MANILA, Philippines – (UPDATE 2) A 49-year-old woman from Metro Manila with Influenza A(H1N1) has died, the Department of Health (DoH) said Monday.

However, Health Secretary Francisco Duque said it could not be immediately confirmed if the woman, who also had heart disease, died due to the A(H1N1) virus.

According to the woman’s autopsy report, she died of “congestive heart failure and acute myocardial infarction aggravated by pneumonia,” Duque said.

The woman was among 17 new cases of the disease, which brought to 445 the total number of people afflicted with the disease in the country, Duque said.

The woman self-medicated with paracetamol and was not among the confirmed A(H1N1) patients until Saturday, a day after she died last Friday, when doctors got a swab sample from her throat, Duque said.

The woman’s family reported to the DoH that she had flu symptoms before her death, prompting the A(H1N1) test, Duque said.

“We report today the death of a 49 year-old female with pre-existing heart disease. She presented flu signs on June 17, such as dry cough, chills and difficulty in breathing just before death on June 19,” said Duque.

“Although the female who died is positive for H1N1, we cannot conclude that death is due to H1N1 but in other countries with deaths from H1N1, majority of deaths are those who have pre-existing medical conditions,” said Duque.

The DoH had said that people with medical conditions such as heart disease and asthma are at higher risk of A(H1N1).

“Because of this first death with incidental finding of H1N1, the DoH will aggressively target those high risk groups. They should be the one receiving supportive care from medical professional. High risk groups with flu signs should immediately go to a doctor,” he reiterated,” Duque said.

Five people who had contact with the woman, including her husband, children, and siblings were quarantined and tested for the virus, he said.

The DoH is investigating how the woman got the A(H1N1), Duque said, as he did not discount the possibility that the case could be linked to confirmed cases in Metro Manila schools.

Duque said he also ordered that the woman be tested for the seasonal flu virus.

Meanwhile, 35 more A(H1N1) patients have fully recovered from the virus, bringing the total number of persons to overcome the disease to 374 or 84 percent of the total cases since May, he said.