The Indiana State Department of Health says flu cases are rising in many parts of the state and four Indiana residents have died of influenza since October.

The Centers for Disease Control and Prevention (CDC) recommends the flu vaccine for everyone six months of age and older.

IU Health doctor says there are a number of reasons she is not recommending the mist.

One inmate is dead after the H1N1 flu virus spread through the facility. Thirteen remain in the hospital, two in the Intensive Care Unit.

Flu season occurs annually, typically starting around October and continuing through May. The health department says seasonal flu viruses can vary from year to year, so it is important to get a flu vaccine every year.