"A. Baum" wrote in message
news
On Tue, 25 Jan 2011 00:49:27 -0500, Robert Green wrote:
Interestingly enough, that's not always a given. The recent flu as well
as the flu that caused the great 1918 epidemic killed more youngsters
than oldsters. The reason? "Juicy" young people can apparently
generate enough phlegm to drown themselves in it. Dried up older people
like me and Willie Nelson (who claims to have "outlived his dick") can't
produce nearly as much phlegm as so can't produce the prodigious amounts
of it that clog the lungs and helps cause death.
Somewhat true but most elderly who die from the flue die from
complications like congestive heart failure. Especially those who
already have compromised heart output. Or they die from organ shutdown.
A cascading failure of heart, kidney, liver and eventually succumb to
asphyxiation of the brain due to inadequate blood supply and under-
oxygenated blood. Flu hits the young and elderly in most cases the
hardest.
You raise an interesting point. Since the number of autosopies performed
each year has been dropping steadily (except for judicially ordered ones) we
have less and less meaningful data about the actual causes of death.
http://en.wikipedia.org/wiki/Autopsy
"In the United States, autopsy rates fell from 17% in 1980 to 14% in 1985
and 11.5% in 1989, although the figures vary notably from county to county."
Something like the death from influenza could end up being listed in any
number of the categories you've described (and does). Determining the true
source of mortality is becoming harder and harder because autopsies are
performed on just about 10% of the people who die (and a large number of
those are judicial autopsies, where criminality may be an issue). The stats
on causes of death are important because they tend to direct where we spend
our research dollars. The stats I quoted in the original post indicate the
death rates and how the deaths of previously healthy individuals stand out
when compared to the young and elderly, *even* considering the latter's
tendency towards death from pre-existing conditions.
To illustrate how "soft" flu death stats a
http://www.cdc.gov/flu/about/qa/disease.htm says:
"Over a period of 30 years, between 1976 and 2006, estimates of
flu-associated deaths range from a low of about 3,000 to a high of about
49,000 people."
That's a pretty damn wide range.
The medical researchers I know say that our information about causes of
death is extremely unreliable and getting worse every year. As you might
imagine, when given the choice between reporting a cause of death that
leaves them open to possible malpractice charges and one that does not,
doctors almost always check the "I had nothing to do with it" block. As
computer scientists say, Garbage In, Garbage Out.
All that aside, flu statistics show that some variations of the disease,
like the one that caused the 1918 epidemic, kill the young and previously
healthy at a greater rate than the elderly precisely because their immune
systems ARE in excellent shape. Half the 1918 deaths were in the 20-40 year
old, previously health group. When those young and healthy immune systems
are "overdriven" they can produce the cytokine storms that kill young people
by literally drowning them in their own phlegm. Our current vaccines,
Tamiflu and Relenza, offer no protection against these lethals "storms:"
http://www.cytokinestorm.com/
The overdriven immune response death is directly attributable to the flu and
its ensuing complications and nothing else. No pre-existing, potentially
lethal conditions are partially to blame so there is far less chance of an
error in the cause of death.
Interestingly enough some of the data that lead to the understanding of
cytokine storms came from autopsies of people who had died in the 1918
epidemic: (who says the dead can't speak?)
http://www2.gi.alaska.edu/ScienceForum/ASF13/1386.html
"Hultin looked at an Alaska permafrost map and selected Brevig Mission as a
place that met the requirements of massive flu mortality and frozen ground
that might have preserved bodies. He flew to Brevig Mission in 1951. With
permission from Native elders, Hultin, Geist and two Iowa researchers opened
a mass grave, marked by two crosses. In the grave, missionaries in 1918
buried the bodies of the 72 people who died of the flu."
Those studies showed that although the cause of death was technically
bacterial pneumonia (germs normally found throat and nose colonizing the
lungs), it was the flu that began the downward spiral and caused the
pneumonia.
http://www.nih.gov/news/health/aug2008/niaid-19.htm
All of which goes to prove that "Cause of Death" on a death certificate is
often times just a guess, especially if the flu is involved.
--
Bobby G.