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:
AA00010654:00020

Related Items

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

Full Text

5C 2 ,9/0://3 97


NATIONAL COMMUNICABLE DISEASE CENTER


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


Vol. 16, No. 39







Week Ending
September 30, 1967



PUBLIC HEALTH SERVICE


BUREAU OF DISI
'.010


CURRENT TRENDS
HEPATITIS 1967-1


Through the 39th week of 1967 (%K ntnig'Septem-'
ber 30), a cumulative total of 30,323 of viral hep-
atitis have been reported in the Lr,, T These
cases represent a 22 percent increase
cases reported during the comparable p. r ,i 0
Figure 1 presents the number of reported c.
100,000 population by 4-week periods from July 1962 through
the 38th week of 1967 (week ending September 23). The
expected seasonal peak which occurred during the middle
of the epidemiologic year 1966-67* was distinctly higher
than the seasonal peak of the previous epidemiologic year
(1965-66). This increase represents a reversal in the
downward trend evident since the peak year (1960-61) of
the last epidemic cycle. The rates observed during the
first 12 weeks of epidemiologic year 1967-68 (July 2


ENVIRONMENTAL CONTROL


CONTENTs
r rends
l 196- l6inoi. ............... .... ... 32
S o1oic Note, nd RPorts
/ t M lar land . . 3-26
llinois . . 327
S waived for Health Offlieer ........ .... 327
N ,otes
o1 ure Dis'as Related to African Monkeys ....... 3:'2
TI hoid Fever Toronto International Airport ....... 33:2


hi,..u-i September 23, 1967) were higher than those in the
comparable period of 1966-67, further supporting the ap-
parent reversal of the downward trend.
(Reported by the Hepatitis Unit, Epidemiology Program,
NCDC.)
*Hepatitis morbidity data are summarized in terms of an "Epi-
demiologic y-ar." which runs from the 27th week of each year
through the 26th week of the succeeding year.


Figure 1
REPORTED CASES OF VIRAL HEPATITIS
CASE RATE BY FOUR-WEEK PERIODS
U.S. SINCE JULY 1952


2


S2,0 ________









Week Number:27 I 27 I 27 I 27 I 27 I 27 I 27 I 27 I 27 I 27 I 27 1 27 I 27 I 27 I 27 1 27 I 27
Yeor: 1952 1953 1954 1955 1956 1957 1958 E 1959 1960 1961 1962 1963 1964 1965 1966 1967 196








Morbidity and Mortality Weekly Report


SEPTEMBER 30, 1967


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous weeks)
39th WEEK ENDED CUMULATIVE, FIRST 39 WEEKS
MEDIAN
DISEASE SEPTEMBER 30, OCTOBER 1, 1962 1966 MEDIAN
1967 1966 1967 1966 1962 1966
Aseptic meningitis .................. ... 90 169 109 2,113 2,231 1,513
Brucellosis. ............................ 3 22 5 196 196 278
Diphtheria............................. 8 2 2 101 144 185
Encephalitis, primary:
Arthropod-bore & unspecified .......... 39 75 --- 1,210 1,622 -
Encephalitis, post-infectious ......... ... 10 7 659 605
Hepatitis, serum ............. .. ..... 47 34 736 1,622 1,039
Hepatitis, infectious .................... 960 590 28,701 23,874
Malaria ....................... ............ 55 11 3 1,486 308 71
Measles (rubeola)....................... 176 478 638 58,222 190,345 360,082
Meningococcal infections, total ........... 28 43 31 1,745 2,784 2.112
Civilian ............................ 27 41 1,630 2,506 -
Military................ ............. 1 2 -- 115 278 -
Poliomyelitis, total ..................... 1 3 25 72 84
Paralytic ............................. 2 21 67 69
Rubella (German measles) ............... 191 236 40,213 42,141 -
Streptococcal sore throat & scarlet fever .. 5,720 5,746 4,688 339,835 320,703 298,612
Tetanus ................................. 6 6 5 164 137 200
Tularemia ............................. 4 4 6 138 136 218
Typhoid fever .......................... .9 9 13 315 284 316
Typhus, tick-bore (Rky. Mt. spotted fever) 3 4 6 277 215 204

Rabies in animals ....................... 56 57 53 3,343 3,183 3,183

NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax: ................... .................... 2 Rabies in man:............. ..................... 2
Botulism: .................................. ........ 2 Rubella, Congenital Syndrome: ........................ 4
Leptospirosis: ................. ...................... 28 Trichinosis: Va.-l ................................. 49
Plague: ................. ................... ...... 2 Typhus, murine: Fla.-l, Tex.- ....................... 33
Psittacosis: Tex.-l ............. ...... ........... 35 Polio, Unsp.......... ... ............... .......... 4


