Foreword
MMWR Summary of Notifiable Diseases, United States, 1997
This publication contains summary tables of the official statistics for the reported occurrence of nationally notifiable diseases in the United States for 1997. These statistics are collected and compiled from reports to the National Notifiable Diseases Surveillance System (NNDSS), which is operated by CDC in collaboration with the Council of State and Territorial Epidemiologists (CSTE). Because the dates of onset or diagnosis for notifiable diseases are not always reported, these surveillance data are presented by the week they were reported to CDC by public health officials in state and territorial health departments. These data are finalized and published in the MMWR Summary of Notifiable Diseases, United States for use by state and local health departments; schools of medicine and public health; communications media; local, state, and federal agencies; and other agencies or persons interested in following the trends of reportable diseases in the United States. The annual publication of the Summary also documents which diseases are considered national priorities for notification and the annual number of cases of such diseases.
The Highlights section presents information on selected nationally notifiable and non-notifiable diseases to provide a context in which to interpret surveillance and disease-trend data and to provide further information on the epidemiology and prevention of selected diseases.
Part 1 contains information regarding morbidity for each of the diseases considered nationally notifiable during 1997. The tables provide the number of cases of notifiable diseases reported to CDC for 1997, as well as the distribution of cases by month and geographic location and by patient's age, sex, race, and Hispanic ethnicity. The data are final totals as of July 25, 1998, unless otherwise noted. Because no cases of anthrax or yellow fever were reported in the United States during 1997, these nationally notifiable diseases do not appear in the tables in Part 1. Nationally notifiable diseases that are reportable in fewer than 40 states also do not appear in these tables. In all tables, leprosy is listed as Hansen disease, and tickborne typhus fever is listed as Rocky Mountain spotted fever (RMSF).
Part 2 contains graphs and maps. These graphs and maps depict summary data for many of the notifiable diseases described in tabular form in Part
Part 3 contains tables that list the number of cases of notifiable diseases reported to CDC since 1966. It also includes a table enumerating deaths associated with specified notifiable diseases reported to the National Center for Health Statistics, CDC during 1987-1996.
Background
As of January 1, 1997, 52 infectious diseases were designated as notifiable at the national level. A notifiable disease is one for which regular, frequent, and timely information regarding individual cases is considered necessary for the prevention and control of the disease. This section briefly summarizes the history of the reporting of nationally notifiable diseases in the United States.
In 1878, Congress authorized the U.S. Marine Hospital Service (i.e., the forerunner of the Public Health Service {PHS}) to collect morbidity reports regarding cholera, smallpox, plague, and yellow fever from U.S. consuls overseas. The intention was to use this information to institute quarantine measures to prevent the introduction and spread of these diseases into the United States. In 1879, a specific Congressional appropriation was made for the collection and publication of reports of these notifiable diseases. Congress expanded the authority for weekly reporting and publication of these reports in 1893 to include data from states and municipal authorities. To increase the uniformity of the data, Congress enacted a law in 1902 directing the Surgeon General to provide forms for the collection and compilation of data and for the publication of reports at the national level. In 1912, state and territorial health authorities -- in conjunction with PHS -- recommended immediate telegraphic reporting of five infectious diseases and the monthly reporting, by letter, of 10 additional diseases. The first annual summary of The Notifiable Diseases in 1912 included reports of 10 diseases from 19 states, the District of Columbia, and Hawaii. By 1928, all states, the District of Columbia, Hawaii, and Puerto Rico were participating in national reporting of 29 specified diseases. At their annual meeting in 1950, state and territorial health officers authorized the Conference of State and Territorial Epidemiologists (CSTE), whose purpose was to determine which diseases should be reported to PHS. In 1961, CDC assumed responsibility for the collection and publication of data concerning nationally notifiable diseases.
The list of nationally notifiable diseases is revised periodically. For example, a disease might be added to the list as a new pathogen emerges, or a disease might be deleted as its incidence declines. Public health officials at state health departments and CDC continue to collaborate in determining which diseases should be nationally notifiable. CSTE, with input from CDC, makes recommendations annually for additions and deletions. However, reporting of nationally notifiable diseases to CDC by the states is voluntary. Reporting currently is mandated (i.e., by legislation or regulation) only at the state and local level. Thus, the list of diseases considered notifiable varies slightly by state. All states generally report the internationally quarantinable diseases (i.e., cholera, plague, and yellow fever) in compliance with the World Health Organization's International Health Regulations.
The list of 52 infectious diseases designated as notifiable at the national level during 1997 is as follows: Table_A
Data Sources
Provisional data concerning the reported occurrence of notifiable diseases are published weekly in MMWR. After each reporting year, staff in state health departments finalize reports of cases for that year with local or county health departments and reconcile the data with reports previously sent to CDC throughout the year. These data are compiled in final form in this summary. Notifiable disease reports (which are published in the annual MMWR Summary of Notifiable Diseases only after approval by the appropriate epidemiologist from each submitting state or territory) are the authoritative and archival counts of cases. Data published in MMWR Surveillance Summaries or other surveillance reports produced by CDC programs, which are useful for detailed epidemiologic analyses, may not agree exactly with data reported in the annual Summary of Notifiable Diseases because of differences in the timing of reports, the source of the data, and the case definitions.
Data in this summary were derived primarily from reports transmitted to the Division of Public Health Surveillance and Informatics, Epidemiology Program Office, CDC, by the 50 state, two city, and five territorial health departments through the National Electronic Telecommunications System for Surveillance (NETSS). (More information regarding NETSS and notifiable diseases, including case definitions for these conditions, is available on the Internet at http://www.cdc.gov/epo/phs.htm.) Final data for other diseases are from the surveillance program records of the following CDC programs (requests for further information regarding these data should be directed to the source specified):
National Center for Health Statistics (NCHS)
Office of Vital and Health Statistics Systems (deaths from selected
notifiable diseases)
National Center for Infectious Diseases (NCID)
Division of Bacterial and Mycotic Diseases (toxic-shock syndrome and
laboratory data regarding botulism, Escherichia coli O157:H7, Salmonella, and Shigella) Division of Vector-Borne Infectious Diseases (laboratory data regarding
arboviral encephalitis) Division of Viral and Rickettsial Diseases (animal rabies)
National Center for HIV, STD, and TB Prevention (NCHSTP)
Division of HIV/AIDS Prevention -- Surveillance and Epidemiology
(acquired immunodeficiency syndrome {AIDS}) Division of Sexually Transmitted Diseases Prevention (chancroid,
chlamydia, gonorrhea, and syphilis) Division of Tuberculosis Elimination (tuberculosis)
National Immunization Program (NIP)
Epidemiology and Surveillance Division (poliomyelitis)
Disease totals for the United States, unless otherwise stated, do not include data for American Samoa, Guam, Puerto Rico, the Virgin Islands, or the Commonwealth of the Northern Mariana Islands (CNMI). Disease totals from American Samoa were unavailable for 1997.
Population estimates for states are based on the July 1, 1997, post-censal estimates made by the U.S. Department of Commerce, Economics and Statistics Administration, Bureau of the Census, Population Division, Population Branch, Press Release PLL91. Population estimates for territories are 1997 estimates from the Bureau of the Census, Press Releases CB98-54 and CB98-80.
Rates in this summary were based on data for the U.S. total-resident population. However, population data from states in which diseases were not notifiable or disease data were not available were excluded from rate calculations.
Interpreting Data
The data reported in this summary are useful for analyzing disease trends and determining relative disease burdens. However, these data must be interpreted in light of reporting practices. Some diseases that cause severe clinical illness (e.g., plague and rabies), if diagnosed by a clinician, are most likely reported accurately. However, persons who have diseases that are clinically mild and infrequently associated with serious consequences (e.g., salmonellosis) might not seek medical care from a health-care provider. Even if these less severe diseases are diagnosed, they are less likely to be reported. The degree of completeness of reporting also is influenced by the diagnostic facilities available; the control measures in effect; the public awareness of a specific disease; and the interests, resources, and priorities of state and local officials responsible for disease control and public health surveillance. Finally, factors such as changes in the case definitions for public health surveillance, the introduction of new diagnostic tests, or the discovery of new disease entities can cause changes in disease reporting that are independent of the true incidence of disease.
Public health surveillance data are published for selected racial and ethnic population groups because these variables can be risk markers for certain notifiable diseases. Risk markers can identify potential risk factors for investigation in future studies. Data regarding race and ethnicity also can be used to identify populations to target for prevention efforts. However, one also must use caution when drawing conclusions from reported data relating to race and ethnicity. Among certain races and ethnicities, there are likely to be differential patterns of access to health care, interest in seeking health care, and detection of disease that would lead to data not representative of disease incidence in these populations. In addition, not all data concerning race and ethnicity are collected uniformly for all diseases. For example, the Division of HIV/AIDS Prevention -- Surveillance and Epidemiology and the Division of Sexually Transmitted Diseases Prevention in the National Center for HIV, STD, and TB Prevention (NCHSTP) collect information regarding race and ethnicity using a single variable. A person's racial and ethnic background is reported as either American Indian/Alaska Native, Asian/Pacific Islander, Black non-Hispanic, White non-Hispanic, or Hispanic. Additionally, although the recommended standard for classifying a person's race or ethnicity is based on self-reporting, this procedure might not always be followed.
Highlights for 1997
The Highlights section presents information on the public health importance of selected nationally notifiable and non-notifiable diseases, including a) domestic and international disease outbreaks; b) active surveillance findings; c) changes in data reporting practices; d) the impact of prevention programs; e) the emergence of antimicrobial resistance; and f) changes in immunization policies. This information is intended to provide a context in which to interpret surveillance and disease-trend data and to provide further information on the epidemiology and prevention of selected diseases.
Highlights for Selected Nationally Notifiable Diseases
Arboviral Encephalitis
The 1997 national total of 127 confirmed or probable California serogroup viral encephalitis cases (all of which were La Crosse encephalitis cases) is the fourth largest yearly total of such cases reported since 1964. The 73 case reports from West Virginia (57% of the national total) represent that state's largest total and an increase of 11% over its 1996 total. Much of the increase in reports from West Virginia may be attributable to this state's recent implementation of an active surveillance system for this disease. La Crosse encephalitis is endemic in the eastern United States, where it is associated with exposure to deciduous forests and Aedes triseriatus (the eastern treehole mosquito). A summertime/autumnal outbreak of St. Louis encephalitis in central Florida accounted for nine of the 13 cases reported nationally in 1997. The last major epidemic of St. Louis encephalitis in the United States (223 cases and 11 deaths) occurred in Florida in 1990. St. Louis encephalitis affects persons in portions of both the eastern and western United States. In Florida, the primary mosquito vector of St. Louis encephalitis virus is Culex nigripalpus. Fourteen cases of eastern equine encephalitis among humans were reported in 1997 from the South (12 cases), New England (one case), and the Upper Midwest (one case). Eastern equine encephalitis virus is typically transmitted to humans by various Aedes mosquito species. No cases of western equine encephalitis among humans have been reported nationally since 1994. The primary mosquito vector of western equine encephalitis virus in the western United States is Culex tarsalis.
Cryptosporidium
National reporting for cryptosporidiosis began in 1995 with 2,972 cases reported from 27 states. During 1996, as cryptosporidiosis became a reportable disease in an increased number of states, 2,426 cases were reported from 42 states. In 1997, a total of 2,566 cases were reported from 45 states. Because the diagnosis of cryptosporidiosis is often not considered, and because laboratories do not routinely test for Cryptosporidium infection, cryptosporidiosis continues to be underdiagnosed and underreported.
Diphtheria
Four cases of diphtheria were reported in the United States in 1997; two persons, both with localized mild illness, had culture-confirmed diphtheria. One confirmed case was caused by infection with a toxigenic strain of Corynebacterium diphtheriae, and was reported from a known endemic focus in South Dakota (MMWR 1997;46:506-10); one case caused by nontoxigenic C. diphtheriae was reported from Oregon. Two probable cases were reported from Nevada. Both case-patients had acute membranous pharyngitis; oropharyngeal specimens were positive for diphtheria toxin by polymerase chain reaction, but bacterial cultures of these specimens were negative.
In 1997, more than 7,000 cases of diphtheria were reported in an ongoing diphtheria epidemic in the New Independent States of the former Soviet Union. No importations were reported in the United States.
Haemophilus Influenzae (Invasive Disease)
In 1997, a total of 260 cases of Haemophilus influenzae (Hi) invasive disease among children aged less than 5 years were reported. (Data were provided by the National Immunization Program and were based on date of onset, not MMWR week.) An estimated 20,000 cases of Haemophilus influenzae type b (Hib) invasive disease among children occurred annually prior to Hib vaccine licensure in 1987. (JAMA 1993;269:221-6) The dramatic decline is attributed to the widespread administration of the Hib vaccine to preschool-aged children. Of the 260 cases, 201 (77%) isolates were serotyped, and 82 (41%) of the isolates for which serotype was known were type b. Of the 82 cases of Hib invasive disease reported in children aged less than 5 years, 42 (51%) were aged less than 6 months, which is too young to have completed a three-dose primary Hib vaccination. However, 27 (68%) of the 40 children who were old enough (aged greater than or equal to 6 months) to have completed a three-dose primary series before they developed Hib invasive disease were incompletely vaccinated or their vaccination status was unknown. These cases might have been prevented with age-appropriate vaccination.
Hantavirus Pulmonary Syndrome
In 1997, a total of 21 cases of Hantavirus pulmonary syndrome (HPS) were reported. HPS is a pan-American viral zoonosis caused by Sin Nombre virus and other New World hantaviruses, which in the United States, include Bayou virus, Black Creek Canal virus, and New York-1 virus. The identified rodent reservoirs for Sin Nombre, New York-1, Black Creek Canal, and Bayou viruses are, respectively, Peromyscus maniculatus (deer mouse), Peromyscus leucopus (white-footed mouse), Sigmodon hispidus (cotton rat), and Oryzomys palustris (rice rat). Cases of HPS have been found in the continental United States, Canada, Argentina, Brazil, Chile, Paraguay, and Uruguay. As of March 31, 1998, national surveillance for HPS has identified 179 confirmed cases in 29 states (case-fatality ratio = 44.7%).
Hemolytic Uremic Syndrome
Post-diarrheal hemolytic uremic syndrome (HUS) is a life-threatening illness characterized by hemolytic anemia, thrombocytopenia, and renal injury. Nearly all cases in the United States are caused by infection with Shiga toxin-producing Escherichia coli, with serotype O157:H7 being predominant. In 1997, the second year of national reporting, 20 states reported 93 cases of post-diarrheal HUS to CDC. By comparison, 18 states reported 104 cases in 1996. The median age of patients was 4 years (range: 1-89 years), with females accounting for 62% of patients overall. Illness was seasonal, with 50% of cases occurring during July through September.
Hepatitis A
In 1996, the Advisory Committee on Immunization Practices (ACIP) issued recommendations for the prevention of hepatitis A through active or passive immunization (MMWR 1996;45{No. RR-15}). The report provides recommendations for use of the hepatitis A vaccines (i.e., HAVRIX , manufactured by SmithKline Beecham Biologicals, and VAQTA , manufactured by Merck & Company, Inc.). For communities with high rates of hepatitis A and periodic outbreaks (peak rates: 700 reported cases per 100,000 population), routine vaccination of children aged 2 years and catch-up vaccination of older children is recommended. To control outbreaks in communities with intermediate rates of hepatitis A (i.e., 50-200 reported cases per 100,000 population), vaccination programs targeting subpopulations with the highest rates of disease may be considered. In these communities, ongoing routine vaccination of young children should be implemented to prevent future outbreaks.
