SAN DIEGO -- The deaths of four more people in San Diego County have been linked to the swine flu pandemic, health officials announced Tuesday.

The latest victims include a 58-year-old man and three women, ages 43, 29 and 27, according to the San Diego County Health and Human Services Agency.

All but the 43-year-old woman had underlying medical conditions.

So far, there have been 32 deaths of San Diego County residents linked to the H1N1 influenza and four deaths of non-residents, according to the HHSA. There have been 564 people hospitalized with the virus locally.

Currently, the county's six public health centers have only "very limited" supplies of the H1N1 nasal spray vaccine.

The nasal spray vaccine is for healthy individuals in high-risk categories that include children and young adults and those who care for infants under 6 months, according to the HHSA. It has not been approved for use in people with ongoing medical conditions or women who are pregnant.

County health officials again encouraged people to stay away from work or school if they have influenza-like symptoms such as fever, cough, sore throat, body aches, headache, chills and fatigue.

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