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 other CDC programs; 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 a small 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 nationally notifiable diseases is reviewed and modified annually by the CSTE and CDC. Every nationally notifiable disease is not necessarily reportable in each state.