As some areas of a flu-ravaged United States are seeing cases decline, South Dakota is still on the climb.
The number of flu cases recorded in South Dakota in a single week hit a five-year high the week ending Jan. 27, with 440 new cases recorded, according to the South Dakota Department of Health.
And it has shown no signs of letting up.
"It is difficult to predict when we might peak in South Dakota. Several western states are seeing early signs of decreasing activity, but we are still seeing increasing activity," said State Epidemiologist Joshua Clayton.
The silver lining is that flu-related deaths and hospitalizations are on pace to stay behind last year's totals, Clayton said. So far this year, 320 people have been hospitalized and 15 people have died due to the flu. All of the deaths have been among people older than 50.
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Nationally, the hospitalization rate is on track to surpass that of the 2014-15 flu season, when approximately 710,000 Americans were hospitalized and 56,000 died.
This week, the Centers for Disease Control (CDC) classified the flu as "widespread" in all states but Hawaii. The CDC stated this level has been consistent for the past three consecutive weeks in the continental United States.
School-aged children are getting hit hard, too, with 898 of the state's 1,974 cases recorded in children ages 0 to 18.
Statewide, 24 school districts reported more than 5 percent of students absent due to illness. The southeast corner of the state averaged 3.46 percent of students absent due to illness, while the state average hovered just below 3 percent.
"We don't have an average percentage that we use to compare activity by region, but ... currently the schools in southeast South Dakota are currently experiencing higher total absenteeism likely due to influenza and other respiratory illnesses," Clayton said.
As the flu season, which spans October to May, progresses, Mitchell School District Superintendent Joe Graves said school officials will continue to monitor the illness.
The Mitchell School District hasn't seen a large number of students absent due to illness yet, Graves said, but he anticipates a surge before spring.
"(Monday and Tuesday), we actually saw a small uptick in a couple of buildings. That may be just normal statistical variation or it may be the start of the influenza or some other malady hitting hard," Graves said.
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If the number of students absent due to illness surpasses 10 percent, Graves said he would confer with the DOH and if the DOH believed it would help contain the virus, the district would dismiss school for a day or two, which has only happened once in the past 17 years.
