Instructions for Reveiwing Nofitable Diseases

Attachment 8

Instructions for Reviewing National Notifiable Diseases Surveillance System

Annual Summary Data Tables 1-12.

Each year during the first quarter, the National Center for Public Health Informatics (NCPHI), CDC generates twelve (12) tables for each state that present notifiable infectious disease data for the previous year that have been transmitted to NCPHI through the specified date. The following pages include instructions to assist you in your review of the data presented in each of the following tables:

Table 1 - State-specific count of case, summary, and phone reports by disease.

Table 2 - State-specific line listing of phone reports of notifiable disease data (for potential

replacement by electronic data)

Note: Only states with one or more phone reports will receive a copy of Table 2.

Table 3 - State-specific case count by MMWR week and disease.

Table 4 - State-specific case count by month and disease.

Table 5 - State-specific case count by age group (years) and disease.

Table 6 - State-specific case count by sex and disease.

Table 7 - State-specific case count by county and disease.

Table 8 - State-specific case count by race/ethnicity and disease.

Table 9 - State-specific case count by case status classification and disease.

Table 10 - State-specific influenza activity codes by MMWR week.

Table 11 – State-specific outbreak status by disease.

Table 12 – State-specific import status by disease.

After you have reviewed these tables and contacted all other state programs and offices (e.g. STD, TB, and Immunizations) to confirm disease totals, please call NCPHI/CDC to resolve any discrepancies in the annual notifiable disease data. NCPHI staff can provide line listings or other tabulations that might help resolve data discrepancies. Delayed, corrected, and deleted notifiable disease reports for 2005 should be transmitted electronically to NCPHI by

April 21, 2006.

Please notify NCPHI as soon as you determine that your data match data in NCPHI=s data base. If there is a major difference that a state feels cannot easily be reconciled, then an electronic year-to-date file with the final data must be transmitted to NCPHI before May 12, 2006.

State Epidemiologist=s Sign-Off on 2005 Notifiable Disease Data Transmitted to CDC:

After the state reporters have agreed that the notifiable disease data NCPHI has for their state is final, NCPHI will e-mail a letter to your State Epidemiologist with a state-specific table presenting disease count data (incidence). Following the State Epidemiologists= approval and sign-off, the approved data will be published in the MMWR Summary of Notifiable Diseases -- United States, 2005. State Reporters are requested to be sure that all state program offices (i.e., STD, TB, and Immunizations) have seen and agreed with all totals prior to confirming with NCPHI the status of these totals as final.

NOTES:

1. Unless otherwise indicated, total disease incidence represents the total number of cases that will be printed in the 2005 Annual Summary. For some diseases, case

totals reported in the MMWR are restricted based upon case status (e.g. confirmed or

probable) per Council of State and Territorial Epidemiologist=s resolution(s).

2. The NNDSS print criteria (which are described in the "Print Criteria" column of the

NNDSS event code list, at URL: http://www.cdc.gov/epo/dphsi/phs/files/NNDSS_event_code_list_January_2006.pdf) will be reviewed to ascertain whether a revision in print criteria is needed, due to the NETSS to NEDSS transition in reporting, and to better align the print criteria to the actual case confirmation status categories described in NNDSS surveillance case definitions. NCPHI staff will also review the 2005 NNDSS data to identify aberrations in reporting based on disease and case status, to help inform our recommendation for a revision of the NNDSS print criteria. Selected states may be contacted to provide input about their data. Proposed revised print criteria will be shared with CDC programs having disease prevention and control responsibility for the NNDSS conditions and diseases, to obtain their approval about proposed print criteria revisions. CDC program approved revisions in print criteria will be shared with you as soon as they are available and are expected to be applied to the 2005 Early Release tables and 2005 Annual Summary.

3. As you finalize your 2005 Notifiable Infectious Diseases database; please periodically update your State Epidemiologist so he or she is aware of any potential data resolution issues.

4. Primary and secondary syphilis are both shown under event code 10310.

5. Some diseases listed on Table 1 may not be notifiable in your state. Please take time

to review all diseases for official reporting status in your state. Contact your NCPHI

representative if there are diseases listed on these tables for which reporting is not

mandatory in your state.

TABLE 1. State-specific count of Case, Summary, and Phone Reports by Disease.

Review the listed disease names.

