BISMARCK — Nearly 400 cases of seasonal influenza have been identified within North Dakota so far this year, according to the state Department of Health, far behind last year’s record-breaking season.

During the 2017-18 flu season, the agency said there were 8,530 cases of lab-verified flu. There is typically about 2,800 per year, according to the website.

The real number of cases may be significantly higher, the report said, because not all people who contract the flu will go to the doctor, and cases diagnosed based on symptoms or other contact are not counted.

Symptoms can include fever, cough, sore throat, runny nose, body aches, headaches, chills and fatigue. It is spread through droplets when infected people cough, sneeze or talk.

The Health Department began collecting data on lab-identified flu cases in August. One person has died from the flu and 20 have been hospitalized as of Nov. 17. Last season, 31 North Dakotans died from the flu.

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The Nov. 17 data shows the highest concentration of cases in Benson and Ramsey counties with 130 and 77 cases, respectively, followed by Pembina (32), Stark (28) and Cass (25) counties. Grand Forks had 12.

Vaccination rates were higher during the 2017-18 season than the 2016-17 season, the report said. Nearly 213,000 flu shots have been given this season as of Nov. 17, and around 254,000 were administered last season, the reports said.