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|
Research
Endemic, Notifiable Bioterrorism-Related
Diseases, United States, 1992–1999
Man-huei Chang,* M. Kathleen Glynn,* and Samuel L. Groseclose*
*Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| Table
1. Number of reported cases and number of states reporting conditions
caused by critical biological agents, National Notifiable Diseases
Surveillance System, United States, 1992–1999a,b |
|
|
Y
|
Anthrax
|
Botulism, foodborne
|
Botulism, Otherc
|
Brucellosis
|
Cholera
|
Encephalitis, eastern equine
|
Encephalitis, western equine
|
Plague
|
Tularemia
|
|
|
1992–1999
|
|
|
|
|
|
|
|
|
|
Total cases
|
1
|
223
|
148
|
813
|
223
|
29
|
1
|
77
|
885
|
|
1992
|
|
|
|
|
|
|
|
|
|
Cases
|
1
|
21
|
4
|
105
|
103
|
N
|
N
|
13
|
159
|
States reporting
|
1
|
8
|
2
|
22
|
12
|
N
|
N
|
7
|
26
|
States requiring reporting
|
52
|
52
|
52
|
52
|
52
|
N
|
N
|
52
|
52
|
|
1993
|
|
|
|
|
|
|
|
|
|
Cases
|
0
|
27
|
5
|
120
|
25
|
N
|
N
|
11
|
132
|
States reporting
|
0
|
10
|
3
|
23
|
11
|
N
|
N
|
4
|
24
|
States requiring reporting
|
52
|
52
|
52
|
52
|
52
|
N
|
N
|
52
|
52
|
|
1994
|
|
|
|
|
|
|
|
|
|
Cases
|
0
|
50
|
8
|
119
|
39
|
N
|
N
|
17
|
96
|
States reporting
|
0
|
11
|
1
|
21
|
14
|
N
|
N
|
5
|
29
|
States requiring reporting
|
52
|
52
|
52
|
52
|
52
|
N
|
N
|
52
|
51
|
|
1995
|
|
|
|
|
|
|
|
|
|
Cases
|
0
|
24
|
19
|
98
|
23
|
1
|
0
|
9
|
117
|
States reporting
|
0
|
9
|
4
|
24
|
14
|
1
|
0
|
4
|
24
|
States requiring reporting
|
52
|
52
|
52
|
52
|
52
|
U
|
U
|
51
|
N
|
|
1996
|
|
|
|
|
|
|
|
|
|
Cases
|
0
|
25
|
22
|
112
|
4
|
5
|
0
|
5
|
88
|
States reporting
|
0
|
10
|
4
|
29
|
4
|
4
|
0
|
3
|
24
|
States requiring reporting
|
52
|
52
|
51
|
52
|
52
|
U
|
U
|
52
|
N
|
|
1997
|
|
|
|
|
|
|
|
|
|
Cases
|
0
|
31
|
22
|
98
|
6
|
14
|
0
|
4
|
101
|
States reporting
|
0
|
8
|
5
|
26
|
5
|
6
|
0
|
3
|
24
|
States requiring reporting
|
50
|
52
|
51
|
51
|
51
|
U
|
U
|
51
|
N
|
|
1998
|
|
|
|
|
|
|
|
|
|
Cases
|
0
|
22
|
29
|
79
|
17
|
4
|
0
|
9
|
96
|
States reporting
|
0
|
6
|
2
|
27
|
7
|
4
|
0
|
4
|
22
|
States requiring reporting
|
52
|
52
|
51
|
50
|
52
|
48
|
48
|
50
|
U
|
|
1999
|
|
|
|
|
|
|
|
|
|
Cases
|
0
|
23
|
39
|
82
|
6
|
5
|
1
|
9
|
96
|
States reporting
|
0
|
8
|
5
|
18
|
5
|
2
|
1
|
2
|
27
|
