While the Minnesota Department of Health reports a downward trend in H1N1 activity in the state - there are still widespread incidents of the H1N1 novel influenza being reported.

Dr. Ruth Lynfield, state epidemiologist, said that they are hesitant to say that H1N1 incidents have peaked, because in other parts of the country health facilities have reported a decrease in hospital stays due to H1N1 one week, only to report an increase the following week.

However, there are several indicators that are positive, Lynfield said, in a Nov. 12 press conference.

There has been a decreased number of influenza outbreaks reported by schools. Forty schools reported outbreaks of influenza-like illness during the first week in November, down from the 147 schools reporting the week before.

There is a decrease in the proportion of patients being seen in outpatient clinics that have the influenza virus and a decrease in the hospitalizations due to H1N1.

However, there are still a high number of hospitalizations. Since Sept. 1 there have been 1,261 confirmed novel H1N1 influenza hospitalizations and 1,521 total novel H1N1 hospitalizations since the virus was first identified in Minnesota.

MDH identified seven deaths occurring between Oct. 25 and the first week of November.

Six of the deaths were lab confirmed as being associated with H1N1; another was an influenza-type unspecified death.

All of those deaths included individuals in their 30s through 80s and almost all had underlying conditions which increased their risk of severe illness, Lynfield said. They occurred in the following counties: Hennepin, Ramsey, Wadena, Stevens, Beltrami, Dakota and Mauer.

Overall there have been 21 confirmed H1N1 deaths and two influenza-type unspecified deaths, according to MDH statistics.

Six of those 23 deaths involved children under age 18; five of the deaths were in individuals 65 and older.

Lynfield said that they are continuing to investigate deaths; some are H1N1 related, others are not. "Almost all the influenza that's circulating is H1N1," she said.

Calls to the Minnesota Flu Line (1-866-259-4655) are down. Initially the Flu Line was inundated with calls, with some callers experiencing a long wait time. Now, nurse callbacks will occur within an hour, she said.

Kris Ehresmann, director of Infectious Disease Epidemiology, Prevention and Control, reports that Minnesota has been allocated 700,000 vaccine dosages: 515,000 injectible and 185,000 doses of the FluMist nasal spray. They anticipated receiving all 700,000 doses of H1N1 vaccine by Nov. 13.

According to the U.S. Department of Health & Human Services, Minnesota has received 615,200 vaccine doses as of Nov. 11.

Ehresmann reported that of the 650 clinics that serve pediatric patients, 603 of them have received doses of the vaccine.

And, 99 percent of the Minnesota clinics that serve pregnant women have received vaccines.

On average, clinics receive 45 percent of their requests, she said.

The MDH continues to recommend that vaccines be given to the highest priority population: children 6 months to 4 years old, children 5-18 with an underlying health problems, pregnant women, and health care workers and emergency service personnel with direct patient contact, and those with a household contact with infants less than 6 months old.

While they have been able to get the H1N1 vaccine out to a number of providers, they received fewer vaccines than they expected during the week of Nov. 1.

"We're frustrated and we know the public is frustrated as well," she said during the Nov. 12 press conference.

Vaccine availability is very fluid and oftentimes they don't get advance warning about how it will be changing.

MDH is planning on clinics to serve school-aged children less than 10 years old. They are recommending that counties that receive doses for school-aged clinics to proceed.

"We're not in a position where every school child in the state will have access to vaccines," she said.

Flu mist will be used for healthy school aged children under 10, she said.

Lynfield said that they are seeing influenza-related hospitalizations and deaths incurring in a younger age group than typical. With seasonal influenza, 90 percent of the deaths occur in individuals 65 years and older.

Lynfield added that if you're in a high priority group, get vaccinated as soon as possible. And, those with an underlying health condition like asthma, diabetes or cancer, should contact their health care provider right away if they develop influenza-like symptoms.

Those who are started quickly on anti-virals fare better.