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Summary of Notifiable Diseases, United States, 1994Foreword MMWR Summary of Notifiable Diseases, United States, 1994 This publication contains summary tables of the official statistics for the reported occurrence of nationally notifiable diseases in the United States for the year 1994. This information is collected and compiled from reports to the National Notifiable Diseases Surveillance System (NNDSS). Because the dates of onset and dates of diagnosis for notifiable diseases are often unknown, these surveillance data are presented by the week that they were reported to public health officials. These data are then finalized and published in the MMWR Summary of Notifiable Diseases, United States, for use by state and local health departments; schools of medicine and public health; communications media; local, state, and federal agencies; and other agencies or persons interested in following the trends of reportable conditions in the United States. Publication of the annual summary also ensures documentation of diseases that are considered national priorities for notification and of the annual number of cases of such diseases. Part 1 contains information on morbidity for each of the conditions considered nationally notifiable during 1994. In all tables, leprosy is listed as Hansen disease 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 1994, as well as the distribution of cases by month and geographic location, and by patient's age, race, and ethnicity. The data are final totals as of July 7, 1995, unless otherwise noted. Part 2 contains graphs and maps depicting summary data for many of the notifiable conditions described in tabular form in Part Part 3 includes tables showing the number of cases of notifiable diseases reported to CDC and to the National Office of Vital Statistics since 1945. It also includes a table on deaths associated with specified notifiable diseases reported to the National Center for Health Statistics, CDC, for the period 1983-1992. Background As of January 1, 1994, 49 infectious diseases were designated as notifiable 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 summarizes the history of national notifiable disease reporting in the United States. In 1878, Congress authorized the U.S. Marine Hospital Service (the precursor to the 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 quarantine measures to prevent the introduction and spread of these diseases into the United States. In 1879, a specific Congressional appropriation was made for the collection and publication of reports of these notifiable diseases. 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 immediate telegraphic reporting of five infectious diseases and monthly reporting by letter of 10 additional diseases. The first annual summary of The Notifiable Diseases in 1912 included reports of 10 diseases from 19 states, the District of Columbia, and Hawaii. By 1928, all states, the District of Columbia, Hawaii, and Puerto Rico were participating in national reporting of nearly 30 specified conditions. At their annual meeting in 1950, the State and Territorial Health Officers authorized a conference of state and territorial epidemiologists whose purpose was to determine which diseases should be reported to PHS. CDC assumed responsibility for the collection and publication of data on nationally notifiable diseases in 1961. The list of nationally notifiable diseases is revised periodically. For example, diseases may be added to the list as new pathogens emerge or deleted as their incidence declines. 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), with CDC input, makes recommendations annually for additions and deletions to the list of nationally notifiable diseases. However, reporting of nationally notifiable diseases to CDC by the states is voluntary. Reporting is currently mandated (by state legislation or regulation) 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. During 1994, 49 infectious diseases were considered notifiable at the national level and were reported to CDC; 41 were reported on a weekly basis, and eight were reported monthly. CSTE and CDC held a national surveillance conference November 30-December 2, 1994 to review the state of national infectious disease surveillance. Infectious diseases that have been approved for addition to national surveillance during 1995 are Chlamydia trachomatis (genital infections), coccidioidomycosis (for regional surveillance), cryptosporidiosis, hantavirus infection, (post-diarrheal) hemolytic uremic syndrome, pediatric infection with the human immunodeficiency virus, invasive group A streptococcal infections, streptococcal toxic-shock syndrome, and drug-resistant Streptococcus pneumoniae. These conditions currently are not reportable in all states, and the mechanism for reporting may not involve clinicians or consist of reports of individual cases (i.e., traditional notification methods). Reports of the number of cases of these conditions will not appear in the current year tables before 1996. At the 1994 conference the following diseases were also proposed as deletions from the list of infectious diseases under national surveillance: amebiasis, aseptic meningitis, primary encephalitis (except for arboviral encephalitis), postinfectious encephalitis, granuloma inguinale, unspecified hepatitis, leptospirosis, lymphogranuloma venereum, rheumatic fever, and tularemia. These changes were confirmed by a vote of the full membership of CSTE in early 1995. The number of reported cases of these diseases will not appear in the current year tables after 1994. The list of 49 infectious diseases that were designated as notifiable at the national level during 1994 appears below: AIDS Amebiasis Anthrax Aseptic meningitis * Botulism ** Brucellosis Chancroid ** Cholera Diphtheria Encephalitis, primary * Encephalitis, postinfectious * Escherichia coli O157:H7 ** Gonorrhea Granuloma inguinale * Haemophilus influenzae, invasive Hansen disease (leprosy) Hepatitis A Hepatitis B Hepatitis, non-A, non-B Hepatitis C, unspecified * Legionellosis Leptospirosis * Lyme disease Lymphogranuloma venereum * Malaria Measles Meningococcal disease Mumps Pertussis Plague Poliomyelitis Psittacosis Rabies, animal Rabies, human Rheumatic fever * Rocky Mountain spotted fever (RMSF) Rubella Rubella, congenital syndrome Salmonellosis ** Shigellosis ** Syphilis Syphilis, congenital Tetanus Toxic-shock syndrome Trichinosis Tuberculosis Tularemia * Typhoid fever Yellow fever **
Data Sources Provisional data on the reported occurrence of notifiable diseases are published weekly in MMWR. After each reporting year, staff in state health departments finalize reports of cases for the year with local or county health departments, as well as reconcile the data with reports previously sent to CDC throughout the year; these data are compiled in final form in this summary. Notifiable disease reports (published in the annual MMWR Summary of Notifiable Diseases only after the approval of each state epidemiologist) are the authoritative and archival counts of cases. MMWR Surveillance Summaries or other surveillance reports produced by CDC programs, which are useful for detailed epidemiologic analyses, may not agree exactly with numbers reported in the annual Summary of Notifiable Diseases due to differences in the timing of reports, the source of the data, and the use of different case definitions. Data in this summary are derived primarily from reports transmitted to the Division of Surveillance and Epidemiology, Epidemiology Program Office, CDC, by the 50 state, two city, and five 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 information regarding these data should be directed to the source specified. 