Morbidity and mortality

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Material Information

Title:
Morbidity and mortality
Uniform Title:
Morbidity and mortality (Washington, D.C. : 1952)
Running title:
Weekly mortality report
Weekly morbidity report
Morbidity and mortality weekly report
Abbreviated Title:
Morb. mortal.
Physical Description:
25 v. : ; 27 cm.
Language:
English
Creator:
United States -- National Office of Vital Statistics
Communicable Disease Center (U.S.)
National Communicable Disease Center (U.S.)
Center for Disease Control
Publisher:
The Office
Place of Publication:
Washington, D.C
Publication Date:
Frequency:
weekly
regular

Subjects

Subjects / Keywords:
Communicable diseases -- Statistics -- Periodicals -- United States   ( lcsh )
Mortality -- Periodicals -- United States   ( lcsh )
Morbidity -- Periodicals -- United States   ( mesh )
Mortality -- Periodicals -- United States   ( mesh )
Statistics, Medical -- Periodicals -- United States   ( lcsh )
Statistics, Vital -- Periodicals -- United States   ( lcsh )
Genre:
federal government publication   ( marcgt )
statistics   ( marcgt )
periodical   ( marcgt )

Notes

Additional Physical Form:
Also issued online.
Statement of Responsibility:
Federal Security Agency, Public Health Service, National Office of Vital Statistics.
Dates or Sequential Designation:
Vol. 1, no. 1 (Jan. 11, 1952)-v. 25, no. 9 (Mar. 6, 1976).
Issuing Body:
Issued by: U.S. National Office of Vital Statistics, 1952-Jan. 6, 1961; Communicable Disease Center, 1961- ; National Communicable Disease Center, ; Center for Disease Control, -Mar. 6, 1976.
General Note:
Title from caption.

Record Information

Source Institution:
University of Florida
Rights Management:
All applicable rights reserved by the source institution and holding location.
Resource Identifier:
oclc - 02246644
lccn - 74648956
issn - 0091-0031
ocm02246644
Classification:
lcc - RA407.3 .A37
ddc - 312/.3/0973
nlm - W2 A N25M
System ID:
AA00010654:00008

Related Items

Preceded by:
Weekly mortality index
Preceded by:
Weekly morbidity report
Succeeded by:
Morbidity and mortality weekly report

Full Text





Morbidity and Mortality


U. S. DEPAR


EDUCATION, AND WELFARE


POLIOMYELITIS Twenty cases of poliomyelitis, 16
paralytic, were reported for the week ending Septemnber 28.
Seven cases were reported from Pennsylvania and four
from Michigan. Two cases each were reported from Illinois
and Mississippi, while New York, Minnesota, Virginia,
Kentucky and Alabama reported single cases.
Five of Pennsylvania's cases-were from Philadelphia,
and occurred before the mass immunization program was
held in that city (see MMWR, Vol. 12, pp. 285, 293, 301).
Philadelphia has had 49, cases thus far in 1963. Of
Michigan's cases, two were from Grand Rapids, bringing
that city's total to five. A mass immunization program,
with over a 90 per 'cent response, was held in Grand
Rapids, September 2.1 (see MMWR, Vol. 12, p. 293).


Vol. 19 Nn SQ


E D NOTIFIABLE DISEASES IN THE UNITED STATES AND ON
ES FOR WEEK ENDED SEPTEMBER 28, 1963


Thus far in 1963, 285 cases have been reported.
This total represents less than one-half the number of
polio cases reported for the comparable period of 1962,
which was the lowest year on record.

BOTULISM Five cases of botulism, including one
death, were reported from Kentucky for the week ending
September 28. This brings the total number of cases of
botulism to 17 thus far in 1963, accounted for by five
separate outbreaks. Outbreaks in Michigan and West
Virginia have been previously described. (See MMWR,
Vol. 12, pp.95 and 311.) Reports on outbreaks in Kentucky
and California are described in this week's Epidemiologi-
cal Reports.


