MANILA (2nd Update) -- A 49-year-old woman with influenza A (H1N1) or swine flu died in the Philippines, marking the country's first death related to the virus, an official said Monday.

As the death of the Filipino woman was announced, health officials said there had been a spike in the number of confirmed infections, but added the increase is expected.

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The woman -- who was not among the 445 cases of swine flu in the country -- died last June 19 due to heart problems and other complications.

The woman's death was the second in the Asia-Pacific region after a man in Australia died last Friday.

Health Secretary Francisco Duque III said the woman's chronic heart disease was aggravated by pneumonia. She started to have flu-like symptoms such as dry cough, fever, chills and difficulty of breathing two days before her death on Friday.

Duque said the woman had no history of travel in countries with confirmed cases of the virus, adding that it was not yet known how she got infected.

Dr. Yolanda Oliveros, director of the Department of Health's (DOH) National Center for Disease Prevention and Control, said the woman died of acute myocardial infarction (AMI), which is characterized by sudden chest pain, shortness of breath, nausea, vomiting, palpitations, and sweating.

Oliveros said the victim, who died at home, was not documented by the DOH. She said a physician was called in before the woman died and an autopsy was performed after her death and it was found out that she had A (H1N1).

The victim, she said, is a "complicated" case because she had heart disease, congestive heart failure, and liver disease.

Oliveros said the woman stayed at home for several days and did not regularly seek medical attention for her other illnesses.

She said the victim was autopsied for A (H1N1) after her death through a throat swab.

The victim’s relatives are now being checked for the flu virus and would be given medicine if they showed possible symptoms, Oliveros added.

The DOH official refused to say where the woman is from so as not to cause panic.

No cause for alarm

Speaking in Malacañang, Deputy presidential spokesperson Lorelei Fajardo said there is no cause for alarm because the victim died of heart disease.

"I think our DOH officials are on the right track by giving more attention on the high-risk patients. Our cases are mild, by the grace of God. So I think there's nothing to be alarmed. We need to be prepared and that's what we're doing now," she said.

Oliveros said 17 more cases of A (H1N1) were reported in the Philippines Monday, bringing the country's total to 455, of which 84 percent have recovered.

Second wave

She said the government is preparing for a possible "second wave" of A (H1N1), which could be "more virulent and more fatal" due to a possible mutation of the virus.

She said the DOH is preparing health facilities in the country to deal with more, and possibly, severe cases.

She said that in case of a surge of cases, the private sector manpower, medical, and nursing schools would be tapped. She added the DOH is planning a simulation exercise in one of its medical centers.

Oliveros said security agencies could also be tapped, citing the DOH's mandate to take over in case of a public health emergency. She said the health of the assisting military and policemen would have to be ensured.

She said the contingency plan would also include communication, transportation, and the business sector. She said businesses and companies have been encouraged to have a contingency plan.

However, she assured that the Philippines is not yet entering the dreaded "second wave."

No protocol breach

Meanwhile, Health officials in Davao City said no protocol was breached when a four-year-old boy, who tested positive of the A (H1N1) virus, was transported from Butuan City to the Davao Medical Center (DMC) in Davao City.

"All those who were in contact with the boy during the transport followed strict protocol, and the ambulance brought the boy directly to the isolation ward of the hospital [DMC]," Dr. Leopoldo Vega, director of the DMC, said Monday.

The patient's grandmother and a playmate have also been placed under quarantine due to their exposure to the four-year-old patient who came from a vacation in Hong Kong last June 13. (JMR/AP/CPM/JCZ/Sun.Star Davao/Sunnex)