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A patient gets a shot during a flu vaccine program in Calgary on Oct. 26, 2009.JEFF McINTOSH/The Canadian Press

Health officials in Saskatchewan say three more people have died after getting the flu, bringing the total number of deaths in the province to six.

Denise Werker, Saskatchewan's deputy chief medical health officer, says two of the latest deaths were people over the age of 65 and the other was between the ages of 20 and 64.

"All six are associated with influenza A H1N1 infection," Werker said Tuesday.

"We need to be clear that when we have these deaths reported, this is not like receiving the official death notice. We do not know that influenza was the cause of death or even a contributing cause of death, but it's the best information that we have in real time."

Three deaths were reported in Saskatchewan last week, two of them young children. Most of the people who died had underlying medical conditions.

Eighteen people in Saskatchewan have also been admitted to intensive care because of the flu.

And Werker warns the flu season has not yet peaked.

"There is more to come. We are still on the steep part of the curve," she said.

"The laboratory confirmations are the tip of the iceberg that we see. So we know from last week, we had 161 lab confirmations and this week, in the space of seven days, we now have 336, so that's almost a 50 per cent increase."

Werker says people need to remember that there are flu-related deaths every year. There were 15 flu-related deaths in Saskatchewan during the 2009-2010 H1N1 influenza pandemic and three flu-related deaths last year.

Werker says the province is "not in pandemic mode."

The situation is different than in 2009 when H1N1 was a new strain of flu. This year, H1N1 is included in the vaccine.

"During pandemic, generally there is only one strain that circulates because that strain is the one that basically out crowds all the other strains because there's no immunity in the population," said Werker.

"When there is immunity in the population, there is basically a battle against the strains as to what's going to take hold. This season, it started out with H1N1, it doesn't mean that it's going to end on H1N1 and I can't predict that."

Word of the deaths in Saskatchewan comes after Alberta Health said Monday that 10 people have died in that province after getting the flu, with 40 others in intensive care.