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Summary of Notifiable Diseases
United States 1997
Interpreting Data
The data reported in this summary are useful for analyzing
disease trends and determining relative disease burdens. However, these
data must be interpreted in light of reporting practices. Some diseases
that cause severe clinical illness (e.g., plague and rabies), if diagnosed
by a clinician, are most likely reported accurately. However, persons
who have diseases that are clinically mild and infrequently associated
with serious consequences (e.g., salmonellosis) might not seek medical
care from a health-care provider. Even if these less severe diseases
are diagnosed, they are less likely to be reported. The degree of completeness
of reporting also is influenced by the diagnostic facilities available;
the control measures in effect; the public awareness of a specific
disease; and the interests, resources, and priorities of state and
local officials responsible for disease control and public health surveillance.
Finally, factors such as changes in the case definitions for public
health surveillance, the introduction of new diagnostic tests, or the
discovery of new disease entities can cause changes in disease reporting
that are independent of the true incidence of disease.
Public health surveillance data are published for selected
racial and ethnic population groups because these variables can be
risk markers for certain notifiable diseases. Risk markers can identify
potential risk factors for investigation in future studies. Data regarding
race and ethnicity also can be used to identify populations to target
for prevention efforts. However, one also must use caution when drawing
conclusions from reported data relating to race and ethnicity. Among
certain races and ethnicities, there are likely to be differential
patterns of access to health care, interest in seeking health care,
and detection of disease that would lead to data not representative
of disease incidence in these populations. In addition, not all data
concerning race and ethnicity are collected uniformly for all diseases.
For example, the Division of HIV/AIDS Prevention -- Surveillance and
Epidemiology and the Division of Sexually Transmitted Diseases Prevention
in the National Center for HIV, STD, and TB Prevention (NCHSTP) collect
information regarding race and ethnicity using a single variable. A
person's racial and ethnic background is reported as either American
Indian/Alaska Native, Asian/Pacific Islander, Black non-Hispanic, White
non-Hispanic, or Hispanic. Additionally, although the recommended standard
for classifying a person's race or ethnicity is based on self-reporting,
this procedure might not always be followed.
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