Morbidity and mortality

MISSING IMAGE

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:
AA00010654:00010

Related Items

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

Full Text



NATIONAL COMMUNICABLE DISEASE CENTER


Vol. 16, No. 9






Week Ending
March 4, 1967


U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE


PUBLIC HEALTH SERVICE


BUREAU OF DISEASE PREVENTION AND ENVIRONMENTAL CONTROL


CURRENT TRENDS
MEASLES 1967

Figure 1, which has appeared in all except one issue
of the 1967 \1I'R. has been changed in this issue to per-
mit an extension through May 1967 of the time period
covered by this graph. To do so, it was necessary to omit
the initial weeks (October 15 through December 3, 1966) of
the epidemiologic year during which there was compara-
ti.I'l. liiile d r ihe epidemiologic curves. The
.jr.irie i edili.- graph has been reduced
b. one-asl


J UL
*1967 I Pi


CONTENTS
Current Trends
Measles 1967 . . 69
Epidemiologic Notes and Reports
Salmonellosis New Mexico . . 70
Surveillance Summary
Hepatitis Summer and Fall Quarters,
Epidemiologic Year 1966-67 . .. 71
International Notes
Quarantine Measures . . 7

The total of 2,390 cases* of measle-s reported for the
9th week of 1967 (ending March 4) represents a decrease
of 75 cases when compared to the total of 2.465 reported
(Continued on page 70)
*Report from Alaska not included.


gure 1


ED MEASLES IN THE UNITED STATES, 1966-67
COMPARED WITH 1963-64 TO 1965-66


*- 196 64
1964 65


- 1965 -66
- 1966 -67















-* S *- -


10 17 24 31 7 14 21 28 4 II 18 25 4 II 18 25 1 8 15 22 29 6 13 20 27
DEC JAN FEB MAR APR MAY
WEEK ENDING


/-\v'-













for the preceding week and 6,274 cases less than the total
of 8,664 cases reported for the comparable week of 1966.
Four states reported 57 percent of the cases for the 9th
week: Arkansas-195: California-242: Ti ,.--; .. and
Washington-168. The number of reported cases by week


MARCH 4, 1967


for the period December 4 through March 4 is shown in
Figure 1 (page 69).

(Reported by the Childhood Viral Diseases Section, Epi-
demiology Program, NCDC.)


EPIDEMIOLOGIC NOTES AND REPORTS
SALMONELLOSIS New Mexico


Between October 30, 1966, and January 20, 1967, Sal-
monella thompson has been isolated from 97 individuals
residing in Rio A,r,. Santa Fe. Sandoval, and Bernalillo
Counties in New Mexico. The epidemic curve reached its
peak during the week ending January 7, 1967.
Of the 97 individuals with positive stool specimens,
41 have been interviewed. Beef jerky caree seca) has
been incriminated in 38 of these 41 interviews. The beef
jerky processed at one local company in Albuquerque has
been specifically named as the brand eaten by 21 persons:
in nine other instances, stores have been named which sell
the same brand as well as other brands. Two of the 41
persons interviewed are believed to have no relation to the
current epidemic.
Salmonella thompson has also been isolated from nu-
merous samples of beef jerky. All positive samples of the
jerky were processed in Bernalillo County, with the ex-
ception of one from out of state.
Recommendations have been made by the New Mexico
Department of Health to the food industries involved regard-


ing methods of safe and sanitary production of beef jerky.
Further investigations are in progress.
(Reported by Dr. Daniel E. Johnson, Chief, Public Health
Laboratory, and Dr. Thomas 11. Tomlinson. Jr., Associate
Director of Human Factors, New Mexico Department of
Public Health; and two EIS 0. -
Editorial Note:
Beef jerky is thinly sliced beef which has been
treated with preservatives and thoroughly heated and
dried. The meat is first sliced so it will have a maximum
thickness of 1/8-inch at the end of the drying process.
After the slices are uniformly salted, they are placed in
single layers on metal racks in a drying chamber or room
which should have a minimum temperature of 165F for
the first hour and a minimum of 145F for an additional 24
hours. Final packing and labeling is often done in the
same work area in which the meat was prepared for drying.
The product needs to be carefully protected against con-
tamination during the entire process since jerky is ordi-
narily eaten without further processing or cooking.


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous weeks)
9th WEEK ENDED CUMULATIVE, FIRST 9 WEEKS
MEDIAN
DISEASE MARCH 4, MARCH 5. 1962 1966 MEDIAN
1967 1966 1967 1966 1962 1966
Aseptic meningitis .... . .. 22 29 27 236 258 231
Brucellosis .......... ................ 4 4 4 30 34 51
Diphtheria ... ........ 1 4 4 25 25 35
Encephalitis, primary:
Arthropod-borne & unspecified ........... 21 19 192 209 -
Encephalitis, post-infectious .... 19 20 92 138 --
Hepatitis, serum . . 37 21 955 318 186 8431
Hepatitis, infectious .................... 823 784 1 6,966 6.452
Malaria .................. ......... ... 53 5 1 319 48 18
Measles (rubeola)....................... 2,390 8,664 12,273 17,587 57,056 71,382
Meningococcal infections, total ... ....... 61 125 79 524 826 514
Civilian ............................ 48 110 484 696 -
Military................ ............ ..... 13 15 40 130 -
Poliomyelitis, total ..... ............... 1 1 2 9
Paralytic ..... ............. ...... 1 1 1 5
Rubella (German measles). .. ....... 1,209 1,489 7.400 9,771 --
Streptococcal sore throat & scarlet fever .. 14,662 13,089 12,202 106,654 97,449 90,321
Tetanus................ ................ 1 1 4 26 18 32
Tularemia ............... ..... ..... 1 2 2 19 40 43
Typhoid fever .......................... 6 8 8 47 44 59
Typhus, tick-bome (Rky. Mt. spotted fever) 6 8 3

