Coroner: Old Mill Student Died of Respiratory Infection

The Marin County Coroner’s Office said Friday that an Old Mill School kindergartner who succumbed to an acute respiratory infection.

But a series of tests that were conducted in the weeks following the 5-year-old boy’s death did not determine conclusively if the cause was Influenza A (H1N1), for which the boy had tested positive, or another virus.

According to Sheriff’s Lt. Keith Boyd, the Coroner’s Office conducted a forensic examination, toxicology, histology and culture studies, as well as a review of the circumstances surrounding the death of the boy.

Marin County Public Health Officer Jason Eberhart-Phillips said the tests were able to rule out a bacterial infection in the boy’s death, but not the exact viral cause. Influenza A (H1N1), widely known as swine flu, and cardiac hypertrophy, which is a thickening of the heart that results in a decrease in size of the chamber of the heart, were also listed as “significant conditions” in the boy’s death by natural causes.

“We know from experience that the flu can kill and the H1N1 has and continues to cause death in a number of very unfortunate cases,” Eberhart-Phillips said. “But apparently there weren’t willing to ascribe the death exclusively to H1N1. What can commonly happen when someone is infected with flu is that they are infected with something else at the same time and the double whammy can result in an even more serious infection.”

“He either died of Influenza A (H1N1) or he may have had another virus,” he continued. “It may have been that another virus was taking the opportunity to infect him at the same time he was infected with the flu.”

The boy’s parents informed Old Mill officials on the night of March 3 that he was experiencing flu-like symptoms and would be kept at home the next day, according to the Sheriff's Office. Mill Valley Police and Mill Valley Fire personnel were called to the family’s home at around 8:30 a.m. the next morning, and the boy was rushed to Marin General Hospital.

The boy died at 9:45 a.m. at Marin General after testing positive for influenza, sending shockwaves throughout the Mill Valley School District community.

At the time, Dr. Anju Goel, the county's deputy public health officer, wrote a letter to local hospitals, clinics, pediatricians and family doctors, notifying them of the boy’s death and he had tested positive for influenza. She informed medical providers the health department was reaching out “to close contacts of the child and asking those at higher risk to contact their medical providers to discuss” antiviral medications.

“Note that although all children aged under 5 years (of age) are considered at higher risk for complications from influenza, the highest risk is for those ages under 2 years, with the highest hospitalization and death rates among infants aged under 6 months,” Goel wrote.

Old Mill did not see a spike in absences following the boy’s death. The Old Mill community held a candlelight vigil in the boy’s memory a few days later.