According to a government health agency report, influenza infections reduced for the fourth consecutive week in the United States but the number of flu deaths were more than the epidemic threshold.
During the week of November 15-21, 32 states reported widespread flu activity, down from 43 states the previous week, the Centers for Disease Control and Prevention (CDC) said in its weekly flu report.
Nearly all the cases of flu were A(H1N1), or swine flu, the report said.
Hospitalization rates and deaths attributed to pneumonia and influenza were both higher than expected for the time of year, with very young children -- ranging from newly-borns to four years -- having the highest hospitalization rate.
More than eight percent of all deaths reported to the CDC during the week covered by the report were due to pneumonia or influenza, a full percentage point above the epidemic threshold.
Deaths from pneumonia and influenza have been above the threshold for eight consecutive weeks, the CDC said.
Thirty-five of the deaths from flu were in young children, and in 27 of those deaths, swine flu had been confirmed in laboratory tests.
Seven children died of other influenza A viruses, which were not subtyped, and one child died of seasonal flu.
Since the swine flu outbreak was first reported, the CDC has received reports of 198 laboratory-confirmed pediatric deaths from the new strain of H1N1 flu, but that toll is thought to be "an undercount of the actual number," the federal health agency said.
The highest pediatric death toll from seasonal flu in the past three years was 88, CDC officials said last month.
Earlier this month, the CDC unveiled a new method for counting deaths from swine flu, and revised its estimated death toll from the new strain of flu to 4,000 people overall, including more than 500 children.
Worldwide, more than 207 countries and overseas territories or communities have reported laboratory-confirmed cases of pandemic swine flu, and 7,820 people have died of the new strain of flu, according to statistics released last week by the World Health Organization (WHO).
In North America, the Caribbean and a limited number of European countries, the WHO said "there are signs that disease activity has peaked."