2009 H1N1 Fatalities: The New Mexico Experience

Abstract: Histopathologic features of New Mexico 2009 H1N1 fatalities have not been representative of those reported nationwide. We retrospectively reviewed medical records of all New Mexico 2009 pandemic influenza A (pH1N1) fatalities (n = 50). In cases in which autopsy was performed (n = 12), histologic sections and culture results were examined. In contrast to previously published studies, the majority of our fatalities did not have diffuse alveolar damage (DAD) (2/12; 16.7%). Common findings included pulmonary interstitial inflammation and edema, tracheobronchitis, and pneumonia. Two cases had significant extra‐pulmonary manifestations: myocarditis and cerebral edema with herniation. The majority had a rapid disease course: range from 1 to 12 days (median, 2 days), and Native Americans were disproportionately represented among fatalities. These findings suggest that New Mexico H1N1 fatalities generally did not survive long enough to develop the classic picture of DAD. Pathologists should be aware that H1N1 may cause extra‐pulmonary pathology and perform postmortem cultures and histologic sampling accordingly.     

Forensic palynology: current status of a rarely used technique in the United States of America

The United States of America would seem to be an excellent location for using pollen data in forensic applications. The vegetation within the region is highly diverse ranging from areas of Arctic tundra to some of the most inhospitable deserts anywhere in the Western Hemisphere. The highly varied ecology, great plant diversity, thousands of vegetational microhabitats, and extensive published pollen records for the region provide an ideal setting for these types of analyses. This diversity, often characterized in most locations by unique combinations of pollen types, makes the use of forensic pollen a reliable technique that can often be used to associate individuals with a unique crime scene or geographical region. Nevertheless, forensic pollen studies in the United States of America are currently one of the most highly under utilized techniques available to assist in solving criminal and civil cases. During the past century there has been a very limited attempt to use pollen evidence in either criminal or civil cases, for a variety of reasons, including a lack of available information about the technique, a very limited number of specialists trained to do forensic pollen work, and an almost total absence of academic centers able to train needed specialists or forensic facilities able, or willing, to fund research in this area. Hopefully, this paucity of use will change if certain steps are taken to encourage the routine collection and use of pollen evidence in both criminal and civil cases.