This document summarizes disease trends and statistics from the Central Shenandoah Health District. It reports that rates of chlamydia are increasing and are highest in Harrisonburg City, Staunton City, Waynesboro City, and Buena Vista City. Gonorrhea rates are also rising, with the top localities being Staunton City, Waynesboro City, Harrisonburg City, and Augusta County. Lyme disease is higher than state averages and increasing, particularly in Staunton City, Rockbridge County, Rockingham County, and Augusta County. Salmonellosis exceeds Virginia rates and is growing, especially in Harrisonburg City, Rockingham County, Waynesboro City, and Highland