Skip Navigation LinksSkip Navigation Links
Centers for Disease Control and Prevention
Safer Healthier People
Blue White
Blue White
bottom curve
CDC Home Search Health Topics A-Z spacer spacer
spacer
Blue curve MMWR spacer
spacer
spacer

The content on this page is being archived for historic and reference purposes only. The content, links, and pdfs are no longer maintained and might be outdated.

Summary of Notifiable Diseases, United States, 1998

The following CDC staff members contributed to this report:

Samuel L. Groseclose, D.V.M., M.P.H.
Carol M. Knowles
Patsy A. Hall
Deborah A. Adams
Willie J. Anderson
Kathryn Snavely
Robert F. Fagan
Gerald F. Jones
Carol A. Worsham
Paul Gangarosa, M.P.H.
M. Kathleen Glynn, D.V.M., M.P.V.M.
Man-Huei Chang, M.P.H.
Timothy Doyle, M.P.H.
Ruth Ann Jajosky, D.M.D., M.P.H.
Division of Public Health Surveillance and Informatics
Epidemiology Program Office

in collaboration with

J. Javier Aponte
TRW, Inc.

David A. Nitschke
Sara Zywicki, M.P.H
EDS, Corp.

 

Preface

The MMWR Summary of Notifiable Diseases, United States, 1998 contains summary tables of the official statistics for the reported occurrence of nationally notifiable diseases in the United States for 1998. 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 each year 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. This publication 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 tables that present morbidity for each of the diseases considered nationally notifiable during 1998.* The tables provide the number of cases of notifiable diseases reported to CDC for 1998, 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 August 13, 1999, unless otherwise noted. 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 1.

Part 3 contains tables that list the number of cases of notifiable diseases reported to CDC since 1967. This section also includes a table enumerating deaths associated with specified notifiable diseases reported to the National Center for Health Statistics (NCHS), CDC, during 1988-1997.

The Bibliography section presents general and disease-specific references pertaining to the notifiable infectious diseases. These references provide additional information on surveillance and epidemiologic issues, diagnostic issues, or disease control activities.

-------------------

* Because no cases of anthrax, western equine encephalitis, or yellow fever were reported in the United States during 1998, these diseases do not appear in the tables in Part 1.

 

Background

As of January 1, 1998, a total of 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 Council of State and Territorial Epidemiologists (CSTE) 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, state reporting of nationally notifiable diseases to CDC 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 1998 is as follows:

The 52 Infectious Diseases Designated as Notifiable at the National Level During 1998

Acquired immunodeficiency syndrome (AIDS)
Anthrax
Botulism
Brucellosis
Chancroid
Chlamydia trachomatis, genital infection
Cholera
Coccidioidomycosis*
Congenital rubella syndrome
Cryptosporidiosis
Diphtheria
Encephalitis, California serogroup viral
Encephalitis, eastern equine
Encephalitis, St. Louis
Encephalitis, western equine
Escherichia coli O157:H7
Gonorrhea
Haemophilus influenzae, invasive disease
Hansen disease (leprosy)
Hantavirus pulmonary syndrome
Hemolytic uremic syndrome, postdiarrheal
Hepatitis A
Hepatitis B
Hepatitis C; non-A, non-B
HIV infection, pediatric
Legionellosis
Lyme disease
Malaria
Measles (rubeola)
Meningococcal disease
Mumps
Pertussis (whooping cough)
Plague
Poliomyelitis, paralytic
Psittacosis
Rabies, animal
Rabies, human
Rocky Mountain spotted fever
Rubella (German measles)
Salmonellosis
Shigellosis
Streptococcal disease, invasive, group A
Streptococcus pneumoniae, drug-resistant*
Streptococcal toxic-shock syndrome
Syphilis
Syphilis, congenital
Tetanus
Toxic-shock syndrome
Trichinosis
Tuberculosis
Typhoid fever
Yellow fever

-------------------

* Not currently published in MMWR weekly tables.

Note: Although varicella (chickenpox) is not a nationally notifiable disease, the Council of State and Territorial Epidemiologists recommends reporting cases of this disease to CDC.

 

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 the MMWR Summary of Notifiable Diseases, United States.

Notifiable disease reports are the authoritative and archival counts of cases. They must be approved by the appropriate epidemiologist from each submitting state or territory before being published in the MMWR Summary of Notifiable Diseases, United States. Although useful for detailed epidemiologic analyses, data published in MMWR Surveillance Summaries or other surveillance reports produced by CDC programs might not agree exactly with data reported in the annual summary because of differences in the timing of reports, the source of the data, and the case definitions.

Data in the MMWR Summary of Notifiable Diseases, United States were derived primarily from reports transmitted to the Division of Public Health Surveillance and Informatics, Epidemiology Program Office, CDC, from health departments in the 50 states, five territories, New York City, and the District of Columbia 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. Policies for reporting notifiable disease cases can vary by disease or reporting jurisdiction, depending on case status classification (i.e., confirmed, probable, or suspect).

Final data for selected diseases (presented in Parts 1, 2, and 3) are from the surveillance records of the CDC programs listed below. Requests for further information regarding these data should be directed to the appropriate program.

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; Streptococcal disease, invasive, group A; Streptococcal toxic-shock syndrome; and laboratory data regarding botulism, Escherichia coli O157:H7, salmonellosis, and shigellosis).

Division of Vector-Borne Infectious Diseases (laboratory data regarding arboviral encephalitis).

Division of Viral and Rickettsial Diseases (animal rabies; Hantavirus pulmonary syndrome).

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, CNMI, and the Virgin Islands were unavailable for 1998.

Population estimates for the states are from the July 1, 1998, estimates from the Bureau of the Census* (Internet release number ST-98-1. December 31, 1998). Population numbers for territories are 1997 estimates from the Bureau of the Census (Press release numbers CB98-54 and CB98-80). Population numbers used to calculate rates for age and sex are from July 1, 1998, estimates from the Bureau of Census (Internet release. June 15, 1999). More information regarding census estimates is available at http://www.census.gov. Rates in the MMWR Summary of Notifiable Diseases, United States are presented as incidence rates per 100,000 population, 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 the MMWR Summary of Notifiable Diseases, United States 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) are most likely reported accurately, if they were diagnosed by a clinician. 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 data 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 the 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. Race/ethnicity data also can be used to target populations for prevention efforts. However, caution must be used when drawing conclusions from reported race/ethnicity data. Certain races and ethnicities have differential patterns of access to health care, interest in seeking health care, and detection of disease, potentially resulting in data that are not representative of disease incidence in these populations.

In addition, not all race/ethnicity data are collected uniformly for all diseases. For example, in NCHSTP, the Division of HIV/AIDS Prevention -- Surveillance and Epidemiology and the Division of Sexually Transmitted Diseases Prevention collect race/ethnicity data using a single variable. A person's race/ethnicity is reported as American Indian/Alaskan 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.

-------------------

* Population Distribution Branch, Population Division of the Bureau of Census, which is under the Economics and Statistics Administration, U.S. Department of Commerce.

 

Highlights for 1998

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

Chancroid

In 1998, a total of 189 cases of chancroid were reported to CDC, for a rate of 0.07 cases/100,000 population. The number of cases reported in 1998 reflects a 23% decline from 1997 and a continuing decline since 1987. However, chancroid is difficult to culture and could be substantially underdiagnosed. Several studies that have used DNA amplification tests (which are not commercially available) have identified this infection in cities where it was previously undetected.

Chlamydia trachomatis, Genital Infection

In 1998, a total of 604,420 cases of genital chlamydial infection were reported to CDC, for a rate of 236.57 cases/100,000 population. This is the highest rate of chlamydial infection reported to CDC since cases were first voluntarily reported to the National Center for HIV, STD, and TB Prevention's Division of STD Prevention in the mid-1980s. It is also the highest rate since chlamydia became a nationally notifiable disease in 1995. This increase reflects the continued expansion of chlamydia screening programs and the increased use of more sensitive diagnostic tests for this condition. During the same period, data on chlamydia prevalence obtained by monitoring seropositivity rates of persons screened in different clinic settings have consistently documented declining levels of infection in many parts of the United States (Sexually transmitted disease surveillance 1998. US Department of Health and Human Services, CDC, September 1999).

Cryptosporidiosis

National reporting for cryptosporidiosis began in 1995. During 1995-1998, a total of 11,612 cases were reported from 47 states, with an annual median of 2,900 cases per year (range: 2,566-3,793). Because the diagnosis of cryptosporidiosis is often not considered, and because laboratories do not routinely test stool specimens for cryptosporidiosis infection, this disease continues to be underdiagnosed and under-reported.

Diphtheria

One probable case of diphtheria was reported from Oregon in 1998. The case-patient had acute membranous pharyngitis. An oropharyngeal specimen was weakly positive for diphtheria toxin by polymerase chain reaction, but bacterial culture of the specimen was negative.

Outside the United States, more than 2,700 cases of diphtheria were reported in an epidemic in the Newly Independent States of the former Soviet Union (Dittmann S, Wharton M, Vitek C, et al. Successful control of epidemic diphtheria in the Newly Independent States of the Former Soviet Union: lessons learned in fighting public health emergencies. J Infect Dis 2000 [in press]). This epidemic has resulted in approximately 155,000 cases and 5,000 deaths since 1990. No importations into the United States were reported in 1998.

Gonorrhea

In 1998, a total of 355,642 cases of gonorrhea were reported to CDC, for a rate of 132.88/100,000 population. This was an 8.9% increase from the 1997 rate and the first increase since 1985. The 1998 increase was reported in all demographic groups defined by age, sex, and race/ethnicity, and it occurred in all major geographic regions except the Northeast. Possible reasons for this trend include expansion of screening programs (motivated by the availability of simultaneous testing for genital chlamydial infections), increased use of new diagnostic tests with improved sensitivity, improvements in surveillance systems, and true increases in morbidity.

Haemophilus influenzae, Invasive Disease

In 1998, a total of 255 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). Before a vaccine was introduced in 1987, approximately 20,000 cases of H. influenzae type b (Hib) invasive disease occurred among children annually (JAMA 1993;269:221-6). The sharp decline in the number of Hib cases is attributed to the widespread use of the Hib vaccine among preschool-aged children. Of the 255 cases reported in 1998, a total of 197 (74%) Hi isolates were serotyped, and 61 (31%) of these were type b. Among the 61 cases of Hib invasive disease reported in children aged less than 5 years, 25 (41%) were among children aged less than 6 months, which is too young to have completed a three-dose primary Hib vaccination. However, 22 (61%) of the 36 children who were old enough (i.e., aged greater than or equal to 6 months) to have completed a three-dose primary series were incompletely vaccinated or their vaccination status was unknown. These cases might have been prevented with age-appropriate vaccination.

Hantavirus Pulmonary Syndrome

In 1998, a total of 30 cases of hantavirus pulmonary syndrome (HPS) reported from 12 states were confirmed by CDC. Nine (30%) cases were fatal. HPS is caused by several hantaviruses in the western hemisphere and has also been reported in Canada, Argentina, Paraguay, Brazil, Uruguay, Chile, and Bolivia. Most HPS in the United States is caused by Sin Nombre virus. Other hantaviruses associated with human disease in the United States include Bayou, Black Creek Canal, New York, and Monongahela. Most hantaviruses have specific rodent reservoirs of the family Muridae. The virus is shed in rodent urine, feces, and saliva, then transmitted via inhalation.

Hemolytic Uremic Syndrome, Postdiarrheal

Postdiarrheal hemolytic uremic syndrome (HUS) is a life-threatening illness characterized by hemolytic anemia, thrombocytopenia, and renal injury. In the United States, most cases are caused by infection with Escherichia coli O157:H7 or other Shiga toxin-producing E. coli. In 1998, the third year of national reporting, 17 states reported 90 cases of postdiarrheal HUS to CDC. By comparison, 20 states reported 93 cases in 1997, and 18 states reported 104 cases in 1996. The median age of patients was 5 years (range: less than 1-87 years), and 53% of patients were female. Illness was seasonal, with 59% of cases occurring during June through September.

Hepatitis A

In 1999, the Advisory Committee on Immunization Practices (ACIP) issued revised recommendations for the use of hepatitis A vaccine (HepA). Routine childhood HepA vaccination is recommended in states or counties/communities where the average annual hepatitis A virus (HAV) rate during 1987-1997 was approximately 20 cases 100,000 population (i.e., approximately twice the national average). In addition, routine childhood HepA vaccination can be considered in states or counties/communities where the average rate during 1987-1997 was at least 10 cases/100,000 population.

Of the 23,229 cases of HAV reported in 1998, approximately 60% originated from the 17 states affected by the ACIP recommendations. Eleven of these states had average rates of approximately 20 cases/100,000 persons during 1987-1997, and six states had average rates of approximately 10/100,000 during this period. However, these 17 states account for only 34% of the U.S. population.

Hepatitis B

The number of reported acute hepatitis B cases has decreased by more than 50% during the past decade, from 21,102 cases in 1990 to 10,258 cases in 1998. This downward trend is expected to continue as a national strategy for eliminating hepatitis B virus (HBV) transmission is implemented. Components of this strategy include a) screening pregnant women for hepatitis B surface antigen (HBsAg) and providing postexposure immunoprophylaxis to infants of infected women; b) routinely vaccinating infants; c) providing catch-up vaccinations for children aged less than 19 years (particularly those aged 11-12 years); and d) targeting vaccinations to children, adolescents, and adults at increased risk for infection. Draft Healthy People 2010 objectives emphasize the elimination of HBV transmission and include reducing the number of perinatal HBV infections to less than 400 and reducing the number of acute hepatitis B cases in persons aged 2-18 years to less than 10. Proposed age-specific target rates per 100,000 population for persons aged greater than 18 years are as follows: 3.2 cases/100,000 for persons aged 19-24 years, 11.1/100,000 for persons aged 25-39 years, and 1.0/100,000 for persons aged greater than or equal to 40 years.

Hepatitis C

Hepatitis C virus (HCV) infection is the most common chronic bloodborne infection in the United States (MMWR 1998;47[RR-19]). Based on data from CDC's sentinel counties viral hepatitis surveillance system, approximately 242,000 new HCV infections occurred each year during the 1980s. Since 1989, the annual number of new infections identified in the sentenial counties has declined by 80%. For reasons that are unclear, this dramatic decline correlates with a decrease in cases among injecting-drug users (MMWR 1998;47[RR-19]). But in 1996, data from the Third National Health and Nutrition Examination Survey (1988-1994) indicated that approximately 4 million Americans (1.8%) have been infected with HCV. Most are chronically infected, although the majority might be unaware of their infection because they are not clinically ill. Chronically infected persons can transmit the virus to others and are at risk for chronic liver disease, including cirrhosis and liver cancer.

CDC guidelines for prevention and control of HCV infection and HCV-related chronic disease were published in October 1998 (MMWR 1998;47[RR-19]). The U.S. Food and Drug Administration also issued guidance in 1998 requiring the notification of persons who received blood or blood products before July 1992 from donors subsequently found to be infected with HCV. In May 1999, a national campaign was initiated to educate the public about hepatitis C and the need for persons at increased risk to be tested. These recommendations and activities are expected to increase the number of HCV-infected persons identified and reported to state and local health departments.

HIV Infection, Pediatric

In 1998, reports based on acquired immunodeficiency syndrome (AIDS) surveillance data indicated continued, substantial declines in perinatally acquired AIDS, reflecting declining perinatal human immunodeficiency virus (HIV) transmission. HIV surveillance data indicated that the increasing use of zidovudine was temporally associated with this decline (MMWR 1997;46:1086-92 and CDC. HIV/AIDS surveillance report. Atlanta, GA: US Department of Health and Human Services, 1998:36. [Vol. 10, no. 2]). These data demonstrate success in nationwide efforts to implement Public Health Service (PHS) guidelines for routine, voluntary prenatal HIV testing (MMWR 1995;44[No. RR-7] and MMWR 1998;47:688-91 and MMWR 1999;48:401-4) and the use of zidovudine to reduce perinatal HIV transmission (MMWR 1994;43[No. RR-11] and MMWR 1998;47[No. RR-2]).

States that conduct surveillance of perinatally exposed and infected children aged less than 13 years can evaluate the impact of the guidelines and document resources needed to care for perinatally exposed infants. In 1998, a total of 32 states conducted surveillance of HIV infection among children, reporting 309 HIV-infected children whose infection had not progressed to AIDS and 143 children who had AIDS. These states also received 2,433 new reports of perinatally exposed children who required follow up with health-care providers to determine their HIV infection status.

Lyme Disease

In 1998, a total of 16,801 cases of Lyme disease were reported, the highest number ever reported. This increase could be caused by an increase in human contact with infected ticks and enhanced reporting of cases. Lyme disease occurs primarily in the northeastern and northcentral United States. The following nine states had incidence rates higher than the annual national average of 6.39 cases/100,000 population and accounted for 93.0% of reported cases: Connecticut (105.0/100,000), Rhode Island (79.6), New York (25.5), New Jersey (24.0), Pennsylvania (22.9), Maryland (13.1), Massachusetts (11.5), Wisconsin (12.8), and Delaware (10.7).

In December 1998, a new Lyme disease vaccine was approved by the U.S. Food and Drug Administration. The Advisory Committee on Immunization Practices issued recommendations for use of this vaccine in June 1999 (MMWR 1999;48 [No. RR-7]). These recommendations emphasize that the decision to vaccinate should be based on both geographic risk and individual exposure to tick-infested habitats. Because the Lyme disease vaccine is not 100% effective and does not protect against transmission of other tickborne diseases, vaccinated persons should continue to practice personal protective measures against ticks and seek early diagnosis and treatment of suspected tickborne infections.

