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Notice to Readers National Surveillance for Infectious Diseases, 1995

On October 13, CDC will release the annual Summary of Notifiable Diseases, United States, 1994 (1). A notifiable disease traditionally has been considered to be a condition for which regular, frequent, and timely information about individual cases is necessary for the prevention and control of the disease. During 1994, a total of 49 infectious diseases were considered notifiable at the national level and were reported to CDC; 41 were reported weekly, and eight were reported monthly.

During November 30-December 2, 1994, the Council of State and Territorial Epidemiologists (CSTE) and CDC held a conference to review the status of national infectious disease surveillance. At this conference, 10 diseases were proposed for deletion from the list of nationally notifiable diseases: amebiasis, aseptic meningitis, primary encephalitis (except for arboviral encephalitis), postinfectious encephalitis, granuloma inguinale, unspecified hepatitis, leptospirosis, lymphogranuloma venereum, rheumatic fever, and tularemia. In addition, nine diseases were proposed for addition to the list during 1995: genital Chlamydia trachomatis infections, coccidioidomycosis (for regional surveillance), cryptosporidiosis, hantavirus disease, (postdiarrheal) hemolytic uremic syndrome, pediatric infection with human immunodeficiency virus, invasive group A streptococcal infections, streptococcal toxic-shock syndrome, and drug-resistant Streptococcus pneumoniae invasive disease. These changes were approved by a vote of the full membership of CSTE in March 1995. However, these conditions are currently not reportable in all states, and the mechanism for reporting may not involve clinicians or consist of weekly reports of individual cases (i.e., traditional notification methods); rather, some may be reported directly by laboratories or in summary form on a monthly basis.

As of October 1, 1995, 52 infectious diseases were designated as notifiable at the national level (Table_1).

Reported by: Council of State and Territorial Epidemiologists. Div of Surveillance and Epidemiology, Epidemiology Program Office, CDC.

Editorial Note

Editorial Note: In 1878, Congress authorized the U.S. Marine Hospital Service (the precursor to the Public Health Service {PHS}) to collect morbidity reports on cholera, smallpox, plague, and yellow fever from U.S. consuls overseas; this information was used to implement quarantine measures to prevent the introduction and spread of these diseases into the United States. In 1879, Congress approved appropriations explicitly for the collection and publication of reports of these notifiable diseases. The authority for weekly reporting and publication was expanded by Congress in 1893 to include information from states and municipal authorities. To increase the uniformity of the data, Congress enacted a law in 1902 directing the Surgeon General to provide forms for the collection and compilation of data and for the publication of reports at the national level.

In 1912, state and territorial health authorities -- in conjunction with PHS -- recommended immediate telegraphic reporting of five infectious diseases and monthly reporting by letter of 10 additional diseases. The first annual summary of The Notifiable Diseases in 1912 included reports of 10 diseases from 19 states, the District of Columbia, and Hawaii. By 1928, all states, the District of Columbia, Hawaii, and Puerto Rico were participating in national reporting of nearly 30 specified conditions. At their meeting in 1950, the State and Territorial Health Officers authorized a conference of state and territorial epidemiologists whose purpose was to determine which diseases should be reported to PHS. In 1961, CDC assumed responsibility for the collection and publication of data on nationally notifiable diseases.

The list of nationally notifiable diseases is revised periodically. Diseases may be added to the list as new pathogens emerge and deleted as their incidence declines. Public health officials at state health departments and CDC collaborate in determining which diseases should be nationally notifiable; CSTE, in conjunction with CDC, makes recommendations annually for additions and deletions to the list of nationally notifiable diseases. However, reporting of nationally notifiable diseases to CDC by the states is voluntary. Reporting is currently mandated (by state legislation or regulation) only at the state level. Therefore, the list of diseases that are considered notifiable varies slightly by state. All states generally report the internationally quarantinable diseases (i.e., cholera, plague, and yellow fever) in compliance with the World Health Organization's International Health Regulations.

The Summary of Notifiable Diseases, United States, 1994 contains summary tables of the official statistics for the reported occurrence of nationally notifiable diseases during 1994. Data are presented in tables by month, geographic location, and patient age and race/ethnicity and in maps and graphs for many conditions. New features included in this year's annual summary include written highlights of important developments in the reported occurrences of selected nonnotifiable diseases, data from the Public Health Laboratory Information System, and short statements under each map or graph that underscore their important public health messages. Tables presenting historical notifiable disease data since 1945 and a table on deaths associated with specific notifiable diseases reported to CDC's National Center for Health Statistics also are included.


  1. CDC. Summary of notifiable diseases, United States, 1994. MMWR 1995; 43(no. 53).

Note: To print large tables and graphs users may have to change their printer settings to landscape and use a small font size.

TABLE 1. Infectious diseases designated as notifiable at the national
level * -- United States, 1995
Acquired immunodeficiency syndrome
Botulism +
Chancroid +
Chlamydia trachomatis, genital infections +
Coccidioidomycosis +
Congenital rubella syndrome
Congenital syphilis
Cryptosporidiosis +
Encephalitis, California +
Encephalitis, eastern equine +
Encephalitis, St. Louis +
Encephalitis, western equine +
Escherichia coli O157:H7 +
Haemophilus influenzae, invasive disease
Hansen disease (Leprosy)
Hantavirus disease +
Hepatitis A
Hepatitis B
Hepatitis, C/non-A, non-B
HIV infection, pediatric +
Lyme disease
Meningococcal disease
Rabies, animal
Rabies, human
Rocky Mountain spotted fever
Salmonellosis +
Shigellosis +
Streptococcal disease, invasive, Group A +
Streptococcus pneumoniae, drug-resistant +
Streptococcal toxic-shock syndrome +
Toxic-shock syndrome
Typhoid fever
Yellow fever +
* Although varicella is not a nationally notifiable disease, the Council
  of State and Territorial Epidemiologists recommends reporting of cases
  of this disease to CDC.
+ Not currently published in the weekly tables.

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