By BARBARA A. SCHMITT

With officials at the Centers for Disease Control saying it's gearing up to be a bad flu season, several North Carolina hospitals are taking no chances and requiring that all employees either get a flu shot or be fired.

This past summer, officials at First Health Moore Regional Hospital adopted a policy that requires all staff who routinely work in patient care areas to be vaccinated annually for influenza.

Officials at the care facilities say the forward-thinking policy was put in place because the common flu may have not-so-common effects on people facing more serious illnesses and whose immune systems are not strong enough to combat the virus.

First Health is just one of several North Carolina medical facilities taking the aggressive preventative approach.

"It's a definitely a national trend," says Dr. B. Anthony Lindsey, chief medical officer for University of North Carolina Hospitals where the policy is also in its pilot year. "Influenza is an extremely contagious disease. For some of our patients, it could have very serious consequences - including death."

Most hospitals already require tuberculosis tests and hepatitis shots, but while the flu may be more common than those illnesses, its impact could be just as serious.

"Hospitals require personnel to get tested for tuberculosis so that they don't spread that disease. The flu shot requirement is no different," says ABC News' chief health and medical editor Dr. Richard Besser.

Cone Health Systems, a conglomerate of five North Carolina hospitals, was one of the first hospital groups to put the policy in place three years ago during the H1N1, or "Bird flu" outbreak. Since that time, two people who work closely with patients have been fired for not taking the vaccine - showing hospitals are not taking chances on patients' health.

"Our values at this hospital is that we care for our patients, we care for others and we care for our community," says Dr. Mary Jo Cagle, the executive vice president and chief quality officer for Cone Health. "It's not unusual in many venues - in schools, and in many jobs - to have to require vaccinations. "

There are exceptions, ranging from health to religious reasons, that hospitals take into account. Employees who fall under those categories are not considered non-compliant.

The policies at these medical facilities come just as the Centers for Disease Control warns of a bad flu season. CDC director Dr. Thomas Frieden said Monday that instances of the flu had arrived a full month earlier than normal.

"It looks like it's shaping up to be a bad flu season," Frieden said.

Tennessee, Mississippi, Alabama, Louisiana and Texas have reported enough seasonal flu cases to officially mark the beginning of the flu season.

"We're seeing the beginning of the uptick start at least a month before we'd generally see it," Frieden said, explaining that flu rates typically start to rise in early January.

Only 37 percent of Americans eligible for the flu vaccine actually get vaccinated for the virus.

"This is a part of our hospital's and other hospitals' nation-wide attempt to provide the safest possible care of the patients for whom we're responsible," Frieden said. "This is just another part of that effort."