Rabies in animals ..... ............. 100 73 73 690 646 636

NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax .... .. ............ Rabies in man ........
Botulism ............ ... .... ........... Rubella, Congenital Syndrome ........................
Leptospirosis: La.-2 ................................ 8 Trichinosis: Wash.-1 .... ... ............... ... 14
Plague ... ........ ... .. ... ..... ....... Typhus, marine .................................... 4
Psittacosis ............. .... ....... .. ...... 7 .. ... ...................... ............. ... .....


Morbidity and Mortality Weekly Report


MEASLES 1967 (Continued from front paye)








Morbidity and Mortality Weekly Report


SURVEILLANCE SUMMARY
HEPATITIS Summer and Fall Quarters
Epidemiologic Year 1966-67*


During hei sununer quarter (July 3 October 1) of the
current opidemiologic ear 19I16(-67, 7.298 cases of viral
hepatitis were, reported ini the United States. During the
fall quarter (October 2 January 1) 9,150 cases were re-
ported. These represent rates of 3.7 and 4.6 cases per
100.000 population for the two quarters. respectively.
Tablles 1 and 2 show the numbers of cases and rates, re-
spectively, for these two quarters in relation to those for
the last S epidemiologic years.
Figure 2 presents the number of reported cases per
100,000 population by 4-week periods from July 1952
through December 1966. The overall pattern since 1960(1-61
has been one of continuing decline in incidence: the donwn-
ward trend, howleer. has been less marked since 1964-65.
Since the peak summer quarter incidence in 1961-62
(7.8). successive summer quarters through 1966-67 reflect
a continuing decline in rates. Although a similar pattern


has generally been observed for corresponding ears in
(the fall quarters, the -rate noted in thlie fall of 1966-67 (1,6)
was greater than that of the fall for the pre ious 1,iar(L.2).
Subsequent to the peak year (1953-51) of the first
epidemic cycle, the downward trend in rates during suc-
cessive fall quarters \Aas reversed in 195l-59. The fall
quarter rate rose to 2.3 from the rate of 1.6 noted during
the 1957-58 fall quarter; this reversal took place 2 years
before the peak of the second eyele of 196(0-61. If the samll
pattern were to continue as in the 2 years prior to the peak
year 1960-61. one might expect an increasing incidence,
over the next 2 years with another peak occurring in the
epidemiologic year 196S-69.
(Reported by the hepatitis Unit, Kpidemlioloiy Progrnm.
NCDC.)
*Hepatitis morbidity dat;, are summarizd in term, of an "Epi-
demiologic .. which runs from the 27th woe k of (ach ear
Through the '. i week of the succeeding year.


4.0 --


A


2C ________ _






11. ____
0 T I- A -- 4 \ A -


Week Number: 27 1 27 1 V7


---+ -I + I -


Year: 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968


Table 1
Number of Reported Cases of Viral Hepatitis Per Quarter
(Values include revised and delayed weekly reports
through current week)


Table 2
Reported Cases of Viral Hepatitis
Per 100,000 Population Per Quarter
(Population as of January 1, middle of epidemiologic year)


Epidemi
ologic
year


Summer Fall Winter Spring Total
Quarter Quarter Quarter Quarter Year


1956-57 3,469 4,115 5,019 3,938
1957-58 2,925 2,782 4,414 3,876
1958-59 3,262 4.'4 '"- 7,088 4,864
1959-60 4,630 ,..1I 9,793 9,917
1960-61 8,940 12,403 23,026 19,898
1961-62 14,229 15,637 18,028 13,626
1962-63 10,273 11,383 13,805 9,861
1963-64 8,969 l1,-.0., 12,118 9,330
1964-65 7. 11*, 9,350* 10,311 7,876
1965-66 7,361 8,100 9,208 7,744
1966-67 7.298 9,150
*14-week periods


16,541
13,997
19,457
30,774
64,267
61,520
45,322
40,673
35,127
32,413


Epidemi-
ologic
Year
1956-57
1957-58
1958-59
1959-60
1960-61
1961-62
1962-63
1963-64
1964-65
1965-66
1966-67


Summer Fall Winter Spring Total
Quarter Quarter Quarter Quarter Year


Figure 2
REPORTED CASES
OF VIRAL HEPATITIS

Case Rate by Four-Week Periods
U.S. Since July 1952


MIRCI( 4, 1967


L .. ....


