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2009 H1N1 Fatalities: The New Mexico Experience
Author(s) -
Brooks Erin G.,
Bryce Clare H.,
Avery Catherine,
Smelser Chad,
Thompson Deborah,
Nolte Kurt B.
Publication year - 2012
Publication title -
journal of forensic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.715
H-Index - 96
eISSN - 1556-4029
pISSN - 0022-1198
DOI - 10.1111/j.1556-4029.2012.02163.x
Subject(s) - medicine , autopsy , myocarditis , pneumonia , forensic pathology , pulmonary edema , h1n1 influenza , diffuse alveolar damage , covid-19 , pathology , disease , lung , infectious disease (medical specialty) , acute respiratory distress
Histopathologic features of New Mexico 2009 H1N1 fatalities have not been representative of those reported nationwide. We retrospectively reviewed medical records of all New Mexico 2009 pandemic influenza A (pH1N1) fatalities ( n = 50). In cases in which autopsy was performed ( n = 12), histologic sections and culture results were examined. In contrast to previously published studies, the majority of our fatalities did not have diffuse alveolar damage (DAD) (2/12; 16.7%). Common findings included pulmonary interstitial inflammation and edema, tracheobronchitis, and pneumonia. Two cases had significant extra‐pulmonary manifestations: myocarditis and cerebral edema with herniation. The majority had a rapid disease course: range from 1 to 12 days (median, 2 days), and Native Americans were disproportionately represented among fatalities. These findings suggest that New Mexico H1N1 fatalities generally did not survive long enough to develop the classic picture of DAD. Pathologists should be aware that H1N1 may cause extra‐pulmonary pathology and perform postmortem cultures and histologic sampling accordingly.