title: Influenza and respiratory syncytial virus are the major respiratory viruses detected from prospective testing of pediatric and adult coronial autopsies.
abstract: BACKGROUND
  To ascertain the full mortality of influenza and other respiratory viruses, the testing of community autopsy specimens is essential.
  
  
  METHODS
  Respiratory virus PCR and culture were performed on 2418 fresh unfrozen respiratory samples collected from 1611 coronial cases where the death was either unknown or infection was suspected, from July 2007 to June 2011, to detect the common respiratory viruses in children and adults, using standardized microbiological testing.
  
  
  RESULTS
  The respiratory virus positive rate was 8·3% (134 cases) with a peak of 28% (42 of 151 cases) in children under 10 years of age. Influenza virus was the commonest respiratory virus (50 cases, 3%), followed by respiratory syncytial virus (RSV) (30 cases, 2%). All tested respiratory viruses were found in children, most commonly adenovirus, enterovirus and RSV, and influenza A and RSV predominated in those over 60 years, but coinfection was uncommon. Almost all influenza cases occurred when influenza was widely circulating in the community but few were diagnosed pre-mortem. Influenza and RSV detection was associated with bronchitis or bronchiolitis in 7 (9%) of the 80 cases and caused pneumonia in 14 (0·8%) deaths overall.
  
  
  CONCLUSIONS
  Our prospective review of respiratory viruses using standardized testing found a single lower respiratory tract autopsy specimen for respiratory virus PCR would detect most community infections at the time of death.
authors.affiliation: Department of Microbiology, PathWest Laboratory Medicine WA, Queen Elizabeth II Medical Centre, Nedlands, WA, Australia; School of Medicine and Pharmacology, University of Western Australia, Crawley, WA, Australia.
authors.forename: David J
authors.initials: DJ
authors.lastname: Speers
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Moss
authors.forename: Cara
authors.initials: C
authors.lastname: Minney-Smith
authors.forename: Avram
authors.initials: A
authors.lastname: Levy
authors.forename: David W
authors.initials: DW
authors.lastname: Smith
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001344:Autopsy; D001988:Bronchiolitis / Q000453:epidemiology / Q000821:virology; D001991:Bronchitis / Q000453:epidemiology / Q000821:virology; D002648:Child; D002675:Child, Preschool; D060085:Coinfection / Q000453:epidemiology / Q000821:virology; D017714:Community-Acquired Infections / Q000453:epidemiology* / Q000821:virology*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D011024:Pneumonia, Viral / Q000453:epidemiology / Q000821:virology; D016133:Polymerase Chain Reaction; D011446:Prospective Studies; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000821:virology*; D014777:Virus Diseases / Q000453:epidemiology* / Q000821:virology*; D014780:Viruses / Q000145:classification / Q000302:isolation & purification*; D055815:Young Adult
keywords: Autopsy; PCR; coronial; culture; influenza; respiratory virus