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Summary
Many communicable disease cases go unreported in the US. This study found low reporting rates, with viral hepatitis at 11% and total cases at 35%, highlighting a critical surveillance gap.
Area of Science:
- Public Health
- Epidemiology
- Infectious Disease Surveillance
Background:
- Communicable disease surveillance in the US relies on physician reporting.
- Underreporting of communicable diseases is a recognized issue.
- Determining accurate reporting rates for many diseases remains a challenge.
Purpose of the Study:
- To determine the reporting rates for selected communicable diseases.
- To assess the completeness of disease case reporting in a specific geographic area.
Main Methods:
- Retrospective review of hospital discharge records from 11 Washington, DC hospitals.
- Identification of patients with specific communicable diseases.
- Calculation of the percentage of identified cases that were reported.
Main Results:
- 0.61% of hospitalized patients had a selected communicable disease.
- Reporting rates varied significantly by disease: viral hepatitis (11%), H. influenzae meningitis (32%), salmonellosis (42%), meningococcal meningitis (50%), shigellosis (62%), tuberculosis (63%).
- Overall reporting rate for all studied communicable diseases was 35%.
Conclusions:
- Significant underreporting of communicable diseases exists, impacting surveillance accuracy.
- Low reporting rates may not be confined to the study area.
- Recommendations include supplemental reporting from medical laboratories and hospital infection control.