The 25th flu-related death in the central San Joaquin Valley was reported Thursday by Merced County health officials.
It was Merced County's fourth death this winter from flu. So far this flu season, Fresno County has had 14 deaths, Kings County has had four, Madera County has had two and Tulare County, one.
Valley health officials stressed again the importance of flu shots for everyone and said people with chronic health problems should also consider a pneumonia vaccine.
Severe cases of influenza typically progress to pneumonia, said David Luchini, assistant director of the Fresno County Department of Public Health.
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The flu strain widely circulating this year is the virulent H1N1 influenza A virus, also called swine flu. All but one of the Valley's deaths have been H1N1. The virus has proved deadly to younger adults.
Health departments receive reports of flu-related deaths of people who are younger than 65 and who have been hospitalized in intensive care units. The latest death in Merced County was a man between the ages of 20 and 60, county Health Director Kathleen Grassi said. The county's three previous deaths also were males in that age range.
Grassi said four people -- two men and two women -- remain in intensive care units with flu-related symptoms. They also are between the ages of 20 and 60, she said.
The medical history of those who have died and those remaining in intensive care was not known, Grassi said.
But on Thursday, Fresno County health officials said 12 of those who have died in the county had risk factors that contributed to the deaths from influenza. This is the most severe flu season in five years, the officials said. Fresno County has had 31 people in intensive care units. Eight remain hospitalized.
State health officials are expected to release updated flu-related death numbers Friday. Last week, 95 had been reported statewide and another 51 were under investigation.
Medical information was available on 65 of the statewide deaths -- and of those, 53 had health conditions that would increase the risk for influenza complications, Fresno County health officials said Thursday.
People who are smokers, the obese and pregnant women are at increased risk of complications from the flu and so are people with chronic health conditions, such as diabetes, lung and heart disease.
Vaccination against the flu is the best protection. Even healthy people can become severely ill with the virus, Luchini said.
People can improve their overall health by taking steps to achieve and maintain a healthy weight, stop smoking, reduce stress and get plenty of rest, said Sarah Bosse, manager of the Office of Policy, Planning and Communication at the Fresno County Department of Public Health.
But of all those actions, Bosse said, an increase in activity is the most important. "We see the impact on being able to maintain and prevent chronic disease" much faster from physical activity, Bosse said. A healthy diet takes a bit of time to see results, she said.
Physical activity can be 30 minutes of walking a day, she said. "It doesn't have to be super-vigorous."
Symptoms: Fever, cough, body aches, headache
In case of flu
Adults: Stay home from work, drink plenty of fluids and get rest. If you are short of breath or your flu becomes worse after several days, seek care from a doctor or emergency room.
For infants or young children: Follow your pediatrician's recommendations. If the child has labored breathing or appears excessively sleepy, seek immediate care.
For older children: Follow your doctor's recommendations; many times a child can be nursed at home. Keep the child home from school. Make sure the child drinks fluids to prevent dehydration. Give acetaminophen or ibuprofen to reduce fever. Never give children aspirin. If the child's breathing is labored, seek immediate care.
To stay well
Get a flu shot
Wash your hands
Wash telephones, computer keyboards and other shared instruments
Use tissue and cover your mouth when coughing or sneezing
When ill, stay home to protect others