Table 1. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous week)
39th Week Cumulative
Ended Ended First 39 weeks
Disease Median
September 28, September 29, 1958 1962 Median
1963 1962 1963 1962 1958 1962
Aseptic meningitis............... 72 115 --- 1,325 1,856 ---
Brucellosis ...................... 4 5 9 277 311 566
Diphtheria...................... 8 16 16 186 306 477
Encephalitis, infectious .......... 45 51 60 1,197 1,419 1,419
Hepatitis, infectious and serum... 755 877 840 32,630 41,927 28,036
Measles ........................ 850 848 848 360,076 444,363 397,260
Meningococcal infections ......... 35 30 30 1,833 1,627 1,738
Poliomyelitis, total .............. 20 43 179 285 608 2,296
Paralytic.................... 16 34 127 242 473 1,570
Nonparalytic ................. 4 7 30 29 98 499
Unspecified.................. 2 22 14 37 227
Streptococcal sore throat
and Scarlet fever ............ 3,882 4,196 --- 259,222 241,289 ---
Tetanus ........................ 12 5 --- 196 202 ---
Tularemia ...................... 7 6 --- 217 223
Typhoid fever................... 9 27 28 390 474 618
Typhus fever, tick-borne,
(Rocky Mountain spotted)...... 5 4 --- 161 196 ---
Rabies in Animals ............... 50 43 63 2,876 2,922 2,919


Table 2. NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax: 4 Psittacosis: Calif. 1, Ky. 1 61
Botulism: Ky. 5 17 Rabies in Man: 1
Malaria: N.C. 1, Calif. 3 70 Smallpox:
Plague: Typhus, murine: Texas 2 21


For release October 4
PROVISIONAL INFI
DEAT]


A, GEORGIA


W el


FS~3~L O/B.' /d/~S 54







Morlbidity and YMortality weekly Relport


EPIDEMIOLOGICAL REPORTS

Botulism Kentucky
Five members of a Mayslick, Kentucky, family of ten
became ill with symptoms characteristic of botulism fol-
lowing a Saturday night supper which consisted of home
preserved corn.
On September 14, the mother opened a quart sized
jar of the corn, which she had cold packed approximately
one month earlier. The corn was served in varying quanti-
ties to seven members of this family. Five became ill
from 18 to 60 hours i..11. ;,, the meal. The severity of
the symptoms appeared to correlate with the amount
consumed.
The fatality occurred in a 12-year-old daughter who
began experiencing vomiting, diarrhea, diplopia, dys-
phagia, generalized weakness, and respiratory difficulty
about 18 hours after she had eaten two dishes of the corn.
Three days after ingestion she was taken to a local
physician who prescribed chewing tobacco for her vomit-
ing. The following day she was taken to another physician
who diagnosed botulism and prescribed antitoxin; but the
patient died on Friday, September 20. Autopsy demon-
strated only hyperemia of the brain.
The four other victims included the mother and three
children. The mother ate one dish of the corn. Two days
later she experienced diplopia, dysphagia and weakness
without vomiting or diarrhea A 14-year-old son ate the
contents of one dish and two additional tablespoons of
corn. Hie developed diarrhea, diplopia, dysphagia and
weakness 48 hours later. He also experienced "asthmatic
breathing" which responded to adrenalin. A 9-year-old
daughter consumed a dishful of the corn. About 60 hours
later, she began to experience diplopia, nasal speech, a
sore throat, vomiting, diarrhea, and weakness. A five-year-
old daughter consumed no more than two teaspoons of the
corn, yet developed diarrhea, dysphagia, diplopia, and
muscle weakness. All received bivalent antitoxin.
Two other members consumed very small quantities
of the corn and demonstrated symptoms to a minor degree,
only. The father ate less than one teaspoon of the corn.
He experienced diarrhea and abdominal cramping, as well
as a tightness in his throat, but was not officially reported
as a case. Although the father noted that the corn tasted
bad and smelled worse, he did not actively prevent the
other members of the family from eating this particular
food.
Three other children in the family were asleep during
the meal and did not consume any corn; none of these
three became ill at any time.
Corn from the family garden had been cold packed in
sterilized jars and boiled for four and one-half hours,
then allowed to cool after the addition of salt. In addition
to the quart jar, four half gallon jars were also prepared
and stored in the family chicken coop. At one time during


the period of storage, the jar tops were changed in the
coop
All of the contents of the quart jar were consumed by
the family. The jar was cleaned with detergent by the
mother and was not available for lab studies. The four
other half gallon jars of corn remained and were sub-
mitted for laboratory studies. In one of these four re-
maining jars, Type B toxin was demonstrated and C.
botulinum was cultured, according to preliminary lab-
oratory tests.
(Rcporri-by C. C i Toddl. M.P !., State Epidemrt-
ologist, kntaluck, and an FI8 Officcr.)