Pertussis

On July 29, 1998, the fourth diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP) was licensed for use in children aged 6 weeks-6 years. This vaccine is called Certiva,TM and it is manufactured by North American Vaccine, Inc. Other DTaP vaccines licensed since 1996 include Tripedia® (Connaught Laboratories, Inc.), ACEL-IMUNE® (Lederle Laboratories Division of American Cyanamid Company), and Infanrix® (SmithKline Beecham Pharmaceuticals). The Advisory Committee on Immunization Practices recommends DTaP vaccines for all five doses in the childhood vaccination schedule.

Since 1980, the number of reported cases of pertussis has increased in the United States. The reasons for this rise are unknown, but could include increased awareness of pertussis among health-care providers, increased use of more sensitive diagnostic tests, and better reporting of cases to health departments. In 1998, a total of 24% of 7,405 reported cases occurred among children aged less than 7 months, who were too young to have received the recommended three doses of pertussis vaccine. Thirteen percent of cases were among preschool-aged children (i.e., those aged 1-4 years). Since 1995, the coverage rate with at least three doses of pertussis vaccine has been 95% among U.S. children aged 19-35 months. Twenty-six percent of cases were reported among children aged 10-19 years. Because vaccine-induced immunity wanes approximately 5-10 years after pertussis vaccination, adolescents can become susceptible to disease. Since 1990, the incidence among preschool-aged children has not changed, but the incidence among adolescents has increased in some states (Clin Inf Dis 1999;28:1230-7).

Plague

In 1998, nine cases of plague among humans were reported in the United States (six cases in New Mexico, one in Arizona, one in California, and one in Colorado). None were fatal. Of the 360 cases that occurred during 1970-1998, approximately 80% were reported from the southwestern states of New Mexico, Arizona, and Colorado. Nine percent occurred in California, and limited numbers of cases were reported from nine other western states. Yersinia pestis was recently designated as a potential agent of biological terrorism (see page xvi). In recognition of this potential threat, CDC is collaborating with other public health and federal agencies to develop guidelines for responding to bioterrorism events involving Y. pestis. Also in 1998, CDC was informed that Greer Laboratories, Inc., was ceasing production of the only plague vaccine commercially available in the United States. This vaccine has a limited shelf life, and no remaining stockpiles exist.

Poliomyelitis, Paralytic

As of January 1999, the Advisory Committee on Immunization Practices recommends only inactivated polio vaccine (IPV) for the first two doses of the polio vaccination series. Distribution of IPV as a proportion of overall polio vaccine use has increased from 6% in 1996 to 29% in 1997 to 34% in 1998. All six cases of vaccine-associated polio reported in the United States since January 1997 (including the single case reported in 1998) were associated with receipt of trivalent oral polio vaccine (OPV) for the first or second dose in an all-OPV schedule. An all-IPV schedule is recommended for routine childhood vaccination beginning January 1, 2000.

St. Louis Encephalitis

A summertime epidemic of St. Louis encephalitis in southern Louisiana accounted for 18 of the 24 cases reported nationally. No cases were fatal. Culex pipiens quinquefasciatus was presumed to be the primary mosquito vector. The last major epidemic of St. Louis encephalitis in the United States (223 cases and 11 deaths) occurred in Florida in 1990. This disease occurs in portions of both the eastern and western United States.

Streptococcal Disease, Invasive, Group A

Nationally, approximately 10,200 cases of invasive group A streptococcal disease and 1,300 deaths occurred in 1998, according to reports from the Active Bacterial Core Surveillance (ABCS) project under CDC's Emerging Infectious Diseases Program, which operates in seven states (California, Connecticut, Georgia, Maryland, Minnesota, New York, and Oregon). The incidence of this disease during 1998 was 3.8 cases/100,000 population. Rates were highest among children aged less than 1 year (7.5 cases/100,000) and adults aged greater than or equal to 65 years (10.0/100,000). Streptococcal toxic shock syndrome and necrotizing fasciitis each accounted for approximately 5.1% of invasive cases. The overall case-fatality rate among patients with invasive group A streptococcal disease was 12.2%.

Streptococcus pneumoniae, Drug-Resistant

During 1998, the Active Bacterial Core Surveillance (ABCS) project of CDC's Emerging Infectious Diseases Program collected information on invasive pneumococcal disease, including drug-resistant Streptococcus pneumoniae, in eight states -- California, Connecticut, Georgia, Maryland, Minnesota, New York, Oregon, and Tennessee. Of 3,335 S. pneumoniae isolates collected during 1998, a total of 10.2% exhibited intermediate penicillin resistance (minimum inhibitory concentration [MIC] 0.1-1 ug/mL), and 13.6% were resistant (MIC greater than or equal to 2 ug/mL). For cefotaxime, 7.7% of all isolates had intermediate resistance (MIC 1 ug/mL), and 6.1% were resistant (MIC greater than or equal to 2 ug/mL). The proportion of isolates resistant to erythromycin was 14.7% (MIC greater than or equal to 2 ug/mL). The overall proportions of isolates that were not susceptible to these three drugs were not substantially different compared with 1997 data. However, the proportions that were resistant varied widely among surveillance sites in 1998, and an increase in the prevalence of resistant strains, compared with earlier years, was reported from some states (data available at http://www.cdc.gov/ncidod/dbmd/abcs/survreports.htm).

Syphilis, Congenital

In 1998, a total of 801 cases of congenital syphilis were reported to CDC, for a rate of 20.6/100,000 live births. Like primary and secondary syphilis, the rate of congenital syphilis has declined sharply in recent years, from a peak of 107.3 cases/100,000 live births in 1991. Congenital syphilis persists in the United States because of the substantial number of women who do not receive syphilis serologic testing during pregnancy or who receive this testing too late in their pregnancy. This lack of screening is often related to a lack of prenatal care or late prenatal care (Am J Public Health 1999;89:557-60).

Syphilis, Primary and Secondary

In 1998, a total of 6,993 primary and secondary syphilis cases were reported to CDC. During 1990-1998, the primary and secondary syphilis rate declined 86%, from 20.3 cases/100,000 population to 2.6/100,000 -- the lowest level since reporting began in 1941. Although syphilis has declined in all regions of the United States and in all racial/ethnic groups, rates remain disproportionately high in the South and among non-Hispanic blacks, and focal outbreaks continue to occur.

Tetanus

The first case of neonatal tetanus reported in the United States since 1995 was reported from Montana in 1998. The case occurred in an infant born to a mother who was not immunized because of her philosophic beliefs and who used a nonsterile bentonite clay recommended by a lay midwife for the care of the baby's umbilical cord. The infant recovered after a 3-week hospitalization, including 12 days of mechanical ventilation. Of the 41 cases of tetanus that occurred in 1998, a total of 16 (39%) were among persons aged greater than or equal to 60 years, and 16 (39%) were among persons aged 20-59 years.

 

Highlights for Selected Non-Notifiable Diseases

Cyclosporiasis

In recent years, multiple foodborne outbreaks of cyclosporiasis linked to various types of fresh produce (i.e., mesclun lettuce, basil, and Guatemalan raspberries) have occurred in the United States. In Spring 1998, Canada allowed importation of fresh Guatemalan raspberries, which resulted in a cyclosporiasis outbreak. The United States did not allow importation and thus, did not have an outbreak associated with raspberries (MMWR 1998;47:806-9).

Dengue

In 1998, a total of 90 confirmed or probable cases of dengue were imported into the United States and diagnosed in CDC's Dengue Branch. One case in a man aged 65 years was fatal. The number of cases reported in 1998 is higher than the 56 confirmed or probable cases reported in 1997. No indigenous cases were reported in the United States.

Also in 1998, the preliminary number of dengue and dengue hemorrhagic fever (DHF) cases reported by Pan American Health Organization member countries (741,794, of which 535,388 were reported by Brazil) was more than twice the total for 1997 (364,945). In addition, cases of dengue-3 were reported from islands in the Caribbean for the first time after a 20-year absence. Hurricanes Georges (September 1998) and Mitch (October-November 1998) did not cause acute changes in dengue incidence in the affected areas, except for brief interruptions in disease surveillance systems.

HIV Infection in Adults

In June 1997, reporting of human immunodeficiency virus (HIV) infection among adults (i.e., persons aged greater than or equal to 13 years) was added to the list of nationally notifiable diseases at the annual Council of State and Territorial Epidemiologists (CSTE) meeting. The revised surveillance case definition and associated recommendations become effective January 1, 2000 (MMWR 1999;48[RR-13]). As of December 31, 1998, a total of 29 states and the Virgin Islands had implemented confidential reporting of HIV among adolescents and adults as an extension of current surveillance for acquired immunodeficiency syndrome (AIDS).

During 1998, reports based on AIDS data continued to highlight substantial declines in AIDS incidence and deaths. As a result of improvements in treatment and care of persons infected with HIV, surveillance of AIDS alone no longer accurately reflects the magnitude of the epidemic or trends in HIV transmission. 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. In its June 1997 statement, CSTE recommended that all states and territories implement confidential HIV infection reporting based on methods that provide accurate and representative data for all persons diagnosed confidentially.

Streptococcal Disease, Invasive, Group B

Efforts to prevent neonatal group B streptococcal (GBS) infections, a leading cause of bacterial disease and death among newborns in the United States, were supported by a 1996 release of consensus guidelines for the prevention of perinatal GBS disease. Adoption of a prevention policy at one hospital correlated with declines in neonatal GBS incidence (Am J Obstet Gynecol 1998:179:1568-71). In addition, surveillance areas with a high proportion of hospitals with GBS-prevention policies have a lower incidence of neonatal GBS disease (MMWR 1998;47:665-70). A recent multistate evaluation demonstrated that the proportion of hospitals with prevention policies increased from 39% in 1994 to 58% in 1997. Active surveillance during 1993-1995 in four U.S. areas (i.e., Maryland and select counties in California, Georgia, and Tennessee) demonstrated an overall 24% decline in newborn GBS disease, from 1.7 cases/1,000 live-born infants in 1993 to 1.3/1,000 in 1995. Surveillance data from these same sites in 1998 revealed a further decline of 54%, to 0.6 cases/1,000 live-born infants (MMWR 1997;46:473-7).

Tularemia

The reported incidence of tularemia in the United States continues to be low. Sporadic cases are primarily associated with handling infected animals or exposure to infected arthropods. Because of concerns that Francisella tularensis could be a potential bioterrrorist agent, tularemia will be reinstated as a nationally notifiable disease, effective January 2000 (see page xvi).

Vancomycin-Resistant Enterococci

Data regarding the magnitude and impact of vancomycin-resistant enterococci (VRE) in the United States are collected by CDC's National Nosocomial Infections Surveillance (NNIS) system, which includes more than 280 U.S. hospitals. During 1989-1998, the percentage of VRE isolated from patients with nosocomial infections in hospital intensive care units increased from 0.4% to 22.6%. The percentage of VRE isolated from patients with nosocomial infections in nonintensive care units increased from 0.3% to 21.2%. Although the differences between VRE rates by health-care setting have diminished, the overall rates of resistance for many nosocomial pathogens continue to rise and are highest among patients in intensive care units. Additional data are available at http://www.cdc.gov/ncidod/hip/SURVEILL/NNIS.HTM.




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

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

1998

22.6

21.2

* N>2000 isolates for each year.
† P<0.0001, chi-square for linear trend.

Source: National Nosocomial Infections Surveillance (NNIS) system, Hospital Infections Program, National Center for Infectious Diseases, CDC

Varicella

Although varicella (chickenpox) deaths did not become nationally notifiable until January 1, 1999, some states began reporting varicella deaths to CDC during the second half of 1998. These data highlighted that both children and adults are continuing to die from a disease that is now vaccine-preventable. During 1998, national coverage for varicella vaccine among children aged 19-35 months was 43%. Efforts to increase vaccination of susceptible children, adolescents, and adults should include educating health-care providers that deaths and severe morbidity from varicella are preventable.

Surveillance for Potential Bioterrorism Agents

CDC established the Bioterrorism Preparedness and Response Program in January 1999 to improve the public health capability to detect and respond to biological and chemical terrorism. Members of this program are working with the FBI and other federal agencies to develop an organized and tiered response to suspect and confirmed biological events. The program focuses on state-level preparedness for early clinical and laboratory detection, which is essential to ensure a prompt response to a bioterrorist attack (e.g., providing prophylactic medicines or vaccines). Initial activities target critical agents that a) are associated with high case-fatality, b) can be disseminated to a large population, c) can cause social disruption because of public perception, and d) require special preparedness needs. These critical agents and their associated diseases include variola major (smallpox), Bacillus anthracis (anthrax), Yersinia pestis (plague), Francisella tularensis (tularemia), Clostridium botulinum (botulism), and the viral hemorrhagic fevers (e.g., arenaviruses and filoviruses).

Several other agents have been identified but require less broad-based preparedness efforts, including ones that cause foodborne and waterborne diseases. A critical element for preparedness is defining the natural epidemiology of diseases that can be caused by critical agents, including anthrax and plague, which are nationally notifiable diseases. The last case of naturally occurring anthrax in the United States was reported in 1992. In 1998, a total of 9 cases of plague among humans were reported in the United States.

Part 1: Summaries of Notifiable Diseases in the United States, 1998

EXPLANATION OF SYMBOLS USED IN TABLES, GRAPHS, AND MAPS

Data not availableNA
Report of disease is not required in that jurisdiction (not notifiable)NN
No reported cases--



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

NOTIFIABLE DISEASES -- Summary of reported cases, by month, United States, 1998

Disease

Total

Jan.

Feb.

Mar.

Apr.

May

June

July

Aug.

Sept.

Oct.

Nov.

Dec

AIDS*

46,521

3,144

4,236

4,723

4,023

3,924

3,924

3,522

4,112

3,992

3,475

3,673

3,773

Botulism, total

116

5

5

4

9

13

10

9

14

11

13

4

19

Brucellosis

79

1

1

--

4

7

6

8

8

6

7

2

29

Chancroid

189

53

58

37

41

Chlamydia†§

604,420

136,428

146,994

152,886

168,112

Cholera

17

1

--

--

--

1

2

1

1

2

3

2

4

Cryptosporidiosis

3,793

124

170

246

152

182

173

262

1,158

424

365

218

319

Diphtheria

1

--

--

--

--

1

--

--

--

--

--

--

--

Encephalitis, California serogroup viral

97

--

--

--

--

--

--

8

38

22

15

3

11

  Eastern equine

4

--

--

--

--

--

--

1

--

1

--

1

1

  St. Louis

24

--

--

--

--

--

--

--

2

1

17

1

3

Escherichia coli O157:H7

3,161

62

59

66

67

183

291

421

577

421

355

235

424

Gonorrhea

355,642

80,036

82,229

96,129

97,248

Haemophilus influenzae, invasive disease

1,194

89

93

104

98

110

92

82

93

57

84

71

221

Hansen disease (leprosy)

108

5

12

7

17

4

12

8

10

4

9

12

8

Hepatitis A

23,229

1,232

1,474

1,676

2,259

2,327

2,001

1,489

2,280

1,766

2,044

1,659

3,022

Hepatitis B

10,258

547

621

699

832

974

902

805

995

747

865

669

1,602

Hepatitis C; non-A, non-B

3,518

155

232

279

362

304

293

182

317

239

355

318

482

Legionellosis

1,355

67

108

95

73

92

85

140

185

97

143

96

174

Lyme disease

16,801

200

249

440

380

572

1,306

2,824

3,458

2,504

1,855

888

2,125

Malaria

1,611

96

77

81

96

102

111

130

202

178

167

100

271

Measles (rubeola)

100

1

2

6

9

11

10

5

6

19

10

10

11

Meningococcal disease

2,725

256

288

251

259

242

236

144

192

140

199

179

339

Mumps

666

20

37

47

200

54

39

33

46

46

38

37

69

Pertussis (whooping cough)

7,405

263

313

410

330

513

521

526

854

774

905

749

1,247

Plague

9

--

--

--

--

--

3

2

2

--

1

--

1

Poliomyelitis, paralytic

1

--

--

--

--

--

--

--

--

1

--

--

--

Psittacosis

47

6

1

2

3

3

6

5

--

3

5

11

2

Rabies, animal

7,259

443

452

646

631

710

633

564

854

683

654

447

542

Rabies, human

1

--

--

--

--

--

--

--

--

--

--

--

1

Rocky Mountain spotted fever

365

2

5

6

9

22

45

50

69

53

33

18

53

Rubella (German measles)

364

12

23

70

63

69

47

26

19

4

12

4

15

Rubella, congenital syndrome

7

--

1

--

1

--

1

--

1

--

--

--

3

Salmonellosis

43,694

1,840

1,743

1,861

2,179

3,213

3,485

4,323

6,034

4,985

5,592

3,276

5,163

Shigellosis

23,626

1,064

1,155

1,146

1,416

1,712

1,752

1,640

2,656

2,365

2,935

2,170

3,615

Syphilis, total (all stages)

37,977

9,473

9,879

9,244

9,381

  Primary and secondary

6,993

1,685

1,693

1,845

1,770

  Congenital (age <1 yr)

801

231

186

215

169

Tetanus

41

1

1

1

4

4

1

6

6

3

5

1

8

Toxic-shock syndrome

138

9

9

12

15

11

14

8

12

5

14

13

16

Trichinosis

19

--

1

--

2

2

1

--

3

--

1

--

9

Tuberculosis

18,361

685

1,035

1,328

1,293

1,413

1,707

1,737

1,492

1,441

1,740

1,514

2,976

Typhoid fever

375

24

25

24

35

24

25

28

45

53

36

18

38

Varicella (chickenpox)**

82,455

8,849

10,830

11,129

11,199

12,119

5,342

2,254

690

1,539

2,721

4,169

11,614

* Total number of acquired immunodeficiency syndrome (AIDS) 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, 1998.
† Cases were updated through the Division of Sexually Transmitted Diseases Prevention, NCHSTP, as of July 19, 1999.
§ Chlamydia refers to genital infections caused by C. trachomatis.
¶ Cases were updated through the Division of Tuberculosis Elimination, NCHSTP, as of June 3, 1999.
** Not nationally notifiable.




