Coroner Believes H1N1 Death Toll Much Higher

[Ronan Kelly]

Coroner Believes H1N1 Death Toll Much Higher
By Daren Sukhram

Story Created: Nov 20, 2009 at 4:55 PM CST

(Story Updated: Nov 20, 2009 at 5:15 PM CST )

DES MOINES - The Polk County medical examiner claims the H1N1 death toll in Iowa is really much higher.

Doctor Gregory Schmunk says he believes he's found H1N1 in a number of autopsies on people who were never diagnosed with the flu.

Schmunk says accurate tests for H1N1 are sometimes too invasive for sick patients.
"Because of our limitations on testing, sometimes the tests aren't positive. But they do appear to fit clinically the course of an H1N1 viral type pneumonia."

Schmunck says the best advice for Iowans is to get the H1N1 vaccine as soon as it's available.
http://www.kcrg.com/news/health/local/70658547.html

 

[yielddude]

Re: Coroner Believes H1N1 Death Toll Much Higher

DES MOINES, Iowa -- Iowa has officially recorded 21 H1N1 deaths, including seven in Polk County alone. But the county's medical examiner said he has performed autopsies on some residents who were never diagnosed with H1N1, but actually had it.

"In the autopsy, what we're seeing is very heavy, wet hemorrhagic lungs, lungs with a lot of blood in them," said Dr. Gregory Schmunk.

He said the official count of seven H1N1 deaths is inaccurate, but patient rights laws prohibit him from giving specific numbers.

He said there are two reasons for the discrepancy. First, not all sick patients get tests and second, the virus is difficult to detect. Some patients may be too sick to receive the most accurate H1N1 test.

"They're not always done and it can be hazardous to the patient if they're in a respiratory critical situation," Schmunk said.

He also said that some tests reveal a false negative.

"Because of our limitations on testing, sometimes the tests aren't positive," he said. "They do appear to fit clinically the course of a H1N1 viral-type pneumonia."

He said the cases he's seen in Polk County were all middle-aged adults with a few underlying health conditions.

"These may be the patients that are obese," Schmunk said. "Obesity restricts your ability to breathe and clear the virus from your upper respiratory."

He also said that some of the patients had diabetes.

Schmunk said his urging people to get the vaccine.

"The thing that concerns me the most is, you still have people out there they believe that if I get the vaccine, the shot, then I'm going to get the flu," he said. "You can't get the flu from the shot."

He said that in the meantime, remember to wash your hands, sneeze into your sleeve and stay home if you're sick. The Centers for Disease Control and Prevention said one person who goes to work sick with the virus will infect 10 percent of his or her co-workers.

http://www.kcci.com/news/21670309/detail.html

(video on link)

 

[AlaskaDenise]

Re: Coroner Believes H1N1 Death Toll Much Higher

.............."In the autopsy, what we're seeing is very heavy, wet hemorrhagic lungs, lungs with a lot of blood in them," said Dr. Gregory Schmunk......

From The Plague of the Spanish Lady: The Influenza Pandemic of 1918-1919 :

Fellow autopsy surgeons discussed what they called a ?pathological nightmare,? with lungs up to six times their normal weight, looking ?like melted red currant jelly.?

From Secret Agents: The Menace of Emerging Infections:

An account published by the National Academies of Science describes the lungs taken from victims as ?hideously transformed? from light, buoyant, air-filled structures to dense sacks of bloody fluid.

Both of the above quotes were found here.

I'm not saying we're having or going to have a 1918-type pandemic, but one cannot help but ask how often this situation has occured in even a portion of influenza deaths in the last 90 years.

.

 

[Roehl_JC]

Re: Coroner Believes H1N1 Death Toll Much Higher

I too believe we've missed the count, and by as much as 200-500%. If we tried, we could find many, many cases of deaths and near-death/crippling illnesses so far ignored or dismissed without PCR testing of lung/lower respiratory samples during the height of the illness, or the person died so suddenly and unexpected that it was dismissed as a stroke or heart attack without exhaustive autopsy, or the person was tested with the unreliable fast tests and then at death simply put in the non-H1N1 categories. And of course high Tamiflu blood concentration levels has been known to MASK H1N1 detection.