Botulism California
Six cases of botulism, including one death, were
reported from California (See MMWR, Vol. 12, page 302)
following a 25th anniversary dinner celebration for a
Parish priest. The dinner, held June 30, was attended by
300 people. The source of the botulism outbreak appears
to have been home canned mushrooms.
A 47'year-old female, who attended the affair, noted
double vision approximately 26 hours following the meal.
Two days later, because of illnuli, in speaking and
swallowing, she was admitted to a hospital. On the sixth
day after the meal, the patient died following an angio-
gram to rule out a suspected brain tumor. An autopsy was
performed but did not reveal the cause of death. The
coroner's office, however, reported the case as possible
botulism; an epidemiological investigation began. At that
time, it was learned that another patient in a different
hospital, who had symptoms of double vision and diffi-
culty in swallowing and talking, had also attended the
same affair. This patient's physician had diagnosed
botulism and had administered botulinus antitoxin. The
brother of this same patient experienced similar symptoms
but was not hospitalized. Three others autending the
dinner were found to have symptoms consisterit-with botu-
lism. None of these four received antitoxin. Another
patient, who complained of spots before her eyes and
numbness of tongue and teeth, was .lagriosed as not
botulism.
A wide variety of foods were served at this buffet
dinner. The mushrooms appear implicated on the basis of
the attack rates below:

CALIFORNIA BOTULISM
Persons Eating Listed Food Persons Not Eating Listed Food
Food Total No. III Attack Rate Total No. III Attack Rate

Mushrooms 24 7 29% 117 0 0%
Sausage 107 4 4% 35 3 9%
Ham 114 7 6% 26 0 0%
Turkey 54 1 2% 84 5 6%
Corned Beef 17 0 0% 24 7 6%
Olives 56 1 2% 78 3 4%
Cheese Coke 48 2 4% 89 4 4%


322








Morbidity and Mortality Weekly Report


The woman in charge of the food preparation did not
know the source of the mushrooms. Her husband received
a number of jars, including the mushrooms, from an un-
identified woman, whom he presumed was a Parish mem-
ber. Yet no member acknowledged this contribution. A
kitchen worker remembered emptying three quart jars of
home prepared mushrooms into a bowl for serving. No
mushrooms remained following the meal. Although all
seven individuals who had nervous system symptoms ate
the mushrooms, several other persons did likewise. Many
who tasted the mushrooms thought they were not good
and did not eat them.
Samples of the remaining food, including bologna,
salami, sausage, cream cheese, and turkey were submitted
to the Los Angeles City Health.Department Laboratory, as
well as to the Food and Drug Administration Laboratories.
All samples were negative for cultures of Clostridium
botulinum. Injection of suspensions of the food into mice
did not cause a single fatality.
Los Angeles City Health Department officials pre-
sumed that the mushrooms were improperly home prepared.
The probability that only one of the three jars of mush-
rooms was contaminated with C. botulinu, may have ac-
counted for the lack of. symptoms in those -who ate the
mushrooms but remained well.
IReported by F. A. Listick, Sanitarian, Los Angeles City
Health Department, and Philip K. Condit, M.D., Chief,
Bureau of Communicable Diseases, State Department of
Health, Berkeley, California.)

Dengue Fever Puerto Rico
As of September 30, a total of 12,962 cases of dengue
fever had been reported to the Puerto Rico Department
of Health. This represents an increase of 1,621 cases
during the past week. The predominant number of cases
continue to be received from relatively few of the
municipios. Of 77 municipios, 66 have reported cases;
11, however, account for 76 percent of the total. Even
in those reporting the largest numbers of cases, neither
high school absenteeism nor hospital admissions have
shown notable increases.


A morbidity survey, utilizing a random sample of 177
households, was conducted in the township of Guaynabo
on September 24 and 25 to determine the current attack
rate of dengue-like illness in that community. Interviews
completed on 171 households of the 591 households in
the Guaynabo study area, reveal an attack rate of 17.6
percent for the period August 1 through September 24.

AGE-SPECIFIC ATTACK RATES: DENGUE-LIKE ILLNESS
GUAYNABO, PUERTO RICO
AUGUST 1 SEPTEMBER 24, 1963


POPULATION
AGE M F T
0-9 135 135 270
10.19 107 84 191
20-29 55 57 112
30-39 46 52 98
40-49 41 46 87
50-59 22 23 45
60+ 30 32 62
Unk. 0 3 3
Total 436 432 868


CASES


A.R. (%)


67 86 153 15.4 19.9 17.6


The total attack rate in females was slightly although
not significantly higher than in males. Those in the age
groups 20 to 59 years appeared to be somewhat more
commonly afflicted (see table above).
DENGUE-LIKE ILLNESS BY WEEK OF ONSET*
Guoynabo, Puerto Rico
August I -September 24, 1963

















