At the end of the day Tuesday, nearly 257,000 shots had been given by regional health authorities across Manitoba.

A second person has died in Manitoba from complications attributed to the fall outbreak of the H1N1 virus.

The victim was an adult between the age of 18 and 65 who was confirmed to have H1N1 influenza but was otherwise healthy, health officials announced Thursday.

The first recorded death this fall was reported by health officials on Nov. 10. That person was also an adult between ages 18 and 65 but was confirmed to have underlying medical conditions.

Health officials have not revealed where either person lived. The provincial government's protocol since the spring outbreak of H1N1, or swine flu, has been to withhold the identity of communities with confirmed cases for fear it will stigmatize them.

There were seven deaths in Manitoba during the spring wave of the virus. The fall deaths bring the provincial H1N1 death total to nine.

543 cases of H1N1 in Manitoba

Manitoba Health officials are also reporting 251 additional lab-confirmed cases of H1N1 during the week of Nov. 10 to 16, bringing the total to 543 since Oct. 6.

They noted those cases do not come close to indicating how many people in the province have actually been infected by the virus because many people don't bother to go to the hospital when they have mild symptoms.

Dr. Joel Kettner, the province's chief medical officer of health, has said the actual number of Manitobans who have contracted the virus is likely closer to 100,000.

The province is encouraging the public to take the following measures to help prevent flu infections:

• Cover your cough by coughing into your elbow or sleeve or use a tissue to cover your nose and mouth when coughing or sneezing. Place the tissue in the garbage.
• Wash your hands often with soap and water, especially after coughing or sneezing. Hand sanitizers may also be effective.
• Reduce the spread of germs. Limit touching your eyes, nose or mouth.
• Maintain your health by making healthy food choices, being physically active and getting enough sleep.

Anyone with the following symptoms is advised to go directly to an emergency room, nursing station or health-care provider or call 911:

• Shortness of breath or difficulty breathing.
• Severe or worsening symptoms.
• Dehydration, drowsiness or confusion.
• Fever in an infant under three months old.
• Any signs of serious illness in a child under five years of age.

Manitobans are encouraged to contact their nearest health-care provider or visit the nearest health-care centre if they have flu symptoms. Early treatment — within 24 to 48 hours — may be very important, health officials said.

H1N1 vaccination clinics remain open around the province. The 12 clinics operated in Winnipeg by the Winnipeg Regional Health Authority are open Monday to Thursday, 9:30 a.m. to 8 p.m. and Friday from 9:30 a.m. to 4 p.m. Locations are on the map below.

Clinics outside the city can be found by visiting Manitoba Health's H1N1 website, which can be reached by clicking on the link at the top right of this story.

At the end of the day Tuesday, nearly 257,000 vaccinations had been administered by regional health authorities across Manitoba.