Swine flu infections seem to be dropping, but the number of children who died with the illness rose by about 30, according to a government report released Monday.
Widespread infections of swine flu were reported in 32 states as of Nov. 21, down from 43 states the week before, U.S. Centers for Disease Control and Prevention officials said.
The CDC also said there were 27 new lab-confirmed swine flu deaths in children under 18, bringing the total to about 200 children. That's the largest one-week tally for children since the pandemic started.
Since it was first identified in April, swine flu has sickened an estimated 22 million Americans, hospitalized about 98,000 and killed 4,000. It has proved to be similar to seasonal flu but a bigger threat to children and young adults.
The swine flu pandemic has so far hit in two waves in the United States: First in the spring, then a larger wave that started in the late summer.
In late October, 48 states reported widespread flu activity. Increasingly, that appears to have been the peak of the second wave. Since then, fewer states have been reporting widespread cases, and the number of school closings due to swine flu has at times dropped to zero.
But there are still plenty of ill people — as many as during the worst days of many regular flu seasons. And CDC officials have said the signs of declining cases do not necessarily mean the worst is over.
"We won't be surprised if we see another uptick later this year or early next year when kids return to school from Christmas break," said CDC spokesman Tom Skinner.
That post-holiday increase happened during a flu pandemic in 1957 that is being studied as a possible model for what's going on lately with swine flu, he noted.
Monday's count of children's deaths represents cases reported in the week ending Nov. 21. While there have been about 200 deaths reported, officials believe there are probably a few hundred more.
Death statistics can lag behind the spread of an illness, CDC officials say.