Swine flu kills 6 more people in Md.; all had underlying conditions

State public health officials said Thursday that six more people have died in Maryland in the past four weeks of swine flu, bringing the number of deaths statewide since the pandemic began to 19.

All six were adults with underlying health conditions. Three were from the Baltimore area, two were from Western Maryland and one was from Southern Maryland. No further details were provided by the state Department of Health and Mental Hygiene.

So far, 664 people have been hospitalized in Maryland as a result of the H1N1 virus.

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"We wish to express our sympathies to the family and friends of all those who have died," said Health Secretary John M. Colmers in a statement. "Unfortunately, such deaths occur in Maryland every year with seasonal flu as well. The impact of this H1N1 flu is similar in that deaths usually involve people with underlying health conditions who are at greater risk of serious complications from flu of any strain."

Maryland plans to begin reporting statewide deaths next week the same way they are reported by the federal Centers for Disease Control and Prevention, which involves estimates that officials believe provide a more accurate accounting. Until now, only deaths in which a lab confirmed swine flu were reported, which sometimes took weeks and often left out patients who died of secondary infections such as pneumonia, the CDC said.

Despite the uptick in Maryland deaths reported, officials believe that there has been a decline in flu activity in general, said Frances Phillips, the state's deputy secretary for public health services. But vaccination programs continue around the state, with more than 750,000 doses ordered through Thursday.

Nationwide, the CDC said that from April, when the flu outbreak began, through Oct. 17, an estimated 22 million people have become ill with swine flu. About 98,000 people have been hospitalized, and 3,900 people have died.

Swine flu disproportionately affects those under age 65, unlike seasonal flu, which normally takes a toll on older people. So far, 36,000 children have been hospitalized and 540 have died nationwide.