TABLE 2e. Annual reported cases* of notifiable diseases, by region and reporting area, United States, U.S. Territories, and Non-U.S. Residents, 2021^† column labels in same order that data fields appears in each record below: Reporting Area Cholera Coccidioidomycosis Coronavirus Disease 2019 (COVID-19), Total Coronavirus Disease 2019 (COVID-19), Confirmed Coronavirus Disease 2019 (COVID-19), Probable ^§ Cryptosporidiosis, Total Cryptosporidiosis, Confirmed Cryptosporidiosis, Probable Cyclosporiasis tab delimited data: U.S. Residents, excluding U.S. Territories 5 20,201 36,096,494 29,076,268 7,020,226 9,155 7,191 1,964 2,424 New England 1 4 1,657,645 1,413,254 244,391 408 236 172 75 Connecticut 1 N 379,698 335,419 44,279 71 22 49 27 Maine — N 129,555 92,080 37,475 59 40 19 2 Massachusetts — N 789,146 725,479 63,667 137 124 13 37 New Hampshire — 3 159,450 103,165 56,285 59 9 50 5 Rhode Island — 1 140,820 100,252 40,568 34 34 — 4 Vermont — N 58,976 56,859 2,117 48 7 41 — Middle Atlantic 2 — 5,287,985 4,591,100 696,885 1,214 1,063 151 328 New Jersey — N 1,177,276 996,567 180,709 165 139 26 81 New York (excluding New York City) 1 N 1,401,007 1,401,007 0 439 428 11 132 New York City 1 N 1,295,753 1,064,595 231,158 277 277 — 115 Pennsylvania — N 1,413,949 1,128,931 285,018 333 219 114 N East North Central — 105 5,515,789 4,359,616 1,156,173 1,786 1,400 386 370 Illinois — N 1,548,564 1,234,151 314,413 304 247 57 132 Indiana — 4 747,617 526,784 220,833 212 196 16 17 Michigan — 57 1,228,568 1,062,976 165,592 250 184 66 53 Ohio — 16 1,357,105 991,964 365,141 398 314 84 70 Wisconsin — 28 633,935 543,741 90,194 622 459 163 98 West North Central — 204 2,143,824 1,613,135 530,689 1,454 1,170 284 361 Iowa — N 279,675 204,533 75,142 437 355 82 88 Kansas — 18 302,547 218,213 84,334 104 93 11 69 Minnesota — 121 639,161 526,968 112,193 429 374 55 66 Missouri — 27 582,110 432,989 149,121 226 213 13 82 Nebraska — 22 176,207 113,963 62,244 96 84 12 31 North Dakota — 10 82,605 54,185 28,420 35 9 26 9 South Dakota — 6 81,519 62,284 19,235 127 42 85 16 South Atlantic — 4 7,863,787 5,959,048 1,904,739 1,367 1,023 344 550 Delaware — — 128,735 115,457 13,278 23 17 6 5 District of Columbia — N 66,949 64,217 2,732 5 5 — — Florida — N 2,957,529 2,238,984 718,545 343 208 135 252 Georgia — N 1,185,323 871,814 313,509 265 227 38 67 Maryland — 4 660,288 518,359 141,929 94 94 — 47 North Carolina — N 1,153,937 929,647 224,290 262 223 39 108 South Carolina — N 672,094 501,001 171,093 87 82 5 27 Virginia — N 791,062 528,799 262,263 220 116 104 35 West Virginia — N 247,870 190,770 57,100 68 51 17 9 East South Central — 25 2,320,973 1,523,587 797,386 637 534 103 82 Alabama — 13 538,910 367,711 171,199 124 82 42 6 Kentucky — 12 613,171 404,557 208,614 228 181 47 29 Mississippi — N 346,313 169,353 176,960 65 64 1 N Tennessee — N 822,579 581,966 240,613 220 207 13 47 West South Central — 25 4,214,591 3,158,295 1,056,296 743 632 111 375 Arkansas — 7 340,623 224,956 115,667 67 64 3 15 Louisiana — 18 577,506 412,264 165,242 131 71 60 48 Oklahoma — N 402,126 276,197 125,929 101 99 2 N Texas — N 2,894,336 2,244,878 649,458 444 398 46 312 Mountain — 11,769 2,685,511 2,394,810 290,701 701 451 250 184 Arizona — 11,489 827,573 719,016 108,557 110 79 31 21 Colorado — N 626,308 561,557 64,751 214 125 89 123 Idaho — N 182,004 139,612 42,392 80 67 13 N Montana — 22 117,396 87,555 29,841 56 52 4 4 Nevada — 189 290,144 263,133 27,011 23 16 7 N New Mexico — 12 207,733 207,491 242 67 48 19 9 Utah — 57 363,541 363,120 421 137 53 84 24 Wyoming — — 70,812 53,326 17,486 14 11 3 3 Pacific 2 8,065 4,406,389 4,063,423 342,966 845 682 163 99 Alaska — N 107,925 100,478 7,447 19 15 4 — California 2 8,058 3,251,617 3,032,549 219,068 527 432 95 66 Hawaii — N 