EPIDEMIOLOGIC NOTES AND REPORTS
ASEPTIC MENINGITIS Maryland


Since July 1, 1967, 177 cases of aseptic meningitis
have been reported to the Baltimore City Health Depart-
ment. This total represents an increase of 92 cases over
the number reported for the week ending September 2, 1967
(MMWR, Vol. 16, No. 35). The cases reported to date are
shown by week of onset in Figure 2. The outbreak is con-
tinuing. The ages of the patients range from 7 days to
54 years, 71 percent of the cases being in children under
15 years of age.
Thus far, 20 viral isolations have been obtained from
specimens submitted from 62 patients. The predominant
enterovirus isolated has been Coxsackie B5 (7isolations);
however, one isolation of Coxsackie A9, one of ECHO 9,
and four of ECHO 4 have also been identified.
Unconfirmed cases are still being reported in Balti-
more. Evidence of increased prevalence of aseptic menin-
gitis has also been noted in the counties surrounding Bal-
timore City.

(Reported by James Peterman, M.D., Chief, Communicable
Diseases, Baltimore City Health Department; John H. Jan-
ney, M.D., Acting Chief, Communicable Disease Division,
Maryland State Department of Health; and an EIS Officer.)


Figure 2
REPORTED CASES OF ASEPTIC MENINGITIS
BALTIMORE, MARYLAND


310 r a I 12 1 S6 9 aa 5Q i4 Z\o B 1 I5 zl2 2 9 S6 2330
JUNE JOULT AUG SEPT OCT NOV DEC
E967
DATE OF ONSET


326







SEPTEMBER 30, 1967


Morbidity and Mortality Weekly Report


FEBRILE ILLNESS Illinois


Between July 20 and July 25, 1967. a total of 77 per-
sons developed acute febrile illnesses while at a summer
camp for underprivileged boys. The dates of onset are
shown in Figure 3. The illnesses were characterized by
fever (ranging from 101* to 104F). diffuse headache, and
malaise, often accompanied by mild sore throat and pharyn-
geal erythema. There was a striking absence of coryza,
cough, chest pain, and gastrointestinal symptoms. There
was no cervical adenitis, exanthem or enanthem. The aver-
age duration of illness was about 48 hours.


Figure 3
OUTBREAK OF FEBRILE ILLNESS IN ILLINOIS
BOYS CAMP JULY 17.30, 1967*


15 17


*THIRO TWO-WEEK


19 21 23 25
JULY 1967
DATE OF ONSET
CAMP SESSION


27 29 31


The illnesses occurred 3 to S days after the beginning
of the third 2-week session of the camp. Approximately
100 campers and 30 staff members were there during this
period. The camp has 10 cabins, each housing 10 boys and
2 counselors. Six counselors and administrative personnel
lived in a separate building, and the caretaker and his
family of three lived in the "infirmary building." The
overall attack rate was 60 percent, and individual cabins
had attack rates ranging from 40 to 90 percent. In general,


there was no difference in the dates of onset of illnneses
by cabin of residence.
The explosive character of the outbreak suggests some
common source. Efforts to incriminate a specific food item
were unsuccessful. The menu at the camp had been the
same for each of the three sessions. Food and dairy pro-
ducts were obtained from local commercial source-.
I'nchlorinated. fresh, drinking water is obtained from
a deep well. Wash water is provided from a nearby lake.
The septic tank and the camp swimming pool both drain
into a ravine. The swimming pool water, which is chlori-
nated. had been checked 10 days prior to the outbreak and
was found to haxe one coliform per 50 ml.. 200.000 bacteria
per ml.. and one of two samples \\as positive for non-hemo-
lytic streptooccci. \hen rechecked during the outbreak.
the swimming pool water was negative for coliforms and
streptococci.
The only variation in the almost constant outdoor acti-
vity of the campers during the third session occurred 2
days prior to the outbreak when. due to rain, all campers
were together indoors for movies and games for one whole
evening.
The outbreak was initially suspected to be acute
streptococcal pharyngitis. Accordingly. symptomatic per-
sons were treated with oral penicillin(600,000 units daily)
and asymptomatic persons were given prophylactic oral
penicillin (4,0.00 units daily). Throat cultures were taken
prior to treatment from 7 ill campers, 5 healthy campers,
7 counselors, and 6 kitchen staff, all of which were nega-
tixe for beta hemolytic streptococci. Throat and rectal
swabs were also taken from these persons for viral cul-
tures and were inoculated on three types of cell culture.
primary monkey kidney, HEp2. and human embryonic fibro-
blast. These were negative for cytopathic effect and
hemadsorption. Six counselors provided acute and convales-
cent blood specimens which have not yet been tested in
viral serology.
No specific control measures were undertaken. The
camp continued in operation, and the fourth 2-week ses-
sion passed without recurrence of this illness.
(Reported by Norman Rose, V.D.. V.P.H., Chief. Bureau of
Epidemiology, Wi. Keith lf eeber, Acting Director, North-
western Regional Office, and Richard Morrissey, .I.P.H.,
Chief, Bureau of Virus Diseases and Research, Division
Laboratories, all with the Illinois State Department of
Health; and an EIS Officer.)


