The eastern and northwestern health districts of the state have shown the greatest reduction in the number of reported cases of shigellosis. Hepatitis B cases fell from 437 cases in 1995 to 327 cases in 1996, continuing its downward trend since 1990. It is 39.0 percent below the five year median of 538 cases. Hepatitis A showed a geographic shift. In the Southwestern Health District, Hepatitis A increased 127 cases in 1995 to 629 in 1996.
Meningococcal disease continues to increase in the state following a three year trend.
The disease has shifted from the southwest to the larger Kansas City and St. Louis metro areas. Meningococcal meningitis at 63 cases is 70.0 percent above the five year median of 37 cases. For two years in a row, Missouri's tuberculosis cases have declined. This represents an 8.2 percent decrease from 1995 when 244 cases were reported. Specifically, St. Louis city increased from 40 to 44 cases, Springfield-Greene County increased from 10 to 17 and Kansas City increased from 43 to 48.