Estimating the Continuously Evolving COVID-19 Case-Fatality Ratio in the United States using a Time-Delay Correcting Algorithm

Diphtheria attack rates and cases, and to a much lesser extent case-fatality rates, have fallen steadily within the United States during the past 25 years. However, during 1959 and 1960 there was a halt in this long-term trend. Epidemiologic data on 868 clinical cases of diphtheria occurring in 1959 and 873 cases in 1960 were submitted to the Communicable Disease Center by 45 states. The cases and several major outbreaks tended to concentrate in the southern and southwestern states. Attack rates and deaths were highest for children under 10 years, and attack rates were more than five times greater for nonwhite children. Analysis of 1960 immunization data shows that 72% of the patients had received no immunizations. Fifty-five per cent of carriers, but only 18% of persons with bacteriologically confirmed cases, had received a primary series. Only 1 person of 58 fatal cases occurring in 1960 had received a primary series. Certain problems for future investigation, disclosed by the surveillance data, are discussed.

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CASE FATALITY IN INFANTS AND CHILDREN WITH PERTUSSIS, 1942-1946

PEDIATRICS ◽

10.1542/peds.5.5.840 ◽

1950 ◽

Vol 5 (5) ◽

pp. 840-852

Author(s):

JEROME L. KOHN ◽

ALFRED E. FISCHER ◽

HERBERT H. MARKS

Keyword(s):

United States ◽

Case Fatality Rate ◽

Communicable Disease ◽

Case Fatality ◽

The United States ◽

Fatality Rate ◽

Older Children ◽

Severity Of The Disease ◽

One Year ◽

In Infants And Children

Analysis of data on patients with pertussis during 1942-1946 obtained by means of a questionnaire from communicable disease hospitals and from health officers in a number of cities in the United States and Canada showed these results: Case fatality rates of patients admitted to hospitals for treatment have declined substantially in the period under review. This decline is general, both among infants under one year of age and among older children. In 1946, the case fatality rate of the infants hospitalized for the disease was 5.0% in those cities for which data for at least four years were available. This may be compared with the rate of 7.8% in 1942 and 11.1% in 1943. At ages one year and over, the rate was only 1.3% in 1946, as compared with 1.7% in 1942 and 3.7% in 1943. The rates in the hospitals with larger experiences were generally more favorable than in hospitals with smaller experiences. Despite the incomplete reporting of pertussis, which results in exaggerating the case fatality rate for the general population, the level of these rates in the community as a whole was lower than for hospitalized cases. This reflects the higher proportion of the severer cases in the hospitalized group. Indications are that in many places hospitalization is limited more and more to severe cases. Progress in the management of pertussis, especially of the severer cases admitted to hospitals, is believed to be the chief factor in the decline in case fatality of pertussis. A request contained in the questionnaire for an opinion on the severity of pertussis during the period studied elicited few replies, and these replies showed a division of opinion on the matter. It appears unlikely that there has been much of any change in the severity of the disease.

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Influenza Circulation in United States Army Training Camps Before and During the 1918 Influenza Pandemic: Clues to Early Detection of Pandemic Viral Emergence

Open Forum Infectious Diseases ◽

10.1093/ofid/ofv021 ◽

2015 ◽

Vol 2 (2) ◽

Cited By ~ 3

Author(s):

Daniel S. Chertow ◽

Rongman Cai ◽

Junfeng Sun ◽

John Grantham ◽

Jeffery K. Taubenberger ◽

...

Keyword(s):

United States ◽

World War I ◽

United States Army ◽

Respiratory Diseases ◽

National Guard ◽

Influenza Pandemic ◽

Case Fatality ◽

The United States ◽

Low Incidence ◽

1918 Influenza

Abstract Background. Surveillance for respiratory diseases in domestic National Army and National Guard training camps began after the United States’ entry into World War I, 17 months before the “Spanish influenza” pandemic appeared. Methods. Morbidity, mortality, and case-fatality data from 605 625 admissions and 18 258 deaths recorded for 7 diagnostic categories of respiratory diseases, including influenza and pneumonia, were examined over prepandemic and pandemic periods. Results. High pandemic influenza mortality was primarily due to increased incidence of, but not increased severity of, secondary bacterial pneumonias. Conclusions. Two prepandemic incidence peaks of probable influenza, in December 1917–January 1918 and in March–April 1918, differed markedly from the September–October 1918 pandemic onset peak in their clinical-epidemiologic features, and they may have been caused by seasonal or endemic viruses. Nevertheless, rising proportions of very low incidence postinfluenza bronchopneumonia (diagnosed at the time as influenza and bronchopneumonia) in early 1918 could have reflected circulation of the pandemic virus 5 months before it emerged in pandemic form. In this study, we discuss the possibility of detecting pandemic viruses before they emerge, by surveillance of special populations.

