"Summary of Notifiable Diseases, 2001"

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"Summary of Notifiable Diseases, 2001"
Tue, 05-13-2003 - 11:31pm
May 5, 2003


The Centers for Disease Control and Prevention (CDC) published

"Summary of Notifiable Diseases--United States, 2001" in the

May 2 "MMWR Summary of Notifiable Diseases."

The 136-page summary has three primary sections: Part 1:

Summaries of Notifiable Diseases in the United States, 2001;

Part 2: Graphs and Maps for Selected Notifiable Diseases in the

United States; and Part 3: Historical Summaries of Notifiable

Diseases in the United States, 1970-2001. The opening paragraph

of the preface follows:


The MMWR "Summary of Notifiable Diseases, United States, 2001"

contains, in tabular and graphic form, the official statistics

for the reported occurrence of nationally notifiable diseases in

the United States for 2001. These statistics are collected and

compiled from reports sent by state health departments to the

National Notifiable Diseases Surveillance System (NNDSS), which

is operated by CDC in collaboration with the Council of State

and Territorial Epidemiologists (CSTE).


To obtain the complete text of the summary online, go to:


Because the summary is a large file (1,201,152 bytes), printing

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To obtain a camera-ready (PDF format) copy of the summary, go

to: http://www.cdc.gov/mmwr/PDF/wk/mm5053.pdf


To obtain a free electronic subscription to the "Morbidity and

Mortality Weekly Report" (MMWR), visit CDC's MMWR website at:

http://www.cdc.gov/mmwr Select "Free Subscription" from the menu

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information, weekly issues of the MMWR and all new ACIP

statements (published as MMWR's "Recommendations and Reports")

will arrive automatically by email.


Some excerpts:

"Haemophilus influenzae, Invasive Disease

Since 1990, when Haemophilus influenzae type b (Hib) conjugate vaccines were licensed for use in infants beginning at age 2 months, Hib has become a rare cause of invasive disease (e.g., meningitis) among children aged <5 years in the United States (1). Surveillance information is used to monitor the effectiveness of immunization programs and vaccines and to assess progress toward disease elimination."

"Hepatitis A vaccine is recommended for persons at increased risk of acquiring hepatitis A (e.g., illegal drug users, men who have sex with men ) and also for children in states and counties that have historically had consistently elevated rates of hepatitis A (1). After routine childhood vaccination was recommended, the overall hepatitis A rate has declined steadily, and in 2001 it was the lowest yet recorded (4.0/100,000). Because hepatitis A rates tend to vary from year to year and from region to region, continued monitoring of hepatitis A incidence is needed to determine whether this low rate is due to routine immunization or natural variability in infection rates. However, declines in rates have been greater among children and in the states where routine childhood vaccination is recommended, suggesting an impact of childhood vaccination."

"Hepatitis B

During 2001, a total of 7,843 acute hepatitis B cases were reported, representing a >60% decrease since 1990 (21,102 cases). Surveillance data are being used to monitor the impact of the national strategy for eliminating hepatitis B virus (HBV) infection. Healthy People 2010 objectives call for a 75%–90% reduction in the national incidence of hepatitis B among adults (baseline: 15–24 cases/100,000), a 99% reduction among children aged 2–18 years (baseline: 945 cases/year), and a 75% reduction in the number of perinatal HBV infections (baseline: 1,682 infections/year) (1). The effect of routine infant and adolescent vaccination can already be seen in the declining rate of disease among persons aged <19 years. In contrast, the continued high incidence among persons in other risk groups for which vaccination is recommended, e.g., injection drug users and persons engaging in high-risk sexual behaviors, indicates that programs for reaching these populations need to be developed or strengthened."


A total of 116 confirmed measles cases were reported in 2001; cases occurred in 22 states. Fifty-four of the cases were internationally imported, and exposure to these cases resulted in 25 additional cases. Twelve other cases had virologic evidence of importation (i.e., genotypic analysis of measles viruses indicated an imported source). The remaining 25 cases were classified as unknown source cases because no link to importation was detected. The majority of confirmed measles cases (61 cases) occurred in persons aged >20 years; 29 cases occurred in persons 5–19 years, and 26 occurred in children aged <5 years. Ten outbreaks, ranging in size from 3 to 14 cases, accounted for 49% of cases (n = 57). All 10 outbreaks were linked to international importation; nine had an epidemiologic link to imported cases and one had virologic evidence of importation."


Because of the recommendation of two doses of Measles/Mumps/Rubella vaccine and its high coverage rate in the United States, mumps is at record low levels. During the 1990s, mumps cases declined substantially, from 5,292 reported cases in 1990 to 266 reported cases in 2001, meeting the Healthy People 2000 objective of <500 cases per year (1)."


During 2001, a total of 7,580 cases of pertussis were reported. Of these, 22% occurred among infants aged <6 months, who were too young to have received the recommended three doses of diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccine; 3% occurred among children aged 6–11 months; 13% among preschool-aged children (i.e., those aged 1–4 years); 10% among children aged 5–9 years; 30% among persons aged 10–19 years; and 22% among persons aged >20 years.

Since 1995, the coverage rate with >3 doses of a pertussis-containing vaccine has been >94% among U.S. children aged 19–35 months (1). Since 1980, the number of reported cases of pertussis in infants aged <7 months and in adolescents and adults has increased markedly in some states (2). The reasons for this rise are unknown but could include increased awareness of pertussis among health-care providers, increased use of more sensitive diagnostic tests, better reporting of cases to health departments, and possibly an increase in circulating pertussis. In contrast, the incidence of reported pertussis among children aged 7 months to 9 years has not increased markedly and suggests protection against pertussis. Adolescents and adults can become susceptible to disease because vaccine-induced immunity is believed to wane approximately 5– 10 years after pertussis vaccination."


Because of the success of the U.S. rubella vaccination program, rubella is at a record low level, with 23 reported cases in 2001. Rubella now mostly occurs among adults born in countries that do not have routine rubella vaccination programs or that have only recently implemented such programs. In 2000 and 2001, 10 mothers of the 11 children with reported congenital rubella syndrome were foreign-born Hispanics."


In 2001, 37 cases of tetanus were reported from 15 states. Four (10.8%) cases were among persons aged <25 years, 19 (51.4%) cases were among persons aged 25–59 years, and 14 (37.8%) cases were among persons aged >60 years. The percentage of cases among persons aged 25–59 years has increased during the last decade; previously, most cases were among persons aged >60 years (1). One neonatal case with an atypical presentation of tetanus was reported from California. The mother of the infant was foreign born and had an unknown vaccination status. The infant recovered after 30 days of hospitalization. Six (16.7%) of the non- neonatal cases were fatal."