The lethal H1N1 flu has returned to South Dakota. But health officials currently classify the spread of H1N1 at a low level in South Dakota. It is widespread in 10 states - Wyoming, Kansas, Alabama, Alaska, Louisiana, Massachusetts, New York, Pennsylvania, Texas and Virginia. Dr. Lon Kightlinger, state epidemiologist for the South Dakota Department of Health, says the virus is a similar strain to the lethal mutation of influenza that swept across the state and nation in 2009-10.