SEATTLE - State health officials say a Snohomish County man is the first person in our state to die from complications of the swine flu - but his family is angry and skeptical of that diagnosis.

The family, which has asked not to be identified, say they understand that nothing is going to bring their loved one back. But they're upset with the branding of his death as being swine flu-related.

They say the 39-year-old man had been dealing with a variety of serious medical problems, and that those other illnesses are at fault.

Family members tell KOMO News that the man was 5-feet-6-inches tall, and weighed about 400 pounds. They say he died of an "enlarged heart," and that there's a family history of heart disease that's to blame.

They say a diagnosis of swine flu was never mentioned to them until after he died.

But state and Snohomish County health officials are sticking with their diagnosis. They say the man died from "viral pneumonia," a deadly result of the swine flu.

He is the third person in the United States to die from swine flu complications, officials say. The other two victims - a 2-year-old boy and 33-year old woman - died in Texas. All of the victims suffered from other medical conditions when they were infected with the swine flu.

"As we're learning with swine flu, or H1N1, the complications of flu can also cause a death," says Secretary of Health Mary Selecky. "Our thoughts are with those who suffered, because this is a sad loss - particularly for the family involved. It's tough to hear that kind of news."

"His unfortunate death is consistent with the two other confirmed deaths in the United States. Both of them involved underlying heath problems," adds Dr. Gary Goldbaum, Snohomish Health District medical director.

But even health officials are at a loss the explain how the man was exposed to the disease. He hasn't visited Mexico and, in fact, family members say the victim had been homebound since November, when he lost his job.

The family says he rarely left the house, which has them wondering how he could have contracted the virus. They say he became sick about a month ago, and his health never improved.

Concerned about a stigma, the family insists "he did not die from swine flu," but because of the underlying heart problems.

Health officials freely admit they don't understand everything about the man's death - other than that the virus turned up during the autopsy and that the man had other health problems as well.

"That's one of the concerns about this new strain of influenza. We don't know enough about how it's going to really affect the general public," Goldbaum said.

"Does this mean there is something new going on here? Is it affecting these people for a reason we don't yet understand? ... We've got to learn more."

A day after Washington state health officials announced the state's first case of a swine flu-related death, they increased the number of confirmed cases in the state to 127, an increase of 26 from Saturday.

Another 19 cases are considered probable, the state Department of Health said Sunday.

The swine flu has been blamed for 53 deaths worldwide, including 48 in Mexico, three in the U.S., one in Canada and one in Costa Rica.