(*OTE. ET *g S TEBR2
(Continued on page 328)


INFANT DEATHS IN 108 CITIES
The weekly average number of infant deaths in 108
cities for the four-week period ending September 28 was
736 as compared with an expected weekly average of
755.
TOTAL DEATHS UNDER ONE YEAR OF AGE
IN 108 CITIES

WEEK ENDING 4 Week Weekly
9/7 9/14 9/21 9/28 Total Average
Observed 689 805 707 741 2,942 736

Expected 751 754 756 759 3,020 755
Excess 62 51 -49 18 78 19


DEATHS UNDER ONE YEAR OF AGE IN 108 U.S. CITIES
Average number per week by four-week periods


323










324 Morbidity and Mortality Weekly Report



Table 3. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

SEPTEMBER 28, 1963 AND SEPTEMBER 29, 1962


Poliomyelitis, Aseptic
Poliomyelitis, total cases Poliomyelitis, paralytic nonparalytic Meningitis
Cumulative Cumulative
39th week First 39 weeks 39th week First 39 weeks 39th week 39th week

1963 1962 1963 1962 1963 1962 1963 1962 1963 1962 1963 1962

UNITED STATES ...... 20 43 285 608 16 34 242 473 4 7 72 115

NEW ENGLAND.............. 2 3 7 2 3 7 -
Maine ................. -
New Hampshire ......... -
Vermont............... 1 1
Massachusetts ......... 2 2 6 2 2 6 -
Rhode Island........... -
Connecticut........... 1 1

MIDDLE ATLANTIC.......... 8 4 94 65 5 2 72 45 3 2 6 3
New York.............. 1 4 8 50 2 5 32 1 2 4 2
New Jersey............ 1 6 1 6 -
Pennsylvania.......... 7 85 9 5 66 7 2 2 1

EAST NORTH CENTRAL ....... 6 10 42 70 6 5 32 47 3 18 17
Ohio................... 8 16 4 14 2 8
Indiana............... 4 2 13 3 1 9 3
Illinois.............. 2 3 14 27 2 2 13 16 1 9 2
Michigan.............. 4 2 12 9 4 12 6 2 7 4
Wisconsin............. 1 6 5 2 2 -

WEST NORTH CENTRAL ....... 1 2 5 29 1 2 5 19 4 5
Minnesota............. 1 4 6 1 4 6 4 2
Iowa.................. 5 2
Missouri.............. 2 9 2 4
North Dakota........... 3 1
South Dakota.......... 1 1 -
Nebraska.............. 1 5 5 -
Kansas ................ 3

SOUTH ATLANTIC........... 1 4 38 46 4 34 40 1 11 10
Delaware ..... I ..... 1 I 1 1
Maryland.............. 1 I 1 1
District of Columbia.. 2 1 1 -
Virginia.............. 1 7 7 5 7 1 2 2
West Virginia......... 1 5 1 5 2 -
North Carolina ........ 3 5 3 4 -
South Carolina ........ 6 5 5 5 3
Georgia............... 1 14 11 1 13 10 -
Florida............... 2 6 10 2 6 7 2 7

EAST SOUTH CENTRAL ....... 4 9 60 58 4 9 56 47 11 6
Kentucky.............. 1 4 1 25 1 4 1 19 3
Tennessee............. 8 9 8 4 2
Alabama ............... 1 5 44 22 1 5 40 22 1 1
Mississippi ........... 2 7 2 2 7 2 10 -

WEST SOUTH CENTRAL ....... 9 24 261 7 23 204 2 15
Arkansas.............. 2 4 9 2 3 9 1
Louisiana.............. 1 14 19 1 14 17 --
Oklahoma.............. 1 12 I 10 6
Texas................. 5 6 221 3 6 168 2 8

MOUNTAIN................. 1 12 1 8 6 6
Montana............... 3 -
Idaho................. 1 2 1 1 -
Wyoming............... 2 1 1
Colorado.............. -1 2 5
New Mexico ............ -
Arizona.................. 3 3 2 1
Utah................. .. 1 1 1
Nevada................. .... -

PACIFIC.................. 3 18 60 3 16 56 16 53
Washington ............ 2 1 2 1 3
Oregon ................ 2 5 1 5-
California............ 3 15 53 3 14 49 15 50
Alaska................ -
Hawaii................ .- -

Puerto Rico.............. 5 11 4 11 -








Morbidity and Mortality Weekly Report 325


Table 3. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

SEPTEMBER 28, 1963 AND SEPTEMBER 29, 1962 (Continued)