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

NOTIFIABLE DISEASES -- Reported cases, by geographic division and area--United States, 1998

 

Botulism

 

Area

Total resident population (in thousands)

AIDS*

Foodborne

Infant

Brucellosis

Chancroid†

United States

270,296

46,521§

22

65

79

189

New England

13,429

1,811

--

--

--

2

Maine

1,244

31

--

--

--

--

N.H.

1,185

42

--

--

--

--

Vt.

591

20

--

--

--

--

Mass.

6,147

924

--

--

--

--

R.I.

988

128

--

--

--

--

Conn.

3,274

666

--

--

--

2

Mid. Atlantic

38,291

12,588

2

15

2

82

Upstate N.Y.

10,850

1,581

--

3

1

--

N.Y. City

7,325

7,133

--

1

1

82

N.J.

8,115

2,134

2

9

--

--

Pa.

12,001

1,740

--

2

--

--

E.N. Central

44,194

3,390

--

8

9

6

Ohio

11,209

685

--

4

1

3

Ind.

5,899

484

--

--

--

1

Ill.

12,045

1,304

--

3

5

--

Mich.

9,817

714

--

--

3

--

Wis.

5,224

203

--

1

--

2

W.N. Central

18,694

927

--

--

5

1

Minn.

4,725

190

--

--

1

--

Iowa

2,862

75

--

NN

1

--

Mo.

5,439

443

--

--

3

--

N. Dak.

638

6

--

--

NN

NN

S. Dak.

738

15

--

--

--

--

Nebr.

1,663

72

--

--

--

--

Kans.

2,629

126

--

--

--

1

S. Atlantic

48,944

12,194

1

3

9

40

Del.

744

174

--

--

1

--

Md.

5,135

1,639

--

1

1

--

D.C.

523

989

--

--

--

--

Va.

6,791

998

1

--

1

7

W. Va.

1,811

86

--

--

--

--

N.C.

7,546

788

--

2

1

9

S.C.

3,836

777

--

--

NN

19

Ga.

7,642

1,295

--

--

2

2

Fla.

14,916

5,448

--

--

3

3

E.S. Central

16,471

1,874

--

4

5

4

Ky.

3,936

280

--

3

1

--

Tenn.

5,431

695

--

1

2

--

Ala.

4,352

484

--

--

1

1

Miss.

2,752

415

--

--

1

3

W.S. Central

30,014

5,406

--

5

29

42

Ark.

2,538

203

--

--

2

7

La.

4,369

951

--

--

1

1

Okla.

3,347

285

--

--

--

--

Tex.

19,760

3,967

--

5

26

34

Mountain

16,814

1,632

1

7

3

3

Mont.

880

29

1

--

--

--

Idaho

1,229

32

--

1

1

--

Wyo.

481

6

--

--

--

1

Colo.

3,971

314

--

2

1

--

N. Mex.

1,737

209

--

--

--

--

Ariz.

4,669

645

--

--

1

2

Utah

2,100

139

--

1

--

--

Nev.

1,747

258

--

3

--

--

Pacific

43,445

6,489

18

23

17

9

Wash.

5,689

441

6

--

3

1

Oreg.

3,282

204

--

4

--

--

Calif.

32,667

5,654

4

19

12

8

Alaska

614

29

8

--

2

--

Hawaii

1,193

161

--

--

--

--

             

Guam

145

2

--

--

--

--

P.R.

3,860

1,711

--

--

--

2

V.I.

114

35

NN

NN

NN

--

American Samoa

60

--

NA

NA

NA

NA

C.N.M.I.

63

--

NA

NA

NA

NA

* Total number of acquired immunodeficiency syndrome (AIDS) cases reported to the Division of HIV/AIDS Prevention -- Surveillance and Epidemiology, National Center for HIV, STD, and TB Prevention (NCHSTP), through December 31, 1998.
† Totals reported to the Division of Sexually Transmitted Diseases Prevention, NCHSTP, as of July 19, 1999.
§ Total includes 210 cases among persons with unknown state of residence.


NOTIFIABLE DISEASES -- Reported cases, by geographic division and area, United States, 1998 -- Continued

 

Encephalitis

Area

Chlamydia*

Cholera

Cryptosporidiosis

Diphtheria

California serogroup viral

Eastern equine

United States

604,420

17

3,793

1

97

4

New England

20,093

1

152

--

--

1

Maine

1,073

--

33

--

--

--

N.H.

960

--

18

--

--

--

Vt.

413

--

26

--

--

--

Mass.

8,363

--

68

--

--

--

R.I.

2,307

--

7

--

--

1

Conn.

6,977

1

NA

--

--

--

Mid. Atlantic

62,533

1

580

--

--

--

Upstate N.Y.

NN

--

343

--

--

--

N.Y. City

26,218

1

208

--

--

--

N.J.

11,686

--

29

--

--

--

Pa.

24,629

--

NN

--

--

--

E.N. Central

100,984

--

737

--

24

1

Ohio

27,786

--

75

--

11

--

Ind.

10,801

--

63

--

1

1

Ill.

26,363

--

84

--

4

--

Mich.

22,156

--

39

--

--

--

Wis.

13,878

--

476

--

8

--

W.N. Central

35,920

--

374

--

6

--

Minn.

6,970

--

173

--

4

--

Iowa

5,174

--

66

--

2

--

Mo.

12,670

--

29

--

--

--

N. Dak.

1,036

--

34

--

--

--

S. Dak.

1,572

--

25

--

--

--

Nebr.

2,911

--

36

--

--

--

Kans.

5,587

--

11

--

--

--

S. Atlantic

122,963

--

430

--

53

1

Del.

2,608

--

3

--

--

--

Md.

13,097

--

21

--

--

--

D.C.

NN

--

25

--

--

--

Va.

13,561

--

22

--

3

1

W. Va.

2,791

--

3

--

46

--

N.C.

22,197

--

NN

--

4

--

S.C.

18,510

--

--

--

--

--

Ga.

25,250

--

152

--

--

--

Fla.

24,949

--

204

--

--

--

E.S. Central

40,837

--

27

--

14

--

Ky.

6,441

--

10

--

4

--

Tenn.

13,717

--

11

--

10

--

Ala.

10,065

--

NN

--

--

--

Miss.

10,614

--

6

--

--

--

W.S. Central

89,140

3

932

--

--

1

Ark.

4,123

--

6

--

--

--

La.

15,188

3

20

--

--

1

Okla.

9,393

--

NN

--

--

--

Tex.

60,436

--

906

--

--

--

Mountain

34,096

2

124

--

--

--

Mont.

1,412

--

10

--

--

--

Idaho

2,035

--

17

--

--

--

Wyo.

725

--

2

--

--

--

Colo.

9,113

1

19

--

--

--

N. Mex.

3,793

--

48

--

--

--

Ariz.

11,489

--

19

--

--

--

Utah

2,209

--

NN

--

--

--

Nev.

3,320

1

9

--

--

--

Pacific

97,854

10

437

1

--

--

Wash.

10,998

--

NN

--

NN

NN

Oreg.

5,855

--

70

1

NN

NN

Calif.

76,490

9

363

--

--

--

Alaska

1,907

1

1

--

NN

NN

Hawaii

2,604

--

3

--

NN

NN

             

Guam

410

2

--

--

--

--

P.R.

1,685

--

NN

--

--

--

V.I.

10

NA

NA

NA

NA

NA

American Samoa

NA

NA

NA

NA

NA

NA

C.N.M.I.

NA

NA

NA

NA

NA

NA

* Chlamydia refers to genital infections caused by C. trachomatis. Totals reported to the Division of Sexually Transmitted Diseases Prevention, NCHSTP, as of July 19, 1999.


NOTIFIABLE DISEASES -- Reported cases, by geographic division and area, United States, 1998 -- Continued

 

Encephalitis

Escherichia coli O157:H7

 

Area

St. Louis

NETSS*

PHLIS†

Gonorrhea§

Haemophilus influenzae, invasive disease

United States

24

3,161

2,172

355,642

1,194

New England

--

340

286

6,061

108

Maine

--

37

--

67

5

N.H.

--

48

47

91

10

Vt.

--

21

18

38

9

Mass.

--

153

164

2,258

42

R.I.

--

14

1

430

9

Conn.

NN

67

56

3,177

33

Mid. Atlantic

--

312

87

38,639

196

Upstate N.Y.

--

231

--

6,965

81

N.Y. City

--

14

13

12,097

50

N.J.

--

67

53

7,858

53

Pa.

--

NN

21

11,719

12

E.N. Central

--

464

374

69,027

186

Ohio

--

128

77

18,275

48

Ind.

--

106

54

6,307

51

Ill.

--

113

81

21,735

67

Mich.

--

117

74

16,359

13

Wis.

--

NN

88

6,351

7

W.N. Central

--

499

408

17,914

104

Minn.

--

209

215

2,708

77

Iowa

--

93

60

1,616

5

Mo.

--

55

64

9,463

12

N. Dak.

--

12

15

80

1

S. Dak.

--

37

40

221

1

Nebr.

--

57

--

1,204

2

Kans.

--

36

14

2,622

6

S. Atlantic

2

404

179

98,054

224

Del.

--

--

2

1,556

1

Md.

--

43

15

11,254

57

D.C.

--

1

NA

4,508

--

Va.

--

NN

55

9,265

19

W. Va.

--

14

10

920

7

N.C.

--

186

47

19,230

24

S.C.

--

15

12

11,575

3

Ga.

--

84

--

20,666

69

Fla.

2

61

38

19,080

44

E.S. Central

--

120

67

39,079

64

Ky.

--

36

--

3,813

7

Tenn.

--

54

41

11,840

38

Ala.

--

24

20

12,737

16

Miss.

--

6

6

10,689

3

W.S. Central

22

137

108

54,528

68

Ark.

--

12

10

3,953

--

La.

18

14

7

12,499

29

Okla.

--

26

9

5,243

36

Tex.

4

85

82

32,833

3

Mountain

--

367

249

9,157

127

Mont.

--

17

5

55

--

Idaho

--

43

25

182

2

Wyo.

--

53

55

36

1

Colo.

--

90

69

2,033

21

N. Mex.

--

19

20

957

8

Ariz.

--

46

29

4,213

69

Utah

--

75

22

236

7

Nev.

--

24

24

1,445

19

Pacific

--

518

414

23,183

117

Wash.

--

143

131

1,948

11

Oreg.

NN

107

102

880

42

Calif.

--

261

165

19,518

50

Alaska

NN

7

--

331

4

Hawaii

NN

--

16

506

10

           

Guam

--

NN

NA

72

--

P.R.

--

5

NA

400

2

V.I.

NA

NA

NA

39

NA

American Samoa

NA

NN

NA

NA

NA

C.N.M.I.

NA

NN

NA

NA

NA

* National Electronic Telecommunications System for Surveillance.
† Public Health Laboratory Information System. Totals reported to the National Center for Infectious Diseases as of August 26, 1999.
§ Totals reported to the Division of Sexually Transmitted Diseases Prevention, NCHSTP, as of July 19, 1999.


NOTIFIABLE DISEASES -- Reported cases, by geographic division and area, United States, 1998 -- Continued

   

Hepatitis

   

Area

Hansen disease (leprosy)

A

B

C; non-A, non-B

Legionellosis

Lyme disease

United States

108

23,229

10,258

3,518

1,355

16,801

New England

1

299

230

61

98

5,056

Maine

NN

20

5

--

1

78

N.H.

--

19

21

--

7

45

Vt.

NN

17

10

6

7

11

Mass.

--

126

81

51

34

699

R.I.

1

18

75

4

26

789

Conn.

--

99

38

--

23

3,434

Mid. Atlantic

7

1,726

1,249

246

332

9,311

Upstate N.Y.

3

376

262

124

113

4,409

N.Y. City

4

591

423

--

37

231

N.J.

--

343

205

NA

18

1,911

Pa.

NN

416

359

122

164

2,760

E.N. Central

--

3,715

1,414

673

420

774

Ohio

--

398

77

8

133

47

Ind.

--

174

117

6

83

39

Ill.

--

821

230

41

54

14

Mich.

--

2,135

476

470

82

17

Wis.

NN

187

514

148

68

657

W.N. Central

4

1,362

438

52

80

317

Minn.

--

145

71

20

12

261

Iowa

1

400

55

8

11

27

Mo.

--

637

252

15

18

12

N. Dak.

NN

4

4

--

--

--

S. Dak.

1

40

4

--

7

--

Nebr.

2

27

24

5

21

4

Kans.

--

109

28

4

11

13

S. Atlantic

6

2,395

1,323

197

170

977

Del.

--

6

4

--

13

77

Md.

--

416

143

23

38

659

D.C.

--

66

19

--

9

8

Va.

--

226

109

13

27

73

W. Va.

NN

9

14

9

NN

13

N.C.

2

128

243

26

14

63

S.C.

--

54

65

20

12

8

Ga.

NN

879

209

9

8

5

Fla.

4

611

517

97

49

71

E.S. Central

1

416

512

284

66

115

Ky.

--

32

49

23

27

27

Tenn.

1

234

294

173

23

47

Ala.

--

81

75

5

9

24

Miss.

--

69

94

83

7

17

W.S. Central

28

4,461

2,466

655

42

68

Ark.

--

82

115

30

2

8

La.

--

174

219

137

6

15

Okla.

NN

667

172

25

17

13

Tex.

28

3,538

1,960

463

17

32

Mountain

--

3,134

813

387

78

19

Mont.

--

96

8

8

2

--

Idaho

--

235

49

87

3

7

Wyo.

--

37

11

102

1

1

Colo.

--

345

102

32

20

--

N. Mex.

--

155

311

97

2

4

Ariz.

--

1,843

185

19

21

1

Utah

--

196

66

22

21

--

Nev.

--

227

81

20

8

6

Pacific

61

5,721

1,813

963

69

164

Wash.

--

1,037

136

29

15

7

Oreg.

4

435

201

21

NN

21

Calif.

38

4,178

1,445

859

52

135

Alaska

--

17

13

--

1

1

Hawaii

19

54

18

54

1

NN

             

Guam

3

1

2

1

2

1

P.R.

--

94

276

--

--

NN

V.I.

NA

NA

NA

NA

NA

NA

American Samoa

NA

NA

NA

NA

NA

NA

C.N.M.I.

NA

NA

NA

NA

NA

NA


NOTIFIABLE DISEASES -- Reported cases, by geographic division and area, United States, 1998 -- Continued

 

Measles

 

Area

Malaria

Indigenous

Imported*

Meningococcal disease

Mumps

Pertussis

United States

1,611

74

26

2,725

666

7,405

New England

98

1

2

123

10

1,114

Maine

5

--

--

8

--

5

N.H.

6

--

--

13

--

149

Vt.

2

--

1

5

--

80

Mass.

27

1

1

59

6

805

R.I.

15

--

--

8

1

21

Conn.

43

--

--

30

3

54

Mid. Atlantic

426

11

5

295

207

695

Upstate N.Y.

93

3

1

84

14

352

N.Y. City

240

--

--

35

167

54

N.J.

58

7

1

60

6

29

Pa.

35

1

3

116

20

260

E.N. Central

147

12

4

399

82

919

Ohio

15

--

1

143

29

299

Ind.

11

2

1

74

7

185

Ill.

59

1

--

104

10

173

Mich.

50

9

1

44

33

71

Wis.

12

--

1

34

3

191

W.N. Central

110

--

--

231

34

756

Minn.

71

--

--

37

13

439

Iowa

8

--

--

46

11

78

Mo.

15

--

--

80

4

59

N. Dak.

3

--

--

5

2

46

S. Dak.

1

--

--

9

--

8

Nebr.

2

--

--

17

--

21

Kans.

10

--

--

37

4

105

S. Atlantic

349

4

5

482

57

380

Del.

3

--

1

2

--

5

Md.

89

--

1

35

--

66

D.C.

19

--

--

4

--

1

Va.

61

--

2

49

13

56

W. Va.

2

--

--

19

--

7

N.C.

30

1

--

59

12

112

S.C.

6

--

--

57

8

29

Ga.

43

1

1

102

2

38

Fla.

96

2

--

155

22

66

E.S. Central

35

--

2

205

19

168

Ky.

7

--

--

38

1

95

Tenn.

17

--

1

75

2

40

Ala.

6

--

1

55

9

27

Miss.

5

--

--

37

7

6

W.S. Central

101

--

--

338

67

427

Ark.

2

--

--

31

13

93

La.

17

--

--

69

8

13

Okla.

4

--

--

44

4

33

Tex.

78

--

--

194

42

288

Mountain

68

9

2

157

40

1,324

Mont.

1

--

--

5

--

17

Idaho

8

--

--

14

7

263

Wyo.

--

--

--

8

1

8

Colo.

18

--

--

31

7

357

N. Mex.

12

--

--

26

NN

100

Ariz.

15

9

2

48

6

241

Utah

2

--

--

15

5

297

Nev.

12

--

--

10

14

41

Pacific

277

37

6

495

150

1,622

Wash.

30

--

1

77

11

407

Oreg.

17

--

--

91

NN

89

Calif.

217

5

4

319

110

1,085

Alaska

4

32

1

3

3

15

Hawaii

9

--

--

5

26

26

             

Guam

2

--

--

2

5

1

P.R.

1

--

--

11

7

10

V.I.

NA

NA

NA

NA

NA

NA

American Samoa

NA

NA

NA

NA

NA

NA

C.N.M.I.

NA

NA

NA

NA

NA

NA

* Imported cases include only those resulting from importation from other countries.


