The current wave of pandemic H1N1 appears to have peaked, with four weeks of declines in several key indicators, the Centers for Disease Control and Prevention announced. But despite the decrease, the outbreak is continuing to take a heavy toll of hospitalizations and deaths, especially among children. Widespread activity of H1N1 was reported in 32 states in the week ending Nov. 21, down from 43 states the week before and 48 a month ago.