Hepatitis C
Hepatitis C virus (HCV) infection is the most common bloodborne infection in the United States. Based on data from the CDC Sentinel Counties Study of Viral Hepatitis, it is estimated that as many as 180,000 new HCV infections occurred each year during the 1980s. Since 1989, the annual number of new infections has declined by 80%. However, in 1996, data from the third National Health and Nutrition Examination Survey, conducted from 1988 through 1994, indicated that approximately 4 million Americans (1.8%) are infected with HCV. Many of these chronically infected persons might not be aware of their infection or be clinically ill, because symptoms of hepatitis C-related chronic liver disease might not develop for 10-20 years after infection. However, such persons can infect others and are at risk for chronic liver disease or other HCV-related chronic diseases. Cirrhosis develops in 10%-20% of persons with HCV-related chronic hepatitis during the first two decades after infection, and 8,000-12,000 persons die from HCV-related chronic liver disease each year. CDC recently published new guidelines for HCV prevention and control (MMWR 1998;47{No. RR-19}).
HIV Infection in Children and Infants
In 1997, reports based on AIDS surveillance data indicated substantial declines in perinatally acquired AIDS, reflecting declining perinatal HIV transmission. HIV surveillance data indicated that the increasing use of zidovudine was temporally associated with this substantial decline in perinatally acquired AIDS (MMWR 1997;46:1086-92). These data demonstrate success in nationwide efforts to implement Public Health Service guidelines for use of zidovudine to reduce perinatal HIV transmission (MMWR 1994;43{No. RR-11}); MMWR 1998;47{No. RR-2}) and routine, voluntary prenatal HIV testing (MMWR 1995;44{No. RR-7}). States that conduct surveillance of perinatally exposed and infected children can evaluate the impact of the guidelines more completely and document resources needed to care for perinatally exposed infants. In 1997, a total of 30 states conducted surveillance of HIV infection in children, reporting 258 HIV-infected children who had not progressed to AIDS and 200 children who had AIDS. These states also received 2,238 new reports of perinatally exposed children who required follow up with health-care providers to determine their HIV infection status.
Measles
A total of 138 laboratory-confirmed cases of measles were reported to CDC in 1997, which is the lowest number of measles cases reported in one year and is less than half the previous record low. Of the 138 cases reported, 57 (41%) were international importations, and exposure to these cases resulted in 17 (12%) additional cases. Thus, 74 (54%) cases were associated with importation. An additional seven cases had virologic evidence suggesting an imported measles virus. Fifty-four (41%) measles patients were aged less than 5 years, 39 (28%) were aged 5-19 years, and 42 (30%) were aged greater than or equal to 20 years. Thirty-two patients (23%) reported having been vaccinated; seven (5%) received two doses. A total of 13 outbreaks were reported, with the largest involving eight cases. In 1997, no confirmed measles cases were reported from 21 states, and fewer than five cases were reported from 20 states and the District of Columbia.
Plague
In 1997, four plague cases among humans were reported in the United States (two cases in California, one in Arizona, and one in Colorado). One case was fatal and, like two fatal cases that occurred in 1996, septicemic plague was diagnosed postmortem. Each of these cases, which occurred in plague-endemic areas, illustrates the need for health-care providers to maintain a high level of awareness about the risks of human plague. Of the 350 cases reported in the United States from 1970 through 1997, approximately 80% were reported from the southwestern states of New Mexico, Arizona, and Colorado; 9% were reported from California; and nine other western states reported limited numbers of cases. Plague also occurs in animal populations in four other western states that have not reported cases among humans, including Kansas, where Yersinia pestis-infected prairie dog fleas were identified in 1997. This is the first report of plague in an animal in Kansas since 1950; however, a nearby county in Oklahoma experienced one case among a person in 1991, and other Great Plains states have reported epizootic activity in recent years (MMWR 1994;43:242-6). Internationally, outbreaks of rat-associated plague occurred in the port city of Mahajanga, Madagascar from 1995 through 1997. These are the first port-related outbreaks to be reported from that country in decades. Researchers reported the first case of multidrug-resistant Y. pestis in 1997. This isolate, which was obtained in 1995 from a case in Madagascar, contained a plasmid that conferred resistance to antibiotics commonly prescribed for plague treatment or prophylaxis (e.g., streptomycin, chloramphenicol, and tetracycline) (N Engl J Med 1997;337:677-80, 702-4).
Poliomyelitis
In 1997, the Advisory Committee on Immunization Practices (ACIP) recommended a change in routine childhood vaccination policy for polio in the United States. The previously recommended schedule of four doses of attenuated oral poliovirus vaccine (OPV) was changed to a sequential schedule of two doses of inactivated poliovirus vaccine (IPV) followed by two doses of OPV for routine vaccination of children. Since 1980, a total of 147 cases have been reported, of which 139 were associated with the use of OPV. The last imported case was reported in 1993.
Streptococcal Disease, Invasive, Group A
According to reports from active surveillance programs in five states (i.e., California, Connecticut, Georgia, Minnesota, and Oregon), the incidence of invasive group A streptococcal disease during 1997 was 4.1 cases/100,000 population; disease incidence ranged from 2.2 to 5.1 cases/100,000 population among the surveillance areas. Streptococcal toxic shock syndrome and necrotizing fasciitis accounted for approximately 6.9% and 7.7% of invasive cases, respectively. Overall case-fatality among patients with invasive group A streptococcal disease was 13%; case-fatality rates were higher among patients with streptococcal toxic shock syndrome and necrotizing fasciitis (43% and 21%, respectively). Risk factors for invasive group A streptococcal disease include elderly age, HIV infection, diabetes, cancer, alcohol abuse, and varicella infection.
Streptococcus pneumoniae, Drug-Resistant
The proportion of drug-resistant Streptococcus pneumoniae isolates continues to increase, according to reports from active surveillance programs in seven states (i.e., California, Connecticut, Georgia, Maryland, Minnesota, Oregon, and Tennessee). During 1997, approximately 26% of pneumococcal isolates obtained from sterile sites were no longer susceptible to penicillin (mean inhibitory concentration {MIC} greater than or equal to 0.1 ug/mL). In 1997, the proportion of all isolates with high-level penicillin resistance (MIC greater than or equal to 2 ug/mL), increased from 12% in 1996 to 14.4%; a total of 7.2% of isolates had MICs greater than or equal to 4 ug/mL compared with 5.4% in 1996. The resistant proportion varied widely by geographic region. To limit the contribution of unnecessary antimicrobial use to the spread of drug-resistant S. pneumoniae, CDC and the American Academy of Pediatrics issued recommendations for judicious use of antimicrobial agents for upper-respiratory-tract infections among children (Pediatrics 1998;101{suppl}). Educational materials concerning the principles of judicious antimicrobial use can be obtained by calling the National Center for Infectious Diseases at (404) 639-4702 for an order form.
Tetanus
Fifty cases of tetanus were reported in 1997. During 1995-1997, an average annual incidence of 41 cases were reported, the lowest ever reported since national tetanus surveillance began in 1947. The average annual incidence of 0.15 cases per million population represents a slight decline from the incidence of 0.2 cases per million population reported during 1991-1994.
Highlights for Selected Non-Notifiable Diseases
Cyclosporiasis
In 1997, several outbreaks of cyclosporiasis associated with various types of fresh produce (e.g., raspberries, mesclun lettuce, and basil) occurred in the United States. In the largest outbreak, which was associated with consumption of fresh raspberries, 41 clusters with a total of 762 cases (25% were laboratory confirmed) were reported by 13 states, the District of Columbia, and one province in Canada.
Dengue
Fifty-six laboratory-positive cases of dengue were imported into the United States in 1997 and diagnosed at the CDC Dengue Branch. This number represents a 30% increase from the number of laboratory-confirmed cases reported in 1996 (n=43). Similarly, the total number of dengue and dengue hemorrhagic fever (DHF) cases reported by Pan American Health Organization member countries in 1997 (n=364,945) was 46% higher than the 1996 total (n=250,707). Autochthonous dengue cases (n=3) were documented in south Texas again in 1997, underscoring the risk of dengue transmission in southern gulf coast states where mosquito vectors occur. After a 15-year absence, dengue cases were reported from Cuba in 1997. The municipality of Santiago de Cuba experienced an outbreak with 2,946 laboratory-diagnosed cases and 205 DHF cases, which resulted in 12 deaths.
HIV Infection in Adults
In June 1997, HIV-infection reporting for adults (i.e., persons aged greater than or equal to 13 years) was added to the list of nationally notifiable diseases at a Council of State and Territorial Epidemiologists (CSTE) meeting. During 1997, reports based on acquired immunodeficiency syndrome (AIDS) surveillance data highlighted substantial declines in AIDS incidence and deaths. As a result of improvements in treatment and care of persons infected with the human immunodeficiency virus (HIV), surveillance of AIDS alone no longer accurately reflects the magnitude or direction of the epidemic. Data concerning persons in whom HIV infection is diagnosed before AIDS is diagnosed are needed to determine populations that could benefit from prevention and treatment services. CSTE recommends that all states and territories implement confidential HIV infection reporting based on methods that provide accurate and representative data for all persons confidentially diagnosed with HIV infection.
Influenza A (H5N1)
In May 1997, the first known case of disease among humans caused by influenza A (H5N1) virus occurred in a previously healthy 3-year-old child in Hong Kong; this child died from his illness. An additional 17 cases (including five deaths) were detected in November and December 1997. All cases occurred coincident with outbreaks of highly pathogenic avian influenza A (H5N1) virus among poultry. At the end of December, Hong Kong authorities initiated the slaughter of all chickens in Hong Kong and, since then, no additional cases of influenza A (H5N1) virus have been detected among humans despite enhanced surveillance. The pandemic potential of influenza A (H5N1) viruses remains unknown. No cases of H5N1 infection were reported in the United States.
Tularemia
Tularemia was removed from the nationally notifiable disease list in 1995. However, as of January 1998, a total of 36 states maintained tularemia as a notifiable condition. Based on a telephone survey of state departments of health conducted from 1995 through 1997, a total of 313 cases of tularemia were reported by 43 states (119 cases in 1995, 89 cases in 1996, and 105 cases in 1997). Of these, 155 (49%) were reported from Missouri, Oklahoma, Kansas, and Arkansas.
Vancomycin-Resistant Enterococci (VRE)
The magnitude and impact of vancomycin-resistant enterococci (VRE) in the United States are demonstrated by CDC's National Nosocomial Infections Surveillance (NNIS) system, which includes more than 275 U.S. hospitals. Additional data are available on the Internet at http://www.cdc.gov/ncidod/hip/Surveill/surveill.htm. During 1989-1997, the percentage of enterococci resistant to vancomycin isolated from patients in intensive care units with nosocomial infections increased from 0.4% to 23.2% (Table Table_B). The percentage of VRE isolated from patients in noncritical care units with nosocomial infections increased from 0.3% to 15.4%.
PART 1: Summaries of Notifiable Diseases in the United States
EXPLANATION OF SYMBOLS USED IN TABLES, GRAPHS, AND MAPS Data not available..............................................NA Report of disease is not required
in that jurisdiction (not notifiable) .............................................NN No reported cases ............................................. --
Table_C NOTIFIABLE DISEASES -- Summary of reported cases, by month,
United States, 1997
Table_D1 NOTIFIABLE DISEASES -- Reported cases, by geographic division
and area, United States, 1997
Table_D2 NOTIFIABLE DISEASES -- Reported cases, by geographic division
and area, United States, 1997 (continued)
Table_D3 NOTIFIABLE DISEASES -- Reported cases, by geographic division
and area, United States, 1997 (continued)
Table_D4 NOTIFIABLE DISEASES -- Reported cases, by geographic division
and area, United States, 1997 (continued)
Table_D5 NOTIFIABLE DISEASES -- Reported cases, by geographic division
and area, United States, 1997 (continued)
Table_D6 NOTIFIABLE DISEASES -- Reported cases, by geographic division
and area, United States, 1997 (continued)
Table_E NOTIFIABLE DISEASES -- Summary of reported cases, by age
group, United States, 1997
Table_F NOTIFIABLE DISEASES -- Summary of reported cases, by sex,
United States, 1997
Table_G NOTIFIABLE DISEASES -- Summary of reported cases, by race,
United States, 1997
Table_H NOTIFIABLE DISEASES -- Summary of reported cases, by ethnicity,
United States, 1997
PART 2: Graphs and Maps for Selected Notifiable Diseases in the United States
EXPLANATION OF SYMBOLS USED IN TABLES, GRAPHS, AND MAPS Data not available..............................................NA Report of disease is not required
in that jurisdiction (not notifiable) .............................................NN
Figure_1 ACQUIRED IMMUNODEFICIENCY SYNDROME (AIDS) -- reported cases
per 100,000 population, United States and Puerto Rico, 1997
Figure_2 ACQUIRED IMMUNODEFICIENCY SYNDROME (AIDS) -- reported cases
by quarter, United States, 1986-1997
Figure_3 ACQUIRED IMMUNODEFICIENCY SYNDROME (AIDS) -- reported
pediatric cases, United States and Puerto Rico, 1997
Figure_4 ARBOVIRAL INFECTIONS (of the central nervous system) --
reported laboratory- confirmed cases caused by California serogroup viruses, by month of onset, United States, 1988- 1997
Figure_5 ARBOVIRAL INFECTIONS (of the central nervous system) --
reported laboratory- confirmed cases caused by eastern equine encephalitis virus, by month of onset, United States, 1988-1997
Figure_6 ARBOVIRAL INFECTIONS (of the central nervous system) --
reported laboratory- confirmed cases caused by St. Louis encephalitis virus, by month of onset, United States, 1988- 1997
Figure_7 ARBOVIRAL INFECTIONS (of the central nervous system) --
reported laboratory- confirmed cases caused by western equine encephalitis virus, by month of onset, United States, 1988-1997
Figure_8 BOTULISM (foodborne) -- by year, United States, 1977-1997
Figure_9 BOTULISM (infant) -- by year, United States, 1977-1997
Figure_10 BRUCELLOSIS -- by year, United States, 1967-1997
Figure_11 CHLAMYDIA -- reported cases among women per 100,000
population, United States, 1997
Figure_12 CHOLERA -- reported cases, United States and territories,
1997
Figure_13 CRYPTOSPORIDIOSIS -- reported cases per 100,000 population,
United States and territories, 1997
Figure_14 DIPHTHERIA -- by year, United States, 1967-1997
Figure_15 ESCHERICHIA COLI O157:H7 -- reported cases, United States
and territories, 1997
Figure_16 ESCHERICHIA COLI O157:H7 -- reported isolates, United
States, 1997
Figure_17 GONORRHEA -- reported cases per 100,000 population, United
States, 1997
Figure_18 GONORRHEA -- by sex, United States, 1982-1997
Figure_19 GONORRHEA -- by race and ethnicity, United States, 1982-
1997
Figure_20 HAEMOPHILUS INFLUENZAE (Invasive Disease) -- by age group,
United States, 1991-1997
Figure_21 HANSEN DISEASE (Leprosy) -- by year, United States, 1967-
1997
Figure_22 HEPATITIS -- by year, United States, 1967-1997
Figure_23 HEPATITIS A -- reported cases per 100,000 population,
United States and territories, 1997
Figure_24 HEPATITIS B -- reported cases per 100,000 population,
United States and territories, 1997
Figure_25 LEGIONELLOSIS -- by year, United States, 1982-1997
Figure_26 LYME DISEASE -- reported cases, United States, 1997
Figure_27 MALARIA -- by year, United States, 1967-1997
Figure_28 MEASLES (Rubeola) -- by year, United States, 1962-1997
Figure_29 MENINGOCOCCAL DISEASE -- by year, United States, 1967-1997
Figure_30 MUMPS -- by year, United States, 1972-1997
Figure_31 PERTUSSIS (Whooping Cough) -- by year, United States, 1967-
1997
Figure_32 PERTUSSIS (Whooping Cough) -- by age group, United States,
1997
Figure_33 PLAGUE -- among humans, by year, United States, 1967-1997
Figure_34 POLIOMYELITIS (paralytic) -- by year, United States, 1967-
1997
Figure_35 PSITTACOSIS -- by year, United States, 1967-1997
Figure_36 RABIES -- wild and domestic animals, by year, United States
and Puerto Rico, 1967-1997
Figure_37 ROCKY MOUNTAIN SPOTTED FEVER (RMSF) -- by year, United
States, 1967-1997
Figure_38 RUBELLA (German Measles) -- by year, United States, 1967-
1997
Figure_39 SALMONELLOSIS (excluding Typhoid Fever) -- by year, United
States, 1967-1997
Figure_40 SALMONELLA -- serotype of isolate by year, United States,
1972-1997
Figure_41 SHIGELLOSIS -- by year, United States, 1967-1997
Figure_42 SHIGELLA -- species of isolate by year, United States,
1972-1997
Figure_43 SYPHILIS (Primary and Secondary) -- reported cases per
100,000 population, United States, 1997
Figure_44 SYPHILIS (Primary and Secondary) -- by sex, United States,
1982-1997
Figure_45 SYPHILIS (Primary and Secondary) -- by race and ethnicity,
United States, 1982-1997
Figure_46 CONGENITAL SYPHILIS -- among infants aged <1 year, United
States, 1967-1997
Figure_47 TETANUS -- by year, United States, 1967-1997
Figure_48 TOXIC-SHOCK SYNDROME (TSS) -- by quarter, United States,
1982-1997
Figure_49 TRICHINOSIS -- by year, United States, 1967-1997
Figure_50 TUBERCULOSIS -- reported cases per 100,000 population,
United States and territories, 1997
Figure_51 TUBERCULOSIS -- by year, United States, 1977-1997
Figure_52 TUBERCULOSIS -- by year, among U.S.- and foreign-born
persons, United States, 1986-1997
Figure_53 TYPHOID FEVER -- by year, United States, 1967-1997
Figure_54 VARICELLA (Chickenpox) -- reported cases per 100, 000
population, United States and territories, 1997
PART 3: Historical Summary Tables
EXPLANATION OF SYMBOLS USED IN TABLES, GRAPHS, AND MAPS No reported cases ............................................. --
Table_1 NOTIFIABLE DISEASES -- Summary of reported cases per 100,000
population, United States, 1988-1997
Table_2 NOTIFIABLE DISEASES -- Summary of reported cases, United
States, 1990-1997
Table_3 NOTIFIABLE DISEASES -- Summary of reported cases, United
States, 1982-1989
Table_4 NOTIFIABLE DISEASES -- Summary of reported cases, United
States, 1974-1981
Table_5 NOTIFIABLE DISEASES -- Summary of reported cases, United
States, 1966-1973
Table_6 NOTIFIABLE DISEASES -- Deaths from selected diseases, United
States, 1987-1996
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information for the practicing physician. JAMA 1991;265:756-9. Varicella CDC. Varicella-related deaths among children -- United States,
1997.
