Australia aims to start vaccinating its high-risk population against H1N1 late this month. (John Amis/Associated Press) The death toll from the H1N1 pandemic has reached at least 3,486, up 281 from a week ago, the World Health Organization said Friday.

The number of deaths rose from 3,205 last week, the UN health agency said in a weekly update posted on its website.

Influenza activity remains low in Canada, WHO said. The United States is reporting increases in influenza-like-illness activity — above normal levels for this time of year — in the southern, southeastern, and parts of the northeastern United States.

Children and young adults are still being hit the hardest, said Dr. Daniel Jernigan, deputy director of the influenza division at the U.S. Centers for Disease Control and Prevention.

"There are 21 states that are reporting widespread activity," Jernigan told a news conference. Some emergency departments and outpatient clinics are seeing about twice as many flu patients as expected for this time of year.

"We don't see that kind of activity this time of year usually."

Vaccine delivery

The U.S. expects to roll out about 3.4 million initial doses of H1N1 vaccine in nasal spray form in early October. MedImmune's nasal spray vaccine is not approved for people with asthma, people over age 50 or very young children, mainly because it hasn't been widely tested in those groups.

It will be up to each state to decide how much to distribute at what time.

The goal is to increase capacity to deliver about 20 million doses a week, and eventually distribute the 195 million doses purchased by the U.S. government, the CDC said.

Flu activity remains low overall in Europe and Central Asia, except for France, which reported increases in influenza-like-illness activity above seasonal epidemic levels. Japan also reported influenza activity above the seasonal epidemic threshold, WHO said.

Transmission continues in Central and South America. In temperate regions of the Southern Hemisphere, such as Australia and South Africa, where the seasonal flu season is ending, flu activity is declining.

Donating vaccine

On Friday, Australia's drug regulator announced it has approved CSL Ltd.'s H1N1 vaccine for people over the age of 10. It is waiting for the results of more clinical trials to assess the vaccine in younger children.

Australian Health Minister Nicola Roxon said health authorities will recommend that immunizations start Sept. 30, which would make it one of the first countries to start offering the shots to its population. Those most at risk, including front-line health workers, pregnant women, those with chronic illnesses, and Aborigines in remote Outback communities will be first in line.

Also on Friday, WHO said that countries that receive donated pandemic vaccine will have to sign waivers releasing donors, manufacturers and WHO itself from liability.

WHO applauded donor countries — the U.S. Britain, New Zealand, Australia, France, Italy, Norway, Brazil and Switzerland — for committing to donate H1N1 vaccine.

"Given that current demand outstrips supply, these donations, together with the doses pledged by manufacturers, will help increase supplies of pandemic vaccines to populations that would otherwise not have access," the WHO said in separate statement on Friday.

The number of doses of swine flu vaccine produced will fall short of the 4.9 billion doses WHO previously said it hoped would be available worldwide.

On Thursday, the U.S. said it will donate 10 per cent of its vaccine purchases to WHO to redistribute to less developed countries.

The Public Health Agency of Canada has previously said it was negotiating with pandemic vaccine maker GlaxoSmithKline to sell unused vaccine elsewhere, but it's not clear if Canada will actually do so.

"At this time, Canada is doing an analysis of various options to support the provision of H1N1 vaccine to developing countries," the agency said Friday in an emailed response to questions from The Canadian Press. "Regardless of what decision is taken, Canada has ensured that the vaccine needs of Canadians are met."

With files from The Associated Press and The Canadian Press