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Trends in Gastroenteritis-Associated Mortality in the United States, 1985-2005
Citation:
Jagai, J., G. Smith, AND Tim Wade. Trends in Gastroenteritis-Associated Mortality in the United States, 1985-2005. Presented at UNC Water and Health Conference, October 29 - November 02, 2012.
Impact/Purpose:
for presentation at UNC Water and Health Conference, 10/27-11/02/2012 in Chapel Hill, NC
Description:
Worldwide, gastrointestinal infections are a major, and often preventable, cause of mortality. In much of the developing world, mortality due to gastrointestinal infections disproportionately impacts children and is often associated with poor hygienic conditions (e.g., contaminated food or water). In contrast, in the United States the elderly have a higher mortality rate due to gastrointestinal infections. Trends in gastroenteritis-associated mortality are changing over time with the development of antibiotic resistant strains of certain pathogens, improved diagnostic methods, and changing healthcare. In this analysis we examine rates and trends in gastroenteritis-associated mortality in the United States for a 21-year period. The National Center for Health Statistics Multiple Cause-of-Death Mortality databases for 1985-2005 were analyzed. All deaths in which the underlying cause or any contributing cause included gastroenteritis were included. Cases were selected based on ICD9-CM (pre-1999) and ICD10 (1999-2005) and included cause specific infectious gastroenteritis codes (bacterial, viral, protozoal) and cause unspecified gastroenteritis codes (ICD9-CM 001-009, 041, 047, 070, 074, 079, 127, 558; ICD10 A00.0-09, A08, A87, B15, B08.4, B34.1, B77-79, B81-82, B95-97, K52). Gastroenteritis was associated with an average of 7,937 deaths per year during the study period. Rates of gastroenteritis-associated mortality more than doubled over the 21-year period from 2.22 deaths to 5.05 deaths per 100,000 people associated with gastroenteritis. The elderly (65+ years of age) accounted for the majority of deaths (76.5%) of which 13.8 per 100 gastroenteritis-associated deaths were due to bacterial pathogens and 10.8 per 100 gastroenteritis-associated deaths were due to viruses. Rates for bacterial deaths increased from 0.35 deaths per 100,000 people in 1985 to 3.0 deaths per 100,000 people in 2005. The deaths in the bacterial category were driven by an increase in