Updated

The nation's top health agency on Friday stepped up its response to the unusually early outbreak of flu, launching response teams to states and asking all health departments nationwide to report flu deaths of children.

Characterizing the outbreak as a likely epidemic, the Centers for Disease Control and Prevention (search) also sought postmortem tissue samples, autopsy reports and flu virus samples from fatally stricken children.

Earlier Friday, Dr. Julie Gerberding, the CDC director, said 42 children have died from the flu this season.

She said the CDC field teams will help states deal with the outbreak and evaluate the effectiveness of this year's flu shot. The CDC also activated its emergency operations center to coordinate its efforts.

Gerberding said it's too soon to determine how severe this flu season will turn out to be. But in response to a question at a news conference, she said the number of cases -- and the child deaths -- indicate the outbreak could be classified as an epidemic. She said the season has followed "typical" flu patterns but started much earlier than usual.

The CDC has never required states to report flu deaths, largely because it's hard to distinguish flu from other winter viruses. But the agency has been concerned about the number of normally healthy children dying from this year's flu strain.

The agency has estimated that about 92 children under age 5 typically die each year from flu, but that is based on computer models and "in fact is a ballpark estimate," Dr. Keiji Fukuda, the CDC's top flu epidemiologist, said this week.

The child deaths from flu are "very sobering and very worrisome," Gerberding said, adding that at least 16 of the children who died were ill prior to catching the flu and that more than half the deaths involved children under 5.

Twenty-one of the children were previously healthy and three developed a drug-resistant bacterial infection that complicated their flu treatment. The CDC said they had flu shot data on only seven of the deaths; only two of those children had received a flu shot.

At least 36 states have been labeled by the agency as having widespread flu activity, and no state has been untouched.

The emergency operations center was used earlier this year to help the agency manage SARS (search) and West Nile virus (search) activity in the United States.

Gerberding urged people not to crowd emergency rooms. The agency posted information on its Web site Friday to help people decide when they need to go to the hospital and when they should stay home.

"Flu is something that for the vast majority of people can be managed at home," Gerberding said. "It's not necessary to seek medical attention unless there is concern."

With the flu season hitting early, many areas have reported shortages of flu shots as demand outpaced supply. The federal government is trying to purchase remaining flu shot supplies for states.

The state of Georgia, meanwhile, has turned to a private vendor for 100,000 doses of flu vaccine -- a sixth of what the federal government has been able to scrounge for all the states.

Under the $1.65 million deal, Georgia will pay more than double what the vaccine would have cost before the season started. At $16.50 a dose, it's also double what the government recently paid for additional flu shots for states.

The vaccine purchased by Georgia was made by a subsidiary of Chiron Corp. (search) The selling company is Carter Trading Co. (search) of Springdale, Ark., health officials said. A call to Carter not immediately returned on Friday.

Some health officials voiced concern over the fairness of the Georgia deal, when many harder-hit states have been able to find far fewer doses. Colorado, for example, recently was able to buy only 6,060 doses from a private vendor, officials said.