Two more people in Hawaiçi have died after testing positive for the H1N1 virus, or swine flu, bringing the state total to six deaths, the state Department of Health said yesterday.

Both people had underlying health conditions that contributed to their deaths, Health Department spokeswoman Janice Okubo said. The age and gender of the people will be released when Health Department officials complete their investigation, perhaps as soon as Thursday, Okubo said. Both people died on Oçahu.
All six H1N1-related deaths in Hawaiçi have involved people with other health problems, officials have said. The first reported death here happened June 19. Four of the victims were on Oçahu and two were on the Big Island. Their ages ranged from the late 40s to the 60s. Officials have not disclosed specific ages of the victims, their names or other personal information.
Nationwide, there have been more than 300 deaths in which the H1N1 strain of flu was identified as a contributing factor.
Meanwhile, a small Kauaçi daycare center decided today to close temporarily after five of 20 children enrolled and one staff member showed flu symptoms.
Some of those who were sick at the Kauaçi Community College daycare center were confirmed as having seasonal flu virus, but weren’t tested for the H1N1 swine flu virus, KCC Chancellor Helen Cox said.
Cox said the school took the precaution based on state Health Department guidelines for schools, which require schools to report illnesses that affect at least 10 percent of a school population or 20 percent of a class.
That guideline is aimed at tracking significant flu outbreaks and determining the strain of flu present, Okubo said. The Health Department does not require a school with a high flu incidence to close, but to report the situation so it can be monitored, she said.
Schools may decide to close “if a school feels that they cannot operate safely based on what’s happening” because of staff shortages, Okubo said.
However, Okubo said, the Kauaçi daycare closure “definitely is an example that can show parents that they really need to plan ahead for this new school year” in case of flu outbreaks.
The Health Department strongly recommends that people with flu symptoms stay home from work or school, to avoid spreading the disease — whether it’s the seasonal flu or the swine flu, Okubo said.
For more tips on avoiding swine flu, go to http://www.honoluluadvertiser.com/section/swineflu.