When my little brother died in September in Texas with swine flu symptoms, from a heart attack (he'd never had heart problems before), he was never tested for H1N1, was cremated and I've now had 3 other older friends who've passed on SUDDENLY in areas where the H1N1 was surging, and they too were buried without so much as a PCR test, nor were samples taken from lungs, hearts, brains, and other tissues TO DETERMINE CONCLUSIVELY the causes of death. Then again we learn of patients who perished with atypical pneumonias with prior conditions where local coroners offices claimed the patients died of 'pneumonia' as the COD, rather than the infectious agent causing the pneumonia. I think a radical revision is needed to at least test all sudden deaths for H1N1, all heart attacks and strokes too. And we should be looking over the total deaths of those under 65 to determine whether or not there are unusual increases in death rates...for total deaths may highlight a greater number of deaths than the previous decade averages, and that should be cause to up the numbers counted as likely/probable H1N1-related deaths.

It's good to hear one coroner who's seen hemorrhaged lungs in non-H1N1-positives, for those patients almost definitely died of H1N1.

I, for one, believe we are seeing a mirror-image of 1918 in sheer numbers of cases, and although most so far have been mild, a significant and growing proportion of cases IMO are serious health complications unseen in such numbers since that fateful period, and if one looks at the spikes on the ILI chart attached for 2009 and BC, Canadian admissions charts for Oct./Nov '09 and compare these with the 1918 chart. If at the end of this pandemic the deaths are fewer than 2.5% when we're all said and done, it won't IMO be due to the lower lethal potentials of 3rd wave H1N1 with D225G but will be due to the greater medical interventions available for the first time in such a pandemic setting, antiviral meds, respirators, ECMOs, and to all the dedicated doctors and nurses and EMTs and first-responders who are doing great work! The Developing Countries are going to be at the high end of any final tally IMO, so they need all the help we can provide them quickly now before a 3rd wave proves that travel via modern aircraft can carry multiple new candidates for pandemic waves globally while planners are still sorting out sequences from months ago.

I think the undercounting is done intentionally in some areas, states, countries, and so we need to increase confidence in scientific processes rather than in bureaucracies.

 

[silvergirl]

Re: Coroner Believes H1N1 Death Toll Much Higher

I am in Iowa and there is a girl living in a city near here who the tv station did a piece on. Saying she was very sick and was put on ECMO. They say she was in with bacterial pneumonia, which started as a strep infection. Well I am pretty sure H1N1 came first then the strep (she said "I had a cough, fever, HA and then a sore throat, trouble breathing, chest pain, and then I couldn't walk"). THe poor girl was walking so slowly in the hall with her oxygen on...and only 17! I bet they don't even suspect H1N1. But ECMO! Thank goodness she is doing better, but they also said she had been to a doctor and was sent home two days prior to being admitted.

 

[Jojo]

Re: Coroner Believes H1N1 Death Toll Much Higher

I am in Iowa and there is a girl living in a city near here who the tv station did a piece on. Saying she was very sick and was put on ECMO. They say she was in with bacterial pneumonia, which started as a strep infection. Well I am pretty sure H1N1 came first then the strep (she said "I had a cough, fever, HA and then a sore throat, trouble breathing, chest pain, and then I couldn't walk"). THe poor girl was walking so slowly in the hall with her oxygen on...and only 17! I bet they don't even suspect H1N1. But ECMO! Thank goodness she is doing better, but they also said she had been to a doctor and was sent home two days prior to being admitted.

We had the same case here with a 13yr old boy, he was sent home and was back in the ER that night, he has just returned home after 18 weeks.
His doctors gave his parents little hope in surviving.

He is still only 70% better and thought he might lose his feet and hands.
He did eventually get tested for H1N1

http://www.myfoxhouston.com/dpp/health/091111_billy_cary_returns_home

 

[sbrooks]

Re: Coroner Believes H1N1 Death Toll Much Higher

Rhoel JC,
I agree with most of what you posted however I don't think we're even
CLOSE to a mirror image 1918 scenario as it stands now. We have over three
times the population now, and if our H1N1 ever has the morbidity rate that
1918 did we would have much higher death and serious illness rates.

