Nationally Notifiable Infectious Diseases and Conditions, United States: Annual Tables

TABLE 6. Annual reported cases of notifiable diseases and rates, by race*,†,§, United States, excluding U.S. Territories and Non-U.S. Residents, 2020
Data from some reporting areas may be incomplete due to the coronavirus disease 2019 (COVID-19) pandemic or due to post-reconciliation data updates that could not be confirmed or included in the final data set. Please see Note #9 and Note #10, respectively.
Disease American Indian or
Alaska Native		 Asian or Pacific
Islander		 Black or
African American		 White Other or Multi-Race Race not stated Total
No. Rate No. Rate No. Rate No. Rate No. No. No.
Anthrax S S S S S S S S S S 1
Arboviral diseases
Chikungunya virus disease — — 6 0.03 5 0.01 6 0.00 6 14 37
Eastern equine encephalitis virus disease
Neuroinvasive S S S S S S S S S S 13
Non-neuroinvasive — — — — — — — — — — —
Jamestown Canyon virus disease
Neuroinvasive S S S S S S S S S S 10
Non-neuroinvasive S S S S S S S S S S 3
La Crosse virus disease
Neuroinvasive — — — — 1 0.00 68 0.03 2 13 84
Non-neuroinvasive S S S S S S S S S S 4
Powassan virus disease
Neuroinvasive S S S S S S S S S S 19
Non-neuroinvasive S S S S S S S S S S 1
St. Louis encephalitis virus disease
Neuroinvasive S S S S S S S S S S 14
Non-neuroinvasive S S S S S S S S S S 2
West Nile virus disease
Neuroinvasive 5 0.10 11 0.05 32 0.07 421 0.17 45 44 558
Non-neuroinvasive 1 0.02 5 0.02 1 0.00 119 0.05 14 32 172
Western equine encephalitis virus disease
Neuroinvasive — — — — — — — — — — —
Non-neuroinvasive — — — — — — — — — — —
Babesiosis
Total 3 0.08 50 0.26 31 0.08 1,077 0.49 90 569 1,820
Confirmed 3 0.08 47 0.24 26 0.07 972 0.44 87 496 1,631
Probable — — 3 0.02 5 0.01 105 0.05 3 73 189
Botulism
Total 1 0.02 15 0.07 8 0.02 114 0.04 23 28 189
Foodborne S S S S S S S S S S 8
Infant 1 1.21 13 4.93 8 1.19 87 3.20 14 23 146
Other (wound & unspecified) — — 1 0.00 — — 22 0.01 8 4 35
Brucellosis 1 0.02 5 0.02 1 0.00 54 0.02 15 11 87
Campylobacteriosis 500 10.21 1,241 5.54 2,726 5.78 31,825 12.48 5,350 10,122 51,764
Candida auris, clinical ** 1 0.02 14 0.06 94 0.22 89 0.04 14 43 255
Carbapenemase-producing carbapenem-resistant Enterobacteriaceae 15 0.32 68 0.32 353 0.84 696 0.30 104 612 1,848
Chancroid — — — — — — — — — — —
Chlamydia trachomatis infection 16,132 329.26 20,925 93.36 452,005 958.02 450,422 176.64 111,049 529,304 1,579,837
Cholera S S S S S S S S S S 1
Coccidioidomycosis 329 12.79 456 4.28 640 3.98 6,197 5.58 4,061 7,537 19,220
Coronavirus Disease 2019 (COVID-19)
Total 220,844 4,507.49 590,863 2,636.16 2,141,358 4,538.58 10,360,697 4,063.18 2,504,616 5,331,353 21,149,731
Confirmed 203,341 4,150.25 556,198 2,481.50 1,986,358 4,210.06 9,190,005 3,604.07 2,380,343 4,863,111 19,179,356
Probable †† 17,503 357.24 34,665 154.66 155,000 328.52 1,170,692 459.11 124,273 468,242 1,970,375
