TABLE 2p. Annual reported cases of notifiable diseases, by region and reporting area, United States and U.S. Territories, excluding Non-U.S. Residents*, 2019^† column labels in same order that data fields appears in each record below: Reporting Area Spotted fever rickettsiosis, Total Spotted fever rickettsiosis, Confirmed Spotted fever rickettsiosis, Probable Streptococcal toxic shock syndrome Syphilis, Total, all stages ^§ Syphilis, Congenital Syphilis, Primary and secondary tab delimited data: U.S. Residents, excluding U.S. Territories 5,207 128 5,079 416 129,813 1,870 38,992 New England 40 — 40 66 3,044 14 1,034 Connecticut 5 — 5 31 482 3 210 Maine 5 — 5 20 136 — 55 Massachusetts 15 — 15 6 1,844 9 610 New Hampshire 8 — 8 — 135 2 47 Rhode Island — — — 2 423 — 101 Vermont 7 — 7 7 24 — 11 Middle Atlantic 313 23 290 14 15,349 55 4,487 New Jersey 209 2 207 8 2,085 15 631 New York (excluding New York City) 71 14 57 5 2,164 10 886 New York City 4 2 2 — 8,336 17 1,979 Pennsylvania 29 5 24 1 2,764 13 991 East North Central 285 7 278 138 9,983 83 3,316 Illinois 136 4 132 92 4,511 32 1,374 Indiana 76 1 75 27 993 13 336 Michigan 10 — 10 5 1,905 17 678 Ohio 49 2 47 14 2,005 19 749 Wisconsin 14 — 14 — 569 2 179 West North Central 744 11 733 31 4,713 51 1,753 Iowa 11 — 11 N 359 1 132 Kansas 213 2 211 3 565 9 190 Minnesota 7 — 7 13 1,127 21 385 Missouri 483 5 478 15 2,188 18 817 Nebraska 16 1 15 — 291 — 136 North Dakota 4 — 4 — 97 — 45 South Dakota 10 3 7 — 86 2 48 South Atlantic 1,317 35 1,282 93 28,902 292 8,585 Delaware 36 1 35 — 216 2 94 District of Columbia 7 3 4 — 1,085 1 308 Florida 27 1 26 N 12,121 145 3,189 Georgia 27 4 23 53 5,679 52 1,750 Maryland 137 — 137 — 2,778 31 868 North Carolina 679 15 664 13 3,369 27 1,122 South Carolina 77 11 66 2 1,306 17 516 Virginia 302 — 302 21 2,071 11 659 West Virginia 25 — 25 4 277 6 79 East South Central 1,269 25 1,244 14 6,962 40 2,422 Alabama 476 6 470 N 1,634 15 618 Kentucky 347 8 339 14 1,096 9 438 Mississippi 114 3 111 N 2,006 3 690 Tennessee 332 8 324 — 2,226 13 676 West South Central 1,126 7 1,119 — 18,257 660 4,252 Arkansas 1,081 5 1,076 — 1,106 21 404 Louisiana 22 — 22 — 2,744 68 700 Oklahoma — — — N 1,750 43 791 Texas 23 2 21 N 12,657 528 2,357 Mountain 90 16 74 59 9,868 194 3,358 Arizona 49 10 39 — 4,022 109 1,290 Colorado 3 — 3 1 1,434 10 486 Idaho 13 4 9 3 149 1 47 Montana 2 — 2 2 140 1 67 Nevada 7 — 7 30 2,356 41 808 New Mexico — — — — 1,294 28 511 Utah 10 2 8 23 431 4 138 Wyoming 6 — 6 — 42 — 11 Pacific 23 4 19 1 32,735 481 9,785 Alaska N N N N 242 — 129 California 15 1 14 N 28,812 445 8,266 Hawaii N N N 1 252 3 120 Oregon 4 1 3 N 1,245 18 454 Washington 4 2 2 N 2,184 15 816 U.S. Territories — — — — 1,027 7 335 American Samoa N N N N — — — Commonwealth of Northern Mariana Islands — — — — 2 — 1 Guam N N N — 31 — 5 Puerto Rico N N N N 949 7 329 U.S. Virgin Islands — — — — 45 — — —: 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. * The 2019 annual tables exclude cases of nationally notifiable conditions and diseases among non-U.S. residents. As a result, data in Table 2 does not include a "Non-U.S. Resident" or "Total" row, that would have been included in the table had the data been stratified into the following four categories, based upon the "country of usual residence" (COUR) algorithm: U.S. Residents, excluding U.S. Territories; U.S. Territories; Non-US. Residents; and Total.Table 2 for the 2019 annual tables only includes the first two of these stratification categories. † To calculate rates, use the populations provided in Table 8. Note that calculation of rates for the following conditions use population subsets 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 and Invasive pneumococcal disease, and Influenza associated pediatric mortality; see Table 8 (population reference table). Also see notes 3 and 7. § Includes the following categories: primary; secondary; early non-primary non-secondary (includes cases previously reported as early latent); and unknown duration or late (includes cases previously reported as late latent syphilis and cases previously reported as late syphilis with clinical manifestations). 