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MMWR Summary of Notifiable Diseases, United States, 1993

The following CDC staff members prepared this report:

Denise T. Koo, M.D., M.P.H. Andrew G. Dean, M.D., M.P.H.

Ruth W. Slade Carol M. Knowles Deborah A. Adams Wanda K. Fortune

Patsy A. Hall Robert F. Fagan Barbara Panter-Connah

Harry R. Holden Gerald F. Jones Clarence Lee Maddox

Division of Surveillance and Epidemiology

Epidemiology Program Office


Consultant Willie J. Anderson

Office of the Vice President for Health Affairs

Emory University


Foreword

MMWR Summary of Notifiable Diseases, United States, 1993

This publication contains summary tables of the official statistics for the occurrence of nationally notifiable diseases in the United States for calendar year 1993. This information is collected and compiled from reports to the National Notifiable Diseases Surveillance System (NNDSS).

Part 1 contains information on morbidity for each of the 49 currently notifiable conditions. In all tables, leprosy is listed as Hansen disease, typhus fever (flea-borne) as murine typhus fever, and typhus fever (tick- borne) as Rocky Mountain spotted fever (RMSF). The tables show the number of cases of notifiable diseases reported to CDC for 1993, as well as the distri- bution of cases by month and geographic location, and by patient's age, race, and ethnicity.

Part 2 contains graphs and maps depicting summary data for many of the notifiable conditions described in tabular form in Part I.

Part 3 includes tables showing the number of cases of notifiable diseases reported to CDC and to the National Office of Vital Statistics since 1944. It also includes a table on deaths associated with specified notifiable diseases reported to the National Center for Health Statistics, CDC, for the period 1982-1991.

Background

As of January 1, 1994, 49 infectious diseases were designated as noti- fiable at the national level. A notifiable disease is one for which regular, frequent, and timely information on individual cases is considered necessary for the prevention and control of the disease. This section briefly sum- marizes the history of national notifiable disease reporting in the United States.

In 1878, Congress authorized the U.S. Public Health Service (PHS) to collect morbidity reports on cholera, smallpox, plague, and yellow fever from U.S. consuls overseas; this information was to be used for instituting quar- antine 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. The authority for weekly reporting and publication was expanded by Congress 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 weekly telegraphic reporting of five infectious diseases and monthly report- ing 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 nearly 30 specified conditions. At their meeting in 1950, the State and Territorial Health Officers authorized a conference of state epidemiologists whose purpose was to determine which diseases should be reported to PHS. CDC assumed responsibility for the collection and publication of data on nation- ally notifiable diseases in 1961.

Public health officials at state health departments and CDC continue to collaborate in determining which diseases should be nationally notifiable; the Council of State and Territorial Epidemiologists (CSTE) makes recommenda- tions annually for additions and deletions to the national notifiable disease list on the basis of CDC suggestions. However, reporting of nationally noti- fiable diseases to CDC by the states is voluntary. Reporting is currently mandated only at the state level. The list of diseases that are considered notifiable, therefore, 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 nationally notifiable diseases is revised periodically. Diseases are added to the list as new pathogens emerge; diseases are deleted as their incidence declines. During 1993, 49 infectious diseases were con- sidered notifiable at the national level and were reported to CDC; 41 were reported on a weekly basis, and eight were reported monthly. CSTE will review the principles of notifiable disease reporting in late fall 1994.

Data Sources

Provisional data on the reported occurrence of notifiable diseases are published routinely in MMWR; these data are compiled in final form in this summary. Notifiable disease reports published in the annual MMWR Summary of Notifiable Diseases are the authoritative and archival counts of cases. Data from surveillance records for selected diseases, which are useful for de- tailed epidemiologic analyses, are published on a periodic basis. Data ap- pearing in those surveillance reports may not agree exactly with reports published in MMWR due to differences in the timing of reports or the source of the data or due to refinements in case definitions.

Data in this summary are primarily derived from electronic reports trans- mitted to the Epidemiology Program Office, CDC, by state and territorial health departments through the National Electronic Telecommunications System for Surveillance (NETSS). Final data for other diseases are from surveillance program records of the CDC programs listed below. Requests for further infor- mation regarding these data should be directed to the appropriate source.

National Center for Health Statistics

Office of Vital and Health Statistics Systems (deaths from

selected notifiable diseases)

National Center for Infectious Diseases

Division of Bacterial and Mycotic Diseases (cholera and toxic-

shock syndrome) Division of HIV/AIDS (human immunodeficiency virus/acquired

immunodeficiency syndrome) Division of Vector-Borne Infectious Diseases (arboviral infec

tions of the central nervous system and plague) Division of Viral and Rickettsial Diseases (animal rabies)

National Center for Prevention Services

Division of Sexually Transmitted Diseases and HIV Prevention

(gonorrhea, syphilis, chancroid, granuloma inguinale, and lymphogranuloma venereum) Division of Tuberculosis Elimination (tuberculosis)

National Immunization Program

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, and the Commonwealth of the Northern Mariana Islands (CNMI).

Data on notifiable diseases before 1960 are obtained from publications of the National Office of Vital Statistics.

Population estimates for states are based on the July 1, 1993, post- censal estimates made by the U.S. Department of Commerce, Bureau of the Census, Population Division, Population Estimates Branch, Press Release CB93-219.

Population estimates for territories are from the 1990 census, U.S. Department of Commerce, Bureau of the Census, Press Releases CB91-142, 242, 243, 263, and 276.

Rates in the 1993 Summary of Notifiable Diseases were based on data for the U.S. total resident population. However, population data from states in which diseases were not notifiable or not available were excluded from rate calculations.

Interpreting Data

Although the data reported in this summary are important for analyzing disease trends and determining relative disease burdens, these data must be interpreted with caution. Some diseases, such as plague and rabies, that cause severe clinical illness and are associated with serious consequences probably are diagnosed and reported accurately. However, diseases that are clinically mild and infrequently associated with serious consequences (e.g., salmonellosis and mumps) are less likely to be reported. Additionally, sub- clinical cases are seldom detected except in the course of special studies. The degree of completeness of reporting also is influenced by the diagnostic facilities available, the control measures in effect, and the interests and priorities of state and local officials responsible for disease control and surveillance. Finally, factors such as the introduction of new diagnostic tests and the discovery of new disease entities may 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 may be risk markers for certain notifiable diseases. Risk markers can identify potential risk factors for investigation in future studies. Data on race and ethnicity also can be useful for identifying groups to target for prevention efforts. Year 2000 Objectives for racial and ethnic groups have been established for several of the notifiable diseases.

EXPLANATION OF SYMBOLS USED IN

TABLES, GRAPHS, AND MAPS

Data not available ............................................. NA No reported cases .............................................. - Report of disease not required

by state health department (not notifiable) ............................................. NN

1993 HIGHLIGHTS FOR SELECTED DISEASES

This section highlights important developments in the reported occur- rences of certain notifiable and non-notifiable infectious diseases. Those diseases that currently are not nationally notifiable are highlighted under the subheading "Emerging Infections."

AIDS

In 1993, the number of AIDS cases reported to CDC increased 127% from the number reported in 1992. The large increase in the number of cases was largely due to changes in the 1993 AIDS surveillance case definition. As of January 1, 1993, HIV-infected persons with additional clinical conditions, as well as those with markers of severe immunosuppression, were defined as having AIDS.

Botulism

In 1993, two restaurant-associated outbreaks of botulism occurred in which unusual vehicles of transmission were implicated. In one of the out- breaks, which occurred in Georgia, the toxin was transmitted by a canned cheese sauce; in the other outbreak in Texas, toxin was transmitted by a dip containing baked potatoes.

Cholera

Epidemics of cholera caused by a new pathogen, Vibrio cholerae O139, occurred in late 1992 and early 1993 in southern Asia; in the United States, the first recognized case of infection caused by Vibrio cholerae 0139 occurred during 1993 in a California resident who had visited India in January 1993.

Diphtheria

Outbreaks of diphtheria were reported from the Newly Independent States of the former Soviet Union (especially Russia and Ukraine) and Ecuador. No cases were reported last year among U.S. travelers to these countries.

Haemophilus influenzae

The rate of Haemophilus influenzae disease as reported through the National Notifiable Diseases Surveillance System (NNDSS) has continued to decline. Rates decreased 95% between 1987 and 1993. Data collected by active surveillance from selected sites indicate that the decline is primarily in Haemophilus influenzae type b (Hib) disease among children <5 years of age. This decline is associated with the use of the newly licensed Hib conjugate vaccines.

Hepatitis B

The reported incidence of hepatitis B decreased 59% from 1985 through 1993. This decline was caused by decreases in the number of cases reported among homosexual men between 1985 and 1989 (61%) and in the number reported among injecting-drug users from 1989 through 1992 (51%). These decreases are thought to result from an increase in AIDS awareness, which has resulted in behavioral changes (e.g., safer sex and needle-using practices).

Hepatitis, Non-A, Non-B

The steady increase in the number of cases of non-A, non-B hepatitis reported to NNDSS since 1990 is not thought to be caused by an increase in incidence, but rather caused by the screening of blood for the presence of antibody to the hepatitis C virus (anti-HCV, available beginning in May, 1990). Persons testing positive for anti-HCV, regardless of the presence of illness, have been reported as having non-A, non-B hepatitis. Surveillance at sentinel sites has actually shown a steady decrease in the incidence of non- A, non-B hepatitis, with a decline of >50% from 1988 through 1993. This decline is primarily attributable to a 58% decrease in the number of reported cases among injecting-drug users.

Legionnaires' Disease

Although only 1,280 cases of Legionnaires' disease were reported through NNDSS in 1993, data from recent prospective pneumonia studies suggest that between 10,000 and 15,000 cases occur each year.

Lyme Disease

In 1993, the number of cases of Lyme disease reported to CDC nationwide decreased by 15% from 1992. Hunterdon, New Jersey meanwhile experienced an increase in reported cases of Lyme disease from 75 cases in 1992 to 206 cases in 1993; upon investigation, the increase in reported cases was found to be due to both increased reporting by physicians and an increase in disease incidence.

Malaria

In August 1993, three persons without recent bloodborne exposure and who had not recently traveled were diagnosed with Plasmodium falciparum malaria infection in New York City. The results of the epidemiologic investigation suggest local acquisition through mosquito-borne transmission.

Measles

The total number of measles cases reported to CDC in 1993 -- 312 -- was the lowest number ever recorded in the United States. This reduction in reported measles cases may reflect cyclical changes in measles incidence as well as increases in measles vaccination coverage among preschool-aged children, increased use of a second dose of measles vaccine among school- and college-aged persons, and increased efforts to control measles throughout the Western Hemisphere.

Meningococcal disease

Several clusters of group C disease were recognized in 1993, resulting in mass vaccinations with meningococcal vaccine. Because approximately one half of severe meningococcal disease in this country is caused by serogroup B and because the vaccine is only effective for disease caused by serogroups A, C, Y, and W, the clusters illustrate the importance of serogroup determination and reporting for all cases of invasive Neisseria meningitidis.

Mumps

The total number of mumps cases reported in 1993 -- 1,692 -- was the lowest number ever reported in the United States.

Pertussis

The 6,503 pertussis cases reported in the United States in 1993 represent the highest annual total since 1967. Of 1,347 cases of pertussis among children 7 months to 4 years of age with known vaccination status, 630 (46.8%) had received fewer than three doses of DTP vaccine -- the minimum number of doses necessary for clinical protection.

Rubella

The total number of rubella cases reported to the CDC remained low in 1993 (N=192), although the number increased by 19% over the record low number of cases reported in 1992.

Sexually Transmitted Diseases

Nationally, the rates for gonorrhea and primary and secondary syphilis have declined since 1990, reaching low points in 1993 that were below or approaching the Year 2000 Objectives (1) (greater than or equal to 225 cases gonorrhea and greater than or equal to 10 cases primary and secondary syphilis per 100,000 persons). However, rates for both diseases remained higher than the Year 2000 Objectives for certain population subgroups: adolescents and young adults, minorities (especially blacks), and persons living in the southern United States.

Shigella

The number of cases of Shigella reported through NNDSS increased 35% from 1992 to 1993, with increases of 27%-405% reported from nine states. This increase was also reported through the national Shigella surveillance system, which receives reports of laboratory isolates of Shigella through the Public Health Laboratory Information System (PHLIS); 91% of Shigella isolates reported through PHLIS in 1993 were Shigella sonnei.

Tuberculosis

Between 1992 and 1993, the number of reported tuberculosis (TB) cases in the United States decreased from 26,673 to 25,313. This decrease may be associated with the effectiveness of prevention and control measures imple- mented during the period 1989-1993. However, two other factors also may be responsible for the decrease, including a) delayed reporting caused by use of the new TB surveillance reporting form and the change from paper records to a computerized system and b) underreporting because of modification of the AIDS surveillance case definition in January 1993.

EMERGING INFECTIONS

NOTE: The term "emerging infectious diseases" refers to those "infectious diseases whose incidence in humans has increased within the past two decades or threatens to increase in the near future" (2). These can be new or previously unrecognized infectious diseases, reemerging diseases, or infec- tious diseases that have developed resistance to previously effective anti- microbial drugs.

Coccidioidomycosis

The outbreak of coccidioidomycosis in California that began in 1991 continued in 1993. From an annual average number of 428 cases reported per year in California during the period 1981-1990, 1,200 cases were reported in 1991, 4,516 in 1992, and4,137 in 1993, 70% of which were reported from Kern County in central California. Key factors that may be associated with the ongoing outbreak include weather conditions that are conducive to the growth and spread of Coccidioides immitis (e.g., protracted drought followed by heavy rains), activities that disturb the soil and facilitate airborne spread of the organism, and an increasing population of persons who are susceptible to the organism because of migration from areas where coccidoidomycosis is not endemic.

Cryptosporidiosis

In spring 1993, a municipal water supply in Milwaukee, Wisconsin, contaminated with Cryptosporidium caused the largest recognized outbreak of waterborne illness in the history of the United States. More than 400,000 persons became ill, 4,400 of whom required hospitalization.

Escherichia coli O157:H7

In 1993, an outbreak of E. coli O157:H7 affected more than 500 people in four western states, resulting in 56 cases of hemolytic uremic syndrome and four deaths. Because of this outbreak, many clinical laboratories began screening stool samples for E. coli O157:H7, which resulted in the identifi- cation of many more cases and outbreaks. In May 1993, the Council of State and Territorial Epidemiologists (CSTE) passed a resolution recommending that E. coli O157:H7 infection be made reportable by all states and territories.

Group A Streptococcal Disease

During 1993, CDC surveillance for invasive group A streptococcal infec- tions consisted of a passive nationwide surveillance system. This system operated through the collection of isolates from normally sterile sites and the collection of case reports. Although current data on incidence and trends for invasive disease, streptococcal toxic shock syndrome, and necrotizing fasciitis are not available, population-based active surveillance for these infections has begun in several geographic areas and will be expanded in 1994 as part of surveillance for emerging infectious diseases.

Hantavirus Pulmonary Syndrome

Hantavirus Pulmonary Syndrome (HPS), a newly recognized illness charac- terized by an influenza-like prodrome followed by the acute onset of respira- tory failure, was first identified in the southwestern United States in June 1993 during the investigation of a cluster of unexplained deaths. A new hantavirus (Sin Nombre virus) and a rodent reservoir for the virus (the deer mouse {Peromyscus maniculatus}) were identified. As of August 31, 1994, national surveillance for HPS, initiated by CDC in coordination with CSTE, has identified 91 confirmed cases of HPS (with 48 deaths) in 20 states (case fatality rate: 53%).

Drug-Resistant Pneumococcus

The increasing incidence of drug-resistant Streptococcus pneumoniae (DRSP) strains in the United States has created an emerging public health challenge. CDC surveillance data from 1992 indicated that the prevalence of pneumococcal strains that are highly resistant to penicillin increased 60- fold (from 0.02% to 1.3%) when compared with the prevalence of isolates collected from 1979 through 1987. CDC, CSTE, and the infectious diseases and microbiology communities are developingrecommendations for the surveillance of DRSP infections. This surveillance data will be used to determine optimal empiric treatment regimens for pneumococcal infections.

