EVERETT — The flu has turned fatal in Snohomish County.

The first two flu-related deaths for the 2019-20 influenza season were confirmed Tuesday by the Snohomish Health District.

A Lake Stevens man in his late 80s died Jan. 5 and a woman in her early 30s from a rural northern part of the county died Jan. 1. Both had multiple underlying medical conditions, according to the health district.

In Washington, at least 21 people have died this season from the flu, including two children. Nationwide, there have been 2,900 deaths. During the 2018-19 flu season, there were 26 confirmed flu-related deaths in Snohomish County and 362 people were hospitalized.

This season there have been 28 hospitalizations and 12 schools reporting greater than 10% absenteeism due to influenza-like illness through late December. One long-term care facility reported an outbreak.

Influenza B has been the predominant strain from the start. Typically, it strikes later. Health officials track two main strains, designated as A and B.

There were 371 confirmed cases of the flu in the county during the one-week period ending Dec. 28, according to the latest figures available. Of those, 302 were influenza B.

Similar figures were reported the previous week. That’s the good news, if there is any.

“The peak seems to have occurred right around Christmas, and since then we’ve seen a decrease in the number of positive flu tests,” said Dr. Yuan-Po Tu, who monitors influenza for The Everett Clinic.

Now for the possible bad news.

“The question that everybody has is, ‘Are we going to see a second wave?’” Tu said. “Most of the tests so far have been due to influenza B and there is a smattering of A. The question is, ‘Is influenza A going to dominate the second half of the season?’ So far, I have not seen that.”

It is not too late to get a flu shot.

People who are at higher risks for flu complications, such as pregnant women, infants, or seniors, should contact their health care provider with early signs of illness, said Heather Thomas, Snohomish Health District spokeswoman.

“If you have trouble breathing, pain or pressure in the chest, blue or gray skin color, sudden dizziness or other symptoms that aren’t getting better, call 911 or go to an emergency room,” she said.

The federal Centers for Disease Control and Prevention reports about 6.4 million flu illnesses, mostly the B variety, so far this season. Of those, 55,000 required hospitalization. Of the 2,900 people who have died, 27 were children, the CDC reported.

In another matter, unrelated to the flu is a health concern about hepatitis A, a contagious but not airborne infection.

There has been an increase of hepatitis A cases in the county. Eight cases have been reported starting in mid-December. All reported illicit drug use, and seven were homeless and from the Arlington, Everett, Marysville and Tulalip areas. Onset dates range from Nov. 29 through Jan. 4.

Hepatitis A is spread through food, water contaminated with the feces of an infected person, or personal contact. It can be a mild or severe illness, lasting from a few weeks to several months. Even mildly ill people can be highly infectious.

Symptoms usually appear two to seven weeks after infection and can include yellow skin or eyes (jaundice), dark urine or pale stools, loss of appetite, fever, diarrhea and fatigue.

Andrea Brown: abrown@heraldnet.com; 425-339-3443. Twitter @reporterbrown.