Brucellosis Diphtheria Encephalitis, Hepatitis, Measles
infectious infectious and serum
Cumu- Cumu- 39th week
lative lative Under 20 &
39th week 39 weeks 39th week 39 weeks 39th week 20 yr. over Total 39th week
1963 1963 1963 1963 1963 1962 1963 1963 1963 1962 1963 1962
UNITED STATES ...... 4 277 8 186 45 51 357 352 75-5 877 850 848

NEW ENGLAND.............. 1 8 36 30 70 71 22 67
Maine................. 12 8 20 22 4 1
New Hampshire......... 12 10 25 1 -
Vermont............... 1 1 1 1 16
Massachusetts......... 6 10 6 17 36 6 34
Rhode Island .......... 2 2 2 2
Connecticut........... 1 6 7 10 9 .14

MIDDLE ATLANTIC.......... 6 21 11 14 72 87 159 170 109 77
New York.............. 3 13 10 11 34 53 87 100 58 29
New Jersey............ 1 3 6 18 24 31 17 26
Pennsylvania.......... 2 5 1 3 32 16 48 39 34 22

EAST NORTH CENTRAL ....... 1 30 23 7 1 69 48 123 137 201 186
Ohio.................. 1 1 15 5 22 54 33 18
Indiana............... 5 5 5 11 5 16 11 19 10
Illinois.............. 18 12 1 16 20 38 24 34 26
Michigan.............. 5 3 1 25 18 43 38 54 68
Wisconsin .............. 1 2 2 2 4 10 61 64

WEST NORTH CENTRAL ....... 3 155 1 38 8 1 15 4 22 32 81 38
Minnesota............. 8 15 2 1 1 6 1 4
Iowa.................. 2 115 1 1 1 1 6 9 23
Missouri............... 1 12 1 2 8 3 11 3 44 -
North Dakota ...... .... 1 2 2 1 1 8 27 11
South Dakota........... 8 11 2 1 3 1 -
Nebraska.............. 6 8 1 1 -
Kansas................ 6 1 2 5 7 NN NN

SOUTH ATLANTIC........... 15 3 43 7 18 32 36 76 100 77 48
Delaware .............. 1 1 2 3 1 1
Maryland.............. 2 3 6 9 13 14 1
District of Columbia.. 1 1 1 2 4 -
Virginia.............. 7 5 5 15 14 5 10
West Virginia......... i 3 2 7 9 35 19
North Carolina........ 4 2 2 1 11 8 19 32 1 3
South Carolina........ 2 17 1 1 6 6 11
Georgia................ 3 1 13 11 1 1 3 3 -
Florida............... 1 9 3 6 7 11 18 16 15 3

EAST SOUTH CENTRAL ....... 13 1 14 4 4 27 23 52 78 41 32
Kentucky.............. 3 6 5 13 33 4 9
Tennessee ............. 6 3 2 2 15 6 21 24 25 22
Alabama............... 4 10 3 3 6 11 1 1
Mississippi........... 1 1 2 2 3 9 12 10 11 -

WEST SOUTH CENTRAL ....... 32 3 30 1 5 25 16 41 80 56 97
Arkansas.............. 7 2 1 3 3 1 4 9 -
Louisiana.............. 8 3 13 11 7 18 13 2
Oklahoma............... 5 6 1 1 1 -
Texas.................. 12 9 2 11 7 18 58 55 95

MOUNTAIN.................. 9 5 3 3 15 11 49 64 69 81
Montana............... 3 3 5 9 5 34 15
Idaho ................. 8 3 8 20
Wyoming................ 1 4 6
Colorado .............. 3 8 1 13 25 3 15
New Mexico ............ 2 2 4 6 4 NN NN
Arizona ............... 3 2 10 17 20 12
Utah .................. 5 1 2 1 3 6 4 13
Nevada............... -

PACIFIC.................. 16 4 4 5 66 97 163 145 194 222
Washington............ 1 1 9 18 27 36 20 45
Oregon................. 3 9 12 21 16 27 29
California............ 12 4 3 4 45 63 108 88 110 76
Alaska................ 3 4 7 5 33 27
Hawaii................ 1 4 45

Puerto Rico.............. 12 9 3 12 33 19 19









326 M4orbidily and Mortality Weekl Report


'ahblc T. CASES OF SPECIFIED NOTIIIABLE DISEASES: VNITII) STATES

FOR WEEKS NDI)IED

SEPTEMBER 28, 1963 AND SEPTEMBER 29, 1962 (Continued)


