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Update in Infectious Diseases
- John G. Bartlett, MD
- From Johns Hopkins University School of Medicine, Baltimore, Maryland. Requests for Reprints: John Bartlett, MD, Johns Hopkins University School of Medicine, Ross Research Building, Room 1159, 720 Rutland Avenue, Baltimore, MD 21205. Current Author Addresses: Dr. Bartlett: Johns Hopkins University School of Medicine, Ross Research Building, Room 1159, 720 Rutland Avenue, Baltimore, MD 21205.
Infectious diseases is a rapidly moving field, largely because of advances against the human immunodeficiency virus (HIV). However, the situation in other, more traditional, areas of infectious diseases is more worrisome, especially given the emergence of new viral diseases and the growing resistance to treatment of older, more common bacteria.
General Topics
Deaths from Infection Are on the Upswing
Pinner RW, Teutsch SM, Simonsen L, Klug LA, Graber JM, Clarke MA, et al. Trends in infectious diseases mortality in the United States. JAMA. 1996; 275:189-93.
At the beginning of the 20th century, infectious diseases were by far the most common cause of death. By mid-century, however, advances in the prevention and management of these diseases were dramatic enough to raise hopes that infectious diseases would cease to be a significant cause of death by the century's end. The opposite, however, seems to be the case.
To evaluate recent trends in mortality from infectious diseases in the United States, Pinner and colleagues studied International Classification of Diseases, Ninth Revision (ICD-9) codes from the National Center for Health Statistics for 1980 through 1992. They focused on codes for underlying causes of death that exclusively represent infectious diseases. Some infection-related diseases were analyzed separately because recent studies had implicated a microbial cause. Examples of the latter are peptic ulcer disease (Helicobacter pylori), cervical carcinoma (human papilloma virus), nonalcoholic cirrhosis, and hepatocellular carcinoma (hepatitis B and C viruses).
During the 13-year study period, the rate of death from infectious diseases increased from 41 per 100 000 persons to 65 per 100 000 persons, an increase of 58% (Table 1). The rate increased 6.3-fold for persons 25 to 44 years of age, primarily because of the acquired immunodeficiency syndrome (AIDS). However, the rate of death from infections increased 25% for persons 65 years of age and older, and the rate of death from septicemia …
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