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Research
Endemic, Notifiable Bioterrorism-Related
Diseases, United States, 1992–1999
Man-huei Chang,* M. Kathleen Glynn,* and Samuel L. Groseclose*
*Centers for Disease Control and Prevention, Atlanta, Georgia, USA
Table
1. Number of reported cases and number of states reporting conditions
caused by critical biological agents, National Notifiable Diseases
Surveillance System, United States, 1992–1999a,b |
|
Y
|
Anthrax
|
Botulism, foodborne
|
Botulism, Otherc
|
Brucellosis
|
Cholera
|
Encephalitis, eastern equine
|
Encephalitis, western equine
|
Plague
|
Tularemia
|
|
1992–1999
|
|
|
|
|
|
|
|
|
|
Total cases
|
1
|
223
|
148
|
813
|
223
|
29
|
1
|
77
|
885
|
1992
|
|
|
|
|
|
|
|
|
|
Cases
|
1
|
21
|
4
|
105
|
103
|
N
|
N
|
13
|
159
|
States reporting
|
1
|
8
|
2
|
22
|
12
|
N
|
N
|
7
|
26
|
States requiring reporting
|
52
|
52
|
52
|
52
|
52
|
N
|
N
|
52
|
52
|
1993
|
|
|
|
|
|
|
|
|
|
Cases
|
0
|
27
|
5
|
120
|
25
|
N
|
N
|
11
|
132
|
States reporting
|
0
|
10
|
3
|
23
|
11
|
N
|
N
|
4
|
24
|
States requiring reporting
|
52
|
52
|
52
|
52
|
52
|
N
|
N
|
52
|
52
|
1994
|
|
|
|
|
|
|
|
|
|
Cases
|
0
|
50
|
8
|
119
|
39
|
N
|
N
|
17
|
96
|
States reporting
|
0
|
11
|
1
|
21
|
14
|
N
|
N
|
5
|
29
|
States requiring reporting
|
52
|
52
|
52
|
52
|
52
|
N
|
N
|
52
|
51
|
1995
|
|
|
|
|
|
|
|
|
|
Cases
|
0
|
24
|
19
|
98
|
23
|
1
|
0
|
9
|
117
|
States reporting
|
0
|
9
|
4
|
24
|
14
|
1
|
0
|
4
|
24
|
States requiring reporting
|
52
|
52
|
52
|
52
|
52
|
U
|
U
|
51
|
N
|
1996
|
|
|
|
|
|
|
|
|
|
Cases
|
0
|
25
|
22
|
112
|
4
|
5
|
0
|
5
|
88
|
States reporting
|
0
|
10
|
4
|
29
|
4
|
4
|
0
|
3
|
24
|
States requiring reporting
|
52
|
52
|
51
|
52
|
52
|
U
|
U
|
52
|
N
|
1997
|
|
|
|
|
|
|
|
|
|
Cases
|
0
|
31
|
22
|
98
|
6
|
14
|
0
|
4
|
101
|
States reporting
|
0
|
8
|
5
|
26
|
5
|
6
|
0
|
3
|
24
|
States requiring reporting
|
50
|
52
|
51
|
51
|
51
|
U
|
U
|
51
|
N
|
1998
|
|
|
|
|
|
|
|
|
|
Cases
|
0
|
22
|
29
|
79
|
17
|
4
|
0
|
9
|
96
|
States reporting
|
0
|
6
|
2
|
27
|
7
|
4
|
0
|
4
|
22
|
States requiring reporting
|
52
|
52
|
51
|
50
|
52
|
48
|
48
|
50
|
U
|
1999
|
|
|
|
|
|
|
|
|
|
Cases
|
0
|
23
|
39
|
82
|
6
|
5
|
1
|
9
|
96
|
States reporting
|
0