Z7 I 27 I1


27 I Z7 I


7 2 I 27 I 27 I 27 I 2 I


27 I


I 27 I Z?


^-









72 Morbidity and Mortality Weekly Report


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED
MARCH 4, 1967 AND MARCH 5. 1966 (9TH WEEK)


ENCEPHALITIS HEPATITIS

ASEPTIC Primary
AREA MENINGITIS BIRUCELLOSIS DIPHTHERIA including post- Serum Infectious
unsp. cases Infectious
1967 1966 1967 1967 1967 1966 1967 1967 1966 1967 1966
UNITED STATES... 22 29 4 1 21 19 19 37 21 823 784

NEW ENGLAND.......... 5 2 3 1 31 25
Maine .............. 1 3 9
New Hampshire...... 3
Vermont............ 2 2
Massachusetts...... 1 20 8
Rhode Island ....... 2 2 1 2 2
Connecticut ........ 2 1 4 1

MIDDLE ATLANTIC ...... 1 1 3 6 1 23 13 147 120
New York City ...... 1 3 16 8 41 19
New York, up-State. 1 1 2 1 31 32
New Jersey......... 3 4 2 26 19
Pennsylvania ....... 1 1 1 2 49 50

EAST NORTH CENTRAL... 1 5 1 3 4 1 2 126 213
Ohio................ 1 1 2 1 1 17 36
Indiana............ 2 28 7
Illinois........... 1 2 25 47
Michigan........... 2 1 2 1 44 115
Wisconsin .......... 12 8

WEST NORTH CENTRAL... 1 2 1 2 1 1 59 37
Minnesota.......... 1 1 8 5
Iowa............... 1 1 8 15
Missouri........... 1 1 42 16
North Dakota ....... -
South Dakota....... 1 I
Nebraska........... 1 -
Kansas ............. i

SOUTH ATLANTIC ....... 2 4 2 2 1 2 2 64 86
Delaware ........... 1 2 2
Maryland........... 1 1 1 20 18
Dist. of Columbia.. 1 1 -
Virginia........... 1 1 7 22
West Virginia...... 1 6
North Carolina ..... 1 1 1 11 11
South Carolina..... 1 2 2
Georgia............ 1 7 3
Florida............ 1 I 14 22

EAST SOUTH CENTRAL... 1 3 1 2 70 84
Kentucky........... 1 40 47
Tennessee .......... 1 1 1 17 28
Alabama............ 1 1 I 6 5
Mississippi........ 7 4

WEST SOUTH CENTRAL... 3 7 2 3 3 1 90 70
Arkansas........... I 8 8
Louisiana.......... 2 2 12 11
Oklahoma........... 1 11 -
Texas............... 2 5 2 3 1 59 51

MOUNTAIN............. 1 1 2 26 32
Montana............ I 1 4
Idaho.............. 6 1
Wyoming............ 1 1 4
Colorado........... 1 3 8
New Mexico.......... 2 7
Arizona ............ 1 5 6
Utah................ 8 2
Nevada............. -

PACIFIC............... 13 7 1 7 2 5 6 3 210 117
Washington......... 1 18 5
Oregon............. 1 35 9
California......... 10 5 7 2 5 6 3 156 101
Alaska............. -... --- -- --- --- --- -- 2
Hawaii............. 2 2 -

Puerto Rico 25 13




MMWR SUPPLEMENT MARC








INTRODUCTION
The development of a live, attenuated measles virus vaccine by Dr. John F. Enders and colleagues
and the vaccine's licensing in 1963 heralded the eventual elimination of measles as a disease of child-
hood in the United States. On November 1, 1966, Dr. William H. Stewart, Surgeon General of the Public
Health Service, U.S. Department of Health, Education, and Welfare, challenged medical, public health,
and other groups responsible for health care to eradicate measles in 1967. Dr. Stewart emphasized four
major targets in the development of plans for achieving success:
1. Routine immunization of all children when they are one year old. Nearly all health departments
have measles vaccine available for those who cannot afford it.
2. Immunization of any susceptible children found in kindergartens, first, and second grades.
3. The development of improved reporting systems for finding out when and where measles cases
occur, so more effective control measures can be designed.
4. The stopping of epidemics where not enough children have been vaccinated by launching
crash immunization programs. Epidemics of measles need no longer be tolerated in the United
States.
The Morbidity and Mortality Weekly Report has enlarged its regular coverage of measles to present an
up-to-date appraisal of what is clearly an unprecedented period in preventive medicine. Never before has
the eradication of an important communicable disease been readily within reach. The enthusiastic and
collaborative efforts of the medical, public health, and allied professions have set this effort into unique
perspective among the cooperative health activities for which the United States has become recognized.
The present MMWR supplement has been prepared to keep readers informed generally of the status of
measles eradication and its broader implications. The MMWR as an archive is not a suitable vehicle for
describing much of the evolution of the measles eradication campaign. Supplements similar to the present
one will be included intermittently in the MMWR during the coming months, and will be directed toward
broader interpretations and coverage of the total measles eradication effort. The MMWR will, of course,
continue to emphasize measles surveillance in its regular reviews.

