A recent spurt in reporting has pushed the cumulative total of AIDS cases diagnosed in Maryland past the 10,000 mark.
The total leaped by more than 1,100 cases -- a 13 percent increase -- between July 1 and Sept. 30, according to figures released by the state this month.
The new data show that 10,140 cases of AIDS -- up from 8,976 in June -- have been diagnosed in Maryland since the start of the epidemic in 1981. Of those 10,140 people, 5,637 have died.
The recent three-month increase in reported cases -- about equal to the number of new cases for all of 1990 -- stemmed mainly from a backlog that had gone unrecorded by the Baltimore City Health Department in early 1994, said state health officials.
The reporting foul-up was caused by job vacancies in the city's AIDS surveillance division -- which have since been filled.
"What we have learned is that [AIDS] cases have been going under-reported and now we need to apply those lessons to future reporting methods," said Dr. Joseph Horman, acting director of the state AIDS Administration.
The agency, which has overall responsibility for AIDS case-reporting in Maryland, will evaluate both the methods used to process the 1,164 newly recorded cases as well as the city's entire surveillance program. The evaluation won't be completed until sometime next month, said Dr. Horman.
"We have come away feeling as though we are caught up [on the number of cases], but I wouldn't say that everything is OK with the city as far as surveillance goes. We need to review the data first," he said.
But city officials say they are confident that the surveillance division is now performing adequately. "We are up to full staff now and we're running well," said Dr. Arista Garnes, assistant health commissioner. "We should be able to stay on top of things."
As of last year, Maryland had the seventh highest rate of AIDS, or cases of acquired immune deficiency syndrome per 100,000 population, according to the federal Centers for Disease Control and Prevention in Atlanta.
Accurate counts of cases are important because federal AIDS funding is partially based on the totals for each metropolitan area.
There are two deadlines -- March 31 and Sept. 30 -- for metropolitan areas and states to report new AIDS diagnoses to CDC as part of applications for federal money.
Several months ago, state officials began to suspect that there was a backlog of cases in Baltimore; for the first quarter of 1994, the city had recorded 14 new AIDS diagnoses.
To prevent Maryland from losing more money, state and city health officials and health care providers scrambled to update their lists of AIDS cases and to record them properly during the period from July 1 to Sept. 30.
The city health department plays a key role in tracking the AIDS epidemic in Maryland because almost 50 percent of all cases of AIDS in the state occur in the city.
Many health care providers throughout in the state have tended to fall behind in reporting new cases of AIDS, said Jan Markowitz, chief of epidemiology at the AIDS Administration.
Under Maryland law, doctors and health care workers are required to notify the local health department if a patient has AIDS or symptoms considered indicative of AIDS.