CDC releases combined summary of notifiable infectious, noninfectious diseases

Beginning with the Oct. 23, 2015, Supplements to Morbidity and Mortality Weekly Report (MMWR), CDC will publish the summaries of all notifiable conditions – infectious and noninfectious – at the same time. Together, these two reports provide official statistics for all nationally notifiable conditions in the same MMWR volume.

Notifiable diseases and conditions are those for which regular, frequent, and timely information is necessary for prevention and control. Monitoring this data gives CDC and other public health authorities the ability to detect and respond to sudden changes in the occurrence and distribution of health threats. State and local health departments voluntarily submit the data to CDC.

“Tracking and responding to infectious and noninfectious diseases is a major part of CDC’s mission to protect America’s health,” said CDC Director Tom Frieden, M.D., M.P.H. “These annual summaries let us take the nation’s pulse and see where we are succeeding and what we need to do better.”

The reports being released are the Summary of Notifiable Infectious Diseases and Conditions — United States, 2013, and the Summary of Notifiable Noninfectious Conditions and Disease Outbreaks — United States. Together, the reports are referred to as the Summary (Infectious and Noninfectious). The reports were prepared by CDC in collaboration with the Council of State and Territorial Epidemiologists (CSTE).

The Summary (Infectious) summarizes data on dozens of nationally notifiable diseases and conditions in the United States.  Highlights include:

• West Nile virus (WNV) — In 2013, 47 states and the District of Columbia reported 2,469 cases of WNV disease – including 1,267 cases of WNV meningitis, encephalitis, and acute flaccid paralysis. There were 119 deaths. WNV disease incidence was similar to that during 2004-2007 but was higher than during 2008-2011.
• Chlamydia — In 2013, about 1.4 million cases of this sexually transmitted disease were reported – decrease of 1.5 percent from 4.46.6 to 453.3 cases per 100,000 population. This is the first time since national chlamydia reporting began that the overall rate declined – largely due to decreases among women. It is not clear whether the decrease is due to fewer chlamydia infections or to a drop in chlamydia screening.
• Valley fever (coccidioidomycosis) —This fungal infection caused by inhalation of spores present in the dry soil of the southwestern U.S. and California was recently detected in Washington State, far outside its usual range. The 9,438 reported cases in 2013 are a 47 percent decrease from 2012. Cases decreased by 55 percent in Arizona, which reports the most cases of any state, and by 27 percent in California. Despite the decrease, valley fever remains a major source of illness in affected areas.
• Cyclosporiasis — This intestinal illness is caused by a microscopic parasite lurking in contaminated food and water. In 2013, the largest number of outbreak-associated cases of cyclosporiasis – 784 -- was reported to CDC since 1997. At least two outbreaks were linked to fresh produce imported from Mexico (bagged salad mix and cilantro). But the vehicle of infection for more than two thirds of reported cases could not be determined. CDC is working to develop advanced molecular detection methods to link cases to specific sources of infection.
• Dengue — Spread by mosquitoes, dengue is a potentially serious viral infection. In 2013, dengue outbreaks occurred in Florida, Texas, and Puerto Rico. Epidemics in the Caribbean and in Central and South America resulted in 794 travel-associated cases – more than in previous years.
• Gonorrhea — U.S. cases of this sexually transmitted bacterial infection increased 8.8 percent from 2009 to 2012, but decreased slightly (by 0.6 percent) in 2013 to 106.1 cases per 100,000 population. Nationwide, the gonorrhea rate increased 4.3 percent among men and decreased 5.1 percent among women. Treatment for gonorrhea is complicated by the bacteria’s growing resistance to antibiotics.
• Influenza-associated pediatric deaths — From Dec. 30, 2012, to Dec. 28, 2013, CDC received reports of 161 deaths among people under the age 18 years – a more than three-fold increase compared with 2012, and a two-fold decrease compared with the pandemic year 2009. There were 69 pediatric deaths from seasonal influenza per calendar year during 2005-2012 and 358 pediatric deaths reported during the 2009-2010 flu pandemic.
• Measles — There were 10 measles outbreaks in 2013, accounting for three-fourths of reported cases. The three largest outbreaks accounted for more than half of cases. In each outbreak, measles spread after a U.S. resident who caught measles abroad introduced the extremely contagious viral infection into communities with pockets of people unvaccinated because of philosophical or religious beliefs.
• Meningococcal Disease — In 2013, U.S. rates of meningococcal disease continued to be at historic lows. However, there were serogroup B outbreaks at two universities – one in California and one in New Jersey – resulting in 13 cases and one death.
• Novel flu viruses —  In 2013, there were 21 cases of human infection with variant flu viruses in the U.S. – all associated with direct or indirect contact with swine. There were no human-to-human transmissions. Any public health laboratory that receives a suspicious specimen of flu virus – one that cannot be subtyped using standard methods -- immediately submits that specimen to CDC for further testing.
• Whooping cough (pertussis) — Reported pertussis cases decreased from 2012 to 2013. However, cases continue to exceed those reported during the 1990s and early 2000s.
• Salmonellosis —  Salmonella causes an estimated 1.2 million illnesses per year in the U.S. The largest multistate outbreak in 2013 was traced to contaminated chicken. Other notable outbreaks were linked to live poultry, tahini sesame paste, cucumbers, and small pet turtles.
• Hepatitis C (HCV) —  After receiving reports of about 800 to 1,000 cases of acute HCV infection per year from 2006-2010, there was an increase of 73.9 percent to 2,138 cases in 2013. Investigations show a marked increase in the number of acute cases of HCV among young, nonminority people who inject drugs, many of whom also abuse oral prescription opioid drugs.