MMWR 1998;47:365-8. CDC. Outbreak of invasive Group A Streptococcus associated with
varicella in a childcare center -- Boston, Massachusetts, 1997.
MMWR
1997;46:944-9. Izurieta HS, Strebel PM, Blake PA. Postlicensure effectiveness
of
varicella vaccine during an outbreak in a child care center.
JAMA
1997;278:1495-9. CDC. Prevention of varicella: recommendations of the Advisory
Committee
on Immunization Practices (ACIP). MMWR 1996;45(No. RR-11). All MMWR HTML versions of articles are electronic conversions from ASCII text into HTML. This conversion may have resulted in character translation or format errors in the HTML version. Users should not rely on this HTML document, but are referred to the electronic PDF version and/or the original MMWR paper copy for the official text, figures, and tables. An original paper copy of this issue can be obtained from the Superintendent of Documents, U.S. Government Printing Office (GPO), Washington, DC 20402-9371; telephone: (202) 512-1800. Contact GPO for current prices. Return To: MMWR MMWR Home Page CDC Home Page Page converted: 01/11/99
Table_A
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The 52 Infectious Diseases Designated
as Notifiable at the National Level During 1997
===============================================================================================
---------------------------------------------------------------------------------------------
Acquired immunodeficiency Haemophilus influenzae Rabies, animal
syndrome (Invasive Disease) Rabies, human
Anthrax Hansen disease (leprosy) Rocky Mountain spotted fever
Botulism* Hantavirus pulmonary syndrome Rubella
Brucellosis Hemolytic uremic syndrome, Salmonellosis*
Chancroid* post-diarrheal Shigellosis*
Chlamydia trachomatis, Hepatitis A Streptococcal disease,
genital infection Hepatitis B invasive, group A
Cholera Hepatitis, C/non-A, non-B Streptococcus pneumoniae,
Coccidioidomycosis* HIV infection, pediatric drug-resistant*
Congenital rubella syndrome Legionellosis Streptococcal toxic-shock
Congenital syphilis Lyme disease syndrome
Cryptosporidiosis Malaria Syphilis
Diphtheria Measles (Rubeola) Tetanus
Encephalitis, California Meningococcal disease Toxic-shock syndrome
Encephalitis, eastern equine Mumps Trichinosis
Encephalitis, St. Louis Pertussis Tuberculosis
Encephalitis, western equine Plague Typhoid fever
Escherichia coli O157:H7 Poliomyelitis, paralytic Yellow fever
Gonorrhea Psittacosis
---------------------------------------------------------------------------------------------
NOTE: Although varicella is not a nationally notifiable disease, the Council of State and
Territorial Epidemiologists recommends reporting of cases of this disease to CDC.
* Not currently published in the MMWR weekly tables.
===============================================================================================
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Table_B
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TABLE: Percentage of nosocomial enterococci reported as resistant to vancomycin,
by health-care setting and year*
===========================================================================================
Year Intensive care unit (ICU) + Non-ICU +
--------------------------------------------------
1989 0.4 0.3
1990 1.5 0.8
1991 5.3 2.9
1992 7.1 2.9
1993 11.6 4.8
1994 13.6 9.0
1995 12.8 12.0
1996 16.6 11.6
1997 23.2 15.4
--------------------------------------------------
* N>20
+ P<0.
Source: NNIS System, Hospital Infections Program, National Center for Infectious Diseases
===========================================================================================
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Table_C
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NOTIFIABLE DISEASES -- Summary of reported cases, by month, United States, 1997
================================================================================================================================================================================
NAME Total Jan. Feb. Mar. Apr. May June July Aug. Sept. Oct. Nov. Dec. Unk.
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
AIDS * 58,492 4,682 5,066 5,364 4,586 5,072 5,234 4,281 4,803 4,964 4,636 4,016 5,788 -
Botulism, total 132 9 5 8 2 14 9 19 16 8 8 20 14 -
Brucellosis 98 20 1 6 4 7 6 10 13 8 3 9 11 -
Chancroid + 243 ............. 65 .......... ............. 80 ........ ............. 58 ........ .............. 40 ......... -
Chlamydia +& 526,671 ........ 119,217 .......... ........ 130,697 ........ ........ 135,403 ........ ......... 141,354 ......... -
Cholera 6 - - - - 1 - - 2 - 2 1 - -
Cryptosporidiosis 2,566 146 94 154 121 152 117 211 358 311 293 310 299 -
Diphtheria 4 - - 2 1 - 1 - - - - - - -
Escherichia coli O157:H7 2,555 82 73 107 71 173 190 400 432 335 281 196 215 -
Gonorrhea + 324,907 ......... 74,417 .......... ......... 76,126 ........ ......... 87,378 ........ .......... 86,986 ......... -
Haemophilus influenzae, invasive 1,162 71 86 123 98 116 103 69 82 76 58 103 177 -
Hansen disease (leprosy) 122 6 4 12 11 12 5 4 7 11 2 19 29 -
Hepatitis A 30,021 1,716 2,184 2,885 2,033 3,124 2,163 2,091 2,628 2,517 2,526 2,524 3,630 -
Hepatitis B 10,416 696 637 947 736 1,022 774 731 955 809 735 923 1,451 -
Hepatitis, C/non-A non-B 3,816 273 257 322 246 384 291 304 370 319 242 312 496 -
Legionellosis 1,163 61 84 72 63 83 69 75 116 112 127 152 149 -
Lyme disease 12,801 512 254 390 293 612 724 1,638 3,197 1,944 1,057 988 1,192 -
Malaria 2,001 124 98 111 100 168 181 188 279 160 147 181 264 -
Measles (rubeola) 138 3 3 9 14 31 10 21 13 9 11 3 11 -
Meningococcal disease 3,308 138 348 469 282 360 248 175 184 171 168 230 535 -
Mumps 683 32 46 72 63 101 57 25 37 61 45 72 72 -
Pertussis (whooping cough) 6,564 607 403 512 537 475 404 393 543 475 397 740 1,078 -
Plague 4 - - - - 1 1 - - 1 - 1 - -
Poliomyelitis, paralytic 3 1 - - - 1 - - - - - - 1 -
Psittacosis 33 2 2 4 5 5 2 - 4 3 2 - 4 -
Rabies, animal 8,105 268 422 667 741 781 678 599 830 832 862 707 718 -
Rabies, human 2 - - 1 - - - - - - - - 1 -
Rocky Mountain spotted fever 409 20 7 14 11 24 58 54 87 48 45 25 16 -
Rubella (German measles) 181 10 4 7 10 30 34 36 7 10 17 1 15 -
Rubella, congenital syndrome 5 - - 1 - 1 - - - 1 - - 2 -
Salmonellosis 41,901 1,663 2,030 2,544 2,351 3,391 3,175 3,626 5,398 4,364 3,961 4,219 5,179 -
Shigellosis 23,117 1,572 1,200 1,301 1,064 1,615 1,522 1,694 2,717 2,166 2,100 2,792 3,374 -
Syphilis, total all stages + 46,540 ......... 11,872 .......... ......... 13,007 ........ ......... 11,371 ........ .......... 10,290 ......... -
Primary and secondary + 8,550 .......... 2,264 .......... .......... 2,252 ........ .......... 2,198 ........ ........... 1,836 ......... -
Congenital <1 year + 1,049 .......
Tetanus 50 5 3 5 2 8 5 4 3 2 2 7 4 -
Toxic-shock syndrome 157 15 9 13 14 13 9 12 16 12 10 12 22 -
Trichinosis 13 5 - - - - - - 4 - - - 4 -
Tuberculosis @ 19,851 794 1,285 1,630 1,790 1,813 1,553 1,697 1,644 1,583 1,601 1,442 3,019 -
Typhoid fever 365 9 20 28 17 33 25 23 43 44 35 36 52 -
Varicella (chickenpox)** 98,727 5,463 10,792 15,484 11,394 17,909 6,744 2,665 1,370 2,159 3,069 6,748 14,930 -
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
* The total number of acquired immunodeficiency syndrome (AIDS) cases includes all cases reported to the Division of HIV/ AIDS Prevention -- Surveillance and Epidemiology,
National Center for HIV, STD, and TB Prevention (NCHSTP) as of December 31, 1997.
+ Cases were updated through the Division of Sexually Transmitted Diseases Prevention, NCHSTP, as of July 13, 1998.
& Chlamydia refers to genital infections caused by C. trachomatis.
@ Cases were updated through the Division of Tuberculosis Elimination, NCHSTP, as of April 15, 1998.
** Not nationally notifiable.
================================================================================================================================================================================
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Table_D1
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NOTIFIABLE DISEASES -- Reported cases, by geographic division and area,
United States, 1997
=============================================================================================================================
Total resident Botulism Chlamydia
population -------------------- trachomatis
Area (in thousands) AIDS* Foodborne Infant Brucellosis Chancroid + infection +
----------------------------------------------------------------------------------------------------------------
United States 267,637 58,492 31 79 98 243 526,671
New England 13,379 2,372 - - 1 4 18,433
Maine 1,242 51 - - - - 1,066
N.H. 1,173 55 - - - - 816
Vt. 589 29 - - - NN 434
Mass. 6,118 863 - - 1 4 7,984
R.I. 987 152 - - - - 2,069
Conn. 3,270 1,222 - - - - 6,064
Mid. Atlantic 38,210 18,327 - 17 3 119 58,653
Upstate N.Y. 10,828 3,858 - 2 1 - NN
N.Y. City 7,309 9,331 - - - 119 28,468
N.J. 8,053 3,226 - 3 - - 10,347
Pa. 12,020 1,912 - 12 2 - 19,838
E.N. Central 43,890 4,350 1 6 12 8 86,404
Ohio 11,186 848 - 3 2 3 22,827
Ind. 5,864 523 - - - - 9,600
Ill. 11,896 1,842 1 1 7 5 23,024
Mich. 9,774 882 - - 3 - 21,399
Wis. 5,170 255 NA 2 NA - 9,554
W.N. Central 18,571 1,166 - - 7 - 32,968
Minn. 4,686 214 - - - - 6,631
Iowa 2,852 101 - NN 4 - 4,907
Mo. 5,402 577 - - 2 - 12,308
N. Dak. 641 13 - - NN NN 902
S. Dak. 738 11 - - - - 1,450
Nebr. 1,657 91 - - 1 - 2,767
Kans. 2,595 159 - - - - 4,003
S. Atlantic 48,230 13,858 1 3 8 30 106,486
Del. 732 231 - - - - 2,613
Md. 5,094 1,875 - - - 1 13,763
D.C. 529 998 - - 1 - 3,069
Va. 6,734 1,175 - - 1 1 11,615
W. Va. 1,816 130 - 2 - - 3,108
N.C. 7,425 850 1 - 3 9 17,108
S.C. 3,760 779 - - - 15 12,511
Ga. 7,486 1,722 - 1 1 1 15,911
Fla. 14,654 6,098 - - 2 3 26,788
E.S. Central 16,326 2,062 - - 2 2 35,437
Ky. 3,908 361 - - 1 - 6,332
Tenn. 5,368 784 - - 1 1 12,502
Ala. 4,319 570 - - - 1 8,704
Miss. 2,731 347 - - - - 7,899
W.S. Central 29,631 6,337 1 11 20 57 72,139
Ark. 2,523 242 - 1 1 1 2,503
La. 4,352 1,094 - 1 - 3 11,545
Okla. 3,317 283 - - - - 7,416
Tex. 19,439 4,718 1 9 19 53 50,675
Mountain 16,483 1,850 1 8 8 1 29,216
Mont. 879 41 - - - - 1,146
Idaho 1,210 52 - 2 - - 1,709
Wyo. 480 16 - - 2 1 635
Colo. 3,893 380 - - 2 - 7,196
N. Mex. 1,730 169 - 1 1 - 4,021
Ariz. 4,555 448 1 2 3 - 10,783
Utah 2,059 152 - 2 - - 1,774
Nev. 1,677 592 - 1 - - 1,952
Pacific 42,917 8,121 27 34 37 22 86,935
Wash. 5,610 641 3 - 3 2 9,574
Oreg. 3,243 305 3 2 1 1 5,270
Calif. 32,268 7,029 2 29 30 19 68,647
Alaska 609 52 19 - - - 1,615
Hawaii 1,187 94 - 3 3 - 1,829
----------------------------------------------------------------------------------------------------------------
Guam 145 2 - - - - 368
P.R. 3,827 2,040 - - - 1 2,123
V.I. 114 99 NA NA NA NA 14
American Samoa 60 - NA NA NA NA NA
C.N.M.I. 63 1 - - - NA NA
----------------------------------------------------------------------------------------------------------------
* Totals reported to Division of HIV/AIDS Prevention -- Surveillance and Epidemiology, National Center for HIV, STD, and TB
Prevention (NCHSTP), as of December 31, 1997. Total includes 49 cases in persons with unknown state of residence.
+ Cases were updated through the Division of Sexually Transmitted Diseases Prevention, NCHSTP, as of July 13, 1998.
=============================================================================================================================
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Table_D2
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NOTIFIABLE DISEASES -- Reported cases, by geographic division and area,
United States, 1997 (continued)
======================================================================================================================================
Escherichia coli O157:H7 Haemophilus
------------------------ influenzae
Area Cholera Cryptosporidiosis Diphtheria NETSS* PHLIS + Gonorrhea & (Invasive Disease)
------------------------------------------------------------------------------------------------------------------------------------
United States 6 2,566 4 2,555 1,658 324,907 1,162
New England - 166 - 197 133 5,889 67
Maine - 34 - 19 - 66 5
N.H. - 6 - 15 16 96 13
Vt. - 18 - 8 3 53 3
Mass. - 62 - 99 95 2,225 40
R.I. - 4 - 12 1 422 4
Conn. - 42 - 44 18 3,027 2
Mid. Atlantic - 528 - 167 56 39,947 184
Upstate N.Y. - 328 - 111 - 6,801 69
N.Y. City - 169 - 20 9 15,592 42
N.J. - 31 - 36 27 7,587 53
Pa. - NN - NN 20 9,967 20
E.N. Central 1 523 - 574 302 59,591 172
Ohio - 38 - 108 55 14,961 86
Ind. - 46 - 82 49 6,155 24
Ill. - 73 - 76 40 18,423 42
Mich. 1 46 - 152 108 15,736 19
Wis. NN 320 - 156 50 4,316 1
W.N. Central 1 424 1 503 417 14,860 75
Minn. 1 242 - 199 210 2,417 57
Iowa - 71 - 114 76 1,311 6
Mo. - 38 - 58 69 7,941 8
N. Dak. - 15 - 15 12 68 -
S. Dak. - 23 1 29 37 173 3
Nebr. - 21 - 58 - 1,210 1
Kans. - 14 - 30 13 1,740 -
S. Atlantic - 289 - 222 151 93,011 188
Del. - 8 - 5 4 1,273 -
Md. - 15 - 28 16 11,568 66
D.C. - - - 2 - 4,557 -
Va. - NN - NN 46 8,731 15
W. Va. - 1 - NN 1 957 4
N.C. - NN - 74 40 16,888 21
S.C. - - - 13 9 11,487 5
Ga. - 74 - 45 - 18,471 42
Fla. - 191 - 55 35 19,079 35
E.S. Central - 47 - 101 56 35,409 58
Ky. - 20 - 30 - 4,027 8
Tenn. - 17 - 50 40 11,023 32
Ala. - NN - 14 13 12,032 15
Miss. - 10 - 7 3 8,327 3
W.S. Central 1 88 - 83 33 46,532 60
Ark. - 10 - 10 11 4,382 3
La. - 23 - 18 12 10,782 19
Okla. - 12 - 13 7 4,756 33
Tex. 1 43 - 42 3 26,612 5
Mountain 1 141 2 275 152 8,084 94
Mont. - 5 - 21 9 66 1
Idaho - NN - 38 25 158 1
Wyo. - 4 - 15 13 54 4
Colo. - 25 - 83 57 2,320 23
N. Mex. - 67 - 7 6 857 9
Ariz. 1 20 - 42 31 3,802 35
Utah - - - 57 - 278 3
Nev. - 20 2 12 11 549 18
Pacific 2 360 1 433 358 21,584 264
Wash. - NN - 150 147 1,968 7
Oreg. - 32 1 87 98 773 38
Calif. 2 328 - 184 99 17,941 203
Alaska - - - 12 5 392 8
Hawaii - NN - NN 9 510 8
------------------------------------------------------------------------------------------------------------------------------------
Guam - - - NN - 47 -
P.R. - - - 5 - 526 -
V.I. NA NA - NA - 40 -
American Samoa NA NA NA NA NA NA NA
C.N.M.I. - - - NN - NA 6
------------------------------------------------------------------------------------------------------------------------------------
* National Electronic Telecommunications System for Surveillance.
+ Public Health Laboratory Information System. Cases were updated through the National Center for Infectious Diseases as of
August 10, 1998.
& Cases were updated through the Division of Sexually Transmitted Diseases Prevention, NCHSTP, as of July 13, 1998.
======================================================================================================================================
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Table_D3
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NOTIFIABLE DISEASES -- Reported cases, by geographic division and area,
United States, 1997 (continued)
======================================================================================================
Hepatitis
Hansen ------------------------------
disease C/non-A, Legionel- Lyme
Area (leprosy) A B non-B losis disease Malaria
----------------------------------------------------------------------------------------------------
United States 122 30,021 10,416 3,816 1,163 12,801 2,001
New England - 650 190 58 93 3,111 101
Maine NN 66 6 - 3 34 1
N.H. - 35 18 - 7 39 10
Vt. NN 15 11 4 13 8 2
Mass. - 254 77 46 32 291 33
R.I. - 131 22 8 18 442 13
Conn. - 149 56 - 20 2,297 42
Mid. Atlantic 14 2,124 1,417 364 253 7,556 519
Upstate N.Y. 1 395 363 279 79 3,149 81
N.Y. City 10 907 460 - 27 178 310
N.J. 1 316 249 NA 30 2,041 88
Pa. 2 506 345 85 117 2,188 40
E.N. Central 2 3,089 1,501 536 347 593 169
Ohio - 332 94 20 120 40 19
Ind. - 330 99 12 57 33 18
Ill. - 868 284 86 35 13 72
Mich. 2 1,372 458 392 91 27 44
Wis. NN 187 566 26 44 480 16
W.N. Central - 2,300 532 66 75 299 79
Minn. - 243 62 7 9 256 42
Iowa - 490 44 29 12 8 10
Mo. - 1,151 360 10 26 28 16
N. Dak. NN 14 7 4 2 - 3
S. Dak. - 27 1 - 4 1 3
Nebr. - 113 26 3 15 2 1
Kans. - 262 32 13 7 4 4
S. Atlantic 7 2,413 1,603 297 146 792 383
Del. - 31 7 - 13 109 5
Md. 1 187 172 12 23 494 85
D.C. - 36 30 - 5 10 20
Va. 1 250 137 27 34 67 73
W. Va. - 12 16 18 NN 10 1
N.C. 1 211 265 51 14 34 21
S.C. 1 110 99 40 8 3 19
Ga. - 764 224 NA 6 9 57
Fla. 3 812 653 149 43 56 102
E.S. Central 2 679 759 383 58 103 40
Ky. - 79 44 17 13 20 13
Tenn. 2 417 454 241 33 45 11
Ala. - 87 80 13 4 11 10
Miss. - 96 181 112 8 27 6
W.S. Central 27 6,445 1,627 680 47 145 146
Ark. 2 223 107 15 2 27 5
La. 1 266 208 276 9 13 21
Okla. - 1,445 67 10 4 45 9
Tex. 24 4,511 1,245 379 32 60 111
Mountain 3 4,326 870 342 69 15 67
Mont. - 71 12 24 1 - 2
Idaho - 150 54 86 2 4 1
Wyo. - 35 25 83 1 3 2
Colo. - 402 147 38 19 - 30
N. Mex. - 351 257 61 3 1 8
Ariz. - 2,330 202 26 18 4 12
Utah 1 550 93 5 18 1 3
Nev. 2 437 80 19 7 2 9
Pacific 67 7,995 1,917 1,090 75 187 497
Wash. 1 1,015 115 42 12 11 49
Oreg. - 376 119 4 - 20 25
Calif. 40 6,422 1,657 862 61 154 405
Alaska - 34 15 - - 2 5
Hawaii 26 148 11 182 2 - 13
----------------------------------------------------------------------------------------------------
Guam - - 3 - - - -
P.R. - 273 843 - - - 6
V.I. NA 8 25 1 5 NA 1
American Samoa NA NA NA NA NA NA NA
C.N.M.I. 1 1 48 2 - - -
----------------------------------------------------------------------------------------------------
======================================================================================================
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Table_D4
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NOTIFIABLE DISEASES -- Reported cases, by geographic division and area,
United States, 1997 (continued)
========================================================================================================
Measles Meningo- Polio-
----------------------- coccal myelitis,
Area Indigenous Imported* disease Mumps Pertussis Plague paralytic
------------------------------------------------------------------------------------------------------
United States 81 57 3,308 683 6,564 4 3
New England 11 8 209 14 1,096 - -
Maine - 1 19 - 26 - -
N.H. 1 - 17 1 150 - -
Vt. - - 4 - 283 - -
Mass. 10 6 100 4 582 - -
R.I. - - 24 8 19 - -
Conn. - 1 45 1 36 - -
Mid. Atlantic 18 9 357 66 503 - -
Upstate N.Y. 2 3 97 16 214 - -
N.Y. City 8 3 57 4 78 - -
N.J. 3 - 75 8 14 - -
Pa. 5 3 128 38 197 - -
E.N. Central 6 4 499 99 714 - -
Ohio - - 164 35 165 - -
Ind. - - 60 15 104 - -
Ill. 6 1 156 17 155 - -
Mich. - 2 72 28 71 - -
Wis. - 1 47 4 219 NN NN
W.N. Central 14 3 248 19 890 - -
Minn. 5 3 41 7 547 - -
Iowa - - 47 10 207 - -
Mo. 1 - 106 - 80 - -
N. Dak. - - 2 - 2 - -
S. Dak. 8 - 6 - 5 - -
Nebr. - - 20 1 16 - -
Kans. - - 26 1 33 - -
S. Atlantic 4 14 578 85 446 - 1
Del. - - 5 - 1 - -
Md. - 2 42 1 119 - -
D.C. - 2 12 - 3 - -
Va. - 1 60 21 59 - -
W. Va. 1 - 19 - 6 - -
N.C. - 2 97 12 118 - -
S.C. - 1 64 11 32 - -
Ga. - 1 108 11 18 - -
Fla. 3 5 171 29 90 - 1
E.S. Central - 1 242 34 159 - -
Ky. - - 50 3 74 - -
Tenn. - - 77 8 40 - -
Ala. - 1 85 9 34 - -
Miss. - - 30 14 11 - -
W.S. Central 3 5 335 98 376 - 1
Ark. - - 38 3 62 - -
La. - - 57 17 21 - -
Okla. - 1 45 3 60 - -
Tex. 3 4 195 75 233 - 1
Mountain 6 2 189 61 1,333 2 -
Mont. - - 8 - 18 - -
Idaho - - 15 6 570 - -
Wyo. - - 3 1 7 - -
Colo. - - 51 3 415 1 -
N. Mex. - - 31 NN 198 - -
Ariz. 5 - 44 34 45 1 -
Utah - 1 17 8 29 - -
Nev. 1 1 20 9 51 - -
Pacific 19 11 651 207 1,047 2 1
Wash. 1 1 115 21 481 - -
Oreg. - - 124 NN 48 - -
Calif. 16 8 402 151 483 2 1
Alaska - - 3 8 16 - -
Hawaii 2 2 7 27 19 - -
------------------------------------------------------------------------------------------------------
Guam - - 1 1 - - -
P.R. - - 8 7 - - -
V.I. - - 1 1 - NA -
American Samoa NA NA NA NA NA NA NA
C.N.M.I. 1 - - 4 - - -
------------------------------------------------------------------------------------------------------
* Imported cases include only those resulting from importation from other countries.
========================================================================================================
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Table_D5
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NOTIFIABLE DISEASES -- Reported cases, by geographic division and area,
United States, 1997 (continued)
==========================================================================================================
Rubella
Rabies -------------------
Psitta- --------------- Cong. Salmonel- Shigel-
Area cosis Animal Human RMSF* Rubella syndrome losis losis
--------------------------------------------------------------------------------------------------------
United States 33 8,105 2 409 181 5 41,901 23,117
New England 1 1,257 - 5 6 - 2,348 592
Maine 1 227 - - - - 137 15
N.H. - 49 - - - - 151 54
Vt. - 113 - - - - 88 11
Mass. - 282 - 1 1 - 1,259 316
R.I. - 42 - 1 - - 167 95
Conn. - 544 - 3 5 - 546 101
Mid. Atlantic 5 1,722 - 39 40 - 6,505 3,168
Upstate N.Y. 3 1,264 - 8 11 - 1,649 801
N.Y. City - NA - 6 29 - 1,796 956
N.J. - 190 - 9 - - 1,501 625
Pa. 2 268 - 16 - - 1,559 786
E.N. Central 4 203 - 19 6 - 6,207 2,552
Ohio - 116 - 12 - - 1,545 835
Ind. - 13 - 3 - - 590 88
Ill. - 20 - 3 2 - 1,935 1,163
Mich. 4 28 - - - - 906 346
Wis. NA 26 NA 1 4 NN 1,231 120
W.N. Central 2 537 - 35 2 - 2,287 908
Minn. 1 70 - 1 - - 632 138
Iowa - 160 - 1 - - 297 90
Mo. 1 31 - 24 2 - 568 222
N. Dak. NN 91 - - - - 69 10
S. Dak. - 94 - 2 - - 90 31
Nebr. - 2 - - - - 185 284
Kans. - 89 - 7 - - 446 133
S. Atlantic 7 3,109 - 136 79 1 8,475 4,499
Del. 1 67 - - - - 101 35
Md. 1 603 - 20 - - 1,231 423
D.C. - 5 - - 1 - 115 47
Va. - 678 - 23 1 - 1,120 416
W. Va. - 89 - 3 - - 133 27
N.C. 1 879 - 35 59 - 1,226 387
S.C. 1 186 - 36 15 - 603 87
Ga. - 324 - 11 - - 1,356 1,131
Fla. 3 278 - 8 3 1 2,590 1,946
E.S. Central - 271 - 91 1 - 1,771 1,127
Ky. - 29 - 5 - - 373 449
Tenn. - 149 - 40 - - 443 291
Ala. - 88 - 9 1 - 470 272
Miss. - 5 - 37 NN - 485 115
W.S. Central - 439 - 69 12 - 4,246 4,252
Ark. - 56 - 31 - - 445 273
La. - 7 - 5 - - 617 182
Okla. - 113 - 29 - - 391 293
Tex. - 263 - 4 12 - 2,793 3,504
Mountain 3 197 1 12 7 1 2,587 1,913
Mont. - 52 1 4 - - 63 11
Idaho - - - 5 2 - 141 79
Wyo. - 31 - 1 - - 49 5
Colo. 3 34 - - - - 608 258
N. Mex. - 13 - - - - 311 331
Ariz. - 53 - 1 5 1 853 1,076
Utah - 6 - 1 - - 271 101
Nev. - 8 - - - - 291 52
Pacific 11 370 1 3 28 3 7,475 4,106
Wash. 1 - 1 - 5 - 680 318
Oreg. 2 14 - 1 - - 368 189
Calif. 8 327 - 2 14 3 5,993 3,528
Alaska - 29 - - - NN 50 6
Hawaii - - - - 9 - 384 65
--------------------------------------------------------------------------------------------------------
Guam - - - - - - 24 35
P.R. - 71 - - - - 838 70
V.I. NA NA NA NA - - 10 2
American Samoa NA NA NA NA NA NA NA NA
C.N.M.I. - - - - - - 43 34
--------------------------------------------------------------------------------------------------------
* Rocky Mountain spotted fever.
