Runny noses, coughs, fever, aches and the flu.
That's what Beaufort County doctors are seeing in offices and emergency rooms as flu season ramps up.
And this season seems particularly bad.
About four times as many county cases have been reported this year compared to last year, according to S.C. Department of Health and Environmental Control statistics released last week.
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The agency confirmed 330 cases from Sept. 28, the official start of flu season, to Dec. 20.
Last year, 87 county cases were confirmed during the same period.
The virus hit schools hard before winter break.
Bridges Preparatory School in Beaufort discussed canceling classes earlier this month after as many as a quarter of its 440 students were absent, according to executive director Josefina Blanc.
The outbreak has been felt at hospitals as well.
About 95 cases were confirmed at Beaufort Memorial Hospital for the week beginning Dec. 8, said spokeswoman Courtney McDermott, noting a "huge increase" from the previous week.
Six of those patients were hospitalized, she said in an email.
Hilton Head Hospital spokeswoman Kelly Presnell said Friday she could not confirm the number of cases at Hilton Head and Coastal Carolina hospitals but said in an email the hospitals were "caring for patients with flu and flu-like symptoms."
Statewide, the number of reported cases has already topped 2013 levels.
About 19,000 cases have been reported across South Carolina through the week ending Dec. 20. That's nearly 7,000 more than had been confirmed at the same time last year.
The most recently reported week was especially miserable.
Nearly half, or 8,967, of this year's cases were confirmed between Dec. 14 and Dec. 20, according to DHEC.
Nationally, some medical experts say, the bad flu season might be due to an ineffective vaccine.
The U.S. Centers for Disease Control and Prevention has said this year's flu vaccine is less effective than previous years, because the current strain of the virus has already mutated.
But the agency says the vaccine is still better than no vaccine at all.
Local hospital officials agree.
"While it may not be a perfect match, it still offers greater protection than not being vaccinated," said Presnell, the Hilton Head Hospital spokeswoman.
There are other things families can do to prevent the spread of the virus.
Beaufort County School District officials ask parents not to send students to school with a fever.
The typical rule is that students must be fever-free for 24 hours before returning to school. But with the current outbreak, students are being advised to stay home for five days if they or someone in their household has the flu, based on CDC recommendations.
Other recommendations for adults include washing hands and avoiding travel.
Hospital officials say patients should only go to the emergency room if they have a fever of 101 degrees or higher that is not responsive to Tylenol or Motrin. Other reasons to go to the hospital include shortness of breath, a cough with mucus or blood in the mucus, signs of pneumonia, low oxygen levels or severe dehydration.
"Using this as a basic guide, many people can save themselves from making a trip to their local hospital and in doing so also save money by treating themselves at home with rest, liquids and over-the-counter painkillers," said Stephen Larson, Beaufort Memorial emergency department medical director.
"Patients may feel badly for up to a week, but will get better at home."