A Manitoba man has died after contracting the H1N1 flu virus, health officials said on Thursday.

He's the fourth person to die after contracting swine flu since the second wave of the virus hit the province in early October.

Health officials did not identify the man, nor give any indication about where in Manitoba he's from. They would only say he was between 18 and 65 years old and had underlying health conditions.

Between Dec. 22 and Monday, 21 new cases of H1N1 were confirmed by laboratory tests, bringing the total number of confirmed cases in the second wave to 1,768, officials said.

Manitoba Health continues to encourage anyone who has not yet had an H1N1 flu shot to get one as soon as possible. The vaccine is still available at some community or workplace clinics, public health offices and doctor's offices, officials said.

As of Tuesday, 442,000 swine flu vaccination shots have been administered.

Health officials said people with the following symptoms of severe illness should go to the emergency room, nursing station 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.