The Summary (Noninfectious) summarizes data that has been added to the list of nationally notifiable conditions in the United States. Highlights in the 2015 report include:

• Acute occupational pesticide-related illness and injury. During 2007–2010, a total of 2,014 cases were identified in the 11 states [California, Florida, Iowa, Louisiana, Michigan, North Carolina, New Mexico (2007–2008 only), New York, Oregon, Texas, and Washington] reporting this data to the CDC’s Sentinel Event Notification System for Occupational Risks (SENSOR). Rates of illness and injury among agricultural industry workers (18.4/100,000) were 37 times greater than the rates for nonagricultural workers (0.5/100,000). Rates were highest in Washington.
• Elevated blood lead levels (BLLs) in adults. In U.S. adults, most lead exposures are occupational. In 2012, the vast majority of elevated BLLs were in men. The overall prevalence of elevated BLLs declined from 2010 to 2012.
• Childhood blood lead levels (BLLs). Permanent neurological damage and behavioral disorders in children have been linked to lead exposures at 5 μg/dL. The most common source of exposure in children is lead paint, which is easily inhaled or ingested by children when lead-based paint deteriorates into flakes, chips, or dust. In 2007, 38 states and New York City reported childhood BLL data to CDC; by 2012 that number was reduced to 29 states and New York City. Among states reporting this data for the entire period 2007-2012, the number of children with confirmed BLLs at or above 10 μg/dL declined. A summary of childhood lead exposure in 2013, the most recent year for which data are available, is available at http://www.cdc.gov/nceh/lead.
• Foodborne disease outbreaks.  During 1973-2012, CDC received reports of 29,429 foodborne disease outbreaks with 729,020 confirmed illnesses. An average of 736 outbreaks were reported each year.  A summary of foodborne disease outbreaks in 2013, the most recent year for which data are available, is available at http://www.cdc.gov/foodsafety/fdoss/data/annual-summaries/index.html.
• Waterborne disease outbreaks.  During 1971-2012, CDC received reports of 1,901 waterborne disease outbreaks with 639,949 associated illnesses. An average of 45 waterborne outbreaks are reported each year. CDC publishes detailed summaries of waterborne disease outbreaks – including those associated with recreational water and those associated with drinking water – at http://www.cdc.gov/healthywater/surveillance/surveillance-reports.html.

The MMWR Summaries of Nationally Notifiable Diseases is available at

https://www.cdc.gov/mmwr/mmwr_nd/index.html

The Official List of NNCs is available at: https://c.ymcdn.com/sites/cste.site-ym.com/resource/resmgr/CSTENotifiableConditionListA.pdf

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES