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Summary of Notifiable Diseases, United States, 1997


Foreword

MMWR Summary of Notifiable Diseases, United States, 1997

This publication contains summary tables of the official statistics for the reported occurrence of nationally notifiable diseases in the United States for 1997. These statistics are collected and compiled from reports to the National Notifiable Diseases Surveillance System (NNDSS), which is operated by CDC in collaboration with the Council of State and Territorial Epidemiologists (CSTE). Because the dates of onset or diagnosis for notifiable diseases are not always reported, these surveillance data are presented by the week they were reported to CDC by public health officials in state and territorial health departments. These data are finalized and published in the MMWR Summary of Notifiable Diseases, United States for use by state and local health departments; schools of medicine and public health; communications media; local, state, and federal agencies; and other agencies or persons interested in following the trends of reportable diseases in the United States. The annual publication of the Summary also documents which diseases are considered national priorities for notification and the annual number of cases of such diseases.

The Highlights section presents information on selected nationally notifiable and non-notifiable diseases to provide a context in which to interpret surveillance and disease-trend data and to provide further information on the epidemiology and prevention of selected diseases.

Part 1 contains information regarding morbidity for each of the diseases considered nationally notifiable during 1997. The tables provide the number of cases of notifiable diseases reported to CDC for 1997, as well as the distribution of cases by month and geographic location and by patient's age, sex, race, and Hispanic ethnicity. The data are final totals as of July 25, 1998, unless otherwise noted. Because no cases of anthrax or yellow fever were reported in the United States during 1997, these nationally notifiable diseases do not appear in the tables in Part 1. Nationally notifiable diseases that are reportable in fewer than 40 states also do not appear in these tables. In all tables, leprosy is listed as Hansen disease, and tickborne typhus fever is listed as Rocky Mountain spotted fever (RMSF).

Part 2 contains graphs and maps. These graphs and maps depict summary data for many of the notifiable diseases described in tabular form in Part

Part 3 contains tables that list the number of cases of notifiable diseases reported to CDC since 1966. It also includes a table enumerating deaths associated with specified notifiable diseases reported to the National Center for Health Statistics, CDC during 1987-1996.

Background

As of January 1, 1997, 52 infectious diseases were designated as notifiable at the national level. A notifiable disease is one for which regular, frequent, and timely information regarding individual cases is considered necessary for the prevention and control of the disease. This section briefly summarizes the history of the reporting of nationally notifiable diseases in the United States.

In 1878, Congress authorized the U.S. Marine Hospital Service (i.e., the forerunner of the Public Health Service {PHS}) to collect morbidity reports regarding cholera, smallpox, plague, and yellow fever from U.S. consuls overseas. The intention was to use this information to institute quarantine measures to prevent the introduction and spread of these diseases into the United States. In 1879, a specific Congressional appropriation was made for the collection and publication of reports of these notifiable diseases. Congress expanded the authority for weekly reporting and publication of these reports in 1893 to include data from states and municipal authorities. To increase the uniformity of the data, Congress enacted a law in 1902 directing the Surgeon General to provide forms for the collection and compilation of data and for the publication of reports at the national level. In 1912, state and territorial health authorities -- in conjunction with PHS -- recommended immediate telegraphic reporting of five infectious diseases and the monthly reporting, by letter, of 10 additional diseases. The first annual summary of The Notifiable Diseases in 1912 included reports of 10 diseases from 19 states, the District of Columbia, and Hawaii. By 1928, all states, the District of Columbia, Hawaii, and Puerto Rico were participating in national reporting of 29 specified diseases. At their annual meeting in 1950, state and territorial health officers authorized the Conference of State and Territorial Epidemiologists (CSTE), whose purpose was to determine which diseases should be reported to PHS. In 1961, CDC assumed responsibility for the collection and publication of data concerning nationally notifiable diseases.

The list of nationally notifiable diseases is revised periodically. For example, a disease might be added to the list as a new pathogen emerges, or a disease might be deleted as its incidence declines. Public health officials at state health departments and CDC continue to collaborate in determining which diseases should be nationally notifiable. CSTE, with input from CDC, makes recommendations annually for additions and deletions. However, reporting of nationally notifiable diseases to CDC by the states is voluntary. Reporting currently is mandated (i.e., by legislation or regulation) only at the state and local level. Thus, the list of diseases considered notifiable varies slightly by state. All states generally report the internationally quarantinable diseases (i.e., cholera, plague, and yellow fever) in compliance with the World Health Organization's International Health Regulations.

The list of 52 infectious diseases designated as notifiable at the national level during 1997 is as follows: Table_A

Data Sources

Provisional data concerning the reported occurrence of notifiable diseases are published weekly in MMWR. After each reporting year, staff in state health departments finalize reports of cases for that year with local or county health departments and reconcile the data with reports previously sent to CDC throughout the year. These data are compiled in final form in this summary. Notifiable disease reports (which are published in the annual MMWR Summary of Notifiable Diseases only after approval by the appropriate epidemiologist from each submitting state or territory) are the authoritative and archival counts of cases. Data published in MMWR Surveillance Summaries or other surveillance reports produced by CDC programs, which are useful for detailed epidemiologic analyses, may not agree exactly with data reported in the annual Summary of Notifiable Diseases because of differences in the timing of reports, the source of the data, and the case definitions.

Data in this summary were derived primarily from reports transmitted to the Division of Public Health Surveillance and Informatics, Epidemiology Program Office, CDC, by the 50 state, two city, and five territorial health departments through the National Electronic Telecommunications System for Surveillance (NETSS). (More information regarding NETSS and notifiable diseases, including case definitions for these conditions, is available on the Internet at http://www.cdc.gov/epo/phs.htm.) Final data for other diseases are from the surveillance program records of the following CDC programs (requests for further information regarding these data should be directed to the source specified):

National Center for Health Statistics (NCHS)

Office of Vital and Health Statistics Systems (deaths from selected

notifiable diseases)

National Center for Infectious Diseases (NCID)

Division of Bacterial and Mycotic Diseases (toxic-shock syndrome and

laboratory data regarding botulism, Escherichia coli O157:H7, Salmonella, and Shigella) Division of Vector-Borne Infectious Diseases (laboratory data regarding

arboviral encephalitis) Division of Viral and Rickettsial Diseases (animal rabies)

National Center for HIV, STD, and TB Prevention (NCHSTP)

Division of HIV/AIDS Prevention -- Surveillance and Epidemiology

(acquired immunodeficiency syndrome {AIDS}) Division of Sexually Transmitted Diseases Prevention (chancroid,

chlamydia, gonorrhea, and syphilis) Division of Tuberculosis Elimination (tuberculosis)

National Immunization Program (NIP)

Epidemiology and Surveillance Division (poliomyelitis)

Disease totals for the United States, unless otherwise stated, do not include data for American Samoa, Guam, Puerto Rico, the Virgin Islands, or the Commonwealth of the Northern Mariana Islands (CNMI). Disease totals from American Samoa were unavailable for 1997.

Population estimates for states are based on the July 1, 1997, post-censal estimates made by the U.S. Department of Commerce, Economics and Statistics Administration, Bureau of the Census, Population Division, Population Branch, Press Release PLL91. Population estimates for territories are 1997 estimates from the Bureau of the Census, Press Releases CB98-54 and CB98-80.

Rates in this summary were based on data for the U.S. total-resident population. However, population data from states in which diseases were not notifiable or disease data were not available were excluded from rate calculations.

Interpreting Data

The data reported in this summary are useful for analyzing disease trends and determining relative disease burdens. However, these data must be interpreted in light of reporting practices. Some diseases that cause severe clinical illness (e.g., plague and rabies), if diagnosed by a clinician, are most likely reported accurately. However, persons who have diseases that are clinically mild and infrequently associated with serious consequences (e.g., salmonellosis) might not seek medical care from a health-care provider. Even if these less severe diseases are diagnosed, they are less likely to be reported. The degree of completeness of reporting also is influenced by the diagnostic facilities available; the control measures in effect; the public awareness of a specific disease; and the interests, resources, and priorities of state and local officials responsible for disease control and public health surveillance. Finally, factors such as changes in the case definitions for public health surveillance, the introduction of new diagnostic tests, or the discovery of new disease entities can cause changes in disease reporting that are independent of the true incidence of disease.

Public health surveillance data are published for selected racial and ethnic population groups because these variables can be risk markers for certain notifiable diseases. Risk markers can identify potential risk factors for investigation in future studies. Data regarding race and ethnicity also can be used to identify populations to target for prevention efforts. However, one also must use caution when drawing conclusions from reported data relating to race and ethnicity. Among certain races and ethnicities, there are likely to be differential patterns of access to health care, interest in seeking health care, and detection of disease that would lead to data not representative of disease incidence in these populations. In addition, not all data concerning race and ethnicity are collected uniformly for all diseases. For example, the Division of HIV/AIDS Prevention -- Surveillance and Epidemiology and the Division of Sexually Transmitted Diseases Prevention in the National Center for HIV, STD, and TB Prevention (NCHSTP) collect information regarding race and ethnicity using a single variable. A person's racial and ethnic background is reported as either American Indian/Alaska Native, Asian/Pacific Islander, Black non-Hispanic, White non-Hispanic, or Hispanic. Additionally, although the recommended standard for classifying a person's race or ethnicity is based on self-reporting, this procedure might not always be followed.

Highlights for 1997

The Highlights section presents information on the public health importance of selected nationally notifiable and non-notifiable diseases, including a) domestic and international disease outbreaks; b) active surveillance findings; c) changes in data reporting practices; d) the impact of prevention programs; e) the emergence of antimicrobial resistance; and f) changes in immunization policies. This information is intended to provide a context in which to interpret surveillance and disease-trend data and to provide further information on the epidemiology and prevention of selected diseases.

Highlights for Selected Nationally Notifiable Diseases

Arboviral Encephalitis

The 1997 national total of 127 confirmed or probable California serogroup viral encephalitis cases (all of which were La Crosse encephalitis cases) is the fourth largest yearly total of such cases reported since 1964. The 73 case reports from West Virginia (57% of the national total) represent that state's largest total and an increase of 11% over its 1996 total. Much of the increase in reports from West Virginia may be attributable to this state's recent implementation of an active surveillance system for this disease. La Crosse encephalitis is endemic in the eastern United States, where it is associated with exposure to deciduous forests and Aedes triseriatus (the eastern treehole mosquito). A summertime/autumnal outbreak of St. Louis encephalitis in central Florida accounted for nine of the 13 cases reported nationally in 1997. The last major epidemic of St. Louis encephalitis in the United States (223 cases and 11 deaths) occurred in Florida in 1990. St. Louis encephalitis affects persons in portions of both the eastern and western United States. In Florida, the primary mosquito vector of St. Louis encephalitis virus is Culex nigripalpus. Fourteen cases of eastern equine encephalitis among humans were reported in 1997 from the South (12 cases), New England (one case), and the Upper Midwest (one case). Eastern equine encephalitis virus is typically transmitted to humans by various Aedes mosquito species. No cases of western equine encephalitis among humans have been reported nationally since 1994. The primary mosquito vector of western equine encephalitis virus in the western United States is Culex tarsalis.

Cryptosporidium

National reporting for cryptosporidiosis began in 1995 with 2,972 cases reported from 27 states. During 1996, as cryptosporidiosis became a reportable disease in an increased number of states, 2,426 cases were reported from 42 states. In 1997, a total of 2,566 cases were reported from 45 states. Because the diagnosis of cryptosporidiosis is often not considered, and because laboratories do not routinely test for Cryptosporidium infection, cryptosporidiosis continues to be underdiagnosed and underreported.

Diphtheria

Four cases of diphtheria were reported in the United States in 1997; two persons, both with localized mild illness, had culture-confirmed diphtheria. One confirmed case was caused by infection with a toxigenic strain of Corynebacterium diphtheriae, and was reported from a known endemic focus in South Dakota (MMWR 1997;46:506-10); one case caused by nontoxigenic C. diphtheriae was reported from Oregon. Two probable cases were reported from Nevada. Both case-patients had acute membranous pharyngitis; oropharyngeal specimens were positive for diphtheria toxin by polymerase chain reaction, but bacterial cultures of these specimens were negative.

In 1997, more than 7,000 cases of diphtheria were reported in an ongoing diphtheria epidemic in the New Independent States of the former Soviet Union. No importations were reported in the United States.

Haemophilus Influenzae (Invasive Disease)

In 1997, a total of 260 cases of Haemophilus influenzae (Hi) invasive disease among children aged less than 5 years were reported. (Data were provided by the National Immunization Program and were based on date of onset, not MMWR week.) An estimated 20,000 cases of Haemophilus influenzae type b (Hib) invasive disease among children occurred annually prior to Hib vaccine licensure in 1987. (JAMA 1993;269:221-6) The dramatic decline is attributed to the widespread administration of the Hib vaccine to preschool-aged children. Of the 260 cases, 201 (77%) isolates were serotyped, and 82 (41%) of the isolates for which serotype was known were type b. Of the 82 cases of Hib invasive disease reported in children aged less than 5 years, 42 (51%) were aged less than 6 months, which is too young to have completed a three-dose primary Hib vaccination. However, 27 (68%) of the 40 children who were old enough (aged greater than or equal to 6 months) to have completed a three-dose primary series before they developed Hib invasive disease were incompletely vaccinated or their vaccination status was unknown. These cases might have been prevented with age-appropriate vaccination.

Hantavirus Pulmonary Syndrome

In 1997, a total of 21 cases of Hantavirus pulmonary syndrome (HPS) were reported. HPS is a pan-American viral zoonosis caused by Sin Nombre virus and other New World hantaviruses, which in the United States, include Bayou virus, Black Creek Canal virus, and New York-1 virus. The identified rodent reservoirs for Sin Nombre, New York-1, Black Creek Canal, and Bayou viruses are, respectively, Peromyscus maniculatus (deer mouse), Peromyscus leucopus (white-footed mouse), Sigmodon hispidus (cotton rat), and Oryzomys palustris (rice rat). Cases of HPS have been found in the continental United States, Canada, Argentina, Brazil, Chile, Paraguay, and Uruguay. As of March 31, 1998, national surveillance for HPS has identified 179 confirmed cases in 29 states (case-fatality ratio = 44.7%).

Hemolytic Uremic Syndrome

Post-diarrheal hemolytic uremic syndrome (HUS) is a life-threatening illness characterized by hemolytic anemia, thrombocytopenia, and renal injury. Nearly all cases in the United States are caused by infection with Shiga toxin-producing Escherichia coli, with serotype O157:H7 being predominant. In 1997, the second year of national reporting, 20 states reported 93 cases of post-diarrheal HUS to CDC. By comparison, 18 states reported 104 cases in 1996. The median age of patients was 4 years (range: 1-89 years), with females accounting for 62% of patients overall. Illness was seasonal, with 50% of cases occurring during July through September.

Hepatitis A

In 1996, the Advisory Committee on Immunization Practices (ACIP) issued recommendations for the prevention of hepatitis A through active or passive immunization (MMWR 1996;45{No. RR-15}). The report provides recommendations for use of the hepatitis A vaccines (i.e., HAVRIX , manufactured by SmithKline Beecham Biologicals, and VAQTA , manufactured by Merck & Company, Inc.). For communities with high rates of hepatitis A and periodic outbreaks (peak rates: 700 reported cases per 100,000 population), routine vaccination of children aged 2 years and catch-up vaccination of older children is recommended. To control outbreaks in communities with intermediate rates of hepatitis A (i.e., 50-200 reported cases per 100,000 population), vaccination programs targeting subpopulations with the highest rates of disease may be considered. In these communities, ongoing routine vaccination of young children should be implemented to prevent future outbreaks.

Hepatitis C

Hepatitis C virus (HCV) infection is the most common bloodborne infection in the United States. Based on data from the CDC Sentinel Counties Study of Viral Hepatitis, it is estimated that as many as 180,000 new HCV infections occurred each year during the 1980s. Since 1989, the annual number of new infections has declined by 80%. However, in 1996, data from the third National Health and Nutrition Examination Survey, conducted from 1988 through 1994, indicated that approximately 4 million Americans (1.8%) are infected with HCV. Many of these chronically infected persons might not be aware of their infection or be clinically ill, because symptoms of hepatitis C-related chronic liver disease might not develop for 10-20 years after infection. However, such persons can infect others and are at risk for chronic liver disease or other HCV-related chronic diseases. Cirrhosis develops in 10%-20% of persons with HCV-related chronic hepatitis during the first two decades after infection, and 8,000-12,000 persons die from HCV-related chronic liver disease each year. CDC recently published new guidelines for HCV prevention and control (MMWR 1998;47{No. RR-19}).

