A man in his 50s with underlying medical conditions is Hawaii's 11th death associated with swine flu.

The state Health Department confirmed yesterday the Oahu resident's death from H1N1 influenza at Tripler Army Medical Center, but released no details, citing “;privacy considerations and federal law.”;

“;The patient had multiple, additional co-morbidities and these conditions were contributing factors to his death,”; Dr. Sarah Park, state epidemiologist and chief of the department's Disease Outbreak Division, said in a news release.

“;We are continuing to monitor critical case testing and focused clusters to help identify if this pandemic virus changes into something that causes more severe disease.”;

Hawaii's first H1N1 cases were confirmed May 5. The deaths include one child. All but one adult and the child were reported with other medical conditions.

Contributing factors could include obesity, smoking, asthma, heart disease, diabetes and respiratory difficulties.

“;This is a warning to people with chronic conditions who could suffer complications that it is really important for them to get vaccinated,”; said department spokeswoman Janice Okubo.

“;We encourage people, when vaccine becomes available, to get it,”; she emphasized. “;There seems to be a lot of concern about the safety and how necessary it is, but we have seen widespread outbreaks on the mainland. We want to prevent Hawaii from having some of the issues that other states have had.”;

Emergency, health and essential workers have priority for the first H1N1 swine flu vaccine, which arrived Monday. However, it is in nasal spray form, approved only for people age 2 to 49. Others must wait for a swine flu shot.

Primary target groups for H1N1 vaccine include pregnant women, people who live with or care for children under 6 months old, health care and emergency medical services personnel, people age 6 months through 24 years, and those 25 through 64 who have underlying medical conditions putting them at high risk for complications from influenza.

Information for pregnant women who may be at risk for complications from swine flu is available from the U.S. Centers for Disease Control and Prevention at cdc.gov/h1n1flu/pregnancy.

Okubo said vaccine continues to arrive and the department is working with doctors, health clinics and other groups that want to give swine flu vaccinations.

Seasonal flu clinics will start in more than 300 public and private Hawaii schools next week and the health agency hopes to have consent forms ready to go to parents the week of Oct. 19 for H1N1 vaccine school clinics, Okubo said.

She said she has been hearing that many teachers are being very cautious, keeping things clean in their classrooms and making sure kids wash their hands frequently.

For more information on H1N1 influenza, vaccine and locations to get flu shots, see the Health Department's Web site: flu.hawaii.gov, or call Aloha United Way at 2-1-1. The department also is on Twitter: http://www.twitter.com/ HIgov_Health.