The highest concentration of flu cases is in the Southeast and a few other states, Anne Schuchat of the Centers for Disease Control and Prevention said at a briefing.
The good news is that testing of vaccines for swine flu showed that they work with one dose and take effect rapidly.
Supplies of swine flu vaccine are expected to be available in mid-October, but the seasonal flu vaccine is available now and officials have encouraged people to get it.
The H1N1 swine flu broke out in the spring and never went away, Schuchat said. It struck in many summer camps, spread into the Southern Hemisphere, and now is widening its range. Currently 98 percent of the flu viruses circulating are swine flu.
Cases are mainly occurring in children and young adults, Schuchat said.
"There's no better protection against the flu than vaccine," Health and Human Services Secretary Kathleen Sebelius said.
There had been concerns that it would take two doses to build up immunity, delaying the protection.
While the single dose works in adults, testing is still under way to determine the effectiveness of the vaccine in children and pregnant women, said Anthony Fauci, director of the National Institute of Allergy and Infectious Disease.
He said the tested vaccines, made by Sanofi Pasteur and CSL Ltd., both produced "robust" immune responses.
There were no significant side effects, Fauci said.
People over 65 did not respond as strongly but still got enough of an immune reaction that they should seek out the shots when their turn comes, officials said.
First on the list for the swine flu shots, however, are children and young adults, pregnant women, and others with health problems, since the H1N1 flu seems to strike them more often.
Older people are more at risk from the regular seasonal flu and - along with other people - should get those shots now, Sebelius said.
She noted she got her own seasonal flu shot yesterday at a school near Alexandria, Va.
"The fact that the [seasonal] virus is not circulating now is absolutely no reason not to get vaccinated," Fauci said. People should "get vaccinated before the seasonal flu is circulating so you will have an immune response."
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