HIV Infection in Children and Infants

In 1997, reports based on AIDS surveillance data indicated substantial declines in perinatally acquired AIDS, reflecting declining perinatal HIV transmission. HIV surveillance data indicated that the increasing use of zidovudine was temporally associated with this substantial decline in perinatally acquired AIDS (MMWR 1997;46:1086-92). These data demonstrate success in nationwide efforts to implement Public Health Service guidelines for use of zidovudine to reduce perinatal HIV transmission (MMWR 1994;43{No. RR-11}); MMWR 1998;47{No. RR-2}) and routine, voluntary prenatal HIV testing (MMWR 1995;44{No. RR-7}). States that conduct surveillance of perinatally exposed and infected children can evaluate the impact of the guidelines more completely and document resources needed to care for perinatally exposed infants. In 1997, a total of 30 states conducted surveillance of HIV infection in children, reporting 258 HIV-infected children who had not progressed to AIDS and 200 children who had AIDS. These states also received 2,238 new reports of perinatally exposed children who required follow up with health-care providers to determine their HIV infection status.

Measles

A total of 138 laboratory-confirmed cases of measles were reported to CDC in 1997, which is the lowest number of measles cases reported in one year and is less than half the previous record low. Of the 138 cases reported, 57 (41%) were international importations, and exposure to these cases resulted in 17 (12%) additional cases. Thus, 74 (54%) cases were associated with importation. An additional seven cases had virologic evidence suggesting an imported measles virus. Fifty-four (41%) measles patients were aged less than 5 years, 39 (28%) were aged 5-19 years, and 42 (30%) were aged greater than or equal to 20 years. Thirty-two patients (23%) reported having been vaccinated; seven (5%) received two doses. A total of 13 outbreaks were reported, with the largest involving eight cases. In 1997, no confirmed measles cases were reported from 21 states, and fewer than five cases were reported from 20 states and the District of Columbia.

Plague

In 1997, four plague cases among humans were reported in the United States (two cases in California, one in Arizona, and one in Colorado). One case was fatal and, like two fatal cases that occurred in 1996, septicemic plague was diagnosed postmortem. Each of these cases, which occurred in plague-endemic areas, illustrates the need for health-care providers to maintain a high level of awareness about the risks of human plague. Of the 350 cases reported in the United States from 1970 through 1997, approximately 80% were reported from the southwestern states of New Mexico, Arizona, and Colorado; 9% were reported from California; and nine other western states reported limited numbers of cases. Plague also occurs in animal populations in four other western states that have not reported cases among humans, including Kansas, where Yersinia pestis-infected prairie dog fleas were identified in 1997. This is the first report of plague in an animal in Kansas since 1950; however, a nearby county in Oklahoma experienced one case among a person in 1991, and other Great Plains states have reported epizootic activity in recent years (MMWR 1994;43:242-6). Internationally, outbreaks of rat-associated plague occurred in the port city of Mahajanga, Madagascar from 1995 through 1997. These are the first port-related outbreaks to be reported from that country in decades. Researchers reported the first case of multidrug-resistant Y. pestis in 1997. This isolate, which was obtained in 1995 from a case in Madagascar, contained a plasmid that conferred resistance to antibiotics commonly prescribed for plague treatment or prophylaxis (e.g., streptomycin, chloramphenicol, and tetracycline) (N Engl J Med 1997;337:677-80, 702-4).

Poliomyelitis

In 1997, the Advisory Committee on Immunization Practices (ACIP) recommended a change in routine childhood vaccination policy for polio in the United States. The previously recommended schedule of four doses of attenuated oral poliovirus vaccine (OPV) was changed to a sequential schedule of two doses of inactivated poliovirus vaccine (IPV) followed by two doses of OPV for routine vaccination of children. Since 1980, a total of 147 cases have been reported, of which 139 were associated with the use of OPV. The last imported case was reported in 1993.

Streptococcal Disease, Invasive, Group A

According to reports from active surveillance programs in five states (i.e., California, Connecticut, Georgia, Minnesota, and Oregon), the incidence of invasive group A streptococcal disease during 1997 was 4.1 cases/100,000 population; disease incidence ranged from 2.2 to 5.1 cases/100,000 population among the surveillance areas. Streptococcal toxic shock syndrome and necrotizing fasciitis accounted for approximately 6.9% and 7.7% of invasive cases, respectively. Overall case-fatality among patients with invasive group A streptococcal disease was 13%; case-fatality rates were higher among patients with streptococcal toxic shock syndrome and necrotizing fasciitis (43% and 21%, respectively). Risk factors for invasive group A streptococcal disease include elderly age, HIV infection, diabetes, cancer, alcohol abuse, and varicella infection.

Streptococcus pneumoniae, Drug-Resistant

The proportion of drug-resistant Streptococcus pneumoniae isolates continues to increase, according to reports from active surveillance programs in seven states (i.e., California, Connecticut, Georgia, Maryland, Minnesota, Oregon, and Tennessee). During 1997, approximately 26% of pneumococcal isolates obtained from sterile sites were no longer susceptible to penicillin (mean inhibitory concentration {MIC} greater than or equal to 0.1 ug/mL). In 1997, the proportion of all isolates with high-level penicillin resistance (MIC greater than or equal to 2 ug/mL), increased from 12% in 1996 to 14.4%; a total of 7.2% of isolates had MICs greater than or equal to 4 ug/mL compared with 5.4% in 1996. The resistant proportion varied widely by geographic region. To limit the contribution of unnecessary antimicrobial use to the spread of drug-resistant S. pneumoniae, CDC and the American Academy of Pediatrics issued recommendations for judicious use of antimicrobial agents for upper-respiratory-tract infections among children (Pediatrics 1998;101{suppl}). Educational materials concerning the principles of judicious antimicrobial use can be obtained by calling the National Center for Infectious Diseases at (404) 639-4702 for an order form.

Tetanus

Fifty cases of tetanus were reported in 1997. During 1995-1997, an average annual incidence of 41 cases were reported, the lowest ever reported since national tetanus surveillance began in 1947. The average annual incidence of 0.15 cases per million population represents a slight decline from the incidence of 0.2 cases per million population reported during 1991-1994.

Highlights for Selected Non-Notifiable Diseases

Cyclosporiasis

In 1997, several outbreaks of cyclosporiasis associated with various types of fresh produce (e.g., raspberries, mesclun lettuce, and basil) occurred in the United States. In the largest outbreak, which was associated with consumption of fresh raspberries, 41 clusters with a total of 762 cases (25% were laboratory confirmed) were reported by 13 states, the District of Columbia, and one province in Canada.

Dengue

Fifty-six laboratory-positive cases of dengue were imported into the United States in 1997 and diagnosed at the CDC Dengue Branch. This number represents a 30% increase from the number of laboratory-confirmed cases reported in 1996 (n=43). Similarly, the total number of dengue and dengue hemorrhagic fever (DHF) cases reported by Pan American Health Organization member countries in 1997 (n=364,945) was 46% higher than the 1996 total (n=250,707). Autochthonous dengue cases (n=3) were documented in south Texas again in 1997, underscoring the risk of dengue transmission in southern gulf coast states where mosquito vectors occur. After a 15-year absence, dengue cases were reported from Cuba in 1997. The municipality of Santiago de Cuba experienced an outbreak with 2,946 laboratory-diagnosed cases and 205 DHF cases, which resulted in 12 deaths.

HIV Infection in Adults

In June 1997, HIV-infection reporting for adults (i.e., persons aged greater than or equal to 13 years) was added to the list of nationally notifiable diseases at a Council of State and Territorial Epidemiologists (CSTE) meeting. During 1997, reports based on acquired immunodeficiency syndrome (AIDS) surveillance data highlighted substantial declines in AIDS incidence and deaths. As a result of improvements in treatment and care of persons infected with the human immunodeficiency virus (HIV), surveillance of AIDS alone no longer accurately reflects the magnitude or direction of the epidemic. Data concerning persons in whom HIV infection is diagnosed before AIDS is diagnosed are needed to determine populations that could benefit from prevention and treatment services. CSTE recommends that all states and territories implement confidential HIV infection reporting based on methods that provide accurate and representative data for all persons confidentially diagnosed with HIV infection.

Influenza A (H5N1)

In May 1997, the first known case of disease among humans caused by influenza A (H5N1) virus occurred in a previously healthy 3-year-old child in Hong Kong; this child died from his illness. An additional 17 cases (including five deaths) were detected in November and December 1997. All cases occurred coincident with outbreaks of highly pathogenic avian influenza A (H5N1) virus among poultry. At the end of December, Hong Kong authorities initiated the slaughter of all chickens in Hong Kong and, since then, no additional cases of influenza A (H5N1) virus have been detected among humans despite enhanced surveillance. The pandemic potential of influenza A (H5N1) viruses remains unknown. No cases of H5N1 infection were reported in the United States.

Tularemia

Tularemia was removed from the nationally notifiable disease list in 1995. However, as of January 1998, a total of 36 states maintained tularemia as a notifiable condition. Based on a telephone survey of state departments of health conducted from 1995 through 1997, a total of 313 cases of tularemia were reported by 43 states (119 cases in 1995, 89 cases in 1996, and 105 cases in 1997). Of these, 155 (49%) were reported from Missouri, Oklahoma, Kansas, and Arkansas.

Vancomycin-Resistant Enterococci (VRE)

The magnitude and impact of vancomycin-resistant enterococci (VRE) in the United States are demonstrated by CDC's National Nosocomial Infections Surveillance (NNIS) system, which includes more than 275 U.S. hospitals. Additional data are available on the Internet at http://www.cdc.gov/ncidod/hip/Surveill/surveill.htm. During 1989-1997, the percentage of enterococci resistant to vancomycin isolated from patients in intensive care units with nosocomial infections increased from 0.4% to 23.2% (Table Table_B). The percentage of VRE isolated from patients in noncritical care units with nosocomial infections increased from 0.3% to 15.4%.


PART 1: Summaries of Notifiable Diseases in the United States

EXPLANATION OF SYMBOLS USED IN TABLES, GRAPHS, AND MAPS Data not available..............................................NA Report of disease is not required

in that jurisdiction (not notifiable) .............................................NN No reported cases ............................................. --

Table_C NOTIFIABLE DISEASES -- Summary of reported cases, by month,

United States, 1997

Table_D1 NOTIFIABLE DISEASES -- Reported cases, by geographic division

and area, United States, 1997

Table_D2 NOTIFIABLE DISEASES -- Reported cases, by geographic division

and area, United States, 1997 (continued)

Table_D3 NOTIFIABLE DISEASES -- Reported cases, by geographic division

and area, United States, 1997 (continued)

Table_D4 NOTIFIABLE DISEASES -- Reported cases, by geographic division

and area, United States, 1997 (continued)

Table_D5 NOTIFIABLE DISEASES -- Reported cases, by geographic division

and area, United States, 1997 (continued)

Table_D6 NOTIFIABLE DISEASES -- Reported cases, by geographic division

and area, United States, 1997 (continued)

Table_E NOTIFIABLE DISEASES -- Summary of reported cases, by age

group, United States, 1997

Table_F NOTIFIABLE DISEASES -- Summary of reported cases, by sex,

United States, 1997

Table_G NOTIFIABLE DISEASES -- Summary of reported cases, by race,

United States, 1997

Table_H NOTIFIABLE DISEASES -- Summary of reported cases, by ethnicity,

United States, 1997


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

EXPLANATION OF SYMBOLS USED IN TABLES, GRAPHS, AND MAPS Data not available..............................................NA Report of disease is not required

in that jurisdiction (not notifiable) .............................................NN

Figure_1 ACQUIRED IMMUNODEFICIENCY SYNDROME (AIDS) -- reported cases

per 100,000 population, United States and Puerto Rico, 1997

Figure_2 ACQUIRED IMMUNODEFICIENCY SYNDROME (AIDS) -- reported cases

by quarter, United States, 1986-1997

Figure_3 ACQUIRED IMMUNODEFICIENCY SYNDROME (AIDS) -- reported

pediatric cases, United States and Puerto Rico, 1997

Figure_4 ARBOVIRAL INFECTIONS (of the central nervous system) --

reported laboratory- confirmed cases caused by California serogroup viruses, by month of onset, United States, 1988- 1997

Figure_5 ARBOVIRAL INFECTIONS (of the central nervous system) --

reported laboratory- confirmed cases caused by eastern equine encephalitis virus, by month of onset, United States, 1988-1997

Figure_6 ARBOVIRAL INFECTIONS (of the central nervous system) --

reported laboratory- confirmed cases caused by St. Louis encephalitis virus, by month of onset, United States, 1988- 1997

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

reported laboratory- confirmed cases caused by western equine encephalitis virus, by month of onset, United States, 1988-1997

Figure_8 BOTULISM (foodborne) -- by year, United States, 1977-1997

Figure_9 BOTULISM (infant) -- by year, United States, 1977-1997

Figure_10 BRUCELLOSIS -- by year, United States, 1967-1997

Figure_11 CHLAMYDIA -- reported cases among women per 100,000

population, United States, 1997

Figure_12 CHOLERA -- reported cases, United States and territories,

1997

Figure_13 CRYPTOSPORIDIOSIS -- reported cases per 100,000 population,

United States and territories, 1997

Figure_14 DIPHTHERIA -- by year, United States, 1967-1997

Figure_15 ESCHERICHIA COLI O157:H7 -- reported cases, United States

and territories, 1997

Figure_16 ESCHERICHIA COLI O157:H7 -- reported isolates, United

States, 1997

Figure_17 GONORRHEA -- reported cases per 100,000 population, United

States, 1997

Figure_18 GONORRHEA -- by sex, United States, 1982-1997

Figure_19 GONORRHEA -- by race and ethnicity, United States, 1982-

1997

Figure_20 HAEMOPHILUS INFLUENZAE (Invasive Disease) -- by age group,

United States, 1991-1997

Figure_21 HANSEN DISEASE (Leprosy) -- by year, United States, 1967-

1997

Figure_22 HEPATITIS -- by year, United States, 1967-1997

Figure_23 HEPATITIS A -- reported cases per 100,000 population,

United States and territories, 1997

Figure_24 HEPATITIS B -- reported cases per 100,000 population,

United States and territories, 1997

Figure_25 LEGIONELLOSIS -- by year, United States, 1982-1997

Figure_26 LYME DISEASE -- reported cases, United States, 1997

Figure_27 MALARIA -- by year, United States, 1967-1997

Figure_28 MEASLES (Rubeola) -- by year, United States, 1962-1997

Figure_29 MENINGOCOCCAL DISEASE -- by year, United States, 1967-1997

Figure_30 MUMPS -- by year, United States, 1972-1997

Figure_31 PERTUSSIS (Whooping Cough) -- by year, United States, 1967-

1997

Figure_32 PERTUSSIS (Whooping Cough) -- by age group, United States,

1997

Figure_33 PLAGUE -- among humans, by year, United States, 1967-1997

Figure_34 POLIOMYELITIS (paralytic) -- by year, United States, 1967-

1997

Figure_35 PSITTACOSIS -- by year, United States, 1967-1997

Figure_36 RABIES -- wild and domestic animals, by year, United States

and Puerto Rico, 1967-1997

Figure_37 ROCKY MOUNTAIN SPOTTED FEVER (RMSF) -- by year, United

States, 1967-1997

Figure_38 RUBELLA (German Measles) -- by year, United States, 1967-

1997

Figure_39 SALMONELLOSIS (excluding Typhoid Fever) -- by year, United

States, 1967-1997

Figure_40 SALMONELLA -- serotype of isolate by year, United States,

1972-1997

Figure_41 SHIGELLOSIS -- by year, United States, 1967-1997

Figure_42 SHIGELLA -- species of isolate by year, United States,

1972-1997

Figure_43 SYPHILIS (Primary and Secondary) -- reported cases per

100,000 population, United States, 1997

Figure_44 SYPHILIS (Primary and Secondary) -- by sex, United States,

1982-1997

Figure_45 SYPHILIS (Primary and Secondary) -- by race and ethnicity,

United States, 1982-1997

Figure_46 CONGENITAL SYPHILIS -- among infants aged <1 year, United

States, 1967-1997

Figure_47 TETANUS -- by year, United States, 1967-1997

Figure_48 TOXIC-SHOCK SYNDROME (TSS) -- by quarter, United States,

1982-1997

Figure_49 TRICHINOSIS -- by year, United States, 1967-1997

Figure_50 TUBERCULOSIS -- reported cases per 100,000 population,

United States and territories, 1997

Figure_51 TUBERCULOSIS -- by year, United States, 1977-1997

Figure_52 TUBERCULOSIS -- by year, among U.S.- and foreign-born

persons, United States, 1986-1997

Figure_53 TYPHOID FEVER -- by year, United States, 1967-1997

Figure_54 VARICELLA (Chickenpox) -- reported cases per 100, 000

population, United States and territories, 1997


PART 3: Historical Summary Tables

EXPLANATION OF SYMBOLS USED IN TABLES, GRAPHS, AND MAPS No reported cases ............................................. --

Table_1 NOTIFIABLE DISEASES -- Summary of reported cases per 100,000

population, United States, 1988-1997

Table_2 NOTIFIABLE DISEASES -- Summary of reported cases, United

States, 1990-1997

Table_3 NOTIFIABLE DISEASES -- Summary of reported cases, United

States, 1982-1989

Table_4 NOTIFIABLE DISEASES -- Summary of reported cases, United

States, 1974-1981

Table_5 NOTIFIABLE DISEASES -- Summary of reported cases, United

States, 1966-1973

Table_6 NOTIFIABLE DISEASES -- Deaths from selected diseases, United

States, 1987-1996


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Group A Streptococcal Disease

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Haemophilus influenzae (Invasive Disease)

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Hepatitis

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Hepatitis A

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Hepatitis B

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Hepatitis, C/Non-A, Non-B

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Influenza A (H5N1)

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Legionellosis

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Lyme Disease

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Malaria

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Measles

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Meningococcal Disease

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Mumps

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Pertussis

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Plague

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Poliomyelitis

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Psittacosis

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Rabies

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Rocky Mountain Spotted Fever

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Rubella

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CDC. Rubella and congenital rubella syndrome -- United States, January 1, 1991-May 7, 1994. MMWR 1994;43:391,397-401.