NOTIFIABLE DISEASES -- Reported cases, by geographic division and area, United States, 1998 -- Continued

 

Rabies

 

Area

Plague

Poliomyelitis, paralytic

Psittacosis

Animal

Human

RMSF*

United States

9

1

47

7,259

1

365

New England

--

--

1

1,452

--

2

Maine

--

--

--

241

--

--

N.H.

--

--

1

83

--

--

Vt.

--

--

--

72

--

--

Mass.

--

--

--

498

--

--

R.I.

--

--

--

103

--

--

Conn.

--

--

NN

455

--

2

Mid. Atlantic

--

--

18

1,609

--

38

Upstate N.Y.

--

--

5

1,095

--

11

N.Y. City

--

--

--

NA

--

2

N.J.

--

--

--

224

--

12

Pa.

--

--

13

290

--

13

E.N. Central

--

1

6

127

--

22

Ohio

--

--

--

59

--

12

Ind.

--

1

2

12

--

6

Ill.

--

--

1

NN

--

1

Mich.

--

--

3

37

--

3

Wis.

NN

NN

--

19

--

--

W.N. Central

--

--

2

741

--

16

Minn.

--

--

2

119

--

1

Iowa

--

--

--

153

--

2

Mo.

--

--

--

42

--

5

N. Dak.

--

--

--

155

--

2

S. Dak.

--

--

--

166

--

--

Nebr.

--

--

--

7

--

3

Kans.

--

--

--

99

--

3

S. Atlantic

--

--

4

2,350

1

148

Del.

--

--

--

49

--

--

Md.

--

--

--

439

--

18

D.C.

--

--

--

10

--

--

Va.

--

--

1

549

1

14

W. Va.

--

--

--

77

--

4

N.C.

--

--

--

555

--

71

S.C.

--

--

--

147

--

34

Ga.

--

--

--

309

--

4

Fla.

--

--

3

215

--

3

E.S. Central

--

--

--

278

--

58

Ky.

--

--

--

32

NN

6

Tenn.

--

--

--

142

--

27

Ala.

NN

--

--

102

--

11

Miss.

--

--

--

2

--

14

W.S. Central

--

--

--

35

--

72

Ark.

--

--

--

35

--

23

La.

--

--

--

--

--

5

Okla.

--

--

NN

NN

--

41

Tex.

--

--

NN

--

--

3

Mountain

8

--

7

251

--

8

Mont.

--

--

--

56

--

1

Idaho

--

--

4

NN

--

1

Wyo.

--

--

1

66

--

--

Colo.

1

--

2

42

--

2

N. Mex.

6

--

--

6

--

2

Ariz.

1

--

--

48

--

--

Utah

--

--

--

27

--

1

Nev.

--

--

--

6

--

1

Pacific

1

--

9

416

--

1

Wash.

--

--

3

--

--

--

Oreg.

--

--

--

7

--

--

Calif.

1

--

6

384

--

1

Alaska

--

--

--

25

--

NN

Hawaii

--

--

--

--

--

NN

             

Guam

--

--

--

--

--

--

P.R.

--

--

--

52

--

NN

V.I.

NA

NA

NA

NA

NA

NA

American Samoa

NA

NA

NA

NA

NA

NA

C.N.M.I.

NA

NA

NA

NA

NA

NA

* Rocky Mountain spotted fever.


NOTIFIABLE DISEASES -- Reported cases, by geographic division and area, United States, 1998 -- Continued

 

Rubella

 

Syphilis*

Area

Congenital syndrome

Rubella

Salmonellosis

Shigellosis

Congenital (age <1 yr)

Primary & secondary

United States

7

364

43,694

23,626

801

6,993

New England

--

38

2,508

413

2

80

Maine

--

--

165

14

--

1

N.H.

--

--

187

18

--

2

Vt.

NN

--

144

7

--

4

Mass.

--

8

1,312

266

2

46

R.I.

--

1

159

37

--

1

Conn.

--

29

541

71

--

26

Mid. Atlantic

3

150

6,767

2,412

163

324

Upstate N.Y.

--

114

1,680

678

13

38

N. Y. City

3

20

1,895

710

43

81

N.J.

--

14

1,476

662

86

107

Pa.

--

2

1,716

362

21

98

E.N. Central

--

2

6,279

3,037

97

1,044

Ohio

--

--

1,491

566

4

134

Ind.

--

--

685

180

--

215

Ill.

--

1

1,921

1,573

71

424

Mich.

--

1

1,169

279

16

211

Wis.

NN

--

1,013

439

6

60

W.N. Central

--

41

2,361

1,119

15

146

Minn.

--

--

601

331

--

9

Iowa

--

--

375

69

--

5

Mo.

--

2

632

221

15

109

N. Dak.

--

--

68

11

--

--

S. Dak.

--

--

132

33

--

1

Nebr.

--

--

190

372

--

8

Kans.

--

39

363

82

--

14

S. Atlantic

1

22

9,326

4,727

184

2,523

Del.

--

--

79

46

--

21

Md.

--

1

931

202

44

648

D.C.

--

--

84

37

8

81

Va.

--

1

1,135

200

4

149

W. Va.

--

--

181

11

--

3

N.C.

--

16

1,309

372

24

723

S.C.

1

--

667

198

19

271

Ga.

--

--

1,839

1,138

14

333

Fla.

--

4

3,101

2,523

71

294

E.S. Central

--

2

2,363

1,734

38

1,208

Ky.

--

--

364

158

5

106

Tenn.

--

2

624

1,062

9

567

Ala.

--

--

695

459

9

274

Miss.

--

NN

680

55

15

261

W.S. Central

3

90

5,381

5,295

155

1,079

Ark.

--

--

616

211

30

108

La.

--

1

863

384

8

430

Okla.

--

--

501

712

15

98

Tex.

3

89

3,401

3,988

102

443

Mountain

--

6

2,601

1,323

27

231

Mont.

--

--

79

8

--

--

Idaho

--

--

122

20

--

2

Wyo.

--

--

70

4

--

1

Colo.

--

--

539

229

1

10

N. Mex.

--

1

306

306

--

14

Ariz.

--

2

885

643

25

185

Utah

--

2

355

48

1

4

Nev.

--

1

245

65

--

15

Pacific

--

13

6,108

3,566

120

358

Wash.

--

8

703

277

1

44

Oreg.

--

--

329

194

--

6

Calif.

--

3

4,724

3,033

119

303

Alaska

NN

--

57

11

--

1

Hawaii

--

2

295

51

--

4

             

Guam

--

--

46

39

--

--

P.R.

--

14

901

69

27

177

V.I.

NA

NA

NA

NA

--

7

American Samoa

NA

NA

NA

NA

NA

NA

C.N.M.I.

NA

NA

NA

NA

NA

NA

* Totals reported to the Division of Sexually Transmitted Diseases Prevention, NCHSTP, as of July 19, 1999.


NOTIFIABLE DISEASES -- Reported cases, by geographic division and area, United States, 1998 -- Continued

 

Syphilis*

 

Area

All stages

Tetanus

Toxic-shock syndrome

Trichinosis

Tuberculosis†

Typhoid fever

United States

37,977

41

138

19

18,361

375

New England

824

--

2

1

505

24

Maine

4

--

--

--

13

--

N.H.

14

--

--

--

14

1

Vt.

6

--

2

1

5

--

Mass.

568

--

--

--

282

15

R.I.

55

--

--

--

63

--

Conn.

177

--

NN

--

128

8

Mid. Atlantic

6,881

1

17

--

3,088

90

Upstate N.Y.

495

--

10

--

442

17

N.Y. City

4,650

--

--

--

1,558

52

N.J.

826

--

--

--

640

16

Pa.

910

1

7

--

448

5

E.N. Central

3,905

12

30

9

1,762

56

Ohio

474

3

1

7

230

9

Ind.

509

1

6

--

188

2

Ill.

2,028

5

7

2

850

38

Mich.

686

2

14

--

385

6

Wis.

208

1

2

--

109

1

W.N. Central

645

2

23

--

520

7

Minn.

74

--

5

--

161

3

Iowa

48

1

4

--

55

--

Mo.

375

--

6

--

184

4

N. Dak.

--

--

1

--

10

--

S. Dak.

2

1

--

--

23

--

Nebr.

33

--

3

--

31

--

Kans.

113

--

4

--

56

--

S. Atlantic

10,946

9

16

--

3,565

49

Del.

114

--

4

--

36

3

Md.

2,156

1

NN

--

324

11

D.C.

579

--

--

--

107

--

Va.

707

1

--

--

339

7

W. Va.

11

3

--

--

42

1

N.C.

2,133

1

2

--

498

1

S.C.

871

--

4

--

286

--

Ga.

1,836

--

3

--

631

10

Fla.

2,539

3

3

--

1,302

16

E.S. Central

4,383

1

7

4

1,224

10

Ky.

339

--

1

NN

179

2

Tenn.

1,750

1

5

3

439

2

Ala.

1,133

--

1

--

381

4

Miss.

1,161

--

NN

1

225

2

W.S. Central

6,475

6

6

--

2,569

31

Ark.

506

--

2

NN

171

--

La.

1,651

2

NN

--

380

1

Okla.

363

--

4

NN

198

1

Tex.

3,955

4

NN

--

1,820

29

Mountain

1,099

2

10

2

619

12

Mont.

--

1

--

2

20

--

Idaho

15

--

1

NN

14

1

Wyo.

2

--

--

--

4

--

Colo.

118

--

4

--

79

1

N. Mex.

76

--

--

--

68

2

Ariz.

697

1

1

--

254

5

Utah

55

--

2

--

52

--

Nev.

136

--

2

--

128

3

Pacific

2,819

8

27

3

4,509

96

Wash.

141

--

6

--

265

8

Oreg.

32

--

NN

--

156

1

Calif.

2,618

8

21

3

3,852

83

Alaska

13

--

NN

--

55

--

Hawaii

15

--

NN

--

181

4

             

Guam

3

--

--

--

89

--

P.R.

1,460

1

NN

--

201

2

V.I.

35

NA

NA

NA

NA

NA

American Samoa

NA

NA

NA

NA

NA

NA

C.N.M.I.

NA

NA

NA

NA

NA

NA

* Totals reported to the Division of Sexually Transmitted Diseases Prevention, NCHSTP, as of July 19, 1999.
† Totals reported to the Division of Tuberculosis Elimination, NCHSTP, as of June 3, 1999.




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

NOTIFIABLE DISEASES -- Summary of reported cases, by age group, United States, 1998

 

<1

1-4

5-14

15-24

25-39

40-64

>=65

 

Disease

Total

No.

(Rate)

No.

(Rate)

No.

(Rate)

No.

(Rate)

No.

(Rate)

No.

(Rate)

No.

(Rate)

Age not stated

AIDS*

46,521

93

( 2.46)

133

( 0.88)

199

( 0.51)

1,667

( 4.48)

24,689

( 40.21)

19,008

(24.01)

732

( 2.13)

  --

Botulism, total

116

66

( 1.76)

3

( 0.02)

--

( --)

3

( 0.01)

14

( 0.02)

25

( 0.03)

5

( 0.01)

--

Brucellosis

79

--

( --)

10

( 0.07)

10

( 0.03)

9

( 0.02)

18

( 0.03)

23

( 0.03)

9

( 0.03)

  --

Chlamydia†§

604,023

NA

( NA)

NA

( NA)

NA

( NA)

441,225

(1,259.62)

124,556

(209.45)

11,397

(15.59)

1,226

( 3.78)

   9,629

Cholera

17

--

( --)

--

( --)

--

( --)

--

( 0.00)

8

( 0.01)

6

( 0.01)

3

( 0.01)

  --

Cryptosporidiosis

3,793

93

( 2.81)

674

( 5.07)

629

( 1.84)

328

( 1.01)

1,056

( 1.97)

741

( 1.08)

209

( 0.70)

  63

Diphtheria

1

--

( --)

--

( --)

--

( --)

1

( 0.00)

--

( --)

--

( --)

--

( --)

  --

Encephalitis, California serogroup viral

97

4

( 0.11)

23

( 0.16)

65

( 0.17)

1

( 0.00)

1

( 0.00)

1

( 0.00)

1

( 0.00)

  1

  Eastern equine

4

--

( --)

--

( --)

--

( --)

--

( --)

1

( 0.00)

1

( 0.00)

2

( 0.01)

  --

  St. Louis

24

1

( 0.03)

--

( --)

--

( --)

2

( 0.01)

6

( 0.01)

10

( 0.01)

5

( 0.02)

  --

Escherichia coli O157:H7

3,161

70

( 2.01)

639

( 4.57)

655

( 1.83)

392

( 1.15)

341

( 0.61)

583

( 0.81)

366

( 1.18)

115

Gonorrhea§

355,627

NA

( NA)

NA

( NA)

NA

( NA)

209,036

( 571.45)

109,680

(176.24)

24,257

(31.58)

1,199

( 3.52)

4,252

Haemophilus influenzae, invasive disease

1,194

157

( 4.16)

96

( 0.63)

63

( 0.16)

55

( 0.15)

107

( 0.17)

256

( 0.32)

452

( 1.31)

  8

Hansen disease (leprosy)

108

2

( 0.06)

--

( --)

2

( 0.01)

11

( 0.03)

32

( 0.06)

27

( 0.04)

14

( 0.05)

  20

Hepatitis A

23,229

122

( 3.23)

1,154

( 7.60)

4,739

(12.10)

3,718

( 9.99)

7,589

( 12.36)

4,560

( 5.76)

1,056

( 3.07)

  291

Hepatitis B

10,258

67

( 1.77)

54

( 0.36)

161

( 0.41)

1,757

( 4.72)

4,357

( 7.10)

3,117

( 3.94)

525

( 1.53)

  220

Hepatitis C; non-A, non-B

3,518

21

( 0.56)

7

( 0.05)

16

( 0.04)

166

( 0.45)

1,101

( 1.79)

1,619

( 2.05)

145

( 0.42)

  443

Legionellosis

1,355

4

( 0.11)

2

( 0.01)

4

( 0.01)

17

( 0.05)

136

( 0.23)

609

( 0.79)

569

( 1.69)

  14

Lyme disease

16,801

70

( 1.86)

923

( 6.10)

3,193

( 8.19)

1,396

( 3.77)

2,875

( 4.70)

5,857

( 7.43)

2,332

( 6.81)

  155

Malaria

1,611

10

( 0.26)

70

( 0.46)

180

( 0.46)

299

( 0.80)

507

( 0.83)

438

( 0.55)

65

( 0.19)

    42

Measles (rubeola)

100

15

( 0.40)

15

( 0.10)

12

( 0.03)

29

( 0.08)

24

( 0.04)

5

( 0.01)

--

( --)

   --

Meningococcal disease

2,725

433

( 11.47)

417

( 2.75)

354

( 0.90)

471

( 1.27)

249

( 0.41)

386

( 0.49)

390

( 1.13)

 25

Mumps

666

7

( 0.19)

120

( 0.80)

289

( 0.75)

88

( 0.24)

99

( 0.16)

54

( 0.07)

--

( --)

  9

Pertussis (whooping cough)

7,405

2,134

( 56.51)

953

( 6.27)

2,016

( 5.15)

890

( 2.39)

634

( 1.03)

675

( 0.85)

56

( 0.16)

  47

Plague

9

--

( --)

--

( --)

1

( 0.00)

--

( --)

2

( 0.00)

6

( 0.01)

--

( --)

  --

Poliomyelitis, paralytic

1

1

( 0.03)

--

( --)

--

( --)

--

( --)

--

( --)

--

( --)

--

( --)

--

Psittacosis

47

2

( 0.06)

2

( 0.01)

2

( 0.01)

3

( 0.01)

11

( 0.02)

19

( 0.03)

7

( 0.02)

  1

Rabies, human

1

--

( --)

--

( --)

--

( --)

--

( --)

1

( 0.00)

--

( --)

--

( --)

--

Rocky Mountain spotted fever

365

2

( 0.05)

25

( 0.17)

58

( 0.15)

34

( 0.09)

86

( 0.14)

118

( 0.15)

39

( 0.11)

3

Rubella (German measles)

364

16

( 0.42)

12

( 0.08)

19

( 0.05)

147

( 0.40)

122

( 0.20)

47

( 0.06)

--

( --)

  1

Salmonellosis

43,694

5,517

(146.09)

6,975

(45.92)

5,348

(13.66)

3,622

( 9.73)

5,944

( 9.68)

6,475

( 8.18)

3,954

(11.49)

  5,859

Shigellosis

23,626

513

( 13.58)

6,399

(42.13)

6,134

(15.66)

1,653

( 4.44)

3,209

( 5.23)

1,818

( 2.30)

436

( 1.27)

3,464

Syphilis§

                               

  Primary and secondary

6,995

NA

( NA)

NA

( NA)

NA

( NA)

1,626

( 4.45)

3,368

( 5.41)

1,833

( 2.39)

103

( 0.30)

  18

Tetanus

41

1

( 0.03)

--

( --)

2

( 0.01)

6

( 0.02)

8

( 0.01)

10

( 0.01)

14

( 0.04)

--

Toxic-shock syndrome

138

2

( 0.06)

3

( 0.02)

20

( 0.06)

23

( 0.07)

42

( 0.08)

40

( 0.06)

7

( 0.02)

  1

Trichinosis

19

--

( --)

1

( 0.01)

--

( --)

2

( 0.01)

7

( 0.01)

7

( 0.01)

1

( 0.00)

  1

Tuberculosis

18,361

108

( 2.86)

533

( 3.51)

441

( 1.13)

1,548

( 4.16)

4,585

( 7.47)

6,753

( 8.53)

4,393

(12.77)

--

Typhoid fever

375

8

( 0.21)

47

( 0.31)

63

( 0.16)

86

( 0.23)

105

( 0.17)

51

( 0.06)

12

( 0.03)

   3

* Total number of acquired immunodeficiency syndrome (AIDS) 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, 1998.
† Chlamydia refers to genital infections caused by C. trachomatis.
§ 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 <15 years are not shown because some of these might not be caused by sexual transmission; these cases are, however, included in the totals. Cases and rates were updated through the Division of Sexually Transmitted Diseases Prevention, NCHSTP, as of July 19, 1999. Age-related data for 1998 are unavailable for chancroid.
¶ Cases were updated through the Division of Tuberculosis Elimination, NCHSTP, as of June 3, 1999.

