SAN DIEGO -- The number of confirmed cases of swine flu reported in San Diego County since the pandemic began earlier this year stood at 752 Thursday morning, health officials said.

A total of 14 of those cases have been fatal, according to the county Health and Human Services Agency.

Four deaths were reported Wednesday. The latest victims were all women -- ages 30, 41, 50 and 53 -- and all had underlying medical conditions, the HHSA reported.

Two of the 14 people who have died locally from swine flu, caused by the H1N1 virus, were visiting San Diego at the time of their deaths. They will not be included in local statistics but will be counted in their hometowns, according to the HHSA.

"The worst may be ahead of us." Dr. Gil Chafes commenting at a bi-national conference of health care professionals meeting in Old Town.

Swine flu has already doubled the patient load in Australia now going through its flu season.

"The hope is that a vaccine will be ready by October, and that cross border information and cooperation will help us keep swine flu in check as best we can," said Chafes.

County health officials urged the public again this week to stay home from work or school if they have flu-like symptoms such as fever, cough, sore throat, body aches, headaches, chills and fatigue.

Those with underlying medical conditions experiencing influenza-like symptoms should contact their doctor, according to the HHSA.