SIOUX FALLS - The state Health Department says the swine flu-related death toll has reached 21.

Included was the death last week of a 12-year-old sixth-grader from Sioux Falls, Tyler Newville.

The state says flu indicators ebbed last week, including fewer absences from schools.

The state says that of the 21 deaths from the H1N1 virus, five have been in Pennington County, three in Minnehaha and two each in Shannon and Todd counties.

There has been one recorded swine flu death in Brookings, Brown, Buffalo, Clay, Codington, Davison, Turner, Union and Walworth counties.

The virus can cause a high fever, body aches, coughing, a sore throat, respiratory congestion, and, in some cases, vomiting and diarrhea.