Meningocotcal Streptococcal Tickborne
Infections Sore Throat & Tetanus Typhus Tirlaremia Typhoid Fever Rabies in Animals
SScarlet Fever (Rcky Mt.
Area Cumu- Spotted) Cumu- Cumu-
lative native lative
39th wk 39 weeks 39th week 39th wk. 39th wk. 39th wk. 39thwk. 39 weeks 39th week 39 weeks


UNITED STATES.... 35 1,833 3,882 4,196 12 5 7 9 390 50 43 2,876

NEW ENGLAND......... 112 249 237 1 11 26
Maine.............. 17 13 10 2 1
New Hampshire ...... 4 5 7 12
Vermont ............ 4 1 1 12
Massachusetts ...... 53 33 36 6 1
Rhode Island......... 10 14 2? -
Connecticut........ 24 184 157 2 -

MIDDLE ATLANTIC..... 4 252 122 119 74 6 90
New York........... 3 119 85 60 34 3 67
New Jersey......... 35 25 26 5 -
Pennsylvania......... 1 98 12 33 35 3 23

EAST NORTH CENTRAL.. 7 283 262 259 1 2 39 3 8 450
Ohio ............... 77 29 31 15 7 263
Indiana............ 7 43 47 60 1 1 7 42
Illinois ........... 52 65 43 9 64
Michigan ........... 84 76 70 1 3 1 42
Wisconsin .......... 27 45 55 5 2 1 39

WEST NORTH CENTRAL.. 115 180 139 2 2 23 14 15 736
Minnesota.......... 22 11 4 3 9 4 184
Iowa ............... 7 21 42 2 4 5 279
Missouri ........... 34 8 3 1 14 2 119
North Dakota ....... 12 72 80 1 29
South Dakota ....... 5 2 3 1 1 1 1 2 81
Nebraska ........... 24 1 1 26
Kansas ............. 11 66 7 1 2 18

SOUTH ATLANTIC...... 6 338 478 375 2 4 1 52 8 5 405
Delaware ........... 4 5 4 3 1
Maryland ........... 50 50 5 1 1 9 -
Dist. of Columbia.. 6 1 -
Virginia........... 1 75 151 82 8 3 1 145
West Virginia ...... 17 128 128 6 3 106
North Carolina..... 2 60 19 22 1 3 6 1 12
South Carolina..... 1 18 45 29 3 7
Georgia............ 1 28 1 2 2 4 65
Florida............ 1 80 78 103 1 15 1 69

EAST SOUTH CENTRAL.. 1 134 170 733 4 5 55 3 4 228
Kentucky........... 1 29 115 77 1 11 1 2 109
Tennessee .......... 60 598 633 1 21 2 2 102
Alabama ............ 23 19 2 9 17
Mississippi........ 22 38 21 3 4 14 -

WEST SOUTH CENTRAL.. 4 168 396 561 2 1 1 1 71 9 1 554
Arkansas........... 11 2 1 1 25 4 63
Louisiana.......... 2 69 2 2 22 1 42
Oklahoma........... 1 30 4 1 5 1 1 49
Texas.............. 1 58 388 560 1 19 3 400

MOUNTAIN............ 1 60 772 1,057 4 16 7 2 113
Montana ............ 3 41 49 1 -
Idaho .............. 6 43 98 -
Wyoming............ 4 12 33 3 -
Colorado........... 16 177 382 6 1 16
New Mexico......... 4 341 288 3 2 35
Arizona............ 1 10 93 134 7 4 1 51
Utah............... 14 65 73 -
Nevada............. 3 1 11

PACIFIC............. 12 371 653 716 49 6 2 274
Washington......... 28 155 195 2 -
Oregon............. 2 27 4 19 2 1 8
California......... 10 296 396 415 42 5 2 257
Alaska............. 12 16 54 I 9
Hawaii............. 8 82 33 -2 -
Puerto Rico......... 7 8 1 1 12 1 12









327


Morbidity and Mortality Weekly Report





Table 4 (C). TOTAL DEATHS UNDER 1 YEAR OF AGE IN REPORTING CITIES



(Tables 4(A), 4(B), 4(C), and 4(D) will be published in sequence covering a four-week period.)o


For weeks ending For weeks ending
Area / Area
19/7 9/14 9/21 9/28 119/7 9/14 9/21 9/28