Cryptosporidiosis
Total 54 1.10 84 0.37 581 1.23 5,265 2.06 438 1,226 7,648
Confirmed 40 0.82 65 0.29 457 0.97 3,957 1.55 356 986 5,861
Probable 14 0.29 19 0.08 124 0.26 1,308 0.51 82 240 1,787
Cyclosporiasis 19 0.45 20 0.09 95 0.22 1,843 0.80 143 569 2,689
Dengue virus infections §§
Dengue — — 25 0.11 17 0.04 263 0.10 55 81 441
Dengue-like illness S S S S S S S S S S 9
Severe dengue — — — — — — — — — — —
Diphtheria S S S S S S S S S S 1
Ehrlichiosis and Anaplasmosis
Anaplasma phagocytophilum infection 10 0.23 16 0.08 18 0.04 2,386 0.97 156 1,051 3,637
Ehrlichia chaffeensis infection 1 0.02 15 0.07 36 0.08 838 0.34 56 232 1,178
Ehrlichia ewingii infection S S S S S S S S S S 21
Undetermined ehrlichiosis/anaplasmosis — — — — 2 0.00 37 0.02 1 10 50
Giardiasis 74 1.96 193 1.01 568 1.59 5,214 2.61 1,116 2,288 9,453
Gonorrhea 8,923 182.12 7,398 33.01 274,869 582.58 186,552 73.16 42,432 157,577 677,751
Haemophilus influenzae, invasive disease
All ages, all serotypes 36 0.73 30 0.13 470 1.00 1,905 0.75 132 423 2,996
Age <5 years
Serotype b S S S S S S S S S S 15
Non-b serotype 4 0.97 — — 15 0.44 41 0.29 2 14 76
Nontypeable 3 0.72 — — 23 0.67 53 0.38 7 18 104
Unknown serotype 2 0.04 2 0.01 20 0.04 73 0.03 8 16 121
Hansen's disease — — 16 0.08 3 0.01 30 0.01 6 13 68
Hantavirus infection, non-hantavirus pulmonary syndrome ¶¶ S S S S S S S S S S 2
Hantavirus pulmonary syndrome S S S S S S S S S S 14
Hemolytic uremic syndrome post-diarrheal 2 0.04 5 0.02 7 0.01 124 0.05 12 17 167
Hepatitis, Viral Disease ***
Hepatitis A 60 1.22 96 0.43 703 1.49 8,022 3.15 302 763 9,946
Hepatitis B
Acute 10 0.20 52 0.23 317 0.68 1,485 0.59 110 181 2,155
Perinatal infection S S S S S S S S S S 10
Hepatitis C
Acute 66 1.52 89 0.41 553 1.20 4,261 1.72 331 725 6,025
Confirmed 51 1.18 78 0.36 473 1.02 3,290 1.33 291 615 4,798
Probable 15 0.35 11 0.05 80 0.17 971 0.39 40 110 1,227
Perinatal infection — — 3 0.40 5 0.27 109 1.48 11 37 165
Human immunodeficiency virus diagnoses 164 3.35 571 2.55 11,011 23.34 6,653 2.61 6,608 — 25,007
Influenza-associated pediatric mortality 5 0.35 14 0.28 32 0.26 98 0.18 1 21 171
Invasive pneumococcal disease †††
All ages 265 8.66 160 1.23 1,884 4.85 6,931 3.63 476 2,230 11,946
Confirmed 252 8.24 160 1.23 1,863 4.80 6,813 3.56 464 2,166 11,718
Probable 13 0.42 — — 21 0.05 118 0.06 12 64 228
Age <5 years 12 0.33 14 0.10 103 0.25 294 0.14 31 107 561
Confirmed 11 3.56 14 1.54 101 3.37 276 2.44 30 104 536
Probable 1 0.32 — — 2 0.07 18 0.16 1 3 25
Legionellosis §§§ 22 0.45 87 0.39 1,297 2.75 3,970 1.56 444 490 6,310
Leptospirosis — — 4 0.02 2 0.01 28 0.01 8 9 51
Listeriosis ¶¶¶
Total 6 0.12 56 0.25 61 0.13 499 0.20 76 82 780
Confirmed 6 0.12 53 0.24 58 0.12 488 0.19 71 78 754
Probable — — 3 0.01 3 0.01 11 0.00 5 4 26
Lyme disease
Total 22 0.45 132 0.61 167 0.35 9,785 3.84 325 7,569 18,000
