TABLE 7. Annual reported cases of notifiable diseases and rates, by ethnicity*^,†, United States, excluding U.S. Territories and Non-U.S. Residents, 2021 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 — — — — — — Arboviral diseases, Chikungunya virus disease 3 0.00 18 0.01 14 35 Arboviral diseases, Eastern equine encephalitis virus disease, Neuroinvasive S S S S S 5 Arboviral diseases, Eastern equine encephalitis virus disease, Non-neuroinvasive — — — — — — Arboviral diseases, Jamestown Canyon virus disease, Neuroinvasive S S S S S 21 Arboviral diseases, Jamestown Canyon virus disease, Non-neuroinvasive S S S S S 11 Arboviral diseases, La Crosse virus disease, Neuroinvasive 1 0.00 31 0.01 7 39 Arboviral diseases, La Crosse virus disease, Non-neuroinvasive S S S S S 1 Arboviral diseases, Powassan virus disease, Neuroinvasive S S S S S 24 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 11 Arboviral diseases, St. Louis encephalitis virus disease, Non-neuroinvasive S S S S S 6 Arboviral diseases, West Nile virus disease, Neuroinvasive 198 0.32 1,501 0.56 308 2,007 Arboviral diseases, West Nile virus disease, Non-neuroinvasive 42 0.07 594 0.22 263 899 Arboviral diseases, Western equine encephalitis virus disease, Neuroinvasive — — — — — — Arboviral diseases, Western equine encephalitis virus disease, Non-neuroinvasive — — — — — — Babesiosis, Total 169 0.31 1,584 0.69 921 2,674 Babesiosis, Confirmed 159 0.29 1,427 0.62 843 2,429 Babesiosis, Probable 10 0.02 157 0.07 78 245 Botulism, Total 43 0.07 146 0.05 47 236 Botulism, Foodborne S S S S S 20 Botulism, Infant 29 2.99 110 3.98 32 171 Botulism, Other (wound & unspecified) 13 0.02 22 0.01 10 45 Brucellosis 45 0.07 46 0.02 23 114 Campylobacteriosis 9,172 14.96 36,581 13.64 17,656 63,409 Candida auris, clinical § 59 0.15 419 0.19 130 608 Carbapenemase-producing carbapenem-resistant Enterobacteriaceae 166 0.30 1,295 0.53 867 2,328 Chancroid S S S S S 3 Chlamydia trachomatis infection 217,522 358.60 766,630 291.75 629,688 1,613,840 Cholera S S S S S 5 Coccidioidomycosis 3,417 13.06 7,520 6.59 9,264 20,201 Coronavirus Disease 2019 (COVID-19), Total 5,762,044 9,397.77 20,907,285 7,796.24 9,427,165 36,096,494 Coronavirus Disease 2019 (COVID-19), Confirmed 4,913,090 8,013.15 16,586,604 6,185.08 7,576,574 29,076,268 Coronavirus Disease 2019 (COVID-19), Probable ¶ 848,954 1,384.63 4,320,681 1,611.16 1,850,591 7,020,226 Cryptosporidiosis, Total 975 1.59 6,004 2.24 2,176 9,155 Cryptosporidiosis, Confirmed 787 1.28 4,610 1.72 1,794 7,191 Cryptosporidiosis, Probable 188 0.31 1,394 0.52 382 1,964 Cyclosporiasis 308 0.53 1,506 0.61 610 2,424 Dengue virus infections, Dengue ** 79 0.13 72 0.03 31 182 Dengue virus infections, Dengue-like illness ** S S S S S 7 Dengue virus infections, Severe dengue ** S S S S S 4 Diphtheria — — — — — — Ehrlichiosis and Anaplasmosis, Anaplasma phagocytophilum infection 84 0.14 4,371 1.69 2,274 6,729 Ehrlichiosis and Anaplasmosis, Ehrlichia chaffeensis infection 36 0.06 1,024 0.40 277 1,337 Ehrlichiosis and Anaplasmosis, Ehrlichia ewingii infection S S S S S 19 Ehrlichiosis and Anaplasmosis, Undetermined ehrlichiosis/anaplasmosis 1 0.00 64 0.02 12 77 Giardiasis 1,018 2.24 6,326 2.91 4,299 11,643 Gonorrhea 85,429 140.84 403,435 153.53 210,721 699,585 Haemophilus influenzae, invasive disease, All ages, all serotypes 243 0.40 2,269 0.85 530 3,042 Haemophilus influenzae, invasive disease, Age <5 years, Serotype b 3 0.06 20 0.14 4 27 Haemophilus influenzae, invasive disease, Age <5 years, Non-b serotype 15 0.30 101 0.71 21 137 Haemophilus influenzae, invasive disease, Age <5 years, Nontypeable 17 0.34 50 0.35 27 94 Haemophilus influenzae, invasive disease, Age <5 years, Unknown serotype 26 0.04 125 0.05 21 172 Hansen's disease 3 0.01 36 0.01 18 57 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 31 0.05 239 0.09 32 302 Hepatitis, Viral Disease, Hepatitis A §§ 410 0.67 4,417 1.65 899 5,726 Hepatitis, Viral Disease, Hepatitis B, Acute §§ 223 0.37 1,538 0.58 283 2,044 Hepatitis, Viral Disease, Hepatitis B, Perinatal infection §§ S S S S S 17 Hepatitis, Viral Disease, Hepatitis C, Acute §§ 610 1.04 4,297 1.65 1,121 6,028 Confirmed 549 0.94 3,550 1.36 924 5,023 Probable 61 0.10 747 0.29 197 1,005 Hepatitis, Viral Disease, Hepatitis