States requiring reporting
|
52
|
52
|
52
|
51
|
52
|
48
|
49
|
51
|
U
|
|
| aAbbreviations
used: N, not nationally notifiable; U, unknown. |
| bReports from
50 U.S. states, Washington, D.C., and New York City. |
| cIncludes wound
and unspecified botulism. |
| Table
2. Reported cases of conditions caused by critical biologic agents,
by demographic characteristics and seasonal occurrence, National Notifiable
Disease Surveillance System, United States, 1992–1999a,b |
|
|
|
Botulism, foodborne
|
Botulism, otherc
|
Brucellosis
|
Cholera
|
Plague
|
Tularemiad
|
| |
|
|
|
|
|
|
| Demographic characteristics |
Cases (%)
|
Ratee
|
Cases (%)
|
Rate
|
Cases (%)
|
Rate
|
Cases (%)
|
Rate
|
Cases (%)
|
Rate
|
Cases (%)
|
Rate
|
|
Sex
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Male
|
101 (45.3)
|
9.8
|
86 (58.1)
|
8.4
|
487 (59.9)
|
47.4
|
82 (36.8)
|
8.0
|
41 (53.2)
|
4.0
|
587 (66.3)
|
57.1
|
|
Female
|
120 (53.8)
|
11.2
|
61 (41.2)
|
5.7
|
316 (38.9)
|
29.4
|
83 (37.2)
|
7.7
|
32 (41.6)
|
3.0
|
291 (32.9)
|
27.1
|
|
Sex not stated
|
2 (0.9)
|
NC
|
1 (0.7)
|
NC
|
10 (1.2)
|
NC
|
58 (26.0)
|
NC
|
4 (5.2)
|
NC
|
7 (0.8)
|
NC
|
|
Age group (y)
|
|
|
|
|
|
|
|
|
|
|
|
|
|
<1
|
21 (9.4)
|
68.7
|
3 (2.0)
|
9.8
|
8 (1.0)
|
26.2
|
1 (0.4)
|
3.3
|
0 (0.0)
|
C
|
5 (0.6)
|
16.4
|
|
1–4
|
1 (0.4)
|
0.8
|
2 (1.4)
|
1.6
|
34 (4.2)
|
27.1
|
7 (3.1)
|
5.6
|
3 (3.9)
|
2.4
|
100 (11.3)
|
79.6
|
|
5–14
|
9 (4.0)
|
3.0
|
1 (0.7)
|
0.3
|
94 (11.6)
|
31.0
|
4 (1.8)
|
1.3
|
10 (13.0)
|
3.3
|
189 (21.4)
|
62.3
|
|
15–24
|
15 (6.7)
|
5.2
|
3 (2.0)
|
1.0
|
150 (18.5)
|
51.8
|
13 (5.8)
|
4.5
|
10 (13.0)
|
3.5
|
59 (6.7)
|
20.4
|
|
25–39
|
45 (20.2)
|
8.9
|
59 (39.9)
|
11.7
|
231 (28.4)
|
45.7
|
40 (17.9)
|
7.9
|
17 (22.1)
|
3.4
|
128 (14.5)
|
25.3
|
|
40–64
|
88 (39.5)
|
15.2
|
75 (50.7)
|
12.9
|
229 (28.2)
|
39.5
|
71 (31.8)
|
12.2
|
23 (29.9)
|
4.0
|
243 (27.5)
|
41.9
|
|
>65
|
36 (16.1)
|
13.4
|
4 (2.7)
|
1.5
|
58 (7.1)
|
21.6
|
30 (13.5)
|
11.2
|
13 (16.9)
|
4.8
|
141 (15.9)
|
52.5
|
|
Age not stated
|
8 (3.6)
|
NC
|
1 (0.7)
|
NC
|
9 (1.1)
|
NC
|
57 (25.6)
|
NC
|
1 (1.3)
|
NC
|
20 (2.3)
|
NC
|
|
Race
|
|
|
|
|
|
|
|
|
|
|
|
|
|
White
|
110 (49.3)
|
6.3
|
49 (33.1)
|
2.8
|
415 (51.0)
|
23.8
|
74 (33.2)
|
4.2
|
46 (59.7)
|
2.6
|
602 (68.0)
|
34.5
|
|
Black
|
2 (0.9)
|
0.8
|
5 (3.4)
|
1.9
|
53 (6.5)
|
