NORTH CAROLINA -- Eighteen more flu deaths have been reported in North Carolina this season.

Officials released the updated numbers on Thursday. 

A total of 253 people have died as a result of the virus since the flu season began Oct. 1.

Nationwide, toward the end of January, roughly 1 in 15 doctor visits were for symptoms of the flu. That's the highest level since the swine flu pandemic in 2009.

Last year, 218 people died from the flu in North Carolina.

Flu effects in NC

Hospitals, schools and facilities across North Carolina have closed or limited hours or visitors due to the widespread spread of the virus this year.

The following places have been affected by this year's flu virus:

Charlotte region:

• At Carmel Christian in Matthews, more than 160 students were out with the flu one day in late January.
• Six assisted living facilities in Mecklenburg County announced widespread flu cases in late January.
• At Carolinas Healthcare Center and Novant Health Presbyterian Medical Center, children 12 and under are restricted from visiting patients to prevent the spread of the flu.

Triad:

• Cone, Novant, High Point Regional and Wake Forest Baptist announced in late January a limit of visitors to ages 13 and up to prevent the spread of the flu.
• East Bend Elementary School in the Triad closed until Friday this week due to more than 100 kids out with flu-like symptoms.

Central N.C.:

• Krzyzewskiville campsite at Duke University was closed on Wednesday night until further notice because of fears over the flu. The campsite, where students were waiting for tickets to the game against UNC, is now empty, and students' place in line is being held by headline monitors.
•  At the end of January, the Naval Center Camp Lejeune reported an influx of patients in their emergency room with flu-like symptoms, causing extremely long lines. They advised people to treat themselves at home, if possible. 
• Cape Fear Valley Medical Center and Southeastern Regional Hospital restricted visitors in late January because of the flu. 

Coastal N.C.:

• Carolina East Medical Center is banning visitors younger than age 15 and limiting the number of visitors per patient to two people.
• Carteret Health Care is restricting vistors under age 18 and limiting the number of visitors per patient to two people.
• At Craven County Elementary School, about 1/3 of the students were reported absent with flu-like symptoms last week.

Elsewhere:

• The American Red Cross is struggling to meet demand because of the flu and the winter weather in January. The Red Cross was forced to cancel hundreds of blood drives and was reporting they were short more than 3,300 blood units. 

Symptoms for the virus include fever, chills, cough and sore throat and nausea.

Experts advise everyone to avoid people with flu-like symptoms, get the flu vaccine and wash hands frequently, cover your mouth and go to the doctor if symptoms occur.