C, Perinatal infection §§ 16 0.68 129 1.69 55 200 Human immunodeficiency virus diagnoses 8,787 14.33 22,482 8.38 — 31,269 Influenza-associated pediatric mortality S S S S S 6 Invasive pneumococcal disease, All ages ¶¶ 1,059 2.65 8,693 4.22 2,346 12,098 Invasive pneumococcal disease, All ages, Confirmed ¶¶ 1,031 2.58 8,503 4.13 2,298 11,832 Invasive pneumococcal disease, All ages, Probable ¶¶ 28 0.07 190 0.09 48 266 Invasive pneumococcal disease, Age <5 years ¶¶ 105 0.24 553 0.25 112 770 Invasive pneumococcal disease, Age <5 years, Confirmed ¶¶ 100 2.81 532 4.45 107 739 Invasive pneumococcal disease, Age <5 years, Probable ¶¶ 5 0.14 21 0.18 5 31 Legionellosis *** 576 0.94 6,506 2.43 1,360 8,442 Leptospirosis 6 0.01 39 0.02 24 69 Listeriosis, Total ††† 149 0.24 685 0.26 143 977 Listeriosis, Confirmed ††† 144 0.23 662 0.25 135 941 Listeriosis, Probable ††† 5 0.01 23 0.01 8 36 Lyme disease, Total 541 0.88 14,465 5.42 9,604 24,610 Lyme disease, Confirmed 355 0.58 9,331 3.50 6,525 16,211 Lyme disease, Probable 186 0.30 5,134 1.92 3,079 8,399 Malaria 30 0.05 1,072 0.40 401 1,503 Measles, Total §§§ — — 43 0.02 5 48 Measles, Indigenous §§§ — — 27 0.01 2 29 Measles, Imported §§§ — — 16 0.01 3 19 Meningococcal disease, All serogroups 39 0.06 145 0.05 24 208 Meningococcal disease, Serogroups ACWY 21 0.03 54 0.02 8 83 Meningococcal disease, Serogroup B 5 0.01 26 0.01 1 32 Meningococcal disease, Other serogroups 1 0.00 9 0.00 6 16 Meningococcal disease, Unknown serogroup 12 0.02 56 0.02 9 77 Mumps 29 0.05 105 0.04 55 189 Novel Influenza A virus infections S S S S S 16 Pertussis 254 0.41 1,328 0.50 534 2,116 Plague ¶¶¶ S S S S S 4 Poliomyelitis, paralytic — — — — — — Poliovirus infection, nonparalytic — — — — — — Psittacosis S S S S S 4 Q fever, Total 41 0.07 120 0.04 31 192 Q fever, Acute 38 0.06 101 0.04 26 165 Q fever, Chronic 3 0.00 19 0.01 5 27 Rabies, Human S S S S S 5 Rubella S S S S S 7 Rubella, congenital syndrome — — — — — — Salmonella Paratyphi infection **** 8 0.01 42 0.02 14 64 Salmonella Typhi infection †††† 45 0.07 145 0.05 44 234 Salmonellosis (excluding S. Typhi infection and S. Paratyphi infection) §§§§ 8,027 13.09 28,226 10.53 12,996 49,249 Severe acute respiratory syndrome-associated coronavirus disease — — — — — — Shiga toxin-producing Escherichia coli (STEC) 2,582 4.21 8,361 3.12 3,000 13,943 Shigellosis 2,571 4.19 5,115 1.91 2,313 9,999 Smallpox — — — — — — Spotted fever rickettsiosis, Total 34 0.06 922 0.35 301 1,257 Spotted fever rickettsiosis, Confirmed 3 0.00 31 0.01 9 43 Spotted fever rickettsiosis, Probable 31 0.05 891 0.33 292 1,214 Streptococcal toxic shock syndrome 15 0.06 110 0.06 20 145 Syphilis, Total, all stages ¶¶¶¶ 43,279 71.35 112,122 42.67 18,966 174,367 Syphilis, Congenital ***** 846 95.44 1,871 66.22 103 2,820 Syphilis, Primary and secondary 10,705 17.65 36,736 13.98 5,593 53,034 Tetanus 2 0.00 24 0.01 2 28 Toxic shock syndrome (other than Streptococcal) S S S S S 15 Trichinellosis S S S S S 2 Tuberculosis 2,410 3.93 5,458 2.04 14 7,882 Tularemia 5 0.01 119 0.04 38 162 Vancomycin-intermediate Staphylococcus aureus 5 0.01 57 0.03 11 73 Vancomycin-resistant Staphylococcus aureus ††††† S S S S S 5 Varicella morbidity 600 1.06 2,040 0.90 856 3,496 Varicella mortality U U U U U U Vibriosis, Total 339 0.56 1,849 0.70 665 2,853 Vibriosis, Confirmed 182 0.30 1,017 0.39 357 1,556 Vibriosis, Probable 157 0.26 832 0.32 308 1,297 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 S S S S S 1 Zika virus, Zika virus disease, congenital §§§§§ S S S S S 1 Zika virus, Zika virus disease, non-congenital S S S S S 2 Zika virus, Zika virus infection, congenital §§§§§ — — — — — — Zika virus, Zika virus infection, non-congenital — — — — — — —: 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) ¶ 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. ** 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, 2021, 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. *** Beginning 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 began to be combined and 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 2 vancomycin-resistant Staphylococcus aureus cases in 2021. §§§§§ 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 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