CDC. Rubella among crew members of commercial cruise ships. MMWR 1997;46:1247-50.

Salmonellosis

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Mermin J, Hoar B, Angulo FJ. Iguanas and Salmonella marina infection in children: a reflection of the incidence of reptile-associated salmonellosis in the United States. Pediatrics 1997;99:399-402.

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CDC. Outbreaks of Salmonella serotype Enteritidis infection associated with consumption of raw shell eggs -- United States, 1994-1995. MMWR 1996;45:737-42.

Shigellosis

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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.

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Syphilis

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Syphilis, Congenital

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Coles BF, Hipp SS, Silberstein GS, Chen JH. Congenital syphilis surveillance in upstate New York, 1989-1992: implications for prevention and clinical management. J Infect Dis. 1995;171:732-5.

CDC. Surveillance for geographic and secular trends in congenital syphilis -- United States, 1983-1991. MMWR 1993;42(No. SS-6):59-71.

CDC. Guidelines for the prevention and control of congenital syphilis. MMWR 1988;37(No. S-1):1-13.

Tetanus

CDC. Tetanus surveillance -- United States, 1995-1997. MMWR 1998;47(No. SS-2):1-13.

Craig AS, Reed GW, Mohon RT, et al. Neonatal tetanus in the United States: a sentinel event in the foreign-born. Pediatr Infect Dis J 1997;16:955-9.

CDC. Tetanus surveillance -- United States, 1991-1994. MMWR 1997;46(No. SS-2):15-25.

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Toxic-Shock Syndrome

Schuchat A, Broome CV. Toxic shock syndrome and tampons. Epidemiol Rev 1991;13:99-112.

CDC. Reduced incidence of menstrual toxic shock syndrome -- United States, 1980-1990. MMWR 1990;39:421-3.

Gaventa S, Reingold AL, Hightower AW, et al. Active surveillance for toxic shock syndrome in the United States, 1986. Rev Infect Dis 1989;11(suppl):S28-S34.

Trichinellosis (Trichinosis)

CDC. Outbreak of trichinellosis associated with eating cougar jerky -- Idaho, 1995. MMWR 1996;45:205-6.

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.

CDC. Trichinosis surveillance -- United States, 1987-1990. MMWR 1991;40(No. SS-3):35-42.

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.

Tuberculosis

CDC. Reported tuberculosis in the United States, 1997. Washington, DC: US Department of Health and Human Services, CDC, 1998.

CDC. Tuberculosis morbidity -- United States, 1997. MMWR 1998;47:253-7.

CDC. Recommendations for counting reported tuberculosis cases. In: Reported tuberculosis in the United States, 1996. July 1997:61-8.

American Thoracic Society, CDC. Treatment of tuberculosis and tuberculosis infection in adults and children. Am J Respir Crit Care Med 1994;149:1359-74.

Typhoid Fever

Mermin JH, Townes JM, Gerber M, Dolan N, Mintz ED, Tauxe RV. Typhoid fever in the United States, 1985-1994: changing risks of international travel and increasing antimicrobial resistance. Arch Intern Med 1998;158:633-8.

CDC. Typhoid immunization: recommendations of the Advisory Committee on Immunization Practices. MMWR 1994;43(No. RR-14).

Woodruff BA, Pavia AT, Blake PA. A new look at typhoid vaccination: information for the practicing physician. JAMA 1991;265:756-9.

Varicella

CDC. Varicella-related deaths among children -- United States, 1997. MMWR 1998;47:365-8.

CDC. Outbreak of invasive Group A Streptococcus associated with varicella in a childcare center -- Boston, Massachusetts, 1997. MMWR 1997;46:944-9.

Izurieta HS, Strebel PM, Blake PA. Postlicensure effectiveness of varicella vaccine during an outbreak in a child care center. JAMA 1997;278:1495-9.

CDC. Prevention of varicella: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR 1996;45(No. RR-11).


Table_A
Note: To print large tables and graphs users may have to change their printer settings to landscape and use a small font size.

The 52 Infectious Diseases Designated
as Notifiable at the National Level During 1997
===============================================================================================
---------------------------------------------------------------------------------------------
Acquired immunodeficiency       Haemophilus  influenzae          Rabies, animal
  syndrome                        (Invasive Disease)             Rabies, human
Anthrax                         Hansen disease (leprosy)         Rocky Mountain spotted fever
Botulism*                       Hantavirus pulmonary syndrome    Rubella
Brucellosis                     Hemolytic uremic syndrome,       Salmonellosis*
Chancroid*                        post-diarrheal                 Shigellosis*
Chlamydia trachomatis,          Hepatitis A                      Streptococcal disease,
  genital infection             Hepatitis B                        invasive, group A
Cholera                         Hepatitis, C/non-A, non-B        Streptococcus  pneumoniae,
Coccidioidomycosis*             HIV infection, pediatric           drug-resistant*
Congenital rubella syndrome     Legionellosis                    Streptococcal toxic-shock
Congenital syphilis             Lyme disease                       syndrome
Cryptosporidiosis               Malaria                          Syphilis
Diphtheria                      Measles (Rubeola)                Tetanus
Encephalitis, California        Meningococcal disease            Toxic-shock syndrome
Encephalitis, eastern equine    Mumps                            Trichinosis
Encephalitis, St. Louis         Pertussis                        Tuberculosis
Encephalitis, western equine    Plague                           Typhoid fever
Escherichia  coli  O157:H7      Poliomyelitis, paralytic         Yellow fever
Gonorrhea                       Psittacosis
---------------------------------------------------------------------------------------------
NOTE: Although varicella is not a nationally notifiable disease, the Council of State and
Territorial Epidemiologists recommends reporting of cases of this disease to CDC.

* Not currently published in the MMWR  weekly tables.
===============================================================================================

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Table_B
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TABLE: Percentage of nosocomial enterococci reported as resistant to vancomycin,
by health-care setting and year*
===========================================================================================
Year     Intensive care unit (ICU) +     Non-ICU +
--------------------------------------------------
1989                 0.4                    0.3
1990                 1.5                    0.8
1991                 5.3                    2.9
1992                 7.1                    2.9
1993                11.6                    4.8
1994                13.6                    9.0
1995                12.8                   12.0
1996                16.6                   11.6
1997                23.2                   15.4
--------------------------------------------------
* N>20
+ P<0.

Source: NNIS System, Hospital Infections Program, National Center for Infectious Diseases
===========================================================================================

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Table_C
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NOTIFIABLE DISEASES -- Summary of reported cases, by month, United States, 1997
================================================================================================================================================================================
NAME                                    Total     Jan.       Feb.       Mar.      Apr.        May     June     July       Aug.    Sept.     Oct.        Nov.      Dec.    Unk.
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
AIDS *                                 58,492    4,682      5,066      5,364     4,586      5,072    5,234    4,281      4,803    4,964    4,636       4,016     5,788       -
Botulism, total                           132        9          5          8         2         14        9       19         16        8        8          20        14       -
Brucellosis                                98       20          1          6         4          7        6       10         13        8        3           9        11       -
Chancroid +                               243    ............. 65 ..........     ............. 80 ........    ............. 58 ........    .............. 40 .........       -
Chlamydia +&                          526,671    ........ 119,217 ..........     ........ 130,697 ........    ........ 135,403 ........    ......... 141,354 .........       -
Cholera                                     6        -          -          -         -          1        -        -          2        -        2           1         -       -
Cryptosporidiosis                       2,566      146         94        154       121        152      117      211        358      311      293         310       299       -
Diphtheria                                  4        -          -          2         1          -        1        -          -        -        -           -         -       -
Escherichia coli O157:H7                2,555       82         73        107        71        173      190      400        432      335      281         196       215       -
Gonorrhea +                           324,907    ......... 74,417 ..........     ......... 76,126 ........    ......... 87,378 ........    .......... 86,986 .........       -
Haemophilus influenzae, invasive        1,162       71         86        123        98        116      103       69         82       76       58         103       177       -
Hansen disease (leprosy)                  122        6          4         12        11         12        5        4          7       11        2          19        29       -
Hepatitis A                            30,021    1,716      2,184      2,885     2,033      3,124    2,163    2,091      2,628    2,517    2,526       2,524     3,630       -
Hepatitis B                            10,416      696        637        947       736      1,022      774      731        955      809      735         923     1,451       -
Hepatitis, C/non-A non-B                3,816      273        257        322       246        384      291      304        370      319      242         312       496       -
Legionellosis                           1,163       61         84         72        63         83       69       75        116      112      127         152       149       -
Lyme disease                           12,801      512        254        390       293        612      724    1,638      3,197    1,944    1,057         988     1,192       -
Malaria                                 2,001      124         98        111       100        168      181      188        279      160      147         181       264       -
Measles (rubeola)                         138        3          3          9        14         31       10       21         13        9       11           3        11       -
Meningococcal disease                   3,308      138        348        469       282        360      248      175        184      171      168         230       535       -
Mumps                                     683       32         46         72        63        101       57       25         37       61       45          72        72       -
Pertussis (whooping cough)              6,564      607        403        512       537        475      404      393        543      475      397         740     1,078       -
Plague                                      4        -          -          -         -          1        1        -          -        1        -           1         -       -
Poliomyelitis, paralytic                    3        1          -          -         -          1        -        -          -        -        -           -         1       -
Psittacosis                                33        2          2          4         5          5        2        -          4        3        2           -         4       -
Rabies, animal                          8,105      268        422        667       741        781      678      599        830      832      862         707       718       -
Rabies, human                               2        -          -          1         -          -        -        -          -        -        -           -         1       -
Rocky Mountain spotted fever              409       20          7         14        11         24       58       54         87       48       45          25        16       -
Rubella (German measles)                  181       10          4          7        10         30       34       36          7       10       17           1        15       -
Rubella, congenital syndrome                5        -          -          1         -          1        -        -          -        1        -           -         2       -
Salmonellosis                          41,901    1,663      2,030      2,544     2,351      3,391    3,175    3,626      5,398    4,364    3,961       4,219     5,179       -
Shigellosis                            23,117    1,572      1,200      1,301     1,064      1,615    1,522    1,694      2,717    2,166    2,100       2,792     3,374       -
Syphilis, total all stages +           46,540    ......... 11,872 ..........     ......... 13,007 ........    ......... 11,371 ........    .......... 10,290 .........       -
  Primary and secondary +               8,550    .......... 2,264 ..........     .......... 2,252 ........    .......... 2,198 ........    ........... 1,836 .........       -
  Congenital <1 year +                  1,049    .......
Tetanus                                    50        5          3          5         2          8        5        4          3        2        2           7         4       -
Toxic-shock syndrome                      157       15          9         13        14         13        9       12         16       12       10          12        22       -
Trichinosis                                13        5          -          -         -          -        -        -          4        -        -           -         4       -
Tuberculosis @                         19,851      794      1,285      1,630     1,790      1,813    1,553    1,697      1,644    1,583    1,601       1,442     3,019       -
Typhoid fever                             365        9         20         28        17         33       25       23         43       44       35          36        52       -
Varicella (chickenpox)**               98,727    5,463     10,792     15,484    11,394     17,909    6,744    2,665      1,370    2,159    3,069       6,748    14,930       -
------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
 * The total number of acquired immunodeficiency syndrome (AIDS) cases includes all cases reported to the Division of HIV/ AIDS Prevention -- Surveillance and Epidemiology,
   National Center for HIV, STD, and TB Prevention (NCHSTP) as of December 31, 1997.
 + Cases were updated through the Division of Sexually Transmitted Diseases Prevention, NCHSTP, as of July 13, 1998.
 & Chlamydia refers to genital infections caused by C. trachomatis.
 @ Cases were updated through the Division of Tuberculosis Elimination, NCHSTP, as of April 15, 1998.
** Not nationally notifiable.
================================================================================================================================================================================

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Table_D1
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NOTIFIABLE DISEASES -- Reported cases, by geographic division and area,
United States, 1997
=============================================================================================================================
                    Total resident                    Botulism                                         Chlamydia
                        population              --------------------                                 trachomatis
Area                (in thousands)      AIDS*   Foodborne     Infant    Brucellosis  Chancroid +     infection +
----------------------------------------------------------------------------------------------------------------
United States              267,637     58,492          31         79             98          243         526,671
New England                 13,379      2,372           -          -              1            4          18,433
  Maine                      1,242         51           -          -              -            -           1,066
  N.H.                       1,173         55           -          -              -            -             816
  Vt.                          589         29           -          -              -           NN             434
  Mass.                      6,118        863           -          -              1            4           7,984
  R.I.                         987        152           -          -              -            -           2,069
  Conn.                      3,270      1,222           -          -              -            -           6,064
Mid. Atlantic               38,210     18,327           -         17              3          119          58,653
  Upstate N.Y.              10,828      3,858           -          2              1            -              NN
  N.Y. City                  7,309      9,331           -          -              -          119          28,468
  N.J.                       8,053      3,226           -          3              -            -          10,347
  Pa.                       12,020      1,912           -         12              2            -          19,838
E.N. Central                43,890      4,350           1          6             12            8          86,404
  Ohio                      11,186        848           -          3              2            3          22,827
  Ind.                       5,864        523           -          -              -            -           9,600
  Ill.                      11,896      1,842           1          1              7            5          23,024
  Mich.                      9,774        882           -          -              3            -          21,399
  Wis.                       5,170        255          NA          2             NA            -           9,554
W.N. Central                18,571      1,166           -          -              7            -          32,968
  Minn.                      4,686        214           -          -              -            -           6,631
  Iowa                       2,852        101           -         NN              4            -           4,907
  Mo.                        5,402        577           -          -              2            -          12,308
  N. Dak.                      641         13           -          -             NN           NN             902
  S. Dak.                      738         11           -          -              -            -           1,450
  Nebr.                      1,657         91           -          -              1            -           2,767
  Kans.                      2,595        159           -          -              -            -           4,003
S. Atlantic                 48,230     13,858           1          3              8           30         106,486
  Del.                         732        231           -          -              -            -           2,613
  Md.                        5,094      1,875           -          -              -            1          13,763
  D.C.                         529        998           -          -              1            -           3,069
  Va.                        6,734      1,175           -          -              1            1          11,615
  W. Va.                     1,816        130           -          2              -            -           3,108
  N.C.                       7,425        850           1          -              3            9          17,108
  S.C.                       3,760        779           -          -              -           15          12,511
  Ga.                        7,486      1,722           -          1              1            1          15,911
  Fla.                      14,654      6,098           -          -              2            3          26,788
E.S. Central                16,326      2,062           -          -              2            2          35,437
  Ky.                        3,908        361           -          -              1            -           6,332
  Tenn.                      5,368        784           -          -              1            1          12,502
  Ala.                       4,319        570           -          -              -            1           8,704
  Miss.                      2,731        347           -          -              -            -           7,899
W.S. Central                29,631      6,337           1         11             20           57          72,139
  Ark.                       2,523        242           -          1              1            1           2,503
  La.                        4,352      1,094           -          1              -            3          11,545
  Okla.                      3,317        283           -          -              -            -           7,416
  Tex.                      19,439      4,718           1          9             19           53          50,675
Mountain                    16,483      1,850           1          8              8            1          29,216
  Mont.                        879         41           -          -              -            -           1,146
  Idaho                      1,210         52           -          2              -            -           1,709
  Wyo.                         480         16           -          -              2            1             635
  Colo.                      3,893        380           -          -              2            -           7,196
  N. Mex.                    1,730        169           -          1              1            -           4,021
  Ariz.                      4,555        448           1          2              3            -          10,783
  Utah                       2,059        152           -          2              -            -           1,774
  Nev.                       1,677        592           -          1              -            -           1,952
Pacific                     42,917      8,121          27         34             37           22          86,935
  Wash.                      5,610        641           3          -              3            2           9,574
  Oreg.                      3,243        305           3          2              1            1           5,270
  Calif.                    32,268      7,029           2         29             30           19          68,647
  Alaska                       609         52          19          -              -            -           1,615
  Hawaii                     1,187         94           -          3              3            -           1,829
----------------------------------------------------------------------------------------------------------------
  Guam                         145          2           -          -              -            -             368
  P.R.                       3,827      2,040           -          -              -            1           2,123
  V.I.                         114         99          NA         NA             NA           NA              14
  American Samoa                60          -          NA         NA             NA           NA              NA
  C.N.M.I.                      63          1           -          -              -           NA              NA
----------------------------------------------------------------------------------------------------------------
* Totals reported to Division of HIV/AIDS Prevention -- Surveillance and Epidemiology, National Center for HIV, STD, and TB
  Prevention (NCHSTP), as of December 31, 1997. Total includes 49 cases in persons with unknown state of residence.
+ Cases were updated through the Division of Sexually Transmitted Diseases Prevention, NCHSTP, as of July 13, 1998.
=============================================================================================================================

