3:54 p.m. - Burleigh County coughed and sweated its way into the lead in a dubious category last week.

It surpassed Cass as the North Dakota county with the most number of flu cases reported. According to the North Dakota Department of Health, 636 positive cases of influenza have been reported in Burleigh this season. Cass, which led the way two weeks ago, has reported 567 cases.

The total number of flu cases reported in North Dakota this season is 3,265, the most since officials started tracking the illness 10 years ago. Cases topped 3,000 two weeks ago.

North Dakota's flu season runs from October to May. The health department gathers flu information weekly, and releases it on Wednesdays. The number of positive cases confirmed last week was 35.

The weekly number of positive reports has decreased steadily from a high of 520, which was reported during the week of Feb. 5.

Still, the cases keep mounting. The number of positive reports this season are nearly double that of the 1,663 reported in the 2003-04 flu season.

There are two major reasons for that, according to Melissa Casteel, influenza surveillance coordinator for the health department. First, the general public is more aware of flu symptoms and more physicians are testing for the flu. Also, there was a vaccine shortage this season, and many people who typically get flu shots didn't do so. Flu shots are available now in many areas of the state, Casteel said, and have been for some time.

According to a weekly update -- available at www.ndflu.com -- no unusual trends of pneumonia- and influenza-related deaths have been reported to the state health department. Neither have any pediatric influenza-associated deaths.

It's unclear how many North Dakotans may have died from the flu this season; the health department doesn't typically get that information until June or July.

There were 386 flu-related deaths in the state last season, according to the North Dakota Division of Vital Records. An average of 408 people have died from the flu over each of the last five flu seasons. The vast majority of the deaths -- about 92 percent -- were people age 65 and older.

(Reach Tony Spilde at 250-8260 or tspilde@ndonline.com.)