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 (toxic-shock syndrome and laboratory data on botulism, Escherichia coli O157:H7, Salmonella, and Shigella) Division of HIV/AIDS (human immunodeficiency virus/acquired immunodeficiency syndrome) Division of Vector-Borne Infectious Diseases (laboratory data on arboviral encephalitis) 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 (before CDC assumed responsibility for collection and publication of these data) are obtained from publications of the National Office of Vital Statistics. Population estimates for states are based on the July 1, 1994, post-censal estimates made by the U.S. Department of Commerce, Bureau of the Census, Population Division, Population Estimates Branch, Press Release CB94-204. 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 1994 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 disease data were not available were excluded from rate calculations. Interpreting Data The data reported in this summary are useful for analyzing disease trends and determining relative disease burdens. However, these data must be interpreted in light of reporting practices. Some diseases that cause severe clinical illness (e.g., plague or rabies), if diagnosed by a clinician, are most likely reported accurately. However, persons who have diseases that are clinically mild and infrequently associated with serious consequences (e.g., salmonellosis) may not even seek medical care from a health-care provider; even if these diseases are diagnosed, they are less likely to be reported. The degree of completeness of reporting also is influenced by the diagnostic facilities available; the control measures in effect; the public awareness of a specific disease; and the interests, resources, and priorities of state and local officials responsible for disease control and public health surveillance. Finally, factors such as changes in the case definitions for public health surveillance, the introduction of new diagnostic tests, or the discovery of new disease entities 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 (standardized to the 1940 U.S. population) have been established for several of the notifiable diseases. HIGHLIGHTS FOR SELECTED INFECTIOUS DISEASES NOT NATIONALLY NOTIFIABLE DURING 1994 Chlamydia Chlamydia trachomatis infections are common among adolescents and young adults. An estimated 10% of sexually active adolescent females are infected with chlamydia. In 1994, 47 states reported 448,984 chlamydia infections. From 1984 through 1994, reported cases increased from 3.2 cases per 100,000 to 188.4. This trend may reflect increasing recognition and interest among health-care providers and public health officials. Coccidioidomycosis An outbreak of coccidioidomycosis occurred in Ventura County, California, following the 1994 Northridge earthquake. From January 24 through March 15, 1994, 203 infected persons were identified, compared with 52 cases that were reported through passive surveillance in the county in 1993. The National Center for Infectious Diseases (NCID/CDC) Emerging Infections Program (EIP), in collaboration with the State of California Department of Health Services, is conducting active surveillance for coccidioidomycosis in 10 California counties. Cryptosporidiosis In 1994, waterborne outbreaks of cryptosporidiosis were investigated in Las Vegas, Nevada, Walla Walla, Washington, and Lake Nummy, New Jersey, focusing national attention on the potential for waterborne transmission of Cryptosporidium. In September 1994, a national workshop on waterborne cryptosporidiosis was held at CDC, which resulted in guidelines and recommendations for prevention of cryptosporidiosis in severely immunosuppressed persons, appropriate public health responses to the problem, and epidemiologic and laboratory-based surveillance and research. Hantavirus Hantavirus Pulmonary Syndrome (HPS) is a recently recognized hantaviral illness caused by Sin Nombre virus and the newly identified Black Creek Canal and Bayou viruses. The identified rodent reservoirs for these viruses -- Peromyscus maniculatus and leucopus (deer and white-footed mice) for Sin Nombre virus and its variants and Sigmodon hispidus (cotton rat) for Black Creek Canal virus -- extend across the continental United States. As of July 20, 1995, national surveillance for HPS has identified 113 confirmed case-patients in 23 states (case fatality rate: 52%); 31 of these cases occurred in 1994. Invasive group A streptococcal infections Prospective and retrospective active surveillance data for invasive group A streptococcal (GAS) infections were analyzed and several risk groups identified, including: persons who have human immunodeficiency virus (HIV) infections and acquired immunodeficiency syndrome (AIDS), injecting-drug users, persons who have cancer, diabetes mellitus, heart disease or chronic lung disease, alcohol abusers, and children who have varicella. Although different GAS strains have been identified from individual case patients, M-type 1 strains predominated. Drug-resistant Streptococcus pneumoniae In the United States, the prevalence of drug-resistant Streptococcus pneumoniae (DRSP) has increased since 1987 from 3.6% to 14.5%, according to limited voluntary reporting by 12 sentinel hospitals. Limited 1994 surveillance data from these hospitals indicate the proportion of invasive disease (bacteremia and meningitis) caused by penicillin-resistant pneumococci ranges from 3% to 30% and shows widespread geographic variation. Information regarding community-specific DRSP prevalence is needed to assist clinicians in choosing optimal empiric therapy. To enhance efficient and timely reporting, CDC is currently piloting an electronic laboratory-based surveillance system. Vancomycin-resistant enterococci In 1994, the percentage of nosocomial enterococci reported as resistant to vancomycin increased from 11.5% in 1993 to 13.6% among Intensive Care Unit (ICU) isolates and from 4.9% to 9.1% among noncritical care unit isolates. The increase was more dramatic among isolates from noncritical care units, suggesting that vancomycin-resistant enterococci are spreading from their focus in ICUs. Pneumonia of unknown etiology From 1979 to 1994, the overall crude death rate for pneumonia and influenza increased 59%, from 20.0 to 31.8 deaths per 100,000. Through 1992 (the most recent year for which complete data are available), pneumonia of unspecified etiology (ICD-9 code 486) accounted for most of the overall increase -- the age-adjusted death rates in this diagnostic category increased 74%. Since the 1970s, several previously unrecognized infectious agents have been identified as causes of lower respiratory infections, including Legionella pneumophila, Chlamydia pneumoniae, and Sin Nombre virus. Recent prospective studies of community-acquired pneumonia indicate that an etiology cannot be identified in up to 50% of cases. Transfusion-associated infectious diseases An Institute of Medicine committee recently released the report, "HIV and the Blood Supply: An Analysis of Crisis Decisionmaking," calling for the establishment of a surveillance system at CDC to detect, monitor, and warn of adverse effects in the recipients of blood and blood products. CDC is reviewing existing surveillance systems to highlight and address areas that need improvement. Diseases that are being examined to evaluate the level of risk associated with transfusion include HIV/AIDS, Chagas disease, babesiosis, Creutzfeld-Jacob disease, the hepatitis viruses, malaria, and transfusion-associated sepsis. INTERNATIONAL NOTES Dengue Although dengue fever is not endemic in the United States, its incidence is increasing in most tropical areas throughout the world. In 1994, CDC processed serum samples from 91 residents of 27 states and the District of Columbia who had travelled to countries where dengue is endemic. Among these 91 persons, 37 (40.7%) cases of dengue were diagnosed serologically or virologically. Plague During September and October 1994, outbreaks of bubonic and pneumonic plague were reported from sites east and north of Bombay, India, respectively. A lack of reliable epidemiologic information contributed to the