Vancomycin-Resistant Enterococci (VRE)

From 1989 through 1993, the percentage of nosocomial enterococci resis- tant to vancomycin reported from hospitals participating in the National Nosocomial Infections Surveillance System increased from 0.3% to 7.9%. During this period, numerous VRE outbreaks (occurring primarily among immunocom- promised patients) were reported. Because of the public health importance of the emergence of VRE, CDC has published draft Guidelines for Preventing the Spread of Vancomycin Resistance and is conducting studies to assess the effectiveness of these guidelines in preventing disease transmission.

References

  1. Public Health Service. Healthy people 2000: national health promotion and disease prevention objectives -- full report, with commentary. Washing- ton, DC: US Department of Health and Human Services, Public Health Service, 1991:152; DHHS publication no. (PHS)91-50212.

  2. Institute of Medicine. Emerging infections: microbial threats to health in the United States. Washington, DC: National Academy Press, 1992.

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of group C meningococcal disease in the U.S. Infect Dis Clin Prac 1994; 3:136-40.

Mumps

Briss PA, Fehrs LJ, Parker RA, et al. Sustained transmission of mumps in a

highly vaccinated population: assessment of primary vaccine failure and waning vaccine-induced immunity. J Infect Dis 1994;169:77-82. CDC. Mumps prevention. MMWR 1989;38(22):388-92,397-400. CDC. Mumps -- United States, 1985-1988. MMWR 1989;38(7):101-5. Hersch BS, Fine PEM, Kent WK, et al. Mumps outbreak in a highly vaccinated

population. J Pediatr 1991;119:187-93.

Murine Typhus Fever

Benenson AS. Control of communicable diseases in man. 15th ed. Washington,

DC: American Public Health Association, 1990. McDade JE, Fishbein DB. Rickettsiaceae: the rickettsiae. In: Laboratory

diagnosis of infectious diseases: principles and practice. Vol II. Viral, rickettsial, and chlamydial diseases. New York: Springer-Verlag, 1988: 864-89. Woodward TE. Murine typhus fever: its clinical and biologic similarity of

epidemic typhus. In: Biology of rickettsial disease. Vol II. Boca Raton, Florida: CRC Press, 1988:79-92.

Pertussis

CDC. Pertussis surveillance -- United States, 1989-1991. MMWR 1992;41(No.

SS-8):11-9. Cherry JD, Brunell PA, Golden GS, et al. Report of the Task Force on Pertus-

sis and Pertussis Immunization, 1988. Pediatrics 1988;81(suppl):S939-84. Strebel PM, Cochi SL, Farizo KM, et al. Pertussis in Missouri: evaluation of

nasopharyngeal culture, direct fluorescent antibody testing and clinical case definitions in the diagnosis of pertussis. Clin Infect Dis 1993;16: 276-85.

Plague

Craven RB, Barnes AM. Plague and tularemia. Infect Dis Clin North Am 1991;5:

165-75. Poland JD. Plague. In: Hoeprich PD, ed. Infectious Diseases. 2nd ed. New

York: Harper and Row, 1989:151;1296-1306.

Poliomyelitis

CDC. Poliomyelitis -- United States, 1975-1984. MMWR 1986;35(11):180-2. Prevots DR, Suter RW, Strebel PM, Weibel RE, Cochi SL. Completeness of

reporting for paralytic poliomyelitis, United States, 1980 through 1991. Archives of Pediatrics and Adolescent Medicine 1994;148:479-85. Strebel PM, Sutter RW, Cochi SL, et al. Epidemiology of poliomyelitis in the

United States: one decade after the last reported case of indigenous wild virus-associated disease. Clin Infect Dis 1992;14:568-79.

Psittacosis

Anonymous. Compendium of chlamydiosis (psitticosis) control, 1994. National

Association of State Public Health Veterinarians, Inc. J Am Vet Med Assoc 1993;203:1673-80. Barnes RC. Laboratory diagnosis of human chlamydial infections. Clin Micro-

biol Rev 1989;2:119-36. Kuritsky JN, Schmid GP, Potter ME, Anderson DC, Kaufmann AF. Psittacosis: a

diagnostic challenge. J Occup Med 1984;26:731-3.

Rabies

Baer G. Natural history of rabies. 2nd ed. Boca Raton, Florida: CRC press,

1991. CDC. Compendium of animal rabies control, 1994. MMWR 1994;43(No. RR-10). CDC. Rabies prevention -- United States, 1991: recommendations of the Immuni-

zation Practices Advisory Committee (ACIP). MMWR 1991;40(No. RR-3). Krebs JW, Strine TW, Childs JE. Rabies surveillance in the United States

during 1992. J Am Vet Med Assoc 1993;203:1718-31.

Rheumatic Fever

Dajani AS. Prevention of rheumatic fever: a statement for health profession-

als by the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease of the Council on Cardiovascular Disease in the Young, the American Heart Association. Pediatr Infect Dis J 1989;8:263-6. Kaplan EL, Johnson DR, Cleary PP. Group A streptococcal serotypes isolated

from patients and sibling contacts during the resurgence of rheumatic fever in the United States in the mid-1980's. J Infect Dis 1989;1259: 101-3. Veasy GL, Wiedmeier SE, Orsmond GS, et al. Resurgence of acute rheumatic

fever in the intermountain area in the United States. N Engl J Med 1987;316:421-8.

Rocky Mountain Spotted Fever (RMSF)

Burgdorfer W, Anacker FL, eds. Rickettsiae and Rickettsial Diseases. New

York: Academic Press, 1981. McDade JE, Fishbein DB. Rickettsiaceae: the rickettsiae. In: Laboratory

diagnosis of infectious diseases: principles and practice. Vol II. Viral, rickettsial, and chlamydial diseases. New York: Springer-Verlag, 1988: 864-89.

Rubella

CDC. Increase in rubella and congenital rubella syndrome -- United States,

1988-1990. MMWR 1991;40(6):93-9. CDC. Rubella and congenital rubella syndrome -- United States, January 1,

1991-May 7, 1994. MMWR 1994;43(21):391,397-401. CDC. Outbreaks of rubella among the Amish -- United States, 1991. MMWR

1991;40(16):264. CDC. Congenital rubella syndrome among the Amish -- Pennsylvania, 1991-1992.

MMWR 1992;41(26):468-9,475-6. CDC. Rubella prevention: recommendations of the Immunization Practices

Advisory Committee (ACIP). MMWR 1990;39(No. RR-15). Lindegren ML, Fehrs LJ, Hadler SC, Hinman AR. Update: rubella and congenital

rubella syndrome, 1980-1990. Epidemiol Rev 1991;13:341-8.

Salmonellosis

Lee LA, Puhr ND, Maloney EK, Bean NH, Tauxe RV. Increase in antimicrobial-

resistant Salmonella infections in the United States, 1989-1990. J Infect Dis 1994;170:128-34. Mishu B, Griffin PM, Tauxe RV, Cameron DN, Hutcheson RH, Schaffner W. Salmo-

nella enteritidis gastroenteritis transmitted by intact chicken eggs. Ann Intern Med 1991;115:190-4. St. Louis ME, Morse DL, Potter ME, et al. The emergence of grade A eggs as a

major source of Salmonella enteritidis infections: new implications for the control of salmonellosis. JAMA 1988;259:2103-7. Tauxe RV. Salmonella : a postmodern pathogen. Journal of Food Protection

1991;54:563-8.

Shigellosis

Lee LA, Shapiro CN, Hargrett-Bean N, Tauxe RV. Hyperendemic shigellosis in

the United States: a review of surveillance data for 1967-1988. J Infect Dis 1991;164:894-900. Parsonnet J, Greene KD, Gerber AR, et al. Shigella dysenteriae type 1 infec-

tions in U.S. travellers to Mexico. Lancet 1989:543-5. Ries AA, Wells JG, Olivola D, et al. Epidemic Shigella dysenteriae type 1 in

Burundi: panresistance and implications for prevention. J Infect Dis 1994;169:1035-41.

Syphilis

Aral SO, Wasserheit JN, Green SB, Judson FN, Sparling FP. The NIAID/NIH

working group on integrated behavioral research for prevention and control of STDs. Part III: Issues in evaluating behavioral interventions. Sex Transm Dis 1990;17:208-10. CDC. Primary and secondary syphilis -- United States, 1981-1990. MMWR 1991;

40(19):314-5,321-3. CDC. Regional and temporal trends in the surveillance of syphilis, United

States, 1986-1990. MMWR 1991;40(No. SS-3):29-33. CDC. Special focus: surveillance for sexually transmitted diseases. MMWR

1993;42(No. SS-3):13-9.

Tetanus

CDC. Surveillance of tetanus -- United States, 1989-1990. MMWR 1992;41(No.

SS-8):1-9. Sutter RW, Cochi SL, Brink EW, Sirotkin BI. Assessment of vital statistics

and surveillance data for monitoring tetanus mortality, United States, 1979-1984. Am J Epidemiol 1990;131:132-42.

Toxic Shock Syndrome

CDC. Reduced incidence of menstrual toxic shock syndrome -- United States,

1980-1990. MMWR 1990;39(25):421-3. Gaventa S, Reingold AL, Hightower AW, et al. Active surveillance for toxic

shock syndrome in the United States, 1986. Rev Infect Dis 1989;(suppl): S28-34. Schuchat A, Broome CV. Toxic shock syndrome and tampons. Epidemiol Rev

1991;13:99-112.

Trichinosis

Bailey TM, Schantz PM. Trends in the incidence and transmission patterns of

human trichinosis in the United States, 1982-1986. Rev Infect Dis 1990; 12:5-11. Campbell WC (ed.). Trichinella and trichinosis. New York: Plenum Press, 1983. CDC. Trichinosis surveillance -- United States, 1987-1990. MMWR 1991;40(No.

SS-3):35-42. McAuley JB, Michelson MK, Hightower AW, Engeran S, Wintermeyer LA, Schantz

PM. A trichinosis outbreak among Southeast Asian refugees. Am J Epidemiol 1992;135:1404-10.

Tuberculosis

American Thoracic Society/CDC. Treatment of tuberculosis and tuberculosis

infection in adults and children. Am J Respir Crit Care Med 1994;149: 1359-74. CDC. Recommendations for counting reported tuberculosis cases. Atlanta: US

Department of Health and Human Services, Public Health Service, 1977. CDC. Expanded tuberculosis surveillance and tuberculosis morbidity -- United

States, 1993. MMWR 1994;43(20):361-6.

Tularemia

Evans ME, Gregory DW, Schaffner W, McGee ZA. Tularemia: a 30 year experience

with 88 cases. Medicine 1985;64:251-69. Taylor JP, Istre GR, McChesny TC, Satalowich FT, Parker RE, McFarland LM.

Epidemiologic characteristics of human tularemia in the southwest-central states, 1981-1987. Am J Epidemiol 1991;133:1032-8.

Typhoid Fever

CDC. Typhoid immunization: recommendations of the Immunization Practices

Advisory Committee. MMWR 1990;39(No. RR-10). Ryan CA, Hargrett-Bean NT, Blake PA. Salmonella typhi infections in the

United States, 1975-1984: increasing role of foreign travel. Rev Infect Dis 1989;II:1-7. Woodruff BA, Pavia AT, Blake PA. A new look at typhoid vaccination: informa-

tion for the practicing physician. JAMA 1991;265(6):756-9.

Varicella

CDC. Varicella outbreak in a women's prison -- Kentucky. MMWR 1989;38(37):

635-6,641-2. Gershon AA, LaRussa P, Hardy I, Steinberg S, Silverstein S. Varicella vac-

cine: the American experience. J Infect Dis 1992;166(suppl 1):S63-8. Lieu TA, Cochi SL, Black SB, et al. Cost-effectiveness of a routine varicella

vaccination program for U.S. children. JAMA 1994;271:375-81.


PART 1: Summaries of Notifiable Diseases in the United States

Table_N1 NOTIFIABLE DISEASES -- summary of reported cases, by month,

United States, 1993

Table_N2 NOTIFIABLE DISEASES -- reported cases, by geographic division

and area, United States, 1993

Table_N3 NOTIFIABLE DISEASES -- summary of reported cases, by age

group, United States, 1993

Table_N4 NOTIFIABLE DISEASES -- summary of reported cases, by race,

United States, 1993

Table_N5 NOTIFIABLE DISEASES -- summary of reported cases, by ethnici-

ty, United States, 1993


PART 2: Graphs and Maps for Selected Notifiable Diseases in the United States

Figure_1 ACQUIRED IMMUNODEFICIENCY SYNDROME (AIDS) -- reported cases

and known deaths, by year, United States, 1981-1993

Figure_2 ACQUIRED IMMUNODEFICIENCY SYNDROME (AIDS) -- annual rates, by

selected age group and sex for reported cases, United States, 1993

Figure_3 ACQUIRED IMMUNODEFICIENCY SYNDROME (AIDS) -- reported pediat-

ric cases, United States and Puerto Rico, 1993

Figure_4 ACQUIRED IMMUNODEFICIENCY SYNDROME (AIDS) -- reported cases,

per 100,000 population, United States and Puerto Rico, 1993

Figure_5 ACQUIRED IMMUNODEFICIENCY SYNDROME (AIDS) -- reported adult/

adolescent cases among men, by exposure category, United States, 1993

Figure_6 ACQUIRED IMMUNODEFICIENCY SYNDROME (AIDS) -- reported adult/

adolescent cases among women, by exposure category, United States, 1993

Figure_7 ARBOVIRAL INFECTIONS (of the central nervous system) -- cases

due to St. Louis encephalitis virus, by month, United States, 1975-1993

Figure_8 ARBOVIRAL INFECTIONS (of the central nervous system) -- cases

due to California serogroup viruses, by month, United States, 1975-1993

Figure_9 ARBOVIRAL INFECTIONS (of the central nervous system) --

cases due to Western equine encephalitis virus, by month, United States, 1975-1993

Figure_10 ARBOVIRAL INFECTIONS (of the central nervous system) --

cases due to Eastern equine encephalitis virus, by month, United States, 1975-1993

