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The rates of a wide range of common infectious diseases are plummeting, a new analysis of GP weekly returns data reveals.

The RCGP's Birmingham research unit has recorded dramatic falls in the rates of flu and flu-like illness, otitis media, infectious intestinal disease and the common cold.

The declines, revealed in the unit's annual report this week, have mystified researchers.

Dr Douglas Fleming, director of the Birmingham research unit, said the falls in incidence were 'baffling'. He added: 'The data exposes another area of uncertainty.'

Dr Fleming suggested continuing improvements in general public health stemming from lower pollution levels and less overcrowding might have contributed.

Researchers found rates of flu or flu-like illness had dropped almost six-fold in less than a decade, from 52.7 per 100,000 in 1995 to 18.2 per 100,000 in 2003 and just 8.8 per 100,000 in 2004 (see graph). The incidence of the common cold fell from 218.61 per 100,000 in 1995 to 98.5 per 100,000 in 2004.

Rates of otitis media and infectious intestinal disease also dropped by more than half since 1995.

Dr Fleming said he believed the fall was real and not a consequence of people self-treating rather than visiting their GP. Citing the fall in otitis media as an example, he said: 'I don't think mothers have stopped bringing in their young babies.'

The report also questioned the widely held view that cases of sexually transmitted diseases were on the rise.

The mean weekly incidence of infections such as non-specific urethritis, candidiasis, trichomonas vaginalis and inflammatory diseases of female pelvic organs were all found to be lower now than five years ago.

'This data offers no support to the widely held view that the incidence of sexually related infections is increasing,' the report said.

But Professor Adam Finn, professor of paediatrics at the University of Bristol, cautioned that changes in reporting ­ possibly including underreporting of common con- ditions ­ might explain the magnitude of many of the apparent declines.

By Daniel Cressey

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