BOISE (AP) — Idaho state health officials say at least two children have died of influenza-related causes recently and a third child’s death is under investigation because it appears to be flu-related.

Officials with the Idaho Department of Health and Welfare announced the deaths Friday, saying they are unusual because most influenza-related deaths occur among older adults.

“This flu strain appears to be impacting some children in Idaho heavily, and we want to make sure that Idahoans are taking precautions to stay safe this flu season,” said Dr. Christine Hahn, medical director for the department’s Division of Public Health.

Hahn said influenza illness has been increasing in Idaho and nationwide. The Centers for Disease Control and Prevention has also seen more reported pediatric flu deaths than usual this time of year, Hahn said.

As of Jan. 4, 32 children have died from the flu nationwide this season, according to the Centers for Disease Control and Prevention.

The two confirmed pediatric flu deaths happened in northern and eastern Idaho; the child who likely died of flu-related causes was also in eastern Idaho, according to the Department of Health and Welfare.

Hahn said that they don’t believe the children who died in Idaho had any underlying medical conditions. But she said state health officials don’t always have access to the patients’ entire medical history, so it can’t be completely ruled out.

“It is pretty unusual in Idaho — we had one child death reported in the last season, but prior to that we had not had any child deaths for several years,” Hahn said. “The fact that we are looking into possibly a third flu-related death is very concerning.”

Most of the pediatric flu-related deaths nationwide appear to be from a strain of influenza B, Hahn said, which is less common than influenza A strains. Experts are still trying to figure out what makes this particular influenza B strain harder on kids, she said, but it could be because many children will have had no or low exposure to influenza B strains in the past, so their body doesn’t have any experience fighting the virus to draw on.

“That’s one of the theories about why in some years, like in 1918, young people had the highest mortality rate from the flu. Sometimes kids get hit harder because there’s something about the virus that kids haven’t seen but adults have,” Hahn said.

People who are sick with flu-like symptoms — which can include coughing, fever, sore throat, headache, fatigue, and a runny or stuffy nose — should consider seeking medical attention, according to the Department of Health and Welfare. Some people, especially kids, may also experience diarrhea and vomiting with influenza.

“If you know how your child normally handles a cold or virus and they’re worse than that, they’re declining, or if they’re having trouble breathing, then I would take that child in” to the doctor, Hahn said. “If there is any concern above what you think is a normal, mild illness, it doesn’t hurt to get checked out.”

Anyone with underlying health conditions, under the age of 2, and pregnant women should contact a healthcare provider if they have flu symptoms, Hahn said.

“There are medications that can reduce the severity and duration of the illness,” Hahn said.

The flu vaccine protects against four flu strains, two type A and two type B. Of the four strains in this season’s vaccine, one type A and one type B appear to be a strong match, offering high levels of protection against those viruses, Hahn said. The other type A and type B strains in the vaccine appear to be less closely matched to the viruses circulating in the wild, she said, but they still help.

“Even when it’s not a perfect match, it still provides some protection,” Hahn said.