Update: Fresno County health officials confirmed a fifth person has died of flu-related complications.
The death is the 11th in the central San Joaquin Valley. Kings and Merced counties have had three deaths each.
Influenza continues its spread across the central San Joaquin Valley.
On Wednesday, Fresno Unified officials said 12 schools reported 33 children with flu-like symptoms, an increase from nine schools that reported 12 cases Tuesday and eight schools that reported 10 sick children on Monday.
H1N1, sometimes called "swine flu," has been the predominant strain making people sick. As of Wednesday, the deaths of 10 Valley adults had been attributed to the virus -- including a 60-year-old jail inmate who died Monday.
So far this flu season, Fresno County has had four deaths, including the inmate. Kings and Merced counties reported three deaths each.
Health officials have urged people to get flu shots, which offer protection from H1N1.
Fresno State has vaccine available free to enrolled students, said Dirk Ruthrauff, interim director of University Health and Psychological Services. He said there has not been an increase in the number of students with flu symptoms, but the staff will be ready when classes resume today.
Ten Fresno County Jail inmates with H1N1 remained in isolation Wednesday, a day after a judge suspended federal criminal proceedings for inmates because of the jail's flu outbreak.
The inmates -- nine men and one woman -- are being kept separate from the rest of the jail population, said Fresno County Sheriff's Department spokesman Chris Curtice.
Steps to control flu at the jail include giving Tamiflu, an anti-viral medication, to inmates as soon as they have symptoms, Curtice said.
He said he has received complaints from the public that inmates were not getting flu shots, but that's happening only to inmates who have symptoms.
Newly booked inmates also are offered the vaccine at a medical screening done by Fresno County Department of Public Health staff, said David Pomaville, interim county public health officer.
"If they want to be vaccinated we'll provide that," he said. "And certain high-risk inmates we will encourage to be vaccinated."
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