A man from Toronto is the second Canadian to die after contracting swine flu, health officials in Ontario said Monday.

The unidentified 44-year-old died Saturday after suffering from a chronic, pre-existing medical condition, Ontario's acting chief medical officer, Dr. David Williams, told a teleconference with reporters. The man is said to have had diabetes.

The man was at home and became critical. An ambulance was called, but he passed away before being hospitalized.

A previously taken nasal swab came back positive for H1N1 swine flu on Sunday.

"Right now, we don't know whether that had anything to do with the person's death or has contributed in any extent," Williams said.

"We'll have to wait for the coroner's office to investigate that. It is atypical."

Williams said he knew no more about the man's medical history than that he suffered from the chronic, pre-existing health condition — a term that can include a wide umbrella of diseases from obesity and asthma to cancer, Williams acknowledged.

The death is the second in Canada linked to the virus. On April 28, a woman in Alberta with a confirmed case of H1N1 flu and chronic, pre-existing health problems died, Alberta's chief medical officer of health, Dr. André Corriveau, said on May 8.

There have been 58 new confirmed cases of H1N1 in Ontario since May 22, bringing the total number in the province to 352.

Of the cases of H1N1 in Ontario, eight have needed to be hospitalized in the last month, some for diagnostic purposes only. One person needed mechanical ventilation.

Seasonal flu wanes

At the start of the province's investigation of the outbreak, cases of seasonal H3N2 flu were running three to one over H1N1 cases, Williams noted.

"It's now switched around. So in the last week, 60 per cent of the tests being done were H1N1, so it's reversed."

Cases of seasonal flu, which leads to 5,000 premature deaths in Canada each year, tend to decline heading into summer.

"I think as we see these little waves or blips where it seems to bounce, it's like waves coming ashore. They tend to get shallower and shallower as you move into the summer season," Williams said.

As of May 22, a total of 805 laboratory-confirmed cases of H1N1 flu virus have been reported in Canada, according to the Public Health Agency of Canada.

Ontario plans to continue its regular flu surveillance throughout the summer.

The aim is not to count all cases, Williams said, but to spot check whether the virus is present and whether new cases are arising. The information will guide health officials on whether to ramp up enhanced surveillance in the fall.

The World Health Organization reported Monday that 12,515 cases of swine flu have been reported in 46 countries globally, with 91 deaths attributed to the flu.