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Table_D2
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NOTIFIABLE DISEASES -- Reported cases, by geographic division and area,
United States, 1997 (continued)
======================================================================================================================================
                                                                         Escherichia coli O157:H7                        Haemophilus
                                                                         ------------------------                         influenzae
Area                  Cholera    Cryptosporidiosis    Diphtheria          NETSS*         PHLIS +   Gonorrhea &    (Invasive Disease)
------------------------------------------------------------------------------------------------------------------------------------
United States               6                2,566             4           2,555           1,658       324,907                 1,162
New England                 -                  166             -             197             133         5,889                    67
  Maine                     -                   34             -              19               -            66                     5
  N.H.                      -                    6             -              15              16            96                    13
  Vt.                       -                   18             -               8               3            53                     3
  Mass.                     -                   62             -              99              95         2,225                    40
  R.I.                      -                    4             -              12               1           422                     4
  Conn.                     -                   42             -              44              18         3,027                     2
Mid. Atlantic               -                  528             -             167              56        39,947                   184
  Upstate N.Y.              -                  328             -             111               -         6,801                    69
  N.Y. City                 -                  169             -              20               9        15,592                    42
  N.J.                      -                   31             -              36              27         7,587                    53
  Pa.                       -                   NN             -              NN              20         9,967                    20
E.N. Central                1                  523             -             574             302        59,591                   172
  Ohio                      -                   38             -             108              55        14,961                    86
  Ind.                      -                   46             -              82              49         6,155                    24
  Ill.                      -                   73             -              76              40        18,423                    42
  Mich.                     1                   46             -             152             108        15,736                    19
  Wis.                     NN                  320             -             156              50         4,316                     1
W.N. Central                1                  424             1             503             417        14,860                    75
  Minn.                     1                  242             -             199             210         2,417                    57
  Iowa                      -                   71             -             114              76         1,311                     6
  Mo.                       -                   38             -              58              69         7,941                     8
  N. Dak.                   -                   15             -              15              12            68                     -
  S. Dak.                   -                   23             1              29              37           173                     3
  Nebr.                     -                   21             -              58               -         1,210                     1
  Kans.                     -                   14             -              30              13         1,740                     -
S. Atlantic                 -                  289             -             222             151        93,011                   188
  Del.                      -                    8             -               5               4         1,273                     -
  Md.                       -                   15             -              28              16        11,568                    66
  D.C.                      -                    -             -               2               -         4,557                     -
  Va.                       -                   NN             -              NN              46         8,731                    15
  W. Va.                    -                    1             -              NN               1           957                     4
  N.C.                      -                   NN             -              74              40        16,888                    21
  S.C.                      -                    -             -              13               9        11,487                     5
  Ga.                       -                   74             -              45               -        18,471                    42
  Fla.                      -                  191             -              55              35        19,079                    35
E.S. Central                -                   47             -             101              56        35,409                    58
  Ky.                       -                   20             -              30               -         4,027                     8
  Tenn.                     -                   17             -              50              40        11,023                    32
  Ala.                      -                   NN             -              14              13        12,032                    15
  Miss.                     -                   10             -               7               3         8,327                     3
W.S. Central                1                   88             -              83              33        46,532                    60
  Ark.                      -                   10             -              10              11         4,382                     3
  La.                       -                   23             -              18              12        10,782                    19
  Okla.                     -                   12             -              13               7         4,756                    33
  Tex.                      1                   43             -              42               3        26,612                     5
Mountain                    1                  141             2             275             152         8,084                    94
  Mont.                     -                    5             -              21               9            66                     1
  Idaho                     -                   NN             -              38              25           158                     1
  Wyo.                      -                    4             -              15              13            54                     4
  Colo.                     -                   25             -              83              57         2,320                    23
  N. Mex.                   -                   67             -               7               6           857                     9
  Ariz.                     1                   20             -              42              31         3,802                    35
  Utah                      -                    -             -              57               -           278                     3
  Nev.                      -                   20             2              12              11           549                    18
Pacific                     2                  360             1             433             358        21,584                   264
  Wash.                     -                   NN             -             150             147         1,968                     7
  Oreg.                     -                   32             1              87              98           773                    38
  Calif.                    2                  328             -             184              99        17,941                   203
  Alaska                    -                    -             -              12               5           392                     8
  Hawaii                    -                   NN             -              NN               9           510                     8
------------------------------------------------------------------------------------------------------------------------------------
  Guam                      -                    -             -              NN               -            47                     -
  P.R.                      -                    -             -               5               -           526                     -
  V.I.                     NA                   NA             -              NA               -            40                     -
  American Samoa           NA                   NA            NA              NA              NA            NA                    NA
  C.N.M.I.                  -                    -             -              NN               -            NA                     6
------------------------------------------------------------------------------------------------------------------------------------
* National Electronic Telecommunications System for Surveillance.
+ Public Health Laboratory Information System. Cases were updated through the National Center for Infectious Diseases as of
  August 10, 1998.
& Cases were updated through the Division of Sexually Transmitted Diseases Prevention, NCHSTP, as of July 13, 1998.
======================================================================================================================================

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Table_D3
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NOTIFIABLE DISEASES -- Reported cases, by geographic division and area,
United States, 1997 (continued)
======================================================================================================
                                             Hepatitis
                         Hansen     ------------------------------
                        disease                           C/non-A,   Legionel-       Lyme
Area                  (leprosy)          A          B        non-B       losis    disease    Malaria
----------------------------------------------------------------------------------------------------
United States               122     30,021     10,416        3,816       1,163     12,801      2,001
New England                   -        650        190           58          93      3,111        101
  Maine                      NN         66          6            -           3         34          1
  N.H.                        -         35         18            -           7         39         10
  Vt.                        NN         15         11            4          13          8          2
  Mass.                       -        254         77           46          32        291         33
  R.I.                        -        131         22            8          18        442         13
  Conn.                       -        149         56            -          20      2,297         42
Mid. Atlantic                14      2,124      1,417          364         253      7,556        519
  Upstate N.Y.                1        395        363          279          79      3,149         81
  N.Y. City                  10        907        460            -          27        178        310
  N.J.                        1        316        249           NA          30      2,041         88
  Pa.                         2        506        345           85         117      2,188         40
E.N. Central                  2      3,089      1,501          536         347        593        169
  Ohio                        -        332         94           20         120         40         19
  Ind.                        -        330         99           12          57         33         18
  Ill.                        -        868        284           86          35         13         72
  Mich.                       2      1,372        458          392          91         27         44
  Wis.                       NN        187        566           26          44        480         16
W.N. Central                  -      2,300        532           66          75        299         79
  Minn.                       -        243         62            7           9        256         42
  Iowa                        -        490         44           29          12          8         10
  Mo.                         -      1,151        360           10          26         28         16
  N. Dak.                    NN         14          7            4           2          -          3
  S. Dak.                     -         27          1            -           4          1          3
  Nebr.                       -        113         26            3          15          2          1
  Kans.                       -        262         32           13           7          4          4
S. Atlantic                   7      2,413      1,603          297         146        792        383
  Del.                        -         31          7            -          13        109          5
  Md.                         1        187        172           12          23        494         85
  D.C.                        -         36         30            -           5         10         20
  Va.                         1        250        137           27          34         67         73
  W. Va.                      -         12         16           18          NN         10          1
  N.C.                        1        211        265           51          14         34         21
  S.C.                        1        110         99           40           8          3         19
  Ga.                         -        764        224           NA           6          9         57
  Fla.                        3        812        653          149          43         56        102
E.S. Central                  2        679        759          383          58        103         40
  Ky.                         -         79         44           17          13         20         13
  Tenn.                       2        417        454          241          33         45         11
  Ala.                        -         87         80           13           4         11         10
  Miss.                       -         96        181          112           8         27          6
W.S. Central                 27      6,445      1,627          680          47        145        146
  Ark.                        2        223        107           15           2         27          5
  La.                         1        266        208          276           9         13         21
  Okla.                       -      1,445         67           10           4         45          9
  Tex.                       24      4,511      1,245          379          32         60        111
Mountain                      3      4,326        870          342          69         15         67
  Mont.                       -         71         12           24           1          -          2
  Idaho                       -        150         54           86           2          4          1
  Wyo.                        -         35         25           83           1          3          2
  Colo.                       -        402        147           38          19          -         30
  N. Mex.                     -        351        257           61           3          1          8
  Ariz.                       -      2,330        202           26          18          4         12
  Utah                        1        550         93            5          18          1          3
  Nev.                        2        437         80           19           7          2          9
Pacific                      67      7,995      1,917        1,090          75        187        497
  Wash.                       1      1,015        115           42          12         11         49
  Oreg.                       -        376        119            4           -         20         25
  Calif.                     40      6,422      1,657          862          61        154        405
  Alaska                      -         34         15            -           -          2          5
  Hawaii                     26        148         11          182           2          -         13
----------------------------------------------------------------------------------------------------
  Guam                        -          -          3            -           -          -          -
  P.R.                        -        273        843            -           -          -          6
  V.I.                       NA          8         25            1           5         NA          1
  American Samoa             NA         NA         NA           NA          NA         NA         NA
  C.N.M.I.                    1          1         48            2           -          -          -
----------------------------------------------------------------------------------------------------
======================================================================================================

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Table_D4
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NOTIFIABLE DISEASES -- Reported cases, by geographic division and area,
United States, 1997 (continued)
========================================================================================================
                              Measles           Meningo-                                        Polio-
                      -----------------------     coccal                                     myelitis,
Area                  Indigenous    Imported*    disease     Mumps    Pertussis    Plague    paralytic
------------------------------------------------------------------------------------------------------
United States                 81           57      3,308       683        6,564         4            3
New England                   11            8        209        14        1,096         -            -
  Maine                        -            1         19         -           26         -            -
  N.H.                         1            -         17         1          150         -            -
  Vt.                          -            -          4         -          283         -            -
  Mass.                       10            6        100         4          582         -            -
  R.I.                         -            -         24         8           19         -            -
  Conn.                        -            1         45         1           36         -            -
Mid. Atlantic                 18            9        357        66          503         -            -
  Upstate N.Y.                 2            3         97        16          214         -            -
  N.Y. City                    8            3         57         4           78         -            -
  N.J.                         3            -         75         8           14         -            -
  Pa.                          5            3        128        38          197         -            -
E.N. Central                   6            4        499        99          714         -            -
  Ohio                         -            -        164        35          165         -            -
  Ind.                         -            -         60        15          104         -            -
  Ill.                         6            1        156        17          155         -            -
  Mich.                        -            2         72        28           71         -            -
  Wis.                         -            1         47         4          219        NN           NN
W.N. Central                  14            3        248        19          890         -            -
  Minn.                        5            3         41         7          547         -            -
  Iowa                         -            -         47        10          207         -            -
  Mo.                          1            -        106         -           80         -            -
  N. Dak.                      -            -          2         -            2         -            -
  S. Dak.                      8            -          6         -            5         -            -
  Nebr.                        -            -         20         1           16         -            -
  Kans.                        -            -         26         1           33         -            -
S. Atlantic                    4           14        578        85          446         -            1
  Del.                         -            -          5         -            1         -            -
  Md.                          -            2         42         1          119         -            -
  D.C.                         -            2         12         -            3         -            -
  Va.                          -            1         60        21           59         -            -
  W. Va.                       1            -         19         -            6         -            -
  N.C.                         -            2         97        12          118         -            -
  S.C.                         -            1         64        11           32         -            -
  Ga.                          -            1        108        11           18         -            -
  Fla.                         3            5        171        29           90         -            1
E.S. Central                   -            1        242        34          159         -            -
  Ky.                          -            -         50         3           74         -            -
  Tenn.                        -            -         77         8           40         -            -
  Ala.                         -            1         85         9           34         -            -
  Miss.                        -            -         30        14           11         -            -
W.S. Central                   3            5        335        98          376         -            1
  Ark.                         -            -         38         3           62         -            -
  La.                          -            -         57        17           21         -            -
  Okla.                        -            1         45         3           60         -            -
  Tex.                         3            4        195        75          233         -            1
Mountain                       6            2        189        61        1,333         2            -
  Mont.                        -            -          8         -           18         -            -
  Idaho                        -            -         15         6          570         -            -
  Wyo.                         -            -          3         1            7         -            -
  Colo.                        -            -         51         3          415         1            -
  N. Mex.                      -            -         31        NN          198         -            -
  Ariz.                        5            -         44        34           45         1            -
  Utah                         -            1         17         8           29         -            -
  Nev.                         1            1         20         9           51         -            -
Pacific                       19           11        651       207        1,047         2            1
  Wash.                        1            1        115        21          481         -            -
  Oreg.                        -            -        124        NN           48         -            -
  Calif.                      16            8        402       151          483         2            1
  Alaska                       -            -          3         8           16         -            -
  Hawaii                       2            2          7        27           19         -            -
------------------------------------------------------------------------------------------------------
  Guam                         -            -          1         1            -         -            -
  P.R.                         -            -          8         7            -         -            -
  V.I.                         -            -          1         1            -        NA            -
  American Samoa              NA           NA         NA        NA           NA        NA           NA
  C.N.M.I.                     1            -          -         4            -         -            -
------------------------------------------------------------------------------------------------------
* Imported cases include only those resulting from importation from other countries.
========================================================================================================