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. The list of national notifiable infectious diseases and conditions for 2019 and their national surveillance case definitions are available by navigating to the https://ndc.services.cdc.gov/, Surveillance Case Definitions | CDC web page, selecting "2019" for the notifiable condition list year, checking "infectious" conditions, and clicking "Get Notifiable List by Year". This list incorporates the Council of State and Territorial Epidemiologists (CSTE) position statements approved in 2018 by CSTE for national surveillance that were implemented in January 2019. Candida auris, clinical became a new national notifiable condition, and revised case definitions were implemented for the following conditions: diphtheria, acute hepatitis A, listeriosis, yellow fever, Salmonella Paratyphi infection and Salmonella Typhi infection. Salmonella Paratyphi infection and Salmonella Typhi infection replaced Paratyphoid fever and Typhoid fever, respectively, as national notifiable conditions. Salmonellosis (excluding S. Typhi infection and S. Paratyphi infection) replaced Salmonellosis (excluding paratyphoid fever and typhoid fever) as a national notifiable condition. In addition, Carbapenemase Producing Carbapenem-Resistant Enterobacteriaceae (CP-CRE) represents a consolidation of CP-CRE species Klebsiella spp, CP-CRE E. coli, and CP-CRE Enterobacter spp. Publication criteria for the finalized 2019 data are available at https://wonder.cdc.gov/nndss/documents/2019_NNDSS _Publication_Criteria_01212021.pdf, https://wonder.cdc.gov/nndss/documents/2019_NNDSS _Publication_Criteria_01212021.pdf. See also https://www.cdc.gov/nndss/docs/Readers-Guide-WONDER-Tables-20210421-508.pdf, Guide to Interpreting Provisional and Finalized NNDSS Data. Population estimates for incidence rates are July 1st, 2019, 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, 2019, 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 2019), prepared under a collaborative arrangement with the U.S. Census Bureau. Population estimates for states released July 9, 2020, 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 2019 mid-year estimates from the U.S. Census Bureau International Data Base, accessed on August 6, 2020, at https://www.census.gov/data-tools/demo/idb/#/country?YR_ANIM=2021, https://www.census.gov/data-tools/demo/idb/#/country?YR_ANIM=2021. 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 is ≤24 months, denominator is <24 months) Perinatal Hepatitis C infection (age restriction in numerator is ≤36 months, 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 2019 (National Center for Health Statistics https://wonder.cdc.gov/natality.html, Natality 2019, as compiled from data provided by the Vital Statistics Cooperative Program). The mother's race and ethnicity are used for race- and ethnicity-specific rates of congenital syphilis cases. Congenital syphilis data are published in Syphilis Statistics in the sexually transmitted diseases (STD) surveillance report (https://www.cdc.gov/std/syphilis/stats.htm, https://www.cdc.gov/std/syphilis/stats.htm) and in the historical archives of the STD surveillance report (https://www.cdc.gov/std/stats/archive.htm, https://www.cdc.gov/std/stats/archive.htm). The STD surveillance report (https://www.cdc.gov/std/syphilis/stats.htm, https://www.cdc.gov/std/syphilis/stats.htm) updates congenital syphilis cases and rates over time. 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). The following 24 jurisdictions may have incomplete data, due to the coronavirus disease 2019 (COVID-19) pandemic: Alaska, California, Connecticut, Delaware, District of Columbia, Florida, Idaho, Indiana, Kansas, Massachusetts, Minnesota, Missouri, Montana, Nebraska, New Hampshire, New York (excluding New York City), New York City, North Dakota, Ohio, Oklahoma, South Carolina, Tennessee, Texas, and West Virginia. In addition, the following 2 U.S. Territories may have incomplete data due to the COVID-19 pandemic: American Samoa and the U.S. Virgin Islands. Suggested Citation: Centers for Disease Control and Prevention. National Notifiable Diseases Surveillance System, 2019 Annual Tables of Infectious Disease Data. Atlanta, GA. CDC Division of Health Informatics and Surveillance, 2021. 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