TABLE 7. Annual reported cases of notifiable diseases and rates, by ethnicity*,†, United States, excluding U.S. Territories and Non-U.S. Residents, 2020 column labels in same order that data fields appears in each record below: Disease Hispanic or Latino, No. Hispanic or Latino, Rate Non-Hispanic/Latino, No. Non-Hispanic/Latino, Rate Ethnicity not stated, No. Total, No. tab delimited data: Anthrax S S S S S 1 Arboviral diseases, Chikungunya virus disease 5 0.01 15 0.01 17 37 Arboviral diseases, Eastern equine encephalitis virus disease, Neuroinvasive S S S S S 13 Arboviral diseases, Eastern equine encephalitis virus disease, Non-neuroinvasive — — — — — — Arboviral diseases, Jamestown Canyon virus disease, Neuroinvasive S S S S S 10 Arboviral diseases, Jamestown Canyon virus disease, Non-neuroinvasive S S S S S 3 Arboviral diseases, La Crosse virus disease, Neuroinvasive 6 0.01 47 0.02 31 84 Arboviral diseases, La Crosse virus disease, Non-neuroinvasive S S S S S 4 Arboviral diseases, Powassan virus disease, Neuroinvasive S S S S S 19 Arboviral diseases, Powassan virus disease, Non-neuroinvasive S S S S S 1 Arboviral diseases, St. Louis encephalitis virus disease, Neuroinvasive S S S S S 14 Arboviral diseases, St. Louis encephalitis virus disease, Non-neuroinvasive S S S S S 2 Arboviral diseases, West Nile virus disease, Neuroinvasive 114 0.19 345 0.13 99 558 Arboviral diseases, West Nile virus disease, Non-neuroinvasive 19 0.03 102 0.04 51 172 Arboviral diseases, Western equine encephalitis virus disease, Neuroinvasive — — — — — — Arboviral diseases, Western equine encephalitis virus disease, Non-neuroinvasive — — — — — — Babesiosis, Total 83 0.15 965 0.42 772 1,820 Babesiosis, Confirmed 74 0.13 865 0.38 692 1,631 Babesiosis, Probable 9 0.02 100 0.04 80 189 Botulism, Total 39 0.06 104 0.04 46 189 Botulism, Foodborne S S S S S 8 Botulism, Infant 29 2.99 82 2.97 35 146 Botulism, Other (wound & unspecified) 9 0.01 17 0.01 9 35 Brucellosis 37 0.06 31 0.01 19 87 Campylobacteriosis 6,240 10.18 29,425 10.97 16,099 51,764 Candida auris, clinical § 20 0.04 140 0.06 95 255 Carbapenemase-producing carbapenem-resistant Enterobacteriaceae 86 0.16 837 0.34 925 1,848 Chancroid — — — — — — Chlamydia trachomatis infection 188,936 308.15 762,201 284.22 628,700 1,579,837 Cholera S S S S S 1 Coccidioidomycosis 2,663 10.18 5,400 4.73 11,157 19,220 Coronavirus Disease 2019 (COVID-19), Total 4,233,166 6,904.20 10,493,416 3,912.95 6,423,149 21,149,731 Coronavirus Disease 2019 (COVID-19), Confirmed 3,983,486 6,496.98 9,362,160 3,491.11 5,833,710 19,179,356 Coronavirus Disease 2019 (COVID-19), Probable ¶ 249,680 407.22 1,131,256 421.84 589,439 1,970,375 Cryptosporidiosis, Total 572 0.93 5,088 1.90 1,988 7,648 Cryptosporidiosis, Confirmed 458 0.75 3,831 1.43 1,572 5,861 Cryptosporidiosis, Probable 114 0.19 1,257 0.47 416 1,787 Cyclosporiasis 194 0.33 1,688 0.70 807 2,689 Dengue virus infections, Dengue ** 183 0.30 168 0.06 90 441 Dengue virus infections, Dengue-like illness ** S S S S S 9 Dengue virus infections, Severe dengue ** — — — — — — Diphtheria S S S S S 1 Ehrlichiosis and Anaplasmosis, Anaplasma phagocytophilum infection 51 0.09 2,128 0.82 1,458 3,637 Ehrlichiosis and Anaplasmosis, Ehrlichia chaffeensis infection 23 0.04 867 0.33 288 1,178 Ehrlichiosis and Anaplasmosis, Ehrlichia ewingii infection S S S S S 21 Ehrlichiosis and Anaplasmosis, Undetermined ehrlichiosis/anaplasmosis 2 0.00 38 0.01 10 50 Giardiasis 650 1.44 5,108 2.40 3,695 9,453 Gonorrhea 73,313 119.57 400,347 149.29 204,091 677,751 Haemophilus influenzae, invasive disease, All ages, all serotypes 225 0.37 2,073 0.77 698 2,996 Haemophilus influenzae, invasive disease, Age <5 years, Serotype b S S S S S 15 Haemophilus influenzae, invasive disease, Age <5 years, Non-b serotype 3 0.06 56 0.39 17 76 Haemophilus influenzae, invasive disease, Age <5 years, Nontypeable 20 0.40 54 0.38 30 104 Haemophilus influenzae, invasive disease, Age <5 years, Unknown serotype 27 0.04 69 0.03 25 121 Hansen's disease 5 0.01 45 0.02 18 68 Hantavirus infection, non-hantavirus pulmonary syndrome †† S S S S S 2 Hantavirus pulmonary syndrome S S S S S 14 Hemolytic uremic syndrome post-diarrheal 18 0.03 122 0.05 27 167 Hepatitis, Viral Disease, Hepatitis A §§ 386 0.63 8,031 2.99 1,529 9,946 Hepatitis, Viral Disease, Hepatitis B, Acute §§ 155 0.25 1,624 0.61 376 2,155 Hepatitis, Viral Disease, Hepatitis B, Perinatal infection §§ S S S S S 10 Hepatitis, Viral Disease, Hepatitis C, Acute §§ 485 0.83 4,302 1.65 1,238 6,025 Confirmed 415 0.71 3,390 1.30 993 4,798 Probable 70 0.12 912 0.35 245 1,227 Hepatitis, Viral Disease, Hepatitis C, Perinatal infection §§ 7 0.29 95 1.22 63 165 Human immunodeficiency virus diagnoses 6,141 10.02 18,866 7.04 — 25,007 Influenza-associated pediatric mortality 32 0.17 118 0.22 21 171 Invasive pneumococcal disease, All ages ¶¶ 836 2.09 7,953 3.86 3,157 11,946 Invasive pneumococcal disease, All ages, Confirmed ¶¶ 816 2.04 7,820 3.80 3,082 11,718 Invasive pneumococcal disease, All ages, Probable ¶¶ 20 0.05 133 0.06 75 228 Invasive pneumococcal disease, Age <5 years ¶¶ 77 0.18 357 0.16 127 561 Invasive pneumococcal disease, Age <5 years, Confirmed ¶¶ 76 2.13 339 2.83 121 536 Invasive pneumococcal disease, Age <5 years, Probable ¶¶ 1 0.03 18 0.15 6 25 Legionellosis *** 440 0.72 4,578 1.71 1,292 6,310 Leptospirosis 3 0.01 29 0.01 19 51 Listeriosis, Total ††† 99 0.16 551 0.21 130 780 Listeriosis, Confirmed ††† 92 0.15 538 0.20 124 754 Listeriosis, Probable ††† 7 0.01 13 0.00 6 26 Lyme disease, Total 370 0.60 8,742 3.28 8,888 18,000 Lyme disease, Confirmed 247 0.40 5,687 2.13 6,189 12,123 Lyme disease, Probable 123 0.20 3,055 1.14 2,699 5,877 Malaria 6 0.01 437 0.16 160 603 Measles, Total §§§ S S S S S 12 Measles, Indigenous §§§ S S S S S 6 Measles, Imported §§§ S S S S S 6 Meningococcal disease, All serogroups 44 0.07 156 0.06 42 242 Meningococcal disease, Serogroups ACWY 23 0.04 48 0.02 9 80 Meningococcal disease, Serogroup B 3 0.00 28 0.01 9 40 Meningococcal disease, Other serogroups 3 0.00 11 0.00 2 16 Meningococcal disease, Unknown serogroup 15 0.02 69 0.03 22 106 Mumps 101 0.16 334 0.12 259 694 Novel Influenza A virus infections — — — — — — Pertussis 861 1.40 3,639 1.36 1,624 6,124 Plague ¶¶¶ S S S S S 9 Poliomyelitis, paralytic — — — — — — Poliovirus infection, nonparalytic — — — — — — Psittacosis S S S S S 8 Q fever, Total 15 0.02 73 0.03 32 120 Q fever, Acute 12 0.02 52 0.02 26 90 Q fever, Chronic 3 0.00 21 0.01 6 30 Rabies, Human — — — — — — Rubella S S S S S 6 Rubella, congenital syndrome — — — — — — Salmonella Paratyphi infection **** 2 0.00 53 0.02 20 75 Salmonella Typhi infection †††† 21 0.03 119 0.04 42 182 Salmonellosis (excluding S. Typhi infection and S. Paratyphi infection) §§§§ 6,263 10.21 27,175 10.13 12,004 45,442 Severe acute respiratory syndrome-associated coronavirus disease — — — — — — Shiga toxin-producing Escherichia coli (STEC) 1,367 2.23 6,316 2.36 2,239 9,922 Shigellosis 2,087 3.40 4,947 1.84 2,074 9,108 Smallpox — — — — — — Spotted fever rickettsiosis, Total 26 0.04 841 0.32 308 1,175 Spotted fever rickettsiosis, Confirmed 5 0.01 44 0.02 15 64 Spotted fever rickettsiosis, Probable 21 0.03 797 0.30 293 1,111 Streptococcal toxic shock syndrome 20 0.08 161 0.09 43 224 Syphilis, Total, all stages ¶¶¶¶ 32,942 53.73 88,656 33.06 12,335 133,933 Syphilis, Congenital ***** 637 69.64 1,395 48.24 116 2,148 Syphilis, Primary and secondary 8,421 13.73 29,718 11.08 3,515 41,654 Tetanus S S S S S 17 Toxic shock syndrome (other than Streptococcal) S S S S S 24 Trichinellosis — — — — — — Tuberculosis 2,133 3.48 5,030 1.88 11 7,174 Tularemia 4 0.01 106 0.04 40 150 Vancomycin-intermediate Staphylococcus aureus 4 0.01 36 0.02 5 45 Vancomycin-resistant Staphylococcus aureus ††††† S S S S S 1 Varicella morbidity 531 0.96 1,665 0.74 731 2,927 Varicella mortality U U U U U U Vibriosis, Total 199 0.33 1,168 0.44 485 1,852 Vibriosis, Confirmed 110 0.18 740 0.28 283 1,133 Vibriosis, Probable 89 0.15 428 0.16 202 719 Viral hemorrhagic fevers, Crimean-Congo hemorrhagic fever virus — — — — — — Viral hemorrhagic fevers, Ebola virus — — — — — — Viral hemorrhagic fevers, Guanarito virus — — — — — — Viral hemorrhagic fevers, Junin virus — — — — — — Viral hemorrhagic fevers, Lassa virus — — — — — — Viral hemorrhagic fevers, Lujo virus — — — — — — Viral hemorrhagic fevers, Machupo virus — — — — — — Viral hemorrhagic fevers, Marburg virus — — — — — — Viral hemorrhagic fevers, Sabia virus — — — — — — Yellow fever — — — — — — Zika virus, Zika virus disease, congenital §§§§§ — — — — — — Zika virus, Zika virus disease, non-congenital S S S S S 4 Zika virus, Zika virus infection, congenital §§§§§ — — — — — — Zika virus, Zika virus infection, non-congenital 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 ethnicity. † 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. § 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: 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. The list of national notifiable Infectious diseases and conditions for 2020 and their national surveillance case definitions are available by navigating to the https://ndc.services.cdc.gov/, 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, https://wonder.cdc.gov/nndss/documents/2020_NNDSS_Publication_Criteria_03162022.pdf. See also https://www.cdc.gov/nndss/data-statistics/readers-guides/index.html, Guide to Interpreting Provisional and Finalized NNDSS Data. 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, 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, 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. Annual tables for 2016 and later years are available on https://wonder.cdc.gov/nndss/nndss_annual_tables_menu.asp, CDC WONDER. Annual summary reports from 1993–2015 are available as published in the https://www.cdc.gov/mmwr/mmwr_nd/index.html, Morbidity and Mortality Weekly Report. NNDSS annual tables since 1952 are available at https://stacks.cdc.gov/nndss, CDC Stacks (once in CDC Stacks, select "Annual Reports" in the "Genre" box to the left). 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 https://wonder.cdc.gov/natality.html, 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. 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). 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. 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. 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. 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: Centers for Disease Control and Prevention. National Notifiable Diseases Surveillance System, 2020 Annual Tables of Infectious Disease Data. Atlanta, GA. CDC Division of Health Informatics and Surveillance, 2023. Available at: https://www.cdc.gov/nndss/data-statistics/infectious-tables/index.html, https://www.cdc.gov/nndss/data-statistics/infectious-tables/index.html. 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. https://www.cdc.gov/nndss/, National Notifiable Diseases Surveillance System Provided by https://wonder.cdc.gov, CDC WONDER