economics Nature Is Weird

China almost wiped out kids dying from stomach bugs, but now the cases are weirdly making a comeback in older school kids.

March 20, 2026

Original Paper

Global and Chinese Burden of Diarrheal Diseases among Children and Adolescents Aged 0–19 Years from 1990 to 2023: Insights from the Global Burden of Disease (GBD) 2023 Study

SSRN · 6437124

The Takeaway

While mortality rates have plummeted by 99% due to infant-focused interventions, the actual incidence of the disease is rebounding and shifting toward 5-to-14-year-olds. This reveals a 'decoupling' in public health where making a disease less lethal can unexpectedly allow it to find and thrive in a new, older demographic that is less monitored.

From the abstract

Background: Diarrheal disease remains a critical threat to child and adolescent health globally. While historical interventions have focused heavily on children under 5 years, the evolving epidemiological landscape among older children (5–19 years) and the specific transition patterns in China remain under-explored.<br><br>Methods: Utilizing data from the Global Burden of Disease (GBD) 2023 Study, we analyzed the incidence, mortality, and disability-adjusted life years (DALYs) of diarrheal disea