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Suicide Case-Fatality Rates in the United States, 2007 to 2014

Annals of Internal Medicine ◽

10.7326/m19-1324 ◽

2019 ◽

Vol 171 (12) ◽

pp. 885 ◽

Cited By ~ 23

Author(s):

Andrew Conner ◽

Deborah Azrael ◽

Matthew Miller

Keyword(s):

United States ◽

Case Fatality ◽

The United States ◽

Suicide Case

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Case fatality and population mortality associated with anaphylaxis in the United States

Journal of Allergy and Clinical Immunology ◽

10.1016/j.jaci.2013.10.029 ◽

2014 ◽

Vol 133 (4) ◽

pp. 1075-1083 ◽

Cited By ~ 122

Author(s):

Larry Ma ◽

Theodore M. Danoff ◽

Larry Borish

Keyword(s):

United States ◽

Case Fatality ◽

The United States ◽

Population Mortality

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LB9. Rising High Rate of Invasive Group A Streptococcus Infections Among Persons Experiencing Homelessness in San Francisco, 2010–2017

Open Forum Infectious Diseases ◽

10.1093/ofid/ofy229.2183 ◽

2018 ◽

Vol 5 (suppl_1) ◽

pp. S762-S762

Author(s):

Tara Scheuer ◽

Tanya Libby ◽

Chris Van Beneden ◽

James Watt ◽

Arthur Reingold ◽

...

Keyword(s):

United States ◽

San Francisco ◽

Group A Streptococcus ◽

Disease Incidence ◽

Case Fatality ◽

The United States ◽

Invasive Group ◽

Incidence Trends ◽

Disease Case ◽

Group A

Abstract Background Rates of invasive group A Streptococcus (iGAS) disease in the United States have risen since 2014; reasons remain unclear. Outbreaks of iGAS infection among persons experiencing homelessness (PEH) and persons who inject drugs in Europe, Canada, and the United States have been described. Using active, population-based surveillance data from California’s Emerging Infections Program, we describe incidence trends and characteristics of iGAS infection among PEH and persons not experiencing homelessness (PNEH) in San Francisco (SF) County during 2010–2017. Methods We defined an iGAS case as infection with GAS isolated from a normally sterile site (e.g., blood) in an SF resident. We calculated annual iGAS disease incidence rates (cases per 100,000 population) for PEH and PNEH using denominators from SF’s Department of Homelessness and Supportive Housing and the State of California Department of Finance. Demographic, clinical, and exposure characteristics of PEH and PNEH were compared by chi-square or t-test. Results We identified 673 iGAS cases in SF during 2010–2017. Among these, 34% (229/673) were among PEH. Annual iGAS incidence among PEH rose from ~300 (2010–2014) to 547 (95% CI: 379–714) per 100,000 in 2017 (P < 0.001, Cochran-Armitage trend test); rates peaked at 758 (95% CI: 561–955) in 2016. Annual iGAS incidence in PNEH rose from a mean of 5 in 2010–2013 to 9.3 (95% CI: 7.3–11.4) per 100,000 in 2017 (P < 0.001). Annual iGAS incidence in PEH was 42–72 times that in PNEH. PEH with iGAS infections were significantly younger and more likely to be male, white, and uninsured or enrolled in Medicaid (P < 0.05 for each) compared with PNEH with iGAS disease. Case fatality ratios, ICU admission, infection type, and length of hospital stay did not differ significantly. Smoking, current injection drug use, current alcohol abuse, and AIDS diagnosis were significantly more common among PEH with iGAS. Obesity, diabetes, and cancer were significantly more common among PNEH with iGAS. Conclusion In San Francisco, iGAS rates among both PEH and PNEH have risen significantly. Incidence of iGAS is strikingly higher in PEH than in PNEH and exposures differed between PEH and PNEH with iGAS. This information could inform development of disease control and prevention strategies. Disclosures All authors: No reported disclosures.

