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Summary of Notifiable Diseases
United States 1999
Interpreting Data
The data reported in the 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) 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 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 and
ethnicity data also can be used to target populations for prevention
efforts. However, caution must be used when drawing conclusions from
reported race and ethnicity data. Certain racial/ethnic population
groups have differential patterns of access to health care, potentially
resulting in data that are not representative of disease incidence
in these populations.
In addition, not all race and 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.
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