The seasonal characteristic of measles, with a peak in reported cases occurring in the late winter of
each year, is shown in the chart below. From 1954 through 1963, the decade before measles vaccine be-
came available, the number of reported cases ranged annually from a low of nearly 400,000 to a high of
more than 700,000. Since 1963, when measles vaccine was licensed, there has been a gradual but con-
stant decline in total cases and a tendency for the curve to flatten.
The number of cases reported in recent weeks reflects the lowest incidence since measles data first
began to be compiled early in the century. Through 1966, an estimated 20 million doses of measles vac-
cine have been distributed in the United States. Most of these have been used by private practitioners in
infants and small children. An estimated additional 8 to 10 million susceptible children must be immunized
in 1967 if eradication is to be achieved.

REPORTED CASES OF MEASLES BY FOUR-WEEK PERIODS, UNITED STATES
EPIDEMIOLOGIC YEARS, 1964-65, 1965-66 AND 1966-67 COMPARED WITH 10-YEAR PERIOD, 1954-63
160,000-

140,000 / \
/ \
S\ 1964-65 Epodemn.oogqc Year
120,000 \ -- -1965"66 Ep.oem.ologic rear
S- 1966 6 7 E p.dem.oloq0 c Year
e 100,000 RAiNCE
u/ 11954-1963
3 80,000

0

0 40,000


4 8 12 16 20 24 28 32 36 40
WEEK NUMBER






REPORTED MEASLES CASES FOR FIRST 4-WEEK PERIOD OF 1966


El ALASKA
] HAWA II .





















5 -249 CASES


S250-499 CASES

S500C + CASES


REPORTED MEASLES CASES FOR FIRST 4-WEEK PERIOD OF 1967




























S 50- 249 CASES

S250-499 CASES
S500+ CASES


The mo U.S. map.s .hov. th. geogra.phi.cal extent of' reported ca.S -if mcra le in early 1967, when
the erdicatiIon effort aer- beginning, n oniparedl ith thi. .ame- time period in 1966. Arbitrar. levels of
reported numbers of ..: --e rather than rr.-. .r.-- prsen-ned for implic iy. It iF et ident that the disease
i -still occurrine ideI althoughh tht? relatiP amount i: rn'ltd i.to bie lov.er.
Titentl\-onne Statez sh..) lower level of rrp'orted m ii.l-lp c:.-e: in 1967, twenty are unchanged, and
onl\ nine Slates hace increaS.id t -i higher I.1. A more detailed anal; is of reporting data indicates
that epidemie.s in a lfe- partly< ulir :.unti.-- of the Stite often recount for the bulk of its reported cases.





MEASLES ERADICATION PLANNING

The basic responsibility for measles eradication resides with the medical and public health profes-
sions and official agencies which contribute to the Nation's health. Surgeon General William H. Stewart
charged the National Communicable Dis.ease Center to coordinate the efforts of the Public Health Service
and to assist in formulating plans to support programs developed generally by organized medicine and
public health.
Already manj of the Nation's professional groups have endorsed the concept of measles or.ilir-ation
in 1967 and offered their active support. Statements from some of them are abstracted in the present sup-
plement. A large number of voluntary health, civic, and fraternal organizations have also given their en-
thusiastic encouragement and assistance in developing community measles eradication activities.
Federal support for measles eradication beyond the coordinative efforts of the NCDC has been de-
veloped. The Immunization Program, NCDC, which .idministers the Vaccination Assistance Act of 1962,
offers direct assistance through its established project grants to 42 States and 62 local or urban areas.
Under its authority, measles vaccine is provided for preschool children as part of a comprehensive immuni-
zation program. A stockpile of vaccine is maintained at the Center to be used by States in helping to con-
trol measles epidemics. This often becomes the initial phase of broader community measles immunization
programs. The Children's Bureau of the Welfare Administration is encouraging use of its grant funds for
purchase of measles vaccine for children not eligible under the Vaccination Assistance Act. The Office of
Education is urging schools to participate in the planning and implementation of measles eradication pro-
grams as part of total community efforts. The Surgeon Generals of the Armed Forces have implemented
comprehensive measles immunization programs among dependents of military personnel.
Promotional efforts for measles eradication are largely being developed as part of State and local
programs. In addition, a national awareness of measles eradication is indicated by the coverage in medical
and public health journals and in a great variety of news and health related publications.
For example, Peanuts, the popular comic strip drawn by Charles Schulz, dealt with measles immuni-
zation on six successive days. These strips appeared early in 1967, examples of which are reprinted by
permission of United Feature Syndicate, Inc. To Dr. Mary Jean Trudeau, Immunization Project Leader of
the California State Department of Public Health goes credit for stimulating the cartoonist's interest in
measles immunization.