ensuing international health emergency. Evidence revealed that plague did not occur in international travelers or spread beyond the original foci. Bibliography General Benenson AS. Control of communicable diseases in man. 15th ed. Washington, DC: American Public Health Association, 1990. CDC. Manual of procedures for the reporting of nationally notifiable diseases to CDC. Atlanta: US Department of Health and Human Services, Public Health Service, CDC, 1995. CDC. Case definitions for public health surveillance. MMWR 1990;39(No. RR-13). CDC. Mandatory reporting of infectious diseases by clinicians, and mandatory reporting of occupational diseases by clinicians. MMWR 1990;39(No. RR-9). CDC. National electronic telecommunications system for surveillance -- United States, 1990-1991. MMWR 1991;40:502. CDC. Update: graphic method for presentation of notifiable disease data -- United States, 1991. MMWR 1991;40:124-5. CDC. Use of race and ethnicity in public health surveillance. MMWR 1993;42(No. RR-10). CDC. Update: changes in notifiable disease surveillance data -- United States, 1992-1993. MMWR 42(42):824-6. CDC. Sexually transmitted disease surveillance, 1993. Atlanta: US Department of Health and Human Services, Public Health Service, 1994. Stroup DF, Wharton M, Kafadar K, Dean AG. An evaluation of a method for detecting aberrations in public health surveillance data. Am J Epidemiol 1993;137(3):373-80. Teutsch SM, Churchill RE, eds. Principles and practice of public health surveillance. New York: Oxford University Press, 1994. Thacker SB, Choi K, Brachman PS. The surveillance of infectious diseases. JAMA 1983; 249:1181-5. AIDS CDC. AIDS among racial/ethnic minorities -- United States, 1993. MMWR 1994;43(35):644-7, 653-5. CDC. Heterosexually acquired AIDS -- United States, 1993. MMWR 1994;43(9):155-60. CDC. HIV/AIDS surveillance report. Atlanta: US Department of Health and Human Services, 1994;6(2):1-39. CDC. Recommendations of the U.S. Public Health Service Task Force on the use of zidovudine to reduce perinatal transmission of human immunodeficiency virus. MMWR 1994;43(No. RR-11):1-20. CDC. Update: acquired immunodeficiency syndrome -- United States, 1994. MMWR 1995;44(4):64-7. CDC. Update: trends in AIDS diagnosis and reporting under the expanded surveillance definition for adolescents and adults -- United States, 1993. MMWR 1994;43(45):826-31. CDC. Update: AIDS among women -- United States, 1994. MMWR 1995;44(5):81-4. Amebiasis Katzenstein DA. Drug treatment of amebiasis. In: Peterson PK, Verhoef J, eds. Antimicrobial agents annual 2. New York: Elsevier Science Publishers, 1987:247-52. McAuley JB, Herwaldt BL, Stokes SL, et al. Diloxanide furoate for treating asymptomatic Entamoeba histolytica cyst passers: 14 years' experience in the United States. Clin Infect Dis 1992;15:464-8. Ravdin JI, ed. Amebiasis: human infection by Entamoeba histolytica. New York: John Wiley and Sons, Inc., 1988. Ravdin JI. Amebiasis. Clin Infect Dis 1995;20:1453-66. Anthrax Brachman PS. Anthrax. In: Hoeprich PD, Jordan MC, Roland AR, eds. Infectious diseases. 5th ed. Philadelphia: JB Lippincott Co., 1994:1003-8. Meselson M, Guillemin J, Hugh-Jones M, et al. 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An efficacy trial of doxycycline chemoprophylaxis against leptospirosis. N Engl J Med 1984;310:497-500. Lyme disease CDC. Lyme disease surveillance -- United States, 1993. MMWR 1994;43(31):564-5,571-2. Kalish R. Lyme disease. Rheum Dis Clin North Am 1993;19:399-426. Steere AC. Lyme disease. N Engl J Med 1989;321:586-96. Lymphogranuloma venereum Perine PL, Osoba AO. Lymphogranuloma venereum. In: Holmes KK, Mardh PA, Sparling PF, et al. eds. Sexually transmitted disease. New York: McGraw-Hill, 1990:195-204. Malaria CDC. Health information for international travel 1994. Atlanta: CDC, 1994: US Department of Health and Human Services, Public Health Service, CDC. DHHS publication no. (CDC) 94-8280. CDC. Local transmission of Plasmodium vivax malaria -- Houston, Texas, 1994, MMWR 1994; 44(15):295. Lobel HO, Miani M, Eng T, Bernard KW, Hightower AW, Campbell CC. Long-term malaria prophylaxis with weekly mefloquine. Lancet 1993;341:848-51. Zucker JR, Campbell CC. Malaria: principles of prevention and treatment. Infect Dis Clin North Am 1993;7:547-67. Measles CDC. Measles prevention: recommendations of the Immunization Practices Advisory Committee. MMWR 1989;38(No. SS-9):1-18. CDC. Measles -- United States, first 26 weeks, 1993. MMWR 1993;42:813-6. CDC. Absence of reported measles -- United States, November 1993. MMWR 1993;42:925-6. Meningococcal disease CDC. Meningococcal vaccines. MMWR 1985;34(18):255-9. CDC. Laboratory-based surveillance for meningococcal disease in selected areas -- United States, 1989-1991. MMWR 1993;42(No. SS-2):21-30. Jackson LA, Schuchat A, Reeves MW, Wenger JD. Serogroup C meningococcal outbreaks in the United States: an emerging threat. JAMA 1995;273(5):383-9. Schwartz B, Moore PS, Broome CV. Global epidemiology of meningococcal disease. Clin Microbiol Rev 1989;2(suppl):S118-24. 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. CDC. Mumps Surveillance -- United States, 1988-1993. MMWR 1995;44(No. SS-3):1-14. Hersch BS, Fine PEM, Kent WK, et al. Mumps outbreak in a highly vaccinated population. J Pediatr 1991;119:187-93. Pertussis CDC. Pertussis surveillance -- United States, 1989-1991. MMWR 1992;41(No. SS-8):11-19. Cherry JD, Brunell PA, Golden GS, et al. Report of the Task Force on Pertussis and Pertussis Immunization, 1988. Pediatrics 1988;81(suppl):S939-84. Davis SF, Sutter RW, Strebel PM, et al. Concurrent outbreaks of pertussis and Mycoplasma pneumoniae infection: clinical and epidemiological characteristics of illnesses manifested by cough. Clin Infect Dis 1995;20(3):621-8. 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;1296-306. Poliomyelitis CDC. Lack of evidence for wild poliovirus circulation -- United States, 1993. MMWR 1993;43:957-9. Prevots DR, Sutter 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. JAVMA 1993;203:1673-80. Barnes RC. Laboratory diagnosis of human chlamydial infections. Clin Microbiol 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. Wong KH, Skelton SK, Daugharty H. Utility of complement fixation and microimmunofluorescence assays for detecting serologic responses in patients with clinically diagnosed psittacosis. J Clin Microbiol 1994;32:2417-21. Rabies CDC. Rabies prevention -- United States, 1991: recommendations of the Immunization Practices Advisory Committee (ACIP). MMWR 1991;40(No. RR-3). Baer G. Natural history of rabies. 2nd ed. Boca Raton, FL: CRC press, 1991. CDC. Compendium of animal rabies control, 1995. MMWR 1995;44(No. RR-2). Krebs JW, Strine TW, Smith JS, Rupprecht CE, Childs JE. Rabies surveillance in the United States during 1993. JAVMA 1993;205:1695-1709. Rheumatic fever Dajani AS. Prevention of rheumatic fever: a statement for health professionals 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. Dalton MJ, Clarke MJ, Holman RC, et al. National surveillance for Rocky Mountain spotted fever, 1981-1992, epidemiologic summary and evaluation of risk factors for fatal outcome. Am J Trop Med Hyg 1995;52(5):405-13. 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. Rubella prevention: recommendations of the Immunization Practices Advisory Committee (ACIP). MMWR 1990;39(No. RR-15). CDC. Increase in rubella and congenital rubella syndrome -- United States, 1988-1990. MMWR 1991;40(6):93-9. 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 and congenital rubella syndrome -- United States, January 1, 1991-May 7, 1994. MMWR 1994;43(21):391,397-401. 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. Salmonella enteritidis gastroenteritis transmitted by intact chicken eggs. Ann Intern Med 1991;115:190-4. Mishu B, Koehler J, Lee LA, et al. Outbreaks of Salmonella enteritidis infections in the United States, 1985-1991. J Infect Dis 1994;169:547-52. 