Health officials are reporting four more H1N1 associated deaths in Kentucky over the past week, bring the state’s total to 14.

But Commissioner of Public Health Dr. William Hacker remains “concerned but not alarmed,” and he is hopeful the widespread H1N1 flu activity in Kentucky may slacken off in the coming weeks.

All four persons who died in the past week from causes associated with the flu had underlying medical conditions or were among the targeted groups given priority for the H1N1 vaccine, said state epidemiologist Kraig Humbaugh. That’s true for 11 of the 14 total number of victims in Kentucky.

Hacker said the flu has been widespread in Kentucky since mid-September and the state laboratory has seen continuous H1N1 activity since the first case was reported on April 30. After a lull during July, activity picked back up with the opening of schools in August, said Humbaugh.

“Most patients are recovering without treatment,” Humbaugh said. “We’re seeing a similar pattern of severity as we see with seasonal flu. Only a small percentage of the population has been reported to be seriously ill.”

Hacker said there has been no discernible uptick in the virulence of the new strain of flu which appears to attack younger people more frequently than older persons. That may be due to a similar flu strain which older person may have contracted between 1945 and 1957 or so, developing an immunity which protects them now.

Hacker said heath officials are not seeing more deaths from the flu this year – 36,000 people die annually from flu in the United States – but they are seeing more pediatric cases and deaths, more since August 30 than in a typical entire year.

And the flu out there is nearly exclusively H1N1, Humbaugh said. More than 96 percent of confirmed samples sent to the state lab have been identified as H1N1, he said. During the first two weeks of October, the lab tested 758 specimens of which 441 tested positive for flu, and almost all of those were H1N1, he said.

Hacker said the number of vaccine doses allocated for Kentucky has doubled and shipments are arriving sooner after orders, he said. Local health departments are also doing a good job of distributing and giving vaccinations.

Hacker said pandemic flu infections usually peak over a six to eight week period and he hopes “we may see it calm down in the next couple of weeks.” But he expects the virus to be “highly active” throughout the flu season which usually peaks in January and February.

Hospital emergency rooms are seeing more traffic, Hacker said, but he’s detected no panic or alarm since President Barack Obama declared a national emergency. Some hospitals have sought guidance on establishing alternative examination sites just to ease bottlenecks at the emergency room which might interfere with normal emergency treatment.

Hacker said commercial anti-viral flu medications remain available except for pediatric suspension varieties and those are easily replaced by liquid suspensions which pharmacists can produce. He said the state hotline (1-877-843-7727) is receiving about 200 calls a day, responding to general questions about the vaccine and signs and symptoms of the flu.

Hacker again attested to his personal comfort level about the safety of the vaccine, saying the youngest of his six grandchildren has already been vaccinated. The other five will get the vaccine as soon as it’s available in their community, Hacker said.

RONNIE ELLIS writes for CNHI News Service and is based in Frankfort. Reach him at rellis@cnhi.com. Follow CNHI News Service stories on Twitter at www.twitter.com/cnhifrankfort.