Photo/Illutration The influenza virus (Provided by the U.S. Centers for Disease Control and Prevention)

The Tokyo metropolitan government on Sept. 21 issued its first influenza health alert in September since 2009, a day after similar warnings were announced in neighboring Saitama and Chiba prefectures.

The metropolitan government is urging residents to wear masks when going to crowded places or having conversations, to frequently wash and disinfect their hands, and to ventilate rooms well.

“There is a possibility that the epidemic will spread further in the future,” a Tokyo government official said.

Influenza alerts in September are rare because the flu virus typically spreads from December to March, according to the metropolitan government.

The number of influenza patients reported per fixed-point medical institution was 11.37 from Sept. 11 to 17, up from 5.95 in the previous week, according to the metropolitan government's Bureau of Public Health.

The threshold for issuing an advisory is 10.0 cases per institution.

A total of 4,742 influenza patients were reported from 417 medical institutions in the capital.

By health center, Nakano Ward had the most patients, with 20.30, followed by 18.29 in Bunkyo Ward, and 16.67 in Hachioji city.

Children under 14 years old accounted for more than 60 percent of all influenza patients reported from Sept. 4 to 17.

A total of 207 public schools in Tokyo temporarily closed some of their classes during the same period.