Four more Utahns have died during the past week after contracting the novel H1N1 flu virus, despite the fact that flu-like illness rates in the state have been dropping. And though Utah has ranked high per capita in the number of H1N1 cases reported by the Centers for Disease Control and Prevention in recent weeks, the numbers don't reflect the true pervasiveness of the illness either locally or nationally.

The Utah Department of Health released its most recent figures Wednesday, showing 268 Utahns with the virus have now been hospitalized, up 23 from one week ago.

A total of 14 Utahns with the virus have died. The previous week, no new deaths were reported. "At this time, all indicators suggest that the outbreak has peaked in Utah," the report said, noting that while flu-like illness rates are dropping, cases are "still slightly above the epidemic threshold."

Health Department director Dr. David Sundwall said the deaths in the past week are unfortunate, and involve some patients "who have been ill for some time. A general state of poor health caught up with them."

Even so, reporting from county health departments for the past two weeks "for the first time has let me breathe a sigh of relief," Sundwall said, as the rates of flu-like illness continue to drop.

Salt Lake County and Utah County have had their share of the virus, as has Weber County, Sundwall said. "Washington County was kind of late in the game but they've had their fair share as well. It's been uneven, but that's what you would expect with a migratory germ."

Although pockets of "fairly high prevalence remain, statewide it seems to be on the wane," he said.

Nationwide, the CDC collects data from individual states about the rate of disease, but because many states — including Utah — have stopped testing for the virus except in severe cases, getting a handle on how many Utahns specifically and Americans in general have had the virus is impossible, Sundwall said.

"We made a policy decision, which was ahead of the game, to stop asking for routine tests," when physicians suspected their patients had the virus. Because 90-plus percent of the people tested were confirmed with novel H1N1, "we began assuming that those with influenza-like illness had it.

"Continued testing was a waste of time and effort," he said, noting many other states have done the same and the World Health Organization is now following the same policy.