Houston Methodist is reporting an early increase in flu cases, with numbers hitting levels not usually seen until the end of the year.

The hospital recorded 100 cases of influenza A and B in the week ending Sept. 21. A week prior, this figure hit 226. 

“We experienced an early uptick in mid-September, which relaxed some last week, but still these are the sorts of numbers we usually see in December, not now,” Wesley Long, MD, PhD, a pathologist and medical director of diagnostic microbiology at Houston Methodist, tweeted Sept. 26.

Texas is the only state in the U.S. — outside of Washington, D.C. — that already has a moderately high rate of flu cases, according to the CDC’s latest weekly flu report published Sept. 23.

The early rise in cases comes amid warnings that this season’s flu season may be severe.