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Table_D5
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NOTIFIABLE DISEASES -- Reported cases, by geographic division and area,
United States, 1997 (continued)
==========================================================================================================
                                                                   Rubella
                                    Rabies                   -------------------
                     Psitta-    ---------------                            Cong.   Salmonel-     Shigel-
Area                   cosis    Animal    Human     RMSF*    Rubella    syndrome       losis       losis
--------------------------------------------------------------------------------------------------------
United States             33     8,105        2       409        181           5      41,901      23,117
New England                1     1,257        -         5          6           -       2,348         592
  Maine                    1       227        -         -          -           -         137          15
  N.H.                     -        49        -         -          -           -         151          54
  Vt.                      -       113        -         -          -           -          88          11
  Mass.                    -       282        -         1          1           -       1,259         316
  R.I.                     -        42        -         1          -           -         167          95
  Conn.                    -       544        -         3          5           -         546         101
Mid. Atlantic              5     1,722        -        39         40           -       6,505       3,168
  Upstate N.Y.             3     1,264        -         8         11           -       1,649         801
  N.Y. City                -        NA        -         6         29           -       1,796         956
  N.J.                     -       190        -         9          -           -       1,501         625
  Pa.                      2       268        -        16          -           -       1,559         786
E.N. Central               4       203        -        19          6           -       6,207       2,552
  Ohio                     -       116        -        12          -           -       1,545         835
  Ind.                     -        13        -         3          -           -         590          88
  Ill.                     -        20        -         3          2           -       1,935       1,163
  Mich.                    4        28        -         -          -           -         906         346
  Wis.                    NA        26       NA         1          4          NN       1,231         120
W.N. Central               2       537        -        35          2           -       2,287         908
  Minn.                    1        70        -         1          -           -         632         138
  Iowa                     -       160        -         1          -           -         297          90
  Mo.                      1        31        -        24          2           -         568         222
  N. Dak.                 NN        91        -         -          -           -          69          10
  S. Dak.                  -        94        -         2          -           -          90          31
  Nebr.                    -         2        -         -          -           -         185         284
  Kans.                    -        89        -         7          -           -         446         133
S. Atlantic                7     3,109        -       136         79           1       8,475       4,499
  Del.                     1        67        -         -          -           -         101          35
  Md.                      1       603        -        20          -           -       1,231         423
  D.C.                     -         5        -         -          1           -         115          47
  Va.                      -       678        -        23          1           -       1,120         416
  W. Va.                   -        89        -         3          -           -         133          27
  N.C.                     1       879        -        35         59           -       1,226         387
  S.C.                     1       186        -        36         15           -         603          87
  Ga.                      -       324        -        11          -           -       1,356       1,131
  Fla.                     3       278        -         8          3           1       2,590       1,946
E.S. Central               -       271        -        91          1           -       1,771       1,127
  Ky.                      -        29        -         5          -           -         373         449
  Tenn.                    -       149        -        40          -           -         443         291
  Ala.                     -        88        -         9          1           -         470         272
  Miss.                    -         5        -        37         NN           -         485         115
W.S. Central               -       439        -        69         12           -       4,246       4,252
  Ark.                     -        56        -        31          -           -         445         273
  La.                      -         7        -         5          -           -         617         182
  Okla.                    -       113        -        29          -           -         391         293
  Tex.                     -       263        -         4         12           -       2,793       3,504
Mountain                   3       197        1        12          7           1       2,587       1,913
  Mont.                    -        52        1         4          -           -          63          11
  Idaho                    -         -        -         5          2           -         141          79
  Wyo.                     -        31        -         1          -           -          49           5
  Colo.                    3        34        -         -          -           -         608         258
  N. Mex.                  -        13        -         -          -           -         311         331
  Ariz.                    -        53        -         1          5           1         853       1,076
  Utah                     -         6        -         1          -           -         271         101
  Nev.                     -         8        -         -          -           -         291          52
Pacific                   11       370        1         3         28           3       7,475       4,106
  Wash.                    1         -        1         -          5           -         680         318
  Oreg.                    2        14        -         1          -           -         368         189
  Calif.                   8       327        -         2         14           3       5,993       3,528
  Alaska                   -        29        -         -          -          NN          50           6
  Hawaii                   -         -        -         -          9           -         384          65
--------------------------------------------------------------------------------------------------------
  Guam                     -         -        -         -          -           -          24          35
  P.R.                     -        71        -         -          -           -         838          70
  V.I.                    NA        NA       NA        NA          -           -          10           2
  American Samoa          NA        NA       NA        NA         NA          NA          NA          NA
  C.N.M.I.                 -         -        -         -          -           -          43          34
--------------------------------------------------------------------------------------------------------
* Rocky Mountain spotted fever.
==========================================================================================================

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Table_D6
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NOTIFIABLE DISEASES -- Reported cases, by geographic division and area,
United States, 1997 (continued)
=====================================================================================================================
                                   Syphilis*
                        -------------------------------                  Toxic-
                          Cong.    Primary &        All                   shock    Trich-      Tuber-     Typhoid
Area                    <1 yr.)    secondary     stages
-----------------------------------------------------------------------------------------------------------------
United States            1, 049       8, 550    46, 540          50         157        13     19, 851         365
New England                   4          144     1, 172           -           5         -         478          21
  Maine                       -            2         13           -           1         -          21           -
  N.H.                        -            -         23           -           3         -          17           -
  Vt.                         -            -          1           -           -         -           6           1
  Mass.                       2           78        731           -           1         -         268          19
  R.I.                        -            2         84           -           -         -          38           1
  Conn.                       2           62        320           -           -         -         128           -
Mid. Atlantic               220          412     7, 950           6          20         2      3, 511         101
  Upstate N.Y.               21           41        684           3          10         -         535          21
  N.Y. City                  78           97     4, 955           -           4         -      1, 730          49
  N.J.                       84          151     1, 129           2           -         2         718          29
  Pa.                        37          123     1, 182           1           6         -         528           2
E.N. Central                118       1, 046     4, 336           2          46         4      1, 932          53
  Ohio                       10          218        761           -           2         1         286           5
  Ind.                        3          151        522           -           4         1         168           3
  Ill.                       72          435     1, 953           2          12         -         974          28
  Mich.                      26          153        785           -          20         1         374           7
  Wis.                        7           89        315          NA           8         1         130          10
W.N. Central                 12          172        874           2          28         1         614           5
  Minn.                       -           16        124           1          10         -         161           1
  Iowa                        -            7         72           1           3         -          74           -
  Mo.                        10          114        494           -           8         1         248           1
  N. Dak.                     -            -          -           -           1         -          12           -
  S. Dak.                     -            1          7           -           1         -          19           -
  Nebr.                       -            5         32           -           4         -          22           1
  Kans.                       2           29        145           -           1         -          78           2
S. Atlantic                 201       3, 177     13,253           6          15         -      3, 780          48
  Del.                        2           22        113           -           1         -          39           -
  Md.                        56          891     2, 453           1           -         -         340           5
  D.C.                       12          117        645           1           1         -         110           -
  Va.                         6          236     1, 103           -           1         -         350           5
  W. Va.                      -            1         19           1           -         -          54           2
  N.C.                       22          721     2, 206           1           1         -         463           5
  S.C.                       15          378     1, 135           1           3         -         328           3
  Ga.                        15          515     2, 833           -           1         -         696           8
  Fla.                       73          296     2, 746           1           7         -      1, 400          20
E.S. Central                104       1, 682     5, 689           3           3         1      1, 315           2
  Ky.                         5          135        403           -           -         -         198           -
  Tenn.                      30          747     2, 366           2           2         1         467           1
  Ala.                       29          410     1, 481           -           1         -         405           1
  Miss.                      40          390     1, 439           1          NN         -         245           -
W.S. Central                213       1, 330     8, 159          11           1         -      2, 810          25
  Ark.                       31          173        562           1           1        NN         200           -
  La.                        22          364     1, 808           2           -         -         406           2
  Okla.                       9          117        405           2           -         -         212           3
  Tex.                      151          676     5, 384           6           -         -      1, 992          20
Mountain                     12          172     1, 045           6          18         4         644           9
  Mont.                       -            -          5           1           -         4          18           1
  Idaho                       -            1         24           -           1         -          15           -
  Wyo.                        -            -          1           -           -         -           2           -
  Colo.                       -           15        154           2           9         -          94           4
  N. Mex.                     -            9        103           -           -         -          71           -
  Ariz.                      12          132        600           -           4         -         296           2
  Utah                        -            5         56           3           3         -          36           -
  Nev.                        -           10        102           -           1         -         112           2
Pacific                     165          415     4, 062          14          21         1      4, 767         101
  Wash.                       1           17        132           1           5         -         305           7
  Oreg.                       1           10         48           2           -         -         161           3
  Calif.                    163          386     3, 823          11          16         1      4, 056          84
  Alaska                      -            1         12           -           -         -          78           -
  Hawaii                      -            1         47           -           -         -         167           7
-----------------------------------------------------------------------------------------------------------------
  Guam                        -            -          1           -           -         -           -           1
  P.R.                        7          249     1, 575           1           -         -         257           -
  V.I.                        -            2         10           -          NA        NA           1          NA
  American Samoa             NA           NA         NA          NA          NA        NA           5          NA
  C.N.M.I.                   NA           NA         NA           -           -         -          88           -
-----------------------------------------------------------------------------------------------------------------
* Cases were updated through the Division of Sexually Transmitted Diseases Prevention, NCHSTP, as of July 13, 1998.
+ Cases were updated through the Division of Tuberculosis Elimination, NCHSTP, as of April 15, 1998.
=====================================================================================================================

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Table_E
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NOTIFIABLE DISEASES -- Summary of reported cases, by age group,* United States, 1997
================================================================================================================================================================================================================
                                                     <1                   1-4                 5-14                   15-24                   25-39                  40-64
                                             -----------------     ----------------    -----------------     ---------------------    -------------------     -----------------    ----------------        not
NAME                                Total      No.      (Rate)       No.     (Rate)       No.     (Rate)         No.        (Rate)        No.      (Rate)        No.     (Rate)      No.     (Rate)     stated
--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
AIDS +                             58,492      125     ( 3.32)       181    ( 1.17)       203    ( 0.53)       2,099       ( 5.79)     32,234    ( 51.21)     22,836    (30.63)      814    ( 2.40)          -
Botulism, total                       132       78     ( 2.06)         1    ( 0.01)         1    ( 0.01)           -        ( -  )          3     ( 0.02)         31    ( 0.03)       18    ( 0.02)          -
Brucellosis                            98        -      ( -  )         6    ( 0.04)        14    ( 0.04)          22       ( 0.06)         29     ( 0.05)         24    ( 0.03)        3    ( 0.01)          -
Chlamydia &                       520,164        -      ( -  )         -      ( - )    12,301    (32.02)     374,295    (1,033.34)    105,410    (167.46)      9,910    (13.29)    1,358    ( 4.01)     14,923
Cholera                                 6        -      ( -  )         -      ( - )         -     (  - )           1       ( 0.00)          1     ( 0.00)          3    ( 0.00)        1    ( 0.00)          -
Cryptosporidiosis                   2,566       58     ( 1.78)       525    ( 3.91)       410    ( 1.24)         193       ( 0.62)        725     ( 1.34)        477    ( 0.75)      132    ( 0.46)         46
Diphtheria                              4        1     ( 0.03)         -      ( - )         -     (  - )           2       ( 0.01)          -      ( -  )          1    ( 0.00)        -     (  - )          -
Escherichia coli O157:H7            2,555       67     ( 1.92)       538    ( 3.74)       560    ( 1.58)         292       ( 0.88)        282     ( 0.49)        463    ( 0.68)      289    ( 0.94)         64
Gonorrhea  &                      323,307        -      ( -  )         -      ( - )     5,707    (14.85)     185,933     ( 513.32)     97,423    (154.77)     20,890    (28.02)    1,254    ( 3.70)     11,272
Haemophilus influenzae
  (Invasive Disease)                1,162      159     ( 4.22)        90    ( 0.58)        47    ( 0.12)          42       ( 0.12)         92     ( 0.15)        269    ( 0.36)      442    ( 1.31)         21
Hansen disease (leprosy)              122        -      ( -  )         -      ( - )         -     (  - )          13       ( 0.04)         15     ( 0.02)         51    ( 0.07)       17    ( 0.05)         26
Hepatitis A                        30,021      142     ( 3.77)     1,808    (11.65)     6,852    (17.83)       4,933      ( 13.62)      9,830    ( 15.62)      5,138    ( 6.89)      981    ( 2.90)        337
Hepatitis B                        10,416       53     ( 1.41)        57    ( 0.37)       196    ( 0.51)       1,789       ( 4.94)      4,556     ( 7.24)      3,016    ( 4.05)      547    ( 1.62)        202
Hepatitis, C/non-A non-B            3,816       23     ( 0.65)         7    ( 0.05)        20    ( 0.06)         201       ( 0.59)      1,496     ( 2.54)      1,820    ( 2.60)      211    ( 0.66)         38
Legionellosis                       1,163        4     ( 0.11)         1    ( 0.01)         5    ( 0.01)          24       ( 0.07)        144     ( 0.23)        517    ( 0.70)      454    ( 1.35)         14
Lyme disease                       12,801       49     ( 1.30)       666    ( 4.29)     2,415    ( 6.29)       1,065       ( 2.94)      2,348     ( 3.73)      4,441    ( 5.96)    1,661    ( 4.91)        156
Malaria                             2,001       14     ( 0.37)        86    ( 0.55)       269    ( 0.70)         370       ( 1.02)        592     ( 0.94)        539    ( 0.72)       80    ( 0.24)         51
Measles (rubeola)                     138       14     ( 0.37)        40    ( 0.26)        20    ( 0.05)          30       ( 0.08)         28     ( 0.04)          6    ( 0.01)        -     (  - )          -
Meningococcal disease               3,308      480    ( 12.73)       522    ( 3.36)       457    ( 1.19)         600       ( 1.66)        316     ( 0.50)        454    ( 0.61)      434    ( 1.28)         45
Mumps                                 683        8     ( 0.22)       128    ( 0.84)       249    ( 0.66)          74       ( 0.21)        141     ( 0.23)         60    ( 0.08)        5    ( 0.02)         18
Pertussis (whooping cough)          6,564    1,978    ( 52.47)       786    ( 5.07)     1,860    ( 4.84)         774       ( 2.14)        564     ( 0.90)        511    ( 0.69)       76    ( 0.22)         15
Plague                                  4        -      ( -  )         -      ( - )         -     (  - )           -         ( - )          -      ( -  )          2    ( 0.00)        2    ( 0.01)          -
Poliomyelitis, paralytic                3        2     ( 0.05)         -      ( - )         -     (  - )           1       ( 0.00)          -       ( - )          -     (  - )        -     (  - )          -
Psittacosis                            33        -      ( -  )         -      ( - )         1    ( 0.00)           4       ( 0.01)         11     ( 0.02)         16    ( 0.02)        1    ( 0.00)          -
Rabies, human                           2        -      ( -  )         -      ( - )         -     (  - )           -         ( - )          -      ( -  )          1    ( 0.00)        1    ( 0.00)          -
Rocky Mountain spotted fever          409        1     ( 0.03)        29    ( 0.19)        59    ( 0.15)          31       ( 0.09)         77     ( 0.12)        147    ( 0.20)       58    ( 0.17)          7
Rubella (German measles)              181       10     ( 0.27)         6    ( 0.04)         6    ( 0.02)          72       ( 0.20)         68     ( 0.11)         19    ( 0.03)        -     (  - )          -
Salmonellosis                      41,901    4,531    (120.20)     6,380    (41.12)     4,562    (11.87)       3,393       ( 9.37)      5,890     ( 9.36)      6,026    ( 8.08)    3,636    (10.74)      7,483
Shigellosis                        23,117      478    ( 12.68)     6,005    (38.70)     5,583    (14.53)       1,669       ( 4.61)      3,114     ( 4.95)      1,654    ( 2.22)      450    ( 1.33)      4,164
Syphilis, primary and
  secondary &                       8,540        -      ( -  )         -      ( - )        44    ( 0.11)       2,091       ( 5.77)      4,302     ( 6.83)      1,965    ( 2.64)      108    ( 0.32)         19
Tetanus                                50        -      ( -  )         -      ( - )         2    ( 0.01)           3       ( 0.01)         13     ( 0.02)         19    ( 0.03)       13    ( 0.04)          -
Toxic- shock syndrome                 157        1     ( 0.03)         4    ( 0.03)        22    ( 0.06)          41       ( 0.11)         49     ( 0.08)         34    ( 0.05)        6    ( 0.02)          -
Trichinosis                            13        -      ( -  )         -      ( - )         1    ( 0.00)           1       ( 0.00)          4     ( 0.01)          1    ( 0.00)        2    ( 0.01)          4
Tuberculosis @                     19,851      124     ( 3.29)       623    ( 4.02)       518    ( 1.35)       1,681       ( 4.64)      4,976     ( 7.91)      7,233    ( 9.70)    4,691    (13.85)          5
Typhoid fever                         365        4     ( 0.11)        44    ( 0.28)        81    ( 0.21)          81       ( 0.22)        100     ( 0.16)         44    ( 0.06)        8    ( 0.02)          3
--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
NOTE: Rates <

* July 1, 1997, postcensal population estimates were used to calculate incidence rates per 100,000 population.
+ The total number of acquired immunodeficiency syndrome (AIDS) cases includes all cases reported to the Division of HIV/AIDS Prevention -- Surveillance and Epidemiology, National
  Center for HIV, STD, and TB Prevention (NCHSTP), as of December 31, 1997.
& Age-related data are collected on aggregate forms different from those used for the number of reported cases. Therefore, the total cases reported on this table can differ slightly from
  other tables. Cases among persons aged <
  Cases were updated through the Division of Sexually Transmitted Diseases Prevention, NCHSTP, as of July 13, 1998. Age-related data for 1997 are unavailable for chancroid.
@ Cases were updated through the Division of Tuberculosis Elimination, NCHSTP, as of April 15, 1998.
================================================================================================================================================================================================================

