Endemic, Notifiable Bioterrorism-Related Diseases, United States, 1992–1999

摘要

Little information is available in the United Statesregarding the incidence and distribution of diseases causedby critical microbiologic agents with the potential for use inacts of terrorism. We describe disease-specific, demo-graphic, geographic, and seasonal distribution of selectedbioterrorism-related conditions (anthrax, botulism, brucel-losis, cholera, plague, tularemia, and viral encephalitides)reported to the National Notifiable Diseases SurveillanceSystem in 1992 to 1999. Tularemia and brucellosis werethe most frequently reported diseases. Anthrax, plague,western equine encephalitis, and eastern equineencephalitis were rare. Higher incidence rates for choleraand plague were noted in the western United States and fortularemia in the central United States. Overall, the inci-dence of conditions caused by these critical agents in theUnited States is low. Individual case reports should be con-sidered sentinel events. For potential bioterrorism-relatedconditions that are endemic and have low incidence, theuse of nontraditional surveillance methods and comple-mentary data sources may enhance our ability to rapidlydetect changes in disease incidence