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 infections 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. Nakashima AK, Rolfs RT, Flock ML, Kilmarx P, Greenspan GR. Epidemiology of syphilis in the United States, 1941-1993. Sex Transm Dis 1995 (in press). Tetanus CDC. Surveillance of tetanus -- United States, 1989-1990. MMWR 1992;41(No. SS-8):1-9. Gergen PJ, McQuillan GM, Kiely M, et al. A population-based survey of immunity to tetanus in the United States. N Engl J Med 1995;332:761-6. 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. Tuberculosis morbidity -- United States, 1994. MMWR 1995;44:(20)387-95. Tularemia Evans ME, Gregory DW, Schaffner W, McGee ZA. Tularemia: a 30 year experience with 88 cases. Medicine 1985;64:251-69. Schmid GP, Kornblatt AN, Connors CA, et al. Clinically mild tularemia associated with tick-borne Francisella tularensis. J Infect Dis 1983;148:63-7. 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 Advisory Committee on Immunization Practices. MMWR 1994;43(No. RR-14). 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;11(1):1-8. Woodruff BA, Pavia AT, Blake PA. A new look at typhoid vaccination: information 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 vaccine: 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. Varicella Vaccine. Medical Letter 1995;37(950):55-7. PART 1: Summaries of Notifiable Diseases in the United States Table_1 NOTIFIABLE DISEASES -- Summary of reported cases, by month, United States, 1994 Table_2A NOTIFIABLE DISEASES -- Reported cases, by geographic division and area, United States, 1994 Table_2B NOTIFIABLE DISEASES -- Reported cases, by geographic division and area, United States, 1994 (continued) Table_2C NOTIFIABLE DISEASES -- Reported cases, by geographic division and area, United States, 1994 (continued) Table_2D NOTIFIABLE DISEASES -- Reported cases, by geographic division and area, United States, 1994 (continued) Table_2E NOTIFIABLE DISEASES -- Reported cases, by geographic division and area, United States, 1994 (continued) Table_2F NOTIFIABLE DISEASES -- Reported cases, by geographic division and area, United States, 1994 (continued) Table_3 NOTIFIABLE DISEASES -- Summary of reported cases, by age group, United States, 1994 Table_4 NOTIFIABLE DISEASES -- Summary of reported cases, by age group, United States, 1994 Table_5 NOTIFIABLE DISEASES -- Summary of reported cases, by race, United States, 1994 Table_6 NOTIFIABLE DISEASES -- Summary of reported cases, by ethnicity, United States, 1994 PART 2: Graphs and Maps for Selected Notifiable Diseases in the United States Figure_1 ACQUIRED IMMUNODEFICIENCY SYNDROME (AIDS) -- reported cases, by quarter, and definition category, United States, 1984-1994 Figure_2 ACQUIRED IMMUNODEFICIENCY SYNDROME (AIDS) -- reported cases, per 100,000 population, United States and Puerto Rico, 1994 Figure_3 ACQUIRED IMMUNODEFICIENCY SYNDROME (AIDS) -- reported pediatric cases, United States and Puerto Rico, 1994 Figure_4 ARBOVIRAL INFECTIONS (of the central nervous system) -- reported laboratory-confirmed cases caused by California serogroup viruses, by month of onset, United States, 1985-1994 Figure_5 ARBOVIRAL INFECTIONS (of the central nervous system) -- reported laboratory-confirmed cases caused by eastern equine encephalitis virus, by month of onset, United States, 1985-1994 Figure_6 ARBOVIRAL INFECTIONS (of the central nervous system) -- reported laboratory-confirmed cases caused by St. Louis encephalitis virus, by month of onset, United States, 1985-1994 Figure_7 ARBOVIRAL INFECTIONS (of the central nervous system) -- reported laboratory-confirmed cases caused by western equine encephalitis virus, by month of onset, United States, 1985-1994 Figure_8A BOTULISM (foodborne) -- by year, United States, 1975-1994 Figure_8B BOTULISM (foodborne) -- by year, United States, 1975-1994 (continued) Figure_9 BRUCELLOSIS -- by year, United States, 1965-1994 Figure_10 CHOLERA -- reported cases, United States and territories, 1994 Figure_11 DIPTHERIA -- by year, United States, 1965-1994 Figure_12 ESCHERICHIA COLI O157:H7 -- reported cases, United States and territories, 1994 Figure_13 ESCHERICHIA COLI O157:H7 -- reported isolates, United States, 1994 Figure_14 GONORRHEA -- by sex, United States, 1981-1994 Figure_15 GONORRHEA -- by race, United States, 1981-1994 Figure_16 GONORRHEA -- reported cases, per 100,000 population, United States, 1994 Figure_17 HAEMOPHILUS INFLUENZAE, INVASIVE -- by age group, United States, 1994 Figure_18 HANSEN DISEASE (leprosy) -- by year, United States, 1965-1994 Figure_19 HEPATITIS -- by year, United States, 1965-1994 Figure_20 HEPATITIS A -- reported cases, per 100,000 population, United States and territories, 1994 Figure_21 HEPATITIS B -- reported cases, per 100,000 population, United States and territories, 1994 Figure_22 LEGIONELLOSIS -- by year, United States, 1978-1994 Figure_23 LYME DISEASE -- reported cases, per 100,000 population, United States and territories, 1994 Figure_24 MALARIA -- by year, United States, 1965-1994 Figure_25 MEASLES (rubeola) -- by year, United States, 1960-1994 Figure_26 MENINGOCOCCAL DISEASE -- by year, United States, 1965-1994 Figure_27 MUMPS -- by year, United States, 1968-1994 Figure_28 PERTUSSIS (whooping cough) -- by year, United States, 1965-1994 Figure_29 PERTUSSIS (whooping cough) -- by age group, United States, 1994 Figure_30 PLAGUE -- among humans, by year, United States, 1965-1994 Figure_31 POLIOMYELETIS (paralytic) -- by year, United States, 1965-1994 Figure_32 PSITTACOSIS -- by year, United States, 1965-1994 Figure_33 RABIES -- wild and domestic animals, by year, United States and Puerto Rico, 1955-1994 Figure_34 ROCKY MOUNTAIN SPOTTED FEVER (RMSF) -- by year, United States, 1965-1994 Figure_35 RUBELLA (German measles) -- by year, United States, 1966-1994 Figure_36 SALMONELLOSIS (excluding typhoid fever) -- by year, United States, 1955-1994 Figure_37 SALMONELLA -- serotype of isolate by year, United States, 1968-1994 Figure_38 SHIGELLOSIS -- by year, United States, 1965-1994 Figure_39 SHIGELLA -- species of isolate by year, United States, 1968-1994 Figure_40 SYPHILIS (primary and secondary) -- reported cases, per 100,000 population, United States, 1994 Figure_41 SYPHILIS (primary and secondary) -- by sex, United States, 1981-1994 Figure_42 SYPHILIS (primary and secondary) -- by race, United States, 1981-1994 Figure_43 CONGENITAL SYPHILIS -- in infants <1 year of age, United States, 1963-1994 Figure_44 TETANUS -- by year, United States, 1965-1994 Figure_45 TOXIC SHOCK SYNDROME (TSS) -- by quarter, United States, 1979-1994 Figure_46 TRICHINOSIS -- by year, United States, 1965-1994 Figure_47 TUBERCULOSIS -- reported cases, per 100,000 population, United States and territories, 1994 Figure_48 TUBERCULOSIS -- by year, United States, 1975-1994 Figure_49 TUBERCULOSIS -- by year, among foreign-born persons and persons born in the United States, 1986-1994 Figure_50 TYPHOID FEVER -- by year, United States, 1965-1994 Figure_51 VARICELLA (chickenpox) -- by month, United States, 1986-1994 PART 3: Historical Summary Tables Table_7 NOTIFIABLE DISEASES -- summary of reported cases, 100,000 population, United States, 1985-1994 Table_8 NOTIFIABLE DISEASES -- summary of reported cases, United States, 1985-1994 Table_9 NOTIFIABLE DISEASES -- summary of reported cases, United States, 1975-1984 Table_10 NOTIFIABLE DISEASES -- summary of reported cases, United States, 1965-1974 Table_11 NOTIFIABLE DISEASES -- summary of reported cases, United States, 1955-1964 Table_12 NOTIFIABLE DISEASES -- summary of reported cases, United States, 1945-1954 Table_13 NOTIFIABLE DISEASES -- deaths from specified notifiable diseases, United States, 1983-1992. (Numbers in ICD column refer to the category numbers listed in the Ninth Revision of the International Classification of Diseases, 1975.) Table_1 Note: To print large tables and graphs users may have to change their printer settings to landscape and use a small font size. NOTIFIABLE DISEASES -- Summary of reported cases, by month, United States, 1994 ======================================================================================================================================================================== NAME Total Jan. Feb. Mar. Apr. May June July Aug. Sept. Oct. Nov. Dec. Unk. ------------------------------------------------------------------------------------------------------------------------------------------------------------------------ AIDS * 78,279 7,058 4,446 8,774 5,954 6,136 7,100 6,305 7,814 7,563 5,800 6,056 5,273 - Amebiasis 2,983 158 167 196 315 215 258 226 281 197 280 202 488 - Anthrax - - - - - - - - - - - - - - Aseptic meningitis 8,932 351 322 423 516 497 690 1,043 1,067 1,030 1,086 7,180 1,189 - Botulism, total 143 13 8 12 7 19 19 11 12 8 15 9 10 - Brucellosis 119 4 3 6 9 8 5 18 11 10 1 9 35 - Chancroid + 773 .......... 