Table columns:

- Case data includes all cases you transmitted to NCPHI as individual records.

- Summary data includes cases transmitted as summary (aggregate) records, such as gonorrhea, syphilis, or TB.

- Phone/Text data includes diseases you reported as a text message, such as gonorrhea, syphilis, TB, animal rabies, or a disease you reported by telephone for entry at NCPHI when you were unable to transmit. Phone/Text reports are listed in Table 2 by week and disease. (Note: Only states with one or more phone reports will receive a copy of Table 2.)

- MMWR Print Total is the total for the given disease regardless of how it was reported. If you have reported a disease by both methods (i.e., case and summary), be sure to mention this to your NCPHI contact named in the cover letter.

DISEASES marked N or U:

Please verify diseases listed as not notifiable (N) or unavailable (U) in your state for MMWR year 2005.

If some conditions on the attached tables are incorrectly marked N or U, the data set needs to be corrected. Please contact NCPHI as soon as possible to update our information.

DISEASES with a A0" (zero) total:

Please review with your epidemiologist(s) to verify that the disease incidence is, in fact, A0" and that 1) the disease data are not Aunavailable@ (U) or 2) the disease was not Anon-notifiable@ (N) in your state in 2005.

TABLE 2. State-specific line listing of Phone Reports of Notifiable Disease Data.

Note: Only states with phone reports will receive this table.

The records listed in this report are considered to be temporary records pending some other action.

These temporary records will remain on the NNDSS database until you send electronically transmitted individual case records to replace these records.

- Are any phone reports duplicates of case or summary records? If so, tell your NCPHI contact to delete the duplicate phone reports.

- All temporary phone reports must be replaced. You should transmit individual cases for the same disease and WEEK. If you transmit 4 individual records to replace a phone report for 10 cases, the new count will be 4. If the individual cases are marked for a different week, then you will have the same reports in 2 different weeks. To correct this situation, contact NCPHI staff.

- The Acount@ for influenza activity represents an activity code, not total case count.

TABLE 3. State-specific case count by MMWR Week and Disease.

- Check week numbers. Are any weeks missing? If weeks are missing, are the cases listed in Table 2 (Line Listing of Phone Reports)? If yes, see instructions for Table 2.

TABLE 4. State-specific case count by Month and Disease.

The month is determined by using the MMWR weeks as listed below. A week ending calendar for MMWR weeks is also attached.

January Weeks 01-04 January 2, 2005 --------------- January 29, 2005

February Weeks 05-08 January 30, 2005 --------------- February 26, 2005

March Weeks 09-12 February 27, 2005 --------------- March 26, 2005

April Weeks 13-17 March 27, 2005 --------------- April 30, 2005

May Weeks 18-21 May 1, 2005 --------------- May 28, 2005

June Weeks 22-25 May 29, 2005 --------------- June 25, 2005

July Weeks 26-30 June 26, 2005 --------------- July 30, 2005

August Weeks 31-34 July 31, 2005 --------------- August 27, 2005

September Weeks 35-38 August 28, 2005 --------------- September 24, 2005

October Weeks 39-43 September 25, 2005 --------------- October 29, 2005

November Weeks 44-47 October 30, 2005 --------------- November 26, 2005

December Weeks 48-52 November 27, 2005 --------------- December 31, 2005

TABLE 5. State-specific case count by Age Group (years) and Disease.

PLEASE NOTE:

If Agetype equals (1 = Months) or (2 = Weeks) or (3 = Days) then Age group becomes age < 1

If Agetype equals 4 (coded age) and Age equals 0, then age group becomes age < 1.

If Agetype equals 9, then age group becomes age unknown.

- This table includes a column labeled AAGE UNKNOWN@. These counts include Summary records and/or telephone text reports which do not include age. IF YOU HAVE AGE DATA FOR DISEASES REPORTED AS SUMMARY RECORDS, PLEASE TELL YOUR NCPHI CONTACT PERSON.

- Missing or invalid values for agetype and/or age have been set to Aage unknown.@ Can you send corrections for any of these records? Do you need a line listing of the Aage unknown@ cases?

