Prince Rogers Nelson – Prince – died today at his Paisley Park residence in Chanhassan, Minnesota.... [+]
The gifted musician, songwriter and actor Prince Rogers Nelson died this morning at his home outside of Minneapolis. The cause of death has not yet been made public.
However, the artist had been battling the flu since at least April 7, his representatives confirmed to several media outlets, when he canceled two shows in Atlanta on his Piano and a Microphone tour. After playing the rescheduled shows on Thursday, April 14, his plane made an unscheduled emergency landing at Quad-City International Airport in Moline, Ill., at 1:30 a.m. on April 15. He was treated at Trinity Moline medical center for about three hours and was suffering from "bad dehydration." He returned to his Paisley Park home in Chanhassan, Minn., and held a dance party for 200 on the night of April 16, where he appeared for about five minutes.
[Update 4/21, 10 p.m.: TMZ is reporting based on anonymous sources that he was treated at Trinity Moline for a drug overdose.]
[Update 4/29, 11 a.m. The AP and the New York Times are now reporting that Prince was in possession of prescription opioids that included Percocet. Authorities are investigating whether a doctor was on the plane that landed in Moline. Bear in mind that the contributions of flu could still be in play even if opioids end up being the primary cause. Pulmonary complications of flu could combine with the respiratory depressant effects of opioids.]
After years of what the Mirror called hedonistic excess, Prince became a teetotaling vegan and Jehovah's Witness by 2010. Again, the cause of death is still unknown, but is the flu a possibility? Can a health nut fit enough for long flamboyant performances be taken down by influenza in his mid-50s? Doesn't flu really only kill infants and elders?
For several of the last few years, the Northern Hemisphere has been experiencing a resurgence of the 2009 pandemic strain of the influenza A virus. Last year – the 2014-2015 flu season – 61% of flu hospitalizations were among adults aged 18 to 64, according to the U.S. Centers for Disease Control and Prevention. By comparison, an H3N2 strain predominated during the previous season, with only 35% of hospitalizations occurring in the 18-64 age group.
This season, H3N2 was the predominant strain early on but the majority of cases during recent weeks has been due to 2009 H1N1. During that original pandemic season, adults 18 to 64 represented 56% of flu hospitalizations.
The influenza strains that kill young and middle-aged adults take advantage of a phenomenon immunologists call a cytokine storm. People with an otherwise healthy immune system mount an overblown response to the pathogen. They experience severe lung inflammation (pneumonia) and their blood vessels become leaky, filling the lungs with fluid. Some evidence suggests that the blood supply to the intestines also becomes leaky and digestive enzymes gain access to the bloodstream. Secondary bacterial infections can also lead to septic shock, or sepsis, the cause of actress Patty Duke's recent death.
Prolonged pneumonia and pulmonary edema can progress to acute respiratory distress syndrome (ARDS) where the air sacs of the lung can no longer absorb enough oxygen. The lungs become stiff and heavy from the infiltration of fluid, making it difficult for the lungs to expand. The constellation of symptoms from the overreaching immune response and problems maintaining oxygen levels and fluid balance can lead to the failure of other organs.
Patients are treated in the intensive care unit and their breathing assisted by ventilation with oxygen and positive end expiratory pressure (PEEP). Some patients will undergo extracorporeal membrane oxygenation (ECMO) where the blood is oxygenated and carbon dioxide removed mechanically, outside the body.
As a result, ARDS kills about one-third of people whose illness progresses that far. And those who survive ARDS may suffer some degree of permanent lung damage from pulmonary fibrosis. Many also have memory and other cognitive issues from oxygen deprivation to the brain during their illness.
ARDS can occur from causes other than influenza, such as trauma, smoke inhalation, or aspiration of vomit. It strikes about 150,000 patients in the U.S. each year but death numbers are often spread across other more general categories such as pneumonia.
Those of us in science communications and journalism are all too familiar with how flu and ARDS can claim younger people. The former physicist and science writer Helen Chappell, 28, died from ARDS caused by H1N1 two years ago this month, just a week after being admitted to the Duke University Hospital for breathing problems while on a camping trip.
So, yes, young healthy people can die from flu and it's not uncommon for the currently circulating flu strain to disproportionately affect young and middle-aged adults. The best approach, always, is to not get the flu or at least reduce its severity by getting your annual influenza vaccination. This year's vaccines are an excellent match for the circulating strains.
I contacted Trinity Moline to learn more about how Prince was treated last week but spokesperson Erin Platt said, "We have no patient by that name in our directory." It's also not known how Prince had been treated at his residence or whether he had received this year's flu vaccine.
Calls to Prince's publicist who first confirmed his death have gone to voicemail. I'll update this story when I receive a response as to the cause of death.
