Serious question for a physician or pathologist re: flu and cause of death

[Mike 03]

Say a person contracts a virus, but the virus turns bacterial and results in pneumonia, which is the ultimate cause of death.

Is that death ruled a death by the virus, or a death by the pneumonia caused by the virus?

I'm trying to figure out why some of the mortality figures with respect to the 2009 H1N1 have been rescinded.

Thanks!

[Tangerine LaBamba]

1. Viral pneumonia, bacterial pneumonia -

two different illnesses, with two different causes.

Viruses do not change into bacteria.

The figures were probably changed because errors were discovered. That's all.

[Individualist]

8. Complications of flu can include bacterial pneumonia

http://www.cdc.gov/flu/keyfacts.htm

[Tangerine LaBamba]

12. Oh, yeah ...........

Anytime you've got respiratory involvement - all that gunk piling up in the lungs - you've got the danger of pneumonia.

That's why patients in hospitals are up and out of bed so quickly after surgery - don't let those lungs fill up ................

[JuniperLea]

2. Good question...

I know in the case of HIV, and AIDS, the opportunistic diseases are what kills people. It's too easy to fudge with numbers...

[jody]

3. Aren't most pathologists actually physicians, i.e. M.D. or D.O.? n/t

[Barack_America]

7. Yes.

Only medical school graduates are eligible to study and become board certified in pathology.

[Barack_America]

4. Influenza virus can cause pneumonia on its own.

And I believe the deaths are ruled as "death due to complications from influenza".

[ananda]

5. One time I got viral pneumonia on the back of the flu.

I got over it, but they wouldn't let
me play sports for six weeks. I was
pretty miserable over that....

[lunatica]

6. If the pneumonia is a symptom of the virus, like the virus creates it by

proliferating in the lungs and triggering it then the virus kills you.

Another example is what causes death in AIDS is not the virus, but the effect it has on breaking down the immune system which then is unable to fight normal germs and diseases that would otherwise not kill. It's still considered death by AIDS, even though it may have been cancer or pneumonia.

But I'm not a doctor so I'm just spouting off.

[Tangerine LaBamba]

13. Well, strictly speaking,

it's the accumulation of contaminated fluid in the lungs that kills you - and that can be a symptom of flu, or just plain pneumonia, bacterial or viral.

People don't die of AIDS - they die of the opportunistic infections that swoop in and thrive in the absence of a healthy immune system. So, death certificates will read "Bronchial pneumonia" or "bacterial pneumonia" or any of the multiple kinds of cancer as the cause(s) of death..................

[nadinbrzezinski]

9. From readying El Universal yesterday here is the skinny

when this broke out Mexico sent 20 suspected samples to Manitoba... They tested them and they were found to be positive. Realize mexico does not have the L-3 or above lab (though congress just approved the funds)

Their molecular tests said all 20 were positive

At the request of WHO they sent same tests to CDC, where they were repeated, and now seven came out positive and 13 as probable

Following protocol, since they were no longer definite they rescinded them

Now I will not be too shocked if they send them next to Stockholm for re-testing


And yes I wish our press went into the boring detail

I went, that is good news

As to the actual cause of death, and what the cert will say, who knows?

And to prove how fast this moves

http://www.eluniversal.com.mx/notas/594674.html

En rueda de prensa, el director del Centro Nacional de Vigilancia Epidemiológica y Control de Enfermedades, Miguel Angel Lezana, informó que el laboratorio podrá analizar cada seis horas un paquete de 65 muestras para determinar si existe la nueva cepa de influenza porcina conocida como AH1N1.

During a press conference, the director of the national center for epidemiological diseases (CDC equivalent), Migel Angel Lezana, said that the lab can test 65 samples every six hours, to determine if any has AH1N1

Now I should go troll the mexican press to see what other juicy tidbits I find

[dipsydoodle]

10. It's now considered

that the great majority of deathgs from the 1918 flu were as a result of subsequent bacterial infection - not the virus.

[HamdenRice]

11. Think of it as getting a cut that gets infected

Iirc, a recent study showed that the majority of people who died in the 1918 flu virus actually died of bacterial pneumonia.

That does not mean that the virus turns into a bacteria. It means that the viral infection, the flu, causes damage to the lungs. Think of it as little sores. Then because there are these sores, the bacteria, which is all around us, infects the wound. Because the person is weakened, including his immune system, he gets a secondary bacterial infection.

It's not possible to say which one killed him. If it hadn't been for the viral infection, he would not have gotten the bacterial infection. But if he had not gotten the bacterial infection, he might have survived the viral infection.

[kestrel91316]

14. There is no such thing as a virus "turning bacterial". A virus is a virus and

can only remain such. Ditto for bacteria. Just like a horse cannot become a banana tree.

I assume you probably mean a secondary bacterial infection developing on top of a viral infection?

The only official H1N1 virus mortality numbers are going to come as a result of lab testing for the virus. I tend to think that if a patient testing positive for the virus dies of ANY complications, it will still be reported as a fatality for the CDC database.

CDC has strict criteria. And if the testing simply hasn't been done (like in Mexico where bodies are long since buried, and there's little money for testing anyway) then they will NOT make it into the database.

The actual confirmed cases in Third World countries are probably only the tip of the iceberg. In places like the US, they reflect reality more closely.

Something to be aware of: the CDC has said they may soon move to just reporting clusters of the virus rather than individual numbers. If they become too numerous to keep track of.