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Ever since societies created registration systems of their citizens, they also provided something literally transcendental to each individual—a lasting record of their existence. Today these documents are not only a testimony of a person’s life but also precious sources of knowledge to understand the workings of diseases that still haunt us. For instance, the understanding of secular trends in maternal mortality,1 and the identification of early warnings of influenza pandemics2 were only possible thanks to the information on historical death certificates kept in archives, cemeteries, and churches.3 The recent study by Brosco4 on the history of medical care for children in the United States also illustrates nicely the importance of vital statistics preservation and how this information contributed to improving pediatric health policies in this country.  Unfortunately, the uniqueness and fragility of (mostly) paper collections, often kept in less than ideal conditions (Figure 1), make them a silently vanishing treasure. Although well preserved in some countries,3 we witnessed the advanced stages of deterioration or disposal of entire vital statistics collections in several regions of the world because of improper storage, mishandling, natural disasters, or active disposal. The permanent loss of these documents is a silent yet ongoing process3 that persists with little awareness of public authorities and, more critically, from those sectors of the scientific community that will otherwise miss the opportunity to develop retrospective studies in geographically diverse contexts.    FIGURE 1—  Historical death certificates kept in a cemetery—a fragile treasure.    Still, the increasing availability of affordable technologies for collecting and curating data in a long-lasting format now makes it possible to address the preservation of this global heritage. Printed material can now be easily digitized even in remote settings and preserved in virtual libraries. For example, as part of our studies on past pandemics,5 a student digitized 10 years of death certificates from a Brazilian city, revealing novel aspects of the 1918 influenza pandemic. Additionally, the density of information showed that smallpox mortality had been largely underestimated in the 1920s. More important, this digital material is now preserved in the local public archive. Similarly precious data could be stored on digital repositories to facilitate long-term access.  Whereas the challenges of maintaining digital information can be addressed with technical solutions, nothing can be done when a unique source of knowledge is irreversibly lost. This is as true for the scrolls lost in the fire that destroyed the Library of Alexandria as it is for the vanishing volumes of certificates around the world today.

The Fate of Historical Death Certificates: The Silent Burning of Another Library of Alexandria