0
ARTICLE |

Diarrheal Deaths in the United States, 1979 Through 1987: Title and subTitle BreakA Special Problem for the Elderly FREE

Judy F. Lew, MD; Roger I. Glass, MD, PhD; Raymond E. Gangarosa, MD, MPH; Ivan P. Cohen; Caryn Bern, MD; Christine L. Moe, PhD
[+] Author Affiliations

Reprint requests to Mailstop G-04, Viral Gastroenteritis Unit, Respiratory and Enteric Virus Branch, Centers for Disease Control, Atlanta, GA 30333 (Dr Lew).


JAMA. 1991;265(24):3280-3284. doi:10.1001/jama.1991.03460240076031
Text Size: A A A
Published online

Objective.—  Diarrhea is an important cause of death among young children in both developing and developed countries, but little is known about diarrheal deaths among adults. In this study, we examined trends in diarrheal deaths among all age groups in the United States.

Design/Setting/Participants.—  We reviewed national mortality data compiled by the National Center for Health Statistics, Hyattsville, Md, which consist of information from all death certificates filed in the United States for the period 1979 through 1987. A death for which diarrhea was listed as an immediate or underlying cause was considered a "diarrheal death" and included in the analysis.

Results.—  We found that 28 538 persons died of diarrhea cited as either an immediate or the underlying cause of death during the 9-year period. A majority of diarrheal deaths occurred among the elderly (older than 74 years of age, 51%), followed by adults 55 to 74 years of age (27%), and young children ( younger than 5 years of age, 11%). For the elderly, adjusted risk factors for dying of diarrhea included being white, female, and residing in a long-term care facility. Only the elderly and young children had clear, distinct winter peaks of diarrheal deaths, suggesting that the diarrhea may, in part, be infectious in origin.

Conclusion.—  For the elderly, more directed studies of those at risk, such as nursing home residents, are needed to determine if oral rehydration therapy, vaccines, or other preventive measures might benefit this population.(JAMA. 1991;265:3280-3284)

REFERENCES

Breslow L.  The future of public health: prospects in the United States . In: Breslow L, Fielding JE, Lave JB, eds. Annual Review of Public Health, XI . Palo Alto, Calif: Annual Reviews Inc; 1990;:1-28.
National Center for Health Statistics. Health United States, 1989 . Hyattsville, Md: Public Health Service, 1990;. US Dept of Health and Human Services publication PHS 90-1232.
The State of the World's Children 1990 . New York, NY: Oxford University Press Inc; 1990;.
Avery ME, Snyder JD.  Oral therapy for acute diarrhea . N Engl J Med. 1990;;323:891-894.
Gellert GA, Waterman SH, Ewert D, et al.  An outbreak of acute gastroenteritis caused by a small round structured virus in a geriatric convalescent facility . Infect Control Hosp Epidemiol. 1990;;11:459-464.
Gordon SM, Oshiro LS, Jarvis WR, et al.  Foodborne Snow Mountain agent gastroenteritis with secondary person-to-person spread in a retirement community . Am J Epidemiol. 1990;;131:702-710.
Israel RA, Rosenberg HR, Curtin LR.  Analytical potential for multiple cause-of-death data . Am J Epidemiol. 1986;;124:161-179.
US Bureau of the Census.  Preliminary estimates of the population of the United States, by age, sex, and race: 1970 to 1981 . Current Population Reports . Washington, DC: US Bureau of the Census; 1982;. Series P-25, No. (917) .
US Bureau of the Census.  United States population estimates, by age, sex, and race: 1980 to 1987 . Current Population Reports . Washington, DC: US Bureau of the Census; 1988;. Series P-25, No. (1022) .
Ho M-S, Glass RI, Pinsky PF, et al.  Diarrheal deaths in American children: are they preventable? JAMA . 1988;;260:3281-3285.
Maasdam CF, Anuras S.  Are you overlooking GI infections in your elderly patients? Geriatrics . 1981;;36:127-134.
LeBaron CW, Lew J, Glass RI, et al.  Annual rotavirus epidemic patterns in North America . JAMA . 1990;;264:983-988.
Ho M-S, Glass RI, Pinsky PF, Anderson LJ.  Rotavirus as a cause of diarrheal morbidity and mortality in the United States . JAMA . 1988;;258:1112-1116.
Kapikian AZ, Yolken RH, Greenberg HB, et al.  Gastroenteritis viruses . In: Lennette EH, Schmidt NJ, eds. Diagnostic Procedures for Viral, Rickettsial and Chlamydial Infections . 5th ed. Washington, DC: American Public Health Association; 1979;:927-995.
Matson DO, Estes MK.  Impact of rotavirus infection at a large pediatric hospital . J Infect Dis. 1990;;162:598-604.
Hing E.  Nursing home utilization by residents: United States, 1985 . Vital Health Stat [13] . 1989;;102:24-31.
Hing E. Use of Nursing Homes by the Elderly: Preliminary Data From the 1985 National Nursing Home Survey, 1987 . Advancedata 135, (May 14) , 1987;; US Dept of Health and Human Services publication PHS 87-1270.
Smith PW.  Nosocomial infections in the elderly . Infect Dis Clin North Am. 1989;;3:763-777.
Wing S, Mason KG, Stallard E, Hames CG, Tyroler HA.  The black/white mortality crossover: investigation in a community-based study . J Gerontol. 1985;;40:78-84.
Centers for Disease Control.  Human immunodeficiency virus (HIV) infection codes: official authorized addendum ICD-9CM (revision 1) effective January, 1988 . MMWR . 1987;;36( (S-7) ):1-24.
Fitzgerald JF.  Management of acute diarrhea . Pediatr Infect Dis J. 1989;;8:564-569.

