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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.

The ministry said the five were diagnosed with H1N1 on Saturday. Health workers said it appeared to have been kept out of Gaza until now due to restrictions that limit the flow of people as well as goods into the enclave, which is governed by Hamas.

"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 haj pilgrimage in Saudi Arabia might bring the virus back to Gaza with them.

Khalaf said the five patients suffered from other serious illnesses. He declined to confirm or deny reports that two of the cases had died of the disease.

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 it.

Restrictions on who could enter and leave the Gaza Strip were tightened in 2007 when Hamas seized full control of the territory.

Some medicines are in short supply, but Israel insists it does not limit shipment of medical supplies. Instead, Palestinians say the rivalry between Hamas and Abbas' Palestinian Authority could be to blame.

The Palestinian Authority is responsible for sending medicines to Gaza, but officials there way Abbas' government routinely keeps Gaza in short supply.

One key shortage is swine flu vaccine. Senior WHO official Mahmoud Daher said Gaza has only 1,000 vaccine doses for around 8,000 health employees, serving 1.5 million Palestinians in Gaza.

West Bank Health Ministry official Dr. Asad Ramlawi denied that the shortage is deliberate. He said 1 million doses would be arriving between mid-December and late January, and they would be divided between the two territories.

Daher said there was no need for panic, and that patients with chronic diseases, the elderly and pregnant women should be vigilant about their hygiene.

However, at Shifa Hospital, Gaza City's largest, a reporter saw doctors and nurses refusing to go near a young woman believed to have the virus.

The young woman's family had to carry her to the isolation ward on a stretcher.

Ramlawi said 1,250 cases of swine flu have been reported in the West Bank. In Israel, the number is more than 3,000.

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.