@ United Feature Syndicate, Inc. 1967
F-TELL OuR ARA "VEA'LE- T ~ N CoMPLICATIONG ARE MIDLE-EAQ DID qO HEAR THAT, ARM?
MWARMHATE NOTTO 00.RR... AND SERIOUS 'CAILDHOOP NFe1ThiN PNEULMONIA AND IT'5 601N6 TO BE WLORTH IT!
TO GETi5OT5l HERE,READTTHI... DIGEAE ........HMM... EVEN BRAIN CAMA6E Wt0( -o




IPEANWTS I' t- / I


SAT ARE IS THAT TE WERES TE E JUS OT THE MEASLES!
N00 UTT NEEDLE? 1 NEE L?--
N T4ATIT"AeE .NEEDLE? ATAT 7
ON tA VOU DOING IT WHERE'S" \ WSN IT
ARd NOWi WHAT ARM? WAAT .
ARE O TO IYIAPONEDTO ARE YOU.. f -
S I SUAR CUBES AAUGH!

PEANUTS N


50o WEU)ENT AND LUCY AND I 3-'H GOT 1SN'T IT Y4L"Y'FlLTrATSUCH H AT
OVER TO OUR MEAGLES -LT- NO,. iE LL N\EI A VACCINE 4A- K.EN)ELLED F :LIKtN WHAi
PEDIATRiCIANS/ 6ETMEASL .-'T .-THT' 50-THAT CHILDREN DON'T -. YOU'RE HINTING]!
SSEE... -.TO GET MEASLES, AND..




SELECTED ENDORSEMENTS


The American Medical Association's Coun-
cil on Environmental and Public Health has
called attention to the seriousness of measles
and has urged immediate concerted action:
"The great cyclic waves of the disease can be
expected to continue among children unless
better use is made of available vaccines .

"Now is the time for concerted action, and
physicians should take the initiative before
another winter-spring season of greatest inci-
dence arrives. Each medical society ought to
alert its members. Each can work with the
health groups, the governmental agencies, and
the communities in its area to review the situ-
ation, to plan cooperatively and act to immu-
nize all the susceptibles against measles.

"Man3 but not all of the susceptibles can
be reached within the private practice of medi-
cine. For the rest of the children, however,
some direct community immunization prner.in
is usually necessary. Otherwise susceptible
children will be missed and will remain a prob-
lem in future years."


"I h Report of the Committee on the Control
of Infectious Diseases, American Academy of
Pediatrics is in agreement: Mealei can be
the next infectious disease to be eliminated
from the United States To eliminate it, we
need only take the last step in the long chain
of events which leads eventually to the control
of an infectious disease, i.e., public accept-
ance and use of vaccines now available. All
physicians and public health personnel are
urged to immunize all susceptible children."


The Public Health Service Advisory Com-
mittee on Immunization Practices "'strongly
urged all health authorities to take further ef-
fective action toward the goal of measles erad-
ication from the United State- during lTi-7."



A similar statement by the Executive Com-
mittee of the Conference of State and Territo.
rial Epidemiologists concluded that "it is pos-
sible that measles can be eradicated in the
United States. To accomplish this purpose it
is incumbent on state health departments, state


medical societies, local health departments
and local medical societies to exert leadership
in measles surveillance and immunization ac-
tivities."



The American Public Health Association
says "Among our children today, measles
is a major cause of morbidity, an important
cause of death and a not infrequent cause of
brain damage. We now have the technical
resources available which can, if they are
appropriately applied, quickly eliminate this
disease from our population.
The Surgeon General of the Public Health
Service has announced the initiation of a pro-
gram of measles eradication.
The American Public Health Association
applauds this action and urges all official
health agencies to move rapidly and vigor-
ously in the implementation of this program in
collaboration with their colleagues in the
health professions and with voluntary health
agencies."



In a recent resolution, The American School
Health Association asserted:
"Measles is a serious disease with many
complications. In the past measles has killed
hundreds of children each year and left many
others with handicapping conditions. Now
there is no longer any reason for any child to
die or suffer disability from measles. An
effective vaccine is available and once a child
is immunized, lasting protection is provided.
Medical and health authorities are now agreed
that measles can be eradicated within the
foreseeable future if all concerned unite in a
concerted attack on this disease. Accordingly
the American School Health Association
pledges its support to the measles eradication
programs currently being sponsored by the
American Medical Association and the Public
Health Service of the United States Department
of Health, Education, and Welfare. Also, the
Association urges each of its members phy-
sicians, nurses, health educators and others -
to join with their local medical and health
agencies in a vigorous campaign to eradicate
measles throughout the United States."








Morbidity and Mortality Weekly Report 73


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

MARCH 4, 19W6 AND MARCH 5, 1966 (9th WI I K) CONTINUE I)



MALARIA MEASLES (Rubeola) MENINGOCOCCAL INFECTIONS, POLIOMYELITIS RUBELLA
TOTAL
A R E A -- ... .. ... ..
Cumulative Cumulative -otal IPralyti -


UNITED STATES... 53 2,390 17,587 57,056 61 524 826 1 1 1 1,209

NEW ENGLAND.......... 6 5 135 720 1 17 45 78
Maine.............. 8 94 1 3 10
New Hampshire ...... 9 7 -
Vermont............ 4 21 153 I -
Massachusetts ...... 6 66 292 6 19 16
Rhode Island ....... 20 36 2 5
Connecticut........ 1 20 136 1 10 13 46