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Table_F
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NOTIFIABLE DISEASES -- Summary of reported cases, by sex,* United States, 1997
=================================================================================================================================
                                                                 Male                  Female            Sex
                                                          ------------------     ------------------      not
NAME                                             Total        No.     (Rate)         No.     (Rate)   stated
------------------------------------------------------------------------------------------------------------
AIDS +                                          58,492     45,737   ( 35.23)      12,755    ( 9.42)        -
Botulism, total                                    132         55    ( 0.04)          73    ( 0.04)        4
Brucellosis                                         98         56    ( 0.04)          39    ( 0.03)        3
Chancroid  &                                       243        157    ( 0.12)          69    ( 0.05)       17
Chlamydia  &@                                  526,671          -     ( -  )     436,366   (322.10)    2,663
Cholera                                              6          1    ( 0.00)           4    ( 0.00)        1
Cryptosporidiosis                                2,566      1,331    ( 1.20)       1,200    ( 1.04)       35
Diphtheria                                           4          1    ( 0.00)           3    ( 0.00)        -
Escherichia coli O157:H7                         2,555      1,161    ( 0.97)       1,317    ( 1.06)       77
Gonorrhea  &                                   324,907    162,796   (125.41)     161,661   (119.33)      450
Haemophilus influenzae (Invasive Disease)        1,162        522    ( 0.40)         596    ( 0.44)       44
Hansen disease (leprosy)                           122         64    ( 0.05)          32    ( 0.02)       26
Hepatitis A                                     30,021     16,599   ( 12.79)      10,969    ( 8.10)    2,453
Hepatitis B                                     10,416      6,115    ( 4.71)       4,045    ( 2.99)      256
Hepatitis, C/non-A non-B                         3,816      2,424    ( 1.99)       1,354    ( 1.06)       38
Legionellosis                                    1,163        682    ( 0.53)         457    ( 0.34)       24
Lyme disease                                    12,801      6,703    ( 5.16)       6,016    ( 4.44)       82
Malaria                                          2,001      1,258    ( 0.97)         690    ( 0.51)       53
Measles (rubeola)                                  138         70    ( 0.05)          62    ( 0.05)        6
Meningococcal disease                            3,308      1,662    ( 1.28)       1,583    ( 1.17)       63
Mumps                                              683        348    ( 0.27)         286    ( 0.22)       49
Pertussis (whooping cough)                       6,564      3,036    ( 2.34)       3,468    ( 2.56)       60
Plague                                               4          1    ( 0.00)           2    ( 0.00)        1
Poliomyelitis, paralytic                             3          1    ( 0.00)           2    ( 0.00)        -
Psittacosis                                         33         12    ( 0.01)          21    ( 0.02)        -
Rabies, human                                        2          2    ( 0.00)           -    ( 0.00)        -
Rocky Mountain spotted fever                       409        248    ( 0.19)         157    ( 0.12)        4
Rubella (German measles)                           181        109    ( 0.08)          67    ( 0.05)        5
Salmonellosis                                   41,901     16,716   ( 12.88)      17,477   ( 12.90)    7,708
Shigellosis                                     23,117      8,437    ( 6.50)       9,758    ( 7.20)    4,922
Syphilis, primary and secondary &                8,550      4,656    ( 3.59)       3,891    ( 2.87)        3
Tetanus                                             50         29    ( 0.02)          21    ( 0.02)        -
Toxic-shock syndrome                               157         38    ( 0.03)         115    ( 0.09)        4
Trichinosis                                         13          6    ( 0.00)           7    ( 0.01)        -
Tuberculosis**                                  19,851     12,371    ( 9.53)       7,474    ( 5.52)        6
Typhoid fever                                      365        192    ( 0.15)         168    ( 0.12)        5
------------------------------------------------------------------------------------------------------------
NOTE: Rates <

 * July 1, 1997, postcensal population estimates were used to calculate incidence rates per 100,000 population.
 + The total number of acquired immunodeficiency syndrome (AIDS) cases includes all cases reported to the Division of HIV/ AIDS
   Prevention -- Surveillance and Epidemiology, National Center for HIV, STD, and TB Prevention (NCHSTP) as of July 13, 1998.
 & Cases were updated through the Division of Sexually Transmitted Diseases Prevention, NCHSTP, as of December 31, 1997.
 @ Chlamydia refers to genital infections caused by C. trachomatis. The rates for men are not presented because reporting for
   men is more limited than for women.
** Cases were updated through the Division of Tuberculosis Elimination, NCHSTP, as of April 15, 1998.
=================================================================================================================================

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Table_G
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NOTIFIABLE DISEASES -- Summary of reported cases, by race, United States, 1997
=========================================================================================================================================================================================
                                               American Indian       Asian or                                                                     Race
                                              or Alaskan Native  Pacific Islander       Black               White             Other            not stated
                                              -----------------  ----------------  ---------------     ----------------    -----------       ---------------
Name                                   Total     No.       %       No.       %        No.       %         No.        %     No.      %            No       %
------------------------------------------------------------------------------------------------------------------------------------------------------------
AIDS*                                 58,492      206    (<1)       446    ( 1)     27,018    (46)
Botulism, total                          132       19    (14)         6    ( 5)          7    ( 5)          71    ( 54)      -    ( -)            29    (22)
Brucellosis                               98        -    ( -)         3    ( 3)          -     ( )          50    ( 51)      -    ( -)            45    (46)
Chlamydia &                          520,164    6,915    ( 1)     5,034    ( 1)    164,232    (32)     107,527    ( 21)      -    ( -)       236,456+   (45)
Cholera                                    6        -    ( -)         -    ( -)          -    ( -)           3    ( 50)      -    ( -)             3    (50)
Cryptosporidiosis                      2,566      249    (10)        23    ( 1)        196    ( 8)       1,262    ( 49)      1    (<
Diphtheria                                 4        2    (50)         -    ( -)          -    ( -)           2    ( 50)      -    ( -)             -    ( -)
Escherichia coli O157:H7               2,555      127    ( 5)        27    ( 1)         68    ( 3)       1,504    ( 59)      3    (<
Gonorrhea &                          323,307    1,532    (<1)     1,021    (<
Haemophilus influenzae
  (Invasive Disease)                   1,162       67    ( 6)        20    ( 2)        162    (14)         685    ( 59)      1    (<
Hansen disease (leprosy)                 122        -    ( -)        33    (27)          7    ( 6)          30    ( 25)      -    ( -)            52    (43)
Hepatitis A                           30,021      528    ( 2)       445    ( 1)      2,013    ( 7)      17,819    ( 59)     69    (<
Hepatitis B                           10,416       72    ( 1)       752    ( 7)      2,201    (21)       4,096    ( 39)     53    ( 1)         3,242    (31)
Hepatitis,C/non-A non-B                3,816       60    ( 2)        46    ( 1)        460    (12)       2,156    ( 56)     16    (<
Legionellosis                          1,163        1    (<1)         7    ( 1)         97    ( 8)
Lyme disease                          12,801       23    (<1)        86    ( 1)        185    ( 1)
Malaria                                2,001        1    (<1)       286    (14)        554    (28)
Measles (rubeola)                        138        9    ( 7)        18    (13)         10    ( 7)          91    ( 66)      1    ( 1)             9    ( 7)
Meningococcal disease                  3,308       41    ( 1)        35    ( 1)        553    (17)       2,090    ( 63)      9    (<
Mumps                                    683        1    (<1)        58    ( 8)         46    ( 7)         336    (
Pertussis (whooping cough)             6,564      205    ( 3)        66    ( 1)        332    ( 5)       4,079    ( 62)      9    (<
Plague                                     4        2    (50)         -    ( -)          -    ( -)           2    ( 50)      -    ( -)             -    ( -)
Poliomyelitis,paralytic                    3        -    ( -)         -    ( -)          -    ( -)           3    (100)      -    ( -)             -    ( -)
Psittacosis                               33        -    ( -)         -    ( -)          -    ( -)          25    ( 76)      -    ( -)             8    (24)
Rabies,human                               2        1    (50)         -    ( -)          -    ( -)           -    ( - )      -    ( -)             1    (50)
Rocky Mountain spotted fever             409       10    ( 2)         2    (<1)         19    ( 5
Rubella (German measles)                 181        4    ( 2)        14    ( 8)          7    ( 4)          73    ( 40)      4    ( 2)            79    (44)
Rubella,congenital syndrome                5        -    ( -)         1    (20)          -    ( -)           1    ( 20)      -    ( -)             3    (60)
Salmonellosis                         41,901      262    ( 1)       594    ( 1)      3,303    ( 8)      17,956    ( 43)     24    (<
Shigellosis                           23,117      543    ( 2)       115    (<1)      3,055
Syphilis,primary and secondary &       8,540       40    (<1)        32    (<
Tetanus                                   50       10    (20)         -    ( -)          3    ( 6)          33    ( 66)      1    ( 2)             3    ( 6)
Toxic- shock syndrome                    157        1    ( 1)         3    ( 2)         13    ( 8)         117    ( 75)      -    ( -)            23    (15)
Trichinosis                               13        -    ( -)         -    ( -)          -    ( -)           4    ( 31)      -    ( -)             9    (69)
Tuberculosis @                        19,851      276    ( 1)     3,873    (20)      6,806    (34)       8,862    ( 45)      -    ( -)            34    (<
Typhoid fever                            365        2    ( 1)       114    (31)         27    ( 7)          56    ( 15)     19    ( 5)           147    (40)
------------------------------------------------------------------------------------------------------------------------------------------------------------
* The total number of acquired immunodeficiency syndrome (AIDS) cases includes all cases reported to the Division of HIV/ AIDS Prevention -- Surveillance and Epidemiology, National
  Center for HIV, STD, and TB Prevention (NCHSTP) as of December 31, 1997.
+ Includes the following cases originally reported as Hispanic: 10,394 for AIDS; 62,716 for chlamydia, 13,990 for gonorrhea; and 450 for syphilis, primary and secondary.
& In addition to data collected through the National Electronic Telecommunications System for Surveillance (NETSS), some data concerning race are collected on aggregate forms
  different from those used for numbers of reported cases. Thus, the total number of cases reported on this table can differ slightly from other tables. Cases were updated through the
  Division of Sexually Transmitted Diseases Prevention, NCHSTP, as of July 13, 1998. Data regarding race for 1997 are unavailable for chancroid.
@ Cases were updated through the Division of Tuberculosis Elimination, NCHSTP as of April 15, 1998.
=========================================================================================================================================================================================

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Table_H
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NOTIFIABLE DISEASES -- Summary of reported cases, by ethnicity, United States, 1997
==========================================================================================================================================
                                                                                                      Ethnicity
                                                             Hispanic          Non-Hispanic           not stated
                                                          --------------     ---------------       ----------------
NAME                                             Total      No.     (%)         No.      (%)          No.      (%)
-------------------------------------------------------------------------------------------------------------------
AIDS*                                           58,492    10,394    (18)      47,206    ( 81)          892+   (  2)
Botulism, total                                    132        24    (18)          82    ( 62)           26    ( 20)
Brucellosis                                         98        59    (60)          15    ( 15)           24    ( 24)
Chlamydia &                                    520,164    62,716    (12)     271,759    ( 52)      185,689+   ( 36)
Cholera                                              6         3    (50)           1    ( 17)            2    ( 33)
Cryptosporidiosis                                2,566       178    ( 7)       1,366    ( 53)        1,022    ( 40)
Diphtheria                                           4         -    ( -)           3    ( 75)            1    ( 25)
Escherichia coli O157:H7                         2,555        88    ( 3)       1,464    ( 57)        1,003    ( 39)
Gonorrhea &                                    323,307    13,990    ( 4)     226,906    ( 70)       82,411+   ( 25)
Haemophilus influenzae (Invasive Disease)        1,162        93    ( 8)         695    ( 60)          374    ( 32)
Hansen disease (leprosy)                           122        35    (29)          51    ( 42)           36    ( 30)
Hepatitis A                                     30,021     6,828    (23)      13,341    ( 44)        9,852    ( 33)
Hepatitis B                                     10,416       940    ( 9)       5,264    ( 51)        4,212    ( 40)
Hepatitis, C/non-A non-B                         3,816       475    (12)       1,721    ( 45)        1,620    ( 42)
Legionellosis                                    1,163        32    ( 3)         670    ( 58)          461    ( 40)
Lyme disease                                    12,801       140    ( 1)       7,750    ( 61)        4,911    ( 38)
Malaria                                          2,001       176    ( 9)       1,041    ( 52)          784    ( 39)
Measles (rubeola)                                  138        22    (16)         106    ( 77)           10    (  7)
Meningococcal disease                            3,308       311    ( 9)       2,023    ( 61)          974    ( 29)
Mumps                                              683       159    (23)         263    ( 39)          261    ( 38)
Pertussis (whooping cough)                       6,564       594    ( 9)       3,444    ( 52)        2,526    ( 38)
Plague                                               4         -    ( -)           4    (100)            -    ( - )
Poliomyelitis, paralytic                             3         2    (67)           1    ( 33)            -    ( - )
Psittacosis                                         33         -    ( -)          19    ( 58)           14    ( 42)
Rabies, human                                        2         -    ( -)           -    ( - )            2    (100)
Rocky Mountain spotted fever                       409         4    ( 1)         253    ( 62)          152    ( 37)
Rubella (German measles)                           181       109    (60)          46    ( 25)           26    ( 14)
Rubella, congenital syndrome                         5         3    (60)           1    ( 20)            1    ( 20)
Salmonellosis                                   41,901     2,447    ( 6)      16,284    ( 39)       23,170    ( 55)
Shigellosis                                     23,117     3,427    (15)       8,051    ( 35)       11,639    ( 50)
Syphilis, primary and secondary &                8,540       450    ( 5)       7,815    ( 92)          275+   (  3)
Tetanus                                             50        14    (28)          27    ( 54)            9    ( 18)
Toxic- shock syndrome                              157         3    ( 2)         104    ( 66)           50    ( 32)
Trichinosis                                         13         -    ( -)           4    ( 31)            9    ( 69)
Tuberculosis @                                  19,851     4,228    (21)      15,586    ( 79)           37    ( - )
Typhoid fever                                      365        56    (15)         181    ( 50)          128    ( 35)
-------------------------------------------------------------------------------------------------------------------
* The total number of acquired immunodeficiency syndrome (AIDS) cases includes all cases reported to the Division of HIV/ AIDS
  Prevention -- Surveillance and Epidemiology, National Center for HIV, STD, and TB Prevention (NCHSTP) as of December 31, 1997.
+ Ethnicity is not stated and includes cases originally reported as American Indian or Alaskan Native and Asian or Pacific Islander.
& In addition to data collected through the National Electronic Telecommunications System for Surveillance (NETSS), some data
  concerning ethnicity are collected on aggregate forms different from those used for numbers of reported cases. Thus, the total number
  of cases reported on this table can differ slightly from other tables. Cases were updated through the Division of Sexually Transmitted
  Diseases Prevention, NCHSTP, as of July 13, 1998. Data regarding ethnicity for 1997 are unavailable for chancroid.
@ Cases were updated through the Division of Tuberculosis Elimination, NCHSTP, as of April 15, 1998
==========================================================================================================================================