==========================================================================================================
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Table_D6
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NOTIFIABLE DISEASES -- Reported cases, by geographic division and area,
United States, 1997 (continued)
=====================================================================================================================
Syphilis*
------------------------------- Toxic-
Cong. Primary & All shock Trich- Tuber- Typhoid
Area <1 yr.) secondary stages
-----------------------------------------------------------------------------------------------------------------
United States 1, 049 8, 550 46, 540 50 157 13 19, 851 365
New England 4 144 1, 172 - 5 - 478 21
Maine - 2 13 - 1 - 21 -
N.H. - - 23 - 3 - 17 -
Vt. - - 1 - - - 6 1
Mass. 2 78 731 - 1 - 268 19
R.I. - 2 84 - - - 38 1
Conn. 2 62 320 - - - 128 -
Mid. Atlantic 220 412 7, 950 6 20 2 3, 511 101
Upstate N.Y. 21 41 684 3 10 - 535 21
N.Y. City 78 97 4, 955 - 4 - 1, 730 49
N.J. 84 151 1, 129 2 - 2 718 29
Pa. 37 123 1, 182 1 6 - 528 2
E.N. Central 118 1, 046 4, 336 2 46 4 1, 932 53
Ohio 10 218 761 - 2 1 286 5
Ind. 3 151 522 - 4 1 168 3
Ill. 72 435 1, 953 2 12 - 974 28
Mich. 26 153 785 - 20 1 374 7
Wis. 7 89 315 NA 8 1 130 10
W.N. Central 12 172 874 2 28 1 614 5
Minn. - 16 124 1 10 - 161 1
Iowa - 7 72 1 3 - 74 -
Mo. 10 114 494 - 8 1 248 1
N. Dak. - - - - 1 - 12 -
S. Dak. - 1 7 - 1 - 19 -
Nebr. - 5 32 - 4 - 22 1
Kans. 2 29 145 - 1 - 78 2
S. Atlantic 201 3, 177 13,253 6 15 - 3, 780 48
Del. 2 22 113 - 1 - 39 -
Md. 56 891 2, 453 1 - - 340 5
D.C. 12 117 645 1 1 - 110 -
Va. 6 236 1, 103 - 1 - 350 5
W. Va. - 1 19 1 - - 54 2
N.C. 22 721 2, 206 1 1 - 463 5
S.C. 15 378 1, 135 1 3 - 328 3
Ga. 15 515 2, 833 - 1 - 696 8
Fla. 73 296 2, 746 1 7 - 1, 400 20
E.S. Central 104 1, 682 5, 689 3 3 1 1, 315 2
Ky. 5 135 403 - - - 198 -
Tenn. 30 747 2, 366 2 2 1 467 1
Ala. 29 410 1, 481 - 1 - 405 1
Miss. 40 390 1, 439 1 NN - 245 -
W.S. Central 213 1, 330 8, 159 11 1 - 2, 810 25
Ark. 31 173 562 1 1 NN 200 -
La. 22 364 1, 808 2 - - 406 2
Okla. 9 117 405 2 - - 212 3
Tex. 151 676 5, 384 6 - - 1, 992 20
Mountain 12 172 1, 045 6 18 4 644 9
Mont. - - 5 1 - 4 18 1
Idaho - 1 24 - 1 - 15 -
Wyo. - - 1 - - - 2 -
Colo. - 15 154 2 9 - 94 4
N. Mex. - 9 103 - - - 71 -
Ariz. 12 132 600 - 4 - 296 2
Utah - 5 56 3 3 - 36 -
Nev. - 10 102 - 1 - 112 2
Pacific 165 415 4, 062 14 21 1 4, 767 101
Wash. 1 17 132 1 5 - 305 7
Oreg. 1 10 48 2 - - 161 3
Calif. 163 386 3, 823 11 16 1 4, 056 84
Alaska - 1 12 - - - 78 -
Hawaii - 1 47 - - - 167 7
-----------------------------------------------------------------------------------------------------------------
Guam - - 1 - - - - 1
P.R. 7 249 1, 575 1 - - 257 -
V.I. - 2 10 - NA NA 1 NA
American Samoa NA NA NA NA NA NA 5 NA
C.N.M.I. NA NA NA - - - 88 -
-----------------------------------------------------------------------------------------------------------------
* Cases were updated through the Division of Sexually Transmitted Diseases Prevention, NCHSTP, as of July 13, 1998.
+ Cases were updated through the Division of Tuberculosis Elimination, NCHSTP, as of April 15, 1998.
=====================================================================================================================
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Table_E
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NOTIFIABLE DISEASES -- Summary of reported cases, by age group,* United States, 1997
================================================================================================================================================================================================================
<1 1-4 5-14 15-24 25-39 40-64
----------------- ---------------- ----------------- --------------------- ------------------- ----------------- ---------------- not
NAME Total No. (Rate) No. (Rate) No. (Rate) No. (Rate) No. (Rate) No. (Rate) No. (Rate) stated
--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
AIDS + 58,492 125 ( 3.32) 181 ( 1.17) 203 ( 0.53) 2,099 ( 5.79) 32,234 ( 51.21) 22,836 (30.63) 814 ( 2.40) -
Botulism, total 132 78 ( 2.06) 1 ( 0.01) 1 ( 0.01) - ( - ) 3 ( 0.02) 31 ( 0.03) 18 ( 0.02) -
Brucellosis 98 - ( - ) 6 ( 0.04) 14 ( 0.04) 22 ( 0.06) 29 ( 0.05) 24 ( 0.03) 3 ( 0.01) -
Chlamydia & 520,164 - ( - ) - ( - ) 12,301 (32.02) 374,295 (1,033.34) 105,410 (167.46) 9,910 (13.29) 1,358 ( 4.01) 14,923
Cholera 6 - ( - ) - ( - ) - ( - ) 1 ( 0.00) 1 ( 0.00) 3 ( 0.00) 1 ( 0.00) -
Cryptosporidiosis 2,566 58 ( 1.78) 525 ( 3.91) 410 ( 1.24) 193 ( 0.62) 725 ( 1.34) 477 ( 0.75) 132 ( 0.46) 46
Diphtheria 4 1 ( 0.03) - ( - ) - ( - ) 2 ( 0.01) - ( - ) 1 ( 0.00) - ( - ) -
Escherichia coli O157:H7 2,555 67 ( 1.92) 538 ( 3.74) 560 ( 1.58) 292 ( 0.88) 282 ( 0.49) 463 ( 0.68) 289 ( 0.94) 64
Gonorrhea & 323,307 - ( - ) - ( - ) 5,707 (14.85) 185,933 ( 513.32) 97,423 (154.77) 20,890 (28.02) 1,254 ( 3.70) 11,272
Haemophilus influenzae
(Invasive Disease) 1,162 159 ( 4.22) 90 ( 0.58) 47 ( 0.12) 42 ( 0.12) 92 ( 0.15) 269 ( 0.36) 442 ( 1.31) 21
Hansen disease (leprosy) 122 - ( - ) - ( - ) - ( - ) 13 ( 0.04) 15 ( 0.02) 51 ( 0.07) 17 ( 0.05) 26
Hepatitis A 30,021 142 ( 3.77) 1,808 (11.65) 6,852 (17.83) 4,933 ( 13.62) 9,830 ( 15.62) 5,138 ( 6.89) 981 ( 2.90) 337
Hepatitis B 10,416 53 ( 1.41) 57 ( 0.37) 196 ( 0.51) 1,789 ( 4.94) 4,556 ( 7.24) 3,016 ( 4.05) 547 ( 1.62) 202
Hepatitis, C/non-A non-B 3,816 23 ( 0.65) 7 ( 0.05) 20 ( 0.06) 201 ( 0.59) 1,496 ( 2.54) 1,820 ( 2.60) 211 ( 0.66) 38
Legionellosis 1,163 4 ( 0.11) 1 ( 0.01) 5 ( 0.01) 24 ( 0.07) 144 ( 0.23) 517 ( 0.70) 454 ( 1.35) 14
Lyme disease 12,801 49 ( 1.30) 666 ( 4.29) 2,415 ( 6.29) 1,065 ( 2.94) 2,348 ( 3.73) 4,441 ( 5.96) 1,661 ( 4.91) 156
Malaria 2,001 14 ( 0.37) 86 ( 0.55) 269 ( 0.70) 370 ( 1.02) 592 ( 0.94) 539 ( 0.72) 80 ( 0.24) 51
Measles (rubeola) 138 14 ( 0.37) 40 ( 0.26) 20 ( 0.05) 30 ( 0.08) 28 ( 0.04) 6 ( 0.01) - ( - ) -
Meningococcal disease 3,308 480 ( 12.73) 522 ( 3.36) 457 ( 1.19) 600 ( 1.66) 316 ( 0.50) 454 ( 0.61) 434 ( 1.28) 45
Mumps 683 8 ( 0.22) 128 ( 0.84) 249 ( 0.66) 74 ( 0.21) 141 ( 0.23) 60 ( 0.08) 5 ( 0.02) 18
Pertussis (whooping cough) 6,564 1,978 ( 52.47) 786 ( 5.07) 1,860 ( 4.84) 774 ( 2.14) 564 ( 0.90) 511 ( 0.69) 76 ( 0.22) 15
Plague 4 - ( - ) - ( - ) - ( - ) - ( - ) - ( - ) 2 ( 0.00) 2 ( 0.01) -
Poliomyelitis, paralytic 3 2 ( 0.05) - ( - ) - ( - ) 1 ( 0.00) - ( - ) - ( - ) - ( - ) -
Psittacosis 33 - ( - ) - ( - ) 1 ( 0.00) 4 ( 0.01) 11 ( 0.02) 16 ( 0.02) 1 ( 0.00) -
Rabies, human 2 - ( - ) - ( - ) - ( - ) - ( - ) - ( - ) 1 ( 0.00) 1 ( 0.00) -
Rocky Mountain spotted fever 409 1 ( 0.03) 29 ( 0.19) 59 ( 0.15) 31 ( 0.09) 77 ( 0.12) 147 ( 0.20) 58 ( 0.17) 7
Rubella (German measles) 181 10 ( 0.27) 6 ( 0.04) 6 ( 0.02) 72 ( 0.20) 68 ( 0.11) 19 ( 0.03) - ( - ) -
Salmonellosis 41,901 4,531 (120.20) 6,380 (41.12) 4,562 (11.87) 3,393 ( 9.37) 5,890 ( 9.36) 6,026 ( 8.08) 3,636 (10.74) 7,483
Shigellosis 23,117 478 ( 12.68) 6,005 (38.70) 5,583 (14.53) 1,669 ( 4.61) 3,114 ( 4.95) 1,654 ( 2.22) 450 ( 1.33) 4,164
Syphilis, primary and
secondary & 8,540 - ( - ) - ( - ) 44 ( 0.11) 2,091 ( 5.77) 4,302 ( 6.83) 1,965 ( 2.64) 108 ( 0.32) 19
Tetanus 50 - ( - ) - ( - ) 2 ( 0.01) 3 ( 0.01) 13 ( 0.02) 19 ( 0.03) 13 ( 0.04) -
Toxic- shock syndrome 157 1 ( 0.03) 4 ( 0.03) 22 ( 0.06) 41 ( 0.11) 49 ( 0.08) 34 ( 0.05) 6 ( 0.02) -
Trichinosis 13 - ( - ) - ( - ) 1 ( 0.00) 1 ( 0.00) 4 ( 0.01) 1 ( 0.00) 2 ( 0.01) 4
Tuberculosis @ 19,851 124 ( 3.29) 623 ( 4.02) 518 ( 1.35) 1,681 ( 4.64) 4,976 ( 7.91) 7,233 ( 9.70) 4,691 (13.85) 5
Typhoid fever 365 4 ( 0.11) 44 ( 0.28) 81 ( 0.21) 81 ( 0.22) 100 ( 0.16) 44 ( 0.06) 8 ( 0.02) 3
--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
NOTE: Rates <
* July 1, 1997, postcensal population estimates were used to calculate incidence rates per 100,000 population.
+ The total number of acquired immunodeficiency syndrome (AIDS) cases includes all cases reported to the Division of HIV/AIDS Prevention -- Surveillance and Epidemiology, National
Center for HIV, STD, and TB Prevention (NCHSTP), as of December 31, 1997.
& Age-related data are collected on aggregate forms different from those used for the number of reported cases. Therefore, the total cases reported on this table can differ slightly from
other tables. Cases among persons aged <
Cases were updated through the Division of Sexually Transmitted Diseases Prevention, NCHSTP, as of July 13, 1998. Age-related data for 1997 are unavailable for chancroid.
@ Cases were updated through the Division of Tuberculosis Elimination, NCHSTP, as of April 15, 1998.
