Officially Counting the Cases: Reconciling New Jersey's Final Annual MMWR Numbers with CDC's

During 2001 to 2008, New Jersey’s Communicable Disease Service (CDS) transitioned from paper to electronic reporting of communicable diseases in the web-enabled Communicable Disease Reporting and Surveillance System (CDRSS), thereby reducing reporting times from months to days while significantly increasing the level of reporting to CDC annually. Weekly MMWR transmissions are sent to CDC’s National Notifiable Diseases Surveillance System (NNDSS) to report cases of infectious diseases throughout the MMWR year. As a result of increased reporting, progressively more cases (14,608 in 2002 to 36,304 in 2007, not including STDs) required CDS staff verification for the final reconciliation with the NNDSS data for each MMWR year reported. Since CDRSS is a dynamic system, updates and changes by investigators at the local level complicated the process of data transmission to the CDC. In 2006, CDS decided that once a case has been validated for CDC transmission, it becomes unavailable for further investigation by local health departments. By implementing this process electronically, any changes to the cases are only permitted by approval of CDS staff to limit case editing prior to and after transmission to CDC. CDRSS can generate CDC transmission files for specified date ranges, MMWR weeks, or the entire year. Regular communication via e-mail reports sent to stakeholders, including CDC, has helped to make case reporting and closeout timelier and less onerous. Increased confidence in the validity of the final counts provides a solid platform to support public health decisions and further lends credence to a direct correlation between the measured impact of timely public health interventions for specific diseases, including education, and documented decrease in the official counts for those diseases. Streamlining work processes and providing support, training and good communications have helped New Jersey produce higher quality reporting.