As flu cases continue to rapidly escalate on the mainland, local health officials say it’s only a matter of time before the virus intensifies in the islands.

“All U.S. states but Hawaii continue to report widespread flu activity and the number of states experiencing high influenza activity increased from 26 … to 32 states,” the Centers for Disease Control said in its weekly flu report.

Still, state Epidemiologist Sarah Park of the state Health Department said Hawaii is seeing serious cases.

“I would never say we’re spared. Just because our level of flu activity isn’t indicative of the same as the rest of the nation does not mean flu is not here,” Park told lawmakers at an informational briefing Tuesday. “It does not mean there aren’t people who are being sickened and potentially requiring hospitalization and even dying.”

During the week that ended Jan. 6, 5.6 percent of outpatient visits in Hawaii were for “influenza-like illness,” according to health department data based on reports from selected health practitioners. The rate is 3.5 percent for the flu season to date, which runs from October to September.

Park encouraged residents to get a flu shot and to stay home if they have symptoms.

“We may not need to be at the same level of disease activity that the mainland has to have a health care crisis,” Park said. “It is not too late to get vaccinated. It is always appropriate, not just for flu, but for so many other diseases, to wash your hands.”

The state’s Disease Outbreak Control Division investigates thousands of cases each year of 73 illnesses that health care providers and laboratories are required to report to the Health Department, including flu. Other reportable diseases include everything from measles and mumps to dengue fever, malaria and tuberculosis.

Park said the division’s caseload of disease outbreaks has grown from approximately 600 investigations a year in the late 1990s to more than 17,000 investigations that were initiated in 2017. She said in the last five years, flu cases have ranged from 1 to 5 percent of the caseload.

“Flu is endemic, it’s extremely common,” she said. “Like so many other jurisdictions, we follow up on outbreaks — so, school clusters, nursing home clusters,” and severe or unusual cases.