Figure_11 ASEPTIC MENINGITIS -- by month, United States, 1986-1993 Year

Figure_12 AMEBIASIS -- by year, United States, 1955-1993

Figure_13 ASEPTIC MENINGITIS -- reported cases, per 100,000 population,

United States and territories, 1993

Figure_14 BOTULISM (infant) -- by year, United States, 1975-1993

Figure_15 BOTULISM (foodborne) -- by year, United States, 1975-1993

Figure_16 BRUCELLOSIS -- by year, United States, 1945-1993

Figure_17 CHOLERA -- reported cases, United States and territories,

1993

Figure_18 DIPHTHERIA -- by year, United States, 1955-1993

Figure_19 ENCEPHALITIS (post-infectious) -- by year, United States,

1984-1993

Figure_20 GONORRHEA -- by sex, United States, 1960-1993

Figure_21 GONORRHEA -- by race and ethnicity, United States, 1981-1993

Figure_22 GONORRHEA -- reported cases, per 100,000 population, United

States, 1993

Figure_23 HAEMOPHILUS INFLUENZAE -- reported cases, per 100,000 popula-

tion, United States and territories, 1993

Figure_24 HAEMOPHILUS INFLUENZAE -- by age group, United States, 1993

Figure_25 HANSEN DISEASE (leprosy) -- by year, United States, 1955-1993

Figure_26 HEPATITIS -- by year, United States, 1965-1993

Figure_27 HEPATITIS A -- reported cases, per 100,000 population, United

States and territories, 1993

Figure_28 HEPATITIS B -- reported cases, per 100,000 population, United

States and territories, 1993

Figure_29 LEGIONELLOSIS -- reported cases, per 100,000 population,

United States and territories, 1993

Figure_30 LEPTOSPIROSIS -- by year, United States, 1955-1993

Figure_31 LYME DISEASE -- reported cases, per 100,000 population,

United States and territories, 1993

Figure_32 MALARIA -- by year, United States, 1930-1993

Figure_33 MEASLES (rubeola) -- by year, United States, 1950-1993

Figure_34 MEASLES (rubeola) -- counties reporting cases, United States,

1993

Figure_35 MENINGOCOCCAL INFECTION -- counties reporting cases, United

States, 1993

Figure_36 MENINGOCOCCAL INFECTION -- by year, United States, 1935-1993

Figure_37 MUMPS -- by year, United States, 1968-1993

Figure_38 MURINE TYPHUS FEVER -- by year, United States, 1955-1993

Figure_39 PERTUSSIS (whooping cough) -- by year, United States, 1957-

1993

Figure_40 PERTUSSIS (whooping cough) -- by age group, United States,

1993

Figure_41 PERTUSSIS (whooping cough) -- reported cases, per 100,000

population, United States and territories, 1993

Figure_42 PLAGUE -- among humans, by year, United States, 1955-1993

Figure_43 POLIOMYELITIS (paralytic) -- by year, United States, 1951-

1993

Figure_44 PSITTACOSIS -- by year, United States, 1955-1993

Figure_45 RABIES -- wild and domestic animals, by year, United States

and Puerto Rico, 1955-1993

Figure_46 RHEUMATIC FEVER -- reported cases, United States and territo-

ries, 1993

Figure_47 ROCKY MOUNTAIN SPOTTED FEVER -- counties reporting cases,

United States, 1993

Figure_48 ROCKY MOUNTAIN SPOTTED FEVER -- by year, United States,

1955-1993

Figure_49 RUBELLA (German measles) -- by year, United States, 1966-1993

Figure_50 SALMONELLOSIS (excluding typhoid fever) -- by year, United

States, 1955-1993

Figure_51 SHIGELLOSIS -- by year, United States, 1955-1993

Figure_52 SYPHILIS -- by year, United States, 1941-1993

Figure_53 SYPHILIS (primary and secondary) -- reported cases, per

100,000 population, United States, 1993

Figure_54 SYPHILIS (primary and secondary) -- counties with rates above

and below the Year 2000 Objective, United States, 1993

Figure_55 SYPHILIS (primary and secondary) -- by race and ethnicity,

United States, 1981-1993

Figure_56 SYPHILIS (primary and secondary) -- by sex, United States,

1956-1993

Figure_57 CONGENITAL SYPHILIS -- reported cases in infants <1 year of

age and rate of primary and secondary syphilis among women -- United States, 1970-1993

Figure_58 TETANUS -- by year, United States, 1955-1993

Figure_59 TETANUS -- by age group, United States, 1993

Figure_60 TOXIC SHOCK SYNDROME -- by quarter, United States, 1979-1993

Figure_61 TRICHINOSIS -- by year, United States, 1950-1993

Figure_62 TUBERCULOSIS -- rates by state, United States, 1993

Figure_63 TUBERCULOSIS -- percentage of cases, by race and ethnicity,

United States, 1993

Figure_64 TUBERCULOSIS - by year, United States, 1975-1993

Figure_65 TUBERCULOSIS -- frequency distribution of cases by age, race,

and ethnicity, United States, 1993

Figure_66 TUBERCULOSIS -- cases, among foreign-born persons and persons

born in the United Sates, 1993

Figure_67 TULAREMIA -- by year, United States, 1955-1993

Figure_68 TULAREMIA -- counties reporting cases, United States, 1993

Figure_69 TYPHOID FEVER -- by year, United States, 1955-1993

Figure_70 VARICELLA (chickenpox) -- by month, United States, 1986-1993


PART 3: Historical Summary Tables

TABLE_1 NOTIFIABLE DISEASES -- summary of reported cases, United

States, 1984-1993

TABLE_2 NOTIFIABLE DISEASES -- summary of reported cases, per 100,000

population, United States, 1984-1993

TABLE_3 NOTIFIABLE DISEASES -- summary of reported cases, United

States, 1974-1983

TABLE_4 NOTIFIABLE DISEASES -- summary of reported cases, United

States, 1964-1973

TABLE_5 NOTIFIABLE DISEASES -- summary of reported cases, United

States, 1954-1963

TABLE_6 NOTIFIABLE DISEASES -- summary of reported cases, United

States, 1944-1953

TABLE_7 NOTIFIABLE DISEASES -- deaths from specified notifiable

diseases, United States, 1982-1991
Table_N1
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NOTIFIABLE DISEASES -- summary of reported cases, by month, United States, 1993
===========================================================================================================================================================================================
Disease                               Total      Jan.      Feb.      Mar.      Apr.      May       June      July      Aug.      Sept.     Oct.      Nov.      Dec.        Unk.
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
AIDS *                               103,691     7,153     7,222    21,244     6,725    10,081     8,254     7,597     8,524     9,176     5,072     5,797     6,846         -
Amebiasis                              2,970       144       198       202       211       218       228       284       313       272       310       245       345         -
Anthrax                                    -         -         -         -         -         -         -         -         -         -         -         -         -         -
Aseptic meningitis                    12,848       519       532       502       478       698       739     1,569     1,891     1,797     1,909     1,005     1,209         -
Botulism, total                           97         6         5         4         5         6         6        11        11         8        16        10         9         -
Brucellosis                              120         4         6         6         7         8         6        12         8         3        11         7        42         -
Chancroid +                            1,399   ..............401..........   ..............469..........   ..............229..........   ..............300..........         -
Cholera                                   18         5         3         1         3         2         -         2         -         1         1         -         -         -
Diphtheria                                 -         -         -         -         -         -         -         -         -         -         -         -         -         -
Encephalitis, primary infections         919        43        49        45        33        53        45        84        93       158       152        72        92         -
  Post-infectious                        170         7        20        16        14        17        17        13        15         9        10        14        18         -
Gonorrhea +                          439,673   ..........103,178..........   ..........102,890..........   ..........120,498..........   ..........113,107..........         -
Granuloma inguinale +                     19   ...............15..........   ................4..........   ................-..........   ................-..........         -
Haemophilus influenzae                 1,419        99       104       149        97       141       100       105        68        78       126       155       197         -
Hansen disease (leprosy)                 187        11         9        20        17        27        10         8        18        14        30        11        12         -
Hepatitis A                           24,238     1,739     1,718     1,985     1,739     2,104     1,678     2,132     1,661     1,838     2,535     1,916     3,193         -
Hepatitis B                           13,361       772       918     1,000     1,038     1,311       999     1,191       994     1,003     1,207     1,036     1,892         -
Hepatitis, non-A , non-B &             4,786       272       354       337       293       383       301       347       340       364       496       384       915         -
Hepatitis, unspecified                   627        44        47        52        43        77        34        61        40        55        49        39        86         -
Legionellosis                          1,280       110        81        88        77       112        86       104       107       104       155        88       168         -
Leptospirosis                             51         1         8         1         1         3         2         4         7         5         3         8         8         -
Lyme disease                           8,257       175       310       323       234       433       524     1,474     1,156       845       840       738     1,205         -
Lymphogranuloma venereum +               285   ...............69..........   ...............73..........   ...............71 .........   ...............72..........         -
Malaria                                1,411        51        69        74       118        77        98       144       154       124       200       110       192         -
Measles (rubeola)                        312        17        41        27        11        28        72        28        24        17        26         9        12         -
Meningococcal infections               2,637       155       211       311       251       273       180       204       109       121       202       160       460         -
Mumps                                  1,692       101       132       169       144       186       191       120        80        97       138       126       208         -
Murine typhus fever                       25         -         -         1         -         3         -         5         -         4         4         4         4         -
Pertussis (whooping cough)             6,586       214       236       202       239       298       329       777       876       988     1,061       469       897         -
Plague                                    10         -         -         1         -         2         -         1         4         -         2         -         -         -
Poliomyelitis, paralytic @                 3         -         -         -         -         -         -         1         1         -         -         -         1
Psittacosis                               60         3         7         4         3         8         6         5         7         4         1         7         5         -
Rabies, animal                         9,377       408       512       649       801       994       724       876       930       899     1,001       713       870         -
Rabies, human                              3         -         -         -         -         -         -         -         1         -         -         -         2         -
Rheumatic fever, acute                   112         5        16        12         4        10        28        13         7         1         3         4         9         -
Rocky Mountain spotted fever             456         9         3         3         3        16        38        90        95        69        74        24        32         -
Rubella (German measles)                 192        10         8        25        15        30        20        30        19         7         5         6        17         -
Rubella, congenital syndrome               5         1         1         -         2         -         -         1         -         -         -         -         -         -
Salmonellosis                         41,641     1,909     2,099     2,196     2,188     3,131     3,256     4,819     5,119     4,367     4,980     3,164     4,413         -
Shigellosis                           32,198     1,224     1,554     1,507     1,572     2,511     2,799     3,494     3,665     3,060     4,005     2,725     4,082         -
Syphilis, total all stages +         101,259   ...........25,621..........   ...........26,942..........   ...........24,692..........   ...........24,004..........         -
  Primary and secondary +             26,498   ............6,952..........   ............6,684..........   ............6,621..........   ............6,241..........         -
  Congenital <1 year +                 3,211   ..............678..........   ..............834..........   ..............864..........   ..............835..........         -
Tetanus                                   48         1         1         1         3         5         5         4         7         5         4         3         9         -
Toxic-shock syndrome                     212         7        21        26        23        16        15        19        25        23        15         6        16         -
Trichinosis                               16         1         3         3         -         -         1         -         2         -         2         1         3         -
Tuberculosis                          25,313       778     1,322     1,881     2,105     1,979     2,371     2,003     2,009     1,938     2,028     1,769     5,130         -
Tularemia                                132         3         5         4         3        13        20        24        21        12        12         2        13         -
Typhoid fever                            440        26        24        26        25        40        26        46        38        46        62        30        51         -
Varicella (chickenpox)               134,722    12,815    15,322    18,553    17,373    23,933    13,866     5,129     3,093     2,534     4,038     6,536    11,530
-------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
* AIDS total updated through December 31, 1993.                     & The number of reported cases of non-A, non-B hepatitis is misleading because in some states, reported cases
+ Cases updated through Feburary 28, 1994.                            included persons positive for antibody to hepatitis C virus (anti-HCV) identified in routine screening programs but
                                                                      who did not have acute hepatitis.
                                                                    @ Subject to change due to retrospective case evaluations or late reports.
===========================================================================================================================================================================================

Return to top.

Table_N2
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NOTIFIABLE DISEASES -- reported cases, by geographic division and area, United States,
1993 (Page 1)
----------------------------------------------------------------------------------------------------------------------
                    Total resident                                                         Botulism
                      population                                      Aseptic     --------------------------   Brucel-
Area                (in thousands)     AIDS    Amebiasis   Anthrax   meningitis   Foodborne   Infant   Other    losis
----------------------------------------------------------------------------------------------------------------------
United States          257,908       103,691 *   2,970        -        12,848         27        65       5 +     120
New England             13,230         5,156       112        -           425          -         -       -         1
  Maine                  1,239           149        11        -            41          -         -       -         -
  N.H.                   1,125           124         5        -            55          -         -       -         -
  Vt.                      576            74         7        -            45          -         -       -         -
  Mass.                  6,012         2,703        87        -           177          -         -       -         1
  R.I.                   1,000           348         2        -           107          -         -       -         -
  Conn.                  3,277         1,758        NN        -            NN          -         -       -         -
Mid. Atlantic           38,125        26,115       619        -         1,133          -         8       1         3
  N.Y. (excl. NYC)      10,921         3,565       116        -           575          -         -       -         1
  N.Y.C.                 7,276        13,902       457        -           257          -         2       1         -
  N.J.                   7,879         5,434        16        -            NN          -         3       -         1
  Pa.                   12,048         3,214        30        -           301          -         3       -         1
E.N. Central            43,017         8,069       208        -         2,234          -         6       1        10
  Ohio                  11,091         1,585        18        -           720          -         5       1         1
  Ind.                   5,713           954        25        -           244          -         1       -         -
  Ill.                  11,697         2,959        50        -           562          -         -       -         6
  Mich.                  9,478         1,840        48        -           643          -         -       -         1
  Wis.                   5,038           731        67        -            65          -         -       -         2
W.N. Central            18,054         3,181       173        -           817          -         -       -         3
  Minn.                  4,517           659        58        -           118          -         -       -         -
  Iowa                   2,814           202        31        -           159          -         -       -         2
  Mo.                    5,234         1,745        54        -           275          -         -       -         -
  N. Dak.                  635            11         3        -            20          -         -       -         -
  S. Dak.                  715            29         1        -            22          -         -       -         1
  Nebr.                  1,607           179         4        -            21          -         -       -         -
  Kans.                  2,531           356        22        -           202          -         -       -         -
S. Atlantic             45,738        22,783       198        -         2,645          6         2       -        36
  Del.                     700           375         2        -            70          -         1       -         -
  Md.                    4,965         2,528         9        -           220          -         -       -         -
  D.C.                     578         1,585         -        -            37          -         -       -         -
  Va.                    6,491         1,625        34        -           343          -         -       -         -
  W. Va.                 1,820           106         2        -            56          -         -       -         -
  N.C.                   6,945         1,368        11        -           273          -         -       -        27
  S.C.                   3,643         1,476        NN        -            35          -         -       -         -
  Ga.                    6,917         2,789        90        -           173          5         1       -         5
  Fla.                  13,679        10,931        50        -         1,438          1         -       -         4
E.S. Central            15,717         2,720         7        -           774          2         4       -         1
  Ky.                    3,789           323         1        -           335          1         1       -         -
  Tenn.                  5,099         1,203        NN        -           166          1         -       -         -
  Ala.                   4,187           733         1        -           192          -         -       -         1
  Miss.                  2,643           461         5        -            81          -         3       -         -
W.S. Central            27,983        10,136       102        -         1,500          -         3       -        40
  Ark.                   2,424           404         4        -            79          -         1       -         3
  La.                    4,295         1,464         5        -            91          -         -       -         2
  Okla.                  3,231           725         7        -             1          -         -       -         1
  Tex.                  18,031         7,543        86        -         1,329          -         2       -        34
Mountain                14,776         3,913       177        -           732          3         4       -         6
  Mont.                    839            32         -        -             1          -         -       -         -
  Idaho                  1,099            77         7        -            11          -         2       -         -
  Wyo.                     470            46         3        -             8          1         -       -         -
  Colo.                  3,566         1,324        66        -           240          1         -       -         3
  N. Mex.                1,616           294        21        -           115          -         -       -         1
  Ariz.                  3,936         1,238        70        -           202          -         1       -         2
  Utah                   1,860           264         4        -            74          1         1       -         -
  Nev.                   1,389           638         6        -            81          -         -       -         -
Pacific                 41,269        21,460     1,374        -         2,588         16        38       3        20
  Wash.                  5,255         1,564        49        -            NN          4         5       -         -
  Oreg.                  3,032           778        95        -            NN          -         2       -         -
  Calif.                31,211        18,689     1,193        -         2,428          3        29       3        19
  Alaska                   599            70         6        -            23          9         -       -         -
  Hawaii                 1,172           359        31        -           137          -         2       -         1
----------------------------------------------------------------------------------------------------------------------
  Guam                     133             2         -        -             7          -         -       -         -
  P.R.                   3,522         3,199         -        -            72          -         -       -         -
  V.I.                     102            57         -        -             -          -         -       -         -
  C.N.M.I.                  43             -         -        -             2          -         -       -         -
  American Samoa            47             -         -        -             -          -         -       -         -
----------------------------------------------------------------------------------------------------------------------
* Total reported through December 31, 1993. Total includes 158 cases with unknown state of residence.
+ Includes wound and unspecified botulism.