TABLE 6. State-specific case count by Sex and Disease

- This table includes a column labeled ASEX UNKNOWN.@ These counts include Summary records and/or text/telephone reports which do not include sex code. IF YOU HAVE SEX DATA FOR DISEASES REPORTED AS SUMMARY RECORDS, PLEASE TELL YOUR NCPHI CONTACT PERSON.

• Missing or invalid values for sex have been set to Asex unknown.@ Can you send corrections for any of these records? Do you need a line listing of the Asex unknown@ cases?

TABLE 7. State-specific case count by County and Disease.

- This table includes a row labeled ACOUNTY UNKNOWN.@ These counts include Summary and/or telephone/text records which do not include county code. IF YOU KNOW THE NAME OF THE COUNTY REPORTING THE SUMMARY RECORDS, PLEASE TELL YOUR NCPHI CONTACT PERSON.

- Missing or invalid values for county have been set to Acounty unknown.@ Can you send corrections for any of these records? Do you need a line listing of the Acounty unknown@ cases?

- The valid value for county unknown is 999.

TABLE 8. State-specific case count by Race/Ethnicity and Disease.

- Please recall that Hispanic ethnicity can be reported for any race.

- This table includes columns labeled ARACE UNKNOWN@. These counts include Summary and/or text/telephone reports which do not include race/ethnicity codes. IF YOU HAVE RACE/ETHNICITY DATA FOR DISEASES REPORTED AS SUMMARY RECORDS, PLEASE TELL YOUR NCPHI CONTACT PERSON.

- Missing or invalid values for race and/or ethnicity have been set to Arace unknown@ or Aunknown Hispanic.@ Can you send corrections for any of these records? Do you need a line listing of the Arace unknown@ or Aunknown Hispanic@ cases?

TABLE 9. State-specific case count by Case Status Classification and Disease.

NCPHI encourages states to submit all case reports regardless of case status classification. However, for some diseases, case totals reported in the MMWR are restricted based upon case status (e.g., confirmed or probable) per the print criteria column of the NNDSS event code list. The column labeled AMMWR Print Total@ presents the total disease incidence data that will be printed in the 2005 annual Summary.

- Missing or invalid values for case status have been set to AUnknown Status@. Can you send corrections for any of these records?

• Can you confirm or delete any cases listed in the AUnknown Status A or ASuspect Status@ columns? Do you need a line listing of AUnknown Status@ or ASuspect Status@ cases?

• The MMWR Print criteria are currently being reviewed and may be revised. If print criteria revisions are approved by CDC Program Offices, it may be applied to the 2005 data.

TABLE 10. State-specific Influenza Activity Codes by MMWR Week

Influenza activity information is collected for the National Center for Infectious Diseases and is published weekly in the Influenza Summary Update - United States.

- For weeks 1 - 20 and 40 - 52, can you replace any of the A9, No Report@ records?

- If you have more than one activity listed for a given week, please delete the extra records from your system and transmit the correction to NCPHI.

TABLE 11. State-specific Outbreak Status Reports by Disease

This table lists the number of cases reported by the "Outbreak" variable status: yes-associated with an outbreak, sporadic (not associated with an outbreak), and unknown outbreak status. Case totals reported in the MMWR are restricted based upon case status (e.g., confirmed or probable) as described in the print criteria column of the NNDSS event code list. The column labeled "Total" presents the total disease incidence that will be printed in the 2005 annual Summary, unless the print criteria are revised (refer to the second bulleted item under "NOTES" on the second page of these instructions).

Please review this data carefully to ensure that the data were properly reported.

TABLE 12. State-specific Import Status Reports by Disease

This table lists the number of cases reported by the "Imported" variable status: indigenous (acquired in the USA in the reporting state), international (acquired outside the USA), out of state (acquired in the USA but outside the reporting state), and unknown imported status. For measles, this field must be coded as "International" in order for the case to be classified as imported. The column labeled "Total" presents the total disease incidence that will be printed in the 2005 annual Summary, unless the print criteria are revised (refer to the second bulleted item under "NOTES" on the second page of these instructions).

Please review this data carefully to ensure the data were properly reported.

For additional guidance about response categories for the Imported variable, please refer to Appendix 1 on page 7 of CSTE position statement 03-ID-10 entitled "Revised Guidelines for Determining Residency for Disease Reporting Purposes," available at this URL: http://www.cdc.gov/epo/dphsi/phs/files/03-ID-10_residency_rules.pdf .