MIDDLE ATLANTIC ...... 5 75 613 8,127 11 70 97 1 1 1 42
New York City ..... 10 98 4,018 1 12 16 1 1 1 24
New York, Up-State. 1 21 154 877 2 20 19 17
New Jersey.......... 2 22 147 793 7 29 34 -
Pennsylvania ....... 2 22 214 2,439 1 9 28 -

EAST NORTH CENTRAL... 3 209 1,496 23,424 3 48 125 231
Ohio............... 2 37 244 1,480 2 17 33 20
Indiana ........... 26 189 1,612 5 16 16
Illinois........... 1 34 174 5,021 9 29 29
Michigan............ 44 324 3,461 12 35 71
Wisconsin........... 68 565 11,850 1 5 12 95

WEST NORTH CENTRAL... 3 77 785 2,360 3 26 47 50
Minnesota.......... 1 29 801 5 9 -
Iowa............... 38 155 940 3 9 46
Missouri........... 3 15 139 1 8 16 2
North Dakota ....... 34 298 443 3 2
South Dakota ....... 1 16 2 1 4 1 -
Nebraska........... 3 272 35 1 5 3 -
Kansas............. NN NN NN 1 6

SOUTH ATLANTIC....... 14 192 1,846 4,418 13 104 143 94
Delaware........... 1 16 57 4 2
Maryland........... 9 37 799 1 14 17 46
Dist. of Columbia.. 2 6 235 1
Virginia........... 5 43 470 355 11 15 5
West Virginia ...... 39 412 1,871 11 5 12
North Carolina..... 4 44 446 51 7 25 30 -
South Carolina..... 1 6 30 212 2 7 25 1
Georgia............ 4 9 93 11 21 --
Florida............ 48 420 745 3 21 30 27

EAST SOUTH CENTRAL... 191 2,397 6,838 7 57 76 113
Kentucky............ 48 846 2,583 2 16 43 88
Tennessee.......... 63 732 3,689 3 26 18 24
Alabama............ 52 386 423 1 9 12 1
Mississippi........ 28 433 143 1 6 3

WEST SOUTH CENTRAL... 1 1,006 5,799 4,538 10 87 127 41
Arkansas ........... 195 1,100 102 3 4 7 3
Louisiana.......... 1 2 30 40 5 36 46 -
Oklahoma ........... 54 915 58 1 4 4 -
Texas.............. 755 3,754 4,338 1 43 70 38

MOUNTAIN............. 6 156 1,117 2,583 13 32 84
Montana............ 6 167 408 2 8
Idaho.............. 19 126 344 1 1 -
Wyoming ............ 12 45 1 -
Colorado........... 6 30 226 233 6 19 64
New Mexico......... 33 176 64 3 4 -
Arizona............ 52 226 1,393 1 4 8
Utah ............... 16 61 92 I 4
Nevada............. 123 4 1 1 -

PACIFIC.............. 15 479 3,399 4,048 13 102 134 476
Washington......... 1 168 1,761 1,074 1 7 9 65
Oregon............. 54 448 320 2 10 5 46
California......... 8 242 1,086 2,614 10 83 110 355
Alaska............. --- --- 59 10 --- 2 8 ---
Hawaii ............ 6 15 45 30 2 10
7 503 589 2 7 1 1


uer o co.......... .


___ ~







71 Morbidity and Mortality Weekly Report


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

MARCH 4, 196' AND MARCH 5, 1966 (9th WEEK) CONTINUED


STREPTOCOCCAL TYPHUS FEVER
SORE THROAT & TETANUS TULAREMIA TYPHOID TICK-BORNE RABIES IN
AREA SCARLET FEVER (Rky. Mt. Spotted) ANIMALS
1967 1967 Cum. 1967 Cum. 1967 Cum. 1967 Cum. 1967 Cum.
1967 1967 1967 1967 1967
UNITED STATES... 14,662 1 26 1 19 6 47 6 100 690

NEW ENGLAND ........... 1,939 4 9
Maine ....... : ..... 98 2
New Hampshire ...... 1 1 2
Vermont ............ 98 3 5
Massachusetts ...... 345 -
Rhode Island ....... 118 -
Connecticut ........ 1,279 -

MIDDLE ATLANTIC ...... 941 3 1 8 1 16
New York City ...... 28 2 1 6 -
New York, Up-State. 725 1 1 10
New Jersey ......... NN -
Pennsylvania ....... 188 1 1 6

EAST NORTH CENTRAL... 1,507 1 1 3 1 3 10 50
Ohio............... 227 1 1 22
Indiana............ 298 1 1 3 13
Illinois ........... 264 1 2 3 8
Michigan ........... 404 1 1
Wisconsin .......... 314 1 1 3 6

WEST NORTH CENTRAL... 797 1 6 2 2 10 171
Minnesota .......... 12 1 2 41
Iowa............... 350 2 2 1 17
Missouri ........... 41 3 1 39
North Dakota ....... 289 4 35
South Dakota ....... 21 2 20
Nebraska ........... 5 7
Kansas ............. 79 3 12