================================================================================================================================================================================================================
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Table_F
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NOTIFIABLE DISEASES -- Summary of reported cases, by sex,* United States, 1997
=================================================================================================================================
Male Female Sex
------------------ ------------------ not
NAME Total No. (Rate) No. (Rate) stated
------------------------------------------------------------------------------------------------------------
AIDS + 58,492 45,737 ( 35.23) 12,755 ( 9.42) -
Botulism, total 132 55 ( 0.04) 73 ( 0.04) 4
Brucellosis 98 56 ( 0.04) 39 ( 0.03) 3
Chancroid & 243 157 ( 0.12) 69 ( 0.05) 17
Chlamydia &@ 526,671 - ( - ) 436,366 (322.10) 2,663
Cholera 6 1 ( 0.00) 4 ( 0.00) 1
Cryptosporidiosis 2,566 1,331 ( 1.20) 1,200 ( 1.04) 35
Diphtheria 4 1 ( 0.00) 3 ( 0.00) -
Escherichia coli O157:H7 2,555 1,161 ( 0.97) 1,317 ( 1.06) 77
Gonorrhea & 324,907 162,796 (125.41) 161,661 (119.33) 450
Haemophilus influenzae (Invasive Disease) 1,162 522 ( 0.40) 596 ( 0.44) 44
Hansen disease (leprosy) 122 64 ( 0.05) 32 ( 0.02) 26
Hepatitis A 30,021 16,599 ( 12.79) 10,969 ( 8.10) 2,453
Hepatitis B 10,416 6,115 ( 4.71) 4,045 ( 2.99) 256
Hepatitis, C/non-A non-B 3,816 2,424 ( 1.99) 1,354 ( 1.06) 38
Legionellosis 1,163 682 ( 0.53) 457 ( 0.34) 24
Lyme disease 12,801 6,703 ( 5.16) 6,016 ( 4.44) 82
Malaria 2,001 1,258 ( 0.97) 690 ( 0.51) 53
Measles (rubeola) 138 70 ( 0.05) 62 ( 0.05) 6
Meningococcal disease 3,308 1,662 ( 1.28) 1,583 ( 1.17) 63
Mumps 683 348 ( 0.27) 286 ( 0.22) 49
Pertussis (whooping cough) 6,564 3,036 ( 2.34) 3,468 ( 2.56) 60
Plague 4 1 ( 0.00) 2 ( 0.00) 1
Poliomyelitis, paralytic 3 1 ( 0.00) 2 ( 0.00) -
Psittacosis 33 12 ( 0.01) 21 ( 0.02) -
Rabies, human 2 2 ( 0.00) - ( 0.00) -
Rocky Mountain spotted fever 409 248 ( 0.19) 157 ( 0.12) 4
Rubella (German measles) 181 109 ( 0.08) 67 ( 0.05) 5
Salmonellosis 41,901 16,716 ( 12.88) 17,477 ( 12.90) 7,708
Shigellosis 23,117 8,437 ( 6.50) 9,758 ( 7.20) 4,922
Syphilis, primary and secondary & 8,550 4,656 ( 3.59) 3,891 ( 2.87) 3
Tetanus 50 29 ( 0.02) 21 ( 0.02) -
Toxic-shock syndrome 157 38 ( 0.03) 115 ( 0.09) 4
Trichinosis 13 6 ( 0.00) 7 ( 0.01) -
Tuberculosis** 19,851 12,371 ( 9.53) 7,474 ( 5.52) 6
Typhoid fever 365 192 ( 0.15) 168 ( 0.12) 5
------------------------------------------------------------------------------------------------------------
NOTE: Rates <
* July 1, 1997, postcensal population estimates were used to calculate incidence rates per 100,000 population.
+ The total number of acquired immunodeficiency syndrome (AIDS) cases includes all cases reported to the Division of HIV/ AIDS
Prevention -- Surveillance and Epidemiology, National Center for HIV, STD, and TB Prevention (NCHSTP) as of July 13, 1998.
& Cases were updated through the Division of Sexually Transmitted Diseases Prevention, NCHSTP, as of December 31, 1997.
@ Chlamydia refers to genital infections caused by C. trachomatis. The rates for men are not presented because reporting for
men is more limited than for women.
** Cases were updated through the Division of Tuberculosis Elimination, NCHSTP, as of April 15, 1998.
=================================================================================================================================
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Table_G
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NOTIFIABLE DISEASES -- Summary of reported cases, by race, United States, 1997
=========================================================================================================================================================================================
American Indian Asian or Race
or Alaskan Native Pacific Islander Black White Other not stated
----------------- ---------------- --------------- ---------------- ----------- ---------------
Name Total No. % No. % No. % No. % No. % No %
------------------------------------------------------------------------------------------------------------------------------------------------------------
AIDS* 58,492 206 (<1) 446 ( 1) 27,018 (46)
Botulism, total 132 19 (14) 6 ( 5) 7 ( 5) 71 ( 54) - ( -) 29 (22)
Brucellosis 98 - ( -) 3 ( 3) - ( ) 50 ( 51) - ( -) 45 (46)
Chlamydia & 520,164 6,915 ( 1) 5,034 ( 1) 164,232 (32) 107,527 ( 21) - ( -) 236,456+ (45)
Cholera 6 - ( -) - ( -) - ( -) 3 ( 50) - ( -) 3 (50)
Cryptosporidiosis 2,566 249 (10) 23 ( 1) 196 ( 8) 1,262 ( 49) 1 (<
Diphtheria 4 2 (50) - ( -) - ( -) 2 ( 50) - ( -) - ( -)
Escherichia coli O157:H7 2,555 127 ( 5) 27 ( 1) 68 ( 3) 1,504 ( 59) 3 (<
Gonorrhea & 323,307 1,532 (<1) 1,021 (<
Haemophilus influenzae
(Invasive Disease) 1,162 67 ( 6) 20 ( 2) 162 (14) 685 ( 59) 1 (<
Hansen disease (leprosy) 122 - ( -) 33 (27) 7 ( 6) 30 ( 25) - ( -) 52 (43)
Hepatitis A 30,021 528 ( 2) 445 ( 1) 2,013 ( 7) 17,819 ( 59) 69 (<
Hepatitis B 10,416 72 ( 1) 752 ( 7) 2,201 (21) 4,096 ( 39) 53 ( 1) 3,242 (31)
Hepatitis,C/non-A non-B 3,816 60 ( 2) 46 ( 1) 460 (12) 2,156 ( 56) 16 (<
Legionellosis 1,163 1 (<1) 7 ( 1) 97 ( 8)
Lyme disease 12,801 23 (<1) 86 ( 1) 185 ( 1)
Malaria 2,001 1 (<1) 286 (14) 554 (28)
Measles (rubeola) 138 9 ( 7) 18 (13) 10 ( 7) 91 ( 66) 1 ( 1) 9 ( 7)
Meningococcal disease 3,308 41 ( 1) 35 ( 1) 553 (17) 2,090 ( 63) 9 (<
Mumps 683 1 (<1) 58 ( 8) 46 ( 7) 336 (
Pertussis (whooping cough) 6,564 205 ( 3) 66 ( 1) 332 ( 5) 4,079 ( 62) 9 (<
Plague 4 2 (50) - ( -) - ( -) 2 ( 50) - ( -) - ( -)
Poliomyelitis,paralytic 3 - ( -) - ( -) - ( -) 3 (100) - ( -) - ( -)
Psittacosis 33 - ( -) - ( -) - ( -) 25 ( 76) - ( -) 8 (24)
Rabies,human 2 1 (50) - ( -) - ( -) - ( - ) - ( -) 1 (50)
Rocky Mountain spotted fever 409 10 ( 2) 2 (<1) 19 ( 5
Rubella (German measles) 181 4 ( 2) 14 ( 8) 7 ( 4) 73 ( 40) 4 ( 2) 79 (44)
Rubella,congenital syndrome 5 - ( -) 1 (20) - ( -) 1 ( 20) - ( -) 3 (60)
Salmonellosis 41,901 262 ( 1) 594 ( 1) 3,303 ( 8) 17,956 ( 43) 24 (<
Shigellosis 23,117 543 ( 2) 115 (<1) 3,055
Syphilis,primary and secondary & 8,540 40 (<1) 32 (<
Tetanus 50 10 (20) - ( -) 3 ( 6) 33 ( 66) 1 ( 2) 3 ( 6)
Toxic- shock syndrome 157 1 ( 1) 3 ( 2) 13 ( 8) 117 ( 75) - ( -) 23 (15)
Trichinosis 13 - ( -) - ( -) - ( -) 4 ( 31) - ( -) 9 (69)
Tuberculosis @ 19,851 276 ( 1) 3,873 (20) 6,806 (34) 8,862 ( 45) - ( -) 34 (<
Typhoid fever 365 2 ( 1) 114 (31) 27 ( 7) 56 ( 15) 19 ( 5) 147 (40)
------------------------------------------------------------------------------------------------------------------------------------------------------------
* The total number of acquired immunodeficiency syndrome (AIDS) cases includes all cases reported to the Division of HIV/ AIDS Prevention -- Surveillance and Epidemiology, National
Center for HIV, STD, and TB Prevention (NCHSTP) as of December 31, 1997.
+ Includes the following cases originally reported as Hispanic: 10,394 for AIDS; 62,716 for chlamydia, 13,990 for gonorrhea; and 450 for syphilis, primary and secondary.
& In addition to data collected through the National Electronic Telecommunications System for Surveillance (NETSS), some data concerning race are collected on aggregate forms
different from those used for numbers of reported cases. Thus, the total number of cases reported on this table can differ slightly from other tables. Cases were updated through the
Division of Sexually Transmitted Diseases Prevention, NCHSTP, as of July 13, 1998. Data regarding race for 1997 are unavailable for chancroid.
@ Cases were updated through the Division of Tuberculosis Elimination, NCHSTP as of April 15, 1998.
=========================================================================================================================================================================================
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Table_H
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NOTIFIABLE DISEASES -- Summary of reported cases, by ethnicity, United States, 1997
==========================================================================================================================================
Ethnicity
Hispanic Non-Hispanic not stated
-------------- --------------- ----------------
NAME Total No. (%) No. (%) No. (%)
-------------------------------------------------------------------------------------------------------------------
AIDS* 58,492 10,394 (18) 47,206 ( 81) 892+ ( 2)
Botulism, total 132 24 (18) 82 ( 62) 26 ( 20)
Brucellosis 98 59 (60) 15 ( 15) 24 ( 24)
Chlamydia & 520,164 62,716 (12) 271,759 ( 52) 185,689+ ( 36)
Cholera 6 3 (50) 1 ( 17) 2 ( 33)
Cryptosporidiosis 2,566 178 ( 7) 1,366 ( 53) 1,022 ( 40)
Diphtheria 4 - ( -) 3 ( 75) 1 ( 25)
Escherichia coli O157:H7 2,555 88 ( 3) 1,464 ( 57) 1,003 ( 39)
Gonorrhea & 323,307 13,990 ( 4) 226,906 ( 70) 82,411+ ( 25)
Haemophilus influenzae (Invasive Disease) 1,162 93 ( 8) 695 ( 60) 374 ( 32)
Hansen disease (leprosy) 122 35 (29) 51 ( 42) 36 ( 30)
Hepatitis A 30,021 6,828 (23) 13,341 ( 44) 9,852 ( 33)
Hepatitis B 10,416 940 ( 9) 5,264 ( 51) 4,212 ( 40)
Hepatitis, C/non-A non-B 3,816 475 (12) 1,721 ( 45) 1,620 ( 42)
Legionellosis 1,163 32 ( 3) 670 ( 58) 461 ( 40)
Lyme disease 12,801 140 ( 1) 7,750 ( 61) 4,911 ( 38)
Malaria 2,001 176 ( 9) 1,041 ( 52) 784 ( 39)
Measles (rubeola) 138 22 (16) 106 ( 77) 10 ( 7)
Meningococcal disease 3,308 311 ( 9) 2,023 ( 61) 974 ( 29)
Mumps 683 159 (23) 263 ( 39) 261 ( 38)
Pertussis (whooping cough) 6,564 594 ( 9) 3,444 ( 52) 2,526 ( 38)
Plague 4 - ( -) 4 (100) - ( - )
Poliomyelitis, paralytic 3 2 (67) 1 ( 33) - ( - )
Psittacosis 33 - ( -) 19 ( 58) 14 ( 42)
Rabies, human 2 - ( -) - ( - ) 2 (100)
Rocky Mountain spotted fever 409 4 ( 1) 253 ( 62) 152 ( 37)
Rubella (German measles) 181 109 (60) 46 ( 25) 26 ( 14)
Rubella, congenital syndrome 5 3 (60) 1 ( 20) 1 ( 20)
Salmonellosis 41,901 2,447 ( 6) 16,284 ( 39) 23,170 ( 55)
Shigellosis 23,117 3,427 (15) 8,051 ( 35) 11,639 ( 50)
Syphilis, primary and secondary & 8,540 450 ( 5) 7,815 ( 92) 275+ ( 3)
Tetanus 50 14 (28) 27 ( 54) 9 ( 18)
Toxic- shock syndrome 157 3 ( 2) 104 ( 66) 50 ( 32)
Trichinosis 13 - ( -) 4 ( 31) 9 ( 69)
Tuberculosis @ 19,851 4,228 (21) 15,586 ( 79) 37 ( - )
Typhoid fever 365 56 (15) 181 ( 50) 128 ( 35)
-------------------------------------------------------------------------------------------------------------------
* The total number of acquired immunodeficiency syndrome (AIDS) cases includes all cases reported to the Division of HIV/ AIDS
Prevention -- Surveillance and Epidemiology, National Center for HIV, STD, and TB Prevention (NCHSTP) as of December 31, 1997.
+ Ethnicity is not stated and includes cases originally reported as American Indian or Alaskan Native and Asian or Pacific Islander.
& In addition to data collected through the National Electronic Telecommunications System for Surveillance (NETSS), some data
concerning ethnicity are collected on aggregate forms different from those used for numbers of reported cases. Thus, the total number
of cases reported on this table can differ slightly from other tables. Cases were updated through the Division of Sexually Transmitted
Diseases Prevention, NCHSTP, as of July 13, 1998. Data regarding ethnicity for 1997 are unavailable for chancroid.
@ Cases were updated through the Division of Tuberculosis Elimination, NCHSTP, as of April 15, 1998
==========================================================================================================================================
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Table_1
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TABLE 1. NOTIFIABLE DISEASES -- Summary of reported cases per 100,000 population, United States, 1988-1997
=============================================================================================================================================================================
Disease 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997
---------------------------------------------------------------------------------------------------------------------------------------------------
AIDS * 12.61 13.58 16.72 17.32 17.83 40.20 30.07 27.20 25.21 21.85
Amebiasis 1.20 1.34 1.38 1.23 1.21 1.21 1.20 .............. + .........
Anthrax 0.00 - - - 0.00 - - - - -
Aseptic meningitis 2.94 4.14 4.77 6.26 5.18 5.39 3.71 .............. + .........
Botulism, total (including wound and unsp.) 0.03 0.04 0.04 0.05 0.04 0.04 0.06 0.04 0.05 0.05
Foodborne 0.01 0.01 0.01 0.01 0.00 0.01 0.02 0.01 0.01 0.02
Brucellosis 0.04 0.04 0.03 0.04 0.04 0.05 0.05 0.04 0.05 0.04
---------------------------------------------------------------------------------------------------------------------------------------------------
Chancroid 2.04 1.90 1.70 1.40 0.80 0.54 0.30 0.20 0.15 0.09
Chlamydia & ................................ @ ................................ 182.60 188.10 196.80
Cholera 0.00 - 0.00 0.01 0.04 0.00 0.02 0.01 0.01 0.01
Cryptosporidiosis ............................................. @ .............................. ... 1.12
Diphtheria 0.00 0.00 0.00 0.00 0.00 - 0.00 - 0.01 0.01
Encephalitis, primary 0.36 0.40 0.54 0.40 0.30 0.36 0.28 .............. + .........
Post-infectious 0.05 0.04 0.04 0.03 0.05 0.07 0.06 .............. + .........
