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Current Trends Changes in Notifiable Diseases Data Presentation

The next issue of MMWR (dated January 13, 1995 {volume 44, number 1}), will incorporate modifications to Tables I and II, Cases of Notifiable Diseases, United States. The purposes of these modifications are to improve the usefulness of notifiable diseases data (1,2) and to respond to changing priorities in notifiable disease surveillance. This report describes the rationale for data dissemination in Table I and Table II. Table I

Table I will present the cumulative number of cases of low-frequency diseases (in general, less than or equal to 500 cases per year) reported for the current year. In addition, Table I will present the reported number of cases of congenital syphilis, which currently is updated quarterly, and Haemophilus influenzae, for which serotype-specific information about the vaccine-preventable subgroup (serotype b) often is not reported. Data that will be deleted from Table I, but that will continue to be published in Table II, include the number of reported cases of acquired immunodeficiency syndrome (AIDS), gonorrhea, Lyme disease, measles, syphilis (primary and secondary), and tuberculosis. Publication of reports of cases of botulism will be discontinued in MMWR (weekly) but will be included in the Annual Summary of Notifiable Diseases.

Diseases proposed for deletion from the national notifiable diseases list by the Council of State and Territorial Epidemiologists (CSTE) at its National Surveillance Conference (November 30-December 2, 1994) include aseptic meningitis, primary encephalitis (except for arboviral encephalitis), postinfectious encephalitis, unspecified hepatitis, leptospirosis, and tularemia. These diseases had been published weekly; they will continue to be published in Table I until deletion is formally approved by CSTE. Table II

Table II will present high-frequency diseases (in general, greater than 500 cases per year) or selected diseases targeted by the national Childhood Immunization Initiative for elimination of indigenous transmission in the United States (3). Cumulative totals for both the current and immediately preceding years will be presented by state or territory. Table II also will present the number of cases of measles, pertussis, and rubella reported during the previous week. Reports of cases of imported measles previously included out-of-state cases but now will include only the number of cases believed to have resulted from importation from other countries. The category indigenous measles cases will include all other measles cases reported by the state or territory. Publication of reports of cases of three diseases -- tickborne typhus fever (Rocky Mountain spotted fever), toxic shock syndrome, and typhoid fever -- will be discontinued in Table II but will be included in Table I. Reported by: Council of State and Territorial Epidemiologists. Div of Surveillance and Epidemiology, Epidemiology Program Office, CDC.

Editorial Note

Editorial Note: National notifiable diseases data presented weekly in MMWR generally are transmitted through the National Electronic Telecommunications System for Surveillance (NETSS) (4); the exception is data on AIDS cases, which are transmitted through the human immunodeficiency virus/AIDS reporting system.

A key determinant for the changes in the table formats was the importance of listing the distribution of cases by state or region for high-frequency diseases and diseases targeted for national elimination. As a basis for comparison, cumulative totals for both current and past year (when available) will be presented for the diseases listed in Table II. The decision to change the classification of imported measles cases will facilitate tracking of cases imported from other countries. Weekly publication of NETSS data on botulism cases was not believed to be either timely or useful because an emergency botulism antitoxin surveillance system is already in place.

Although deletions and additions to the national notifiable diseases list generally are made during CSTE's annual meeting in the spring, the recent national surveillance conference focused on changes to the list. During that meeting, proposals also were tentatively approved for adding diseases to national public health surveillance, including genital chlamydia infections, coccidioidomycosis (recommended for regional surveillance), cryptosporidiosis, hantavirus infection, hemolytic uremic syndrome, invasive group A streptococcal infections, and drug-resistant Streptococcus pneumoniae. These additions have not yet been formally approved by CSTE.


  1. CDC. Update: changes in notifiable disease surveillance data -- United States, 1992-1993. MMWR 1993;42:824-6

  2. CDC. National notifiable diseases reporting -- United States, 1994. MMWR 1994;43:800-1.

  3. CDC. Reported vaccine-preventable diseases -- United States, 1993, and the Childhood Immunization Initiative. MMWR 1994;43:57-60.

  4. CDC. National Electronic Telecommunications System for Surveillance -- United States, 1990-1991. MMWR 1991;40;502-3.

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