SOUTH ATLANTIC....... 1,183 4 3 4 4 20 86
Delaware........... 24 -
Maryland........... 286 -
Dist. of Columbia.. 9 -
Virginia ........... 307 2 1 10 43
West Virginia ...... 302 -- 1 3 15
North Carolina..... 39 1 -3 1
South Carolina .... 13 2 -
Georgia............ 12 1 1 2 15
Florida............ 191 1 1 5 12

EAST SOUTH CENTRAL... 2,103 1 8 2 4 1 35 180
Kentucky........... 305 1 37
Tennessee.......... 1,645 4 2 1 1 31 137
Alabama ............ 121 3 3 3 5
Mississippi ........ 32 1 1 1

WEST SOUTH CENTRAL... 1,309 3 1 14 10 121
Arkansas ........... 8 2 1 28
Louisiana .......... 1 11 3 12
Oklahoma ........... 84 I 1 22
Texas.............. 1,216 3 1 5 59

MOUNTAIN ............. 2,873 4 2 2 15
Montana ............ 125 1 I -
Idaho.............. 131 -
Wyoming............ 83 -
Colorado........... 1,975 1- -
New Mexico ......... 172 5- -
Arizona............ 167 1 2 10
Utah............... 220 2 -
Nevada.............- -

PACIFIC.............. 2,010 6 2 10 1 8 42
Washington ......... 658 -
Oregon............. 79 -
California......... 1,162 5 1 9 1 8 42
Alaska............. ---- --- -- -... ...
Hawaii............. 111 1 1 1 -

Puerto Rico .......... 2 1 1 3 4







Morbidity and Morlalit W'eekly Rleport






DEATHS IN 122 UNITED STATES CITIES FOR WEEK ENDED MARCH i, 196


(By place of occurrence and week of filing certificate. Excludes fetal deaths)

All Causes Pneumonia Under All Causes Pneumonia Un.I. I
Area All 65 years and I Aear Area All 65 years anzd a
Ages and over Influenza A Ages and over Influenza A
All Ages Causes All Ages Causes


NEW ENGLAND:
Boston, Mass.---------.
Bridgeport, Conn.-----
Cambridge, Mass.-------
Fall River, Mass.- ---
Hartford, Conn.--------
Lowell, Mass.----------
Lynn, Mass.-----------
New Bedford, Mass.----
New Haven, Conn.-------
Providence, R. I.-----
Somerville, Mass.-----
Springfield, Mass.----
Waterbury, Conn.-------
Worcester, Mass.-------

MIDDLE ATLANTIC:
Albany, N. Y.----------
Allentown, Pa.---------
Buffalo, N. Y.--------
Camden, N. J.----------
Elizabeth, N. J.-------
Erie, Pa.-------------
Jersey City, N. J.----
Newark, N. J.----------
New York City, N. Y.--
Paterson, N. J.--------
Philadelphia, Pa.- ----
Pittsburgh, Pa.--------
Reading, Pa.-----------
Rochester, N. Y.-------
Schenectady, N. Y.----
Scranton, Pa.----------
Syracuse, N. Y.--------
Trenton, N. J.---------
Utica, N. Y.-----------
Yonkers, N. Y.---------

EAST NORTH CENTRAL:
Akron, Ohio-----------
Canton, Ohio-----------
Chicago, Ill.----------
Cincinnati, Ohio------
Cleveland, Ohio-------
Columbus, Ohio--------
Dayton, Ohio-----------
Detroit, Mich.---------
Evansville, Ind.-------
Flint, Mich.-----------
Fort Wayne, Ind.-------
Gary, Ind.------------
Grand Rapids, Mich.---
Indianapolis, Ind.----
Madison, Wis.---------
Milwaukee, Wis.--------
Peoria, Ill.-----------
Rockford, Ill.---------
South Bend, Ind.-------
Toledo, Ohio-----------
Youngstown, Ohio------

WEST NORTH CENTRAL:
Des Moines, Iowa------
Duluth, Minn.----------
Kansas City, Kans.----
Kansas City, Mo.-------
Lincoln, Nebr.---------
Minneapolis, Minn.----
Omaha, Nebr.-----------
St. Louis, Mo.---------
St. Paul, Minn.*------
Wichita, Kans.---------


832
299
36
34
27
69
29
24
20
59
71
20
46
30
68

3,462
48
46
140
50
37
34
75
105
1,706
38
539
241
39
122
25
49
58
47
28
35

2,852
81
48
766
191
233
138
94
341
49
41
58
95
58
159
34
138
33
31
34
150
80

954
80
35
27
161
20
143
89
272
81
46


507
166
20
18
19
38
23
15
15
35
42
14
29
23
50

2,089
29
34
87
28
23
17
46
57
1,027
24
330
133
25
86
17
31
31
29
13
22

1,630
51
34
398
121
137
82
54
173
35
17
38
54
36
85
19
89
23
21
21
98
44

585
49
25
10
107
15
96
59
152
53
19


*Estimate based on average percent of divisional total.


