The H1N1 virus responsible for the 2009 global pandemic is back. State health officials from across the country say the resurgence is resulting in a dramatic rise in flu deaths in young and middle-aged adults and in children this season.

The reported death tolls are significantly higher than last year. The Centers for Disease Control and Prevention said the flu has been killing at epidemic levels since mid-January.

The outbreak has been especially severe in California. There have been 243 deaths of residents younger than 65 so far this year.

Doctors and public officials are urging the unvaccinated to get a flu shot immediately.