====================================================================================================================================

NOTIFIABLE DISEASES -- reported cases, by geographic division and area, United States,
1993 (Page 2)
---------------------------------------------------------------------------------------------------------------------------------
                                                              Encephalitis
                                                         -----------------------                                         Hansen
                                                          Primary        Post-      Gonor-    Granuloma   Haemophilus    disease
Area                  Chancroid   Cholera   Diphtheria   infections   infectious     rhea     inguinale   influenzae    (leprosy)
---------------------------------------------------------------------------------------------------------------------------------
UNITED STATES            1,399 *     18         -            919          170       439,673 *     19 *       1,419         187
New England                  5        2         -             26            8         8,391        -            59           7
  Maine                      -        -         -              3            -            80        -             4           -
  N.H.                       3        -         -              -            2            83        -             6           -
  Vt.                        -        -         -              6            -            25        -             3           -
  Mass.                      2        -         -             12            4         3,118        -            35           7
  R.I.                       -        1         -              5            2           427        -             2           -
  Conn.                      -        1         -              -            -         4,658        -             9           -
Mid. Atlantic              618        -         -             63           11        54,796        -           135          18
  N.Y. (excl. NYC)           5        -         -             45            6        10,887        -            43           1
  N.Y.C.                   613        -         -              3            -        19,240        -            34          14
  N.J.                       -        -         -              -            -         6,444        -            27           3
  Pa.                        -        -         -             15            5        18,225        -            31           -
E.N. Central               115        3         -            226           22        80,638        1           221           4
  Ohio                      21        1         -             72            4        22,286        1           125           1
  Ind.                       3        -         -             20            5         8,656        -            12           -
  Ill.                      91        2         -             62            3        28,412        -            57           2
  Mich.                      -        -         -             54           10        18,014        -            18           -
  Wis.                       -        -         -             18            -         3,270        -             9           1
W.N. Central                 3        -         -             56           17        22,415        1           180           1
  Minn.                      1        -         -             18            -         2,543        -            21           -
  Iowa                       -        -         -              7            2         1,915        1             8           -
  Mo.                        1        -         -             11           15        13,148        -           135           -
  N. Dak.                    -        -         -              5            -            54        -             -           -
  S. Dak.                    -        -         -              7            -           270        -             2           -
  Nebr.                      -        -         -              1            -           714        -             9           1
  Kans.                      1        -         -              7            -         3,771        -             5           -
S. Atlantic                 86        2         -            231           78       124,475       13           244          13
  Del.                       1        -         -              3            -         1,586        -             -           -
  Md.                        -        -         -             25            -        13,548        -            52           1
  D.C.                       1        -         -              -            1         6,162        -             1           -
  Va.                        3        1         -             44            7        12,022        -            28           -
  W. Va.                     1        -         -            117            -           635        -            10           -
  N.C.                      13        -         -             31            -        24,187        1            23           1
  S.C.                       -        -         -              -            -        10,953        -            40           -
  Ga.                       21        -         -              2            -        31,483       12            71           -
  Fla.                      46        1         -              9           70        23,899        -            19          11
E.S. Central                35        -         -             37            7        45,173        -            56           2
  Ky.                        4        -         -             21            6         4,627        -            16           -
  Tenn.                      8        -         -             10            -        14,285        -            12           -
  Ala.                      23        -         -              3            -        15,793        -            18           2
  Miss.                      -        -         -              3            1        10,468        -            10           -
W.S. CENTRAL               517        2         -             80            2        55,795        1           109          33
  Ark.                     170        -         -              3            -         7,590        -             8           -
  La.                      310        -         -             10            -        13,323        1             4           -
  Okla.                      -        -         -              8            -         4,759        -            46           2
  Tex.                      37        2         -             59            2        30,123        -            51          31
Mountain                     8        3         -             21            5        11,549        1           125           6
  Mont.                      -        -         -              -            1            81        -             5           -
  Idaho                      -        -         -              -            -           171        -             3           1
  Wyo.                       1        -         -              -            -            85        -             5           -
  Colo.                      -        1         -             14            -         3,803        -            24           -
  N. Mex.                    -        -         -              4            2         1,014        -             9           -
  Ariz.                      3        -         -              -            -         4,176        1            31           3
  Utah                       4        2         -              1            1           350        -            12           1
  Nev.                       -        -         -              2            1         1,869        -            36           1
PACIFIC                     12        6         -            179           20        36,441        2           290         103
  Wash.                      -        -         -              1            -         3,740        -            19           9
  Oreg.                      -        -         -              -            -         1,189        -            11           -
  Calif.                    12        6         -            167           20        29,970        2           240          75
  Alaska                     -        -         -             10            -           678        -             6           1
  Hawaii                     -        -         -              1            -           864        -            14          18
---------------------------------------------------------------------------------------------------------------------------------
  Guam                       -        -         -              -            -            83        -             -           4
  P.R.                      25        -         -              -            -           527        1             3           -
  V.I.                       5        -         -              -            -            84        -             -           -
  C.N.M.I.                   -        -         -              1            -             -        -            24           2
  American Samoa             -        -         -              -            -             -        -             -           -
---------------------------------------------------------------------------------------------------------------------------------
* Cases updated through February 28, 1994.

====================================================================================================================================

NOTIFIABLE DISEASES -- reported cases, by geographic division and area, United States,
1993 (Page 3)
-------------------------------------------------------------------------------------------------------------------------------
                                                   Hepatitis                                                 Lympho-
                                                     non-A,    Hepatitis   Legionel-    Lepto-     Lyme     granuloma
Area                   Hepatitis A   Hepatitis B     non-B       unsp.      losis      spirosis   disease   venereum    Malaria
-------------------------------------------------------------------------------------------------------------------------------
United States             24,238        13,361       4,786 *      627       1,280         51       8,257       285 +     1,411
New England                  448           356         106         13          66          -       1,815         8          97
  Maine                       14            11           2          -           6          -          18         -           7
  N.H.                        18            27           8          -           2          -          15         1           4
  Vt.                          9            10           6          -           3          -          12         -           3
  Mass.                      213           214          77         13          32          -         148         7          46
  R.I.                        77            19          13          -          23          -         272         -           7
  Conn.                      117            75           -          -          NN          -       1,350         -          30
Mid. Atlantic              1,665         1,574         398          7         253          3       4,689       184         325
  N.Y. (excl. NYC)           464           457         259          1          89          2       2,758        12         123
  N.Y.C.                     722           353           3          -           3          -          60       172         126
  N.J.                       295           407          98          -          33          1         786         -          51
  Pa.                        184           357          38          6         128          -       1,085         -          25
E.N. Central               2,727         1,497         595         15         327          5         505         4          93
  Ohio                       338           192          37          -         154          2          30         4          15
  Ind.                       646           249          15          1          49          -          32         -           2
  Ill.                     1,023           344         102          7          26          3          19         -          46
  Mich.                      213           393         400          7          62          -          23         -          19
  Wis.                       507           319          41          -          36          -         401         -          11
W.N. Central               2,372           802          79         27          95          8         319         2          45
  Minn.                      497            96          14          4           3          -         141         -          21
  Iowa                        60            36           9          4          19          3           8         -           5
  Mo.                      1,443           585          25         19          33          3         108         1           9
  N. Dak.                     80             1           3          -           2          -           2         -           1
  S. Dak.                     18             -           -          -           -          -           -         1           2
  Nebr.                      195            19          11          -          30          2           6         -           4
  Kans.                       79            65          17          -           8          -          54         -           3
S. Atlantic                1,329         2,408         723         95         219          2         639        60         338
  Del.                        12            18           1          -           4          1         143         -           2
  Md.                        159           265          42          3          56          -         180         2          48
  D.C.                        11            43           3          -          15          -           2         8          11
  Va.                        156           157          54         43          11          -          95         7          41
  W. Va.                      29            44          43          -           4          -          50         -           2
  N.C.                        94           315          80          -          27          1          86        16         145
  S.C.                        18            51           5          1          19          -           9         -           7
  Ga.                        145           670         451          1          36          -          44        22          20
  Fla.                       705           845          44         47          47          -          30         5          62
E.S. Central                 364         1,748       1,025          4          44          2          40         3          29
  Ky.                        142            99          16          -          19          -          16         1           5
  Tenn.                      104         1,152         994          3          17          1          20         1          12
  Ala.                        58           107           5          1           2          1           4         1           7
  Miss.                       60           390          10          -           6          -           -         -           5
W.S. Central               3,190         1,909         645        173          51          6          78        14          65
  Ark.                        74            90           5          3           6          1           8         -           4
  La.                        105           269         178          4          10          5           3        12           7
  Okla.                      213           195          50          9          13          -          19         -           6
  Tex.                     2,798         1,355         412        157          22          -          48         2          48
Mountain                   4,164           686         366         79          81          -          20         1          40
  Mont.                       77            28           3          -           7          -           -         -           2
  Idaho                      298            89           -          3           1          -           2         -           1
  Wyo.                        17            34         119          -           7          -           9         -           -
  Colo.                      877            81          62         44           9          -           -         -          25
  N. Mex.                    400           215         107          3           6          -           2         -           5
  Ariz.                    1,493            96          13         14          17          -           -         1           1
  Utah                       828            69          42         13          16          -           2         -           2
  Nev.                       174            74          20          2          18          -           5         -           4
Pacific                    7,979         2,381         849        214         144         25         152         9         379
  Wash.                      926           247         219         11          12          -           9         4          41
  Oreg.                      532           221          55          2           1          1           8 &       1          14
  Calif.                   5,677         1,876         560        198         121          -         134         4         314
  Alaska                     775            15          12          -           -          -           -         -           3
  Hawaii                      69            22           3          3          10         24           1         -           7
-------------------------------------------------------------------------------------------------------------------------------
  Guam                         3             6           -         11           -          -           -         -            3
  P.R.                        79           412          90          2           -         11           -         1            -
  V.I.                         1             6           -          -           -          -           -         -            -
  C.N.M.I.                     -             2           -          1           -          1           -         -            2
  American Samoa              20             1           -          -           -          -           -         -            -
-------------------------------------------------------------------------------------------------------------------------------
* The number of reported cases of non-A, non-B hepatitis is misleading because in some states, reported cases included persons
  positive for antibody to hepatitis C virus (anti-HCV) identified in routine screening programs but who did not have hepatitis.
+ Cases updated through February 28, 1994.
& Voluntarily reportable for this state.

====================================================================================================================================

NOTIFIABLE DISEASES -- reported cases, by geographic division and area, United States,
1993 (Page 4)
-----------------------------------------------------------------------------------------------------------
                              Measles           Meningo-            Murine                         Polio-
                       ---------------------     coccal             typhus                        myelitis,
Area                   Indigenous   Imported   infections   Mumps   fever    Pertussis   Plague   paralytic
-----------------------------------------------------------------------------------------------------------
United States             237          75 *      2,637      1,692     25       6,586       10         3 +
New England                54           9          133         15      -         834        -         -
  Maine                     1           -           15          -      -          20        -         -
  N.H.                      2           -            6          3      -         168        -         -
  Vt.                      30           1            7          1      -         122        -         -
  Mass.                    11           7           72          1      -         408        -         -
  R.I.                      1           1            -          2      -          14        -         -
  Conn.                     9           -           33          8      -         102        -         -
Mid. Atlantic              22          19          310        135      2         991        -         1
  N.Y. (excl. NYC)          4           7          126         46      1         373        -         -
  N.Y.C.                   12           7           37          2      1         116        -         1
  N.J.                      6           5           50         17      -          85        -         -
  Pa.                       -           -           97         70      -         417        -         -
E.N. Central               20          11          375        259      -       1,627        -         -
  Ohio                      6           3          108         74      -         523        -         -
  Ind.                      1           -           51          8      -         178        -         -
  Ill.                      5           4          104         74      -         434        -         -
  Mich.                     5           1           65         80      -         116        -         -
  Wis.                      3           3           47         23      -         376        -         -
W.N. Central                1           2          142         67      -         626        -         -
  Minn.                     -           -           23          2      -         393        -         -
  Iowa                      -           -           28         11      -          38        -         -
  Mo.                       1           -           34         46      -         144        -         -
  N. Dak.                   -           -            3          6      -           5        -         -
  S.  Dak.                  -           -            7          -      -           8        -         -
  Nebr.                     -           -           11          1      -          14        -         -
  Kans.                     -           2           36          1      -          24        -         -
S. Atlantic                25           8          470        463      1         673        -         1
  Del.                      -           -           15          1      -          11        -         -
  Md.                       -           4           60         82      -         133        -         1
  D.C.                      -           -            6          1      -          14        -         -
  Va.                       -           4           52         40      1          75        -         -
  W. Va.                    -           -           19         23      -           8        -         -
  N.C.                      1           -           67        231      -         199        -         -
  S.C.                      -           -           31         17      -          73        -         -
  Ga.                       -           -           94         20      -          56        -         -
  Fla.                     24           -          126         48      -         104        -         -
E.S. Central                1           -          154         58      1         297        -         -
  Ky.                       -           -           25          -      -          38        -         -
  Tenn.                     -           -           45         19      1         183        -         -
  Ala.                      1           -           53         22      -          65        -         -
  Miss.                     -           -           31         17      -          11        -         -
W.S. Central                8           3          264        274     13         239        1         -
  Ark.                      -           -           27         10      1          18        -         -
  La.                       1           -           46         20      -          14        -         -
  Okla.                     -           -           34         13      -          86        -         -
  Tex.                      7           3          157        231     12         121        1         -
Mountain                    4           3          211         81      -         464       10         -
  Mont.                     -           -           13          -      -          11        -         -
  Idaho                     -           -           21          6      -         101        -         -
  Wyo.                      -           -            5          5      -           2        -         -
  Colo.                     3           -           41         18      -         187        2         -
  N. Mex.                   -           -            8         NN      -          43        6         -
  Ariz.                     -           3           86         19      -          70        -         -
  Utah                      -           -           24          6      -          45        1         -
  Nev.                      1           -           13         27      -           5        -         -
Pacific                   102          20          578        340      8         835        -         1
  Wash.                     -           -           97         14      -          91        -         1
  Oreg.                     -           4          110         NN      -         106        -         -
  Calif.                   89           7          346        285      8         619        -         -
  Alaska                    2           -           15         11      -           5        -         -
  Hawaii                   11           9           10         30      -          14        -         -
-----------------------------------------------------------------------------------------------------------
  Guam                     22           3            1         13      -           -        -         -
  P.R.                    356           -           14          3      -          11        -         -
  V.I.                      -           -            -          5      -           -        -         -
  C.N.M.I.                 92           1            -         15      -           1        -         -
  American Samoa            -           -            -          5      -           2        -         -
-----------------------------------------------------------------------------------------------------------
* For measles only, imported includes both out-of-state and international importations.
+ Ten suspected cases of paralytic poliomyelitis were reported in 1993. Three cases have been confirmed as of August 12, 1994,
  two of which were vaccine-associated; one was classified as imported. The number of reported cases is subject to change due
  to retrospective case evaluations or late reports.

