NEW YORK (AP) — From the Rocky Mountains to New England, hospitals are swamped with people with flu symptoms.

While flu normally doesn't blanket the country until late January or February, it is already widespread in more than 40 states, with about 30 of them reporting some major hot spots. On Thursday, health officials blamed the flu for the deaths of 20 children so far.

The Wyoming Department of Health says flu activity has sharply increased across the state, particularly over the past two weeks. The agency says the spike is the highest it has seen since the 2009 swine flu outbreak.

Cheyenne Regional Medical Center saw its busiest day ever last week, with 166 visitors.