State health officials expressed growing concern Friday over the number of deaths reported four months into flu season, saying that with one week left until normal peak period, the number of fatal cases statewide is rapidly approaching last year's entire total.

The California Department of Public Health reported a significant increase in the statewide number of flu deaths, declaring a total of 45 confirmed flu-related cases and an additional 50 pending. Officials were alarmed at the prospect of approaching 100 deaths so early in the season, when the number stood in single digits at this time last year -- five fatal cases in total.

"This appears to be a pretty severe season in terms of looking at mortality as a measure of severity." said Gil Chavez, deputy director and epidemiologist for the CDPH. "We have 45 confirmed and 50 under investigation -- that's 95 right there and we're not even to the peak of flu season."

Included in the confirmed total of 45 are two pediatric cases, Chavez said. He could not speak to whether the children -- one in San Mateo County and one in Los Angeles County -- had underlying medical conditions before their infection.

Officials said that of the 95 deaths either confirmed or under investigation as flu-related, a large majority of the victims were unvaccinated or had underlying conditions that put them at increased risk. Although officials did not have a specific number, they said most of the deaths were due to swine flu, also known as H1N1. They also could not immediately estimate what percentage of Californians have been vaccinated, calling the figure a "constantly moving target" that is calculated at the end of the season.

A dose of intranasal vaccine is prepared at a San Jose elementary school during the H1N1 swine flu outbreak in November 2009.
A dose of intranasal vaccine is prepared at a San Jose elementary school during the H1N1 swine flu outbreak in November 2009. (Gary Reyes/Staff file)

Dr. James Watt, chief of the CDPH Division of Communicable Disease Control, said that in general, the patients most vulnerable to the flu, particularly the swine flu, appear to be those with lung disease, heart disease, cancer, HIV infection, pregnant women, and residents who are obese.

"We do know that unlike previous years, H1N1 is the predominant strain circulating, and when H1N1 predominates, there appears to be more fatalities," Chavez said. "We continue to be interested in getting as many people as vaccinated as possible. It's the one thing that is foremost in our agenda."

Chavez added that in addition to spotting vaccination shortages so they can intervene with a stronger supply, the CDPH is enhancing their monitoring of the epidemic by assisting the medical community in planning if facilities get overwhelmed with patients, and working with private industry to ensure the availability of antiviral medication.

Chavez and Watt agreed antivirals can work to treat influenza strains even if it's been several days since the onset, and recommended two antiviral medications, Tamiflu and Relenza, to treat this season's strain. They discouraged the use of antiviral Amantadine, citing various levels of resistance in this year's strain.

Officials are hopeful that the spread of the virus will taper as residents take steps to get themselves vaccinated and seek adequate treatment and isolation if they already have the flu. The normal peak season, after all, doesn't start until late January.

"What we don't know is if this is going to abate and we have equal mortality rates that just happened to peak early," Chavez said. "But as of now, we can certainly say that this is a season that started sooner."

Contact Erin Ivie at eivie@bayareanewsgroup.com. Follow her at Twitter.com/erin_ivie.