Note: Incidence rates per 100,000 population. Rates <0.01 after rounding are listed as 0.00.




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

NOTIFIABLE DISEASES -- Summary of reported cases, by sex, United States, 1998

 

Male

Female

 

Disease

Total

No.

(Rate)

No.

(Rate)

Sex not stated

AIDS*

46,521

35,776

( 27.09)

10,742

( 7.77)

3

Botulism, total

116

62

( 0.05)

52

( 0.04)

2

Brucellosis

79

39

( 0.03)

39

( 0.03)

1

Chancroid

189

112

( 0.09)

76

( 0.06)

1

Chlamydia†§

604,420

NA

( NA)

498,406

(382.24)

--

Cholera

17

10

( 0.01)

6

( 0.00)

1

Cryptosporidiosis

3,793

1,907

( 1.66)

1,822

( 1.52)

64

Diphtheria

1

NA

( NA)

1

( 0.00)

--

Encephalitis, California serogroup viral

97

61

( 0.05)

35

( 0.03)

1

  Eastern equine

4

2

( 0.00)

2

( 0.00)

--

  St. Louis

24

13

( 0.01)

11

( 0.01)

--

Escherichia coli O157:H7

3,161

1,405

( 1.17)

1,563

( 1.24)

193

Gonorrhea

355,642

175,233

(133.75)

179,651

(131.50)

758

Haemophilus influenzae, invasive disease

1,194

517

( 0.39)

578

( 0.42)

99

Hansen disease (leprosy)

108

53

( 0.05)

35

( 0.03)

20

Hepatitis A

23,229

12,656

( 9.58)

8,358

( 6.05)

2,215

Hepatitis B

10,258

5,929

( 4.49)

3,887

( 2.81)

442

Hepatitis C; non-A, non-B

3,518

2,171

( 1.64)

1,272

( 0.92)

75

Legionellosis

1,355

806

( 0.62)

509

( 0.38)

40

Lyme disease

16,801

8,820

( 6.71)

7,948

( 5.77)

33

Malaria

1,611

996

( 0.75)

553

( 0.40)

62

Measles (rubeola)

100

45

( 0.03)

43

( 0.03)

12

Meningococcal disease

2,725

1,329

( 1.01)

1,318

( 0.95)

78

Mumps

666

370

( 0.29)

267

( 0.20)

29

Pertussis (whooping cough)

7,405

3,285

( 2.49)

3,816

( 2.76)

304

Plague

9

3

( 0.00)

5

( 0.00)

1

Poliomyelitis, paralytic

1

1

( 0.00)

--

( -- )

--

Psittacosis

47

12

( 0.01)

34

( 0.03)

1

Rabies, human

1

1

( 0.00)

--

( -- )

--

Rocky Mountain spotted fever

365

222

( 0.17)

141

( 0.10)

2

Rubella (German measles)

364

238

( 0.18)

123

( 0.09)

3

Salmonellosis

43,694

17,942

( 13.59)

19,035

( 13.77)

6,717

Shigellosis

23,626

8,786

( 6.65)

10,667

( 7.72)

4,173

Syphilis, primary and secondary

6,993

3,902

( 2.98)

3,089

( 2.26)

2

Tetanus

41

22

( 0.02)

18

( .01)

1

Toxic-shock syndrome

138

30

( 0.03)

103

( 0.09)

5

Trichinosis

19

10

( 0.01)

9

( 0.01)

--

Tuberculosis

18,361

11,413

( 8.64)

6,935

( 5.02)

13

Typhoid fever

375

196

( 0.15)

161

( 0.12)

18

* Total number of acquired immunodeficiency syndrome (AIDS) 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, 1998.
† Cases and rates were updated through the Division of Sexually Transmitted Diseases Prevention, NCHSTP, as of July 19, 1999.
§ 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 June 3, 1999.

Note: Incidence rates per 100,000 population. Rates <0.01 after rounding are listed as 0.00.




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

NOTIFIABLE DISEASES -- Summary of reported cases, by race, United States, 1998

 

American Indian or Alaskan Native

Asian or Pacific Islander

Black

White

Other

Race not stated

Disease

Total

No.

(%)

No.

(%)

No.

(%)

No.

(%)

No.

(%)

No.

(%)

AIDS*

46,521

148

(<1)

388

( 1)

21,728

( 47)

16,115

( 35)

--

(--)

8,142

(18)

Botulism, total

116

8

( 7)

3

( 3)

7

( 6)

58

( 50)

1

( 1)

39

(34)

Brucellosis

79

1

( 1)

--

(--)

--

( --)

49

( 62)

--

(--)

29

(37)

Chlamydia§¶

604,023

8,466

( 1)

7,483

( 1)

203,013

( 34)

124,323

( 21)

--

(--)

260,738

(43)

Cholera

17

--

(--)

4

(24)

--

( 7)

10

( 59)

--

(--)

3

(18)

Cryptosporidiosis

3,793

312

( 8)

58

( 2)

278

( 7)

1,967

( 52)

9

(<1)

1,169

(31)

Diphtheria

1

--

(--)

--

(--)

--

( --)

1

(100)

--

(--)

--

(--)

Encephalitis, California serogroup viral

97

1

( 1)

--

(--)

1

( 1)

87

( 90)

--

(--)

8

( 8)

  Eastern equine

4

--

(--)

--

(--)

--

( --)

4

(100)

--

(--)

--

(--)

  St. Louis

24

--

(--)

--

(--)

6

( 25)

18

( 75)

--

(--)

--

(--)

Escherichia coli O157:H7

3,161

6

(<1)

28

( 1)

93

( 3)

1,999

( 63)

5

(<1)

1,030

(33)

Gonorrhea

355,627

1,790

( 1)

1,481

(<1)

217,360

( 61)

40,220

( 11)

--

(--)

94,776

(27)

Haemophilus influenzae, invasive disease

1,194

22

( 2)

19

( 2)

159

( 13)

711

( 60)

2

(<1)

281

(24)

Hansen disease (leprosy)

108

1

( 1)

31

(29)

6

( 6)

28

( 26)

--

(--)

42

(39)

Hepatitis A

23,229

236

( 1)

349

( 2)

2,689

( 12)

12,229

( 53)

48

(<1)

7,678

(33)

Hepatitis B

10,258

80

( 1)

683

( 7)

1,855

( 18)

3,958

( 39)

25

(<1)

3,657

(36)

Hepatitis C; non-A, non-B

3,518

46

( 1)

33

( 1)

468

( 13)

1,921

( 55)

7

(<1)

1,043

(30)

Legionellosis

1,355

3

(<1)

8

( 1)

135

( 10)

913

( 67)

--

(--)

296

(22)

Lyme disease

16,801

44

(<1)

102

( 1)

205

( 1)

12,833

( 76)

41

(<1)

3,576

(21)

Malaria

1,611

4

(<1)

160

(10)

613

( 38)

404

( 25)

14

( 1)

416

(26)

Measles (rubeola)

100

1

( 1)

5

( 5)

7

( 7)

47

( 47)

--

(--)

40

(40)

Meningococcal disease

2,725

30

( 1)

34

( 1)

405

( 15)

1,716

( 63)

4

(<1)

536

(20)

Mumps

666

3

(<1)

53

( 8)

35

( 5)

412

( 62)

2

(<1)

161

(24)

Pertussis (whooping cough)

7,405

89

( 1)

130

( 2)

438

( 6)

5,270

( 71)

10

(<1)

1,468

(20)

Plague

9

3

(33)

--

(--)

--

( --)

6

( 67)

--

(--)

--

(--)

Poliomyelitis, paralytic

1

--

(--)

--

(--)

--

( --)

1

(100)

--

(--)

--

(--)

Psittacosis

47

1

( 2)

--

(--)

4

( 9)

31

( 66)

--

(--)

11

(23)

Rabies, human

1

--

(--)

--

(--)

1

(100)

--

( --)

--

(--)

--

(--)

Rocky Mountain spotted fever

365

5

( 1)

3

( 1)

18

( 5)

280

( 77)

--

(--)

59

(16)

Rubella (German measles)

364

4

( 1)

3

( 1)

3

( 1)

238

( 65)

26

( 7)

90

(25)

Rubella, congenital syndrome

7

--

(--)

--

(--)

1

( 14)

3

( 43)

--

(--)

3

(43)

Salmonellosis

43,694

338

( 1)

554

( 1)

3,247

( 7)

19,658

( 45)

25

(<1)

19,872

(45)

Shigellosis

23,626

411

( 2)

147

( 1)

3,483

( 15)

9,430

( 40)

15

(<1)

10,140

(43)

Syphilis, primary and secondary

6,995

55

( 1)

36

( 1)

5,398

( 77)

912

( 13)

--

(--)

594

( 8)

Tetanus

41

1

( 2)

1

( 2)

6

( 15)

29

( 71)

--

(--)

4

(10)

Toxic-shock syndrome

138

--

(--)

3

( 2)

11

( 8)

106

( 77)

--

(--)

18

(13)

Trichinosis

19

1

( 5)

1

( 5)

1

( 5)

12

( 63)

--

(--)

4

(21)

Tuberculosis**

18,361

264

( 1)

3,668

(20)

5,980

( 33)

8,408

( 46)

--

(--)

41

(<1)

Typhoid fever

375

1

(<1)

105

(28)

19

( 5)

65

( 17)

13

( 3)

172

(46)

* Total number of acquired immunodeficiency syndrome (AIDS) 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, 1998.
†Includes the following cases originally reported as Hispanic: 7,931 for AIDS; 70,240 for chlamydia; 16,269 for gonorrhea; and 441 for syphilis, primary and secondary.
§ Chlamydia refers to genital infections caused by C. trachomatis.
¶ 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 19, 1999. Data regarding race for 1998 are unavailable for chancroid.
** Cases were updated through the Division of Tuberculosis Elimination, NCHSTP as of June 3, 1999.




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

NOTIFIABLE DISEASES -- Summary of reported cases, by ethnicity, United States, 1998

 

Hispanic

Non-Hispanic

Ethnicity not stated

Disease

Total

No.

(%)

No.

(%)

No.

(%)

AIDS*

46,521

7,931

(17)

37,843

( 81)

747

( 2)

Botulism, total

116

24

(21)

59

( 51)

33

( 28)

Brucellosis

79

47

(59)

14

( 18)

18

( 23)

Chlamydia§¶

604,023

70,240

(12)

327,336

( 54)

206,447

( 34)

Cholera

17

1

( 6)

13

( 76)

3

( 18)

Cryptosporidiosis

3,793

237

( 6)

1,600

( 42)

1,956

( 52)

Diphtheria

1

--

(--)

--

( --)

1

(100)

Encephalitis, California serogroup viral

97

2

( 2)

33

( 34)

62

( 64)

  Eastern equine

4

--

(--)

2

( 50)

2

( 50)

  St. Louis

24

--

(--)

13

( 54)

11

( 46)

Escherichia coli O157:H7

3,161

86

( 3)

1,698

( 54)

1,377

( 44)

Gonorrhea

355,627

16,269

( 5)

257,580

( 72)

81,778

( 23)

Haemophilus influenzae, invasive disease

1,194

78

( 7)

611

( 51)

505

( 42)

Hansen disease (leprosy)

108

32

(30)

52

( 48)

24

( 22)

Hepatitis A

23,229

4,137

(18)

9,884

( 43)

9,208

( 40)

Hepatitis B

10,258

850

( 8)

4,786

( 47)

4,622

( 45)

Hepatitis C; non-A, non-B

3,518

392

(11)

1,741

( 49)

1,385

( 39)

Legionellosis

1,355

26

( 2)

773

( 57)

556

( 41)

Lyme disease

16,801

172

( 1)

7,780

( 46)

8,849

( 53)

Malaria

1,611

167

(10)

873

( 54)

571

( 35)

Measles (rubeola)

100

10

(10)

44

( 44)

46

( 46)

Meningococcal disease

2,725

263

(10)

1,530

( 56)

932

( 34)

Mumps

666

115

(17)

221

( 33)

330

( 50)

Pertussis (whooping cough)

7,405

813

(11)

4,866

( 66)

1,726

( 23)

Plague

9

1

(11)

8

( 89)

--

( --)

Poliomyelitis, paralytic

1

--

(--)

1

(100)

--

( --)

Psittacosis

47

5

(11)

26

( 55)

16

( 34)

Rabies, human

1

--

(--)

--

( --)

1

(100)

Rocky Mountain spotted fever

365

7

( 2)

241

( 66)

117

( 32)

Rubella, congenital syndrome

7

4

(57)

--

( --)

3

( 43)

Rubella (German measles)

364

289

(79)

54

( 15)

21

( 6)

Salmonellosis

43,694

2,523

( 6)

15,393

( 35)

25,778

( 59)

Shigellosis

23,626

3,406

(14)

7,999

( 34)

12,221

( 52)

Syphilis, primary and secondary

6,995

441

( 6)

6,310

( 90)

244

( 3)

Tetanus

41

10

(24)

21

( 51)

10

( 24)

Toxic-shock syndrome

138

4

( 3)

93

( 67)

41

( 30)

Trichinosis

19

--

(--)

6

( 32)

13

( 68)

Tuberculosis**

18,361

4,099

(22)

14,212

( 77)

50

( <1)

Typhoid fever

375

64

(17)

144

( 38)

167

( 45)

* Total number of acquired immunodeficiency syndrome (AIDS) 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, 1998.
† Ethnicity is not stated and includes cases originally reported as American Indian/Alaskan Native or Asian/Pacific Islander.
§ Chlamydia refers to genital infections caused by C. trachomatis.
¶ 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 19, 1999. Data regarding ethnicity for 1998 are unavailable for chancroid.
** Cases were updated through the Division of Tuberculosis Elimination, NCHSTP, as of June 3, 1999.

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

EXPLANATION OF SYMBOLS USED IN TABLES, GRAPHS, AND MAPS

Data not availableNA
Report of disease is not required in that jurisdiction (not notifiable)NN
























































Part 3: Historical Summary Tables

EXPLANATION OF SYMBOLS USED IN TABLES, GRAPHS, AND MAPS

No reported cases--



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

TABLE 1. NOTIFIABLE DISEASES -- Summary of reported cases per 100, 000 population, United States, 1988- 1998

Disease

1988

1989

1990

1991

1992

1993

1994

1995

1996

1997

1998

AIDS*

12.61

13.58

16.72

17.32

17.83

40.20

30.07

27.20

25.21

21.85

17.21

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 (wound and unspecified)

0.03

0.04

0.04

0.05

0.04

0.04

0.06

0.04

0.05

0.05

0.04

  Foodborne

0.01

0.01

0.01

0.01

0.00

0.01

0.02

0.01

0.01

0.02

0.01

Brucellosis

0.04

0.04

0.03

0.04

0.04

0.05

0.05

0.04

0.05

0.04

0.03

Chancroid

2.04

1.90

1.70

1.40

0.80

0.54

0.30

0.20

0.15

0.09

0.07

Chlamydia§

182.60

188.10

196.80

236.57

Cholera

0.00

--

0.00

0.01

0.04

0.00

0.02

0.01

0.01

0.01

0.01

Cryptosporidiosis

1.12

1.61

Diphtheria

0.00

0.00

0.00

0.00

0.00

--

0.00

--

0.01

0.01

0.00

Encephalitis, primary

0.36

0.40

0.54

0.40

0.30

0.36

0.28

  Postinfectious

0.05

0.04

0.04

0.03

0.05

0.07

0.06

  Encephalitis, California serogroup viral

**

0.04

  Eastern equine

**

0.00

  St. Louis

**

0.01

  Western equine

**

0.00

Escherichia coli O157:H7

0.82

1.01

1.18

1.04

1.28

Gonorrhea

298.74

297.36

276.60

249.48

201.60

172.40

168.40

149.50

122.80

121.40

132.88

Granuloma inguinale

0.00

0.00

0.00

0.01

0.00

0.00

0.00

Haemophilus influenzae, invasive disease

**

1.10

0.55

0.55

0.45

0.45

0.45

0.44

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

0.05

Hepatitis A

11.60

14.43

12.64

9.67

9.06

9.40

10.29

12.13

11.70

11.22

8.59

Hepatitis B

9.43

9.43

8.48

7.14

6.32

5.18

4.81

4.19

4.01

3.90

3.80

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

1.30

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

0.51

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

6.39

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

0.60

Measles (rubeola)

1.38

7.33

11.17

3.82

0.88

0.12

0.37

0.12

0.20

0.06

0.04

Meningococcal disease

1.21

1.10

0.99

0.84

0.84

1.02

1.11

1.25

1.30

1.24

1.01

Mumps

2.05

2.34

2.17

1.72

1.03

0.66

0.60

0.35

0.29

0.27

0.25

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

2.74

Plague

0.01

0.00

0.00

0.00

0.01

0.00

0.01

0.00

0.01

0.01

0.00

Poliomyelitis, paralytic

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.00

0.01

0.01

0.00

Psittacosis

0.05

0.05

0.05

0.04

0.04

0.02

0.02

0.03

0.02

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

0.00

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

0.14

Rubella (German measles)

0.09

0.16

0.45

0.56

0.06

0.07

0.09

0.05

0.10

0.07

0.13

Salmonellosis, excluding typhoid fever

19.91

19.26

19.54

19.10

16.04

16.15

16.64

17.66

17.15

15.66

16.17

Shigellosis

12.46

10.07

10.89

9.34

9.38

12.48

11.44

12.32

9.80

8.64

8.74

Syphilis, primary and secondary

16.43

18.07

20.10

17.26

13.70

10.40

8.10

6.30

4.29

3.19

2.61

  Total, all stages

42.37

44.94

53.80

51.69

45.30

39.70

32.00

26.20

19.97

17.39

14.19

Tetanus

0.02

0.02

0.03

0.02

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

0.06

Trichinosis

0.02

0.01

0.05

0.02

0.02

0.01

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

6.79

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

0.14

Varicella (chickenpox)§§

122.43

121.77

120.06

135.82

176.54

118.54

135.76

118.11

44.13

93.55

70.28

Yellow fever

--

--

--

--

--

--

--

--

0.01

--

--

* Acquired immunodeficiency syndrome (AIDS).
† No longer nationally notifiable.
§ Chlamydia refers to genital infections caused by C. trachomatis.
¶ Not previously nationally notifiable.
** Nationally notifiable; data not presented because of limited number of states reporting.
†† Anti-HCV (hepatitis C virus) antibody test became available May 1990.
§§ Not nationally notifiable.

