DES MOINES, Iowa (AP) – Iowa authorities say at least 25 influenza-related deaths have occurred since Oct. 2, including 11 reported to the state last week. The Iowa Department of Public Health said in a news release Friday that all but one of the people who died had underlying conditions or contributing factors. The department says the deaths included 19 people 81 and older and two people 61 through 80.

There’s still time for a flu shot. The department medical director, Dr. Patricia Quinlisk, says the flu vaccine takes a few days to reach its maximum protection level, so waiting too much longer will mean diminished protection during the peak of the season.

Flu is a viral respiratory illness with symptoms that include fever, headache, tiredness, cough, sore throat, nasal congestion and body aches.