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H1N1 Swine Flu: Autopsies Show Same Lung Damage as 1918 Flu

December 9, 2009

Highlighting the H1N1 flu’s ability to turn deadly is a new study from James R. Gill, MD, from the New York City Medical Examiner’s office, and Jeffrey Taubenberger, MD, PhD, of the National Institutes of Health.  The scientists reviewed autopsy reports, hospital records and other clinical data from 34 people who died of 2009 H1N1 influenza infection between May 15 and July 9, 2009. All but two of the deaths occurred in New York City.

A microscopic examination of tissues throughout the airways revealed that the virus caused damage primarily to the upper airway—the trachea and bronchial tubes—but tissue damage in the lower airway, including deep in the lungs, was present as well. Evidence of secondary bacterial infection was seen in more than half of the victims.

The scientists reviewed autopsy reports, hospital records and other clinical data from 34 people who died of 2009 H1N1 influenza infection between May 15 and July 9, 2009. All but two of the deaths occurred in New York City.

The researchers also examined 33 of the 34 cases for evidence of pulmonary bacterial infections. Of these cases, 18 (55 percent) were positive for such infections. Not all of those individuals who had bacterial pneumonia along with 2009 H1N1 virus infection had been hospitalized, however, indicating that some had acquired their bacterial infections outside of a health-care setting.  This raises the possibility, say the authors, that community-acquired bacterial pneumonia is playing a role in the current pandemic. “Even in an era of widespread and early antibiotic use,” write the authors, “bacterial pneumonia remains an important factor for severe or fatal influenza.”

Computerized tomography (CT) lung images were available in four cases of pulmonary bacterial infection. In all four cases, the CT scans showed an abnormality known as ground-glass opacity, which are patches of rounded haze not seen in normal lung images.

It is not known, say the researchers, whether the abnormalities detected by CT in the four cases also occur in people who have milder H1N1 infections. They call for additional investigation into the utility of CT scans as a tool to help clinicians identify and better treat severe H1N1 infections.

http://www3.niaid.nih.gov/news/newsreleases/2009/FluAutopsy.htm

4 Comments leave one →
  1. May 13, 2010 17:54

    Very useful information. Thanks.

  2. Joanne Burr permalink
    August 18, 2012 10:43

    Hi my name is joanne……I had H1N1 at the end of 2009/2010…..I was in an induced coma for 2 months,,,,,could not walk/talk/eat…..etc. I made an amazing recovery…..Had to learn how to walk again……I am just wondering, what kind of permanent damage I might have to my lungs even though I feel great?

    • August 18, 2012 12:59

      HI Joanne, Thank for your post….what an great story and how wonderful that you have made such an amazing recovery. Your physician could do several tests to assess the overall functioning of your lungs. I would vote for the least invasive unless you are having difficulties which it sounds like you are not. Pulmonary function tests measure your tidal volume and may indicate if you have restrictive or obstructive lung disease. Good luck and be well, Regina

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