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Notice to Readers: Changes to National Notifiable Infectious Disease List and Data Presentation, as of January 2007

This issue of MMWR incorporates modifications to Table I (Provisional cases of infrequently reported notifiable diseases, United States), Table II (Provisional cases of selected notifiable diseases, United States), and Figure I (Selected notifiable disease reports, United States, comparison of provisional 4-week totals with historical data). This year, the modifications add conditions designated as nationally notifiable by the Council of State and Territorial Epidemiologists (CSTE) in conjunction with CDC (1,2).

Modifications to Table I and Table II

Two new conditions have been added to the list of nationally notifiable infectious diseases: nonparalytic poliovirus infection and vibriosis (non-cholera Vibrio species infections). Incidence data for both of these conditions will appear in Table I. The surveillance case definitions adopted for these conditions are listed within their respective CSTE position statements (1,2) and are posted to the case definitions section of the National Notifiable Diseases Surveillance System (NNDSS) website (3).

The CSTE position statement, "Enhancing local, state, and territorial-based surveillance for invasive pneumococcal disease in children less than five years of age" (4), includes reporting guidelines for the surveillance case definitions for drug-resistant Streptococcus pneumoniae invasive disease (DRSP) (event code 11720) and Streptococcus pneumoniae invasive disease in children aged <5 years (event code 11717). In the weekly NNDSS provisional data tables published in MMWR, DRSP data will be displayed in Table II in two columns: one column for DRSP of any age and a second column for DRSP in children aged <5 years.

Modifications to Figure I

Rubella has been deleted from Figure I and replaced with giardiasis. Rubella has been deleted because of low incidence and its designation as no longer endemic in the United States (5,6). Giardiasis, a gastrointestinal illness, is caused by the protozoan parasite Giardia intestinalis. This pathogen has a low infectious dose, protracted communicability, and moderate resistance to chlorine, which makes it ideally suited for transmission through drinking and recreational water, food, and both person-to-person and animal-to-person contact. Transmission of giardiasis occurs throughout the United States with a marked seasonality peaking in summer through early fall (7).


  1. CSTE. Position statement No. 06-ID-15. Inclusion of poliovirus infection reporting in the National Notifiable Diseases Surveillance System. Available at
  2. CSTE. Position statement No. 06-ID-05. National reporting for non-cholera Vibrio infections (Vibriosis). Available at
  3. CDC. Case definitions for nationally notifiable infectious diseases. Available at
  4. CSTE. Position statement No. 06-ID-14. Enhancing local, state, and territorial-based surveillance for invasive pneumococcal disease in children less than five years of age. Available at
  5. Averoff F, Zucker J, Vellozzi C, et al. Adequacy of surveillance to detect endemic rubella transmission in the United States. Clin Infect Dis 2006;43(Suppl 3):S152--7.
  6. CDC. Achievements in public health: elimination of rubella and congenital rubella syndrome---United States, 1969--2004. MMWR 2005; 54:279--82.
  7. Hlavsa MC, Watson JC, Beach MJ. Giardiasis surveillance---United States, 1998--2002. In: Surveillance summaries (January 28, 2004). MMWR 2004;53(No. SS-1):9--16.

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Date last reviewed: 1/11/2007


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