Public Burden Screenshot

Data Collection and Reporting
In order for CDC to collect and use public health surveillance data, the NNDSS staff works closely with state
and local health departments; experts from CDC programs with prevention and control responsibilities; and
partners, such as the Council of State and Territorial Epidemiologists (CSTE).  Together, they develop and
implement consistent standards, tools, training, and technology to help ensure that disease reporting
systems are integrated within each state.  They also help make sure that public health surveillance systems
are interoperable with public health surveillance systems at CDC and other state and local health
departments, as well as with health IT systems used by hospitals, laboratories, and private providers.
 NNDSS provides National Electronic Disease Surveillance System (NEDSS) standards, tools, and resources
to support reporting jurisdictions – state, local, territorial, and tribal health departments – to help them
implement integrated and interoperable public health surveillance systems.  In an integrated system, a
public health record is created to capture information about multiple occurrences of the same or different
diseases in a given person over time.  An interoperable system can exchange information with other
systems.

Notifiable Disease Surveillance Starts at State and Local Levels
CDC receives case notifications from 57 reporting jurisdictions.  Each state has laws requiring certain
diseases be reported at the state level, but it is voluntary for states to provide information or notifications to
CDC at the federal level.  The notifiable diseases data voluntarily shared by these 57 jurisdictions represents
only a portion of the public health surveillance data that jurisdictions collect and use to make decisions and
conduct public health activities in their communities (e.g., outbreak detection and control).  There are
several important distinctions between a reportable disease and a notifiable disease.
• It is mandatory that reportable disease cases be reported to state and territorial jurisdictions when
identified by a health provider, hospital, or laboratory.  This type of required reporting uses personal
identifiers and enables the states to identify cases where immediate disease control and prevention is
needed.  Each state has its own laws and regulations defining what diseases are reportable.  The list of
reportable diseases varies among states and over time.
• It is voluntary that notifiable disease cases be reported to CDC by state and territorial jurisdictions
(without direct personal identifiers) for nationwide aggregation and monitoring of disease data.  Regular,
frequent, timely information on individual cases is considered necessary to monitor disease trends,
identify populations or geographic areas at high risk, formulate and assess prevention and control
strategies, and formulate public health policies.  The list of notifiable diseases varies over time and by
state.  The list of national notifiable diseases is reviewed and modified annually by the CSTE and CDC.

 Every national notifiable disease is not necessarily reportable in each state. In addition, not every state
reportable condition is national notifiable.

 Top of Page

Background
A notifiable disease or condition is one for which regular, frequent, and timely information regarding
individual cases is considered necessary for the prevention and control of the disease or condition. Data are
collected through NNDSS, which is neither a single surveillance system nor a method of reporting. Rather, it
is a “system of systems,” which is coordinated by CDC at the national level across disease-specific programs
to optimize data compilation, analysis, and dissemination of notifiable disease data. Monitoring surveillance
data enables public health authorities to detect sudden changes in disease or condition occurrence and
distribution, identify changes in agents and host factors, and detect changes in health-care practices.
National-level surveillance data are compiled from case notification reports of national notifiable diseases
and conditions submitted from the state, territory, and selected local health departments to CDC.
Cases are first identified through reports of diseases, conditions, and outbreaks from the local level to the
state or territory. Legislation, regulation, or other rules in those jurisdictions require health-care providers,
hospitals, laboratories, and others to provide information on reportable conditions to public health
authorities or their agents. Case reporting at the local level protects the public’s health by ensuring the
proper identification and follow-up of cases. Public health workers ensure that persons who are already ill
receive appropriate treatment; trace contacts who need vaccines, treatment, quarantine, or education;
investigate and control outbreaks; eliminate environmental hazards; and close premises where disease
transmission is believed to be ongoing.
Although disease and condition reporting is mandated at the state, territory, and local levels by legislation or
regulation, state and territory notification to CDC is voluntary. All U.S. state health departments, five
territorial health departments, and two local health departments (New York City and District of Columbia)
voluntarily notify CDC about national notifiable diseases and conditions that are reportable in their
jurisdictions; the data in the case notifications that CDC receives are collected by staff working on
reportable disease and condition surveillance systems in local, state, and territorial health departments.
The list of national notifiable diseases, conditions, and outbreaks is revised periodically. Conditions are
added to the list as emerging pathogens, environmental hazards, or conditions emerge as public health
concerns.  Conditions are deleted from the list when surveillance is not found to be useful. Public health
officials at state and territorial health departments collaborate with CDC staff in determining which
diseases, conditions, and outbreaks should be considered nationally notifiable. CSTE, with input from CDC,
makes recommendations annually for additions and deletions to the list. Similar to local public health
officials, CDC uses these data to monitor trends; develop, implement and maintain programs; allocate
resources; and assess the effectiveness of prevention and control efforts. The list of diseases and conditions

considered reportable in each jurisdiction varies over time and across jurisdictions. Current and historical
national public health surveillance case definitions used for classifying and enumerating cases consistently
at the national level across reporting jurisdictions are available at https://wwwn.cdc.gov/nndss/conditions.

 Top of Page
Form Approved
OMB No. 0920-0728
Expiration Date: 01/31/2022
The public reporting burden of this collection of information is estimated to average 20 minutes per
response for states, cities, and territories that automate case notification, 2 hours for states and cities that
do not automate, and 20 minutes for territories and freely associated states that do not automate. This
includes the time for reviewing instructions, searching existing data sources, gathering and maintaining the
data needed, and completing and reviewing the collection of information. An agency may not conduct or
sponsor, and a person is not required to respond to all collection of information unless it displays a currently
valid OMB control number. Send comments regarding this burden estimate or any other aspect of this
collection of information, including suggestions for reducing this burden to – CDC/ATSDR Reports
Clearance Officer; 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30329 ATTN: PRA (0920-0728).

Search Conditions
Enter Condition Name

CURRENT AND HISTORICAL CONDITIONS
Indexed list of current and historical nationally notifiable conditions.

2018 NATIONALLY NOTIFIABLE CONDITIONS
Conditions designated as notifiable at the national level during 2018.

Related Links

NNDSS Modernization Initiative (NMI) (http://www.cdc.gov/nmi)
NMI eShare (http://www.cdc.gov/nmi/eshare.html)
CSTE Position Statements (http://www.cste.org)
PHIN Tools and Resources (http://www.cdc.gov/phin/)



Morbidity and Mortality Weekly Report (MMWR) (http://www.cdc.gov/mmwr/)
WONDER (http://wonder.cdc.gov/)

Page last reviewed: September 28, 2018
Page last updated: September 28, 2018
Content source: Centers for Disease Control and Prevention (http://www.cdc.gov/)
Office of Public Health Scientific Services (OPHSS) (http://www.cdc.gov/ophss/)
Center for Surveillance, Epidemiology, and Laboratory Services (CSELS) (http://www.cdc.gov/ophss/csels/)
Division of Health Informatics and Surveillance (DHIS) (http://www.cdc.gov/ophss/csels/dhis/)
National Notifiable Diseases Surveillance System (NNDSS) (http://www.cdc.gov/nndss/)