====================================================================================================================================

NOTIFIABLE DISEASES -- reported cases, by geographic division and area, United States,
1993 (Page 5)
----------------------------------------------------------------------------------------------------------------
                                                                             Rubella
                                     Rabies        Rheumatic            ------------------
                       Psitta-   ---------------    fever,                         Cong.     Salmonel-   Shigel-
Area                   cosis     Animal    Human     acute     RMSF *   Rubella   syndrome     losis      losis
----------------------------------------------------------------------------------------------------------------
United States            60      9,377       3        112      456        192        5        41,641     32,198
New England               2      1,695       -          2        4         10        -         3,882        605
  Maine                   -          -       -          1        -          1        -           158          8
  N.H.                    -        148       -         NN        -          -        -           220         17
  Vt.                     1         45       -          -        -          -        -           421          8
  Mass.                   1        720       -          -        4          9        -         2,041        285
  R.I.                    -          2       -          -        -          -        -           231         42
  Conn.                   -        780       -          1        -          -        -           811        245
Mid. Atlantic            16      3,585       1          -       28         59        2         7,005      2,218
  N.Y. (excl. NYC)        5      2,692       1         NN        7         17        1         2,390        790
  N.Y.C.                  -         53       -         NN        1         22        -         1,601        554
  N.J.                    2        458       -          -       10         15        -         1,215        347
  Pa.                     9        382       -         NN       10          5        1         1,799        527
E.N. Central              8        110       -         33       18          8        -         5,810      5,111
  Ohio                    4          6       -          5        8          1        -         1,214      1,411
  Ind.                    -         12       -          -        4          3        -           543        811
  Ill.                    1         23       -          2        4          1        -         2,232      1,722
  Mich.                   1         18       -         21        2          2        -           815        829
  Wis.                    2         51       -          5        -          1        -         1,006        338
W.N. Central              3        351       -         26       34          1        -         1,924      1,509
  Minn.                   -         45       -          7        1          -        -           551        240
  Iowa                    2         79       -          2        7          -        -           241         69
  Mo.                     1         35       -          -       20          1        -           529        674
  N. Dak.                 -         57       -         NN        -          -        -            60          7
  S. Dak.                 -         49       -         14        3          -        -            99        111
  Nebr.                   -          7       -         NN        2          -        -           145        200
  Kans.                   -         79       -          3        1          -        -           299        208
S. Atlantic               8      2,165       -          -      215          7        -         8,502      7,049
  Del.                    -        135       -         NN        -          -        -           185        178
  Md.                     2        605       -         NN       14          3        -           936        384
  D.C.                    -         18       -         NN        -          -        -           102         87
  Va.                     1        387       -         NN       14          -        -         1,055        776
  W. Va.                  -         90       -          -        6          -        -           109         38
  N.C.                    4        107       -         NN      129          -        -         1,121      2,305
  S.C.                    1        165       -         NN       11          -        -           738        414
  Ga.                     -        471       -         NN       37          -        -         1,316        474
  Fla.                    -        187       -         NN        4          4        -         2,940      2,393
E.S. Central              1        260       -          -       63          1        -         1,879      1,849
  Ky.                     -         20       -         NN       16          1        -           302        171
  Tenn.                   1        124       -         NN       32          -        -           558        938
  Ala.                    -        116       -         NN        4          -        -           554        375
  Miss.                   -          -       -         -        11          -        -           465        365
W.S. Central              2        635       1         -        77         24        -         3,297      5,748
  Ark.                    -         42       -         -        17          -        -           402        201
  La.                     -         17       -        NN         2          1        -           650        482
  Okla.                   1         65       -        NN        51          1        -           321        484
  Tex.                    1        511       1        NN         7         22        -         1,924      4,581
Mountain                  3        178       -        28        16         12        -         2,018      1,921
  Mont.                   -         24       -        NN         2          -        -           106         56
  Idaho                   1          8       -        NN         -          2        -           173         46
  Wyo.                    -         25       -         1        10          -        -            59         22
  Colo.                   -         29       -         5         4          3        -           550        611
  N. Mex.                 1          9       -         3         -          -        -           326        411
  Ariz.                   -         60       -        NN         -          2        -           519        693
  Utah                    1          8       -        19         -          4        -           154         42
  Nev.                    -         15       -        NN         -          1        -           131         40
Pacific                  17        398       1        23         1         70        3         7,324      6,188
  Wash.                   4          -       -         -         -          -        -           832        797
  Oreg.                   4          7       -        NN         1          -        -           349        169
  Calif.                  9        363       1        20         -         41        3         5,739      5,093
  Alaska                  -         28       -         3         -          1        -            59         30
  Hawaii                  -          -       -        NN         -         28        -           345         99
----------------------------------------------------------------------------------------------------------------
  Guam                    -          -       -         2         -          -        -           119         35
  P.R.                    -         43       -         -         -          -        -           734         46
  V.I.                    -          -       -         -         -          -        -             5          1
  C.N.M.I.                -          -       -        10         -          -        -            54         73
  American Samoa          -          -       -         1         -          -        -            55         17
----------------------------------------------------------------------------------------------------------------
* Rocky Mountain spotted fever.

====================================================================================================================================

NOTIFIABLE DISEASES -- reported cases, by geographic division and area, United States,
1993 (Page 6)
--------------------------------------------------------------------------------------------------------------------------------
                                  Syphilis
                       -------------------------------              Toxic-                                             Varicella
                       Primary &      Cong.      All                shock     Trich-   Tuber-                Typhoid   (chicken-
Area                   secondary    (<1 yr.)    stages   Tetanus   syndrome   inosis   culosis   Tularemia    fever      pox)
--------------------------------------------------------------------------------------------------------------------------------
United States           26,498 *     3,211 *   101,259 *   48        212        16     25,313       132        440      134,722
New England                330          17       1,713      2         13         -        649         -         31       12,655
  Maine                      7           -          19      -          3         -         27         -          -        1,733
  N.H.                      26           -          50      -          3         -         26         -          2        1,635
  Vt.                        1           -           1      -          1         -          7         -          -           NN
  Mass.                    122           6         935      2          5         -        370         -         23        6,619
  R.I.                      16           1         146      -          1         -         64         -          -        2,668
  Conn.                    158          10         562      -          -         -        155         -          6           NN
Mid. Atlantic            2,415       1,070      19,306      2         33         4      5,611         2        139        4,773
  N.Y. (excl. NYC)         258          94       1,980      -         17         4        718         2         20           NA
  N.Y.C.                 1,132         654      10,513      -          1         -      3,235         -         95        4,773
  N.J.                     328         161       2,556      -          -         -        912         -         18           NN
  Pa.                      697         161       4,257      2         15         -        746         -          6           NN
E.N. Central             4,070         527      11,789      7         48         2      2,385         5         40       64,380
  Ohio                   1,180          70       2,889      2         12         -        315         -          7        5,472
  Ind.                     362           1       1,019      1          1         -        248         1          2           NN
  Ill.                   1,489         368       4,881      1         11         2      1,242         3         23       26,447
  Mich.                    543          84       1,952      3         24         -        480         1          7       32,461
  Wis.                     496           4       1,048      -          -         -        100         -          1           NA
W.N. Central             1,631         111       3,271     10         15         -        582        39          2       16,814
  Minn.                     66           9         261      6          3         -        141         -          -           NN
  Iowa                      64           1         175      1          7         -         59         -          -        5,057
  Mo.                    1,354          97       2,500      1          2         -        257        17          2        9,609
  N. Dak.                    1           -           4      -          -         -          7         -          -           37
  S. Dak.                    2           -           3      -          -         -         16        17          -          420
  Nebr.                     14           1          35      -          -         -         22         2          -            4
  Kans.                    130           3         293      2          3         -         80         3          -        1,687
S. Atlantic              6,513         586      24,237      8         24         6      4,626         4         63        8,332
  Del.                      94           3         274      -          -         -         66         -          1            3
  Md.                      359          30       1,865      2          1         3        406         -          8           NN
  D.C.                     291          74       1,652      -          -         -        161         -          -            4
  Va.                      660          23       1,970      -          7         1        458         -          7        2,917
  W. Va.                     8           6         195      -          -         -         75         -          -        5,288
  N.C.                   1,937          54       4,448      -          4         -        594         2          3           NN
  S.C.                     921          82       2,339      1          -         -        401         -          -          120
  Ga.                    1,052          79       4,077      -          2         -        810         -          3           NN
  Fla.                   1,191         235       7,417      5         10         2      1,655         2         41           NN
E.S. Central             4,117         158      10,494      3         11         -      1,727         4          7        3,981
  Ky.                      331           9         651      -          3         -        405         1          2        1,429
  Tenn.                  1,156          52       3,241      2          4         -        556         2          2        2,552
  Ala.                     869          27       2,333      1          2         -        487         1          3           NN
  Miss.                  1,761          70       4,269      -          2         -        279         -          -           NN
W.S. Central             5,969         409      19,079      9          2         -      3,181        58         19       14,292
  Ark.                     559           8       1,600      1          -         -        209        36          2           NN
  La.                    2,598         144       6,854      -          -         -        367        --          1           NN
  Okla.                    282          11         721      1          2         -        209        17          1            -
  Tex.                   2,530         246       9,904      7          -         -      2,396         5         15       14,291
Mountain                   256          27       1,251      1         16         1        592        12         11        7,192
  Mont.                      1           -           4      -          -         -         22         5          -           84
  Idaho                      2           -          15      -          2         -         12         -          -           NN
  Wyo.                       4           -           9      -          -         1          7         3          -           NN
  Colo.                     90           8         287      1          2         -        102         1          5           NN
  N. Mex.                   34           -         172      -          1         -         74         -          2           NN
  Ariz.                     95          16         557      -          2         -        231         -          3        6,811
  Utah                      10           -          68      -          7         -         46         2          1          297
  Nev.                      20           3         139      -          2         -         98         1          -           NN
Pacific                  1,197         306      10,119      6         50         3      5,960         8        128        2,303
  Wash.                     67           4         360      1          7         -        286         2          8           NN
  Oreg.                     39           4         179      -          -         -        154         3          4           NN
  Calif.                 1,073         298       9,488      5         42         1      5,212         3        113           NN
  Alaska                    11           -          51      -          -         -         57         -          -           NN
  Hawaii                     7           -          41      -          1         2        251         -          3        2,303
--------------------------------------------------------------------------------------------------------------------------------
  Guam                       -           -           5      -          -         -         NA         -          4          553
  P.R.                     470          18       2,482      2          -         -        253         -          -        8,228
  V.I.                      12           1          39      1          -         -          4         -          -          486
  C.N.M.I.                   -           -           -      -          -         -         NA         -          -          178
  American Samoa             -           -           -      -          -         -         NA         -          1          176
--------------------------------------------------------------------------------------------------------------------------------
* Cases updated through February 28, 1994.


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Table_N3
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NOTIFIABLE DISEASES - summary of reported cases, by age group, United States, 1993
===========================================================================================================================================================================================
                                                                                                                                                                Age
                                                                                                                                                                not
Disease                               Total    Under 1      1-4       5-9     10-14     15-19     20-24     25-29     30-39     40-49     50-59      60+     stated
-------------------------------------------------------------------------------------------------------------------------------------------------------------------
AIDS *                              103,691       328       352       148       138       487     3,771    14,795    47,064    26,602     7,423     2,583         -
Amebiasis                             2,970        13       119       147        70        82       123       200       394       234       121        98     1,369
Anthrax                                   -         -         -         -         -         -         -         -         -         -         -         -         -
Aseptic meningitis                   12,848     2,668       917     1,297       913       803     1,091     1,276     2,068       702       267       328       518
Botulism, total                          97        63         1         -         -         -         1         1         3         5         3        11         9
Brucellosis                             120         1         1        12         1         7        11        11        27        18        13        12         6
Cholera                                  18         -         2         -         -         1         -         4         5         1         3         2         -
Diphtheria                                -         -         -         -         -         -         -         -         -         -         -         -         -
Encephalitis, primary infections        919        65        78       115        99        58        58        51       115        79        50       136        15
  Post-infectious                       170        12        25        28         9        10        11         9        20        13         9        23         1
Gonorrhea +                         440,149         -         -         -     8,249   116,974   119,739    62,217    64,110   ...........23,563..........    43,660
Haemophilus influenzae                1,419       288       147        57        32        34        23        28        93        70       100       476        71
Hansen disease (leprosy)                187         -         1         -         3         5        18        16        30        25        18        50        21
Hepatitis A                          24,238       141     1,442     3,075     2,120     1,845     2,520     2,772     4,378     1,912       904     1,237     1,892
Hepatitis B                          13,361        63        78       100       201       915     1,768     2,108     3,670     1,868       800       796       994
Hepatitis, non-A, non-B &             4,786        34        16        23        28        74       245       522     1,881     1,106       290       439       128
Hepatitis, unspecified                  627         4        28        49        33        26        54        74       147        85        49        51        27
Legionellosis                         1,280         4         5         -         7         9        20        35       136       180       188       646        50
Leptospirosis                            51         -         -         4         5         2        10         3        11         7         2         1         6
Lyme disease                          8,257        13       334       621       490       325       312       399     1,161     1,169       845     1,391     1,197
Malaria                               1,411        16        77        69        70        99       234       177       324       158        77        65        45
Measles (rubeola)                       312        34        85        52        35        27        24        14        31         5         1         -         4
Meningococcal infections              2,637       444       480       227       199       297       173        82       127       104        93       270       141
Mumps                                 1,692        14       284       497       316       186        88        50       111        44        18         8        76
Murine typhus fever                      25         -         -         -         1         2         -         1         5         7         2         7         -
Pertussis (whooping cough)            6,586     2,838     1,378       737       552       275        98        92       242       164        45        34       131
Plague                                   10         -         -         -         -         -         2         -         2         1         -         5         -
Poliomyelitis, paralytic @                3         -         1         -         -         -         -         -         2         -         -         -         -
Psittacosis                              60         -         -         -         2         4         1         2        19        16         7         6         3
Rabies, human                             3         -         -         -         1         -         -         -         -         -         -         2         -
Rheumatic fever, acute                  112         -         4        12        34         4         1         1        10         2         -         1        43
Rocky Mountain spotted fever            456         4        38        58        40        24        21        17        70        54        46        69        15
Rubella (German measles)                192        15        17        19        13         8        33        24        34        16         4         2         7
Salmonellosis                        41,641     5,162     5,747     2,344     1,457     1,584     2,337     2,283     4,099     2,796     1,752     4,169     7,911
Shigellosis                          32,198       744     8,849     5,859     1,500       863     1,501     1,690     2,457       930       455       652     6,698
Syphilis, primary and secondary +    26,546         -         -         -       174     2,940     5,469     5,176     8,040   ............4,686..........        35
Tetanus                                  48         -         -         -         -         1         3         3         3         4         8        26         -
Toxic-shock syndrome                    212         -         6         2        15        32        27        28        55        25        11         8         3
Trichinosis                              16         -         -         -         -         2         1         2         1         4         4         -         2
Tuberculosis                         25,313       220       856       355       290       580     1,263     1,965     5,255     4,302     3,021     7,162        44
Tularemia                               132         1        18        13        14         9         3         9        12        13         7        27         6
Typhoid fever                           440         4        39        58        38        38        55        56        83        29        13        18         9
Varicella (chickenpox)              134,722       775     6,896    20,068     3,682       848       330       254       227        68        35        73   101,466
-------------------------------------------------------------------------------------------------------------------------------------------------------------------
* AIDS total updated through December 31, 1993.
+ Age data are collected on aggregate forms different from those used for numbers of reported cases. Therefore, total cases reported on this table may differ slightly from other tables.
  Cases among persons <=9 years of age are not shown because some of these may not be due to sexual transmission;  however, they are included in the totals.
& The number of reported cases of non-A, non-B hepatitis is misleading because in some states, reported cases included persons positive for antibody to hepatitis C virus (anti-HCV)
  who were identified in routine screening programs but who did not have acute hepatitis.
@ Subject to change due to retrospective case evaluations or late reports.
===========================================================================================================================================================================================