Note: Incidence rates per 100,000 population. Rates <0.01 after rounding are listed as 0.00. Data in the MMWR Summary of Notifiable Diseases, United States 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.




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

TABLE 2. NOTIFIABLE DISEASES -- Summary of reported cases, United States, 1991-1998

Disease

1991

1992

1993

1994

1995

1996

1997

1998

AIDS

43,672

45,472

103,691

78,279

71,547

66,885

58,492

46,521*

Amebiasis

2,989

2,942

2,970

2,983

Anthrax

--

1

--

--

--

--

--

--

Aseptic meningitis

14,526

12,223

12,848

8,932

Botulism, total (wound and unspecified)

114

91

97

143

97

119

132

116

  Foodborne

27

21

27

50

24

25

31

22

  Infant

81

66

65

85

54

80

79

65

Brucellosis

104

105

120

119

98

112

98

79

Chancroid

3,476

1,886

1,399

773

606

386

243

189§

Chlamydia

**

477,638

498,884

526,671

604,420§

Cholera

26

103

18

39

23

4

6

17

Cryptosporidiosis

**

2,566

3,793

Diphtheria

5

4

--

2

--

2

4

1

Encephalitis, primary

1,021

774

919

717

  Postinfectious

82

129

170

143

  Encephalitis, California serogroup viral

**

††

97

  Eastern equine

**

††

4

  St. Louis

**

††

24

  Western equine

**

††

--

Escherichia coli O157:H7

**

1,420

2,139

2,741

2,555

3,161

Gonorrhea

620,478

501,409

439,673

418,068

392,848

325,883

324,907

355,642§

Granuloma inguinale

29

6

19

3

Haemophilus influenzae, invasive disease

2,764

1,412

1,419

1,174

1,180

1,170

1,162

1,194

Hansen disease (leprosy)

154

172

187

136

144

112

122

108

Hepatitis A

24,378

23,112

24,238

26,796

31,582

31,032

30,021

23,229

Hepatitis B

18,003

16,126

13,361

12,517

10,805

10,637

10,416

10,258

Hepatitis C; non-A, non-B§§

3,582

6,010

4,786

4,470

4,576

3,716

3,816

3,518

Hepatitis, unspecified

1,260

884

627

444

Legionellosis

1,317

1,339

1,280

1,615

1,241

1,198

1,163

1,355

Leptospirosis

58

54

51

38

Lyme disease

9,465

9,895

8,257

13,043

11,700

16,455

12,801

16,801

Lymphogranuloma venereum

471

302

285

235

Malaria

1,278

1,087

1,411

1,229

1,419

1,800

2,001

1,611

Measles (rubeola)

9,643

2,237

312

963

309

508

138

100

Meningococcal disease

2,130

2,134

2,637

2,886

3,243

3,437

3,308

2,725

Mumps

4,264

2,572

1,692

1,537

906

751

683

666

Murine typhus fever

43

28

25

Pertussis (whooping cough)

2,719

4,083

6,586

4,617

5,137

7,796

6,564

7,405

Plague

11

13

10

17

9

5

4

9

Poliomyelitis, paralytic¶¶

10

6

4

8

7

5

5

1

Psittacosis

94

92

60

38

64

42

33

47

Rabies, animal

6,910

8,589

9,377

8,147

7,811

6,982

8,105

7,259

Rabies, human

3

1

3

6

5

3

2

1

Rheumatic fever, acute

127

75

112

112

Rocky Mountain spotted fever

628

502

456

465

590

831

409

365

Rubella (German measles)

1,401

160

192

227

128

238

181

364

Rubella, congenital syndrome

47

11

5

7

6

4

5

7

Salmonellosis, excluding typhoid fever

48,154

40,912

41,641

43,323

45,970

45,471

41,901

43,694

Shigellosis

23,548

23,931

32,198

29,769

32,080

25,978

23,117

23,626

Syphilis, primary and secondary

42,935

33,973

26,498

20,627

16,500

11,387

8,550

6,993§

  Total, all stages

128,569

112,581

101,259

81,696

68,953

52,976

46,540

37,977§

Tetanus

57

45

48

51

41

36

50

41

Toxic-shock syndrome

280

244

212

192

191

145

157

138

Trichinosis

62

41

16

32

29

11

13

19

Tuberculosis

26,283

26,673

25,313

24,361

22,860

21,337

19,851

18,361***

Tularemia

193

159

132

96

Typhoid fever

501

414

440

441

369

396

365

375

Varicella (chickenpox)†††

147,076

158,364

134,722

151,219

120,624

83,511

98,727

82,455

Yellow fever

§§§

1

--

--

* Total number of acquired immunodeficiency syndrome (AIDS) cases reported to the Division of HIV/AIDS Prevention -- Surveillance and Epidemiology, National Center for HIV, STD, and TB Prevention (NCHSTP), through December 31, 1998.
† No longer nationally notifiable.
§ Cases were updated through the Division of Sexually Transmitted Diseases Prevention, NCHSTP, as of July 19, 1999.
¶ Chlamydia refers to genital infections caused by C. trachomatis.
** Not previously nationally notifiable.
†† Nationally notifiable; data not presented because of limited number of states reporting.
§§ Anti-HCV (hepatitis C virus) 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 June 3, 1999.
††† Varicella was taken off the nationally notifiable disease list in 1991. Many states continue to report these cases to CDC.
§§§ Last indigenous case of yellow fever was reported in 1911; before 1996, the last imported case was reported in 1924.

Note: Data in the MMWR Summary of Notifiable Diseases, United States 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.




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

TABLE 3. NOTIFIABLE DISEASES -- Summary of reported cases, United States, 1983-1990

Disease

1983

1984

1985

1986

1987

1988

1989

1990

AIDS*

4,445

8,249

12,932

21,070

31,001

33,722

41,595

Amebiasis

6,658

5,252

4,433

3,532

3,123

2,860

3,217

3,328

Anthrax

--

1

--

--

1

2

--

--

Aseptic meningitis

12,696

8,326

10,619

11,374

11,487

7,234

10,274

11,852

Botulism, total (wound and unspecified)

133

123

122

109

82

84

89

92

  Foodborne

§

49

23

17

28

23

23

  Infant

§

70

79

59

50

60

65

Brucellosis

200

131

153

106

129

96

95

82

Chancroid

847

665

2,067

3,756

4,998

5,001

4,692

4,212

Cholera

1

1

4

23

6

8

--

6

Diphtheria

5

1

3

--

3

2

3

4

Encephalitis, primary

1,761

1,257

1,376

1,302

1,418

882

981

1,341

  Postinfectious

34

108

161

124

121

121

88

105

Gonorrhea

900,435

878,556

911,419

900,868

780,905

719,536

733,151

690,169

Granuloma inguinale

24

30

44

61

22

11

7

97

Hansen disease (leprosy)

259

290

361

270

238

184

163

198

Hepatitis A

21,532

22,040

23,210

23,430

25,280

28,507

35,821

31,441

Hepatitis B

24,318

26,115

26,611

26,107

25,916

23,177

23,419

21,102

Hepatitis C; non-A, non-B

3,470

3,871

4,184

3,634

2,999

2,619

2,529

2,553

Hepatitis, unspecified

7,149

5,531

5,517

3,940

3,102

2,470

2,306

1,671

Legionellosis

852

750

830

980

1,038

1,085

1,190

1,370

Leptospirosis

61

40

57

41

43

54

93

77

Lymphogranuloma venereum

335

170

226

396

303

185

189

277

Malaria

813

1,007

1,049

1,123

944

1,099

1,277

1,292

Measles (rubeola)

1,497

2,587

2,822

6,282

3,655

3,396

18,193

27,786

Meningococcal disease

2,736

2,746

2,479

2,594

2,930

2,964

2,727

2,451

Mumps

3,355

3,021

2,982

7,790

12,848

4,866

5,712

5,292

Murine typhus fever

62

53

37

67

49

54

41

50

Pertussis (whooping cough)

2,463

2,276

3,589

4,195

2,823

3,450

4,157

4,570

Plague

40

31

17

10

12

15

4

2

Poliomyelitis, total

13

9

**

  Paralytic

13

9

8

10

9

9

11

6

Psittacosis

142

172

119

224

98

114

116

113

Rabies, animal

5,878

5,567

5,565

5,504

4,658

4,651

4,724

4,826

Rabies, human

2

3

1

--

1

--

1

1

Rheumatic fever, acute

88

117

90

147

141

158

144

108

Rocky Mountain spotted fever

1,126

838

714

760

604

609

623

651

Rubella (German measles)

970

752

630

551

306

225

396

1,125

Rubella, congenital syndrome

22

5

--

14

5

6

3

11

Salmonellosis, excluding typhoid fever

44,250

40,861

65,347

49,984

50,916

48,948

47,812

48,603

Shigellosis

19,719

17,371

17,057

17,138

23,860

30,617

25,010

27,077

Syphilis, primary and secondary

32,698

28,607

27,131

27,883

35,147

40,117

44,540

50,223

  Total, all stages

74,637

69,888

67,563

68,215

86,545

103,437

110,797

134,255

Tetanus

91

74

83

64

48

53

53

64

Toxic-shock syndrome

502

482

384

412

372

390

400

322

Trichinosis

45

68

61

39

40

45

30

129

Tuberculosis

23,846

22,255

22,201

22,768

22,517

22,436

23,495

25,701

Tularemia

310

291

177

170

214

201

152

152

Typhoid fever

507

390

402

362

400

436

460

552

Varicella (chickenpox)

177,462

221,983

178,162

183,243

213,196

192,857

185,441

173,099

Yellow fever

††

* Acquired immunodeficiency syndrome (AIDS).
† Not previously nationally notifiable.
§ Not reported as distinct categories during this period.
¶ Beginning in 1984, data were recorded by date of report to state health departments. Before 1984, data were recorded by onset date.
** Categories other than paralytic are no longer reported.
†† Last indigenous case of yellow fever was reported in 1911; before 1996, the last imported case was reported in 1924.

Note: Data in the MMWR Summary of Notifiable Disease, United States might not match data in other CDC Surveillance reports because of differences in timing of reports, the source of the data, and the use of different case definitions.




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

TABLE 4. NOTIFIABLE DISEASES -- Summary of reported cases, United States, 1975-1982

Disease

1975

1976

1977

1978

1979

1980

1981

1982

Amebiasis

2,775

2,906

3,044

3,937

4,107

5,271

6,632

7,304

Anthrax

2

2

--

6

--

1

--

--

Aseptic meningitis

4,475

3,510

4,789

6,573

8,754

8,028

9,547

9,680

Botulism, total (wound and unspecified)

20

55

129

105

45

89

103

97

Brucellosis

310

296

232

179

215

183

185

173

Chancroid

700

628

455

521

840

788

850

1,392

Cholera

--

--

3

12

1

9

19

--

Diphtheria*

307

128

84

76

59

3

5

2

Encephalitis, primary

4,064

1,651

1,414

1,351

1,504

1,362

1,492

1,464

  Postinfectious

237

175

119

78

84

40

43

36

Gonorrhea

999,937

1,001,994

1,002,219

1,013,436

1,004,058

1,004,029

990,864

960,633

Granuloma inguinale

60

71

75

72

76

51

66

17

Hansen disease (leprosy)

162

145

151

168

185

223

256

250

Hepatitis A

35,855

33,288

31,153

29,500

30,407

29,087

25,802

23,403

Hepatitis B

13,121

14,973

16,831

15,016

15,452

19,015

21,152

22,177

Hepatitis, unspecified

7,158

7,488

8,639

8,776

10,534

11,894

10,975

8,564

Legionellosis

235

359

761

593

475

408

654

Leptospirosis

93

73

71

110

94

85

82

100

Lymphogranuloma venereum

353

365

348

284

250

199

263

235

Malaria

373

471

547

731

894

2,062

1,388

1,056

Measles (rubeola)

24,374

41,126

57,345

26,871

13,597

13,506

3,124

1,714

Meningococcal disease

1,478

1,605

1,828

2,505

2,724

2,840

3,525

3,056

Mumps

59,647

38,492

21,436

16,817

14,225

8,576

4,941

5,270

Murine typhus fever

41

69

75

46

69

81

61

58

Pertussis (whooping cough)

1,738

1,010

2,177

2,063

1,623

1,730

1,248

1,895

Plague

20

16

18

12

13

18

13

19

Poliomyelitis, total

13

10

19

8

22

9

10

12

  Paralytic§

13

10

19

8

22

9

10

12

Psittacosis

49

78

94

140

137

124

136

152

Rabies, animal

2,627

3,073

3,130

3,254

5,119

6,421

7,118

6,212

Rabies, human

2

2

2

4

4

--

2

--

Rheumatic fever, acute

2,854

1,865

1,738

851

629

432

264

137

Rocky Mountain spotted fever

844

937

1,153

1,063

1,070

1,163

1,192

976

Rubella (German measles)

16,652

12,491

20,395

18,269

11,795

3,904

2,077

2,325

Rubella, congenital syndrome

30

30

23

30

62

50

19

7

Salmonellosis, excluding typhoid fever

22,612

22,937

27,850

29,410

33,138

33,715

39,990

40,936

Shigellosis

16,584

13,140

16,052

19,511

20,135

19,041

19,859

18,129

Syphilis, primary and secondary

25,561

23,731

20,399

21,656

24,874

27,204

31,266

33,613

  Total, all stages

80,356

71,761

64,621

64,875

67,049

68,832

72,799

75,579

Tetanus

102

75

87

86

81

95

72

88

Trichinosis

252

115

143

67

157

131

206

115

Tuberculosis

33,989

32,105

30,145

28,521

27,669

27,749

27,373

25,520

Tularemia

129

157

165

141

196

234

288

275

Typhoid fever

375

419

398

505

528

510

584

425

Varicella (chickenpox)

154,248

183,990

188,396

154,089

199,081

190,894

200,766

167,423

Yellow fever

**

* Cutaneous diphtheria is no longer nationally notifiable after 1979.
† Not previously nationally notifiable.
§ No cases with paralytic poliomyelitis caused by wild-virus have been reported in the United States since 1979.
¶ Case data after 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.

Note: Data in the MMWR Summary of Notifiable Diseases, United States 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.




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

TABLE 5. NOTIFIABLE DISEASES -- Summary of reported cases, United States, 1967-1974

Disease

1967

1968

1969

1970

1971

1972

1973

1974

Amebiasis

3,157

3,005

2,915

2,888

2,752

2,199

2,235

2,743

Anthrax

2

3

4

2

5

2

2

2

Aseptic meningitis

3,082

4,494

3,672

6,480

5,176

4,634

4,846

3,197

Botulism

5

7

16

12

25

22

34

28

Brucellosis

265

218

235

213

183

196

202

240

Chancroid

784

845

1,104

1,416

1,320

1,414

1,165

945

Cholera

--

--

--

--

1

--

1

--

Diphtheria

219

260

241

435

215

152

228

272

Encephalitis, primary

1,478

1,781

1,613

1,580

1,524

1,059

1,613

1,164

  Postinfectious

1,060

502

304

370

439

243

354

218

Gonorrhea

404,836

464,543

534,872

600,072

670,268

767,215

842,621

906,121

Granuloma inguinale

154

156

154

124

89

81

62

47

Hansen disease (leprosy)

81

123

98

129

131

130

146

118

Hepatitis A (infectious)

38,909

45,893

48,416

56,797

59,606

54,074

50,749

40,358

Hepatitis B (serum)

2,458

4,829

5,909

8,310

9,556

9,402

8,451

10,631

Leptospirosis

67

69

89

47

62

41

57

8,351

Lymphogranuloma venereum

371

485

520

612

692

756

408

394

Malaria

2,022

2,317

3,102

3,051

2,375

742

237

293

Measles (rubeola)

62,705

22,231

25,826

47,351

75,290

32,275

26,690

22,094

Meningococcal disease

2,161

2,623

2,951

2,505

2,262

1,323

1,378

1,346

Mumps

*

152,209

90,918

104,953

124,939

74,215

69,612

59,128

Murine typhus fever

52

36

36

27

23

18

32

26

Pertussis (whooping cough)

9,718

4,810

3,285

4,249

3,036

3,287

1,759

2,402

Plague

3

3

5

13

2

1

2

8

Poliomyelitis, total

41

53

20

33

21

31

8

7

  Paralytic

40

53

18

31

17

29

7

7

Psittacosis

41

43

57

35

32

52

33

164

Rabies, animal

4,481

3,591

3,490

3,224

4,310

4,369

3,640

3,151

Rabies, human

2

1

1

3

2

2

1

--

Rheumatic fever, acute

3,985

3,470

3,229

3,227

2,793

2,614

2,560

2,431

Rocky Mountain spotted fever

305

298

498

380

432

523

668

754

Rubella (German measles)

46,888

49,371

57,686

56,552

45,086

25,507

27,804

11,917

Rubella, congenital syndrome

10

14

31

77

68

42

35

45

Salmonellosis, excluding typhoid fever

18,120

16,514

18,419

22,096

21,928

22,151

23,818

21,980

Shigellosis

13,474

12,180

11,946

13,845

16,143

20,207

22,642

22,600

Streptococcal sore throat and scarlet fever

453,351

435,013

450,008

433,405

Syphilis, primary and secondary

21,053

19,019

19,130

21,982

23,783

24,429

24,825

25,385

  Total, all stages

102,581

96,271

92,162

91,382

95,997

91,149

87,469

83,771

Tetanus

263

178

192

148

116

128

101

101

Trichinosis

66

77

215

109

103

89

102

120

Tuberculosis

45,647

42,623

39,120

37,137

35,217

32,882

30,998

30,122

Tularemia

184

186

149

172

187

152

171

144

Typhoid fever

396

395

364

346

407

398

680

437

Varicella (chickenpox)

*

164,114

182,927

141,495

Yellow fever

§

* 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.

