Two more influenza-related deaths were reported in the central San Joaquin Valley on Thursday, the same day that Fresno County health officials reported a spike in whooping cough cases.
Fresno County reported a fifth flu death and Tulare County reported its first. Kings and Merced counties have previously reported three deaths each for a total so far this winter of a dozen deaths.
On Thursday, the Fresno County Jail reported three more inmates had the flu -- raising the total who have been sickened over the past couple of weeks to 14. One inmate died Monday of complications from the flu.
The sick inmates -- 12 men and one woman -- are in isolation wards, said Chris Curtice, a spokesman for the Fresno County Sheriff's Department.
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The latest flu deaths -- a woman in Tulare County and a man in Fresno County -- involved H1N1, an influenza A virus that has been associated with all of the deaths in the Valley. Counties receive reports of deaths from hospitals of patients who are 64 years of age and younger and who have been in intensive care units.
"Unfortunately, we are reminded that the effects from this illness can be very serious," said Dr. Karen Haught, Tulare County Health Officer.
As Fresno County health officials reported the fifth influenza death Thursday, they said they are keeping tabs on another respiratory disease as it sickens greater numbers of people this winter.
The county has had 17 cases of pertussis, also known as whooping cough, since Nov. 1. By the same time last year, four cases had been reported, said David Luchini, assistant director of the Fresno County Department of Public Health.
This year, 10 of the cases have been infants younger than one year of age. One infant has been hospitalized, Luchini said. There have been no deaths.
"Pertussis cases tend to peak every three to five years," he said. The last spike -- in 2010 -- sickened thousands statewide and claimed 10 babies' lives, including a Fresno County infant.
Vaccine for both the flu and whooping cough are available, Luchini said.
The vaccine for pertussis, called Tdap, is recommended for infants at two, four and six months of age. Pregnant women need to have a Tdap booster during each pregnancy, Luchini said. And because adults can spread the disease to babies, family members who are around infants need to get the vaccine, he said. Since 2011, the vaccine has been a requirement for seventh-graders to enter school.
This year's flu vaccine offers protection against H1N1.
Tulare County officials said the woman who died of flu complications had not been vaccinated for this flu season. Fresno County officials did not know if its latest flu victim had gotten a flu shot.
But health officials have said it's not too late to get a flu shot -- and people have been heeding the advice.
Fresno County immunized more than 1,500 adults and children between Jan. 2 and Tuesday, said Joe Prado, the health department's division manager of community health. Prior to reports of H1N1 deaths, the clinic was giving shots to about 50 people a day, at most, he said.
On Thursday, people were lined up outside the county's flu-shot clinic in downtown Fresno and H1N1 deaths were on their minds.
Irene Aleman, 62, said last year she skipped a flu shot, but not now. This year, the flu season "scared me," she said.
Sidd Moreno, 43, of Fresno, said he was in line to get a flu shot simply to be safe. "People are dying."