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Table_N4
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NOTIFIABLE  DISEASES -- summary of reported cases, by race, * United States, 1993
======================================================================================================================================================================================
                                              American Indian        Asian or                                     Race not
Disease                               Total   or Alaska Native   Pacific Islander     Black     White     Other    stated +
---------------------------------------------------------------------------------------------------------------------------
AIDS &                              103,691           339                765         38,514    48,222         -     15,851
Amebiasis                             2,970             7                140             88       570         3      2,162
Anthrax                                   -             -                  -              -         -         -          -
Aseptic meningitis                   12,848            42                211          1,780     7,210        36      3,569
Botulism, total                          97             9                  2              8        54         -         24
Brucellosis                             120             -                  2             25        58         -         35
Cholera                                  18             -                  1              1         6         -         10
Diphtheria                                -             -                  -              -         -         -          -
Encephalitis, primary infections        919             4                 12             88       603         2        210
  Post-infectious                       170             -                  1             21       110         2         36
Gonorrhea @                         440,149         1,708              1,340        270,829    41,346         -    124,926
Haemophilus influenzae                1,419            17                 21            211       805         1        364
Hansen disease (leprosy)                187             -                 61              7        52         2         65
Hepatitis A                          24,238         1,217                461          2,336    12,528        84      7,612
Hepatitis B                          13,361            76                708          2,953     5,435        48      4,141
Hepatitis, non-A, non-B **            4,786            46                 40            646     2,382         1      1,671
Hepatitis, unspecified                  627             4                 10             64       339         9        201
Legionellosis                         1,280             3                 13            117       865         1        281
Leptospirosis                            51             -                  8              1        25         -         17
Lyme disease                          8,257            13                 39            121     4,855         2      3,227
Malaria                               1,411             4                293            347       424        20        323
Measles (rubeola)                       312             1                 32             24       191         -         64
Meningococcal infections              2,637            15                 37            323     1,626        19        617
Mumps                                 1,692             5                 40            286       817         5        539
Murine typhus fever                      25             -                  -              3        21         -          1
Pertussis (whooping cough)            6,586            33                 38            434     2,539         7      3,535
Plague                                   10             1                  -              -         7         -          2
Poliomyelitis, paralytic ++               3             -                  -              1         2         -          -
Psittacosis                              60             -                  -              3        38         -         19
Rabies, human                             3             -                  -              -         3         -          -
Rheumatic fever, acute                  112            13                  2              -        30         1         66
Rocky Mountain spotted fever            456            24                  1             18       341         -         72
Rubella (German measles)                192             1                 31              4       115         -         41
Rubella, congenital syndrome              5             -                  -              1         2         -          2
Salmonellosis                        41,641           166                481          3,580    17,196        30     20,188
Shigellosis                          32,198           341                147          5,566    12,847        16     13,281
Syphilis, primary and secondary @    26,546            37                 84         22,330     2,230         -      1,865
Tetanus                                  48             -                  1              4        33         -         10
Toxic-shock syndrome                    212             -                  4             10       160         1         37
Trichinosis                              16             -                  1              2         9         -          4
Tuberculosis                         25,313           278              3,739          9,175    11,978         -        143
Tularemia                               132            18                  -              2        93         -         19
Typhoid fever                           440             -                117             40        78        14        191
Varicella (chickenpox)              134,722             2                 94          1,615       477         -    132,534
---------------------------------------------------------------------------------------------------------------------------
 * Some information on race/ethnicity was reported using one variable with the following categories: American Indian or Alaska Native, Asian or Pacific Islander, Black non-Hispanic,
   White non-Hispanic, and Hispanic. Race not stated includes cases originally reported as Hispanic.
 + Includes cases originally reported as Hispanic: 15,681 for AIDS; 16,150 for Gonorrhea; and 1,338 for Syphilis, primary and secondary.
 & AIDS total reported through December 31, 1993.
 @ Race data are collected on aggregate forms different from those used for numbers of reported cases. Therefore, total cases reported on this table may differ slightly from other
   tables.
** The number of reported cases of non-A, non-B hepatitis is misleading because in some states, reported cases included persons positive for antibody to hepatitis C virus (anti-HCV)
   who were identified in routine screening programs but who did not have acute hepatitis.
++ Subject to change due to retrospective case evaluations or late reports.
======================================================================================================================================================================================

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Table_N5
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NOTIFIABLE DISEASES -- summary of reported cases, by ethnicity, * United States, 1993
=======================================================================================================================================
                                                                        Ethnicity not
Disease                               Total   Hispanic   Non-Hispanic          stated
-------------------------------------------------------------------------------------
AIDS +                              103,691     15,681         86,736           1,274
Amebiasis                             2,970        260            518           2,192
Anthrax                                   -          -              -               -
Aseptic meningitis                   12,848      1,545          6,096           5,207
Botulism, total                          97         11             55              31
Brucellosis                             120         58             15              47
Cholera                                  18         13              1               4
Diphtheria                                -          -              -               -
Encephalitis, primary infections        919         52            409             458
  Post-infectious                       170         18             94              58
Gonorrhea &                         440,149     16,150        312,175         111,824
Haemophilus influenzae                1,419         78            722             619
Hansen disease (leprosy)                187         67             90              30
Hepatitis A                          24,238      4,251         11,912           8,075
Hepatitis B                          13,361        928          6,525           5,908
Hepatitis, non-A, non-B @             4,786        364          1,962           2,460
Hepatitis, unspecified                  627        151            294             182
Legionellosis                         1,280         21            652             607
Leptospirosis                            51          -             15              36
Lyme disease                          8,257         92          2,980           5,185
Malaria                               1,411        105            897             409
Measles (rubeola)                       312         43            201              68
Meningococcal infections              2,637        219          1,403           1,015
Mumps                                 1,692        271            716             705
Murine typhus fever                      25          6             16               3
Pertussis (whooping cough)            6,586        422          1,740           4,424
Plague                                   10          2              5               3
Poliomyelitis, paralytic **               3          -              3               -
Psittacosis                              60          3             29              28
Rabies, human                             3          1              2               -
Rheumatic fever, acute                  112          5             21              86
Rocky Mountain spotted fever            456          4            246             206
Rubella (German measles)                192         36            104              52
Rubella, congenital syndrome              5          -              3               2
Salmonellosis                        41,641      2,248         13,620          25,773
Shigellosis                          32,198      3,436         11,523          17,239
Syphilis, primary and secondary &    26,546      1,338         24,560             648
Tetanus                                  48          9             19              20
Toxic-shock syndrome                    212          7            119              86
Trichinosis                              16          1              6               9
Tuberculosis                         25,313      5,197         19,876             240
Tularemia                               132          2             47              83
Typhoid fever                           440        141            191             108
Varicella (chickenpox)              134,722      1,297          2,178         131,247
-------------------------------------------------------------------------------------
 * Some information on race/ethnicity was reported using one variable with the following categories: American Indian or Alaska
   Native, Asian or Pacific Islander, Black non-Hispanic, White non-Hispanic, and Hispanic. Ethnicity not stated includes cases
   originally reported as American Indian or Alaska Native and Asian or Pacific Islander.
 + AIDS total reported through December 31, 1993.
 & Ethnicity data are collected on aggregate forms different from those used for numbers of reported cases. Therefore, total cases
   reported on this table may differ slightly from other tables.
 @ The number of reported cases of non-A, non-B hepatitis is misleading because in some states, reported cases included persons
   positive for antibody to hepatitis C virus (anti-HCV) who were identified in routine screening programs but who did not have acute
   hepatitis.
** Subject to change due to retrospective case evaluations or late reports.
=======================================================================================================================================

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TABLE_1
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TABLE 1. NOTIFIABLE DISEASES -- summary of reported cases, United States, 1984-1993
=================================================================================================================================================================================================
Disease                                             1993      1992      1991      1990      1989      1988      1987      1986      1985      1984
--------------------------------------------------------------------------------------------------------------------------------------------------
U.S. total resident population (in thousands)
1990 census; July 1 est. 1984-1989, 1991-1993.   257,908   255,082   252,177   248,710   248,239   245,807   243,400   241,078   238,740   236,158
--------------------------------------------------------------------------------------------------------------------------------------------------
AIDS                                             103,533    45,472    43,672    41,595    33,722    31,001    21,070    12,932     8,249     4,445
Amebiasis                                          2,970     2,942     2,989     3,328     3,217     2,860     3,123     3,532     4,433     5,252
Anthrax                                                -         1         -         -         -         2         1         -         -         1
Aseptic meningitis                                12,848    12,223    14,526    11,852    10,274     7,234    11,487    11,374    10,619     8,326
Botulism, total (including wound and unsp.)           97        91       114        92        89        84        82       109       122       123
  Foodborne                                           27        21        27        23        23        28        17        23        49        19
  Infant                                              65        66        81        65        60        50        59        79        70        99
--------------------------------------------------------------------------------------------------------------------------------------------------
Brucellosis                                          120       105       104        85        95        96       129       106       153       131
Chancroid                                          1,399     1,886     3,476     4,212     4,692     5,001     4,998     3,756     2,067       665
Cholera                                               18       103        26         6         -         8         6        23         4         1
Diphtheria                                             -         4         5         4         3         2         3         -         3         1
Encephalitis, primary *                              919       774     1,021     1,341       981       882     1,418     1,302     1,376     1,257
  Post-infectious *                                  170       129        82       105        88       121       121       124       161       108
--------------------------------------------------------------------------------------------------------------------------------------------------
Gonorrhea                                        439,673   501,409   620,478   690,169   733,151   719,536   780,905   900,868   911,419   878,556
Granuloma inguinale                                   19         6        29        97         7        11        22        61        44        30
Haemophilus influenzae                             1,419     1,412     2,764   ...................................+...............................
Hansen disease (leprosy)                             187       172       154       198       163       184       238       270       361       290
Hepatitis A                                       24,238    23,112    24,378    31,441    35,821    28,507    25,280    23,430 &  23,210    22,040
Hepatitis B                                       13,361    16,126    18,003    21,102    23,419    23,177    25,916    26,107 &  26,611    26,115
Hepatitis, non-A, non-B @                          4,786     6,010     3,582     2,553     2,529     2,619     2,999     3,634 &   4,184     3,871
Hepatitis, unspecified                               627       884     1,260     1,671     2,306     2,470     3,102     3,940 &   5,517     5,531
--------------------------------------------------------------------------------------------------------------------------------------------------
Legionellosis **                                   1,280     1,339     1,317     1,370     1,190     1,085     1,038       948       830       750
Leptospirosis                                         51        54        58        77        93        54        43        41        57        40
Lyme disease                                       8,257     9,895     9,465   ...................................+...............................
Lymphogranuloma venereum                             285       302       471       277       189       185       303       396       226       170
Malaria                                            1,411     1,087     1,278     1,292     1,277     1,099       944     1,123     1,049     1,007
--------------------------------------------------------------------------------------------------------------------------------------------------
Measles (rubeola)                                    312     2,237     9,643    27,786    18,193     3,396     3,655     6,282     2,822     2,587
Meningococcal infections                           2,637     2,134     2,130     2,451     2,727     2,964     2,930     2,594     2,479     2,746
Mumps                                              1,692     2,572     4,264     5,292     5,712     4,866    12,848     7,790     2,982     3,021
Murine typhus fever                                   25        28        43        50        41        54        49        67        37        53
Pertussis (whooping cough)                         6,586     4,083     2,719     4,570     4,157     3,450     2,823     4,195     3,589     2,276
Plague                                                10        13        11         2         4        15        12        10        17        31
--------------------------------------------------------------------------------------------------------------------------------------------------
Poliomyelitis, paralytic ++                            3         6         9         6         9         9         9         9         7         8
Psittacosis                                           60        92        94       113       116       114        98       224       119       172
Rabies, animal                                     9,377     8,589     6,910     4,826     4,724     4,651     4,658     5,504     5,565     5,567
Rabies, human                                          3         1         3         1         1         -         1         -         1         3
Rheumatic fever, acute                               112        75       127       108       144       158       141       147        90       117
--------------------------------------------------------------------------------------------------------------------------------------------------
Rocky Mountain spotted fever                         456       502       628       651       623       609       604       760       714       838
Rubella (German measles)                             192       160     1,401     1,125       396       225       306       551       630       752
Rubella, congenital syndrome                           5        11        47        11         3         6         5        14         -         5
Salmonellosis, excluding typhoid fever            41,641    40,912    48,154    48,603    47,812    48,948    50,916    49,984    65,347    40,861
Shigellosis                                       32,198    23,931    23,548    27,077    25,010    30,617    23,860    17,138    17,057    17,371
Smallpox                                          .............................Last documented case occurred in 1949..............................
Syphilis, primary and secondary                   26,498    33,973    42,935    50,223    44,540    40,117    35,147    27,883    27,131    28,607
--------------------------------------------------------------------------------------------------------------------------------------------------
  Total, all stages                              101,259   112,581   128,569   134,255   110,797   103,437    86,545    68,215    67,563    69,888
Tetanus                                               48        45        57        64        53        53        48        64        83        74
Toxic-shock syndrome                                 212       244       280       322       400       390       372       412       384       482
Trichinosis                                           16        41        62       129        30        45        40        39        61        68
Tuberculosis                                      25,313    26,673    26,283    25,701    23,495    22,436    22,517    22,768    22,201    22,255
Tularemia                                            132       159       193       152       152       201       214       170       177       291
Typhoid fever                                        440       414       501       552       460       436       400       362       402       390
Varicella (chickenpox)                           134,722   158,364   147,076   173,099   185,441   192,857   213,196   183,243   178,162   221,983
Yellow fever                                     .....................Last indigenous case reported 1911; last imported, 1924.....................
--------------------------------------------------------------------------------------------------------------------------------------------------
 * Beginning in 1984, data reflects change in categories for tabulating encephalitis reports that were recorded by date of report to state health departments. Data for previous years are from
   surveillance records reported by onset date.
 + Not previously notifiable nationally.
 & Reports from  New York City are not available.
 @ The number of reported cases of non-A, non-B hepatitis is misleading because in some states, reported cases included persons positive for antibody to hepatitis C virus (anti-HCV)
   identified in routine screening programs but who did not have acute hepatitis.
** Data are recorded by date of report to the state health department. Data for all years previous to 1982 are from surveillance records reported by onset date.
++ Annual case reports from state health departments; numbers may not reflect changes based on retrospective case evaluations or late reports (see MMWR 1986;35:180-2).
=================================================================================================================================================================================================

