The Rhode Island Department of Health said Wednesday that flu is widespread in the state.
Dr. Michael Fine, the state health director, signed a flu declaration that requires health care workers who have not had a flu shot to wear surgical masks when caring for patients.
Fine also urged residents to get a flu shot. He said flu season would probably last six to eight weeks.
"The dominant strain continues to be H1N1, which is the same strain in 2009. Remember that this year's vaccine protects against H1N1," Fine said.
The state said there have been 51 hospitalizations in Rhode Island related to the flu so far this season.
"You have fevers. You feel like you have been run over by a truck. It hurts to comb your hair, and it hurts to lift your head up. You know people are out of work for five to 10 days. It's a significant illness," Fine said.
The health department said flu has been recorded in all five of the state's counties.
A schedule of free community vaccination clinics and other information about the flu is listed on the Department of Health website.