Escherichia coli O157:H7 ........................ @ .............................. 0.82 1.01 1.18 1.04
---------------------------------------------------------------------------------------------------------------------------------------------------
Gonorrhea 298.74 297.36 276.60 249.48 201.60 172.40 168.40 149.50 122.80 121.40
Granuloma inguinale 0.00 0.00 0.00 0.01 0.00 0.00 0.00 .............. + .........
Haemophilus influenzae, invasive .............. @ ......... 1.10 0.55 0.55 0.45 0.45 0.45 0.44
Hansen disease (leprosy) 0.07 0.07 0.08 0.06 0.07 0.07 0.05 0.06 0.05 0.05
Hepatitis A 11.60 14.43 12.64 9.67 9.06 9.40 10.29 12.13 11.70 11.22
Hepatitis B 9.43 9.43 8.48 7.14 6.32 5.18 4.81 4.19 4.01 3.90
Hepatitis, C/non-A, non-B ** 1.07 1.02 1.03 1.42 2.36 1.86 1.78 1.78 1.41 1.43
Hepatitis, unspecified 1.00 0.93 0.67 0.50 0.35 0.24 0.17 .............. + .........
---------------------------------------------------------------------------------------------------------------------------------------------------
Legionellosis 0.44 0.48 0.55 0.53 0.53 0.50 0.63 0.48 0.47 0.44
Leptospirosis 0.02 0.04 0.03 0.02 0.02 0.02 0.02 .............. + .........
Lyme disease .............. @ ......... 3.80 3.93 3.20 5.01 4.49 6.21 4.79
Lymphogranuloma venereum 0.07 0.08 0.10 0.19 0.10 0.10 0.10 .............. + .........
Malaria 0.45 0.51 0.52 0.51 0.43 0.55 0.47 0.55 0.68 0.75
Measles (rubeola) 1.38 7.33 11.17 3.82 0.88 0.12 0.37 0.12 0.20 0.06
Meningococcal disease 1.21 1.10 0.99 0.84 0.84 1.02 1.11 1.25 1.30 1.24
Mumps 2.05 2.34 2.17 1.72 1.03 0.66 0.60 0.35 0.29 0.27
Murine typhus fever 0.02 0.02 0.02 0.02 0.02 0.01 ............... + ...................
---------------------------------------------------------------------------------------------------------------------------------------------------
Pertussis (whooping cough) 1.40 1.67 1.84 1.08 1.60 2.55 1.77 1.97 2.94 2.46
Plague 0.01 0.00 0.00 0.00 0.01 0.00 0.01 0.00 0.01 0.01
Poliomyelitis, paralytic 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.01 0.01
Psittacosis 0.05 0.05 0.05 0.04 0.04 0.02 0.02 0.03 0.02 0.02
Rabies, human 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.01 0.01
Rheumatic fever, acute 0.14 0.13 0.09 0.12 0.06 0.08 0.09 .............. + .........
Rocky Mountain spotted fever 0.25 0.25 0.26 0.25 0.20 0.18 0.18 0.23 0.32 0.16
Rubella (German measles) 0.09 0.16 0.45 0.56 0.06 0.07 0.09 0.05 0.10 0.07
---------------------------------------------------------------------------------------------------------------------------------------------------
Salmonellosis, excluding typhoid fever 19.91 19.26 19.54 19.10 16.04 16.15 16.64 17.66 17.15 15.66
Shigellosis 12.46 10.07 10.89 9.34 9.38 12.48 11.44 12.32 9.80 8.64
Syphilis, primary and secondary 16.43 18.07 20.10 17.26 13.70 10.40 8.10 6.30 4.29 3.19
Total, all stages 42.37 44.94 53.80 51.69 45.30 39.70 32.00 26.20 19.97 17.39
Tetanus 0.02 0.02 0.03 0.02 0.02 0.02 0.02 0.02 0.02 0.02
Toxic-shock syndrome 0.16 0.16 0.13 0.11 0.10 0.08 0.10 0.07 0.06 0.06
Trichinosis 0.02 0.01 0.05 0.02 0.02 0.01 0.01 0.01 0.01 0.01
---------------------------------------------------------------------------------------------------------------------------------------------------
Tuberculosis 9.13 9.46 10.33 10.42 10.46 9.82 9.36 8.70 8.04 7.42
Tularemia 0.08 0.06 0.06 0.08 0.06 0.05 0.04 .............. + .........
Typhoid fever 0.18 0.19 0.22 0.20 0.16 0.17 0.17 0.14 0.15 0.14
Varicella (chickenpox) ++ 122.43 121.77 120.06 135.82 176.54 118.54 135.76 118.11 44.13 93.55
Yellow fever - - - - - - - - 0.01 -
---------------------------------------------------------------------------------------------------------------------------------------------------
NOTES: Data in the annual Summary of Notifiable Diseases might not match data in other CDC surveillance reports because of differences in the timing of reports, the source
of the data, and the use of different case definitions. Rates <
* Acquired immunodeficiency syndrome.
+ No longer nationally notifiable.
& Chlamydia refers to genital infections caused by C. trachomatis.
@ Not previously nationally notifiable.
** Anti-HCV antibody test became available May 1990.
++ Not nationally notifiable.
=============================================================================================================================================================================
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Table_2
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TABLE 2. NOTIFIABLE DISEASES -- Summary of reported cases, United States, 1990-1997
=========================================================================================================================================================================================
Disease 1990 1991 1992 1993 1994 1995 1996 1997
---------------------------------------------------------------------------------------------------------------------------------------------------
AIDS* 41,595 43,672 45,472 103,691 78,279 71,547 66,885 58,492+
Amebiasis 3,328 2,989 2,942 2,970 2,983 ................. & ..............
Anthrax - - 1 - - - - -
Aseptic meningitis 11,852 14,526 12,223 12,848 8,932 ... & ...
Botulism, total (including wound and unsp.) 92 114 91 97 143 97 119 132
Foodborne 23 27 21 27 50 24 25 31
Infant 65 81 66 65 85 54 80 79
---------------------------------------------------------------------------------------------------------------------------------------------------
Brucellosis 85 104 105 120 119 98 112 98
Chancroid 4,212 3,476 1,886 1,399 773 606 386 243@
Chlamydia ** .............................. ++ ....................... 477,638 498,884 526,671@
Cholera 6 26 103 18 39 23 4 6
Cryptosporidiosis .......................................... ++ ................................... 2,566
Diphtheria 4 5 4 - 2 - 2 4
Encephalitis, primary 1,341 1,021 774 919 717 ................. & ..............
Post-infectious 105 82 129 170 143 ................. & ..............
---------------------------------------------------------------------------------------------------------------------------------------------------
Escherichia coli O157:H7 ... ... ++ ... 1,420 2,139 2,741 2,555
Gonorrhea 690,169 620,478 501,409 439,673 418,068 392,848 325,883 324,907@
Granuloma inguinale 97 29 6 19 3 ................. & ..............
Haemophilus influenzae,invasive ++ 2,764 1,412 1,419 1,174 1,180 1,170 1,162
Hansen disease (leprosy) 198 154 172 187 136 144 112 122
Hepatitis A 31,441 24,378 23,112 24,238 26,796 31,582 31,032 30,021
Hepatitis B 21,102 18,003 16,126 13,361 12,517 10,805 10,637 10,416
Hepatitis, C/non-A, non-B && 2,553 3,582 6,010 4,786 4,470 4,576 3,716 3,816
Hepatitis,unspecified 1,671 1,260 884 627 444 ................. & ..............
Legionellosis 1,370 1,317 1,339 1,280 1,615 1,241 1,198 1,163
Leptospirosis 77 58 54 51 38 ................. & ..............
Lyme disease ++ 9,465 9,895 8,257 13,043 11,700 16,455 12,801
Lymphogranuloma venereum 277 471 302 285 235 ................. & ..............
---------------------------------------------------------------------------------------------------------------------------------------------------
Malaria 1,292 1,278 1,087 1,411 1,229 1,419 1,800 2,001
Measles (rubeola) 27,786 9,643 2,237 312 963 309 508 138
Meningococcal disease 2,451 2,130 2,134 2,637 2,886 3,243 3,437 3,308
Mumps 5,292 4,264 2,572 1,692 1,537 906 751 683
Murine typhus fever 50 43 28 25 ............................ & ..............
---------------------------------------------------------------------------------------------------------------------------------------------------
Pertussis (whooping cough) 4,570 2,719 4,083 6,586 4,617 5,137 7,796 6,564
Plague 2 11 13 10 17 9 5 4
Poliomyelitis, paralytic @@ 6 10 6 4 8 6 5 3
Psittacosis 113 94 92 60 38 64 42 33
Rabies, animal 4,826 6,910 8,589 9,377 8,147 7,811 6,982 8,105
Rabies, human 1 3 1 3 6 5 3 2
Rheumatic fever, acute 108 127 75 112 112 ................. & ..............
Rocky Mountain spotted fever 651 628 502 456 465 590 831 409
Rubella (German measles) 1,125 1,401 160 192 227 128 238 181
Rubella, congenital syndrome 11 47 11 5 7 6 4 5
Salmonellosis, excluding typhoid fever 48,603 48,154 40,912 41,641 43,323 45,970 45,471 41,901
Shigellosis 27,077 23,548 23,931 32,198 29,769 32,080 25,978 23,117
---------------------------------------------------------------------------------------------------------------------------------------------------
Syphilis, primary and secondary 50,223 42,935 33,973 26,498 20,627 16,500 11,387 8,550@
Total, all stages 134,255 128,569 112,581 101,259 81,696 68,953 52,976 46,540@
Tetanus 64 57 45 48 51 41 36 50
Toxic-shock syndrome 322 280 244 212 192 191 145 157
Trichinosis 129 62 41 16 32 29 11 13
Tuberculosis 25,701 26,283 26,673 25,313 24,361 22,860 21,337 19,851***
Tularemia 152 193 159 132 96 ................. & ..............
Typhoid fever 552 501 414 440 441 369 396 365
Varicella (chickenpox) +++ 173,099 147,076 158,364 134,722 151,219 120,624 83,511 98,727
Yellow fever ............................ &&& ................................... 1 -
---------------------------------------------------------------------------------------------------------------------------------------------------
NOTE: Data in the annual Summary of Notifiable Diseases might not match data in other CDC surveillance reports because of differences in the timing of reports, the source
of the data, and the use of different case definitions.
* Acquired immunodeficiency syndrome.
+ The total number of AIDS cases includes all cases reported to the Division of HIV/AIDS Prevention -- Surveillance and Epidemiology, National Center for HIV, STD, and TB Prevention
(NCHSTP) as of December 31, 1997.
& No longer nationally notifiable.
@ Cases were updated through the Division of Sexually Transmitted Diseases Prevention, NCHSTP, as of July 13, 1998.
** Chlamydia refers to genital infections caused by C. trachomatis.
++ Not previously nationally notifiable.
&& Anti-HCV antibody test was available as of May 1990.
@@ Numbers might not reflect changes because of retrospective case evaluations or late reports (see MMWR 1986;35:180-2).
*** Cases were updated through the Division of Tuberculosis Elimination, NCHSTP, as of April 15, 1998
=========================================================================================================================================================================================
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Table_3
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TABLE 3. NOTIFIABLE DISEASES -- Summary of reported cases, United States, 1982-1989
===========================================================================================================================================================================================
Disease 1982 1983 1984 1985 1986 1987 1988 1989
-------------------------------------------------------------------------------------------------------------------------------------------
AIDS * ..... + ........... 4,445 8,249 12,932 21,070 31,001 33,722
Amebiasis 7,304 6,658 5,252 4,433 3,532 3,123 2,860 3,217
Anthrax - - 1 - - 1 2 -
Aseptic meningitis 9,680 12,696 8,326 10,619 11,374 11,487 7,234 10,274
Botulism, total (including wound and unsp.) 97 133 123 122 109 82 84 89
Foodborne ................. & ........... 49 23 17 28 23
Infant ................. & ........... 70 79 59 50 60
-------------------------------------------------------------------------------------------------------------------------------------------
Brucellosis 173 200 131 153 106 129 96 95
Chancroid 1,392 847 665 2,067 3,756 4,998 5,001 4,692
Cholera - 1 1 4 23 6 8 -
Diphtheria 2 5 1 3 - 3 2 3
Encephalitis, primary @ 1,464 1,761 1,257 1,376 1,302 1,418 882 981
Post-infectious @ 36 34 108 161 124 121 121 88
Gonorrhea 960,633 900,435 878,556 911,419 900,868 780,905 719,536 733,151
-------------------------------------------------------------------------------------------------------------------------------------------
Granuloma inguinale 17 24 30 44 61 22 11 7
Hansen disease (leprosy) 250 259 290 361 270 238 184 163
Hepatitis A 23,403 21,532 22,040 23,210 23,430 25,280 28,507 35,821
Hepatitis B 22,177 24,318 26,115 26,611 26,107 25,916 23,177 23,419
Hepatitis, C/non-A, non-B + 3,470 3,871 4,184 3,634 2,999 2,619 2,529
Hepatitis, unspecified 8,564 7,149 5,531 5,517 3,940 3,102 2,470 2,306
Legionellosis ** 654 852 750 830 980 1,038 1,085 1,190
-------------------------------------------------------------------------------------------------------------------------------------------
Leptospirosis 100 61 40 57 41 43 54 93
Lymphogranuloma venereum 235 335 170 226 396 303 185 189
Malaria 1,056 813 1,007 1,049 1,123 944 1,099 1,277
Measles (rubeola) 1,714 1,497 2,587 2,822 6,282 3,655 3,396 18,193
Meningococcal disease 3,056 2,736 2,746 2,479 2,594 2,930 2,964 2,727
Mumps 5,270 3,355 3,021 2,982 7,790 12,848 4,866 5,712
Murine typhus fever 58 62 53 37 67 49 54 41
Pertussis (whooping cough) 1,895 2,463 2,276 3,589 4,195 2,823 3,450 4,157
-------------------------------------------------------------------------------------------------------------------------------------------
Plague 19 40 31 17 10 12 15 4
Poliomyelitis, total 12 13 9 ........................... ++ ........................
Paralytic 12 13 9 8 10 9 9 11
Psittacosis 152 142 172 119 224 98 114 116
Rabies, animal 6,212 5,878 5,567 5,565 5,504 4,658 4,651 4,724
Rabies, human - 2 3 1 - 1 - 1
Rheumatic fever, acute 137 88 117 90 147 141 158 144
-------------------------------------------------------------------------------------------------------------------------------------------
Rocky Mountain spotted fever 976 1,126 838 714 760 604 609 623
Rubella (German measles) 2,325 970 752 630 551 306 225 396
Rubella, congenital syndrome 7 22 5 - 14 5 6 3
Salmonellosis, excluding typhoid fever 40,936 44,250 40,861 65,347 49,984 50,916 48,948 47,812
Shigellosis 18,129 19,719 17,371 17,057 17,138 23,860 30,617 25,010
Syphilis, primary and secondary 33,613 32,698 28,607 27,131 27,883 35,147 40,117 44,540
Total, all stages 75,579 74,637 69,888 67,563 68,215 86,545 103,437 110,797
-------------------------------------------------------------------------------------------------------------------------------------------
Tetanus 88 91 74 83 64 48 53 53
Toxic-shock syndrome + 502 482 384 412 372 390 400
Trichinosis 115 45 68 61 39 40 45 30
Tuberculosis 25,520 23,846 22,255 22,201 22,768 22,517 22,436 23,495
Tularemia 275 310 291 177 170 214 201 152
Typhoid fever 425 507 390 402 362 400 436 460
Varicella (chickenpox) 167,423 177,462 221,983 178,162 183,243 213,196 192,857 185,441
Yellow fever ........................................ && ...............................................