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Table_1
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TABLE 1. NOTIFIABLE DISEASES -- Summary of reported cases per 100,000 population, United States, 1988-1997
=============================================================================================================================================================================
Disease                                            1988      1989      1990       1991      1992      1993      1994       1995      1996      1997
---------------------------------------------------------------------------------------------------------------------------------------------------
AIDS *                                            12.61     13.58     16.72      17.32     17.83     40.20     30.07      27.20     25.21     21.85
Amebiasis                                          1.20      1.34      1.38       1.23      1.21      1.21      1.20     .............. + .........
Anthrax                                            0.00         -         -          -      0.00         -         -          -         -         -
Aseptic meningitis                                 2.94      4.14      4.77       6.26      5.18      5.39      3.71     .............. + .........
Botulism, total (including wound and unsp.)        0.03      0.04      0.04       0.05      0.04      0.04      0.06       0.04      0.05      0.05
Foodborne                                          0.01      0.01      0.01       0.01      0.00      0.01      0.02       0.01      0.01      0.02
Brucellosis                                        0.04      0.04      0.03       0.04      0.04      0.05      0.05       0.04      0.05      0.04
---------------------------------------------------------------------------------------------------------------------------------------------------
Chancroid                                          2.04      1.90      1.70       1.40      0.80      0.54      0.30       0.20      0.15      0.09
Chlamydia &                                      ................................ @ ................................     182.60    188.10    196.80
Cholera                                            0.00         -      0.00       0.01      0.04      0.00      0.02       0.01      0.01      0.01
Cryptosporidiosis                                ............................................. @ ..............................       ...      1.12
Diphtheria                                         0.00      0.00      0.00       0.00      0.00         -      0.00          -      0.01      0.01
Encephalitis, primary                              0.36      0.40      0.54       0.40      0.30      0.36      0.28     .............. + .........
  Post-infectious                                  0.05      0.04      0.04       0.03      0.05      0.07      0.06     .............. + .........
Escherichia coli O157:H7                         ........................ @ ..............................      0.82       1.01      1.18      1.04
---------------------------------------------------------------------------------------------------------------------------------------------------
Gonorrhea                                        298.74    297.36    276.60     249.48    201.60    172.40    168.40     149.50    122.80    121.40
Granuloma inguinale                                0.00      0.00      0.00       0.01      0.00      0.00      0.00     .............. + .........
Haemophilus influenzae, invasive                 .............. @ .........       1.10      0.55      0.55      0.45       0.45      0.45      0.44
Hansen disease (leprosy)                           0.07      0.07      0.08       0.06      0.07      0.07      0.05       0.06      0.05      0.05
Hepatitis A                                       11.60     14.43     12.64       9.67      9.06      9.40     10.29      12.13     11.70     11.22
Hepatitis B                                        9.43      9.43      8.48       7.14      6.32      5.18      4.81       4.19      4.01      3.90
Hepatitis, C/non-A, non-B **                       1.07      1.02      1.03       1.42      2.36      1.86      1.78       1.78      1.41      1.43
Hepatitis, unspecified                             1.00      0.93      0.67       0.50      0.35      0.24      0.17     .............. + .........
---------------------------------------------------------------------------------------------------------------------------------------------------
Legionellosis                                      0.44      0.48      0.55       0.53      0.53      0.50      0.63       0.48      0.47      0.44
Leptospirosis                                      0.02      0.04      0.03       0.02      0.02      0.02      0.02     .............. + .........
Lyme disease                                     .............. @ .........       3.80      3.93      3.20      5.01       4.49      6.21      4.79
Lymphogranuloma venereum                           0.07      0.08      0.10       0.19      0.10      0.10      0.10     .............. + .........
Malaria                                            0.45      0.51      0.52       0.51      0.43      0.55      0.47       0.55      0.68      0.75
Measles (rubeola)                                  1.38      7.33     11.17       3.82      0.88      0.12      0.37       0.12      0.20      0.06
Meningococcal disease                              1.21      1.10      0.99       0.84      0.84      1.02      1.11       1.25      1.30      1.24
Mumps                                              2.05      2.34      2.17       1.72      1.03      0.66      0.60       0.35      0.29      0.27
Murine typhus fever                                0.02      0.02      0.02       0.02      0.02      0.01    ............... + ...................
---------------------------------------------------------------------------------------------------------------------------------------------------
Pertussis (whooping cough)                         1.40      1.67      1.84       1.08      1.60      2.55      1.77       1.97      2.94      2.46
Plague                                             0.01      0.00      0.00       0.00      0.01      0.00      0.01       0.00      0.01      0.01
Poliomyelitis, paralytic                           0.00      0.00      0.00       0.00      0.00      0.00      0.00       0.00      0.01      0.01
Psittacosis                                        0.05      0.05      0.05       0.04      0.04      0.02      0.02       0.03      0.02      0.02
Rabies, human                                      0.00      0.00      0.00       0.00      0.00      0.00      0.00       0.00      0.01      0.01
Rheumatic fever, acute                             0.14      0.13      0.09       0.12      0.06      0.08      0.09     .............. + .........
Rocky Mountain spotted fever                       0.25      0.25      0.26       0.25      0.20      0.18      0.18       0.23      0.32      0.16
Rubella (German measles)                           0.09      0.16      0.45       0.56      0.06      0.07      0.09       0.05      0.10      0.07
---------------------------------------------------------------------------------------------------------------------------------------------------
Salmonellosis, excluding typhoid fever            19.91     19.26     19.54      19.10     16.04     16.15     16.64      17.66     17.15     15.66
Shigellosis                                       12.46     10.07     10.89       9.34      9.38     12.48     11.44      12.32      9.80      8.64
Syphilis, primary and secondary                   16.43     18.07     20.10      17.26     13.70     10.40      8.10       6.30      4.29      3.19
  Total, all stages                               42.37     44.94     53.80      51.69     45.30     39.70     32.00      26.20     19.97     17.39
Tetanus                                            0.02      0.02      0.03       0.02      0.02      0.02      0.02       0.02      0.02      0.02
Toxic-shock syndrome                               0.16      0.16      0.13       0.11      0.10      0.08      0.10       0.07      0.06      0.06
Trichinosis                                        0.02      0.01      0.05       0.02      0.02      0.01      0.01       0.01      0.01      0.01
---------------------------------------------------------------------------------------------------------------------------------------------------
Tuberculosis                                       9.13      9.46     10.33      10.42     10.46      9.82      9.36       8.70      8.04      7.42
Tularemia                                          0.08      0.06      0.06       0.08      0.06      0.05      0.04     .............. + .........
Typhoid fever                                      0.18      0.19      0.22       0.20      0.16      0.17      0.17       0.14      0.15      0.14
Varicella (chickenpox) ++                        122.43    121.77    120.06     135.82    176.54    118.54    135.76     118.11     44.13     93.55
Yellow fever                                          -         -         -          -         -         -         -          -      0.01         -
---------------------------------------------------------------------------------------------------------------------------------------------------
NOTES: Data in the annual Summary of Notifiable Diseases might not match data in other CDC surveillance reports because of differences in the timing of reports, the source
of the data, and the use of different case definitions. Rates <

 * Acquired immunodeficiency syndrome.
 + No longer nationally notifiable.
 & Chlamydia refers to genital infections caused by C. trachomatis.
 @ Not previously nationally notifiable.
** Anti-HCV antibody test became available May 1990.
++ Not nationally notifiable.
=============================================================================================================================================================================

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Table_2
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TABLE 2. NOTIFIABLE DISEASES -- Summary of reported cases, United States, 1990-1997
=========================================================================================================================================================================================
Disease                                             1990         1991        1992        1993        1994        1995        1996           1997
---------------------------------------------------------------------------------------------------------------------------------------------------
AIDS*                                             41,595       43,672      45,472     103,691      78,279      71,547      66,885         58,492+
Amebiasis                                          3,328        2,989       2,942       2,970       2,983     ................. & ..............
Anthrax                                                -            -           1           -           -           -           -              -
Aseptic meningitis                                11,852       14,526      12,223      12,848       8,932         ...           &            ...
Botulism, total (including wound and unsp.)           92          114          91          97         143          97         119            132
  Foodborne                                           23           27          21          27          50          24          25             31
  Infant                                              65           81          66          65          85          54          80             79
---------------------------------------------------------------------------------------------------------------------------------------------------
Brucellosis                                           85          104         105         120         119          98         112             98
Chancroid                                          4,212        3,476       1,886       1,399         773         606         386            243@
Chlamydia **                                    .............................. ++ .......................     477,638     498,884        526,671@
Cholera                                                6           26         103          18          39          23           4              6
Cryptosporidiosis                               .......................................... ++ ...................................          2,566
Diphtheria                                             4            5           4           -           2           -           2              4
Encephalitis, primary                              1,341        1,021         774         919         717     ................. & ..............
 Post-infectious                                     105           82         129         170         143     ................. & ..............
---------------------------------------------------------------------------------------------------------------------------------------------------
Escherichia coli O157:H7                             ...          ...          ++         ...       1,420       2,139       2,741          2,555
Gonorrhea                                        690,169      620,478     501,409     439,673     418,068     392,848     325,883        324,907@
Granuloma inguinale                                   97           29           6          19           3     ................. & ..............
Haemophilus influenzae,invasive                       ++        2,764       1,412       1,419       1,174       1,180       1,170          1,162
Hansen disease (leprosy)                             198          154         172         187         136         144         112            122
Hepatitis A                                       31,441       24,378      23,112      24,238      26,796      31,582      31,032         30,021
Hepatitis B                                       21,102       18,003      16,126      13,361      12,517      10,805      10,637         10,416
Hepatitis, C/non-A, non-B &&                       2,553        3,582       6,010       4,786       4,470       4,576       3,716          3,816
Hepatitis,unspecified                              1,671        1,260         884         627         444     ................. & ..............
Legionellosis                                      1,370        1,317       1,339       1,280       1,615       1,241       1,198          1,163
Leptospirosis                                         77           58          54          51          38     ................. & ..............
Lyme disease                                          ++        9,465       9,895       8,257      13,043      11,700      16,455         12,801
Lymphogranuloma venereum                             277          471         302         285         235     ................. & ..............
---------------------------------------------------------------------------------------------------------------------------------------------------
Malaria                                            1,292        1,278       1,087       1,411       1,229       1,419       1,800          2,001
Measles (rubeola)                                 27,786        9,643       2,237         312         963         309         508            138
Meningococcal disease                              2,451        2,130       2,134       2,637       2,886       3,243       3,437          3,308
Mumps                                              5,292        4,264       2,572       1,692       1,537         906         751            683
Murine typhus fever                                   50           43          28          25      ............................ & ..............
---------------------------------------------------------------------------------------------------------------------------------------------------
Pertussis (whooping cough)                         4,570        2,719       4,083       6,586       4,617       5,137       7,796          6,564
Plague                                                 2           11          13          10          17           9           5              4
Poliomyelitis, paralytic @@                            6           10           6           4           8           6           5              3
Psittacosis                                          113           94          92          60          38          64          42             33
Rabies, animal                                     4,826        6,910       8,589       9,377       8,147       7,811       6,982          8,105
Rabies, human                                          1            3           1           3           6           5           3              2
Rheumatic fever, acute                               108          127          75         112         112     ................. & ..............
Rocky Mountain spotted fever                         651          628         502         456         465         590         831            409
Rubella (German measles)                           1,125        1,401         160         192         227         128         238            181
Rubella, congenital syndrome                          11           47          11           5           7           6           4              5
Salmonellosis, excluding typhoid fever            48,603       48,154      40,912      41,641      43,323      45,970      45,471         41,901
Shigellosis                                       27,077       23,548      23,931      32,198      29,769      32,080      25,978         23,117
---------------------------------------------------------------------------------------------------------------------------------------------------
Syphilis, primary and secondary                   50,223       42,935      33,973      26,498      20,627      16,500      11,387          8,550@
  Total, all stages                              134,255      128,569     112,581     101,259      81,696      68,953      52,976         46,540@
Tetanus                                               64           57          45          48          51          41          36             50
Toxic-shock syndrome                                 322          280         244         212         192         191         145            157
Trichinosis                                          129           62          41          16          32          29          11             13
Tuberculosis                                      25,701       26,283      26,673      25,313      24,361      22,860      21,337         19,851***
Tularemia                                            152          193         159         132          96     ................. & ..............
Typhoid fever                                        552          501         414         440         441         369         396            365
Varicella (chickenpox) +++                       173,099      147,076     158,364     134,722     151,219     120,624      83,511         98,727
Yellow fever                                     ............................ &&& ...................................           1              -
---------------------------------------------------------------------------------------------------------------------------------------------------
NOTE: Data in the annual Summary of Notifiable Diseases might not match data in other CDC surveillance reports because of differences in the timing of reports, the source
of the data, and the use of different case definitions.

  * Acquired immunodeficiency syndrome.
  + The total number of AIDS cases includes all cases reported to the Division of HIV/AIDS Prevention -- Surveillance and Epidemiology, National Center for HIV, STD, and TB Prevention
    (NCHSTP) as of December 31, 1997.
  & No longer nationally notifiable.
  @ Cases were updated through the Division of Sexually Transmitted Diseases Prevention, NCHSTP, as of July 13, 1998.
 ** Chlamydia refers to genital infections caused by C. trachomatis.
 ++ Not previously nationally notifiable.
 && Anti-HCV antibody test was available as of May 1990.
 @@ Numbers might not reflect changes because of retrospective case evaluations or late reports (see MMWR 1986;35:180-2).
*** Cases were updated through the Division of Tuberculosis Elimination, NCHSTP, as of April 15, 1998
=========================================================================================================================================================================================

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Table_3
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TABLE 3. NOTIFIABLE DISEASES -- Summary of reported cases, United States, 1982-1989
===========================================================================================================================================================================================
Disease                                            1982        1983        1984        1985        1986       1987        1988         1989
-------------------------------------------------------------------------------------------------------------------------------------------
AIDS *                                          ..... + ...........       4,445       8,249      12,932     21,070      31,001       33,722
Amebiasis                                         7,304       6,658       5,252       4,433       3,532      3,123       2,860        3,217
Anthrax                                               -           -           1           -           -          1           2            -
Aseptic meningitis                                9,680      12,696       8,326      10,619      11,374     11,487       7,234       10,274
Botulism, total (including wound and unsp.)          97         133         123         122         109         82          84           89
  Foodborne                                     ................. & ...........          49          23         17          28           23
  Infant                                        ................. & ...........          70          79         59          50           60
-------------------------------------------------------------------------------------------------------------------------------------------
Brucellosis                                         173         200         131         153         106        129          96           95
Chancroid                                         1,392         847         665       2,067       3,756      4,998       5,001        4,692
Cholera                                               -           1           1           4          23          6           8            -
Diphtheria                                            2           5           1           3           -          3           2            3
Encephalitis, primary @                           1,464       1,761       1,257       1,376       1,302      1,418         882          981
  Post-infectious @                                  36          34         108         161         124        121         121           88
Gonorrhea                                       960,633     900,435     878,556     911,419     900,868    780,905     719,536      733,151
-------------------------------------------------------------------------------------------------------------------------------------------
Granuloma inguinale                                  17          24          30          44          61         22          11            7
Hansen disease (leprosy)                            250         259         290         361         270        238         184          163
Hepatitis A                                      23,403      21,532      22,040      23,210      23,430     25,280      28,507       35,821
Hepatitis B                                      22,177      24,318      26,115      26,611      26,107     25,916      23,177       23,419
Hepatitis, C/non-A, non-B                             +       3,470       3,871       4,184       3,634      2,999       2,619        2,529
Hepatitis, unspecified                            8,564       7,149       5,531       5,517       3,940      3,102       2,470        2,306
Legionellosis  **                                   654         852         750         830         980      1,038       1,085        1,190
-------------------------------------------------------------------------------------------------------------------------------------------
Leptospirosis                                       100          61          40          57          41         43          54           93
Lymphogranuloma venereum                            235         335         170         226         396        303         185          189
Malaria                                           1,056         813       1,007       1,049       1,123        944       1,099        1,277
Measles (rubeola)                                 1,714       1,497       2,587       2,822       6,282      3,655       3,396       18,193
Meningococcal disease                             3,056       2,736       2,746       2,479       2,594      2,930       2,964        2,727
Mumps                                             5,270       3,355       3,021       2,982       7,790     12,848       4,866        5,712
Murine typhus fever                                  58          62          53          37          67         49          54           41
Pertussis (whooping cough)                        1,895       2,463       2,276       3,589       4,195      2,823       3,450        4,157
-------------------------------------------------------------------------------------------------------------------------------------------
Plague                                               19          40          31          17          10         12          15            4
Poliomyelitis, total                                 12          13           9     ........................... ++ ........................
  Paralytic                                          12          13           9           8          10          9           9           11
Psittacosis                                         152         142         172         119         224         98         114          116
Rabies, animal                                    6,212       5,878       5,567       5,565       5,504      4,658       4,651        4,724
Rabies, human                                         -           2           3           1           -          1           -            1
Rheumatic fever, acute                              137          88         117          90         147        141         158          144
-------------------------------------------------------------------------------------------------------------------------------------------
Rocky Mountain spotted fever                        976       1,126         838         714         760        604         609          623
Rubella (German measles)                          2,325         970         752         630         551        306         225          396
Rubella, congenital syndrome                          7          22           5           -          14          5           6            3
Salmonellosis, excluding typhoid fever           40,936      44,250      40,861      65,347      49,984     50,916      48,948       47,812
Shigellosis                                      18,129      19,719      17,371      17,057      17,138     23,860      30,617       25,010
Syphilis, primary and secondary                  33,613      32,698      28,607      27,131      27,883     35,147      40,117       44,540
  Total, all stages                              75,579      74,637      69,888      67,563      68,215     86,545     103,437      110,797
-------------------------------------------------------------------------------------------------------------------------------------------
Tetanus                                              88          91          74          83          64         48          53           53
Toxic-shock syndrome                                  +         502         482         384         412        372         390          400
Trichinosis                                         115          45          68          61          39         40          45           30
Tuberculosis                                     25,520      23,846      22,255      22,201      22,768     22,517      22,436       23,495
Tularemia                                           275         310         291         177         170        214         201          152
Typhoid fever                                       425         507         390         402         362        400         436          460
Varicella (chickenpox)                          167,423     177,462     221,983     178,162     183,243    213,196     192,857      185,441
Yellow fever                                    ........................................ && ...............................................
-------------------------------------------------------------------------------------------------------------------------------------------
NOTE: Data in the annual Summary of Notifiable Diseases might not match data in other CDC surveillance reports because of differences in the timing of reports, the source
of the data, and the use of different case definitions.