Note: Data in the MMWR Summary of Notifiable Diseases, United States 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.




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

TABLE 6. NOTIFIABLE DISEASES -- Deaths from selected diseases, United States, 1988-1997

Cause of Death

ICD-9*

1988

1989

1990

1991

1992

1993

1994

1995

1996

1997

AIDS

*042-*044

16,602

22,082

25,188

29,555

33,566

37,267

42,114

43,115

31,130

16,516

Anthrax

022

--

--

--

--

--

--

--

--

--

--

Botulism, foodborne

005.1

1

2

4

2

1

--

--

2

1

2

Brucellosis

023

2

--

--

--

--

1

--

1

--

1

Chancroid

099.0

--

--

--

1

--

--

--

--

--

--

Cholera

001

--

--

2

2

2

--

1

--

2

--

Diphtheria

032

--

--

1

--

1

--

--

1

--

--

Encephalitis, California serogroup viral

062.5

--

--

--

--

--

--

--

--

1

1

  Eastern equine

062.2

--

1

1

1

1

1

--

1

1

2

  St. Louis

062.3

--

--

13

9

2

1

3

6

--

1

  Western equine

062.1

--

--

--

--

--

--

--

--

--

--

Gonococcal infections

098

3

4

3

3

4

5

3

3

4

3

Haemophilus influenzae, invasive disease

041.5

25

16

16

17

16

7

5

12

7

7

Hansen disease (leprosy)

030

--

4

3

--

2

1

3

2

--

2

Hepatitis, viral, infectious (Hep A)

070.0,070.1

70

88

76

71

82

95

97

142

121

127

Hepatitis, viral, serum (Hep B)

070.2,070.3

621

711

816

912

903

1,041

1,120

1,027

1,082

1,030

Hepatitis, viral, other and unspecified

070.4-070.9

599

717

686

857

1,016

1,353

1,844

2,231

2,577

2,900

Malaria

084

7

11

3

4

8

12

3

8

4

7

Measles (rubeola)

055

3

32

64

27

4

--

--

2

1

2

Meningococcal disease

036

278

273

215

198

201

260

276

273

290

309

Mumps

072

2

3

1

1

--

--

--

--

1

--

Pertussis (whooping cough)

033

4

12

12

--

5

7

8

6

4

6

Plague

020

--

--

--

--

1

2

2

1

2

--

Poliomyelitis, total

045.0-045.9

1

--

--

1

--

--

--

1

--

--

Psittacosis

073

1

1

2

--

4

1

--

--

1

--

Rabies, human

071

--

1

1

3

1

1

3

3

3

4

Rubella (German measles)

056

1

4

8

1

1

--

--

1

--

--

Salmonellosis, incl. paratyphoid fever

002.1-002.9,003

66

99

80

53

47

52

49

66

58

51

Shigellosis

004

8

16

10

10

8

5

13

8

5

5

Spotted fevers

082.0

20

10

20

13

13

5

9

8

6

12

Syphilis

090-097

85

105

106

93

91

80

79

65

73

62

Tetanus

037

17

9

11

11

9

11

9

5

1

4

Trichinosis

124

--

1

--

--

--

--

--

--

--

--

Tuberculosis (all forms)

010-018

1,921

1,970

1,810

1,713

1,705

1,631

1,478

1,336

1,202

1,166

Typhoid fever

002.0

--

--

1

1

--

--

1

--

1

--

Varicella (chickenpox)§

052

83

89

120

81

100

100

124

115

81

99

Yellow fever

060

--

--

--

--

--

--

--

--

1

--

* International Classification of Diseases, Ninth Revision, 1975. Numbers in this column are ICD-9 categories.
† Acquired immunodeficiency syndrome (AIDS). In 1987, the National Center for Health Statistics introduced categories *042-*044 for classifying and coding human immunodeficiency virus (HIV) infection. The asterisks are not footnote symbols, but indicate that these codes are not part of ICD-9.
§ Varicella was taken off the nationally notifiable disease list in 1991. Many states continue to report these cases to CDC.

Note: Data in the MMWR Summary of Notifiable Diseases, United States 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.

Source: National Center for Health Statistics System, 1988-1997. Deaths are classified according to the ICD-9.

Bibliography

General

Roush S, Birkhead G, Koo D, Cobb A, Fleming D. Mandatory reporting of diseases and conditions by health care professionals and laboratories. JAMA 1999;282:164-70.

CDC. Reporting race and ethnicity data -- National Electronic Telecommunications System for Surveillance, 1994-1997. MMWR 1999;48:305-12.

Niskar AS, Koo D. Differences in notifiable infectious disease morbidity among adult women -- United States, 1992-1994. J Womens Health 1998;7:451-8.

CDC. Case definitions for infectious conditions under public health surveillance. MMWR 1997;46(No. RR-10). Also available on the Internet at http://www.cdc.gov/epo/dphsi/casedef/cover97.htm. Accessed July 23, 1999.

CDC. Sexually transmitted disease surveillance 1997. Atlanta, GA: US Department of Health and Human Services, Public Health Service, CDC, 1998.

CDC. Manual for the surveillance of vaccine-preventable diseases. Atlanta, GA: US Department of Health and Human Services, CDC, 1997. Also available on the Internet at the following site: http://www.cdc.gov/nip/publications/manual/vpd.htm. Accessed July 23, 1999.

CDC. Demographic differences in notifiable infectious disease morbidity -- United States, 1992-1994. MMWR 1997;46:637-41.

CDC. Notifiable disease surveillance and notifiable disease statistics -- United States, June 1946 and June 1996. MMWR 1996;45:530-7.

Koo D, Wetterhall S. History and current status of the National Notifiable Diseases Surveillance System. Journal of Public Health Management and Practice 1996;2:4-10.

CDC. Ten leading nationally notifiable infectious diseases -- United States, 1995. MMWR 1996;45:883-4.

Benenson AS. Control of communicable diseases in man. 16th ed. Washington, DC: American Public Health Association, 1995.

Martin SM, Bean NH. Data management issues for emerging diseases and new tools for managing surveillance and laboratory data. Emerg Infect Dis J 1995;1:124-8.

CDC. Manual of procedures for the reporting of nationally notifiable diseases to CDC. Atlanta, GA: US Department of Health and Human Services, Public Health Service, CDC, 1995.

Teutsch SM, Churchill RE, eds. Principles and practice of public health surveillance. New York, NY: Oxford University Press, 1994.

Thacker SB, Stroup DF. Future directions for comprehensive public health surveillance and health information systems in the United States. Am J Epidemiol 1994;140:383-97.

CDC. Use of race and ethnicity in public health surveillance. MMWR 1993;42(No. RR-10).

CDC. Mandatory reporting of infectious diseases by clinicians, and mandatory reporting of occupational diseases by clinicians. MMWR 1990;39(No. RR-9).

Thacker SB, Choi K, Brachman PS. The surveillance of infectious diseases. JAMA 1983;249:1181-5.

AIDS

CDC. Characteristics of persons living with AIDS at the end of 1997. HIV/AIDS Surveillance Supplemental Report 1999;5(No. 1).

CDC. Success in implementing PHS guidelines to reduce perinatal transmission of HIV -- Louisiana, Michigan, New Jersey, and South Carolina, 1993, 1995, and 1996 [published errata appear in MMWR 1998;47:718]. MMWR 1998;47:688-91.

CDC. Diagnosis and reporting of HIV and AIDS in states with integrated HIV and AIDS surveillance -- United States, January 1994-June 1997. MMWR 1998;47:309-14.

CDC. HIV/AIDS Surveillance Report 1998;10(No. 2).

Botulism

Angulo FJ, Getz J, Taylor JP, et al. A large outbreak of botulism: the hazardous baked potato. J Infect Dis 1998;178:172-7.

CDC. Botulism in the United States, 1899-1996. Handbook for epidemiologists, clinicians, and laboratory workers. Atlanta, GA: US Department of Health and Human Services, CDC, 1998. Also available at http://www.cdc.gov/ncidod/dbmd/diseaseinfo/botulism.pdf. Accessed July 23, 1999.

Shapiro RL, Hatheway C, Becher J, Swerdlow D. Botulism surveillance and emergence response: a public health strategy for a global challenge. JAMA 1997;278:433-5.

Chancroid

Mertz KJ, Weiss JB, Webb RM, et al. An investigation of genital ulcers in Jackson, Mississippi, with use of a multiplex polymerase chain reaction assay: high prevalence of chancroid and human immunodeficiency virus infection. J Infect Dis 1998;178:1060-6.

Mertz KJ, Trees D, Levine WC, et al. Etiology of genital ulcers and prevalence of human immunodeficiency virus coinfection in 10 US cities. The Genital Ulcer Disease Surveillance Group. J Infect Dis 1998;178:1795-8.

DiCarlo RP, Armentor BS, Martin DH. Chancroid epidemiology in New Orleans men. J Infect Dis 1995;172:446-52.

CDC. Chancroid in the United States, 1981-1990: evidence for underreporting of cases. In: CDC surveillance summaries, May 29, 1992. MMWR 1992;41(No. SS-3):57-61.

Chlamydia trachomatis, Genital Infection

CDC. Sexually transmitted disease surveillance 1997 supplement. Chlamydia prevalence monitoring project annual report -- 1997. Atlanta, GA: US Department of Health and Human Services, Public Health Service, CDC, 1998.

Gaydos CA, Howell MR, Pare B, et al. Chlamydia trachomatis infections in female military recruits. N Engl J Med 1998;339:739-44.

Mertz KJ, McQuillan GM, Levine WC, et al. A pilot study of the prevalence of chlamydial infection in a national household survey. Sex Transm Dis 1998;25:225-8.

CDC. Chlamydia trachomatis genital infections -- United States, 1995. MMWR 1997;46:193-8.

Cholera

Ackers ML, Quick RE, Drasbeck CJ, Hutwagner L, Tauxe RV. Are there national risk factors for epidemic cholera? The correlation between socioeconomic and demographic indices and cholera incidence in Latin America. Int J Epidemiol 1998;27:330-4.

Mahon BE, Mintz ED, Greene KD, Wells JG, Tauxe RV. Reported cholera in the United States, 1992-1994: a reflection of global changes in cholera epidemiology. JAMA 1996;276:307-12.

Wachsmuth IK, Blake PA, Olsvik O, eds. Vibrio cholerae and cholera: molecular to global perspectives. Washington, DC: American Society for Microbiology, 1994.

Blake PA. Epidemiology of cholera in the Americas. Gastroenterol Clin North Am 1993;22:639-60.

World Health Organization. Guidelines for cholera control. Geneva: World Health Organization, 1993.

Cryptosporidiosis

Kramer MH, Herwaldt BL, Craun GF, Calderon RL, Juranek DD. Surveillance for waterborne-disease outbreaks -- United States, 1993-1994. In: CDC surveillance summaries, April 12, 1996. MMWR 1996;45(No. SS-1).

Juranek DD. Cryptosporidiosis: sources of infection and guidelines for prevention. Clin Infect Dis 1995;21(suppl 1):S57-S61. Also available on the Internet at the following site: http://www.cdc.gov/ncidod/diseases/crypto/sources.htm. Accessed July 23, 1999.

CDC. Assessing the public health threat associated with waterborne cryptosporidiosis: report of a workshop. MMWR 1995;44(No. RR-6). Also available on the Internet at the following site: http://www.ftp.cdc.gov/pub/Publications/mmwr/rr/rr4406.pdf . Accessed July 23, 1999.

Cyclosporiasis

Herwaldt BL, Beach MJ. The return of Cyclospora in 1997: another outbreak of cyclosporiasis in North America associated with imported raspberries. Cyclospora Working Group. Ann Intern Med 1999;130:210-20.

CDC. Outbreak of cyclosporiasis -- Ontario, Canada, May 1998. MMWR 1998;47:806-9.

Herwaldt BL, Ackers ML, Cyclospora Working Group. An outbreak in 1996 of cyclosporiasis associated with imported raspberries. N Engl J Med 1997;336:1548-56.

Dengue

Rigau-Perez JG, Millard PS, Walker DR, Deseda CC, Casta-Velez A. A deviation bar chart for detecting dengue outbreaks in Puerto Rico. Am J Public Health 1999;89:374-8.

CDC. Dengue outbreak associated with multiple serotypes -- Puerto Rico, 1998. MMWR 1998;47:952-6.

Rawlings JA, Hendricks KA, Burgess CR, et al. Dengue surveillance in Texas, 1995. Am J Trop Med Hyg 1998;59:95-9.

Organización Panamericana de la Salud. Situación de las enfermedades infecciosas de mayor riesgo epidemiológico en el período post-Mitch, países de Centroamerica, 1998 [Segundo informe]. Washington, DC: Organización Panamericana de la Salud, Programa de Enfermedades Transmisibles, División de Prevención y Control de Enfermedades, 1998;OPS/HCP/HCT/134/98:5-8.

Diphtheria

Bisgard K, Hardy I, Popovic T, et al. Respiratory diphtheria in the United States, 1980-1995. Am J Public Health 1998;88:787-91

Vitek CR, Wharton M. Diphtheria in the former Soviet Union: reemergence of a pandemic disease [Review]. Emerg Infect Dis 1998;4:539-50.

Encephalitis, Arboviral
(California Serogroup Viral, Eastern Equine, St. Louis, and Western Equine Encephalitis)

Jones TF, Craig AS, Nasci RS, et al. Newly recognized focus of La Crosse encephalitis in Tennessee. Clin Infect Dis 1999;28:93-7.

CDC. Arboviral infections of the central nervous system -- United States, 1996-1997. MMWR 1998;47:517-22.

Szumlas DE, Apperson CS, Hartig PC, Francy DB, Karabatsos N. Seroepidemiology of La Crosse virus infection in humans in western North Carolina. Am J Trop Med Hyg 1996;54:332-7.

Marfin AA, Bleed DM, Lofgren JP, et al. Epidemiologic aspects of a St. Louis encephalitis epidemic in Jefferson County, Arkansas, 1991. Am J Trop Med Hyg 1993;49:30-7.

Escherichia coli O157:H7; Hemolytic Uremic Syndrome, Postdiarrheal

CDC. PulseNet. The National Molecular Subtyping Network for Foodborne Disease Surveillance. Available on the Internet at http://www.cdc.gov/ncidod/dbmd/pulsenet/pulsenet.htm. Accessed July 23, 1999.

Bender JB, Hedberg CW, Besser JM, Boxrud DJ, MacDonald KL, Osterholm MT. Surveillance for Escherichia coli O157:H7 infections in Minnesota by molecular subtyping. N Engl J Med 1997;337:388-94.

Mahon BE, Griffin PM, Mead PS, Tauxe RV. Hemolytic uremic syndrome surveillance to monitor trends in infection with Escherichia coli O157:H7 and other Shiga toxin-producing E. coli. Emerg Infect Dis 1997;3:409-12.

Slutsker L, Ries AA, Greene KD, Wells JG, Hutwagner L, Griffin PM. Escherichia coli O157:H7 diarrhea in the United States: clinical and epidemiologic features. Ann Intern Med 1997;126:505-13.

Gonorrhea

CDC. Increases in unsafe sex and rectal gonorrhea among men who have sex with men -- San Francisco, California, 1994-1997. MMWR 1999;48:45-8.

CDC. Sexually transmitted diseases surveillance 1997 supplement. Gonococcal Isolate Surveillance Project (GISP) annual report - 1997. Atlanta, GA: US Department of Health and Human Services, Public Health Service, CDC, 1998.

Fox KK, Whittington W, Levine WC, Moran JS, Zaidi AA, Nakashima AK. Gonorrhea in the United States, 1981-1996. Demographic and geographic trends. Sex Transm Dis 1998;25:386-93.

Fox KK, Knapp JS, Holmes KK, et al. Antimicrobial resistance in Neisseria gonorrhoeae in the United States, 1988-1994: the emergence of decreased susceptibility to the fluoroquinolones. J Infect Dis 1997;175:1396-403.

Haemophilus influenzae, Invasive Disease

Bisgard KM, Kao A, Leake J, Strebel PM, Perkins BA, Wharton M. Haemophilus influenzae invasive disease in the United States, 1994-1995: near disappearance of a child vaccine preventable disease. Emerg Infect Dis 1998;4:229-37.

CDC. Progress towards elimination of Haemophilus influenzae type b disease among infants and children -- United States, 1987-1997. MMWR 1998;47:993-8.

Schuchat A, Robinson K, Wenger JD, et al. Bacterial meningitis in the United States in 1995. New Engl J Med 1997;33:970-6.

CDC. Recommendations for the use of Haemophilus b conjugate vaccines and a combined diphtheria, tetanus, pertussis, and Haemophilus b vaccine: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR 1993;42(No. RR-13).

