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Trends in Diarrhea-associated Mortality in Children Less Than 5 Years of Age in the United States, 2005-2024

Mary C Moran1, Aaron T Curns, Umesh D Parashar

  • 1From the Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.

The Pediatric Infectious Disease Journal
|August 17, 2026
PubMed

Insights

Diarrhea-associated deaths in US children under five significantly decreased by 41% from 2005-2024. Rotavirus vaccination likely contributed to this decline, evidenced by reduced seasonal patterns in mortality.

Area of Science:

  • Pediatric Public Health
  • Infectious Disease Epidemiology
  • Vaccine Impact Studies

Background:

  • Rotavirus vaccines were introduced in the US in 2006 and 2008, significantly reducing healthcare use for rotavirus and diarrhea.
  • This study evaluates changes in diarrhea-associated mortality in young children from 2005 to 2024.

Purpose of the Study:

  • To assess trends in diarrhea-associated mortality among children aged 1-59 months in the United States.
  • To investigate the potential impact of rotavirus vaccination on these mortality trends.

Main Methods:

  • Examined diarrhea-associated deaths reported to the National Center for Health Statistics (2005-2024).
  • Calculated death rates using national census data and analyzed using Poisson regression.
  • Identified deaths using International Classification of Diseases codes related to diarrhea.

Main Results:

  • A 41% decrease in diarrhea-associated deaths was observed, from 2.36 to 1.38 per 100,000 children (2005-2006 vs. 2022-2024).
  • Mortality rates were higher in infants, males, Black, and non-Hispanic children, but these disparities lessened over time.
  • Reduced seasonality of deaths during the rotavirus season was noted post-vaccine introduction.

Conclusions:

  • Diarrhea-associated mortality has declined in the US, with rotavirus vaccines likely playing a role.
  • Diminished seasonality suggests a vaccine contribution, though unspecified etiology in most deaths limits definitive attribution.
  • Further research is needed to determine the exact causes of the remaining diarrhea-associated deaths.
Abstract

Keywords:
diarrheamortalityrotavirus

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