The 2016-2017 flu season shifted into high gear at the end of calendar year 2016, as four states were reported to be at the highest level of flu activity and six others were close behind, according to the Centers for Disease Control and Prevention.

For the week ending Dec. 31, 2016, Georgia, New Jersey, Oklahoma, and Oregon were at level 10 on the CDC’s 1-10 scale of influenza-like illness (ILI). Others in the “high” range were New York at level 9 and Alabama, Louisiana, Missouri, South Carolina, and Utah at level 8. Puerto Rico was also at level 8, after being at level 10 for the previous few weeks. An additional 10 states were in the “moderate” range (6-7), the CDC reported.

The overall proportion of outpatient visits for ILI (defined as fever [temperature of 100° F or greater] and cough and/or sore throat) for the week was 3.4% – the highest rate of the season and the third consecutive week over the national baseline of 2.2%, according to data from the U.S. Outpatient Influenza-like Illness Surveillance Network.

The CDC has not reported any flu-related pediatric deaths yet this season. Pediatric death totals for each of the last 3 years were 111 for 2013-2014, 148 for 2014-2015, and 89 for 2015-2016, the CDC said.