100,808 89,668 11,140 8 8 — — Oregon — 7 310,682 300,114 10,568 124 69 55 14 Washington — N 635,357 540,614 94,743 167 158 9 19 U.S. Territories — 1 260,605 155,493 105,112 1 1 — 1 American Samoa — N — — — N N N N Commonwealth of Northern Mariana Islands — — 2,994 2,950 44 — — — — Guam — 1 12,337 8,242 4,095 — — — — Puerto Rico — N 236,760 135,787 100,973 1 1 — 1 U.S. Virgin Islands — — 8,514 8,514 — — — — — Non-U.S. Residents — 2 — — — 1 — 1 1 Total 5 20,204 36,357,099 29,231,761 7,125,338 9,157 7,192 1,965 2,426 —: No reported cases - The reporting jurisdiction did not submit any cases to CDC. N: Not reportable - The disease or condition was not reportable by law, statute, or regulation in the reporting jurisdiction. U: Unavailable - The data are unavailable. * Cases are assigned to the reporting jurisdiction submitting the case to NNDSS if the case's country of usual residence is the United States, a U.S. territory, unknown, or country is not reported; otherwise, the case is assigned to the Non-U.S. Residents' category. Country of usual residence is currently not reported by all jurisdictions or for all conditions because this data element is only available in the HL7 generic version 2 and disease-specific message mapping guides. If a jurisdiction sends data in legacy formats, they are not able to send this information. For further information on interpretation of these data, see https://www.cdc.gov/nndss/data-statistics/readers-guides/. † To calculate rates, use the populations provided in Table 8. Note that calculation of rates for the following conditions uses population subgroups as described in note #7 and population counts presented in Table 8: Zika virus infection, congenital; Zika virus disease, congenital; Infant botulism; Congenital rubella syndrome; Perinatal Hepatitis B infection; Perinatal Hepatitis C infection; Haemophilus influenzae, invasive disease; Invasive pneumococcal disease; and Influenza-associated pediatric mortality. Also see Notes #3 and #7. § Of the reporting areas that submitted 2021 aggregate COVID-19 data to CDC, two did not submit probable cases. New York (excluding New York City) and U.S. Virgin Islands did not collect probable cases. 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 2021 annual tables were officially closed on March 29, 2023. The list of national notifiable Infectious diseases and conditions for 2021 and their national surveillance case definitions are available by navigating to the https://ndc.services.cdc.gov/, Surveillance Case Definitions | CDC web page, selecting "2021" for the notifiable condition list year, checking "Infectious" conditions, and clicking "Get Notifiable List by Year". 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. On June 17, 2021, a revision to the COVID-19 national surveillance case definition was approved, effective September 1, 2021. Publication criteria for the finalized 2021 data are available at https://wonder.cdc.gov/nndss/documents/2021_NNDSS_Publication_Criteria_06072023.pdf, https://wonder.cdc.gov/nndss/documents/2021_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 22, 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 and denominator is ≤24 months) Perinatal hepatitis C infection (age restriction in numerator and 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 2021 (National Center for Health Statistics https://wonder.cdc.gov/natality.html, Natality 2021, 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). Disease data presented in the 2021 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, 2021 Annual Tables of Infectious Disease Data. Atlanta, GA. CDC Office of Public Health Data, Surveillance, and Technology, 2024. 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