Comparison of Provisional with Final Notifiable Disease Case Counts — National Notifiable Diseases Surveillance System, 2009

• Published in: MMWR. Morbidity and mortality weekly report 2013-09, Vol.62 (36), p.747-751
• Main Authors: Adekoya, Nelson, Roberts, Henry
• Format: Article
• Language: English
• Subjects: Acute diseases; Analysis; Biological resistance; Centers for Disease Control and Prevention, U.S; Communicable diseases; Communicable Diseases - epidemiology; Disease Notification - statistics & numerical data; Disease resistance; Epidemiology; Humans; Incidence; Legionnaires disease; Leprosy; Nervous system diseases; Notifiable diseases; Population Surveillance - methods; Public health; Reproducibility of Results; Tuberculosis; United States - epidemiology; Viral diseases
• ISSN: 0149-2195; 1545-861X

States report notifiable disease cases to CDC through the National Notifiable Diseases Surveillance System (NNDSS). This allows CDC to assist with public health action and monitor infectious diseases across jurisdictional boundaries nationwide. The Morbidity and Mortality Weekly Report (MMWR) is used to disseminate these data on infectious disease incidence. The extent to which the weekly notifiable conditions are overreported or underreported can affect public health understanding of changes in the burden, distribution, and trends in disease, which is essential for control of communicable diseases. NNDSS encourages state health departments to notify CDC of a case when initially reported. These cases are included in the weekly provisional counts. The status of reported cases can change after further investigation by the states, resulting in differences between provisional and final counts. Increased knowledge of these differences can help in guiding the use of information from NNDSS. To quantify the extent to which final counts differ from provisional counts of notifiable infectious disease in the United States, CDC analyzed 2009 NNDSS data for 67 conditions. The results of this analysis demonstrate that for five conditions, final case counts were lower than provisional counts, but for 59 conditions, final counts were higher than provisional counts. The median difference between final and provisional counts was 16.7%; differences were ≤20% for 39 diseases but >50% for 12. These differences occur for various diseases and in all states. Provisional case counts should be interpreted with caution and an understanding of the reporting process.