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.
References
CDC. Update: changes in notifiable disease surveillance data --
United States, 1992-1993. MMWR 1993;42:824-6
CDC. National notifiable diseases reporting -- United States,
1994. MMWR 1994;43:800-1.
CDC. Reported vaccine-preventable diseases -- United States,
1993,
and the Childhood Immunization Initiative. MMWR 1994;43:57-60.
CDC. National Electronic Telecommunications System for
Surveillance -- United States, 1990-1991. MMWR 1991;40;502-3.
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