title: Review of immunological and virological aspects as contributory factors in Sudden Unexpected Death in Infancy (SUDI).
abstract: Currently in South Africa research into sudden unexpected death in infancy (SUDI) is limited. The causes of sudden infant death syndrome (SIDS) remain obscure despite full medico-legal investigations inclusive of autopsy, scene visit and ancillary studies. Viral infections play an important role as a multitude of respiratory viruses have been detected in autopsy specimens and are implicated in these deaths. The specific contribution of viruses in the events preceding SIDS still warrants deciphering. Infancy is characterised by marked vulnerability to infections due to immaturities of the immune system that may only resolve by the age of 24 months. Routine viral screening of all SUDI cases at Tygerberg Forensic Pathology Service (FPS) Mortuary in Cape Town focuses on only a portion of respiratory viruses from lung and liver tissue. This review highlights important virological and immunological aspects regarding investigations into the infectious nature of SUDI, including the lack of national standardised guidelines for appropriate specimen collection at autopsy and subsequent laboratory analysis.
authors.affiliation: Division of Medical Virology, Department of Pathology, University of Stellenbosch, P O Box 19063, Tygerberg 7505, South Africa. Electronic address: hlg@sun.ac.za.
authors.forename: Heleen
authors.initials: H
authors.lastname: la Grange
authors.affiliation: Department of Forensic Pathology, University of Pretoria, Private Bag X20, Hatfield, Pretoria 0028, South Africa. Electronic address: janette.verster@up.ac.za.
authors.forename: Janette
authors.initials: J
authors.lastname: Verster
authors.affiliation: Division of Forensic Pathology, Department of Pathology, University of Stellenbosch, P O Box 19063, Tygerberg 7505, South Africa; Western Cape Forensic Pathology Service, Cape Town, South Africa. Electronic address: jd2@sun.ac.za.
authors.forename: Johan J
authors.initials: JJ
authors.lastname: Dempers
authors.affiliation: Division of Medical Virology, Department of Pathology, University of Stellenbosch, P O Box 19063, Tygerberg 7505, South Africa. Electronic address: cdeb@sun.ac.za.
authors.forename: Corena
authors.initials: C
authors.lastname: de Beer
mesh_terms: D006801:Humans; D007107:Immune System / Q000502:physiology; D007223:Infant; D007249:Inflammation / Q000276:immunology; D012141:Respiratory Tract Infections / Q000276:immunology / Q000382:microbiology / Q000821:virology; D013398:Sudden Infant Death / Q000276:immunology*
keywords: Medico-legal investigations; Respiratory immune defence; Respiratory viruses; Sudden infant death syndrome; Sudden unexpected death in infancy