South Dakota health officials report the state's flu activity has stepped up in the past week and is now at the "sporadic" level.
Four more cases of influenza A were confirmed in the past week and the first person has been hospitalized with flu complications.
33 states are now reporting the sporadic spread of the flu.
So far 96 percent of the cases have been influenza A.
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What's Going Around
If you haven't gotten a flu shot yet, you might want to put it at the top of your weekend to-do list.