Misclassification of infant deaths--Alaska, 1990-1991.

In June 1991, the Alaska Section of Vital Statistics reported that nine deaths of Alaskan Native infants occurred in seven villages in southwestern Alaska from January 1990 through June 1991. In comparison, seven Alaskan Native infant deaths occurred in these villages during 1986-1989. Two of the deaths during 1990-1991 had been attributed to acute viral myocarditis (International Classification of Diseases, Ninth Revision [ICD-9], code 422.9) and three to viral or unspecified pneumonitis (ICD-9 codes 480.9 and 486), while from 1985 through 1989, one infant death in these villages had been attributed to either of these causes. An examination of the clinical histories of these nine infants by the Alaska Division of Public Health (ADPH) suggested some of the diagnoses might be inaccurate. This report summarizes an investigation by the ADPH to assess the accuracy of the immediate cause of death recorded on the death certificates for the nine infants.