Health workers in the Gaza Strip announced the first death and first cases of H1N1 swine flu on Sunday, worrying Palestinians who had said that Israel's blockade of the territory was keeping the virus at bay.
The Health Ministry and medical workers said five people diagnosed with H1N1 on Saturday were transferred to Israel for treatment and a sixth, female patient suffering underlying health problems died in the territory run by Hamas Islamists.
Health workers said the flu appeared to have been kept out due to Israeli restrictions that limit the flow of people and goods into the enclave, which is governed by the Hamas group.
"The illness hit Gaza," said Hassan Khalaf, deputy health minister in the Gaza administration. "We have finalized a national plan to deal with it."
Palestinians had been concerned that several thousand pilgrims who recently returned from the annual Muslim haj pilgrimage in Saudi Arabia might bring the virus back.
Khalaf said the five patients had other serious illnesses.
H1N1, which emerged in March, causes moderate symptoms in most patients but poses greater risks to pregnant women, young people and patients with underlying health problems.
With Egypt's help, Israel began restricting the flow of goods into Gaza in 2006 after Hamas won a legislative election. Hamas does not acknowledge Israel's right to exist and remains committed to armed struggle against the Jewish state.
Restrictions on who could enter and leave the Gaza Strip were tightened in 2007 when Hamas seized full control.