198 ............ .......... 204 .......... .......... 182 .......... .......... 189 .......... - Cholera 39 - 2 3 3 1 5 1 3 1 4 8 8 - Diphtheria 2 - - 2 - - - - - - - - - - Encephalitis, primary 717 42 56 43 47 36 43 67 66 86 80 52 99 - infections Post-infectious 143 7 9 12 17 8 13 14 12 10 12 11 18 - Escherichia coli O157:H7 1,420 14 28 23 51 75 88 227 208 150 195 139 222 - Gonorrhea + 418,068 ......... 92,183 ......... ......... 99,347 ........ ........ 111,415 ........ ....... 115,123 ........ - Granuloma inguinale + 3 ........... 1 ............ ........... - ........... ........... 1 ........... .......... 1 ........... - Haemophilus influenzae, 1,174 84 98 91 107 145 72 111 55 69 107 69 166 - invasive Hansen disease 136 11 7 7 17 5 15 18 8 6 15 12 15 - (leprosy) Hepatitis A 26,796 1,235 1,788 1,669 2,250 1,863 1,835 2,597 2,042 2,191 2,820 2,128 4,378 - Hepatitis B 12,517 708 936 959 1,159 906 834 1,093 891 883 1,054 975 2,119 - Hepatitis, C/non-A non-B 4,470 309 276 388 375 296 361 352 297 387 329 318 782 - Hepatitis, unspecified 444 21 30 22 48 34 38 42 33 38 39 32 67 - Legionellosis 1,615 85 112 105 141 100 122 161 175 145 148 120 201 - Leptospirosis 38 6 1 1 5 - - 4 2 6 6 3 4 - Lyme disease 13,043 386 260 377 513 450 831 2,622 1,841 1,528 1,549 1,158 1,528 - Lymphogranuloma 235 ........... 74 .......... ........... 54 .......... ........... 52 .......... ........... 55 .......... - venereum + Malaria 1,229 48 91 99 85 56 71 101 126 104 122 70 256 - Measles (rubeola) 963 6 38 67 241 298 97 71 15 23 19 11 77 - Meningococcal disease 2,886 245 278 274 290 285 198 212 140 124 199 197 444 - Mumps 1,537 71 123 108 153 134 114 126 163 70 141 90 244 - Pertussis (whooping 4,617 257 344 260 274 281 274 362 402 306 603 312 942 - cough) Plague 17 1 - - - 2 6 6 1 - - 1 - - Poliomyelitis, - - - - - - - - - - - - - - paralytic & Psittacosis 38 3 5 4 - 4 4 6 1 2 3 1 5 - Rabies, animal 8,147 474 500 867 759 667 692 628 845 764 759 645 547 - Rabies, human 6 1 - - - - 1 - - - 2 2 - - Rheumatic fever, acute 112 6 3 8 13 6 29 7 5 3 10 6 16 - Rocky Mountain spotted 465 5 6 11 18 20 54 82 84 46 57 28 54 - fever Rubella (German 227 3 31 50 50 12 25 27 4 5 2 2 16 - measles) Rubella, congenital 7 - 2 - - - - - - 1 - 2 2 - syndrome Salmonellosis 43,323 1,560 1,656 1,899 2,799 2,529 3,040 4,776 4,666 4,436 6,057 3,620 6,275 - Shigellosis 29,769 1,293 1,406 1,734 2,319 2,070 2,126 2,969 2,597 2,543 3,190 2,541 4,981 - Syphilis, total all 81,696 ......... 20,981 ........ ......... 21,544 ........ ......... 20,462 ........ ......... 18,709 ........ - stages + Primary and secondary + 20,627 ......... 5,308 ......... ......... 5,154 ......... ......... 5,396 ......... ......... 4,769 ......... - Congenital <1 year + 2,204 .......... 535 .......... .......... 597 .......... .......... 525 .......... .......... 547 .......... - Tetanus 51 1 2 4 4 3 4 3 1 5 8 3 13 - Toxic-shock syndrome 192 13 21 13 28 16 11 10 19 14 13 11 23 - Trichinosis 32 10 3 3 5 - - - 2 - 2 5 2 - Tuberculosis 24,361 567 1,302 1,877 2,138 1,949 2,105 2,063 1,964 2,009 1,860 1,906 4,621 - Tularemia 96 - 1 - 1 7 14 24 10 14 7 - 18 - Typhoid fever 441 17 29 35 51 39 32 44 33 53 43 18 47 - Varicella (chickenpox) 151,219 11,939 14,564 19,132 27,154 22,550 19,723 6,554 2,238 1,994 4,241 7,415 13,715 - ------------------------------------------------------------------------------------------------------------------------------------------------------------------------ & Two suspected cases of paralytic poliomyelitis were reported in 1994. Confirmation of these cases is pending review by external panel. * AIDS total updated through December 31, 1994. + Cases updated through Feburary 28, 1995. ======================================================================================================================================================================== Return to top. Table_2A Note: To print large tables and graphs users may have to change their printer settings to landscape and use a small font size.
NOTIFIABLE DISEASES -- Reported cases, by geographic division and area, United States, 1994
==========================================================================================================================================================
Total Resident Botulism
population (in Aseptic ----------------------
Area thousands) AIDS Ambiasis Anthrax meningitis Foodborne Infant Brucellosis Canchroid
----------------------------------------------------------------------------------------------------------------------------------------------------------
United States 260,341 78,279* 2,983 - 8,932 50 85 119 773+
New England 13,270 2,836 80 - 340 - 1 - 1
Maine 1,240 117 10 - 33 - - - -
N.H. 1,137 92 2 - 47 - - - -
Vt. 580 38 3 - 36 - - - -
Mass. 6,041 1,401 61 - 103 - - - 1
R.I. 997 276 4 - 121 - - - -
Conn. 3,275 912 NN - NN - 1 - -
Mid. Atlantic 38,125 22,465 876 - 957 2 16 2 365
N.Y. (excl. NYC) 10,905 2,220 120 - 466 1 - - 8
N.Y.C. 7,264 12,724 701 - 150 - 1 - 357
N.J. 7,904 4,993 25 - NN - 2 - -
Pa. 12,052 2,528 30 - 341 1 13 2 -
E. N. Central 43,184 6,324 187 - 1,652 2 9 8 48
Ohio 11,102 1,184 22 - 399 1 4 2 8
Ind. 5,752 622 21 - 222 - 2 - -
Ill. 11,752 3,104 45 - 472 1 2 5 38
Mich. 9,496 1,035 42 - 538 - 1 1 -
Wis. 5,082 379 57 - 21 - - - 2
W.N. Central 18,210 1,638 131 - 476 - 2 1 8
Minn. 4,567 422 39 - 43 - - - -
Iowa 2,829 130 21 - 121 - - 1 1
Mo. 5,278 713 38 - 175 - - - 2
N. Dak. 638 20 8 - 14 - - - -
S. Dak. 721 19 4 - 3 - - - -
Nebr. 1,623 89 6 - 41 - - - -
Kans. 2,554 245 15 - 79 - 2 - 5
S. Atlantic 46,398 18,857 203 - 2,000 - 4 17 30
Del. 706 271 3 - 41 - 1 - -
Md. 5,006 2,722 14 - 246 - 1 1 -
D. C. 570 1,399 2 - 53 - - - -
Va. 6,552 1,162 39 - 337 - 2 2 -
W. Va. 1,822 96 6 - 39 - - - -
N.C. 7,070 1,187 19 - 240 - - 3 10
S.C. 3,664 1,158 NN - 31 - - - -
Ga. 7,055 2,245 58 - 80 - - 3 -
Fla. 13,953 8,617 62 - 933 - - 8 20
E.S. Central 15,890 2,099 10 - 582 3 3 2 27
Ky. 3,827 320 6 - 181 - 1 - -
Tenn. 5,175 764 NN - 164 2 1 1 3
Ala. 4,219 582 3 - 174 - - - 24
Miss. 2,669 433 1 - 63 1 1 1 -
W. S. Central 28,404 7,671 124 - 1,072 25 4 32 260
Ark. 2,453 284 4 - 62 - 1 1 -
La. 4,315 1,239 2 - 40 - - 2 209
Okla. 3,258 269 8 - - 1 - - -
Tex. 18,378 5,879 110 - 970 24 3 29 51
Mountain 15,215 2,287 150 - 353 - 8 20 3
Mont. 856 30 - - 8 - 1 - -
Idaho 1,133 61 6 - 6 - 2 - -
Wyo. 476 18 - - 4 - 1 - -
Colo. 3,656 816 39 - 135 - 1 1 -
N. Mex. 1,654 211 27 - 20 - - 1 -
Ariz. 4,075 612 61 - 79 - - 17 3
Utah 1,908 152 6 - 55 - 3 1 -
Nev. 1,457 387 11 - 46 - - - -
Pacific 41,645 13,949 1,222 - 1,500 18 38 37 31
Wash. 5,343 932 78 - NN 3 2 - 1
Oreg. 3,086 606 109 - NN - 3 1 5
Calif. 31,431 12,136 991 - 1,350 4 30 36 25
Alaska 606 59 5 - 19 11 - - -
Hawaii 1,179 216 39 - 131 - 3 - -
Guam 133 1 1 - 13 - - - -
P.R. 3,522 2,359 1 - 72 - - - 32
V.I. 102 52 - - - - - - 1
C.N.M.I. 43 - - - - - - - -
American Samoa 47 - - - - - - - -
----------------------------------------------------------------------------------------------------------------------------------------------------------
* Total reported to Division of HIV/AIDS Prevention, National Center for
Prevention Services, through December 31, 1994. Total includes 153 cases
with unknown state of residence.
