Health bosses have called for vulnerable people to have winter flu jabs after the deaths of a number of people from swine flu in the north west.
The virus was a contributing factor in the deaths of a 32-year-old mother-of-two from Liverpool and three men in Greater Manchester.
Kay Burdett, of Old Swan, died at Royal Liverpool Hospital last week after reportedly being discharged following a three-month spell of treatment for an asthma condition.
Two men from Oldham and a man from Rochdale who died all also had underlying health problems.
The Health Protection Agency (HPA) wants pregnant women, pensioners and people with a long-term health issues to receive the free seasonal flu vaccine, including protection against swine flu.
Diane Wake, Royal Liverpool Hospital's director of nursing and operations, said: "A small number of people with flu, particularly those with chronic ill health, can become seriously ill and die.
"Most people with flu recover completely without any need to see a doctor.
"We would ask that the people of Merseyside with flu-like symptoms do not come into our Emergency Department, visit patients or come in for routine appointments. We are happy to rearrange appointments. This will help protect our vulnerable patients.
"The Emergency Department gives the same medicines you can get from a pharmacist or a GP to those people who come in with flu-like symptoms."