-------------------------------------------------------------------------------------------------------------------------------------------
NOTE: Data in the annual Summary of Notifiable Diseases might not match data in other CDC surveillance reports because of differences in the timing of reports, the source
of the data, and the use of different case definitions.
* Acquired immunodeficiency syndrome.
+ Not previously nationally notifiable.
& Not reported as distinct categories during this period.
@ Beginning in 1984, data reflect change in categories for tabulating encephalitis reports that were recorded by date of record to state health departments. Data for previous years are
from surveillance records reported by onset date.
** Beginning in 1982, data were recorded by date of report to the state health department. Data for 1976-1981 are from surveillance records reported by onset date.
++ Categories other than paralytic are no longer reported.
===========================================================================================================================================================================================
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Table_4
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TABLE 4. NOTIFIABLE DISEASES -- Summary of reported cases, United States, 1974- 1981
============================================================================================================================================================================
Disease 1974 1975 1976 1977 1978 1979 1980 1981
----------------------------------------------------------------------------------------------------------------------------------------------------------
Amebiasis 2,743 2,775 2,906 3,044 3,937 4,107 5,271 6,632
Anthrax 2 2 2 - 6 - 1 -
Aseptic meningitis 3,197 4,475 3,510 4,789 6,573 8,754 8,028 9,547
Botulism, total (including wound and unsp.) 28 20 55 129 105 45 89 103
Brucellosis 240 310 296 232 179 215 183 185
Chancroid 945 700 628 455 521 840 788 850
Cholera - - - 3 12 1 9 19
----------------------------------------------------------------------------------------------------------------------------------------------------------
Diphtheria 272 307 128 84 76 59* 3 5
Encephalitis, primary 1,164 4,064 1,651 1,414 1,351 1,504 1,362 1,492
Post-infectious 218 237 175 119 78 84 40 43
Gonorrhea 906,121 999,937 1,001,994 1,002,219 1,013,436 1,004,058 1,004,029 990,864
Granuloma inguinale 47 60 71 75 72 76 51 66
Hansen disease (leprosy) 118 162 145 151 168 185 223 256
Hepatitis A 40,358 35,855 33,288 31,153 29,500 30,407 29,087 25,802
----------------------------------------------------------------------------------------------------------------------------------------------------------
Hepatitis B 10,631 13,121 14,973 16,831 15,016 15,452 19,015 21,152
Hepatitis, unspecified 8,351 7,158 7,488 8,639 8,776 10,534 11,894 10,975
Legionellosis ..... + ........... 235 359 761 593 475 408
Leptospirosis 68 93 73 71 110 94 85 82
Lymphogranuloma venereum 394 353 365 348 284 250 199 263
Malaria 293 373 471 547 731 894 2,062 1,388
Measles (rubeola) 22,094 24,374 41,126 57,345 26,871 13,597 13,506 3,124
----------------------------------------------------------------------------------------------------------------------------------------------------------
Meningococcal disease 1,346 1,478 1,605 1,828 2,505 2,724 2,840 3,525
Mumps 59,128 59,647 38,492 21,436 16,817 14,225 8,576 4,941
Murine typhus fever 26 41 69 75 46 69 81 61
Pertussis (whooping cough) 2,402 1,738 1,010 2,177 2,063 1,623 1,730 1,248
Plague 8 20 16 18 12 13 18 13
Poliomyelitis, total 7 13 10 19 8 22 9 10
Paralytic & 7 13 10 19 8 22 9 10
----------------------------------------------------------------------------------------------------------------------------------------------------------
Psittacosis 164 49 78 94 140 137 124 136
Rabies, animal 3,151 2,627 3,073 3,130 3,254 5,119 6,421 7,118
Rabies, human - 2 2 2 4 4 - 2
Rheumatic fever, acute 2,431 2,854 1,865 1,738 851 629 432 264
Rocky Mountain spotted fever 754 844 937 1,153 1,063 1,070 1,163 1,192
Rubella (German measles) 11,917 16,652 12,491 20,395 18,269 11,795 3,904 2,077
Rubella, congenital syndrome 45 30 30 23 30 62 50 19
----------------------------------------------------------------------------------------------------------------------------------------------------------
Salmonellosis, excluding typhoid fever 21,980 22,612 22,937 27,850 29,410 33,138 33,715 39,990
Shigellosis 22,600 16,584 13,140 16,052 19,511 20,135 19,041 19,859
Syphilis, primary and secondary 25,385 25,561 23,731 20,399 21,656 24,874 27,204 31,266
Total, all stages 83,771 80,356 71,761 64,621 64,875 67,049 68,832 72,799
Tetanus 101 102 75 87 86 81 95 72
Trichinosis 120 252 115 143 67 157 131 206
----------------------------------------------------------------------------------------------------------------------------------------------------------
Tuberculosis @ 30,122 33,989 32,105 30,145 28,521 27,669 27,749 27,373
Tularemia 144 129 157 165 141 196 234 288
Typhoid fever 437 375 419 398 505 528 510 584
Varicella (chickenpox) 141,495 154,248 183,990 188,396 154,089 199,081 190,894 200,766
Yellow fever .............................................. ** .......................................................
----------------------------------------------------------------------------------------------------------------------------------------------------------
NOTE: Data in the annual Summary of Notifiable Diseases might not match data in other CDC surveillance reports because of differences in the timing of reports, the source
of the data, and the use of different case definitions.
* Cutaneous diphtheria is no longer nationally notifiable.
+ Not previously nationally notifiable.
& No cases of paralytic poliomyelitis caused by wild virus have been reported in the United States since 1979.
@ Case data subsequent to 1974 are not comparable with earlier years because of changes in reporting criteria that became effective in 1975.
** Last indigenous case of yellow fever was reported in 1911; before 1996, the last imported case was reported in 1924.
============================================================================================================================================================================
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Table_5
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TABLE 5. NOTIFIABLE DISEASES -- Summary of reported cases, United States, 1966- 1973
================================================================================================================================================
Disease 1966 1967 1968 1969 1970 1971 1972 1973
----------------------------------------------------------------------------------------------------------------------------------------------
Amebiasis 2,921 3,157 3,005 2,915 2,888 2,752 2,199 2,235
Anthrax 5 2 3 4 2 5 2 2
Aseptic meningitis 3,058 3,082 4,494 3,672 6,480 5,176 4,634 4,846
Botulism 9 5 7 16 12 25 22 34
Brucellosis 262 265 218 235 213 183 196 202
Chancroid 838 784 845 1,104 1,416 1,320 1,414 1,165
Cholera - - - - - 1 - 1
----------------------------------------------------------------------------------------------------------------------------------------------
Diphtheria 209 219 260 241 435 215 152 228
Encephalitis, primary 2,121 1,478 1,781 1,613 1,580 1,524 1,059 1,613
Post-infectious 964 1,060 502 304 370 439 243 354
Gonorrhea 351,738 404,836 464,543 534,872 600,072 670,268 767,215 842,621
Granuloma inguinale 148 154 156 154 124 89 81 62
Hansen disease (leprosy) 109 81 123 98 129 131 130 146
Hepatitis A (infectious) 32,859 38,909 45,893 48,416 56,797 59,606 54,074 50,749
----------------------------------------------------------------------------------------------------------------------------------------------
Hepatitis B (serum) 1,497 2,458 4,829 5,909 8,310 9,556 9,402 8,451
Leptospirosis 72 67 69 89 47 62 41 57
Lymphogranuloma venereum 308 371 485 520 612 692 756 408
Malaria 565 2,022 2,317 3,102 3,051 2,375 742 237
Measles (rubeola) 204,136 62,705 22,231 25,826 47,351 75,290 32,275 26,690
Meningococcal disease 3,381 2,161 2,623 2,951 2,505 2,262 1,323 1,378
Mumps ..... * ........... 152,209 90,918 104,953 124,939 74,215 69,612
----------------------------------------------------------------------------------------------------------------------------------------------
Murine typhus fever 33 52 36 36 27 23 18 32
Pertussis (whooping cough) 7,717 9,718 4,810 3,285 4,249 3,036 3,287 1,759
Plague 5 3 3 5 13 2 1 2
Poliomyelitis, total 113 41 53 20 33 21 31 8
Paralytic 106 40 53 18 31 17 29 7
Psittacosis 50 41 43 57 35 32 52 33
Rabies, animal 4,178 4,481 3,591 3,490 3,224 4,310 4,369 3,640
----------------------------------------------------------------------------------------------------------------------------------------------
Rabies, human 1 2 1 1 3 2 2 1
Rheumatic fever, acute 4,472 3,985 3,470 3,229 3,227 2,793 2,614 2,560
Rocky Mountain spotted fever 268 305 298 498 380 432 523 668
Rubella (German measles) 46,975 46,888 49,371 57,686 56,552 45,086 25,507 27,804
Rubella, congenital syndrome 11 10 14 31 77 68 42 35
Salmonellosis, excluding typhoid fever 16,841 18,120 16,514 18,419 22,096 21,928 22,151 23,818
Shigellosis 11,888 13,474 12,180 11,946 13,845 16,143 20,207 22,642
----------------------------------------------------------------------------------------------------------------------------------------------
Streptococcal sore throat and scarlet fever 427,752 453,351 435,013 450,008 433,405 ... + ...
Syphilis, primary and secondary 21,414 21,053 19,019 19,130 21,982 23,783 24,429 24,825
Total, all stages 105,159 102,581 96,271 92,162 91,382 95,997 91,149 87,469
Tetanus 235 263 178 192 148 116 128 101
Trichinosis 115 66 77 215 109 103 89 102
Tuberculosis 47,767 45,647 42,623 39,120 37,137 35,217 32,882 30,998
Tularemia 208 184 186 149 172 187 152 171
Typhoid fever 378 396 395 364 346 407 398 680
Varicella (chickenpox) .......................................... * ....................... 164,114 182,927
Yellow fever .......................................... & ................................... ...
----------------------------------------------------------------------------------------------------------------------------------------------
NOTE: Data in the annual Summary of Notifiable Diseases might not match data in other CDC surveillance reports because of differences in
the timing of reports, the source of the data, and the use of different case definitions.
* Not previously nationally notifiable.
+ No longer nationally notifiable.
& Last indigenous case of yellow fever was reported in 1911; before 1996, the last imported case was reported in 1924.
================================================================================================================================================
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Table_6
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TABLE 6. NOTIFIABLE DISEASES -- Deaths from selected diseases, United States, 1987- 1996
========================================================================================================================================================================================
Cause of Death ICD* 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996
-------------------------------------------------------------------------------------------------------------------------------------------------------------------
AIDS + *042-* 044 13,468 16,602 22,082 25,188 29,555 33,566 37,267 42,114 43,115 31,130
Amebiasis 006 9 7 4 5 5 6 6 2 4 4
Anthrax 022 - - - - - - - - - -
Aseptic meningitis 047.9 28 37 36 50 47 37 33 30 22 25
Botulism, foodborne 005.1 - 1 2 4 2 1 - - 2 1
Brucellosis 023 1 2 - - - - 1 - 1 -
Chancroid 099.0 - - - - 1 - - - - -
Cholera 001 1 - - 2 2 2 - 1 - 2
Diphtheria 032 1 - - 1 - 1 - - 1 -
Encephalitis, Eastern equine 062.2 - - 1 1 1 1 1 - 1 1
Encephalitis, California 062.5 1 - - - - - - - - 1
Encephalitis, St. Louis 062.3 2 - - 13 9 2 1 3 6 -
Encephalitis, Western equine 062.1 1 - - - - - - - - -
Gonococcal infections 098 7 3 4 3 3 4 5 3 3 4
Granuloma inguinale 099.2 - - - - - - - - - -
Haemophilus influenzae, invasive 041.5 25 25 16 16 17 16 7 5 12 7
Hansen disease (leprosy) 030 1 - 4 3 - 2 1 3 2 -
Hepatitis, viral, infectious (Hep A) 070.0, 070.1 77 70 88 76 71 82 95 97 142 121
Hepatitis, viral, serum (Hep B) 070.2, 070.3 595 621 711 816 912 903 1,041 1,120 1,027 1,082
Hepatitis, viral, other and unsp. 070.4-070.9 510 599 717 686 857 1,016 1,353 1,844 2,231 2,577
Leptospirosis 100 1 2 - 2 1 2 1 - 2 2
Lymphogranuloma venereum 099.1 - - 2 2 1 - 2 - - -
Malaria 084 5 7 11 3 4 8 12 3 8 4
Measles (rubeola) 055 2 3 32 64 27 4 - - 2 1
Meningococcal disease 036 258 278 273 215 198 201 260 276 273 290
Mumps 072 2 2 3 1 1 - - - - 1
Murine typhus fever 081.0 - - 1 - - - - - - -
Pertussis (whooping cough) 033 1 4 12 12 - 5 7 8 6 4
Plague 020 1 - - - - 1 2 2 1 2
Poliomyelitis, total 045.0-045.9 - 1 - - 1 - - - 1 -
Psittacosis 073 2 1 1 2 - 4 1 - - 1
Rabies, human 071 1 - 1 1 3 1 1 3 3 3
Rheumatic fever, acute 390-392 42 76 70 66 89 100 153 191 159 114
Rubella (German measles) 056 - 1 4 8 1 1 - - 1 -
Salmonellosis, incl. paratyphoid fever 002.1-002.9, 003 105 66 99 80 53 47 52 49 66 58
Shigellosis 004 13 8 16 10 10 8 5 13 8 5
Spotted fevers 082.0 21 20 10 20 13 13 5 9 8 6
Syphilis 090-097 98 85 105 106 93 91 80 79 65 73
Tetanus 037 16 17 9 11 11 9 11 9 5 1
Trichinosis 124 - - 1 - - - - - - -
Tuberculosis (all forms) 010-018 1,755 1,921 1,970 1,810 1,713 1,705 1,631 1,478 1,336 1,202
Tularemia 021 4 2 1 1 2 3 - - 2 -
Typhoid fever 002.0 2 - - 1 1 - - 1 - 1
Varicella (chickenpox) & 052 89 83 89 120 81 100 100 124 115 81
Yellow fever 01060 - - - - - - - - - 1
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NOTE: Data in the annual Summary of Notifiable Diseases might not match data in other CDC surveillance reports because of differences in the timing of reports, the source
of the data, and the use of different case definitions.
* Numbers in ICD column refer to the category numbers listed in the International Classification of Diseases, Ninth Revision,1975. (The asterisks in the ICD column pertain to the ICD
code, not a footnote. They indicate that the numbers are not part of the ICD but were introduced for use in the United States.)
+ Acquired immunodeficiency syndrome.
& Varicella was taken off the nationally notifiable disease list in 1991. Many states continue to report these cases to CDC.
Source: National Center for Health Statistics System, 1987-1996. Deaths are classified to the ICD Ninth Revision.
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**Questions or messages regarding errors in formatting should be addressed to mmwrq@cdc.gov.