cases were being reported.