Reportable Condition
is one where every case must be reported at the State level
What is a reliable source of information?
The CDC.
The CDC acquires information from many sources and makes data available as soon as possible.
Part of the process is controlled by State and Federal regulations.
What is a notifiable condition
-one in which data must be forwarded to the CDC
What is the data from the CDC published in?
- Weekly Reports (Morbidity and Mortality Weekly Report (MMWR)
- Annual Reports are available online and represent one of the most reliable sources of information
How is data reported?
- reported by actual case numbers and by incidence (newly diagnosed cases per 100,000 population)
- prevalence (number of existing cases per 100,000 population) is not reported
- infectious diseases are not distributed randomly across the population
- large differences are seen by age, race, geographic region and time of year
- for many non-reportable conditions, such as the common cold and mild food poisoning, the CDC operates surveillance systems that provide estimates of incidence
- it is helpful to know the overall incidence of the most prevalent conditions
Incidence of selected infectious conditions
- Common cold 25,000/100,000
- Gonorrhea 100/100,000
- Influenza 25/100,000
- AIDS 13/100,000
- Pneumonia 10/100,000
- Measles 0-1/100,000
Trends that can be readily seen in the 21st century
- continuing reductions especially of vaccine-preventable infections
- increase in pertussis, Legionella
SARS
- 2003 Severe Acute Respiratory Syndrome-started in China in the Hotel Metropole
- spread to Hong Kong, Taiwan, Canada
- attributed to an animal (Civet) coronavirus that mutated and adapted to humans
- one super-spreader was a physician
- about 8,000 infections worldwide
- number of total death worldwide: about 800
Swine flu
- 2009- H1N1-started in Mexico-spread rapidly world-wide despite quarantine and isolation efforts
- attributed to triple-recombination between human and animal influenza viruses
- number of total deaths worldwide: 250,000
MERS
- 2012-2014 Middle East Respiratory Sybdrome
- started in Saudi Arabia and then spread to neighboring countries
- attributed to one cornavirus that appeared in humans in 2011 by tracing the lineage
- also found in camels and bats
- one paramedic infected 10 others
- two US cases from visitors but no transmission
- total number of deaths worldwide: about 100
Type 2 Diabetes
- transmission resembles an infectious conditions
- modification of the microbiome of experimental animals can induce T2D
- patients have differences in intestinal microorganisms, but no specific pathogens have been found
- the annual incidence of newly-diagnosed cases is about 250/100,000 per yr
Unknown etiology and link to infectious disease
- in addition to these trends and pandemics, other conditions of unknown etiology may be due to infectious agents
- these include common conditions such as Alzheimer’s disease and Multiple Sclerosis
How is information about infectious diseases spread?
- from hospitals, physicians, laboratory directors, school nurses
- then to the State Dept of Health
- then to the CDC
- then to MMWR and the annual summary of notifiable diseases
Trends in Infectious Diseases
- TB- higher incidence in Asian/Pacific Islanders than other race/ethnicity
- Gonorrhea- sometimes difference in genders
- Dengue fever- there is a difference in ages, mostly the middle range
- Hepatitis- difference in incidence per year, same with legionella and pertussis
- Lyme Disease- difference of incidence in region, like its in the East
Proportion of the world population dying in one year from influenza pandemics
- Influenza pandemic of 1919: 3%
- Influenza pandemics of 1968: 0.03%
- Swine flu pandemic of 2009: 0.01%