Confirmed 11 0.22 73 0.34 96 0.20 6,528 2.56 218 5,197 12,123
Probable 11 0.22 59 0.27 71 0.15 3,257 1.28 107 2,372 5,877
Malaria — — 22 0.10 371 0.79 80 0.03 57 73 603
Measles ****
Total S S S S S S S S S S 12
Indigenous S S S S S S S S S S 6
Imported S S S S S S S S S S 6
Meningococcal disease
All serogroups 3 0.06 2 0.01 57 0.12 126 0.05 16 38 242
Serogroups ACWY 1 0.02 1 0.00 20 0.04 44 0.02 8 6 80
Serogroup B 1 0.02 — — 6 0.01 23 0.01 2 8 40
Other serogroups — — — — 4 0.01 11 0.00 — 1 16
Unknown serogroup 1 0.02 1 0.00 27 0.06 48 0.02 6 23 106
Mumps 3 0.06 55 0.25 40 0.08 323 0.13 30 243 694
Novel Influenza A virus infections — — — — — — — — — — —
Pertussis 37 0.76 110 0.49 299 0.63 3,924 1.54 270 1,484 6,124
Plague †††† S S S S S S S S S S 9
Poliomyelitis, paralytic — — — — — — — — — — —
Poliovirus infection, nonparalytic — — — — — — — — — — —
Psittacosis S S S S S S S S S S 8
Q fever
Total — — 4 0.02 3 0.01 80 0.03 16 17 120
Acute — — 3 0.01 2 0.00 59 0.02 13 13 90
Chronic — — 1 0.00 1 0.00 21 0.01 3 4 30
Rabies
Human — — — — — — — — — — —
Rubella S S S S S S S S S S 6
Rubella, congenital syndrome — — — — — — — — — — —
Salmonella Paratyphi infection §§§§ 1 0.02 35 0.16 4 0.01 15 0.01 11 9 75
Salmonella Typhi infection ¶¶¶¶ 1 0.02 89 0.40 9 0.02 25 0.01 45 13 182
Salmonellosis (excluding S. Typhi infection and S. Paratyphi infection) ***** 338 6.90 1,079 4.81 4,079 8.65 28,331 11.11 3,923 7,692 45,442
Severe acute respiratory syndrome-associated coronavirus disease — — — — — — — — — — —
Shiga toxin-producing Escherichia coli (STEC) 82 1.67 269 1.20 540 1.14 6,693 2.62 945 1,393 9,922
Shigellosis 94 1.92 255 1.14 1,749 3.71 4,652 1.82 1,002 1,356 9,108
Smallpox — — — — — — — — — — —
Spotted fever rickettsiosis
Total 45 0.94 8 0.04 30 0.06 812 0.32 26 254 1,175
Confirmed 2 0.04 — — 2 0.00 39 0.02 2 19 64
Probable 43 0.90 8 0.04 28 0.06 773 0.30 24 235 1,111
Streptococcal toxic shock syndrome 2 0.07 3 0.03 24 0.07 162 0.10 9 24 224
Syphilis
Total, all stages ††††† 2,067 42.19 3,080 13.74 44,871 95.10 59,236 23.23 12,154 12,525 133,933
Congenital §§§§§ 63 150.90 34 12.11 765 120.54 1,034 37.06 94 158 2,148
Primary and secondary 712 14.53 1,029 4.59 14,180 30.05 19,039 7.47 3,467 3,227 41,654
Tetanus S S S S S S S S S S 17
Toxic shock syndrome (other than Streptococcal) S S S S S S S S S S 24
Trichinellosis — — — — — — — — — — —
Tuberculosis 93 1.90 2,590 11.56 1,456 3.09 2,772 1.09 161 102 7,174
Tularemia 18 0.37 2 0.01 4 0.01 87 0.03 8 31 150
Vancomycin-intermediate Staphylococcus aureus — — 1 0.01 8 0.02 24 0.01 6 6 45
Vancomycin-resistant Staphylococcus aureus ¶¶¶¶¶ S S S S S S S S S S 1
Varicella morbidity 22 0.57 199 1.02 238 0.58 1,462 0.68 229 777 2,927
Varicella mortality U U U U U U U U U U U
Vibriosis
Total 9 0.19 85 0.38 165 0.35 1,131 0.45 162 300 1,852
Confirmed 6 0.12 46 0.21 82 0.17 714 0.29 109 176 1,133
Probable 3 0.06 39 0.18 83 0.18 417 0.17 53 124 719
