1487. Recent Resurgence of Salmonellosis-Related Mortality in the United States, 1990–2015

Abstract

BackgroundNon-typhoidal salmonellosis is one of the most common causes of foodborne illness in the United States. The objective of this study was to update the epidemiology of salmonellosis-related mortality in the United States by examining multiple-cause-of-death data (MCOD).MethodsMCOD data from the National Center for Health Statistics (NCHS) for the years 1990–2015 were analyzed. Mortality rates and 95% confidence intervals (CI) were calculated for age, sex, race/ethnicity, year, and state. Poisson regression models were used to examine temporal trends. Logistic regression was used to determine whether selected comorbid conditions were associated with salmonellosis-related deaths.ResultsOverall, 1,987 salmonellosis-related deaths (3.17%) were identified as an underlying and/or associated cause of death. The average annual age-adjusted mortality rate was 0.027 per 100,000 person-years. Salmonellosis mortality rates were higher among males with an age-adjusted rate ratio (RR) of 1.89 (95% CI, 1.79–2.01) compared with females. Mortality rates were higher among non-Hispanic Blacks and Asian/Pacific Islanders with an age-adjusted RR of 2.46 (95% CI, 2.19–2.77) and 2.06 (95% CI, 1.67–2.55) compared with Whites, respectively. The highest number of salmonellosis deaths were reported among the 75–84 year age group (n = 467; 24% of all cases). A significant decrease in trend was observed in age-adjusted salmonellosis mortality rates from 1990 to 2015. Since 2006, a significant increase of 66% in mortality rates was observed. Among selected comorbid conditions, HIV, acute renal failure, cancers affecting bone marrow, and diseases of the digestive system were associated with salmonellosis deaths with odds ratios of 11.51 (95% CI 8.78–15.10), 3.09 (95% CI, 2.01 = 4.75), 2.81 (95% CI, 1.67–4.74), and 2.82 (95% CI, 2.34–3.40), respectively.ConclusionSalmonellosis is an underlying and/or associated cause of death, especially among those with immune senescence and suppression. Despite a substantial decline in mortality rates, since 2006 rates have increased, a concerning trend. If rates continue to increase, an evaluation of Salmonella prevention efforts will be warranted.Disclosures All authors: No reported disclosures.