This report draws on data from the National Child Mortality Database (NCMD) to investigate infection related deaths in children and young people, and to draw out learning and recommendations for service providers and policymakers.

Every child or young person whose death is linked to infection is a precious individual and their deaths represent a devastating loss for parents, siblings, grandparents, carers, guardians, extended family and friends.

This NCMD thematic report aims to identify common characteristics of children and young people who died with and because of an infection, investigate factors associated with these deaths and identify common themes, to help inform policymakers, commissioners, those providing services to children and young people, and those involved in reviewing deaths of children and young people.

We are aware that the content of this report may be distressing for some readers.

Key findings in brief

• There were 1,507 infection related child deaths between 1 April 2019 and 31 March 2022 (3 years); an overall rate of 4.20 deaths per 100,000 children per year. This was the equivalent of 15% of all child deaths in this period.
• In 37% (n=553) of these deaths, the infection was thought to be a complete and sufficient explanation of death (6% of all child deaths).
• The risk of death varied according to the age of the child. Children under 1 year of age were more at risk of dying from infection than any other age group. Over half (61%) of deaths where infection was thought to provide a complete and sufficient explanation of death occurred in children under 1 year of age, with a further 16% of deaths between 1 and 4 years.
• Risk also varied by the ethnicity of the child. Children from an Asian/Asian British or black/black British ethnic background were at higher risk, with children from a Pakistani ethnic background at the highest risk of all.
• Children living in urban areas had a higher risk of dying from infection than those in rural areas. The chance of dying of infection in the most deprived neighbourhoods was twice that of those living in the least deprived neighbourhoods.
• Overall, in 90% of the infection related deaths the child had an underlying health condition, including 68% who had a life-limiting condition (e.g., cerebral palsy), and 22% who had another underlying health condition (including prematurity). 10% had no underlying health condition.
• In children where infection provided a complete and sufficient explanation of death, nearly a quarter (24%) had no underlying health condition.
• Of the 425 children aged 5 to 17 years who died with infection, a high proportion (67%) had a learning disability. In the cases where the infection provided a complete and sufficient explanation of death, 52% of the children in this age group had a learning disability. Pneumonia (lower respiratory tract infection) was identified in 75% of the deaths of children with a learning disability.