 * Acquired immunodeficiency syndrome.
 + Not previously nationally notifiable.
 & Not reported as distinct categories during this period.
 @ Beginning in 1984, data reflect change in categories for tabulating encephalitis reports that were recorded by date of record to state health departments. Data for previous years are
   from surveillance records reported by onset date.
** Beginning in 1982, data were recorded by date of report to the state health department. Data for 1976-1981 are from surveillance records reported by onset date.
++ Categories other than paralytic are no longer reported.
===========================================================================================================================================================================================

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Table_4
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TABLE 4. NOTIFIABLE DISEASES -- Summary of reported cases, United States, 1974- 1981
============================================================================================================================================================================
Disease                                             1974        1975           1976           1977           1978          1979           1980        1981
----------------------------------------------------------------------------------------------------------------------------------------------------------
Amebiasis                                          2,743       2,775          2,906          3,044          3,937         4,107          5,271       6,632
Anthrax                                                2           2              2              -              6             -              1           -
Aseptic meningitis                                 3,197       4,475          3,510          4,789          6,573         8,754          8,028       9,547
Botulism, total (including wound and unsp.)           28          20             55            129            105            45             89         103
Brucellosis                                          240         310            296            232            179           215            183         185
Chancroid                                            945         700            628            455            521           840            788         850
Cholera                                                -           -              -              3             12             1              9          19
----------------------------------------------------------------------------------------------------------------------------------------------------------
Diphtheria                                           272         307            128             84             76           59*              3           5
Encephalitis, primary                              1,164       4,064          1,651          1,414          1,351         1,504          1,362       1,492
  Post-infectious                                    218         237            175            119             78            84             40          43
Gonorrhea                                        906,121     999,937      1,001,994      1,002,219      1,013,436     1,004,058      1,004,029     990,864
Granuloma inguinale                                   47          60             71             75             72            76             51          66
Hansen disease (leprosy)                             118         162            145            151            168           185            223         256
Hepatitis A                                       40,358      35,855         33,288         31,153         29,500        30,407         29,087      25,802
----------------------------------------------------------------------------------------------------------------------------------------------------------
Hepatitis B                                       10,631      13,121         14,973         16,831         15,016        15,452         19,015      21,152
Hepatitis, unspecified                             8,351       7,158          7,488          8,639          8,776        10,534         11,894      10,975
Legionellosis                                    ..... + ...........            235            359            761           593            475         408
Leptospirosis                                         68          93             73             71            110            94             85          82
Lymphogranuloma venereum                             394         353            365            348            284           250            199         263
Malaria                                              293         373            471            547            731           894          2,062       1,388
Measles (rubeola)                                 22,094      24,374         41,126         57,345         26,871        13,597         13,506       3,124
----------------------------------------------------------------------------------------------------------------------------------------------------------
Meningococcal disease                              1,346       1,478          1,605          1,828          2,505         2,724          2,840       3,525
Mumps                                             59,128      59,647         38,492         21,436         16,817        14,225          8,576       4,941
Murine typhus fever                                   26          41             69             75             46            69             81          61
Pertussis (whooping cough)                         2,402       1,738          1,010          2,177          2,063         1,623          1,730       1,248
Plague                                                 8          20             16             18             12            13             18          13
Poliomyelitis, total                                   7          13             10             19              8            22              9          10
  Paralytic &                                          7          13             10             19              8            22              9          10
----------------------------------------------------------------------------------------------------------------------------------------------------------
Psittacosis                                          164          49             78             94            140           137            124         136
Rabies, animal                                     3,151       2,627          3,073          3,130          3,254         5,119          6,421       7,118
Rabies, human                                          -           2              2              2              4             4              -           2
Rheumatic fever, acute                             2,431       2,854          1,865          1,738            851           629            432         264
Rocky Mountain spotted fever                         754         844            937          1,153          1,063         1,070          1,163       1,192
Rubella (German measles)                          11,917      16,652         12,491         20,395         18,269        11,795          3,904       2,077
Rubella, congenital syndrome                          45          30             30             23             30            62             50          19
----------------------------------------------------------------------------------------------------------------------------------------------------------
Salmonellosis, excluding typhoid fever            21,980      22,612         22,937         27,850         29,410        33,138         33,715      39,990
Shigellosis                                       22,600      16,584         13,140         16,052         19,511        20,135         19,041      19,859
Syphilis, primary and secondary                   25,385      25,561         23,731         20,399         21,656        24,874         27,204      31,266
  Total, all stages                               83,771      80,356         71,761         64,621         64,875        67,049         68,832      72,799
Tetanus                                              101         102             75             87             86            81             95          72
Trichinosis                                          120         252            115            143             67           157            131         206
----------------------------------------------------------------------------------------------------------------------------------------------------------
Tuberculosis @                                    30,122      33,989         32,105         30,145         28,521        27,669         27,749      27,373
Tularemia                                            144         129            157            165            141           196            234         288
Typhoid fever                                        437         375            419            398            505           528            510         584
Varicella (chickenpox)                           141,495     154,248        183,990        188,396        154,089       199,081        190,894     200,766
Yellow fever                                     .............................................. ** .......................................................
----------------------------------------------------------------------------------------------------------------------------------------------------------
NOTE: Data in the annual Summary of Notifiable Diseases might not match data in other CDC surveillance reports because of differences in the timing of reports, the source
of the data, and the use of different case definitions.

 * Cutaneous diphtheria is no longer nationally notifiable.
 + Not previously nationally notifiable.
 & No cases of paralytic poliomyelitis caused by wild virus have been reported in the United States since 1979.
 @ Case data subsequent to 1974 are not comparable with earlier years because of changes in reporting criteria that became effective in 1975.
** Last indigenous case of yellow fever was reported in 1911; before 1996, the last imported case was reported in 1924.
============================================================================================================================================================================

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Table_5
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TABLE 5. NOTIFIABLE DISEASES -- Summary of reported cases, United States, 1966- 1973
================================================================================================================================================
Disease                                              1966        1967        1968         1969        1970        1971        1972        1973
----------------------------------------------------------------------------------------------------------------------------------------------
Amebiasis                                           2,921       3,157       3,005        2,915       2,888       2,752       2,199       2,235
Anthrax                                                 5           2           3            4           2           5           2           2
Aseptic meningitis                                  3,058       3,082       4,494        3,672       6,480       5,176       4,634       4,846
Botulism                                                9           5           7           16          12          25          22          34
Brucellosis                                           262         265         218          235         213         183         196         202
Chancroid                                             838         784         845        1,104       1,416       1,320       1,414       1,165
Cholera                                                 -           -           -            -           -           1           -           1
----------------------------------------------------------------------------------------------------------------------------------------------
Diphtheria                                            209         219         260          241         435         215         152         228
Encephalitis, primary                               2,121       1,478       1,781        1,613       1,580       1,524       1,059       1,613
  Post-infectious                                     964       1,060         502          304         370         439         243         354
Gonorrhea                                         351,738     404,836     464,543      534,872     600,072     670,268     767,215     842,621
Granuloma inguinale                                   148         154         156          154         124          89          81          62
Hansen disease (leprosy)                              109          81         123           98         129         131         130         146
Hepatitis A (infectious)                           32,859      38,909      45,893       48,416      56,797      59,606      54,074      50,749
----------------------------------------------------------------------------------------------------------------------------------------------
Hepatitis B (serum)                                 1,497       2,458       4,829        5,909       8,310       9,556       9,402       8,451
Leptospirosis                                          72          67          69           89          47          62          41          57
Lymphogranuloma venereum                              308         371         485          520         612         692         756         408
Malaria                                               565       2,022       2,317        3,102       3,051       2,375         742         237
Measles (rubeola)                                 204,136      62,705      22,231       25,826      47,351      75,290      32,275      26,690
Meningococcal disease                               3,381       2,161       2,623        2,951       2,505       2,262       1,323       1,378
Mumps                                             ..... * ...........     152,209       90,918     104,953     124,939      74,215      69,612
----------------------------------------------------------------------------------------------------------------------------------------------
Murine typhus fever                                    33          52          36           36          27          23          18          32
Pertussis (whooping cough)                          7,717       9,718       4,810        3,285       4,249       3,036       3,287       1,759
Plague                                                  5           3           3            5          13           2           1           2
Poliomyelitis, total                                  113          41          53           20          33          21          31           8
  Paralytic                                           106          40          53           18          31          17          29           7
Psittacosis                                            50          41          43           57          35          32          52          33
Rabies, animal                                      4,178       4,481       3,591        3,490       3,224       4,310       4,369       3,640
----------------------------------------------------------------------------------------------------------------------------------------------
Rabies, human                                           1           2           1            1           3           2           2           1
Rheumatic fever, acute                              4,472       3,985       3,470        3,229       3,227       2,793       2,614       2,560
Rocky Mountain spotted fever                          268         305         298          498         380         432         523         668
Rubella (German measles)                           46,975      46,888      49,371       57,686      56,552      45,086      25,507      27,804
Rubella, congenital syndrome                           11          10          14           31          77          68          42          35
Salmonellosis, excluding typhoid fever             16,841      18,120      16,514       18,419      22,096      21,928      22,151      23,818
Shigellosis                                        11,888      13,474      12,180       11,946      13,845      16,143      20,207      22,642
----------------------------------------------------------------------------------------------------------------------------------------------
Streptococcal sore throat and scarlet fever       427,752     453,351     435,013      450,008     433,405         ...           +         ...
Syphilis, primary and secondary                    21,414      21,053      19,019       19,130      21,982      23,783      24,429      24,825
  Total, all stages                               105,159     102,581      96,271       92,162      91,382      95,997      91,149      87,469
Tetanus                                               235         263         178          192         148         116         128         101
Trichinosis                                           115          66          77          215         109         103          89         102
Tuberculosis                                       47,767      45,647      42,623       39,120      37,137      35,217      32,882      30,998
Tularemia                                             208         184         186          149         172         187         152         171
Typhoid fever                                         378         396         395          364         346         407         398         680
Varicella (chickenpox)                            .......................................... * .......................     164,114     182,927
Yellow fever                                      .......................................... & ...................................         ...
----------------------------------------------------------------------------------------------------------------------------------------------
NOTE: Data in the annual Summary of Notifiable Diseases might not match data in other CDC surveillance reports because of differences in
the timing of reports, the source of the data, and the use of different case definitions.

* Not previously nationally notifiable.
+ No longer nationally notifiable.
& Last indigenous case of yellow fever was reported in 1911; before 1996, the last imported case was reported in 1924.
================================================================================================================================================

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Table_6
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TABLE 6. NOTIFIABLE DISEASES -- Deaths from selected diseases, United States, 1987- 1996
========================================================================================================================================================================================
Cause of Death                                           ICD*      1987      1988       1989      1990      1991      1992       1993      1994      1995      1996
-------------------------------------------------------------------------------------------------------------------------------------------------------------------
AIDS +                                             *042-* 044    13,468    16,602     22,082    25,188    29,555    33,566     37,267    42,114    43,115    31,130
Amebiasis                                                 006         9         7          4         5         5         6          6         2         4         4
Anthrax                                                   022         -         -          -         -         -         -          -         -         -         -
Aseptic meningitis                                      047.9        28        37         36        50        47        37         33        30        22        25
Botulism, foodborne                                     005.1         -         1          2         4         2         1          -         -         2         1
Brucellosis                                               023         1         2          -         -         -         -          1         -         1         -
Chancroid                                               099.0         -         -          -         -         1         -          -         -         -         -
Cholera                                                   001         1         -          -         2         2         2          -         1         -         2
Diphtheria                                                032         1         -          -         1         -         1          -         -         1         -
Encephalitis, Eastern equine                            062.2         -         -          1         1         1         1          1         -         1         1
Encephalitis, California                                062.5         1         -          -         -         -         -          -         -         -         1
Encephalitis, St. Louis                                 062.3         2         -          -        13         9         2          1         3         6         -
Encephalitis, Western equine                            062.1         1         -          -         -         -         -          -         -         -         -
Gonococcal infections                                     098         7         3          4         3         3         4          5         3         3         4
Granuloma inguinale                                     099.2         -         -          -         -         -         -          -         -         -         -
Haemophilus influenzae, invasive                        041.5        25        25         16        16        17        16          7         5        12         7
Hansen disease (leprosy)                                  030         1         -          4         3         -         2          1         3         2         -
Hepatitis, viral, infectious (Hep A)             070.0, 070.1        77        70         88        76        71        82         95        97       142       121
Hepatitis, viral, serum (Hep B)                  070.2, 070.3       595       621        711       816       912       903      1,041     1,120     1,027     1,082
Hepatitis, viral, other and unsp.                 070.4-070.9       510       599        717       686       857     1,016      1,353     1,844     2,231     2,577
Leptospirosis                                             100         1         2          -         2         1         2          1         -         2         2
Lymphogranuloma venereum                                099.1         -         -          2         2         1         -          2         -         -         -
Malaria                                                   084         5         7         11         3         4         8         12         3         8         4
Measles (rubeola)                                         055         2         3         32        64        27         4          -         -         2         1
Meningococcal disease                                     036       258       278        273       215       198       201        260       276       273       290
Mumps                                                     072         2         2          3         1         1         -          -         -         -         1
Murine typhus fever                                     081.0         -         -          1         -         -         -          -         -         -         -
Pertussis (whooping cough)                                033         1         4         12        12         -         5          7         8         6         4
Plague                                                    020         1         -          -         -         -         1          2         2         1         2
Poliomyelitis, total                              045.0-045.9         -         1          -         -         1         -          -         -         1         -
Psittacosis                                               073         2         1          1         2         -         4          1         -         -         1
Rabies, human                                             071         1         -          1         1         3         1          1         3         3         3
Rheumatic fever, acute                                390-392        42        76         70        66        89       100        153       191       159       114
Rubella (German measles)                                  056         -         1          4         8         1         1          -         -         1         -
Salmonellosis, incl. paratyphoid fever       002.1-002.9, 003       105        66         99        80        53        47         52        49        66        58
Shigellosis                                               004        13         8         16        10        10         8          5        13         8         5
Spotted fevers                                          082.0        21        20         10        20        13        13          5         9         8         6
Syphilis                                              090-097        98        85        105       106        93        91         80        79        65        73
Tetanus                                                   037        16        17          9        11        11         9         11         9         5         1
Trichinosis                                               124         -         -          1         -         -         -          -         -         -         -
Tuberculosis (all forms)                              010-018     1,755     1,921      1,970     1,810     1,713     1,705      1,631     1,478     1,336     1,202
Tularemia                                                 021         4         2          1         1         2         3          -         -         2         -
Typhoid fever                                           002.0         2         -          -         1         1         -          -         1         -         1
Varicella (chickenpox) &                                  052        89        83         89       120        81       100        100       124       115        81
Yellow fever                                            01060         -         -          -         -         -         -          -         -         -         1
-------------------------------------------------------------------------------------------------------------------------------------------------------------------
NOTE: Data in the annual Summary of Notifiable Diseases might not match data in other CDC surveillance reports because of differences in the timing of reports, the source
of the data, and the use of different case definitions.

* Numbers in ICD column refer to the category numbers listed in the International Classification of Diseases, Ninth Revision,1975. (The asterisks in the ICD column pertain to the ICD
  code, not a footnote. They indicate that the numbers are not part of the ICD but were introduced for use in the United States.)
+ Acquired immunodeficiency syndrome.
& Varicella was taken off the nationally notifiable disease list in 1991. Many states continue to report these cases to CDC.

Source: National Center for Health Statistics System, 1987-1996. Deaths are classified to the ICD Ninth Revision.
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