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Summary of Notifiable Diseases
United States 1996
Interpreting Data
The data reported in this summary are useful for analyzing
disease trends and determining relative disease burdens. However, these
data must be interpreted in light of reporting practices. Some diseases
that cause severe clinical illness (e.g., plague or rabies), if diagnosed
by a clinician, are most likely reported accurately. However, persons
who have diseases that are clinically mild and infrequently associated
with serious consequences (e.g., salmonellosis) may not even seek medical
care from a health-care provider; even if these less severe diseases
are diagnosed, they are less likely to be reported. The degree of completeness
of reporting also is influenced by the diagnostic facilities that are
available; the control measures that are in effect; the public awareness
of a specific disease; and the interests, resources, and priorities
of state and local officials responsible for disease control and public
health surveillance. Finally, factors such as changes in the case definitions
for public health surveillance, the introduction of new diagnostic
tests, or the discovery of new disease entities may cause changes in
disease reporting that are independent of the true incidence of disease.
Public health surveillance data are published for selected
racial and ethnic population groups because these variables may be
risk markers for certain notifiable diseases. Risk markers can identify
potential risk factors for investigation in future studies. Data regarding
race and ethnicity also can be useful for identifying groups to target
for prevention efforts. However, caution must also be used when drawing
conclusions from reported data relating to race and ethnicity. Among
certain races and ethnicities, there are likely to be differential
patterns of access to health care, interest in seeking health care,
and detection of disease that would lead to data that are not representative
of disease incidence in these populations. In addition, not all data
concerning race and ethnicity are collected uniformly for all diseases.
For example, the Division of HIV/AIDS Prevention, Surveillance, and
Epidemiology and the Division of Sexually Transmitted Diseases Prevention
in NCHSTP collect information regarding race and ethnicity using a
single variable. A person's racial and ethnic background is reported
as either American Indian/Alaska Native, Asian/Pacific Islander, black
non-Hispanic, white non-Hispanic, or Hispanic. Additionally, although
the recommended standard for classifying a person's race or ethnicity
is based on self-reporting, this procedure may not always be followed.
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