NEW ENGLAND:
Boston, Mass.............. 3 11 12 14
Bridgeport, Conn.......... 1 2 3 4
Cambridge, Mass........... -
Fall River, Mass.......... 2 3 1
Hartford, Conn............ 3 4 4 6
Lowell, Mass.............. 1 1 1
Lynn, Mass................ 1 1 1
New Bedford, Mass......... 2 1
New Haven, Conn........... 2 3 14
Providence, R.I........... .3 3 3 2
Somerville, Mass.......... 1 2 1
Springfield, Mass......... 2 3 1 1
Waterbury, Conn........... 1 1 2 1
Worcester, Mass........... 1 4 1 3

MIDDLE ATLANTIC:
Albany, N.Y............... 4 3 5 1
Allentown, Pa............. 5 2 2
Buffalo, N.Y.............. 8 9 10 10
Camden, N.J............... 3 9 4
Elizabeth, N.J............ 3 2 5 -
Erie, Pa .................. 5 3 2 1
Jersey City, N.J.......... 4 4 3 7
Newark, N.J............... 9 8 8 3
New York City, N.Y........ 71 80 64 104
Paterson, N.J............. 2 3 2 3
Philadelphia, Pa.......... 11 40 33 32
Pittsburgh, Pa........... 9 13 5 7
Reading, Pa............... 2 4 3 1
Rochester, N.Y............ 7 9 8 5
Schenectady, N.Y.......... 3 1 2 1
Scranton, Pa .............. 2 3 2
Syracuse, N.Y............. 4 7 8 7
Trenton, N.J.............. 2 1 6 2
Utica, N.Y................ 1 1 -
Yonkers, N.Y .............. 1 4 5

EAST NORTH CENTRAL:
Akron, Ohio............... 4 4 2 1
Canton, Ohio.............. 1 3 1 3
Chicago, Ill.............. 49 42 45 40
Cincinnati, Ohio.......... 10 15 8 8
Cleveland, Ohio........... 16 18 15 9
Columbus, Ohio ............ 8 12 8 11
Dayton, Ohio .............. 1 9 11 2
Detroit, Mich............. 14 13 19 21
Evansville, Ind........... 4 1 1 1
Flint, Mich............... 3 9 4 6
Fort Wayne, Ind........... 1 1 1 1
Gary, Ind................. 1 8 3 1
Grand Rapids, Mich........ 1 11 2 7
Indianapolis, Ind......... 10 10 10 13
Madison, Wis............. 5 1 3
Milwaukee, Wis............ 8 8 18 5
Peoria, Ill............... 3 6 4 2
Rockford, Ill ............. 5 2 3 2
South Bend, Ind ........... 2 2 -
Toledo, Ohio.............. 3 5 3 5
Youngstown, Ohio.......... 5 2 1 1

WEST NORTH CENTRAL:
Des Moines, Iowa.......... 3 2 1 3
Duluth, Minn.............. 2 2 -
Kansas City, Kans......... 7 2 6 4
Kansas City, Mo........... 5 6 7 8
Lincoln, Nebr............. 2 1 2
Minneapolis, Minn......... 12 10 9 9
Omaha, Nebr............... 3 4 4 3
St. Louis, Mo............. 13 15 14 13
St. Paul, Minn............ 5 6 3 5
Wichita, Kans............. 3 4 2 6

*Estimate based on average percent of divisional total.
Totals for previous weeks include reported corrections.

NOTE: All deaths by place of occurrence.


SOUTH ATLANTIC:
Atlanta, Ga .............. 11 12 13 13
Baltimore, Md............ 22 16 24 10
Charlotte, N.C............ 5 7 4 5
Jacksonville, Fla........ 8 5 2 4
Miami, Fla............... 7 6 5 4
Norfolk, Va.............. 7 6 2 4
Richmond, Va ............. 16 5 5 5
Savannah, Ga............. 8 5 1
St. Petersburg, Fla ...... 1 2 4 1
Tampa, Fla............... 7 4 2 3
Washington, D.C.......... 18 13 13 11
Wilmington, Del .......... 2 3 6 3

EAST SOUTH CENTRAL:
Birmingham, Ala.......... 7 7 8 7
Chattanooga, Tenn........ 1 1 8
Knoxville, Tenn.......... 3 5 4 -
Louisville, Ky........... 7 16 3 6
Memphis, Tenn............ 17 12 8 7
Mobile, Ala.............. 4 8 3 5
Montgomery, Ala.......... 1 7 4 1
Nashville, Tenn.......... 2 11 7 2