|
8
|
5
|
18
|
5
|
2
|
1
|
2
|
27
|
States requiring reporting
|
52
|
52
|
52
|
51
|
52
|
48
|
49
|
51
|
U
|
|
aAbbreviations
used: N, not nationally notifiable; U, unknown. |
bReports from
50 U.S. states, Washington, D.C., and New York City. |
cIncludes wound
and unspecified botulism. |
Table
2. Reported cases of conditions caused by critical biologic agents,
by demographic characteristics and seasonal occurrence, National Notifiable
Disease Surveillance System, United States, 1992–1999a,b |
|
|
Botulism, foodborne
|
Botulism, otherc
|
Brucellosis
|
Cholera
|
Plague
|
Tularemiad
|
|
|
|
|
|
|
|
Demographic characteristics |
Cases (%)
|
Ratee
|
Cases (%)
|
Rate
|
Cases (%)
|
Rate
|
Cases (%)
|
Rate
|
Cases (%)
|
Rate
|
Cases (%)
|
Rate
|
|
Sex
|
|
|
|
|
|
|
|
|
|
|
|
|
Male
|
101 (45.3)
|
9.8
|
86 (58.1)
|
8.4
|
487 (59.9)
|
47.4
|
82 (36.8)
|
8.0
|
41 (53.2)
|
4.0
|
587 (66.3)
|
57.1
|
Female
|
120 (53.8)
|
11.2
|
61 (41.2)
|
5.7
|
316 (38.9)
|
29.4
|
83 (37.2)
|
7.7
|
32 (41.6)
|
3.0
|
291 (32.9)
|
27.1
|
Sex not stated
|
2 (0.9)
|
NC
|
1 (0.7)
|
NC
|
10 (1.2)
|
NC
|
58 (26.0)
|
NC
|
4 (5.2)
|
NC
|
7 (0.8)
|
NC
|
Age group (y)
|
|
|
|
|
|
|
|
|
|
|
|
|
<1
|
21 (9.4)
|
68.7
|
3 (2.0)
|
9.8
|
8 (1.0)
|
26.2
|
1 (0.4)
|
3.3
|
0 (0.0)
|
C
|
5 (0.6)
|
16.4
|
1–4
|
1 (0.4)
|
0.8
|
2 (1.4)
|
1.6
|
34 (4.2)
|
27.1
|
7 (3.1)
|
5.6
|
3 (3.9)
|
2.4
|
100 (11.3)
|
79.6
|
5–14
|
9 (4.0)
|
3.0
|
1 (0.7)
|
0.3
|
94 (11.6)
|
31.0
|
4 (1.8)
|
1.3
|
10 (13.0)
|
3.3
|
189 (21.4)
|
62.3
|
15–24
|
15 (6.7)
|
5.2
|
3 (2.0)
|
1.0
|
150 (18.5)
|
51.8
|
13 (5.8)
|
4.5
|
10 (13.0)
|
3.5
|
59 (6.7)
|
20.4
|
25–39
|
45 (20.2)
|
8.9
|
59 (39.9)
|
11.7
|
231 (28.4)
|
45.7
|
40 (17.9)
|
7.9
|
17 (22.1)
|
3.4
|
128 (14.5)
|
25.3
|
40–64
|
88 (39.5)
|
15.2
|
75 (50.7)
|
12.9
|
229 (28.2)
|
39.5
|
71 (31.8)
|
12.2
|
23 (29.9)
|
4.0
|
243 (27.5)
|
41.9
|
>65
|
36 (16.1)
|
13.4
|
4 (2.7)
|
1.5
|
58 (7.1)
|
21.6
|
30 (13.5)
|
11.2
|
13 (16.9)
|
4.8
|
141 (15.9)
|
52.5
|
Age not stated
|
8 (3.6)
|
NC
|
1 (0.7)
|
NC
|
9 (1.1)
|
NC
|
57 (25.6)
|
NC
|
1 (1.3)
|
NC
|
20 (2.3)
|
NC
|
Race
|
|
|
|
|
|
|
|
|
|
|
|
|
White
|
110 (49.3)
|
6.3
|
49 (33.1)
|
2.8
|
415 (51.0)
|
23.8
|
74 (33.2)
|
4.2
|
46 (59.7)
|
2.6
|
602 (68.0)
|
34.5
|
Black
|
2 (0.9)
