Health Advisory
2009-2010 Influenza Season Update #8
Influenza-related Death Reporting

To: Vermont Health Care Provider
From: Steve Shapiro, MD, Chief Medical Examiner
Date: November 6, 2009

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In order to monitor deaths associated with influenza, the Vermont Department of Health suggests the following procedures for physicians faced with influenza-associated fatalities. For now, we also recommended that all deaths in otherwise healthy young patients, with or without a laboratory confirmation of 2009 H1N1 influenza, be reported to the Office of Chief Medical Examiner 1-888-552-2952.

This recommendation may change as we become more familiar with the disease.

Death Certification:  Deaths related solely to influenza should be certified as such, with a designation as to confirmed by laboratory or suspected by clinical history and/or circumstances.  Examples:

  1. Otherwise healthy person, presents with influenza-like illness and has laboratory confirmation of influenza, who subsequently dies:
    1. Cause of death:  Influenza H1N1 (confirmed) 
      REPORT TO Office of Chief Medical Examiner 1-888-552-2952.
  2. Otherwise healthy person, presents with influenza-like illness and has NO laboratory confirmation of influenza, who subsequently dies:
    1. Cause of death:  Influenza (presumed)
      REPORT TO Office of Chief Medical Examiner 1-888-552-2952.
  3. Patient with a chronic underlying condition (such as Alzheimer’s disease, diabetes, atherosclerotic cardiovascular disease, emphysema, cancer, etc.) who may be more susceptible to dying as a result of being infected with influenza, presents with influenza-like illness and has laboratory confirmation of influenza, who subsequently dies:
    1. Cause of death:  Influenza (confirmed)
      Contributory causes of death (Part II on the death certificate)
       List all underlying diseases.
  4. Patient with a chronic underlying condition (such as Alzheimer’s disease, diabetes,  atherosclerotic cardiovascular disease, emphysema, cancer etc.) who may be more susceptible to dying as a result of being infected with influenza, presents with influenza-like illness and has NO laboratory confirmation of Influenza, who subsequently dies:
    1. Cause of death:  Influenza (presumed)
      Contributory causes of death: (Part II on the death certificate)
      List all underlying diseases.

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