Morbidity and Mortality Weekly Report Weekly Published June 16, 2006, for 2004 / Vol. 53 / No. 53 Summary of Notifiable Diseases — United States, 2004 department of health and human services Centers for Disease Control and Prevention MMWR CONTENTS The MMWR series of publications is published by the Coordinating Center for Health Information and Service, Centers Preface .................................................................................2 for Disease Control and Prevention (CDC), U.S. Department of Background ..........................................................................2 Health and Human Services, Atlanta, GA 30333. Infectious Diseases Designated as Notifiable at the National SUGGESTED CITATION Level During 2004 ............................................................3 Centers for Disease Control and Prevention. Summary of Data Sources ........................................................................4 notifiable diseases—United States, 2004. Published June 16, 2006, for MMWR 2004;53(No. 53):[inclusive page Interpreting Data ..................................................................5 numbers]. Transition in NNDSS Data Collection and Reporting .............5 Highlights .............................................................................6 PART 1. Summaries of Notifiable Diseases in the United Centers for Disease Control and Prevention States, 2004 ................................................................... 17 Julie L. Gerberding, MD, MPH Director TABLE 1. Reported cases of notifiable diseases, by total cases, rank of the total cases, and rate (per 100,000 Dixie E. Snider, MD, MPH Chief Science Officer population) — United States, 2004 ..............................18 TABLE 2. Reported cases of notifiable diseases, by Tanja Popovic, MD, PhD geographic division and area — United States, 2004 ... 20 Associate Director for Science TABLE 3. Reported cases and incidence of notifiable Coordinating Center for Health Information and Service diseases, by age group — United States, 2004 ............29 Steven L. Solomon, MD TABLE 4. Reported cases and incidence of notifiable Director diseases, by sex — United States, 2004 ....................... 31 TABLE 5. Reported cases and incidence of notifiable National Center for Health Marketing diseases, by race — United States, 2004 ......................33 Jay M. Bernhardt, PhD, MPH Director TABLE 6. Reported cases and incidence of notifiable diseases, by ethnicity — United States, 2004 ............... 35 Division of Scientific Communications TABLE 7. Deaths from selected notifiable diseases — Judith R. Aguilar (Acting) Director United States, 2002 ..................................................... 37 PART 2. Graphs and Maps for Selected Notifiable Diseases Mary Lou Lindegren, MD Editor, MMWR Series in the United States, 2004 ..............................................39 Selected Reading ............................................................... 71 Suzanne M. Hewitt, MPA Managing Editor, MMWR Series Teresa F. Rutledge Lead Technical Writer/Editor Jeffrey D. Sokolow, MA Project Editor Lynda G. Cupell Visual Information Specialist Quang M. Doan, MBA Erica R. Shaver Information Technology Specialists Vol. 53 / No. 53 MMWR 1 Summary of Notifiable Diseases — United States, 2004 Prepared by Ruth Ann Jajosky, DMD Patsy A. Hall, Annual Summary Coordinator Deborah A. Adams Felicia J. Dawkins Pearl Sharp Willie J. Anderson J. Javier Aponte Gerald F. Jones David A. Nitschke Carol A. Worsham Nelson Adekoya, DrPH Timothy Doyle, MPH National Center for Public Health Informatics, Coordinating Center for Health Information and Service, CDC 2 MMWR June 16, 2006 Preface Background The Summary of Notifiable Diseases — United States, 2004 The infectious diseases designated as notifiable at the contains the official statistics, in tabular and graphic form, national level during 2004 are listed on page 3. A notifi- for the reported occurrence of nationally notifiable infec- able disease is one for which regular, frequent, and timely tious diseases in the United States for 2004. Unless other- information regarding individual cases is considered neces- wise noted, the data are final totals for 2004 reported as of sary for the prevention and control of the disease. A brief December 2, 2005. These statistics are collected and com- history of the reporting of nationally notifiable infectious piled from reports sent by state health departments to the diseases in the United States is available at http:// National Notifiable Diseases Surveillance System (NNDSS), www.cdc.gov/epo/dphsi/nndsshis.htm. In 1961, CDC which is operated by CDC in collaboration with the Coun- assumed responsibility for the collection and publication cil of State and Territorial