|
0.8
|
5 (3.4)
|
1.9
|
53 (6.5)
|
20.0
|
3 (1.3)
|
1.1
|
0 (0)
|
NC
|
24 (2.7)
|
9.1
|
American Indian or Alaska Native
|
72 (32.3)
|
399.3
|
0 (0)
|
NC
|
1 (0.1)
|
5.6
|
0 (0)
|
NC
|
23 (29.9)
|
127.6
|
89 (10.1)
|
493.6
|
Asian or Pacific Islander
|
2 (0.9)
|
2.7
|
0 (0)
|
NC
|
10 (1.2)
|
13.3
|
21 (9.4)
|
28.0
|
0 (0)
|
NC
|
2 (0.2)
|
2.7
|
Other
|
1 (0.4)
|
NC
|
0 (0)
|
NC
|
7 (0.9)
|
NC
|
3 (1.3)
|
NC
|
0 (0)
|
NC
|
0 (0)
|
NC
|
Race not stated
|
36 (16.1)
|
NC
|
94 (63.5)
|
NC
|
327 (40.2)
|
NC
|
122 (54.7)
|
NC
|
8 (10.4)
|
NC
|
168 (19.0)
|
NC
|
Ethnicity
|
|
|
|
|
|
|
|
|
|
|
|
|
Hispanic
|
29 (13.0)
|
13.3
|
53 (35.8)
|
24.3
|
468 (57.6)
|
214.5
|
81 (36.3)
|
37.1
|
7 (9.1)
|
3.2
|
12 (1.4)
|
5.5
|
Non-Hispanic
|
113 (50.7)
|
6.0
|
66 (44.6)
|
3.5
|
143 (17.6)
|
7.6
|
56 (25.1)
|
3.0
|
62 (80.5)
|
3.3
|
407 (46.0)
|
21.6
|
Ethnicity not stated
|
81 (36.3)
|
NC
|
29 (19.6)
|
NC
|
202 (24.8)
|
NC
|
86 (38.6)
|
NC
|
8 (10.4)
|
NC
|
466 (52.7)
|
NC
|
Seasonal occurrencef,g
|
|
|
|
|
|
|
|
|
|
|
|
|
Spring
|
49 (22.0)
|
x
|
26 (17.6)
|
x
|
220 (27.1)
|
x
|
38 (17.0)
|
x
|
19 (24.7)
|
x
|
244 (27.6)
|
x
|
Summer
|
33 (14.8)
|
x
|
33 (22.2)
|
x
|
215 (26.4)
|
x
|
37 (16.6)
|
x
|
35 (45.5)
|
x
|
417 (47.1)
|
x
|
Fall
|
35 (15.7)
|
x
|
48 (32.4)
|
x
|
129 (15.9)
|
x
|
32 (14.3)
|
x
|
12 (15.6)
|
x
|
97 (11.0)
|
x
|
Winter
|
25 (11.2)
|
x
|
37 (25.0)
|
x
|
142 (17.5)
|
x
|
96 (43.0)
|
x
|
2 (2.6)
|
x
|
52 (5.9)
|
x
|
Eligible date not reported
|
81 (36.3)
|
x
|
4 (2.7)
|
x
|
107 (13.2)
|
x
|
20 (9.0)
|
x
|
9 (11.7)
|
x
|
75 (8.5)
|
x
|
Total
|
223 (100)
|
10.6
|
148 (100)
|
7.0
|
813 (100)
|
38.7
|
223 (100)
|
10.6
|
77 (100)
|
3.7
|
885 (100)
|
42.1
|
|
aAbbreviations
used: NC, not calculable; x, rate not calculated. |
bReports from
50 U.S. states, Washington D.C., and New York City. |
cIncludes wound
and unspecified botulism. |
dNot nationally
notifiable 1995–1998. |
eAverage annual
incidence rate. |
fIncludes data
reported using one of the following date types only: onset date, date
of diagnosis, or date of laboratory result. |
gSpring includes
March, April, and May; summer includes June, July, and August; fall
includes September, October, and November; winter includes December,
January, and February. |
|