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TABLE_2
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TABLE 2. NOTIFIABLE DISEASES -- summary of reported cases, per 100,000 population, United States, 1984-1993
======================================================================================================================================================================================
Disease                                         1993     1992     1991     1990     1989     1988     1987     1986     1985     1984
-------------------------------------------------------------------------------------------------------------------------------------
AIDS                                           40.20    17.83    17.32    16.72    13.58    12.61     8.66     5.36     3.46     1.88
Amebiasis                                       1.21     1.21     1.23     1.38     1.34     1.20     1.33     1.47     1.92     2.30
Anthrax                                         0.00     0.00     0.00     0.00     0.00     0.00     0.00     0.00     0.00     0.00
Aseptic meningitis                              5.39     5.18     6.26     4.77     4.14     2.94     4.72     4.72     4.50     3.57
Botulism, total (including wound and unsp.)     0.04     0.04     0.05     0.04     0.04     0.03     0.03     0.05     0.05     0.05
  Foodborne                                     0.01     0.00     0.01     0.01     0.01     0.01     0.01     0.01     0.02     0.01
  Infant                                        0.03     0.03     0.03     0.03     0.02     0.02     0.02     0.03     0.03     0.04
-------------------------------------------------------------------------------------------------------------------------------------
Brucellosis                                     0.05     0.04     0.04     0.03     0.04     0.04     0.05     0.04     0.06     0.06
Chancroid *                                     0.54     0.80     1.40     1.70     1.90     2.04     2.07     1.57     0.87     0.28
Cholera                                         0.00     0.04     0.01     0.00     0.00     0.00     0.00     0.01     0.00     0.00
Diphtheria                                      0.00     0.00     0.00     0.00     0.00     0.00     0.00     0.00     0.00     0.00
-------------------------------------------------------------------------------------------------------------------------------------
Encephalitis, primary                           0.36     0.30     0.40     0.54     0.40     0.36     0.58     0.54     0.58     0.53
  Post-infectious                               0.07     0.05     0.03     0.04     0.04     0.05     0.05     0.05     0.07     0.05
Gonorrhea *                                   172.40   201.60   249.48   276.60   297.36   298.74   323.14   376.37   384.51   374.75
Granuloma inguinale *                           0.00     0.00     0.01     0.00     0.00     0.00     0.01     0.03     0.02     0.01
-------------------------------------------------------------------------------------------------------------------------------------
Haemophilus influenzae                          0.55     0.55     1.10     ...........................+..............................
Hansen disease (leprosy)                        0.07     0.07     0.06     0.08     0.07     0.07     0.10     0.11     0.15     0.12
Hepatitis A                                     9.40     9.06     9.67    12.64    14.43    11.60    10.39    10.02    10.03     9.33
Hepatitis B                                     5.18     6.32     7.14     8.48     9.43     9.43    10.65    11.17    11.50    11.06
Hepatitis, non-A, non-B &                       1.86     2.36     1.42     1.03     1.02     1.07     1.23     1.55     l.81     1.64
Hepatitis, unspecified                          0.24     0.35     0.50     0.67     0.93     1.00     1.27     1.69     2.38     2.34
-------------------------------------------------------------------------------------------------------------------------------------
Legionellosis                                   0.50     0.53     0.53     0.55     0.48     0.44     0.43     0.43     0.37     0.35
Leptospirosis                                   0.02     0.02     0.02     0.03     0.04     0.02     0.02     0.02     0.02     0.02
Lyme disease                                    3.20     0.12     3.80     ...........................+..............................
Lymphogranuloma venereum *                      0.10     0.10     0.19     0.10     0.08     0.07     0.13     0.16     0.10     0.07
Malaria                                         0.55     0.43     0.51     0.52     0.51     0.45     0.39     0.47     0.44     0.43
-------------------------------------------------------------------------------------------------------------------------------------
Measles (rubeola)                               0.12     0.88     3.82    11.17     7.33     1.38     1.50     2.61     1.18     1.10
Meningococcal infections                        1.02     0.84     0.84     0.99     1.10     1.21     1.20     1.08     1.04     1.16
Mumps                                           0.66     1.03     1.72     2.17     2.34     2.05     5.43     3.37     1.30     1.32
Murine typhus fever                             0.01     0.01     0.02     0.02     0.02     0.02     0.02     0.03     0.02     0.02
Pertussis (whooping cough)                      2.55     1.60     1.08     1.84     1.67     1.40     1.16     1.74     1.50     0.96
-------------------------------------------------------------------------------------------------------------------------------------
Plague                                          0.00     0.01     0.00     0.00     0.00     0.01     0.00     0.00     0.01     0.01
Poliomyelitis, paralytic                        0.00     0.00     0.00     0.00     0.00     0.00     0.00     0.00     0.00     0.00
Psittacosis                                     0.02     0.04     0.04     0.05     0.05     0.05     0.04     0.09     0.05     0.07
Rabies, human                                   0.00     0.00     0.00     0.00     0.00     0.00     0.00     0.00     0.00     0.00
Rheumatic fever, acute                          0.08     0.06     0.12     0.09     0.13     0.14     0.13     0.12     0.07     0.08
-------------------------------------------------------------------------------------------------------------------------------------
Rocky Mountain spotted fever                    0.18     0.20     0.25     0.26     0.25     0.25     0.25     0.32     0.30     0.36
Rubella (German measles)                        0.07     0.06     0.56     0.45     0.16     0.09     0.13     0.23     0.26     0.32
Rubella, congenital syndrome                    0.00     0.00     0.01     0.00     0.00     0.00     0.00     0.00     0.00     0.00
Salmonellosis, excluding typhoid fever         16.15    16.04    19.10    19.54    19.26    19.91    20.92    20.73    27.37    17.30
Shigellosis                                    12.48     9.38     9.34    10.89    10.07    12.46     9.80     7.11     7.14     7.36
-------------------------------------------------------------------------------------------------------------------------------------
Smallpox                                      .....................Last documented case occurred in 1949.............................
Syphilis, primary and secondary *              10.40    13.70    17.26    20.10    18.07    16.43    14.54    11.65    11.45    12.20
  Total, all stages *                          39.70    45.30    51.69    53.80    44.94    42.37    35.81    28.50    28.50    29.81
Tetanus                                         0.02     0.02     0.02     0.03     0.02     0.02     0.02     0.03     0.03     0.03
Toxic-shock syndrome                            0.08     0.10     0.11     0.13     0.16     0.16     0.15     0.19     0.18     0.24
Trichinosis                                     0.01     0.02     0.02     0.05     0.01     0.02     0.02     0.02     0.03     0.03
Tuberculosis                                    9.82    10.46    10.42    10.33     9.46     9.13     9.25     9.44     9.30     9.42
Tularemia                                       0.05     0.06     0.08     0.06     0.06     0.08     0.09     0.07     0.07     0.12
Typhoid fever                                   0.17     0.16     0.20     0.22     0.19     0.18     0.16     0.15     0.17     0.17
Varicella (chickenpox)                        118.54   176.54   135.82   120.06   121.77   122.43   136.68   122.42   123.23   138.44
Yellow fever                                  .................Last indigenous case reported 1911; last imported, 1924...............
-------------------------------------------------------------------------------------------------------------------------------------
NOTE: Rates <0.01 after rounding are shown as 0.00.
* Post-censal population data from 1992 were used to calculate 1993 rates.
+ Not previously notifiable nationally.
& The number of reported cases of non-A, non-B hepatitis is misleading because in some states, reported cases included persons positive for antibody to hepatitis C virus (anti-HCV)
  identified in routine screening programs but who did not have acute hepatitis.
@ Per 1,000 live births.
======================================================================================================================================================================================

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TABLE_3
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TABLE 3. NOTIFIABLE DISEASES -- summary of reported cases, United States, 1974-1983
==========================================================================================================================================================
Disease                                             1983      1982      1981      1980      1979      1978      1977      1976      1975      1974
--------------------------------------------------------------------------------------------------------------------------------------------------
U.S. total resident population (in thousands)
1980 census; July 1 est. 1974-1979, 1981-1983    233,981   231,534   229,307   226,505   220,099   218,059   216,332   214,659   213,121   211,390
--------------------------------------------------------------------------------------------------------------------------------------------------
Amebiasis                                          6,658     7,304     6,632     5,271     4,107     3,937     3,044     2,906     2,775     2,743
Anthrax                                                -         -         -         1         -         6         -         2         2         2
Aseptic meningitis                                12,696     9,680     9,547     8,028     8,754     6,573     4,789     3,510     4,475     3,197
Botulism, total (including wound and unsp.)          133        97       103        89        45       105       129        55        20        28
Brucellosis                                          200       173       185       183       215       179       232       296       310       240
--------------------------------------------------------------------------------------------------------------------------------------------------
Chancroid                                            847     1,392       850       788       840       521       455       628       700       945
Cholera                                                1         -        19         9         1        12         3         -         -         -
Diphtheria                                             5         2         5         3        59        76        84       128       307       272
Encephalitis, primary                              1,761     1,464     1,492     1,362     1,504     1,351     1,414     1,651     4,064     1,164
  Post-infectious                                     34        36        43        40        84        78       119       175       237       218
--------------------------------------------------------------------------------------------------------------------------------------------------
Gonorrhea                                        900,435   960,633   990,864 1,004,029 1,004,058 1,013,436 1,002,219 1,001,994   999,937   906,121
Granuloma inguinale                                   24        17        66        51        76        72        75        71        60        47
Hansen disease (leprosy)                             259       250       256       223       185       168       151       145       162       118
Hepatitis A                                       21,532    23,403    25,802    29,087    30,407    29,500    31,153    33,288    35,855    40,358
Hepatitis B                                       24,318    22,177    21,152    19,015    15,452    15,016    16,831    14,973    13,121    10,631
Hepatitis, non-A, non-B                            3,470   ...........................................*...........................................
Hepatitis, unspecified                             7,149     8,564    10,975    11,894    10,534     8,776     8,639     7,488     7,158     8,351
Legionellosis +                                      852       654       408       475       593       761       359       235   ........*........
--------------------------------------------------------------------------------------------------------------------------------------------------
Leptospirosis                                         61       100        82        85        94       110        71        73        93        68
Lymphogranuloma venereum                             335       235       263       199       250       284       348       365       353       394
Malaria                                              813     1,056     1,388     2,062       894       731       547       471       373       293
Measles (rubeola)                                  1,497     1,714     3,124    13,506    13,597    26,871    57,345    41,126    24,374    22,094
Meningococcal infections                           2,736     3,056     3,525     2,840     2,724     2,505     1,828     1,605     1,478     1,346
--------------------------------------------------------------------------------------------------------------------------------------------------
Mumps                                              3,355     5,270     4,941     8,576    14,225    16,817    21,436    38,492    59,647    59,128
Murine typhus fever                                   62        58        61        81        69        46        75        69        41        26
Pertussis (whooping cough)                         2,463     1,895     1,248     1,730     1,623     2,063     2,177     1,010     1,738     2,402
Plague                                                40        19        13        18        13        12        18        16        20         8
Poliomyelitis, total                                  15         8         6         9        34        15        18        14         8         7
  Paralytic                                           15         8         6         8        26         9        17        12         8         7
--------------------------------------------------------------------------------------------------------------------------------------------------
Psittacosis                                          142       152       136       124       137       140        94        78        49       164
Rabies, animal                                     5,878     6,212     7,118     6,421     5,119     3,254     3,130     3,073     2,627     3,151
Rabies, human                                          2         -         2         -         4         4         1         2         2         -
Rheumatic fever, acute                                88       137       264       432       629       851     1,738     1,865     2,854     2,431
--------------------------------------------------------------------------------------------------------------------------------------------------
Rocky Mountain spotted fever                       1,126       976     1,192     1,163     1,070     1,063     1,153       937       844       754
Rubella (German measles)                             970     2,325     2,077     3,904    11,795    18,269    20,395    12,491    16,652    11,917
Rubella, congenital syndrome                          22         7        19        50        62        30        23        30        30        45
Salmonellosis, excluding typhoid fever            44,250    40,936    39,990    33,715    33,138    29,410    27,850    22,937    22,612    21,980
Shigellosis                                       19,719    18,129    19,859    19,041    20,135    19,511    16,052    13,140    16,584    22,600
--------------------------------------------------------------------------------------------------------------------------------------------------
Smallpox                                         ..............................Last documented case occurred in 1949..............................
Syphilis, primary and secondary                   32,698    33,613    31,266    27,204    24,874    21,656    20,399    23,731    25,561    25,385
  Total, all stages                               74,637    75,579    72,799    68,832    67,049    64,875    64,621    71,761    80,356    83,771
Tetanus                                               91        88        72        95        81        86        87        75       102       101
Toxic-shock syndrome                                 502   ...........................................*...........................................
Trichinosis                                           45       115       206       131       157        67       143       115       252       120
--------------------------------------------------------------------------------------------------------------------------------------------------
Tuberculosis &                                    23,846    25,520    27,373    27,749    27,669    28,521    30,145    32,105    33,989    30,122
Tularemia                                            310       275       288       234       196       141       165       157       129       144
Typhoid fever                                        507       425       584       510       528       505       398       419       375       437
Varicella (chickenpox)                           177,462   167,423   200,766   190,894   199,081   154,089   188,396   183,990   154,248   141,495
Yellow fever                                     .....................Last indigenous case reported 1911, last imported 1924......................
--------------------------------------------------------------------------------------------------------------------------------------------------
* Not previously notifiable nationally.
+ Data for 1982-1983 recorded by date of report to the state health department. Data for 1976-1981 are from surveillance records reported by onset date.
& Case data subsequent to 1974 are not comparable to prior years due to changes in reporting criteria that became effective in 1975.
==========================================================================================================================================================

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TABLE_4
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TABLE 4. NOTIFIABLE DISEASES -- summary of reported cases, United States, 1964-1973
====================================================================================================================================================
Disease                                             1973      1972      1971      1970      1969      1968      1967      1966      1965      1964
--------------------------------------------------------------------------------------------------------------------------------------------------
U.S. total resident population, July 1, estimate
(in thousands)                                   209,851   208,232   206,256   203,805   201,385   199,399   197,457   195,576   193,526   191,141
--------------------------------------------------------------------------------------------------------------------------------------------------
Amebiasis                                          2,235     2,199     2,752     2,888     2,915     3,005     3,157     2,921     2,768     3,304
Anthrax                                                2         2         5         2         4         3         2         5         7         5
Aseptic meningitis                                 4,846     4,634     5,176     6,480     3,672     4,494     3,082     3,058     2,329     2,177
Botulism                                              34        22        25        12        16         7         5         9        19        23
Brucellosis                                          202       196       183       213       235       218       265       262       262       411
Chancroid                                          1,165     1,414     1,320     1,416     1,104       845       784       838       982     1,247
--------------------------------------------------------------------------------------------------------------------------------------------------
Cholera                                                1         -         1         -         -         -         -         -         2         -
Diphtheria                                           228       152       215       435       241       260       219       209       164       293
Encephalitis, primary                              1,613     1,059     1,524     1,580     1,613     1,781     1,478     2,121     1,722     2,002
  Post-infectious                                    354       243       439       370       304       502     1,060       964       981     1,585
Gonorrhea                                        842,621   767,215   670,268   600,072   534,872   464,543   404,836   351,738   324,925   300,666
Granuloma inguinale                                   62        81        89       124       154       156       154       148       155       135
Hansen disease (leprosy)                             146       130       131       129        98       123        81       109        96        97
Hepatitis A                                       50,749    54,074    59,606    56,797    48,416    45,893    38,909    32,859    33,856 *  37,740 *
Hepatitis B                                        8,451     9,402     9,556     8,310     5,909     4,829     2,458     1,497
Leptospirosis                                         57        41        62        47        89        69        67        72        84       142
--------------------------------------------------------------------------------------------------------------------------------------------------
Lymphogranuloma venereum                             408       756       692       612       520       485       371       308       878       732
Malaria                                              237       742     2,375     3,051     3,102     2,317     2,022       565       147        93
Measles (rubeola)                                 26,690    32,275    75,290    47,351    25,826    22,231    62,705   204,136   261,904   458,083
Meningococcal infections                           1,378     1,323     2,262     2,505     2,951     2,623     2,161     3,381     3,040     2,826
--------------------------------------------------------------------------------------------------------------------------------------------------
Mumps                                             69,612    74,215   124,939   104,953    90,918   152,209   ..................+..................
Murine typhus fever                                   32        18        23        27        36        36        52        33        28        30
Pertussis (whooping cough)                         1,759     3,287     3,036     4,249     3,285     4,810     9,718     7,717     6,799    13,005
Plague                                                 2         1         2        13         5         3         3         5         8         -
Poliomyelitis, total                                   8        31        21        33        20        53        41       113        72       122
  Paralytic                                            7        29        17        31        18        53        40       106        61       106
--------------------------------------------------------------------------------------------------------------------------------------------------
Psittacosis                                           33        52        32        35        57        43        41        50        60        53
Rabies, animal                                     3,640     4,369     4,310     3,224     3,490     3,591     4,481     4,178     4,574     4,780
Rabies, human                                          1         2         2         3         1         1         2         1         2         1
Rheumatic fever, acute                             2,560     2,614     2,793     3,227     3,229     3,470     3,985     4,472     4,998     7,491
Rocky Mountain spotted fever                         668       523       432       380       498       298       305       268       281       277
Rubella (German measles)                          27,804    25,507    45,086    56,552    57,686    49,371    46,888    46,975   ........+........
--------------------------------------------------------------------------------------------------------------------------------------------------
Rubella, congenital syndrome                          35        42        68        77        31        14        10        11   ........+........
Salmonellosis, excluding typhoid fever            23,818    22,151    21,928    22,096    18,419    16,514    18,120    16,841    17,161    17,144
Shigellosis                                       22,642    20,207    16,143    13,845    11,946    12,180    13,474    11,888    11,027    12,984
Smallpox                                         ..............................Last documented case occurred in 1949..............................
Streptococcal sore throat and scarlet fever           NN        NN        NN   433,405   450,008   435,013   453,351   427,752   395,168   402,334
--------------------------------------------------------------------------------------------------------------------------------------------------
Syphilis, primary and secondary                   24,825    24,429    23,783    21,982    19,130    19,019    21,053    21,414    23,338    22,969
  Total, all stages                               87,469    91,149    95,997    91,382    92,162    96,271   102,581   105,159   112,842   114,325
Tetanus                                              101       128       116       148       192       178       263       235       300       289
Trichinosis                                          102        89       103       109       215        77        66       115       199       198
Tuberculosis &                                    30,998    32,882    35,217    37,137    39,120    42,623    45,647    47,767    49,016    50,874
Tularemia                                            171       152       187       172       149       186       184       208       264       342
Typhoid fever                                        680       398       407       346       364       395       396       378       454       501
Varicella (chickenpox)                           182,927   164,114   ......................................+......................................
Yellow fever                                     .....................Last indigenous case reported 1911; last imported, 1924.....................
--------------------------------------------------------------------------------------------------------------------------------------------------
* Includes Hepatitis B.
+ Not previously notifiable nationally.
& Includes new active cases.
====================================================================================================================================================

