Analysis of 35 deaths from A(H1N1) influenza virus infection in the Transbaikal region (autumn 2009) is reported. All the cases were under 60 years of age. Viral/bacterial pneumonia complicated by acute respiratory distress syndrome (ARDS) was the main cause of fatal outcomes. Enteroccocci were found in 83.3% of the seeded autopsy samples. Possible enterococcal infection pathways and mechanisms of ARDS development are discussed. The role of heat shock proteins is postulated. Disturbances of lipid metabolism are supposed to be major risk factors of severe influenza and its fatal outcome that may be related to obesity through common pathogenetic pathways.

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