+ Cases updated through Division of Sexually Transmitted Diseases and HIV
Prevention, National Center for Prevention Services, as of February 28, 1995.
==========================================================================================================================================================
Return to top. Table_2B Note: To print large tables and graphs users may have to change their printer settings to landscape and use a small font size.
NOTIFIABLE DISEASES -- Reported cases, by geographic division and area, United States, 1994 (continued)
===================================================================================================================================================
Encephalitis
-------------------------- Haemophilus Hansen
Primary Post- Escherichia Granuloma influenzae, disease
Area Cholera Diptheria Infections infections coli O157:H7 Gonorrhea inguinale invasive (leprosy)
---------------------------------------------------------------------------------------------------------------------------------------------------
United States 39 2 717 143 1,420 418,068 * 3 * 1,174 136
New England 2 1 18 6 223 8,640 - 45 4
Maine - - 5 - NN 93 - 5 -
N. H. - - - 2 NN 103 - 4 -
Vt. - - 3 1 12 40 - - -
Mass. 1 1 8 1 134 3,159 - 21 4
R.I. - - 2 2 9 478 - 4 -
Conn. 1 - - - 68 4,767 - 11 -
Mid. Atlantic 6 - 63 20 160 49,450 - 149 16
N.Y. (excl. NYC) 3 - 38 3 149 11,506 - 70 2
N.Y.C. 1 - 6 5 11 19,491 - 34 13
N.J. 2 - - - - 5,269 - 16 1
Pa. - - 19 12 NN 13,184 - 29 -
E. N. Central 5 - 169 22 269 87,065 - 199 9
Ohio - - 55 4 109 24,746 - 109 -
Ind. - - 11 1 57 9,757 - 26 -
Ill. 2 - 65 5 103 26,571 - 43 6
Mich. 3 - 38 12 - 18,215 - 19 -
Wis. - - - - NN 7,776 - 2 3
W.N. Central 1 - 52 12 366 22,834 - 103 -
Minn. - - 22 - 147 3,346 - 34 -
Iowa 1 - 1 1 56 1,645 - 9 -
Mo. - - 8 6 40 12,557 - 51 -
N. Dak. - - 4 - 31 35 - - -
S. Dak. - - 4 - 18 243 - 2 -
Nebr. - - 6 5 74 1,335 - 4 -
Kans. - - 7 - NN 3,673 - 3 -
S. Atlantic 3 - 161 65 23 104,591 2 234 2
Del. - - 1 - NN 2,038 - 1 -
Md. 1 - 28 5 NN 15,137 - 87 -
D. C. - - - 1 - 6,827 - - -
Va. 1 - 34 6 NN 13,414 - 22 1
W. Va. - - 51 - NN 805 - 7 -
N. C. - - 44 1 6 28,936 2 32 -
S. C. - - - - 17 13,067 - 3 -
Ga. - - 2 - NN NA - 67 -
Fla. 1 - 1 52 - 24,367 - 15 1
E.S. Central - - 41 4 6 48,208 - 34 1
Ky. - - 16 2 6 5,127 - 4 1
Tenn. - - 12 - NN 15,745 - 10 -
Ala. - - 9 1 - 15,881 - 15 -
Miss. - - 4 1 - 11,455 - 5 -
W. S. Central 4 - 63 2 98 53,529 - 74 33
Ark. - - 1 - 10 6,892 - 5 2
La. - - 10 - - 11,992 - 4 -
Okla. - - - - 16 4,888 - 45 -
Tex. 4 - 52 2 72 29,757 - 20 31
Mountain - - 14 3 100 10,669 - 128 -
Mont. - - - - - 85 - 1 -
Idaho - - - - - 98 - 5 -
Wyo. - - 3 1 NN 82 - 5 -
Colo. - - 4 - 76 3,632 - 17 -
N. Mex. - - - - - 1,130 - 12 -
Ariz. - - - 1 NN 3,603 - 26 -
Utah - - 3 1 NN 303 - 10 -
Nev. - - 4 - 24 1,736 - 52 -
Pacific 18 1 136 9 175 33,082 1 208 71
Wash. - - 1 - 174 2,893 - 10 7
Oreg. - - - - 1 978 1 26 -
Calif. 17 1 131 8 NN 27,593 - 165 43
Alaska - - 4 - NN 918 - 3 -
Hawaii 1 - - 1 NN 700 - 4 21
Guam 1 - - 1 NN 110 - - 11
P. R. - - 1 3 NN 500 - 3 1
V.I. - - - - - 60 - - -
C.N.M.I. - - - - - - - 26 -
American Samoa - - - - - - - - 4
---------------------------------------------------------------------------------------------------------------------------------------------------
* Cases updated through Division of Sexually Transmitted Diseases and HIV Prevention, National Center for Prevention
Services, as of February 28, 1995.
