[Morphological changes in lung tissue of victims associated with the 2009 A H1N1/v09 influenza pandemic in Colombia].
BACKGROUND
Influenza is an acute respiratory infection that may be seasonal or pandemic. In 2009 The World Health Organization (WHO) declared an influenza pandemia; 3,876 cases and 239 deaths were reported in Colombia.


OBJECTIVE
The morphological changes in lung tissues associated with virus infection H1N1/v09 were described from autopsied victims. Materials and methods. Seventy-five cases were diagnosed by RT-PCR for influenza A H1N1/v09, of which the lungs of 20 were selected for morphological study by light microscopy, optical microscopy, high-resolution transmission electron microscopy and immunohistochemistry.


RESULTS
Of the 75 cases, 83% had viral pneumonitis and 17% alveolitis. Complications included intra-alveolar hemorrhage (66%), edema (89%), diffuse alveolar damage (2%), and bacterial co-infection (32%). Morphological changes were as follows: destruction of the alveolar epithelium and interstitium, edema, macrophages with vacuolated cytoplasm,and infiltration of polymorphonuclear leukocytes in the alveolar lumen and interstitium, vacuolization cytoplasmic type I pneumocytes and electronedense bodies in cellular debris in the alveolar lumen, and immunoreactivity of viral antigens in bronchiolar epithelial cells and alveolar infiltrate.


CONCLUSIONS
The low percentage of bacterial co-infection observed in these cases was a prominent feature, and suggested that the fatal result was probably not associated with secondary bacterial disease (Indicated by previous reports). The tissue lesions were attributed to tissue damage due to viral lesion, as well as the cellular and humoral inflammatory response associated with infiltration by polymorphonucleocytes and macrophages in the interstitium and alveolar lumen.
Grupo de Morfología Celular, Instituto Nacional de Salud, Bogotá, D.C, Colombia.
Jorge
J
Rivera
Ladys
L
Sarmiento
Edgar
E
Parra
Gabriel
G
Toro
Marcela
M
Neira
Jairo
J
Méndez
Juliana
J
Barbosa
María Leonor
ML
Caldas
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D060085:Coinfection; D003105:Colombia / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D053118:Influenza A Virus, H1N1 Subtype / Q000502:physiology; D007251:Influenza, Human / Q000150:complications / Q000453:epidemiology / Q000473:pathology* / Q000821:virology; D008168:Lung / Q000473:pathology* / Q000821:virology; D016131:Lymphocyte Subsets / Q000473:pathology; D008264:Macrophages / Q000473:pathology; D008297:Male; D008854:Microscopy, Electron; D008875:Middle Aged; D020556:Neutrophil Infiltration; D058873:Pandemics; D018410:Pneumonia, Bacterial / Q000209:etiology; D011024:Pneumonia, Viral / Q000209:etiology / Q000473:pathology / Q000821:virology; D011654:Pulmonary Edema / Q000209:etiology; D014779:Virus Replication; D055815:Young Adult