A six-year-old girl from the Toronto area is the first child in Ontario to die after contracting swine flu.

The H1N1 influenza A virus "appears to have been a factor in the girl's death," said the Ontario Ministry of Health and Long-term Care in a news release Monday. The Office of the Chief Coroner is investigating exactly what role the virus played in her death.

The girl died on June 15, according to the health ministry. She had not been hospitalized. The identity of the girl has not been released, but she was a resident of the Peel region, just west of Toronto.

A test conducted on the girl's body on June 19 revealed she had the H1N1 virus, the current strain of which first appeared in Mexico in April and has since spread to several other countries.

It's also not clear yet if she had other underlying medical conditions that could have contributed to her death.

"Our thoughts are with the family and friends of this young girl at this difficult time, and we extend to them our deepest sympathies," said Health Minister David Caplan in a statement.

Since the swine flu outbreak started, three other people in Ontario who had the H1N1 virus have died, but all three had chronic medical conditions.

As of last week, 20 people who have the virus were in Ontario hospitals, a number of them with underlying medical conditions.

There have been 2,665 confirmed cases of swine flu in Ontario, but most are considered mild with symptoms similar to an annual seasonal flu. Twenty-four people infected with the virus were in hospital as of June 19.

With files from The Canadian Press