Infectious disease fatalities rise in Australia as overall death rate falls

The rate of death in Australia is now the lowest it has ever been, but some specific causes of death are on the rise, according to new data – and experts say we could be doing more to fix this.

Death rates in Australia have been falling for a while, and the latest figures released on Wednesday by the Australian Institute of Health and Welfare (AIHW), are no different.

Since 1907, the death rate has fallen by 74% to an all-time low of 529 deaths per 100,000 people:

While the overall death rate is falling, the composition of the underlying causes of deaths changes. Often this is related to the change in age composition of the Australian population, with better treatments for certain illnesses prolonging life.

The infectious diseases category is going against the overall trend, with an increase in the death rate since the 1980s. In the historical context the number of deaths is still very low:

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According to a 2006 publication from the AIHW, this trend is being driven by an increase in deaths from septicaemia, HIV/AIDS, and hepatitis.

This trend concerns some experts, who say we could be doing more to reduce deaths caused by infectious diseases, particularly sepsis, or septicaemia, which results when bacteria enter the bloodstream from another infection.

While the advent of antibiotics reduced sepsis deaths in the middle of the century, the death rate for sepsis is now as high or higher than it was in the pre-antibiotic era of the early 1900s, and in some years it is in the top 20 causes of death.

Unfortunately the AIHW does not make all of its cause-of-death data available without paying money, so this chart, converted from a 2006 report, has the longest time period available.

The age composition of sepsis deaths has also changed markedly, with large increases in the 65-85 and over-85 age groups.

Professor Peter Collignon, an infectious diseases expert at the Australian National University, says deaths from sepsis are likely to continue to get worse over time.

“One of the factors is antibiotic resistance, and another is our ageing population,” he said. “Bacterial infections causing septicaemia and death are going up everywhere.”

While sepsis is an under-recognised condition Collignon said that given where it occurs there is good reason to think we can reduce deaths.

“In the early 1900s bloodstream infections had their onset in the community, now almost half happen in healthcare,” he said.

According to Collignon, Australian healthcare services have made good progress in some areas, like reducing Staphylococcus aureus infections.

“Golden staph in blood – we have dropped that by about 60% in healthcare infections,” he said.