A man from northwestern North Dakota has died from H1N1 influenza.

The man, who was in his 60s, is the first person in the state to die from the new strain of influenza.

"Our condolences go out to his family and loved ones," said Terry Dwelle, director of the North Dakota Department of Health, on Monday.

The man had an underlying medical condition, which the health department would not release because of concerns over patient confidentiality. Generally, people over 60 are not as susceptible to the H1N1 influenza, but an underlying medical condition can cause complications, Dwelle said. Age is not a guarantee of immunity against the virus.

Although the health department disseminates weekly influenza statistics by county, it will not release the county in which the man lived because of concerns over patient confidentiality.

"It is much more difficult to identify a person by county, if they are just ill," said Kirby Kruger, state epidemiologist with the health department. With a death, however, people can search obituaries to identify the person who died, and some counties are sparsely populated, he said.

People should continue to wash their hands, practice proper respiratory etiquette and stay home from work or school if ill, department officials said. Also, when the vaccine becomes available, the health department is urging vaccination. This includes people who already have been diagnosed with influenza symptomatically or with a rapid test, which does not specify the strain of influenza that the person acquired.

The state receives weekly shipments of H1N1 vaccine, which it distributes to health care providers. The shipments, however, have included fewer doses than anticipated. The state expects to receive 21,000 doses this week.

The smaller quantities and earlier delays in shipment mean that it could take several weeks before the vaccine is available to the general public. Right now the vaccine is prioritized for health care workers, pregnant women and children between 6 months and 18 years old. How it is distributed at the local level depends on the type of vaccine available.

At a H1N1 vaccination clinic at Bismarck Burleigh Public Health on Monday, people stood in line for more than two hours waiting for vaccines for their children or for themselves if they were pregnant.

"We're both getting shots," said Nicole Flowers of Hazen. She was holding her 9-month-old son Liam. She also is seven weeks pregnant.

She's keeping her hands clean and trying to keep her son's fingers out of his mouth. Now that she has a child, she has paid more attention to influenza vaccination in general.

"I never really got a flu shot before," she said.

As of last week, the state had 1,216 reported cases of influenza, of which 148 tested positive for H1N1 influenza. Most of those cases are attributed to H1N1, but are not distinguished from other influenza viruses because of the type of test performed at the doctor's office.

"I'm glad people are taking this seriously," said Cheri Underhill, Bismarck Burleigh Public Health emergency preparedness coordinator.

Within the first hour of the vaccination clinic, 300 doses were administered. Pregnant women and children under 2 years old could only receive injectable vaccine. A nasal spray vaccine was available for children between 2 and 4 years old.

The vaccines were given free of charge. More clinics will be scheduled as Bismarck Burleigh Public Health receives more vaccine.

Bismarck Burleigh Public Health is out of seasonal influenza vaccine.

(Reach reporter Sara Kincaid at 250-8251 or sara.kincaid@bismarcktribune.com.)