SAN DIEGO -- Three more deaths in San Diego County have been linked to the swine flu pandemic, bringing the total number of fatal cases in the region to 21, health officials announced Wednesday.

The victims included a 61-year-old woman, a 22-year-old woman and a 28- year-old man, all with underlying medical conditions, according to the San Diego County Health and Human Services Agency.

So far, there have been 1,154 confirmed cases of H1N1 influenza in San Diego, including the 21 deaths, according to the HHSA. There have been three deaths of non-residents that are not included in the local count.

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.