Minnesota schools reported a surge in outbreaks of flu-like illness last week — to levels not seen since the 2009 H1N1 epidemic — and another 60 people were hospitalized, according to weekly flu figures released Thursday by the Minnesota Department of Health.

The state also confirmed a second pediatric death — a victim under 18 — while hospitals continued to report busy ERs and inpatient wards.

"We've seen more flu patients this year already than all of last year combined," said Dr. John Wald, a spokesman for Mayo Clinic in Rochester, which is providing specialized treatment to patients with severe breathing complications.

Flu fears have been building since Thanksgiving, after health officials identified an A strain of influenza that is known to cause more severe illnesses and is poorly matched to this year's vaccine.

While that strain is historically hard on the elderly and young children, this year's variety appears to be moving among schoolchildren. In the week ending Dec. 13, 203 Minnesota schools reported outbreaks — up from 19 the prior week. Outbreaks are reported when schools are missing 5 percent or more of their students due to flu-like symptoms, or elementary schools have three or more students absent from the same classroom.

At least one private school, Visitation Lower School in Mendota Heights, closed early this week to prevent the further spread of illness in its halls and classrooms.

Lab testing has confirmed a rising number of cases of influenza and RSV, a source of common colds also known as respiratory syncytial virus. It is possible that schools aren't differentiating between the two, and that RSV is equally responsible for the rise in absences, said Karen Martin, a state epidemiologist.

Still, there is little doubt influenza is spreading, she said. "We don't typically see this high a number of outbreaks in a single week."

Jill Schoon of St. Michael called friends, news organizations and public officials Thursday, urging extra precautions. Her son suffered flu symptoms earlier this fall, and her 63-year-old mother-in-law died Saturday when her influenza infection worsened and aggravated underlying heart problems.

Schoon isn't satisfied with school policies that send children with flu-like symptoms home, because those affected are infectious hours before symptoms emerge. She urged schools to sanitize desks and distribute hand sanitizer. "Influenza A is dormant in your body for a day," she said, "meaning you can have it right now and you are contagious and you can give it to anybody."

Martin, the epidemiologist, agreed but she said the state typically doesn't recommend heightened precautions beyond getting a flu shot, covering a cough, washing hands and staying home if sick.

Influenza survives only two to eight hours on surfaces such as desks, so scrubbing a classroom overnight won't yield much protection, she said. Influenza also spreads through the air when infected people cough at others within a 3-foot radius.

Health officials continue to urge people to get flu shots, even though the vaccine is thought to be less effective than normal this season. Tamiflu can reduce symptoms if taken within 36 hours of infection, but is reserved for people at greatest risk of serious complications. Spot shortages of Tamiflu have cropped up, Martin said, but the drug remains available in Minnesota.

Identities of the children who died from influenza aren't released by the Health Department. However, the father of Shannon Zwanziger, a 17-year-old from Owatonna who died this month, told gatherers at a memorial Sunday that influenza contributed to her death, according to the Owatonna People's Press.

Outbreaks in long-term care facilities also increased last week, from four two weeks ago to 18 last week, the state reported. That's worrisome because of the virulence of the A strain in circulation, Martin said. "Unfortunately, we tend to see more deaths in that age group."

Allison Harper wasn't taking chances when she heard that three neighbors on her floor at Southview Acres of West St. Paul had flu symptoms. The 45-year-old is recovering from a car crash.

She hunkered in her room, exhausted her preferred shows on Netflix and called Jimmy John's for dinner Wednesday.

"I'm leaving here [soon]," she said. "I'm just trying to make it a couple more days without the flu."