Viral hemorrhagic fevers
Crimean-Congo hemorrhagic fever virus — — — — — — — — — — —
Ebola virus — — — — — — — — — — —
Guanarito virus — — — — — — — — — — —
Junin virus — — — — — — — — — — —
Lassa virus — — — — — — — — — — —
Lujo virus — — — — — — — — — — —
Machupo virus — — — — — — — — — — —
Marburg virus — — — — — — — — — — —
Sabia virus — — — — — — — — — — —
Yellow fever — — — — — — — — — — —
Zika virus
Zika virus disease, congenital ****** — — — — — — — — — — —
Zika virus disease, non-congenital S S S S S S S S S S 4
Zika virus infection, congenital ****** — — — — — — — — — — —
Zika virus infection, non-congenital S S S S S S S S S S 19
  • —: No reported cases — The reporting jurisdiction did not submit any cases to CDC.
  • U: Unavailable — The data are unavailable.
  • S: Suppressed
  • * Conditions with <25 cases reported in the year were not broken down by race.
  • † Race data were collected using current Office of Management and Budget (OMB) standards for race/ethnicity data and were mapped to bridged race categories.
  • § Any variation of disease incidence by race or ethnicity does not reflect biological differences but reflects systemic, cultural, behavioral, and social factors including structural racism.
  • ¶ Includes individuals reported as other race or multiple races.
  • ** Candida auris colonization/screening cases are not included in this table. These data are available on the Mycotic Diseases Branch's Tracking Candida auris page (https://www.cdc.gov/fungal/candida-auris/tracking-c-auris.html)
  • †† Please see Note #11.
  • §§ Counts include confirmed and probable dengue cases.
  • ¶¶ Case counts may include Old World hantavirus infections, such as Seoul virus.
  • *** Chronic hepatitis B and chronic hepatitis C data are not included in NNDSS tables but reported case counts are included in the annual Viral Hepatitis Surveillance Report, 2020, published online by CDC's Division of Viral Hepatitis, available at https://www.cdc.gov/hepatitis/statistics/SurveillanceRpts.htm.
  • ††† Counts include drug resistant and susceptible cases of Invasive Pneumococcal Disease. This condition was previously named Streptococcus pneumoniae invasive disease and cases were reported to CDC using different event codes to specify whether the cases were drug resistant or in a defined age group, such as <5 years.
  • §§§ In 2020, the CSTE case definition changed such that cases diagnosed by PCR were classified as confirmed, whereas previously those cases were classified as suspect and did not meet the publication/print criteria.
  • ¶¶¶ Before 2019, probable cases were not reported, and cases in neonates ≤60 days of age were counted as one case in a mother-infant pair. Beginning in 2019, confirmed and probable cases are being reported, and maternal and neonatal cases are being counted separately.