WEST SOUTH CENTRAL:
Austin, Tex.............. 1 6 24 5
Baton Rouge, La.......... 5 6 3
Corpus Christi, Tex ...... 5 4 4 4
Dallas, Tex.............. 12 11 17 11
El Paso, Tex ............. 6 7 5 3
Fort Worth, Tex.......... 4 8 4 3
Houston, Tex............. 8 21 11 18
Little Rock, Ark......... 4 8 7
New Orleans, La.......... 15 18 9 17
Oklahoma City, Okla ...... 9 7 4 8
San Antonio, Tex......... 5 6 7 11
Shreveport, La........... 1 8 7 5
Tulsa, Okla.............. 9 8 5 4

MOUNTAIN:
Albuquerque, N. Mex ...... 8 9 1 2
Colorado Springs, Colo... 4 -
Denver, Colo ............. 6 11 6 15
Ogden, Utah.............. 1 1 2 1
Phoenix, Ariz............ 5 6 10 4
Pueblo, Colo............. 1 1 2
Salt Lake City, Utah ..... 3 2 2 5
Tucson, Ariz............. 7 3 2 5

PACIFIC:
Berkeley, Calif.......... 1 -
Fresno, Calif............ 8 4 4 6
Glendale, Calif.......... 4 2
Honolulu, Hawaii......... 3 7 8 11
Long Beach, Calif........ 6 4 3
Los Angeles, Calif....... 39 29 32 37
Oakland, Calif ........... 3 7 3 3
Pasadena, Calif........... 1 1 1 2
Portland, Oreg............ 8 7 4 7
Sacramento, Calif........ 4 2 3 4
San Diego, Calif......... 11 3 10 5
San Francisco, Calif ..... 5 11 6 14
San Jose, Calif .......... 4 1 3 3
Seattle, Wash ............ 7 4 11 5
Spokane, Wash ............ 2 4 4 3
Tacoma, Wash............. 2 3 2*

San Juan, P.R.............. 1 1 (---)


oCurrent Week Mortality for 108 Selected Cities


4(A) Total Mortality, all ages ...................
4(B) Pneumonia-Influenza Deaths, all ages ........
4(C) Total Deaths under 1 Year of Age............
4(D) Total Deaths, Persons 65 years and over.....


10,988
335
741
6,111







328


The 153 cases are shown by week of onset in the
figure on page 323. Nine cases appeared in early August
followed by a progressive increase in cases in late
August and early September. It is uncertain as to whether
the peak of the outbreak in this community has yet been
reached. Additional surveys will be conducted in subse-
quent months.
(Reported by Victor Gonzales, M.D., Director, Bureau of
Health, Puerto Rico Department of Health, and a team
from the Communicable Disease Center.)

INTERNATIONAL NOTES

Polio Canada

Five new cases of poliomyelitis were reported in
Quebec for the week ending September 21, 1963, bringing
the corrected total thus far in 1963 to 68. (See MMWR,
Vol. 12, page 301.) Only 6 cases of polio have been re-
ported in the other Canadian provinces thus far in 1963.
Two cases each have been reported from New Brunswick
and Alberta. Ontario and Saskatchewan have reported
single cases.
In 1962, there were 76 Canadian poliomyelitis cases
for the comparable period. Forty-four of these were from
Quebec.

Dengue Fever Jamaica
Four hundred and sixty-six cases of dengue have
been reported in Jamaica through September 14 of this
year. Dengue appears to have been on the wane during
the past four weeks.

Smallpox Hungary
Hungary has declared Budapest free of smallpox as
of September 25. One non-imported smallpox case had
been isolated on August 27, but investigation failed to
reveal the origin of infection-of this case.
Budapest was the last remaining smallpox infected
local area in Europe.

Cholera Korea

The first confirmed case of cholera occurred in Pusan
September 17. As of September 21, 53 cases with 10
deaths were reported.
In Seoul, one confirmed local case of Cholera El Tor
occurred September 22.
These represent the first reports of cholera in Korea
since 1937.

Cholera Japan
One imported cholera case was diagnosed September
18 in Yokohama. The victim was among 54 crew members
of the S. S. Gurung Kerinitji, which had left Djakarta
August 20, Hong Kong September 9, and which arrived in
Yokohama September 16. The source of infection is being
investigated.


UNIVERSiTY OF FLORIDA

II 1262 08864 0353III
3 1262 08864 0353


Notes: These provisional dat are based on weekly telegrams to the Coammeal
cable Disease Center by the individual State health deparimelts.
Sy.bol.: --- Data o, -aaijable
SQuantity sere
Procedures for construction of various mortality curves may be obtained fhoa
Statistics Sectioa. Comsnicable Di.ee Cestoe, Public health Servie,
U. S. Department of Health. Education, ad Welfare. Atlata 22, Georsgia.


U.S. DEPOSITORY


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Morbidity and Mortality Weekly Report