PID Surveillance in California

PID case reporting has been required in California since 1989.  Data from 1998-2008 indicated declines in cases and rates/100,000 from 1689 (10.1) in 1998 to 1033 (5.4) in 2008, consistent with national trends.  However, passive provider-based surveillance may reflect significant under-reporting.  Adjunct PID surveillance has included analysis of statewide hospital discharge data for 1995, 2000, and 2005, with the case definition based on ICD-9 codes for acute/unspecified PID—these data also indicated decreasing trends.  Challenges remain for improving these surveillance systems, and for understanding the association of key factors (e.g. shifts from in-patient to out-patient management; expanded chlamydia screening) with observed trends in PID.