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RALEIGH, NC (AP) — State health officials report the death toll from the seasonal flu outbreak has risen to 21, leading to a renewed call for residents across North Carolina to get vaccinated.

The NC Department of Health and Human Services said Thursday that of the 21 deaths, 19 have been young and middle-aged adults, most of whom had underlying medical conditions. Only two deaths have been reported in persons over 65.

Health officials said flu activity has been widespread in North Carolina since mid-December. Flu season typically peaks during January and February.

State Health Director Robin Gary Cummings is encouraging flu vaccination as the best protection, especially for women who are pregnant, people who are obese and people with medical conditions like heart disease or lung disease that place them at higher risk.

(Copyright 2014 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.)

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