HONOLULU -- Some Hawaii schools have changed graduation rituals following the state Health Department's confirmation Friday night of six more cases of H1N1 flu.

Hawaii has recorded 21 confirmed H1N1 cases, and new cases continue to appear in schools, KITV's Dick Allgire reported.

Two of the latest confirmed cases of the H1N1 flu were at Ewa Elementary School, and two others were reported at Anuenue Hawaiian Immersion School in Palolo -- one is a preschool child, another an infant (More).

The Health Department said the Ewa students got the illness from family members who were at Anuenue.

University Lab School held its graduation ceremony at Andrew's Amphitheater. With the University of Hawaii announcing its graduation will forego the customary congratulatory handshake, the Lab School was also concerned.

"We've had thoughts the past couple of weeks, and, lucky for us, we ended school early, but we had a lot of thoughts about it," Principal Fred Birkett said.

Instead of a handshake, students got a diploma, a fist bump and a hug.

"I actually have a bit of a cold, so I spoke to students early. I said, 'Guys, I really would rather give you a fist pump and a hug, that way, I don't have to worry about spreading any of my germs,' and we made it as colorful as we could. It was fun for them and fun for me," Birkett said.

There did not seem to be much concern about person-to-person contact as all 47 graduates clasped hands in a farewell dance, and the students were thinking more about their big night than the flu.

"They just said that we were going on as planned and have hugs and handshakes and nothing," said Chelsey Yoneda, a graduate.

UH graduation ceremonies are scheduled for Saturday at the Stan Sheriff Center, where graduates will be fist bumping.