The report by Ho and colleagues1 in this issue of The Journal provides disturbing data on the mortality associated with diarrhea in the United States and raises two important issues for consideration. The magnitude of the deaths reported, an average of approximately 500 children (400 of whom are infants) each year, is troubling because effective therapy is widely available to treat acute diarrhea. As the authors reasonably ask, are these preventable deaths? An even more disturbing issue is the greatly increased rate of diarrheal deaths among black children.
In considering the magnitude of the deaths and possible interventions, information about the duration of diarrhea, the nature, amount, and duration of therapy used, and the access to and utilization of health facilities is required. Because this study was a retrospective review of mortality surveillance data, only partial information on these factors is available. At least two thirds of the deaths