Influenza activity is on the climb, according to a North Dakota Department of Health report released this week.

For the week ending Nov. 30, there were 84 cases of influenza reported in the state, compared to 26 cases for the same calendar week in 2018.

Overall, though, reported cases are down from last year, Levi Schlosser, influenza surveillance coordinator, said.

"We did see a lot of early high activity last year," he said. "There was a spike early on, which died down a little bit, and it picked up later in the flu season."

Data collection for the 2019-20 flue season began Aug. 1.

This season, 360 cases total have been reported. Cases include people who tested positive for influenza in a healthcare setting.

"The true number of people with influenza in North Dakota is underrepresented," the NDDOH report from Schlosser notes, "but case data allows us to see where and in what populations influenza is circulating."

Stark County has had 21 to 30 cases reported this season, the second most in the state, with Cass County reporting the most at 50-plus cases.

"Last year we saw a lot of cases circulating around the lakes region, like Devil's Lake and Grand Forks," Schlosser told The Dickinson Press.

It is normal for influenza activity figures to fluctuate, Schlosser said.

"Flu is really unpredictable," he said. "It's not unusual for us to see that."

The peak of flu season usually comes in March, Schlosser said.

There have been zero flu-related deaths reported this season.

Many factors can influence the spread of influenza. Good hand hygiene is important to preventing the flu, Schlosser said.

"I always stress that getting your flu shot is the best and easiest way we have at preventing the flu," he said. "I urge everyone to get their flu shot this year. It's definitely not too late."

The majority of reported flu cases have been Tybe B Victoria, Marlys Walter, Southwestern District Health Unit community paramedic coordinator reported at Friday's meeting of the Southwest Regional Disaster Coalition.

There has also been an increase in pertussis across the state.

Walter advocated for getting a Tdap vaccine, which inoculates against tetanus, diphtheria and pertussis.

"If you've gotten your Tdap, it has the pertussis component in it, but after about five years that wanes a little bit," she said. "That's why a lot of people will say, I got my Tdap and now I have pertussis. That's why that happens."

A Tdap may be required more than once every five or 10 years, Walter said.

"It used to be you would get Tdap once in your lifetime and a Td (booster) - tetanus and diphtheria - one time every 10 years, but now they're looking at doing Tdaps all the time," she said.

While figures so far this year are lower overall, those numbers are climbing and are expected to peak later in the influenza season.

"Last season peaked in March and we still have a ways before we approach the historical peak week," Schlosser said. "This year we're not sure when it will peak. We can only expect cases to increase until we reach that week, but it sounds like we still have some time."

He added, "It'll be interesting to see where it goes from here. It's still early in the season."

To make an appointment for an immunization, visit Southwest District Health Unit at 227 16th St. W., or contact 483-0171.