Epidemiologists (CSTE). The of data on nationally notifiable diseases. NNDSS is neither Summary is available at http://www.cdc.gov/mmwr/ a single surveillance system nor a method of reporting. Cer- summary.html. This site also includes publications from tain NNDSS data are reported to CDC through separate previous years. surveillance information systems and through different The Highlights section presents noteworthy epidemio- reporting mechanisms; however, these data are aggregated logic and prevention information for 2004 for selected dis- and compiled for publication purposes. eases and additional information to aid in the interpretation The list of nationally notifiable diseases is revised peri- of surveillance and disease-trend data. Part 1 contains tables odically. A disease might be added to the list as a new patho- showing incidence data for the nationally notifiable dis- gen emerges, or a disease might be deleted as its incidence eases during 2004.* The tables provide the number of cases declines. Public health officials at state health departments reported to CDC for 2004 nationwide as well as the distri- and CDC collaborate in determining which diseases should bution of cases by geographic location and the patient’s be nationally notifiable. CSTE, with input from CDC, demographic characteristics (age, sex, race, and ethnicity). makes recommendations annually for additions and dele- Part 2 contains graphs and maps that depict summary data tions. Although disease reporting is mandated by legisla- for certain notifiable diseases described in tabular form in tion or regulation at the state and local levels, state reporting Part 1. The Selected Reading section presents general and to CDC is voluntary. Thus, the list of diseases considered disease-specific references for notifiable infectious diseases. notifiable varies slightly by state. Current and historic These references provide additional information on surveil- national public health surveillance case definitions used for lance and epidemiologic concerns, diagnostic concerns, and classifying and enumerating cases consistently across report- ing jurisdictions are available at http://www.cdc.gov/epo/ disease-control activities. dphsi/nndsshis.htm. Comments and suggestions from readers are welcome. To All states report conditions that were designated as inter- increase the usefulness of future editions, comments about nationally quarantinable and notifiable (i.e., cholera, plague, the current report and descriptions about how information and yellow fever) in compliance with the International is or could be used are invited. Comments should be sent Health Regulations (IHR) issued by the World Health to Public Health Surveillance Team — NNDSS, National Organization (WHO). In May 2005, the World Health Center for Public Health Informatics at [email protected]. Assembly adopted revised IHR. The current IHR will be replaced by the 2005 IHR when it becomes official on June * Because no cases of anthrax; diphtheria; influenza-associated pediatric mortality; 15, 2007, unless an earlier implementation date is adopted. paralytic poliomyelitis; rubella, congenital syndrome; severe acute respiratory syndrome–associated coronavirus (SARS-CoV) disease; smallpox; vancomycin- The 2005 IHR revision stipulates that smallpox, poliomy- intermediate Staphylococcus aureus; western equine encephalitis; or yellow fever elitis caused by wild-type poliovirus, human influenza caused were reported in the United States during 2004, these diseases do not appear in by a new subtype, and SARS-CoV are directly reportable the tables in Part 1. For certain other nationally notifiable diseases, incidence data were reported to CDC but are not included in the tables or graphs of this to WHO. In addition, the 2005 IHR includes an open- Summary. Data on chronic hepatitis B and hepatitis C virus infection (past or ended algorithm to determine which other conditions or present) are undergoing data quality review. Data on ehrlichiosis attributable to events require mandatory reporting to WHO because they other or unspecified agents are being withheld from publication pending the outcome of discussions about the reclassification of certain Ehrlichia species, might constitute a public health emergency of international which will probably affect how data in this category are reported. Data on concern. Conditions that use the algorithm to determine human immunodeficiency virus (HIV) infections are not included because notifiability include, but are not limited to, cholera, pneu- HIV infection (not acquired immunodeficiency syndrome [AIDS]) reporting has been implemented on different dates and by using different monic plague, yellow fever, and West Nile fever (1). methods than for AIDS case reporting;