Centers for Disease Control and Prevention Launches Sudden, Unexplained Infant Death Initiative to Improve Surveillance

Rates of sudden infant death syndrome (SIDS) have declined by more than 50% since 1990, in large part because of the national Back-to-Sleep campaign’s efforts to eliminate prone sleeping by infants. Despite this success, SIDS remains the third-leading cause of infant mortality in the United States.  In addition, research conducted by the Centers for Disease Control and Prevention (CDC) and others has found that the decline in SIDS rates between 1999 and 2001 was offset by increasing rates of sudden, unexplained infant deaths (SUID) that were not ruled to be SIDS as well as unknown and unspecified causes of death.  This finding suggests that something has changed in how death scene investigators and cause-of-death certifiers are carrying out their responsibilities.  

In 2002, about 4600 infant deaths were attributed to SIDS, other SUID, and unknown and unspecified causes of death.  We know anecdotally that many SUID are not investigated and, when they are, cause-of-death data are not collected and reported consistently.  This is a concern because by definition SIDS can only be assigned as the cause of death if a thorough investigation, including a complete autopsy, examination of the death scene, and review of the clinical history, are conducted.  Inaccurate classification of cause and manner of death ultimately impedes prevention efforts because researchers cannot adequately monitor national trends or evaluate prevention programs.  To improve the classification of SUID deaths, CDC has been collaborating with national organizations to develop a standard investigation reporting form and comprehensive training curriculum and materials for infant death scene investigations.  Currently, there are no national training materials on the conduct of an infant death scene investigation.

The CDC’s Sudden, Unexplained Infant Death Investigation Reporting Form was released on March 1, 2006.  During 2006, the CDC will begin training investigators and death certifiers in how to consistently collect data at the death scene and accurately report their findings on the death certificate.  The first regional train-the-trainer academy will be held in St. Louis, Missouri on March 13-16, 2006 and the second academy is scheduled to take place in Atlanta, Georgia in September. With complete implementation of the activities outlined in this summary, CDC and its partners will have accurate data with which to conduct national surveillance and research to prevent sudden, unexplained infant deaths...

Sudden, Unexplained Infant Death Initiative Activities

Revision of investigation reporting form

• CDC’s Sudden, Unexplained Infant Death Investigation Reporting Form was released on March 1, 2006.  The form is available on CDC's webpage, http://www.cdc.gov/SIDS/index.htm, or contact Ms. Latoshia Gray at (770) 448-6250. Supplemental forms for collecting information about evidence and contacts are also available.

Development of training curriculum and materials

• Training materials were pilot tested at a state-wide training held in Milwaukee, Wisconsin on November 18-19, 2005.
• Final revisions to the training materials will be made during the first part of 2006.
• Training curriculum and materials will be used at the five regional train-the-trainer academies and given to trainers to disseminate at subsequent state-based training sessions. 

Training professionals involved with infant death scene investigations

• CDC will select 50 participants per region (250 total) to attend a 4 ½ day training at no cost. These attendees will work in teams consisting of a medical examiner or coroner, law enforcement officer, child advocate/protection expert, college faculty member, and a medicolegal death scene investigator. In turn, each team will be given financial support to conduct at least one state or local training. Thus, these five regional train-the-trainer academies will ultimately produce 500 trainers, who will be expected to conduct trainings at national conferences, state association meetings, and law enforcement courses.
• The first regional train-the-trainer academy was scheduled for June 12-15, 2006, in St. Louis, Missouri.
• The second regional train-the-trainer academy is scheduled to be held in Atlanta, Georgia on September 18-21, 2006.