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A paediatric emergency medicine consultant is seeing the "most severe influenza outbreak" she has experienced.
Flu cases among adults and children across Northern Ireland went up by 77% in a week, rising from 273 to 484 confirmed cases, official figures show.
Children and young people have been particularly affected with under fives being admitted to hospital with flu at higher rates than any other age group during that period.
In the week ending 23 November, the positivity rate for influenza was highest among children aged five to 14 in Northern Ireland, at 52.3%.
Dr Julie-Ann Maney, who works at the Royal Belfast Hospital for Sick Children, said her department has been "extremely busy" due to the rise in cases.
"I have been a consultant since 2010 and this is the most severe influenza outbreak that I have experienced," she said.
"This is a particularly virulent strain of influenza and there are lots of children experiencing very high temperatures and they are experiencing the flu for much longer than we would expect."
Flu cases surge every winter, but experts have predicted this could be the worst flu season for a decade, fuelled by .
In week ending 23 November, the infection rate stood at 25.4 cases per 100,000 people – up from 14.3 per 100,000 the previous week, according to the latest data published by (PHA).
Dr Peter Naughton, a health protection consultant with the PHA, said the flu season had started earlier this year, and there had been a higher number of cases.
"One utter new feature of the flu season this year has been the higher rate of positive tests we've seen in children," he said.
Dr Thomas Bourke, a consultant paediatrician who also works at the Royal Belfast Hospital for Sick Children, said cases have doubled.
He urged parents to only take their children to the emergency department if they are seriously unwell.
"We understand it's very difficult for parents when their child is sick at home but there are lots of sources of information and places where they can get support," he said.
The Belfast Trust has to help parents judge how serious their child's symptoms are.
Most children recover from the flu without any treatment in about a week, it says on the website.
The regular hand washing, not sharing cups or cutlery and encouraging children to sneeze into a tissue are all ways to help prevent the virus from spreading.
It also said yearly flu vaccines reduce the risk of children getting unwell with the flu and also reduce the risk of them transmitting it to family members.
Dr Bourke, who is also the Royal College of Paediatrics and Child Health officer for Ireland, said vaccination remains the "frontline defence" against the flu.
"Last year 862 children and young people were admitted to hospital with influenza in Northern Ireland," he said.
He added data from southern hemisphere countries, which have already had their flu season, suggests there could be even more admissions this year.
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