The rate of flu in Scotland has again more than doubled over the past week.
Weekly figures released by Health Protection Scotland (HPS) showed an increase in cases from 46 per 100,000 people in the last week of December to 107 per 100,000 in the first week of January.
The flu status has been raised from "normal" seasonal activity to "moderate".
The figures also showed that a further 30 patients needed intensive care.
The HPS statistics also showed that mortality rates related to the virus were still "low", with eight out of the total of 53 intensive care cases having died.
They included 18-year-old midwifery student Bethany Walker, from Applecross in Wester Ross, who died in hospital last week after her flu virus developed into pneumonia.
The increase in cases included all age groups from 15 years upwards.
The flu rate had also doubled the previous week, from just over 20 per 100,000 to 46 per 100,000.
Just over half of the circulating strains of flu match those in the 2017/18 vaccine, and most are believed to be the H3N2 strain known as "Aussie Flu" after problems the virus caused in Australia.
Questions have been asked in recent days about low flu immunisation uptake rates for NHS staff, with HPS again urging everyone who is eligible for vaccination to do so.
The HPS report said: "Vaccination of those eligible for seasonal influenza remains the most important preventative measure to reduce influenza".
The statistics were published shortly after First Minister Nicola Sturgeon faced questions from opposition leaders over the health service's ability to cope with the pressures on it.
Ms Sturgeon said levels of winter flu were currently four times the level recorded in the same week of last year.
She added: "In spite of all that, thanks to winter planning, thanks to the efforts of our NHS staff, our NHS is coping admirably."
Health Secretary Shona Robison said earlier this week that winter flu would be a "key factor" for the NHS to deal with over the coming weeks.
Her statement to MSPs came as the latest weekly figures showed patients waiting more than four hours in A&E reached record levels during the last week of 2017.
The figures showed that just 78% of patients across Scotland were either admitted, transferred or discharged within the four-hour target time of 95% - the lowest since weekly figures began in February 2015.
Flu vaccination rates
BMA Scotland, which represents Scottish doctors, warned on Wednesday the current situation should not be dismissed as "the inevitable increase in pressure that winter brings".
However analysis by the BBC showed that A&E waiting time performance in December continued to be better in Scotland than in England, where senior doctors have warned that patients are
Speaking during first minister's questions at Holyrood, Scottish Conservative leader Ruth Davidson called on Ms Sturgeon to stop cutting hospital beds while Scotland is in the midst of a "flu crisis".
Ms Davidson said there were almost 2,000 fewer hospital beds in Scotland than there were five years ago, when the total was more than 23,000.
As well as the fall in beds, she claimed social care places for the elderly were declining too.
Ms Davidson said: "People are waiting too long in A&E departments because there are no beds for them on wards, and because many of those hospital beds are taken up by patients who are waiting for their social care arrangements.
"But this SNP government has cut both hospital beds and elderly social care places, so when something like a flu crisis hits, the system breaks down."
Ms Sturgeon responded by saying that "hundreds of additional winter surge beds" had been set up in hospitals as part of NHS winter planning.
Meanwhile, Scottish Labour leader Richard Leonard highlighted the case of 80-year-old Tom Wilson from Newtongrage in Midlothian, who he said waited more than three hours for an ambulance after a fall on New Year's Day.
He said Mr Wilson later spent 13 hours on a trolley in the accident and emergency unit.
The Labour leader read an extract from a letter from Mr Wilson's son Michael to Ms Robison, which said: "I am sure you will say that it's got nothing to do with you or the SNP and blame Westminster.
"I've seen on the news your answer is 'we are doing better than England'. Is this a joke?"
Ms Sturgeon apologised "unreservedly" to Mr Wilson, and to anyone else who has had to wait longer than they should do for hospital treatment, or who does not receive the standard of care they should expect.
The first minister added: "I am not standing here saying, and we have not said at any stage, that some patients are not waiting longer during these winter times than we would want them to wait.
"That is down to the fact that we are facing demand and increases in demand that are unprecedented."