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Trends and presentation patterns of acute rheumatic fever hospitalisations in the United States

Cardiology in the Young ◽

10.1017/s1047951119002270 ◽

2019 ◽

Vol 29 (11) ◽

pp. 1387-1390

Author(s):

Tyler Bradley-Hewitt ◽

Chris T. Longenecker ◽

Vuyisile Nkomo ◽

Whitney Osborne ◽

Craig Sable ◽

...

Keyword(s):

United States ◽

Length Of Stay ◽

Rheumatic Fever ◽

Private Insurance ◽

Case Fatality ◽

The United States ◽

Hospital Charges ◽

The South ◽

Asian Pacific Islanders ◽

Asian Pacific

AbstractObjective:Rheumatic fever, an immune sequela of untreated streptococcal infections, is an important contributor to global cardiovascular disease. The goal of this study was to describe trends, characteristics, and cost burden of children discharged from hospitals with a diagnosis of RF from 2000 to 2012 within the United States.Methods:Using the Kids’ Inpatient Database, we examined characteristics of children discharged from hospitals with the diagnosis of rheumatic fever over time including: overall hospitalisation rates, age, gender, race/ethnicity, regional differences, payer type, length of stay, and charges.Results:The estimated national cumulative incidence of rheumatic fever in the United States between 2000 and 2012 was 0.61 cases per 100,000 children. The median age was 10 years, with hospitalisations significantly more common among children aged 6–11 years. Rheumatic fever hospitalisations among Asian/Pacific Islanders were significantly over-represented. The proportion of rheumatic fever hospitalisations was greater in the Northeast and less in the South, although the highest number of rheumatic fever admissions occurred in the South. Expected payer type was more likely to be private insurance, and the median total hospital charges (adjusted for inflation to 2012 dollars) were $16,000 (interquartile range: $8900–31,200). Median length of stay was 3 days, and the case fatality ratio for RF in the United States was 0.4%.Conclusions:Rheumatic fever persists in the United States with an overall downwards trend between 2003 and 2012. Rheumatic fever admissions varied considerably based on age group, region, and origin.

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Incidence of and Risk Factors for Nosocomial Bloodstream Infections in Adults in the United States, 2003

Infection Control and Hospital Epidemiology ◽

10.1086/606167 ◽

2009 ◽

Vol 30 (11) ◽

pp. 1036-1044 ◽

Cited By ~ 31

Author(s):

Omar M. AL-Rawajfah ◽

Frank Stetzer ◽

Jeanne Beauchamp Hewitt

Keyword(s):

United States ◽

Risk Factors ◽

Case Fatality Rate ◽

Nationwide Inpatient Sample ◽

Hospital Admissions ◽

Case Fatality ◽

The United States ◽

Fatality Rate ◽

The Us ◽

National Estimates

Background.Although many studies have examined nosocomial bloodstream infection (BSI), US national estimates of incidence and case-fatality rates have seldom been reported.Objective.The purposes of this study were to generate US national estimates of the incidence and severity of nosocomial BSI and to identify risk factors for nosocomial BSI among adults hospitalized in the United States on the basis of a national probability sample.Methods.This cross-sectional study used the US Nationwide Inpatient Sample for the year 2003 to estimate the incidence and case-fatality rate associated with nosocomial BSI in the total US population. Cases of nosocomial BSI were defined by using 1 or more International Classification of Diseases, 9th Revision, Clinical Modification codes in the secondary field(s) that corresponded to BSIs that occurred at least 48 hours after admission. The comparison group consisted of all patients without BSI codes in their NIS records. Weighted data were used to generate US national estimates of nosocomial BSIs. Logistic regression was used to identify independent risk factors for nosocomial BSI.Results.The US national estimated incidence of nosocomial BSI was 21.6 cases per 1,000 admissions, while the estimated case-fatality rate was 20.6%. Seven of the 10 leading causes of hospital admissions associated with nosocomial BSI were infection related. We estimate that 541,081 patients would have acquired a nosocomial BSI in 2003, and of these, 111,427 would have died. The final multivariate model consisted of the following risk factors: central venous catheter use (odds ratio [OR], 4.76), other infections (OR, 4.61), receipt of mechanical ventilation (OR, 4.97), trauma (OR, 1.98), hemodialysis (OR, 4.83), and malnutrition (OR, 2.50). The total maximum rescaled R2 was 0.22.Conclusions.The Nationwide Inpatient Sample was useful for estimating national incidence and case-fatality rates, as well as examining independent predictors of nosocomial BSI.

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