===================================================================================================================================================
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NOTIFIABLE DISEASES -- Reported cases, by geographic division and area, United States, 1994 (continued)
============================================================================================================================================
Lympho
Hepatitis Hepatitis granuloma
Area Hepatitis A Hepatitis B C/non-A, non-B unsp. Legionellosis Leptospirosis Lyme disease venereum
--------------------------------------------------------------------------------------------------------------------------------------------
United States 26,796 12,517 4,470 444 1,615 38 13,043 235*
New England 296 354 168 15 79 3 2,827 6
Maine 25 11 - - 5 2 33 -
N. H. 17 28 11 - - - 30 -
Vt. 14 12 16 - 1 - 16 -
Mass. 112 200 121 13 55 - 247 6
R.I. 30 8 20 2 18 - 471 -
Conn. 98 95 - - NN 1 2,030 -
Mid. Atlantic 2,007 1,761 489 10 264 2 8,171 108
N.Y. (excl. NYC) 543 402 230 6 62 1 5,105 2
N.Y.C. 941 543 4 - 11 - 95 106
N.J. 306 410 211 - 49 1 1,533 -
Pa. 217 406 44 4 142 - 1,438 -
E. N. Central 2,777 1,221 320 16 433 1 530 9
Ohio 1,203 164 24 - 194 - 45 9
Ind. 361 215 9 - 48 - 19 -
Ill. 615 315 81 9 44 1 24 -
Mich. 352 432 206 7 82 - 33 -
Wis. 246 95 - - 65 - 409 -
W. N. Central 1,222 714 100 12 106 2 347 2
Minn. 261 82 20 - 4 - 208 -
Iowa 4 27 14 11 34 - 17 -
Mo. 619 538 32 1 41 1 102 2
N. Dak. 6 1 1 - 4 - - -
S. Dak. 39 4 - - 2 - - -
Nebr. 122 31 15 - 15 1 3 -
Kans. 111 31 18 - 6 - 17 -
S. Atlantic 1,466 2,240 485 32 413 3 855 65
Del. 22 14 2 - 31 - 106 -
Md. 198 354 21 8 82 1 341 -
D. C. 27 53 2 - 9 - 9 15
Va. 193 142 26 10 17 - 131 -
W. Va. 23 48 47 - 4 - 29 -
N. C. 145 291 59 - 28 1 77 44
S.C. 40 33 10 - 29 - 7 -
Ga. 43 555 220 - 118 - 127 3
Fla. 775 750 98 14 95 1 28 3
E.S. Central 784 1,211 945 2 83 3 43 2
Ky. 221 78 32 - 9 1 24 -
Tenn. 347 1,042 893 1 45 2 13 1
Ala. 139 91 20 1 13 - 6 1
Miss. 77 - - - 16 - - -
W.S. Central 3,719 1,830 599 94 63 1 174 12
Ark. 253 60 8 3 16 1 15 -
La. 170 203 215 2 20 - 4 12
Okla. 419 141 62 3 12 - 99 -
Tex. 2,877 1,426 314 86 15 - 56 -
Mountain 5,296 694 454 73 97 - 18 7
Mont. 25 21 13 - 16 - - -
Idaho 380 77 71 1 2 - 3 -
Wyo. 41 24 177 - 5 - 5 -
Colo. 584 97 79 14 19 - 1 1
N. Mex. 1,100 218 45 11 4 - 5 -
Ariz. 2,159 102 31 27 17 - - 5
Utah 754 96 18 6 8 - 3 -
Nev. 253 59 20 14 26 - 1 1
Pacific 9,229 2,492 910 190 77 23 78 24
Wash. 1,119 255 294 9 13 - 4 3
Oreg. 1,241 158 46 2 - 1 6 2
Calif. 6,602 2,038 565 176 59 - 68 19
Alaska 209 13 - - - - - -
Hawaii 58 28 5 3 5 22 - -
Guam 23 5 - 9 1 - - -
P.R. 86 415 215 3 - 2 - -
V.I. 3 9 1 - - - - -
C.N.M.I. 12 1 - - - - - -
American Samoa 11 - - - - - - -
--------------------------------------------------------------------------------------------------------------------------------------------
* Cases updated through Division of Sexually Transmitted Diseases and HIV Prevention, National Center for Prevention
Services, as of February 28, 1995.
============================================================================================================================================
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NOTIFIABLE DISEASES -- Reported cases, by geographic division and area, United States, 1994 (continued)
==============================================================================================================================
Measles
----------------------
Area Malaria Indigenous Imported Memingococcal Mumps Pertussis Plague Poliomyelitis,
disease paralytic
------------------------------------------------------------------------------------------------------------------------------
United States 1,229 746 217* 2,886 1,537 4,617 17 -+
New England 78 15 12 141 26 760 - -
Maine 6 2 3 23 3 21 - -
N.H. 3 1 - 8 4 107 - -
Vt. 3 2 1 5 - 46 - -
Mass. 38 1 6 68 3 534 - -
R.I. 10 5 2 - 4 8 - -
Conn. 18 4 - 37 12 44 - -
Mid. Atlantic 261 200 27 312 116 695 - -
N.Y. (excl. 60 12 16 105 33 254 -
NYC)
N.Y.C. 106 11 4 40 12 224 - -
N.J. 57 172 3 65 13 15 - -
Pa. 38 5 4 102 58 202 - -
E.N. Central 117 60 46 397 267 615 - -
Ohio 20 15 2 121 77 162 - -
Ind. 15 - 1 55 7 97 - -
Ill. 48 18 41 125 110 111 - -
Mich. 31 24 2 59 59 96 - -
Wis. 3 3 - 37 14 149 - -
W.N. Central 48 127 44 174 71 273 - -
Minn. 16 - - 23 5 142 - -
Iowa 5 6 1 21 16 23 - -
Mo. 14 119 42 78 44 45 - -
N. Dak. 1 - - 1 4 5 - -
S. Dak. - - - 9 - 26 - -
Nebr. 5 1 1 14 1 14 - -
Kans. 7 1 - 28 1 18 - -
S. Atlantic 247 65 9 455 257 431 - -
Del. 3 - - 5 - 3 - -
Md. 83 2 2 35 65 74 - -
D.C. 15 - - 7 - 11 - -
Va. 37 1 2 69 48 37 - -
W. Va. - 37 - 14 5 6 - -
N.C. 12 2 1 57 73 140 - -
S.C. 5 - - 40 8 14 - -
Ga. 43 5 - 82 18 37 - -
Fla. 49 18 4 146 40 109 - -
E.S. Central 32 28 - 195 32 129 - -
Ky. 12 - - 42 - 60 - -
Tenn. 10 28 - 40 9 22 - -
Ala. 9 - - 77 12 35 - -
Miss. 1 - - 36 11 12 - -
W.S. Central 119 16 7 392 302 246 - -
Ark. 5 5 - 55 7 33 - -
La. 12 - 1 47 38 15 - -
Okla. 9 - - 53 23 38 - -
Tex. 93 11 6 237 234 160 - -
Mountain 41 163 55 178 162 609 15 -
Mont. - - - 6 - 12 - -
Idaho 2 1 - 17 10 172 - -
Wyo. 1 - - 9 3 - - -
Colo. 19 24 37 41 4 228 2 -
N. Mex. 3 2 - 17 NN 35 7 -
Ariz. 10 5 4 58 99 122 5 -
Utah 4 131 5 19 28 37 1 -
Nev. 2 - 9 11 18 3 - -
Pacific 286 72 17 642 304 859 2 -
Wash. 45 3 1 111 23 140 - -
Oreg. 17 - 2 143 NN 106 - -
Calif. 207 51 10 374 258 594 2 -
Alaska 2 10 - 5 4 - - -
Hawaii 15 8 4 9 19 19 - -
Guam - 228 - 2 7 2 - -
P.R. 5 46 - 7 2 3 - -
V.I. 1 - - - 4 - - -
C.N.M.I. 1 29 - - 2 - - -
American Samoa - - - - 3 1 - -
------------------------------------------------------------------------------------------------------------------------------
* For 1994, includes both 142 cases of out-of-state importations and 75 cases of international importations.
+ Two suspected cases of paralytic poliomyelitis were reported in 1994. Confirmation of thesecases is pending review by
external panel.