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

Breslow L.  The future of public health: prospects in the United States . In: Breslow L, Fielding JE, Lave JB, eds. Annual Review of Public Health, XI . Palo Alto, Calif: Annual Reviews Inc; 1990;:1-28.
National Center for Health Statistics. Health United States, 1989 . Hyattsville, Md: Public Health Service, 1990;. US Dept of Health and Human Services publication PHS 90-1232.
The State of the World's Children 1990 . New York, NY: Oxford University Press Inc; 1990;.
Avery ME, Snyder JD.  Oral therapy for acute diarrhea . N Engl J Med. 1990;;323:891-894.
Gellert GA, Waterman SH, Ewert D, et al.  An outbreak of acute gastroenteritis caused by a small round structured virus in a geriatric convalescent facility . Infect Control Hosp Epidemiol. 1990;;11:459-464.
Gordon SM, Oshiro LS, Jarvis WR, et al.  Foodborne Snow Mountain agent gastroenteritis with secondary person-to-person spread in a retirement community . Am J Epidemiol. 1990;;131:702-710.
Israel RA, Rosenberg HR, Curtin LR.  Analytical potential for multiple cause-of-death data . Am J Epidemiol. 1986;;124:161-179.
US Bureau of the Census.  Preliminary estimates of the population of the United States, by age, sex, and race: 1970 to 1981 . Current Population Reports . Washington, DC: US Bureau of the Census; 1982;. Series P-25, No. (917) .
US Bureau of the Census.  United States population estimates, by age, sex, and race: 1980 to 1987 . Current Population Reports . Washington, DC: US Bureau of the Census; 1988;. Series P-25, No. (1022) .
Ho M-S, Glass RI, Pinsky PF, et al.  Diarrheal deaths in American children: are they preventable? JAMA . 1988;;260:3281-3285.
Maasdam CF, Anuras S.  Are you overlooking GI infections in your elderly patients? Geriatrics . 1981;;36:127-134.
LeBaron CW, Lew J, Glass RI, et al.  Annual rotavirus epidemic patterns in North America . JAMA . 1990;;264:983-988.
Ho M-S, Glass RI, Pinsky PF, Anderson LJ.  Rotavirus as a cause of diarrheal morbidity and mortality in the United States . JAMA . 1988;;258:1112-1116.
Kapikian AZ, Yolken RH, Greenberg HB, et al.  Gastroenteritis viruses . In: Lennette EH, Schmidt NJ, eds. Diagnostic Procedures for Viral, Rickettsial and Chlamydial Infections . 5th ed. Washington, DC: American Public Health Association; 1979;:927-995.
Matson DO, Estes MK.  Impact of rotavirus infection at a large pediatric hospital . J Infect Dis. 1990;;162:598-604.
Hing E.  Nursing home utilization by residents: United States, 1985 . Vital Health Stat [13] . 1989;;102:24-31.
Hing E. Use of Nursing Homes by the Elderly: Preliminary Data From the 1985 National Nursing Home Survey, 1987 . Advancedata 135, (May 14) , 1987;; US Dept of Health and Human Services publication PHS 87-1270.
Smith PW.  Nosocomial infections in the elderly . Infect Dis Clin North Am. 1989;;3:763-777.
Wing S, Mason KG, Stallard E, Hames CG, Tyroler HA.  The black/white mortality crossover: investigation in a community-based study . J Gerontol. 1985;;40:78-84.
Centers for Disease Control.  Human immunodeficiency virus (HIV) infection codes: official authorized addendum ICD-9CM (revision 1) effective January, 1988 . MMWR . 1987;;36( (S-7) ):1-24.
Fitzgerald JF.  Management of acute diarrhea . Pediatr Infect Dis J. 1989;;8:564-569.
CME Course for:


You need to register in order to view this quiz.


To understand the clinical management of acute heart failure syndromes.
Accreditation Information The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
To view and print your certificate and access a summary of your CME courses go to My CME.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Response

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.