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TABLE_5
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TABLE 5. NOTIFIABLE DISEASES -- summary of reported cases, United States, 1954-1963
====================================================================================================================================================
Disease                                             1963      1962      1961      1960      1959      1958      1957      1956      1955      1954
--------------------------------------------------------------------------------------------------------------------------------------------------
U.S. total resident population, July 1, estimate
(in thousands)                                   188,483   185,771   182,992   179,979   176,513   173,320   170,371   167,306   164,308   161,164
--------------------------------------------------------------------------------------------------------------------------------------------------
Amebiasis                                          2,886     3,048     2,850     3,424     3,508     4,380     5,031     3,689     3,348     3,523
Anthrax                                                3         9        14        23        12        16        26        38        39        22
Aseptic meningitis                                 1,844     2,654     5,162 *   1,593   ............................+............................
Botulism                                              47        10        14        12        20         6        28        17        16        18
Brucellosis                                          407       409       636       751       892       924       983     1,300     1,444     1,823
--------------------------------------------------------------------------------------------------------------------------------------------------
Chancroid                                          1,220     1,344     1,438     1,680     1,537     1,595     1,637     2,135     2,649     3,003
Cholera                                                -         -         -         -         -         -         -         -         -         -
Dengue                                                NN        NN         -         -         -         -         -         2         1         6
Diphtheria                                           314       444       617       918       934       918     1,211     1,568     1,984     2,041
Encephalitis, acute infectious                     1,993     2,094     2,248     2,341     2,347     2,587     2,135     2,624     2,166     2,606
--------------------------------------------------------------------------------------------------------------------------------------------------
Gonorrhea                                        278,289   263,714   264,158   258,933   240,254   232,386   214,496   224,346   236,197   242,050
Granuloma inguinale                                  173       207       241       296       265       314       348       357       490       618
Hansen disease (leprosy)                             103        80        63        54        44        39        36        52        75        56
Hepatitis &                                       42,974    53,016    72,651    41,666    23,574    16,294    14,922    19,234    31,961    50,093
Leptospirosis                                         89        79        71        53        83        55        47        44        24        48
--------------------------------------------------------------------------------------------------------------------------------------------------
Lymphogranuloma venereum                             586       590       787       835       604       434       448       500       762       875
Malaria                                               99       118        73        72        71        85       132       234       522       715
Measles (rubeola)                                385,156   481,530   423,919   441,703   406,162   763,094   486,799   611,936   555,156   682,720
Meningococcal infections                           2,470     2,150     2,232     2,259     2,180     2,581     2,691     2,735     3,455     4,436
Murine typhus fever                                   35        32        46        68        51        71       113        98       135       163
--------------------------------------------------------------------------------------------------------------------------------------------------
Pertussis (whooping cough)                        17,135    17,749    11,468    14,809    40,005    32,148    28,295    31,732    62,786    60,886
Plague                                                 1         -         3         2         4         -         1         1         -         -
Poliomyelitis, total                                 449       910     1,312     3,190     8,425     5,787     5,485    15,140    28,985    38,476
  Paralytic                                          396       762       988     2,525     6,289     3,697     2,499     7,911    13,850    18,308
Psittacosis                                           76        79       102       113       147       158       278       568       334       563
Rabies, animal                                     3,929     3,732     3,599     3,567     4,177     4,787     4,542     5,681     5,799     7,297
--------------------------------------------------------------------------------------------------------------------------------------------------
Rabies, human @                                        1         2         3         2         7         5         5        10         4        13
Rheumatic fever, acute                             7,561     7,977    10,470     9,022     8,285     6,889     6,427     6,562   ........+........
Rocky Mountain spotted fever                         216       240       219       204       199       243       240       293       295       294
Salmonellosis, excluding typhoid fever            15,390     9,680     8,542     6,929     6,606     6,363     6,693     6,704     5,447     5,375
Shigellosis                                       13,009    12,443    12,571    12,487    12,888    11,861     9,822    10,306    13,912    13,846
Smallpox                                         ..............................Last documented case occurred in 1949..............................
--------------------------------------------------------------------------------------------------------------------------------------------------
Streptococcal sore throat and scarlet fever      342,161   315,809   338,410   315,173   334,715   264,097   226,973   176,392   147,502   147,785
Syphilis, primary and secondary                   22,251    21,067    19,851    16,145     9,799     7,176     6,576     6,392     6,454     7,147
  Total, all stages                              124,137   126,245   124,658   122,538   120,824   113,884   123,758   130,201   122,392   130,697
Tetanus                                              325       322       379       368       445       445       447       468       462       524
Trichinosis                                          208       194       306       160       227       176       178       262       264       277
--------------------------------------------------------------------------------------------------------------------------------------------------
Tuberculosis **                                   54,042    53,315    53,726    55,494    57,535    63,534    67,149    69,895    77,368    79,775
Tularemia                                            327       328       365       390       459       587       601       522       584       681
Typhoid fever                                        566       608       814       816       859     1,043     1,231     1,700     1,704     2,169
Yellow fever                                     .....................Last indigenous case reported 1911; last imported, 1924.....................
--------------------------------------------------------------------------------------------------------------------------------------------------
 * Includes Meningitis, other, for some states.
 + Not previously notifiable nationally.
 & Data includes both hepatitis A and B.
 @ Registered deaths, 1954-1961.
** Includes new active cases.
====================================================================================================================================================

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TABLE_6
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TABLE 6. NOTIFIABLE DISEASES -- summary of reported cases, United States, 1944-1953
====================================================================================================================================================
Disease                                             1953      1952      1951      1950      1949      1948      1947      1946      1945      1944
--------------------------------------------------------------------------------------------------------------------------------------------------
U.S. total resident population, July 1, estimate
(in thousands)                                   158,242   155,687   153,310   151,235   148,665   146,093   143,446   140,054   132,481   132,885
--------------------------------------------------------------------------------------------------------------------------------------------------
Amebiasis                                          4,444     4,280     3,550     4,568     5,543     4,871     3,365     4,093     3,412     3,241
Anthrax                                               45        47        60        49        54        60        69        40        40        49
Botulism                                              18        18        33        20        24        39        44   ............NA.............
Brucellosis                                        2,032     2,537     3,139     3,510     4,235     4,991     6,321     5,887     5,049     4,436
Chancroid *                                        3,338     3,738     4,233     4,977     6,707     7,661     9,515     7,091     5,515     7,878
--------------------------------------------------------------------------------------------------------------------------------------------------
Cholera                                                -         -         -         -         -         -         -         -         -         -
Dengue                                                 8         5        16        26        46        24        35        40       106        61
Diphtheria                                         2,355     2,960     3,983     5,796     7,969     9,493    12,262    16,354    18,675    14,150
Encephalitis, acute infectious                     1,935     1,912     1,123     1,135       903       730       785       728       785       788
Gonorrhea *                                      238,340   244,957   254,470   286,746   317,950   345,501   380,666   368,020   287,181   300,676
--------------------------------------------------------------------------------------------------------------------------------------------------
Granuloma inguinale *                                667       951     1,352     1,783     2,402     2,469     2,330     2,232     1,857     1,759
Hansen disease (leprosy)                              60        57        57        44        41        63        56        43        40        37
Hepatitis, infectious +                           33,700    17,428     7,349     2,820     2,027       709     1,092   ............NA.............
Leptospirosis                                         42        62         9        30        17        18        14   ............NA.............
Lymphogranuloma venereum *                           983     1,200     1,300     1,427     1,925     2,429     2,526     2,603     2,631     2,858
--------------------------------------------------------------------------------------------------------------------------------------------------
Malaria                                            1,310     7,023     5,600     2,184     4,151     9,606    15,116    48,610    62,763    57,626
Measles (rubeola)                                449,146   683,077   530,118   319,124   625,281   615,104   222,375   659,843   146,013   630,291
Meningococcal infections                           5,077     4,884     4,164     3,788     3,519     3,376     3,420     5,693     8,208    16,312
Murine typhus fever                                  221       205       378       685       985     1,171     2,050     3,365     5,193     5,401
Pertussis (whooping cough)                        37,129    45,030    68,687   120,718    69,479    74,715   156,517   109,860   133,792   109,873
--------------------------------------------------------------------------------------------------------------------------------------------------
Plague                                                 -         -         1         3         3         -         1         -         -         1
Poliomyelitis, total                              35,592    57,879    28,386    33,300    42,033    27,726    10,827    25,698    13,624    19,029
Psittacosis                                          169       135        25        26        35        32        27        26        27         6
Rabies, animal &                                   8,903     8,445     8,008     7,901     7,587     8,495     8,920    10,850     9,928    10,487
--------------------------------------------------------------------------------------------------------------------------------------------------
Rabies, human @                                       12        24        18        18        10        24        26        34        43        56
Rocky Mountain spotted fever                         313       327       347       464       570       547       596       587       472       470
Salmonellosis, excluding typhoid fever             3,946     2,596     1,773     1,233     1,243       882       951       723       649       712
Shigellosis                                       16,533    23,197    32,215    23,367    29,080    23,753    17,048    24,286    34,943    38,230
Smallpox                                               -         -         -         -        49        57       176       337       346       397
Streptococcal sore throat and scarlet fever      132,935   113,677    84,151    64,494    87,220    91,295    93,595   125,511   185,570   200,539
--------------------------------------------------------------------------------------------------------------------------------------------------
Syphilis, primary and secondary *                  8,637    10,449    14,485    23,939    41,942    68,174    93,545    94,957    77,007    78,443
  Total, all stages *                            148,573   167,762   174,924   217,558   256,463   314,313   355,592   963,647   359,114   467,755
Tetanus                                              506       484       506       486       579       601       560   ............NA.............
Trichinosis                                          395       367       393       327       353       487       451   ............NA.............
Tuberculosis **                                   84,304    86,700   118,491   121,742   134,865   137,006   134,946   119,256   114,931   126,294
--------------------------------------------------------------------------------------------------------------------------------------------------
Tularemia                                            601       668       702       927     1,179     1,086     1,401     1,355       900       781
Typhoid fever                                      2,252     2,341     2,128     2,484     2,795     2,840     3,075     3,268     4,211     4,599
Yellow  fever                                    .....................Last indigenous case reported 1911; last imported, 1924.....................
--------------------------------------------------------------------------------------------------------------------------------------------------
 * Data were reported for fiscal years 1944-1946; data were reported by calendar year beginning in 1947.
 + Data for 1953 includes serum hepatitis.
 & Data for 1944-1951 from Bureau of Animal Industry, U.S. Department of Agriculture, Agricultural Research Administration.
 @ Registered deaths.
** Includes newly reported active and inactive cases, 1944-1951; new active cases 1952-1953.
====================================================================================================================================================

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TABLE_7
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TABLE 7. NOTIFIABLE DISEASES -- deaths from specified notifiable diseases, United States, 1982-1991
===========================================================================================================================================================================================
Cause of Death                                       ICD *    1991      1990      1989      1988      1987      1986      1985      1984      1983      1982
------------------------------------------------------------------------------------------------------------------------------------------------------------
AIDS +                                         *042-*044    29,555    25,188    22,082    16,602    13,468    10,900     6,040     2,943     1,141        NA
Amebiasis                                            006         5         5         4         7         9         8        10        10        21         7
Anthrax                                              022         -         -         -         -         -         -         -         -         -         -
Botulism, foodborne                                005.1         2         4         2         1         -         1         4         4         7         4
Brucellosis                                          023         -         -         -         2         1         1         1         -         -         2
Chancroid                                          099.0         1         -         -         -         -         -         -         -         -         -
Cholera                                              001         2         2         -         -         1         -         1         -         -         -
Diphtheria                                           032         -         1         -         -         1         -         -         -         -         1
Encephalitis, acute infectious &             062-064,049       142       167       143       133       146       230       153       168       169       166
Gonococcal infections                                098         3         3         4         3         7         7         2         3         4         6
Granuloma inguinale                                099.2         -         -         -         -         -         -         -         -         -         -
Haemophilus influenzae                             041.5        17        16        16        25        25        21        22        14        11        24
Hansen disease (leprosy)                             030         -         3         4         -         1         1         2         6         3         3
Hepatitis, viral, infectious (Hep A)         070.0,070.1        71        76        88        70        77        65        80        77        82        83
Hepatitis, viral, serum (Hep B)              070.2,070.3       912       816       711       621       595       557       490       465       438       375
Hepatitis, viral, other and unsp.            070.4-070.9       857       686       717       599       510       384       372       327       343       356
Leptospirosis                                        100         1         2         -         2         1         -         4         -         5         4
Lymphogranuloma venereum                           099.1         1         2         2         -         -         -         3         -         -         1
Malaria                                              084         4         3        11         7         5         5        13         7         3         2
Measles (rubeola)                                    055        27        64        32         3         2         2         4         1         4         2
Meningococcal infections                             036       198       215       273       278       258       286       257       300       299       364
Mumps                                                072         1         1         3         2         2         -         -         1         2         2
Murine typhus fever                                081.0         -         -         1         -         -         -         1         -         -         -
Pertussis (whooping cough)                           033         -        12        12         4         1         6         4         7         5         4
Plague                                               020         -         -         -         -         1         -         1         3         5         3
Poliomyelitis, total                         045.0-045.9         1         -         -         1         -         -         3         -         -         -
Psittacosis                                          073         -         2         1         1         2         -         1         -         1         -
Rabies, human                                        071         3         1         1         -         1         -         -         2         2         -
Rheumatic fever, acute                           390-392        89        66        70        76        42        60        56        70        87        77
Rocky Mountain spotted fever                       082.0        13        20        10        20        21        19        22        34        35        40
Rubella (German measles)                             056         1         8         4         1         -         1         1         1         3         4
Salmonellosis, incl. paratyphoid fever   002.1-002.9,003        53        80        99        66       105       102       117        90        82        89
Shigellosis                                          004        10        10        16         8        13         4        17         8         9         9
Syphilis                                         090-097        93       106       105        85        98        80        80       105       121       126
Tetanus                                              037        11        11         9        17        16        22        23        20        22        22
Trichinosis                                          124         -         -         1         -         -         -         1         -         -         -
Tuberculosis (all forms)                         010-018     1,713     1,810     1,970     1,921     1,755     1,782     1,752     1,729     1,779     1,807
Tularemia                                            021         2         1         1         2         4         4         3         2         1         2
Typhoid fever                                      002.0         1         1         -         -         2         2         -         -         3         2
Varicella (chickenpox)                               052        81       120        89        83        89        47        68        53        57        61
------------------------------------------------------------------------------------------------------------------------------------------------------------
* Numbers in ICD column refer to the category numbers listed in the Ninth Revision of the International Classification of Diseases, 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.)
+ For 1983-1986, deaths are estimated from death certificates with mention of conditions coded to deficiency of cell-mediated immunity (ICD-9 No. 279.1). Includes other human
  immunodeficiency virus (HIV)-related deaths and other diseases classifiable as deficiency of cell-mediated immunity.
& Arthropod-borne encephalitis and other nonarthropod-borne viral diseases of the central nervous system.

Source: National Center for Health Statistics System, 1982-1991. Deaths are classified according to the Ninth Revision, ICD.
===========================================================================================================================================================================================

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