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Recent influenza virus A infections in forensic cases of sudden unexplained death
Abstract:
84 forensic necropsy cases with a history of sudden unexpected death and where no acceptable cause of death was found at autopsy (= cases of sudden unexplained death, SUD) were found to have a significantly higher rate of influenza A (H 3 N 2) infection than did matched controls of the general population and a group of forensic necropsy cases with known cause of death (NON-SUD cases). By contrast, the group of SUD cases was found to have no significantly increased infection rate with influenza H 1 N 1 and B virus, parainfluenza viruses, RS virus, adenovirus, and cytomegalovirus. The influenza A associated SUD cases had a significantly higher rate of pathological and histological findings previously described for cases of primary viral pneumonia than did SUD cases without recent influenza A infection and NON-SUD cases. These findings suggest that virological examination of SUD cases could be helpful in order to determine the probable cause of death. A considerable portion of the influenza associated SUD cases occurred during interepidemic influenza periods. Therefore, such cases could be a useful source for monitoring the interepidemic spread of influenza virus.
Insights
Sudden unexplained death (SUD) cases show a higher rate of influenza A (H3N2) infection. This suggests virological testing may help determine SUD causes and monitor interepidemic influenza spread.
Area of Science:
- Forensic Pathology
- Virology
- Public Health
Background:
- Sudden unexplained death (SUD) presents diagnostic challenges.
- Influenza A (H3N2) is a significant respiratory pathogen.
Purpose of the Study:
- To investigate the association between influenza A (H3N2) infection and SUD.
- To evaluate the utility of virological testing in SUD cases.
- To explore the role of SUD cases in monitoring interepidemic influenza spread.
Main Methods:
- Retrospective analysis of 84 forensic necropsy cases of SUD.
- Comparison of influenza A (H3N2) infection rates in SUD cases versus matched controls (general population and non-SUD forensic cases).
- Pathological and histological examination of SUD cases with and without influenza A infection.
Main Results:
- SUD cases exhibited a significantly higher rate of influenza A (H3N2) infection compared to controls.
- No significant increase in infection rates for other respiratory viruses (H1N1, B, parainfluenza, RSV, adenovirus, CMV) was observed in SUD cases.
- Influenza A-associated SUD cases showed more findings consistent with primary viral pneumonia.
Conclusions:
- Influenza A (H3N2) infection is a potential contributing factor in some cases of sudden unexplained death.
- Virological examination of SUD cases can aid in determining the cause of death.
- SUD cases occurring during interepidemic periods can serve as a valuable resource for tracking influenza virus circulation.