SOUTH ATLANTIC:
Atlanta, Ga.------------
Baltimore, Md.----------
Charlotte, N. C.--------
Jacksonville, Fla.-----
Miami, Fla.-----------
Norfolk, Va.------------
Richmond, Va.-----------
Savannah, Ga.-----------
St. Petersburg, Fla.---
Tampa, Fla.------------
Washington, D. C.-------
Wilmington, Del.--------

EAST SOUTH CENTRAL:
Birmingham, Ala.--------
Chattanooga, Tenn.-----
Knoxville, Tenn.-------
Louisville, Ky.---------
Memphis, Tenn.---------
Mobile, Ala.------------
Montgomery, Ala.--------
Nashville, Tenn.--------

WEST SOUTH CENTRAL:
Austin, Tex.-----------
Baton Rouge, La.--------
Corpus Christi, Tex.---
Dallas, Tex.-----------
El Paso, Tex.-----------
Fort Worth, Tex.--------
Houston, Tex.-----------
Little Rock, Ark.-------
New Orleans, La.--------
Oklahoma City, Okla.---
San Antonio, Tex. ------
Shreveport, La.---------
Tulsa, Okla.-----------

MOUNTAIN:
Albuquerque, N. Mex.---
Colorado Springs, Colo.
Denver, Colo.-----------
Ogden, Utah------------
Phoenix, Ariz.----------
Pueblo, Colo.-----------
Salt Lake City, Utah---
Tucson, Ariz.-----------

PACIFIC:
Berkeley, Calif.--------
Fresno, Calif.----------
Glendale, Calif.--------
Honolulu, Hawaii-------
Long Beach, Calif.-----
Los Angeles, Calif.----
Oakland, Calif.---------
Pasadena, Calif.--------
Portland, Oreg.---------
Sacramento, Calif.-----
San Diego, Calif.-------
San Francisco, Calif.--
San Jose, Calif.--------
Seattle, Wash.----------
Spokane, Wash.---------
Tacoma, Wash.-----------


1,307
151
311
73
57
91
60
88
44
95
80
206
51

592
95
50
33
119
122
45
37
91

1,161
31
33
27
159
35
90
230
53
152
86
135
57
73

523
63
35
139
18
124
30
56
58

1,843
34
38
37
48
100
611
89
39
145
62
91
200
46
204
55
44


673
71
162
23
20
53
29
52
20
77
38
96
32

367
53
38
24
80
75
22
26
49

610
19
13
13
88
16
54
114
27
70
48
72
30
46

319
34
22
76
14
80
20
41
32

1,148
20
23
34
25
53
385
56
31
93
42
49
115
30
129
35
28


Total 13,526 7,928 552 652


Cumulative Totals
including reported corrections for


previous weeks


All Causes, All Ages ------------------------- 118,444
All Causes, Age 65 and over------------------- 68,445
Pneumonia and Influenza, All Ages------------- 4,857
All Causes, Under 1 Year of Age--------------- 5,986


Week No.
9















INTERNATIONAL NOTES
QUARANTINE MEASURES


Immunization Information for International Travel
1965-66 edition -Public Health Service Publication No. 384


The following information should be added to the list of
Yellow Fever Vaccination Centers in Section 6:

Page 74


City:


Center:


Clinic Hours:


Fee:


Page 78


City:


Center:


Clinic Hours:


Fee:


Gainesville. Florida


Alachua County Health Department


Thursday. 1 p.m.


Yes





Duluth, Minnesota


The Duluth Clinic


Friday. 11 a.m. to 12 noon


Yes


THE MORBIDITY AND MORTALITY WEEKLY REPORT, WITH A CIRCULA-
TION OF 17,000, IS PUBLISHED AT THE NATIONAL COMMUNICABLE
DISEASE CENTER, ATLANTA, GEORGIA.
DIRECTOR, NATIONAL COMMUNICABLE DISEASE CENTER
DAVID J. SENCER, M.D.
CHIEF, EPIDEMIOLOGY PROGRAM A.D. LANGMUIR, M.D.
ACTING CHIEF, STATISTICS SECTION IDA L. SHERMAN, M.S.

IN ADDITION TO THE ESTABLISHED PROCEDURES FOR REPORTING
MORBIDITY AND MORTALITY, THE NATIONAL COMMUNICABLE DISEASE
CENTER WELCOMES ACCOUNTS OF INTERESTING OUTBREAKS OR CASE
INVESTIGATIONS WHICH ARE OF CURRENT INTEREST TO HEALTH
OFFICIALS AND WHICH ARE DIRECTLY RELATED TO THE CONTROL OF
COMMUNICABLE DISEASES. SUCH COMMUNICATIONS SHOULD BE
ADDRESSED TO:
THE EDITOR
MORBIDITY AND MORTALITY WEEKLY REPORT
NATIONAL *: :.i : A L E DISEASE CENTER
ATLANTA. .- .:.,
NOTE: THE DATA IN THIS REPORT ARE PROVISIONAL AND ARE
BASED ON WEEKLY TELEGRAMS TO THE NCDC BY THE INDIVIDUAL
STATE HEALTH DEPARTMENTS. THE REPORTING WEEK CONCLUDES
ON SATURDAY; COMPILED DATA ON A NATIONAL BASIS ARE RELEASED
ON THE SUCCEEDING FRIDAY.



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Morbidity and Mortality Weekly Report


UNIVERSITY OF FLORIDA

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3 1262 08864 2201

MARCH 4, 1967