http://www.nytimes.com/2009/05/09/health/09flu.html?ref=health
Some of the serious cases involve healthy young people, and the reasons for that are still unexplained. Many of the patients went into rapid decline and died of viral pneumonia, not bacterial pneumonia, said Dr. Sylvie Briand, a W.H.O. flu expert. Viral pneumonia may be a result of the “cytokine storm,” in which the body’s own immune reaction to a new virus floods the lungs with fluid. It can progress faster and be harder to treat than bacterial pneumonia.
Some influenza viruses can cause an unusually high proportion of deaths among healthy young adults with well-functioning immune systems who become infected, possibly due to this cytokine storm phenomenon. This phenomenon may also explain why the Spanish influenza pandemic of 1918, for example, was also particularly deadly for young healthy adults.
David L. Woodland, PhD, Editor-in Chief of Viral Immunology, and President and Director of the Trudeau Institute, Inc. (Saranac Lake, NY), emphasizes that much is still not known about the current influenza outbreak and the human/avian combination virus causing it. "We do not know how long ago this virus emerged, how deadly it is, whether it has pandemic potential, how the severity of infection relates to patient age, and why some infected patients die—whether a cytokine storm is responsible for these deaths," says Woodland."