Volume 17, Number 11—November 2011
CME ACTIVITY
Deaths Associated with Pandemic (H1N1) 2009 among Children, Japan, 2009–2010
Akihisa Okumura
, Satoshi Nakagawa, Hisashi Kawashima, Takashi Muguruma, Osamu Saito, Jun-ichi Fujimoto, Chiaki Toida, Shuji Kuga, Toshihiro Imamura, Toshiaki Shimizu, Naomi Kondo, and Tsuneo Morishima
, Satoshi Nakagawa, Hisashi Kawashima, Takashi Muguruma, Osamu Saito, Jun-ichi Fujimoto, Chiaki Toida, Shuji Kuga, Toshihiro Imamura, Toshiaki Shimizu, Naomi Kondo, and Tsuneo MorishimaTable 1
Causes of death for 41 patients <20 years of age with pandemic (H1N1) 2009, Japan, May 2009–March 2010
| Cause | Definition |
|---|---|
| Unexpected cardiopulmonary arrest | Cardiopulmonary arrest without clear findings of respiratory failure, cardiomyopathy, or encephalopathy |
| Respiratory failure | Desaturation, need for oxygen supplementation or mechanical ventilation or both, associated with radiologic findings of pneumonia or acute lung injury |
| Myocarditis | Markedly reduced cardiac output, severe and refractory arrhythmia, or severe circulatory collapse |
| Viral sepsis | Refractory hypotension and rapidly progressing multiorgan failure associated with at least 2 of the following: tachypnea; leukopenia <4000 cells/μL or leukocytosis >12,000 cells/μL; tachycardia; body temperature >38.0°C or <36.0°C; cold extremities; and increased capillary refill time |
| Encephalopathy | At least 1 of the following: altered mental state without profound respiratory and cardiac failure or neuroimaging findings consistent with encephalopathy such as marked brain edema, focal lesions, and blurred gray-white matter junction |
| Incidental | Other findings that are not directly attributable to influenza infection |