20.0
|
3 (1.3)
|
1.1
|
0 (0)
|
NC
|
24 (2.7)
|
9.1
|
|
American Indian or Alaska Native
|
72 (32.3)
|
399.3
|
0 (0)
|
NC
|
1 (0.1)
|
5.6
|
0 (0)
|
NC
|
23 (29.9)
|
127.6
|
89 (10.1)
|
493.6
|
|
Asian or Pacific Islander
|
2 (0.9)
|
2.7
|
0 (0)
|
NC
|
10 (1.2)
|
13.3
|
21 (9.4)
|
28.0
|
0 (0)
|
NC
|
2 (0.2)
|
2.7
|
|
Other
|
1 (0.4)
|
NC
|
0 (0)
|
NC
|
7 (0.9)
|
NC
|
3 (1.3)
|
NC
|
0 (0)
|
NC
|
0 (0)
|
NC
|
|
Race not stated
|
36 (16.1)
|
NC
|
94 (63.5)
|
NC
|
327 (40.2)
|
NC
|
122 (54.7)
|
NC
|
8 (10.4)
|
NC
|
168 (19.0)
|
NC
|
|
Ethnicity
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Hispanic
|
29 (13.0)
|
13.3
|
53 (35.8)
|
24.3
|
468 (57.6)
|
214.5
|
81 (36.3)
|
37.1
|
7 (9.1)
|
3.2
|
12 (1.4)
|
5.5
|
|
Non-Hispanic
|
113 (50.7)
|
6.0
|
66 (44.6)
|
3.5
|
143 (17.6)
|
7.6
|
56 (25.1)
|
3.0
|
62 (80.5)
|
3.3
|
407 (46.0)
|
21.6
|
|
Ethnicity not stated
|
81 (36.3)
|
NC
|
29 (19.6)
|
NC
|
202 (24.8)
|
NC
|
86 (38.6)
|
NC
|
8 (10.4)
|
NC
|
466 (52.7)
|
NC
|
|
Seasonal occurrencef,g
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Spring
|
49 (22.0)
|
x
|
26 (17.6)
|
x
|
220 (27.1)
|
x
|
38 (17.0)
|
x
|
19 (24.7)
|
x
|
244 (27.6)
|
x
|
|
Summer
|
33 (14.8)
|
x
|
33 (22.2)
|
x
|
215 (26.4)
|
x
|
37 (16.6)
|
x
|
35 (45.5)
|
x
|
417 (47.1)
|
x
|
|
Fall
|
35 (15.7)
|
x
|
48 (32.4)
|
x
|
129 (15.9)
|
x
|
32 (14.3)
|
x
|
12 (15.6)
|
x
|
97 (11.0)
|
x
|
|
Winter
|
25 (11.2)
|
x
|
37 (25.0)
|
x
|
142 (17.5)
|
x
|
96 (43.0)
|
x
|
2 (2.6)
|
x
|
52 (5.9)
|
x
|
|
Eligible date not reported
|
81 (36.3)
|
x
|
4 (2.7)
|
x
|
107 (13.2)
|
x
|
20 (9.0)
|
x
|
9 (11.7)
|
x
|
75 (8.5)
|
x
|
|
Total
|
223 (100)
|
10.6
|
148 (100)
|
7.0
|
813 (100)
|
38.7
|
223 (100)
|
10.6
|
77 (100)
|
3.7
|
885 (100)
|
42.1
|
|
| aAbbreviations
used: NC, not calculable; x, rate not calculated. |
| bReports from
50 U.S. states, Washington D.C., and New York City. |
| cIncludes wound
and unspecified botulism. |
| dNot nationally
notifiable 1995–1998. |
| eAverage annual
incidence rate. |
| fIncludes data
reported using one of the following date types only: onset date, date
of diagnosis, or date of laboratory result. |
| gSpring includes
March, April, and May; summer includes June, July, and August; fall
includes September, October, and November; winter includes December,
January, and February. |
|