  • **** Measles is considered imported if the disease was acquired outside of the United States and is considered indigenous if the disease was acquired anywhere within the United States or it is not known where the disease was acquired.
  • †††† Beginning in 2020, confirmed and probable plague cases are being combined and published. In 2019, only confirmed plague cases were published.
  • §§§§ Beginning in January 2019, cases began to be reported as Salmonella Paratyphi infection. In 2018, cases were reported as paratyphoid fever. Prior to 2018, cases of paratyphoid fever were considered salmonellosis.
  • ¶¶¶¶ Beginning in January 2019, cases began to be reported as Salmonella Typhi infection. In previous years, cases were reported as typhoid fever.
  • ***** Beginning in January 2019, cases began to be reported as salmonellosis (excluding Salmonella Typhi infection and Salmonella Paratyphi infection). In 2018, cases were reported as salmonellosis (excluding paratyphoid fever and typhoid fever). Prior to 2018, cases of paratyphoid fever were considered salmonellosis.
  • ††††† Includes the following categories: primary; secondary; early non-primary non-secondary (includes cases previously reported as early latent); unknown duration or late (includes cases previously reported as late latent syphilis and cases previously reported as late syphilis with clinical manifestations) and congenital syphilis.
  • §§§§§ Congenital syphilis cases are usually assigned to the mother's state of residence at the time of delivery. Data for congenital syphilis are aggregated by the infant's year of birth.
  • ¶¶¶¶¶ Vancomycin-resistant Staphylococcus aureus cases reported in this table may not have been verified by CDC. CDC verified 0 vancomycin-resistant Staphylococcus aureus cases in 2020.
  • ****** Data reported to ArboNET using the national surveillance case definition for congenital Zika virus infection (CSTE Position Statement 16-ID-01).
Notes:
  1. These are annual cases of selected infectious national notifiable diseases from the National Notifiable Diseases Surveillance System (NNDSS). NNDSS data reported by the 50 states, New York City, the District of Columbia, and the U.S. territories are collated and published. Cases are reported by state health departments to CDC weekly. Because source datasets may be updated as additional information is received, statistics in publications based on that source data may differ from what is presented in these tables. Source datasets for the 2020 annual tables were officially closed on September 27, 2022.
  2. The list of national notifiable Infectious diseases and conditions for 2020 and their national surveillance case definitions are available by navigating to the Surveillance Case Definitions | CDC web page, selecting "2020" for the notifiable condition list year, checking "Infectious" conditions, and clicking "Get Notifiable List by Year". This list incorporates the Council of State and Territorial Epidemiologists (CSTE) position statements approved in 2019 by CSTE for national surveillance that were implemented in January 2020. Revised case definitions were implemented for the following conditions: plague, legionellosis, acute hepatitis C, spotted fever rickettsiosis, and pertussis. In addition, CSTE adopted the first coronavirus disease 2019 (COVID-19) national surveillance case definition on April 5, 2020, and they approved a revision to the COVID-19 national surveillance case definition, effective August 5, 2020. Publication criteria for the finalized 2020 data are available at https://wonder.cdc.gov/nndss/documents/2020_NNDSS_Publication_Criteria_03162022.pdf. See also Guide to Interpreting Provisional and Finalized NNDSS Data.
  3. Population estimates for incidence rates are July 1st, 2020, estimates obtained from the National Center for Health Statistics (NCHS) postcensal estimates of the resident population of the United States for April 1, 2010, to July 1, 2020, by year, county, single year of age (range: 0 to 85 years), bridged-race (white, black or African American, American Indian or Alaska Native, Asian, or Pacific Islander), Hispanic ethnicity (not Hispanic or Latino, Hispanic or Latino), and sex (Vintage 2020), prepared under a collaborative arrangement with the U.S. Census Bureau. Population estimates for states released September 21, 2021, are available at https://www.cdc.gov/nchs/nvss/bridged_race/data_documentation.htm. Population estimates for territories are the 2020 mid-year estimates from the U.S. Census Bureau International Data Base, accessed on March 15, 2022, at https://www.census.gov/data-tools/demo/idb/#/country?YR_ANIM=2022. The choice of population denominators for incidence is based on the availability of population data at the time of publication preparation.
