title: The use of coroner's autopsy reports to validate the use of targeted swabbing rather than tissue collection for rapid confirmation of virological causes of sudden death in the community.
abstract: OBJECTIVE
  In this study, coroner's autopsy reports were used to validate results obtained from respiratory virus screening of swabs rather than tissue collected during autopsy in cases of adult death of unknown cause.
  
  
  METHODS
  Coroner's autopsy samples collected for respiratory virus screening between October 2010 and February 2011, were identified. Autopsy reports were requested from cases positive for a virus. Each report was reviewed to correlate findings at autopsy with the virology result and to determine whether the virus found was listed as a contributing factor in the death.
  
  
  RESULTS
  Sixty-four coroner's autopsy cases were identified and a respiratory virus was found in 25 cases. Influenza A(H1N1)pdm09 virus was found most frequently, then RSV and influenza B with a dual influenza A and B infection and a parainfluenza type 1. Where multiple sites were swabbed, the virus was detected in all sites. Autopsy reports for 12 cases were obtained each reporting findings consistent with respiratory infection. Influenza A was always listed as a contributing factor in the death whereas RSV was listed once and influenza B was omitted in one case. The quality of the reports was variable and full histology was less likely to be performed in the elderly.
  
  
  CONCLUSIONS
  While coroner's reports supported the use of swabbing rather than tissue collection, the lack of consistency and omission of the virology findings as contributing factors to death means that the burden of viruses on mortality statistics will remain under-estimated particularly in the elderly.
authors.affiliation: Wales Specialist Virology Centre, Public Health Wales Microbiology Cardiff, University Hospital of Wales, Cardiff CF14 4XW, United Kingdom. Electronic address: catherine.moore2@wales.nhs.uk.
authors.forename: Catherine
authors.initials: C
authors.lastname: Moore
authors.affiliation: Wales Specialist Virology Centre, Public Health Wales Microbiology Cardiff, University Hospital of Wales, Cardiff CF14 4XW, United Kingdom.
authors.forename: Rachel
authors.initials: R
authors.lastname: Jones
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001344:Autopsy; D017714:Community-Acquired Infections / Q000150:complications / Q000175:diagnosis*; D003645:Death, Sudden / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012141:Respiratory Tract Infections / Q000150:complications / Q000175:diagnosis*; D012189:Retrospective Studies; D013048:Specimen Handling / Q000379:methods*; D014777:Virus Diseases / Q000150:complications / Q000175:diagnosis*; D014780:Viruses / Q000302:isolation & purification*; D055815:Young Adult
keywords: Autopsy; Respiratory; Sudden; death; sampling; virus mortality