Five elderly residents have died at a care home in southern Portugal amid an outbreak of Influenza A, with health authorities continuing to monitor the situation and prosecutors investigating the deaths.

The latest death was reported Sunday at the Santa Casa da Misericórdia de Veiros care home in Estremoz, in the Évora district. The Local Health Unit of Central Alentejo (ULSAC) said nine residents had been transferred to hospital since Wednesday. Three of those patients subsequently died, while three were discharged and three remain hospitalized. Laboratory tests confirmed Influenza A infection in two of the three hospital deaths.

The three hospital deaths brought the number of fatalities associated with the outbreak to five. Two other residents had died earlier at the care home. However, health authorities have stressed that Influenza A has not been laboratory-confirmed in all five cases, meaning a direct link between the virus and every death has not been established.

The outbreak was identified at the Veiros facility on Sept. 23. At the beginning of the outbreak, the home had 38 residents, and a number of them developed respiratory symptoms compatible with Influenza A. Earlier reports said 25 residents had symptoms, while several infected residents were receiving treatment in hospital.

ULSAC's public health department visited the facility on Sept. 24 and has continued epidemiological surveillance, including checks on infection-control measures, hygiene procedures, isolation arrangements and the use of personal protective equipment.

A follow-up visit on Sunday found no new cases and no clinical deterioration among the residents who remained at the facility, according to ULSAC. Health teams are continuing to monitor the residents in coordination with the care home's medical and administrative staff.

The facility has also introduced additional precautions, including restricting visits, deep cleaning and disinfecting the premises, and isolating residents with symptoms. The care home's director previously said symptomatic residents were being treated and kept separately from those without symptoms.

The residents who died earlier in the outbreak were between 89 and 95 years old, according to the care home's director. Two staff members were also reported to be ill and were staying at home while receiving treatment for flu symptoms, although they had not been tested.

Portugal's Public Prosecutor's Office has opened an investigation into the deaths at the care home. No suspects have been formally identified or charged so far.

The investigation comes as authorities seek to establish the circumstances surrounding the deaths and determine whether they were connected to the respiratory outbreak.

ULSAC said it would maintain clinical and epidemiological surveillance of the facility and provide further information as the situation develops. It also expressed condolences to the families of those who died. (ILKHA)