The U.S. influenza season is off to a fast start, which may hurt insurers, hospitals and people lulled by the milder outbreaks of the recent past.

The number of flu cases began to rise in November and reached an elevated level in December, a month earlier than usual, said Michael Jhung, a medical officer with the U.S. Centers for Disease Control and Prevention’s influenza unit. About 5.6% of all doctor visits in the U.S. now are for influenza, according to the Atlanta-based agency. That compares with 2.2% of visits at the peak of the season last year.

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