Mortality Risk


If you’re reading about the rising number of measles cases in California, you may also be thinking about pandemic risk.

First, let’s look at the status of measles cases and outbreaks in the United States.

The CDC notes that from January 1 to January 28, 2015, 84 people from 14 states were reported to have measles. Most of these cases are part of a large, ongoing outbreak linked to Disneyland in California.

On Friday (January 30, 2015), the California Department of Public Health released figures showing there are now 91 confirmed cases in the state. Of those, 58 infections have been linked to visits to Disneyland or contact with a sick person who went there.

At least six other U.S. states – Utah, Washington, Colorado, Oregon, Nebraska and Arizona—as well as Mexico have also recorded measles cases connected to Disneyland, according to this AP report.

What about last year?

The U.S. experienced a record number of measles cases during 2014, with 644 cases from 27 states reported. Many of the cases in the U.S. in 2014 were associated with cases brought in from the Philippines, which experienced a large measles outbreak, according to the CDC.

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Measles, which can be prevented by vaccine, is one of the most contagious of all infectious diseases. The virus is transmitted by direct contact with infectious droplets or by airborne spread when an infected person breathes, coughs, or sneezes.

Approximately 9 out of 10 susceptible persons with close contact to a measles patient will develop measles, the CDC reports.

This is an important point. A study published by Risk Management Solutions (RMS) last year compared the low transmissibility of Ebola (Ebola can only be transmitted through direct contact with bodily fluids), with other infectious diseases such as measles.

RMS noted that each person infected with measles can generate on average more than 10 additional cases in an unvaccinated environment.

What about mortality risk?

Measles is one of the leading causes of death among young children, the World Health Organization (WHO) says. In 2013, there were 145,700 measles deaths globally—about 400 deaths every day or 16 deaths every hour.

One or two out of every 1,000 children who become infected with measles will die from respiratory and neurologic complications, according to the CDC.

One dose of the Measles, Mumps, Rubella (MMR) vaccine is approximately 93 percent effective at preventing measles, CDC notes, while two doses are 97 percent effective. Measles vaccination resulted in a 75 percent drop in measles deaths between 2000 and 2013 worldwide, WHO reports.

A CDC-issued health advisory here provides guidance to healthcare providers nationwide on the multi-state measles outbreak.

The potentially devastating impact of the rapid and massive spread of infectious diseases was a risk underscored by respondents to the recently released World Economic Forum (WEF) Global Risks 2015 report.

This reflects the need for a higher level of preparedness for major pandemics at both the country and international levels, the WEF noted.

The I.I.I. has facts and statistics on mortality risks here.

Are you physically active? You may have more reason to be after reading these startling statistics on physical inactivity from the World Health Organization (WHO).

According to WHO, physical inactivity is the fourth leading risk factor in global mortality. It is only outstripped by high blood pressure (13 percent) and tobacco use (9 percent) and carries the same level of risk as high blood glucose (6 percent).

In fact some 3.2 million people die each year because they are not active enough, WHO says. Globally, one in three adults is not active enough.

And physical inactivity is on the rise in many countries, adding to the burden of noncommunicable diseases, such as cardiovascular diseases, cancer and diabetes, and affecting general health worldwide.

WHO notes that people who are insufficiently active have a 20 percent to 30 percent increased risk of death compared to people who engage in at least 30 minutes of moderate intensity physical activity on most days of the week.

Another interesting takeaway: in high-income countries, 41 percent of men and 48 percent of women were insufficiently physically active, compared to 18 percent of men and 21 percent of women in low-income countries.

Low or decreasing physical activity levels often correspond with a high or rising gross national product, WHO reports.

The decline in physical activity is partly due to inaction during leisure time and sedentary behavior on the job and at home. Likewise, an increase in the use of “passive” modes of transportation also contributes to physical inactivity.

It’s important not to confuse physical activity with exercise.

WHO defines physical activity as any bodily movement produced by skeletal muscles that requires energy expenditure – including activities undertaken while working, playing, carrying out household chores, traveling and engaging in recreational pursuits.

Exercise (a subset of physical activity) is planned structured, repetitive, and aims to improve or maintain one or more components of physical fitness.

So what do we need to do to reduce our risk?

For children and adolescents WHO recommends 60 minutes of moderate to vigorous intensity activity per day.

For adults (18+), the recommendation is 150 minutes of moderate-intensity activity per week.

Check out I.I.I. facts and statistics on mortality risk.

A global pandemic is the most important extreme risk for the insurance industry to worry about in the long term, according to a survey of global insurance industry executives conducted by Towers Watson.

Rounding out the top three extreme risks of concern are a large-scale natural catastrophe and a food/water/energy crisis, the survey found.

Other top 10 extreme risks named in the Towers Watson survey include cyber-warfare, an economic depression, a banking crisis and a default by a major sovereign borrower.

Votes were compiled in a wiki survey which enabled participants to add their own ideas. Over 30,000 votes were cast.

Meanwhile, a new report by AonBenfield says pandemic risk remains the most important mortality exposure for the insurance industry and is placed above other forms of catastrophic event including natural catastrophes, nuclear explosions, and terrorism.

In Pandemic Perspective, AonBenfield points out that according to historical data, pandemics are large enough to destabilize the insurance market more than once every 200 years, with three global pandemics recorded in each of the last three centuries.

This suggests that the majority of people working in the insurance industry today are likely to face at least one pandemic during their careers. Insurers should be aware that now is the time to anticipate and educate themselves on pandemic risk, and begin to model it.”

Check out I.I.I. facts and statistics on mortality risk.