DES MOINES, Iowa "In the autopsy, what we're seeing is very heavy, wet hemorrhagic lungs, lungs with a lot of blood in them,"

DES MOINES, Iowa -- Iowa has officially recorded 21 H1N1 deaths, including seven in Polk County alone. But the county's medical examiner said he has performed autopsies on some residents who were never diagnosed with H1N1, but actually had it.

"In the autopsy, what we're seeing is very heavy, wet hemorrhagic lungs, lungs with a lot of blood in them," said Dr. Gregory Schmunk.He said the official count of seven H1N1 deaths is inaccurate, but patient rights laws prohibit him from giving specific numbers.

He said there are two reasons for the discrepancy.
First, not all sick patients get tests and second, the virus is difficult to detect. Some patients may be too sick to receive the most accurate H1N1 test."They're not always done and it can be hazardous to the patient if they're in a respiratory critical situation," Schmunk said.

He also said that some tests reveal a false negative."Because of our limitations on testing, sometimes the tests aren't positive," he said. "They do appear to fit clinically the course of a H1N1 viral-type pneumonia."He said the cases he's seen in Polk County were all middle-aged adults with a few underlying health conditions."These may be the patients that are obese," Schmunk said. "Obesity restricts your ability to breathe and clear the virus from your upper respiratory."He also said that some of the patients had diabetes.

Schmunk said his urging people to get the vaccine."The thing that concerns me the most is, you still have people out there they believe that if I get the vaccine, the shot, then I'm going to get the flu," he said. "You can't get the flu from the shot."

He said that in the meantime, remember to wash your hands, sneeze into your sleeve and stay home if you're sick. The Centers for Disease Control and Prevention said one person who goes to work sick with the virus will infect 10 percent of his or her co-workers.

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