Optimistically I hope this virus loses steam and kind of peters out over the next twelve months.

Pessimistically this virus just may be an adolescent pulling on our pant leg wanting to be noticed and has yet to become fully grown

 

[Roehl_JC]

Re: Coroner Believes H1N1 Death Toll Much Higher

Sbrooks, thanks for your comments. I was trying to say that we're still EARLY in the pandemic, and it could as you say get much much worse due to scalarity of numbers sick at or near any wave peak period, or due to mutational advantages in viral loads or antiviral resistance, and of course you're correct that we've got 6.8 billion humans on Earth today, more than triple the 1918 global population, and many more connections and mutual-dependencies on nature and food production and healthcare and equal access to antiviruses and other 'best practice' and methodologies of modeling the movement of H1N1 variants with lagtime issues and transparency in sharing samples and/or sequences. I'm glad that much of the opportunity today to alter the outcomes lies in facilitating open communications and FT and the Net offer new ways to achieve timely networking of all stakeholders. Let's work for greater frankness as it benefits all humankind when information is shared readily. Florida1 has asked us all to work for the best outcomes, and we all want to help humanity achieve a fair and just international civil society where each and every person in need of healthcare can receive it promptly, and the distribution of reliable flu information helps that cause tremendously.

 

[Pathfinder]

Re: Coroner Believes H1N1 Death Toll Much Higher

H1N1 deaths may be underreported, but not because of mutation

By Lynda Waddington 11/23/09 11:40 AM

Although a local medical examiner may be right that the number of deaths from the H1N1 influenza virus in Iowa is greater than official statistics would indicate, Iowans should not be concerned that this is because the virus has mutated as some rumors have suggested.

Instead, the disparity is caused by deaths among patients who are never diagnosed with the virus.

?We?ve known all along that there have been cases that have gone undiagnosed for a variety of reasons,? said Polly Carver-Kimm, public information officer for the Iowa Department of Public Health. ?Sometimes people come into the emergency room or are admitted into the hospital and it is later determined, after their death and during an autopsy, that they had the H1N1 virus as a contributing factor.?

State officials want to be clear, however, that these deaths are not a result of a virus mutation or attempts to cover-up the severity of the virus in the state, despite rumors to the contrary.

Late last week, KCCI in Des Moines aired an interview with Dr. Gregory Schmunk, medical examiner for Polk County. Schmunk accurately stated that there are additional deaths in Iowa from H1N1 that were undiagnosed. During the report, Schmunk described the lungs he was seeing during autopsy as ?very heavy, wet? and ?with a lot of blood in them.?

The report ? especially the description of the lungs ? has been circulating on the Internet since it aired and has fueled speculation that perhaps the H1N1 virus in Iowa had mutated. Earlier this year, according to analysis of genetic testing done by the World Health Organization, the virus in the Ukraine had mutated to a strain similar to that of the 1918 Spanish flu epidemic. In particular, the mutation, casually referred to as D225G, causes bleeding in the lungs and has been described as a decimating lung infection.

Carver-Kimm said state examiners do not believe that any mutation has occurred in the H1N1 virus in Iowa.

http://iowaindependent.com/22678/h1...aign=Feed:+IowaIndependent+(Iowa+Independent)

 

[tropical]

Re: Coroner Believes H1N1 Death Toll Much Higher

I think about as Rhoel (my condolences for your brother Rhoel),
and the others.

Globaly, the numbers stil seems at an early phase.

If the sci. supposed a third or a half of humanity will get it, than it probably now stil more behave as depicted by the sb. #7 second option:
"this virus just may be an adolescent pulling on our pant leg wanting to be noticed and has yet to become fully grown"

 

[mickey]

Re: Coroner Believes H1N1 Death Toll Much Higher

Dear Roehl J C

I am most sorry about your brother's passing. These are terrible times for your family. My heart grieves for you and all those who have suffered losses from this flu.