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After the epidemiologic transition: a reassessment of mortality from infectious diseases among over-65s in France and Italy



To assess more accurately the contribution of infectious diseases (IDs) to mortality at age 65+.


We use cause-of-death data for France and Italy in 2009. In addition to chapter I of the 10th International Classification of Diseases (ICD-10), our list of IDs includes numerous diseases classified in other chapters. We compute mortality rates considering all death certificate entries (underlying and contributing causes).


Mortality rates at age 65+ based on our extended list are more than three times higher than rates based solely on ICD-10 chapter I. IDs are frequently contributing causes of death. In France, the share of deaths at age 65+ involving an ID as underlying cause increases from 2.1 to 7.3 % with the extended list, and to 20.8 % when contributing causes are also considered. For Italy, these percentages are 1.4, 4.2 and 18.7 %, respectively.


Publicly available statistics underestimate the contribution of IDs to the over-65s’ mortality. Old age is a risk factor for IDs, and these diseases are more difficult to treat at advanced ages. Health policies should develop targeted actions for that population.

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Correspondence to Aline Désesquelles.

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See Table 3.

Table 3 ICD-10 codes of the extended list of infectious and parasitic diseases

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Désesquelles, A., Demuru, E., Pappagallo, M. et al. After the epidemiologic transition: a reassessment of mortality from infectious diseases among over-65s in France and Italy. Int J Public Health 60, 961–967 (2015).

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