The flu epidemic has already reached warning levels in Hokkaido, a survey by the National Institute of Infectious Diseases showed on Tuesday.

The institute warns that the flu may start spreading across the nation this winter at the fastest pace in two decades.

According to the survey that covers 4,700 medical institutions across the nation, the number of flu patients started to increase during the week starting Oct. 15, some 1-2 months earlier than usual.

In Asahikawa, Hokkaido, an average of 32.9 flu patients were reported per medical institution during the one-week period from Nov. 12 to 18, surpassing the warning level of 30 such patients per hospital.

The number of flu patients reported across the nation over the same period also doubled from the previous week, to a whopping 4,415.

By prefecture, Hokkaido had an average of 8.1 flu patients per medical institution during the period, while the figures were 3.1 for Okinawa, 1.8 for Kanagawa, 1.7 for Wakayama, 1.5 for Chiba, 1.4 for Hyogo, 1.1 for Okayama and 1.0 for Tokyo.

By national average, 0.94 flu patients were reported at each medical institute covered by the survey between Nov. 12 and 18.

"Next week, it is highly likely that the figure could surpass 1.0 -- which is the breaking point for the start of a nationwide flu epidemic. If that happens, it'll be the earliest since 1987 when we started the survey," said a representative of the institute based in Tokyo's Shinjuku-ku.

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