SAN JOSE, Costa Rica (Reuters) - Costa Rica’s Health Ministry said a 53-year-old man died on Saturday infected with the new H1N1 flu strain, the fourth country to report a death of someone ill with the virus that has sickened more than 4,200 people around the world.

The man also had diabetes and asthma, Maria Trejos, a spokeswoman for the Health Ministry, told Reuters. Doctors at the Health Ministry said they would have to wait for autopsy results to determine if the death was from the flu or complications caused by his other health problems.

“His case was confirmed by the U.S. Centers for Disease Control and Prevention,” Trejos said, adding the Central American country now had eight confirmed cases of the swine flu strain, including the man who died.

The flu strain, which combines swine, human and bird elements, has killed 48 people in Mexico, two in the United States and one in Canada.

The Costa Rican man had not traveled recently to Mexico but the country’s main daily newspaper, La Nacion, reported he was a musician who came into contact with crowds.

He was treated with anti-viral medicine after being hospitalized with severe flu-like symptoms more than a week ago but the medicine was not able to save his life, Daniel Salas, another Health Ministry spokesman said.

The seven other people sick with the flu - three children and four adults -- were treated successfully, La Nacion reported.

In Mexico, health officials said diabetes was associated with many of the victims, as were cardiovascular problems such as angina and high blood pressure.

Those conditions can raise the risk of death from seasonal influenza, which kills 250,000 to 500,000 people every year globally and 36,000 in the United States alone.