Minnesota health officials report seven more Minnesotans died of the flu at a time when fewer cases were reported across the state.
"For the second week in a row, we do have some promising indicators that we may be having a downward trend in activity," State Epidemiologist Dr. Ruth Lynfield said.
It is too early to say the flu, also known as swine flu, is on the decline, she added. But signs point to decreasing activity in both the Twin Cities and the rest of the state.
In the spring, when H1N1 first was identified, the illness was concentrated in the Twin Cities. But this fall, the flu spread to the rest of the state.
The good signs include fewer school outbreaks, fewer patients going to clinics with flu-like symptoms and fewer flu-related hospitalizations.
The H1N1 flu, blamed for at least six of the most recent deaths, claimed people from their 30s to someone in their 80s. Almost all of the people who recently died of the flu had other health problems, Lynfield added.
H1N1 normally hits young people and pregnant women harder than older people, who are more susceptible to the seasonal flu.
The latest H1N1 deaths come from Wadena, Dakota, Beltrami, Stevens, Mower, Hennepin and Ramsey counties. A Meeker County resident was the one not confirmed as an H1N1 victim.
With the newly confirmed deaths, 21 Minnesotans have died of H1N1. Two others died of flu-like illnesses that could not be positively blamed on H1N1, but officials say the seasonal flu has yet to take hold in the state.
"We are continuing to see widespread activity in Minnesota," Lynfield said. "There still is a lot of H1N1 virus circulating."
Nearly 700,000 doses of H1N1 vaccine have arrived in Minnesota, but Kris Ehresmann of the Minnesota Health Department said it is arriving slower than planned this week. For instance, the state had expected 22,800 doses of nasal midst, but only received 4,600 this week.
"Not every school child in the state will have access to vaccine," Ehresmann said.
A representative of a public health agency serving Big Stone, Chippewa, Swift, Yellow Medicine and Lac qui Parle counties said the vaccine shortage forced a change in plans, and now it must limit vaccinations to kindergarteners through second graders in 13 schools.
Gloria Tobias of Countryside Public Health said her west-central Minnesota counties’ students will receive vaccinations Monday through Nov. 24.
The number of schools reporting flu-like outbreaks last week fell to 40 from 137 the week before.
School outbreaks centered on the Twin Cities last week. Twelve outbreaks were reported in Ramsey County, with nine in Hennepin. Northeastern Minnesota’s St. Louis County reported just one school with a flu outbreak, down from eight a week earlier and 16 two weeks ago.
Few school flu outbreaks were reported in western and southern Minnesota, although there were a few schools with outbreaks in the central part of the state.
Twenty-one H1N1 hospital cases were reported in northeastern Minnesota last week, second only to 77 in the Twin Cities area. No hospitalizations were reported in west-central Minnesota and just one in the northwest.
Since the outbreak was first identified in Minnesota early this year, 1,521 H1N1 cases have been confirmed. However, in general only people hospitalized are tested and health officials say many more have contracted H1N1.
Activity on the FluLine, set up to give Minnesotans a chance to seek flu-related advice from nurses, is dropping, Lynfield said. That means nurses normally return calls within an hour, down from 13 hours when the line was established.