  4. Annual tables for 2016 and later years are available on CDC WONDER.
  5. Annual summary reports from 1993–2015 are available as published in the Morbidity and Mortality Weekly Report.
  6. NNDSS annual tables since 1952 are available at CDC Stacks (once in CDC Stacks, select "Annual Reports" in the "Genre" box to the left).
  7. For most conditions, national incidence rates are calculated as the number of reported cases for each infectious disease or condition divided by the U.S. resident population for the specified demographic population or the total U.S. resident population, multiplied by 100,000. When a national notifiable infectious condition is associated with a specific age restriction, the same restriction was applied to the population in the denominator of the incidence rate calculation. In addition, population data from reporting jurisdictions in which the disease or condition was not reportable or not available were excluded from the denominator of the incidence rate calculations.

    Age restrictions in the numerator and denominator are applied for the following childhood conditions:

    • Zika virus disease, congenital (age restriction in numerator and denominator is <1 year)
    • Zika virus infection, congenital (age restriction in numerator and denominator is <1 year)
    • Haemophilus influenzae, invasive disease <5 years (age restriction in numerator and denominator is <5 years)
    • Invasive pneumococcal disease <5 years (age restriction in numerator and denominator is <5 years)
    • Influenza associated pediatric mortality (age restriction in numerator and denominator is <18 years)
    • Infant botulism (age restriction in numerator and denominator is <1 year)
    • Congenital rubella syndrome (age restriction in numerator and denominator is <1 year)
    • Perinatal hepatitis B infection (age restriction in numerator is ≤24 months, denominator is <24 months)
    • Perinatal hepatitis C infection (age restriction in numerator is ≤36 months, denominator is <36 months).

    Data for congenital syphilis are aggregated by the infant's year of birth. The rate for congenital syphilis is based upon the number of reported cases per 100,000 live births, using natality data for 2020 (National Center for Health Statistics Natality 2020, as compiled from data provided by the Vital Statistics Cooperative Program). Congenital syphilis cases are usually assigned to the mother's state of residence at the time of delivery. The mother's race and ethnicity are used for race- and ethnicity-specific rates of congenital syphilis cases.

  8. Surveillance data reported by other CDC programs might vary from data reported in these tables because of differences in 1) the date used to aggregate the data, 2) the timing of reports, 3) the source of the data, 4) surveillance case definitions, and 5) policies regarding case jurisdiction (i.e., which jurisdiction should submit the case notification to CDC).
  9. The following reporting areas may have incomplete data, due to technical or programmatic challenges while reconciling data during the COVID-19 pandemic: California, Guam, and Minnesota.
  10. The following reporting areas may have incomplete data due to updates made to their data after the 2020 reconciliation period ended and there was not sufficient time before publication of the annual tables to confirm the updated counts: Idaho, Kansas, Maryland, Vermont, and Virgin Islands.
  11. Of the reporting areas that submitted 2020 aggregate COVID-19 data to CDC, three did not submit probable cases. New York (excluding New York City) and Utah did not collect probable cases. U.S. Virgin Islands collected probable cases, but did not report them to CDC.
  12. Disease data presented in the 2020 tables reflect impacts of the COVID-19 pandemic, such as changes in exposure-related behavior, healthcare-seeking behavior, disease reporting, and public health investigations.
Suggested Citation: Acknowledgment:
  • CDC acknowledges the local, state, and territorial health departments that collected the data from a range of case ascertainment sources (e.g., healthcare providers, hospitals, laboratories) and reported these data to CDC's National Notifiable Diseases Surveillance System.