The death total from the 2017-18 flu season has climbed sharply again, reaching 95 for the week that ended Jan. 27.

The N.C. Department of Health and Human Services said Thursday that there were 20 flu-related deaths last week, as well as an additional seven people who died in previous weeks and were later determined to have had the flu.

Influenza experts at Triad hospitals have said their emergency rooms and clinics continue to see high amounts of influenza activity, so they do not believe the region has reached a peak for the season that typically ends March 31.

No flu-related deaths have been reported publicly in the Triad and Northwest N.C. Some county health directors have declined to disclose flu-related deaths, citing DHHS privacy policies.

Twenty-one of the 27 new flu-related deaths were individuals ages 65 and older, while seven were ages 50 to 64.

For the season, there have been 63 elderly deaths, 25 from ages 50 to 64, four from ages 25 to 49 and three from ages 5 to 17.

By comparison, the 2016-17 season had 219 confirmed deaths related to the flu. That represented the highest level of flu-related deaths since DHHS began providing victim totals in 2008.

At this point of the past four flu seasons, there were 22 deaths for 2016-17, two in 2015-16, 168 in 2014-15 and 50 in 2013-14.

Besides the elderly, other vulnerable population groups are children younger than 5, pregnant women and those with pre-existing medical conditions such as asthma, diabetes or heart disease.

Nationally, flu season has arrived stronger than projected, according to federal health officials.

The predominant strain picked up in lab tests so far is a strain of influenza A known as H3N2. Flu vaccine is protecting about one in three people who have received the shot.

"Flu typically kills because of secondary infections, usually pneumonia," said Josh Bloom with American Council on Science and Health.

Bloom said the current version is killing some victims directly.

"This is the scary part," Bloom said. Fortunately, the fast-killing cases of flu are rare ... but children seem to be more susceptible rapid deaths.

"The cause of fast deaths is very different. It is more insidious, harder to prevent and little can be done about it" in a way he said is similar to someone experiencing a peanut allergy.

"When the numbers are tallied up, this may end up being the worst flu season in a generation," Bloom said. "Since flu is extremely contagious there isn't much you can do except get vaccinated."

The proliferation of the 2017-18 flu season has led Moody's Investor Service to caution that the margins for not-for-profit healthcare systems — such as Cone Health, Novant Health Inc. and Wake Forest Baptist Medical Center — likely are being squeezed despite the increase in admissions.

"Lower reimbursement rates, heightened risk of complications, and on-going staffing needs in nursing will increase hospital costs and make it difficult to execute expense management strategies during this period," Moody's said.

"Reimbursement for flu-related admissions often fails to cover treatment costs. Hospitals incur higher costs when patient volumes surge, including overtime and other unbudgeted staffing costs.

"They also incur the opportunity cost of lost revenue on elective procedures and surgeries that are delayed or canceled," Moody's said.