Hantavirus Pulmonary Syndrome

Mills JN, Ksiazek TG, Peters CJ, Childs JE. Long-term studies of hantavirus reservoir populations in the southwestern United States: a synthesis. Emerg Infect Dis 1999;5:135-42.

Monroe MC, Morzunov SP, Johnson AM, et al. Genetic diversity and distribution of Peromyscus-borne hantaviruses in North America. Emerg Infect Dis 1999;5:75-86.

Engelthaler DM, Mosley DG, Cheek JE, et al. Climatic and environmental patterns associated with hantavirus pulmonary syndrome, Four Corners region, United States. Emerg Infect Dis 1999;5:87-94.

CDC. Hantavirus infection -- southwestern United States: interim recommendations for risk reduction. MMWR 1993;42(No. RR-11).

Hepatitis A

CDC. Prevention of hepatitis A through active or passive immunization: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR 1996;45(No. RR-15).

Lemon SM, Shapiro CN. The value of immunization against hepatitis A. Infectious Agents and Disease 1994;1:38-49.

Shapiro CN, Coleman PJ, McQuillan GM, et al. Epidemiology of hepatitis A: seroepidemiology and risk groups in the U.S.A. Vaccine 1992;10(suppl 1):S59-S62.

Hepatitis B

Coleman PJ, McQuillan GM, Moyer LA, Lambert SB, Margolis HS. Incidence of hepatitis B virus infection in the United States, 1976-1994: estimates from the National Health and Nutrition Examination Surveys. J Infect Dis 1998;178:954-9.

Margolis HS, Alter MJ, Hadler SC. Hepatitis B: evolving epidemiology and implications for control. Semin Liver Dis 1991;11:84-92.

CDC. Hepatitis B virus: a comprehensive strategy for eliminating transmission in the United States through universal childhood vaccination: recommendations of the Immunization Practices Advisory Committee (ACIP). MMWR 1991;40(No. RR-13).

Hepatitis C; Non-A, Non-B

CDC. Recommendations for prevention and control of hepatitis C virus (HCV) infection and HCV-related chronic disease. MMWR 1998;47(No. RR-19).

Alter MJ, Mast EE, Moyer LA, Margolis HS. Hepatitis C. Infect Dis Clin North Am 1998;12:13-26.

Legionellosis

Kool JL, Carpenter JC, Fields BS. Effect of monochloramine disinfection of municipal drinking water on risk of nosocomial Legionnaires' disease. Lancet 1999;353:272-7.

Jernigan DB, Hofmann J, Cetron MS, et al. Outbreak of Legionnaires' disease among cruise ship passengers exposed to a contaminated whirlpool spa. Lancet 1996;347:494-9.

Keller DW, Hajjeh R, DeMaria A, Jr, et al. Community outbreak of Legionnaires' disease: an investigation confirming the potential for cooling towers to transmit legionella species. Clin Infect Dis 1996;22:257-61.

Marston BJ, Lipman HB, Breiman RF. Surveillance for Legionnaires' disease: risk factors for morbidity and mortality. Arch Intern Med 1994;154:2417-22.

Lyme Disease

CDC. Recommendations for the use of Lyme disease vaccine. Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR 1999;48(No. RR-7).

Dennis DT. Epidemiology, ecology, and prevention of Lyme disease. In: Rahn DW, Evans J, eds. Lyme disease. Philadelphia, PA: American College of Physicians, 1998:7-34.

CDC. Lyme disease -- United States, 1996. MMWR 1997:46:531-5.

CDC. Notice to readers: recommendations for test performance and interpretation from the Second National Conference on Serologic Diagnosis of Lyme disease. MMWR 1995;44:590-1.

Malaria

Lobel HO, Kozarsky PE. Update on prevention of malaria for travelers. JAMA 1997;278:1767-71.

Zucker JR. Changing patterns of autochthonous malaria transmission in the United States: a review of recent outbreaks. Emerg Infect Dis 1996;2:37-43.

Zucker JR, Campbell CC. Malaria: principles of prevention and treatment. Infect Dis Clin North Am 1993;7:547-67.

Measles (Rubeola)

CDC. Transmission of measles among a highly vaccinated school population -- Anchorage, Alaska, 1998. MMWR 1999;47:1109-11.

CDC. Measles, mumps and rubella -- vaccine use and strategies for elimination of measles, rubella, and congenital rubella syndrome and control of mumps: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR 1998;47(No. RR-8).

CDC. Measles -- United States, 1997. MMWR 1998;47:273-6.

Meningococcal Disease

Diermayer M, Hedberg K, Hoesly F, et al. Epidemic serogroup B meningococcal disease in Oregon: the evolving epidemiology of the ET-5 strain. JAMA 1999;281:1493-7.

Rosenstein N, Levine O, Taylor JP, et al. Efficacy of meningococcal vaccine and barriers to vaccination. JAMA 1998;279:435-9.

CDC. Control and prevention of meningococcal disease and control and prevention of serogroup C meningococcal disease: evaluation and management of suspected outbreaks. Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR 1997;46(No. RR-5).

CDC. Laboratory-based surveillance for meningococcal disease in selected areas -- United States, 1989-1991. In: CDC surveillance summaries (June 4). MMWR 1993;42(No. SS-2):21-30.

Mumps

CDC. Mumps surveillance -- United States, 1988-1993. In: CDC surveillance summaries, August 11, 1995. MMWR 1995;44(No. SS-3).

Briss PA, Fehrs LJ, Parker RA, et al. Sustained transmission of mumps in a highly vaccinated population: assessment of primary vaccine failure and waning vaccine-induced immunity. J Infect Dis 1994;169:77-82.

Hersh BS, Fine PE, Kent WK, et al. Mumps outbreak in a highly vaccinated population. J Pediatr 1991;119:187-93.

CDC. Recommendations of the Immunization Practices Advisory Committee on Mumps prevention. MMWR 1989;38:388-92,397-400.

Pertussis

Guris D, Strebel PM, Bardenheier B, et al. Changing epidemiology of pertussis in the United States: increasing reported incidence among adolescents and adults, 1990-1996. Clin Infect Dis 1999;28:1230-7.

CDC. Notice to readers: FDA approval of a fourth acellular pertussis vaccine for use among infants and young children. MMWR 1998;47:934-6.

CDC. Pertussis vaccination: use of acellular pertussis vaccines among infants and young children. Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR 1997;46(No.RR-7).

Plague

Poland JD, Dennis DT. Plague. In: Evans AS, Brachman PS, eds. Bacterial infections of humans: epidemiology and control. 3rd ed. New York, NY: Plenum Publishing Corporation, 1998:545-58.

Gage KL. Plague. In: Hausler WJ, Jr, Sussman M, eds. Topley and Wilson's microbiology and microbial infections. Vol. 3: Bacterial infections. 9th ed. London, England: Arnold, 1998:885-903.

CDC. Prevention of plague. Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR 1996;45(No. RR-14).

Poliomyelitis, Paralytic

CDC. Impact of the sequential IPV/OPV schedule on vaccination coverage levels -- United States, 1997. MMWR 1998;47:1017-9.

CDC. Paralytic poliomyelitis -- United States, 1980-1994. MMWR 1997;46:79-83.

CDC. Poliomyelitis prevention in the United States: introduction of a sequential vaccination schedule of inactivated poliovirus vaccine followed by oral poliovirus vaccine. Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR 1997;46(No. RR-3).

Psittacosis

Moroney JF, Guevara R, Iverson C, et al. Detection of chlamydiosis in a shipment of pet birds, leading to recognition of an outbreak of clinically mild psittacosis in humans. Clin Infect Dis 1998;26:1425-9.

Jorgensen DM. Gestational psittacosis in a Montana sheep rancher. Emerg Infect Dis 1997;3:191-4

CDC. Compendium of psittacosis (chlamydiosis) control, 1997. MMWR 1997;46(No. RR-13).

Wong KH, Skelton SK, Daugharty H. Utility of complement fixation and microimmunofluorescence assays for detecting serologic responses in patients with clinically diagnosed psittacosis. J Clin Microbiol 1994;32:2417-21.

Rabies, Animal and Human

CDC. Human rabies prevention -- United States, 1999. Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR 1999;48(No. RR-1).

CDC. Compendium of animal rabies control, 1999. National Association of State and Territorial Public Health Veterinarians, Inc. MMWR 1999;48(No. RR-3).

Krebs JW, Smith JS, Rupprecht CE, Childs JE. Rabies surveillance in the United States during 1997. JAVMA 1998;213:1713-28.

Noah DL, Drenzek CL, Smith JS, et al. Epidemiology of human rabies in the United States, 1980 to 1996 [Review]. Ann Intern Med 1998;128:922-30.

Rocky Mountain Spotted Fever

Paddock CD, Greer PW, Ferebee T, et al. Hidden mortality attributable to Rocky Mountain spotted fever: immunohistochemical detection of fatal, serologically unconfirmed cases. J Infect Dis 1999;179:1469-76.

Thorner AR, Walker DH, Petri WA, Jr. Rocky Mountain spotted fever [Review]. Clin Infect Dis 1998;27:1353-9.

Dalton MJ, Clarke MJ, Holman RC, et al. National surveillance for Rocky Mountain spotted fever, 1981-1992: epidemiologic summary and evaluation of risk factors for fatal outcome. Am J Trop Med Hyg 1995;52:405-13.

Rubella

Schluter WW, Reef SE, Redd SC, Dykewicz CA, Changing epidemiology of congenital rubella syndrome in the United States. J Infect Dis 1998;178:636-41.

CDC. Rubella outbreak -- Westchester County, New York, 1997-98. MMWR 1999;48:560-3.

CDC. Rubella and congenital rubella syndrome -- United States, 1994-1997. MMWR 1997;46:350-4.

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 -- Florida, 1997. MMWR 1998;46:1247-50.

Salmonellosis

Van Beneden CA, Keene WE, Strang RA, et al. Multinational outbreak of Salmonella enterica serotype Newport infections due to contaminated alfalfa sprouts. JAMA 1999;281:158-62.

Mahon BE, Slutsker L, Hutwagner L, et al. Consequences in Georgia of a nationwide outbreak of Salmonella infections: what you don't know might hurt you. Am J Public Health 1999;89:31-5.

Glynn MK, Bopp C, Dewitt WK, Dabney P, Mokhtar M, Angulo FJ. Emergence of multidrug-resistant Salmonella enterica serotype Typhimurium DT104 infections in the United States. N Engl J Med 1998;338:1333-8.

CDC. Multistate outbreak of Salmonella serotype Agona infections linked to toasted oats cereal -- United States, April-May, 1998. MMWR 1998;47:462-4.

Shigellosis

Sobel J, Cameron DN, Ismail J, et al. A prolonged outbreak of Shigella sonnei infections in traditionally observant Jewish communities in North America caused by a molecularly distinct bacterial subtype. J Infect Dis 1998;177:1405-8.

Mohle-Boetani JC, Stapleton M, Finger R, et al. Communitywide shigellosis: control of an outbreak and risk factors in child day-care centers. Am J Public Health 1995;85:812-6.

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.

Lee LA, Shapiro CN, Hargrett-Bean N, Tauxe RV. Hyperendemic shigellosis in the United States: a review of surveillance data for 1967-1988. J Infect Dis 1991;164:894-900.

Streptococcal Disease, Invasive, Group A

CDC. Noscomial group A streptococcal infections associated with asymptomatic health-care workers -- Maryland and California, 1997. MMWR 1999;48:163-6.

The Working Group on Prevention of Invasive Group A Streptococcal Infections. Prevention of invasive group A streptococcal disease among household contacts of case-patients: is prophylaxis warranted? JAMA 1998;279:1206-10.

Davies HD, McGeer A, Schwartz B, et al. A prospective, population-based study of invasive group A streptococcal infections, including toxic shock syndrome and the risk of secondary infections. N Engl J Med 1996;335:547-54.

Working Group on Severe Streptococcal Infections. Defining the group A streptococcal toxic shock syndrome: rationale and consensus definition. JAMA 1993;269:390-1.

Streptococcal Disease, Invasive, Group B

Schuchat A. Group B streptococcus [Review]. Lancet 1999;353:51-6.

CDC. Adoption of hospital policies for prevention of perinatal group B streptococcal disease -- United States, 1997. MMWR 1998;47:665-70.

Factor SH, Levine OS, Nassar A, et al. Impact of a risk-based prevention policy on neonatal group B streptococcal disease. Am J Obstet Gynecol 1998;179:1568-71.

CDC. Decreasing incidence of perinatal group B streptococcal disease -- United States, 1993-1995. MMWR 1997;46:473-7.

Streptococcus pneumoniae, Drug-Resistant

Dowell SF, Butler JC, Giebink GS, et al. Acute otitis media: management and surveillance in an era of pneumococcal resistance -- a report from the Drug-Resistant Streptococcus pneumoniae Therapeutic Working Group [published erratum appears in Pediatr Infect Dis J 1999;18(4):341]. Pediatr Infect Dis J 1999;18:1-9.

Dowell SF. Principles of judicious use of antimicrobial agents for pediatric upper respiratory tract infections. Pediatrics 1998;101(suppl):S163-S184.

CDC. Defining the public health impact of drug-resistant Streptococcus pneumoniae: report of a working group. MMWR 1996;45(No. RR-1).

Butler JC, Hofmann J, Cetron MS, et al. The continued emergence of drug-resistant Streptococcus pneumoniae in the United States: an update from the Centers for Disease Control and Prevention's Pneumococcal Sentinel Surveillance System. J Infect Dis 1996;174:986-93.

Syphilis, Congenital

Southwick KL, Guidry HM, Weldon MM, Mertz KJ, Berman SM, Levine WC. An epidemic of congenital syphilis in Jefferson County, Texas, 1994-1995: inadequate prenatal syphilis testing after an outbreak in adults. Am J Public Health 1999;89:557-60.

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. Congenital syphilis -- United States, 1998. MMWR 1999;48;757-61.

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

Syphilis, Primary and Secondary

Williams LA, Klausner JD, Whittington WL, Handsfield HH, Celum C, Holmes KK. Elimination and reintroduction of primary and secondary syphilis. Am J Public Health 1999;89:1093-7.

CDC. Primary and secondary syphilis -- United States, 1998. MMWR 1999;48:873-8.

St. Louis ME, Wasserheit JN. Elimination of syphilis in the United States. Science 1998;281:353-4.

Nakashima AK, Rolfs RT, Flock ML, Kilmarx P, Greenspan JR. Epidemiology of syphilis in the United States, 1941-1993. Sex Transm Dis 1996;23:16-23.

Tetanus

Bardenheier B, Prevots R, Khetsuriani N, Wharton M. Tetanus surveillance-United States, 1995-1997. In: CDC surveillance summaries, July 3, 1998. MMWR 1998;47(No. SS-2):1-13.

CDC. Neonatal tetanus -- Montana, 1998. MMWR 1998;47:928-30.

CDC. Tetanus among injecting-drug users -- California, 1997. MMWR 1998;47:149-51.

Gergen PJ, McQuillan GM, Kiely M, Ezzati-Rice TM, Sutter RW, Virella G. A population-based serologic survey of immunity to tetanus in the United States. N Engl J Med 1995;332:761-6.

Toxic-Shock Syndrome

Hajjeh RA, Reingold R, Weil A, Shutt K, Schuchat A, Perkins BA. Toxic shock syndrome in the United States: surveillance update, 1979-1996. Emerg Infect Dis 1999;5. Available on the Internet at http://www.cdc.gov/ncidod/eid/vol5no6/hajjeh.htm.

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. Reviews of Infectious Disease 1989;11(suppl):S28-S34.

Trichinellosis (Trichinosis)

Moorhead A, Grunenwald PE, Dietz VJ, Schantz PM. Trichinellosis in the United States, 1991-1996: declining but not gone. Am J Trop Med Hyg 1999;60:66-9.

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

McAuley JB, Michelson MK, Schantz PM. Trichinosis surveillance, United States, 1987-1990. In: CDC surveillance summaries, December 1991. MMWR 1991;40(No. SS-3):35-42.

Tuberculosis

CDC. Recommendations for counting reported tuberculosis cases. In: Reported tuberculosis in the United States, 1996. Atlanta, GA: US Department of Health and Human Services, Public Health Service, CDC, 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 J, Villar R, Carpenter J, et al. A massive epidemic of multidrug-resistant typhoid fever in Tajikistan associated with consumption of municipal water. J Infect Dis 1999;179:1416-22.

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 (ACIP). 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. Evaluation of varicella reporting to the National Notifiable Disease Surveillance System -- United States, 1972-1997. MMWR 1999;48:55-8.

CDC. Prevention of varicella. Updated recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR 1999:48(No. RR-6).

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

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

Disclaimer   All MMWR HTML versions of articles are electronic conversions from ASCII text into HTML. This conversion may have resulted in character translation or format errors in the HTML version. Users should not rely on this HTML document, but are referred to the electronic PDF version and/or the original MMWR paper copy for the official text, figures, and tables. An original paper copy of this issue can be obtained from the Superintendent of Documents, U.S. Government Printing Office (GPO), Washington, DC 20402-9371; telephone: (202) 512-1800. Contact GPO for current prices.

**Questions or messages regarding errors in formatting should be addressed to mmwrq@cdc.gov.

Page converted: 1/12/2000

HOME  |  ABOUT MMWR  |  MMWR SEARCH  |  DOWNLOADS  |  RSSCONTACT
POLICY  |  DISCLAIMER  |  ACCESSIBILITY

Safer, Healthier People

Morbidity and Mortality Weekly Report
Centers for Disease Control and Prevention
1600 Clifton Rd, MailStop E-90, Atlanta, GA 30333, U.S.A

USA.GovDHHS

Department of Health
and Human Services

This page last reviewed 5/2/01