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."

The news came as scientists in Norway announced that they had detected a mutated form of the swine flu virus in two patients who died of the flu and in a third who was severely ill. It is the most recent report of mutations in the virus that is being watched closely for any change that could make it more dangerous. In a statement, the Norwegian Institute of Public Health said the mutation "could possibly make the virus more prone to infect deeper in the airways and thus cause more severe disease," such as pneumonia.