The Western Cape Health Department confirmed one person has died after contracting the virus.
A 22-year-old Stellenbosch University student passed away last week after contracting the H1N1 virus.
There are 42 confirmed cases of swine flu in the Western Cape.
Nationally almost 500 people have been diagnosed with swine flu.
The first case was reported in the middle of June.
The department's Faiza Steyn said, "We've had our first fatality. This case is related to the latest H1N1 virus."
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