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After decades of decline, ID mortality rate has 'leveled off'
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The infectious disease mortality rate has “leveled off” since 1950 in the United States after decades of decline interrupted only by the 1918 influenza epidemic, researchers said.
In 2014, the rate that people died of infectious diseases was mostly the same as it was in 1980, according to a review of statistics by Heidi E. Brown, PhD, MPH, assistant professor in epidemiology and biostatistics at the University of Arizona, and colleagues.
“This is evidence that the problem hasn’t gone away,” William G. Powderly, MD, president of the Infectious Diseases Society of America, told Infectious Disease News.
To investigate trends in infectious disease mortality rates, Brown and colleagues used data from the National Office of Vital Statistics from 1900 to 1967 and from the CDC WONDER database for data from 1968 to 2014. They graphed crude mortality rates for infectious diseases from 1900 to 2014, and for selected infections such as influenza, pneumonia, HIV/AIDS and drug-resistant pathogens from 1980 to 2014.
After decreasing between 1900 and 1950, the mortality rate for infectious diseases leveled off over the past six-plus decades, according to Brown and colleagues.
In 1980, the infectious disease mortality rate per 100,000 was 42 compared with 45.6 in 2014 — an average annual percentage change of just 0.4 (95% CI, –0.4 to 1.2). During that time, most infectious disease deaths were due to pneumonia and influenza, with mortality rates for those infections remaining steady.
Mortality rates for drug-resistant infections also remained steady between 1980 and 2014, while vaccine-preventable disease death rates decreased and rates for Clostridium difficile and vector-borne diseases, including West Nile virus, increased.
An HIV/AIDS-related peak of 63.5 deaths per 100,000 population in 1995 was followed by a decline that paralleled the introduction of antiretroviral therapy, Brown and colleagues noted.
Although their study was limited to mortality as reported on death certificates, Brown and colleagues said grouping related diseases together and using national data allowed them to evaluate “general trends” in infectious disease mortality rates.
“However,” they concluded, “trends in population subgroups and at the community level, such as measles outbreaks within low-vaccination communities, were not captured. These trends illustrate the continued U.S. vulnerability to infectious diseases.” – by Gerard Gallagher
Disclosures: The researchers report no relevant financial disclosures.
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