==============================================================================================================================
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NOTIFIABLE DISEASES -- Reported cases, by geographic division and area, United States, 1994 (continued)
=================================================================================================================================
Rabies Rheumatic Rubella
---------------- fever, ----------------------
Area Psittacosis Animal Human acute RMSF* Rubella Cong.syndrome Salmonellosis Shigellosis
---------------------------------------------------------------------------------------------------------------------------------
United States 38 8,147 6 112 465 227 7 43,323 29,769
New England 2 2,009 - 2 12 132 2 3,439 508
Maine - 10 - 1 - - - 191 10
N.H. 1 221 - NN - - - 213 20
Vt. 1 143 - - - - - 119 4
Mass. - 34 - 1 4 126 2 2,009 243
R.I. - 153 - - - 3 - 248 55
Conn. - 748 - - 8 3 - 659 176
Mid. Atlantic 6 2,249 - 5 24 8 - 7,066 3,163
N.Y. (excl. NYC) 1 1,569 - NN 8 6 - 1,977 1,120
N.Y.C. - 16 - NN 3 1 - 1,889 1,007
N.J. 1 278 - 5 5 1 - 1,160 522
Pa. 4 386 - NN 8 - - 2,040 514
E.N. Central 7 69 - 30 40 10 - 5,678 3,648
Ohio - 4 - 8 19 - - 1,337 740
Ind. 1 14 - 2 8 - - 581 544
Ill. - 21 - 8 11 1 - 1,821 1,494
Mich. 3 14 - 8 2 9 - 869 432
Wis. 3 16 - 4 - - - 1,070 438
W.N. Central 4 232 - 12 42 2 - 2,624 2,361
Minn. - 22 - 3 1 - - 759 554
Iowa - 90 - 3 1 - - 404 338
Mo. 4 27 - 3 22 2 - 642 654
N. Dak. - 14 - NN - - - 68 59
S. Dak. - 44 - 2 13 - - 143 207
Nebr. - - - NN 1 - - 209 426
Kans. - 35 - 1 4 - - 399 123
S. Atlantic 4 2,083 2 - 224 22 - 9,165 8,352
Del. - 74 - NN 1 - - 168 38
Md. 2 520 - NN 21 - - 1,178 323
D.C. - 4 - NN - - - 118 70
Va. 2 428 - NN 22 - - 1,135 656
W. Va. - 84 1 - 2 - - 152 15
N.C. - 175 - NN 88 - - 1,137 1,970
S.C. - 179 - NN 20 - - 599 505
Ga. - 367 - NN 62 7 - 1,583 1,886
Fla. - 252 1 NN 8 15 - 3,095 2,889
E.S. Central 1 242 2 - 47 - - 1,777 1,706
Ky. - 28 - NN 10 - - 380 208
Tenn. - 82 1 NN 29 - - 441 418
Ala. 1 128 1 NN 2 - - 507 617
Miss. - 4 - - 6 NN - 449 463
W.S. Central - 741 1 1 63 13 1 3,578 3,259
Ark. - 38 - 1 18 - - 534 193
La. - 73 - NN 1 - - 591 416
Okla. - 39 - NN 37 4 - 470 240
Tex. - 591 1 NN 7 9 1 1,983 2,410
Mountain 3 154 - 39 13 5 2 2,226 1,953
Mont. - 22 - NN 4 - - 145 4
Idaho - 4 - 1 - - - 130 59
Wyo. - 24 - 1 2 - - 60 8
Colo. 3 18 - 8 4 - - 709 530
N. Mex. - 8 - 1 1 - 1 353 347
Ariz. - 56 - NN 1 - 1 427 680
Utah - 13 - 28 - 4 - 202 240
Nev. - 9 - NN 1 1 - 200 85
Pacific 11 368 1 23 - 35 2 7,770 4,819
Wash. 4 15 - - - - - 863 478
Oreg. 2 13 - NN - 4 - 313 165
Calif. 4 294 1 18 - 27 2 6,235 3,953
Alaska 1 46 - 5 - - - 55 21
Hawaii - - - NN - 4 - 304 202
Guam - - - 3 - 1 - 76 33
P.R. - 77 - - - - - 737 48
V.I. - - - - - - - 2 4
C.N.M.I. - - - 4 - - - 78 60
American Samoa - - - - - - - 14 9
---------------------------------------------------------------------------------------------------------------------------------
* Rocky Mountain spotted fever.
=================================================================================================================================
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NOTIFIABLE DISEASES -- Reported cases, by geographic division and area, United States, 1994 (continued)
==========================================================================================================================================================
Syphillis
-------------------------------------
Primary & Cong. Toxic shock Varicella
Area Secondary (<1 yr.) All stages Tetanus syndrome Trichinosis Tuberculosis Tularemia Typhoid fever (chicken pox)
----------------------------------------------------------------------------------------------------------------------------------------------------------
United 20,627* 2,204* 81,696* 51 192 32 24,361 96 441 151,219
States
New England 219 14 1,128 2 5 1 595 1 25 11,676
Maine 4 - 9 - 1 1 35 - - 711
N.H. 4 - 18 1 - - 17 - - 3,408
Vt. - - 1 - 2 - 10 - - NN
Mass. 90 6 622 - 2 - 329 1 20 5,903
R.I. 16 2 141 - - - 56 - 1 1,654
Conn. 105 6 337 1 - - 148 - 4 NN
Mid. 1,446 681 14,302 7 30 5 5,112 2 121 5,978
Atlantic
N.Y. (excl. 173 59 1,375 3 16 2 641 1 12 NN
NYC)
N.Y.C. 629 329 8,001 - - - 2,995 1 78 5,978
N.J. 240 178 2,188 2 - 2 855 - 25 NN
Pa. 404 115 2,738 2 14 1 621 - 6 NN
E.N. Central 3,162 386 9,492 8 43 3 2,236 6 68 77,332
Ohio 1,187 71 2,740 1 10 - 337 1 7 5,495
Ind. 286 11 844 2 3 - 211 - 4 NN
Ill. 1,099 258 3,877 1 15 - 1,117 3 42 33,889
Mich. 292 28 1,234 4 15 1 462 1 6 37,948
Wis. 298 18 797 - - 2 109 1 9 NA
W.N. Central 1,203 82 2,663 4 28 2 610 38 2 18,210
Minn. 56 2 201 1 2 - 140 1 1 NN
Iowa 75 6 235 1 8 1 66 - - 4,197
Mo. 987 72 1,985 1 7 1 260 24 1 10,147
N. Dak. - - 1 - 1 - 10 1 - 48
S. Dak. 2 - 8 - - - 28 2 - 619
Nebr. 10 - 46 - 5 - 22 3 - 2
Kans. 73 2 187 1 5 - 84 7 - 3,197
S. Atlantic 5,362 322 18,942 7 12 1 4,448 2 56 8,653
Del. 27 5 138 - - - 57 - 1 2
Md. 325 9 1,538 1 - - 363 1 14 NN
D.C. 170 28 967 - - - 121 - 1 16
Va. 796 18 1,919 2 1 - 372 - 9 2,844
W. Va. 8 2 179 - - - 80 - - 5,656
N.C. 1,672 44 4,023 1 1 - 566 - 1 NN
S.C. 799 100 1,945 1 - - 387 NN - 135
Ga. 820 42 3,185 - 1 1 740 1 2 NN
Fla. 745 74 5,048 2 9 - 1,762 - 28 NN
E.S. Central 3,997 144 9,992 - 6 - 1,578 3 6 4,701
Ky. 208 13 534 - 2 - 347 2 1 984
Tenn. 1,044 57 2,978 - 2 - 520 - 3 3,717
Ala. 661 18 1,933 - 1 - 433 - 2 NN
Miss. 2,084 56 4,547 - 1 - 278 1 - NN
W.S. Central 4,124 355 16,275 15 2 - 3,500 27 17 16,159
Ark. 446 29 1,328 - - - 264 23 - NN
La. 1,608 87 5,422 2 - - 433 1 4 NN
Okla. 157 15 497 1 2 - 261 3 3 NN
Tex. 1,913 224 9,028 12 - - 2,542 - 10 16,159
Mountain 242 23 1,137 2 12 4 654 9 13 7,286
Mont. 3 - 9 - - - 24 3 - 53
Idaho 2 - 10 - 3 - 13 - - NN
Wyo. - - 3 - - 2 12 - - NN
Colo. 126 4 296 1 6 1 94 1 3 NN
N. Mex. 18 - 178 - - - 81 1 1 NN
Ariz. 50 16 419 - 1 - 249 - 4 6,783
Utah 12 - 51 1 2 - 55 2 2 450
Nev. 31 3 171 - - 1 126 2 3 NN
Pacific 872 197 7,765 6 54 16 5,628 8 133 1,224
Wash. 36 3 281 1 7 - 264 1 12 NN
Oreg. 22 - 100 - |
