NEW YORK — The level of flu activity across the nation dropped in November, federal health officials said earlier this month, indicating that the second wave of the swine flu pandemic in the United States has peaked.

While officials warned that the number of people getting infected with the H1N1 virus remains high and cases could surge again, November’s four straight weeks of falling activity suggests that the intensity of the outbreak has reached a high.

“We are certainly on the downward slope of the curve,” a spokesman for the Centers for Disease Control and Prevention (CDC) in Atlanta told The Washington Post.

But the CDC noted that 27 deaths from swine flu among people younger than age 18 had been confirmed during the month’s final week, marking the largest one-week tally of pediatric deaths since the pandemic started.

Nearly 200 children have already died from flu this year. About 40 or 50 children usually die from the flu during an entire season.

“We’re far from being out of the woods,” the CDC spokesman said. “There’s still a lot of flu out there. And we wouldn’t be surprised to see another uptick in activity as we approach the end of December and beginning of January, when kids come back from Christmas break.”

Meanwhile, health care providers and community pharmacies are redoubling their efforts to ensure that they have adequate levels of both H1N1 and seasonal flu vaccine.

Walgreen Co.’s Take Care Health Systems subsidiary, for instance, says its clinics in 355 Walgreens stores across the country have ample supplies of seasonal flu vaccine after receiving the remainder of their 2009 seasonal flu vaccine order from manufacturers.

Since beginning this season’s flu shot administration, Take Care Clinics have administered more than 380,000 doses of seasonal flu vaccine, Take Care chief nurse practitioner officer Sandra Ryan says.

Meanwhile, Take Care notes that it is working with health authorities and has registered all Take Care Clinics as vaccine administration sites for H1N1 immunizations. Ryan says a select number of clinics have received limited quantities of the vaccine and are administering the supply to high-risk patients as directed by the CDC and government health authorities.

As more patients continued to seek out flu vaccines this year, issues of pricing emerged around one of the most popular of these drugs, Roche Laboratories Inc.’s Tamiflu. After the liquid version of the drug began to become scarce last month, suspicions arose that community pharmacies were price gouging their customers for the medication, which is used primarily as an H1N1 vaccine for children.

Sen. Chris Dodd (D., Conn.) called on Health and Human Services Secretary Kathleen Sebelius and Attorney General Eric Holder to investigate, and said the price disparities — an investigation found that the same drug was selling for as low as $43 and as much as $130 — were “deplorable.”

In the wake of the controversy, Walgreens reduced its prices by nearly 20%, and CVS Caremark Corp. lowered what it charged for liquid Tamiflu by nearly 10%.

Community pharmacy advocates quickly rushed to the industry’s defense, explaining that many pharmacies have had to compound the drug, which in turn has driven up the cost.

“Pharmacy’s No. 1 priority is to help ensure the safety and health of patients,” says a statement from the National Association of Chain Drug Stores, which rarely comments on price-related issues. “Prices on medications and other products do vary based on many operational and market factors.

“It is important to remember that allegations about inappropriate pricing are just that — allegations. On the other hand, it is an undisputed fact that pharmacies have performed a valuable service in providing a vital treatment that otherwise would be largely unavailable in the absence of pharmacy.”