Recent influenza virus A infections in forensic cases of sudden unexplained death

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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.