POSTAL FEE WAIVED FOR HEALTH OFFICIALS


Prior to September 28, 1967, non-Federal health offi-
cials who wanted to obtain a change of address for use
in communicable disease case finding were charged a fee
of $1.00 by the Post Office Department. According to the
Postal Bulletin (20610, page 3) issued by the Post Office


Department on September 28, 1967, this fee has now been
waived for "Federal. State, and local public health offi-
cials when such officials state that the persons whose
forwarding addresses are being sought are infected with
or were exposed to contagious diseases."








328 Morbidity and Mortality Weekly Report


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

SEPTEMBER 30, 1967 AND OCTOBER 1, 1966 (39th WEEK)


ENCEPHALITIS HEPATITIS
ASEPTIC Primary
AREA MENINGITIS BRUCELLOSIS DIPHTHERIA including Post- Serum Infectious
unsp. cases Infectious
1967 1966 1967 1967 1967 1966 1967 1967 1966 1967 1966


UNITED STATES... 90 169 3 8 39 75 10 47 34 960 590

NEW ENGLAND............ 1 5 3 3 1 1 33 20
Maine.............. 2 3
New Hampshire...... 2 -
Vermont............ 1 1
Massachusetts...... 3 2 12 3
Rhode Island....... 1 2 1 2 1 4
Connecticut........ 1 1 16 9

MIDDLE ATLANTIC...... 13 20 2 11 1 21 17 149 105
New York City...... 7 8 1 6 13 14 58 25
New York, Up-State. 3 1 1 1 29 25
New Jersey......... 5 9 2 7 2 23 26
Pennsylvania....... 1 1 2 1 39 29

EAST NORTH CENTRAL... 12 26 1 18 21 1 1 137 97
Ohio................ 3 4 15 19 1 35 26
Indiana............. 2 2 8 4
Illinois............ 5 3 1 2 44 29
Michigan........... 2 17 1 1 45 35
Wisconsin.......... 2 5 3

WEST NORTH CENTRAL... 3 23 1 1 9 1 1 47 31
Minnesota.......... 2 16 4 1 18 6
Iowa................ 1 1 1 5 3
Missouri........... 1 1 2 1 15 22
North Dakota....... 2 -
South Dakota....... -
Nebraska........... 2 1 1
Kansas............. 1 3 1 6

SOUTH ATLANTIC........ 36 16 4 1 6 1 1 101 60
Delaware............ 1 5 3
Maryland............ 32 2 1 3 21 14
Dist. of Columbia.. 1 1 -
Virginia........... 2 1 1 11 17
West Virginia...... 2 15 7
North Carolina..... 3 1 6 4
South Carolina..... 4 4
Georgia............ 30 4
Florida............. 2 3 2 3 1 12 7

EAST SOUTH CENTRAL... 7 7 1 3 1 3 100 32
Kentucky............ 1 1 71 11
Tennessee.......... 6 3 1 3 9 8
Alabama............ 1 1 5 8
Mississippi........ 2 2 1 15 5

WEST SOUTH CENTRAL... 1 16 1 7 3 11 6 1 127 47
Arkansas........... 3 30 8
Louisiana.......... 6 2 2 3 1 19 4
Oklahoma........... 1 14
Texas............... 1 16 1 1 9 64 35

MOUNTAIN............. 4 35 26
Montana............ 6 2
Idaho............... 1 10
Wyoming............. -
Colorado........... 2 4
New Mexico......... 1 27 2
Arizona.............. 1 1 6
Utah................ 2
Nevada............. -

PACIFIC.............. 17 56 5 14 2 16 10 231 172
Washington......... 4 1 1 25 7
Oregon............... 1 20 34
California......... 17 55 4 10 2 15 9 181 131
Alaska.............- -
Hawaii............. 1 5


Puerto Rico 30 19








Morbidity and Mortality Weekly Report 329


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

SEPTEMBER 30, 1967 AND OCTOBER 1, 1966 (39th WEEK) CONTINUED


MENINGOCOCCAL INFECTIONS,
MALARIA MEASLES (Rubeola) MENINGOCOCCAL INFECTIONS,POLIOMYELITIS RUBELLA
TOTALOLIOMYEITIS
AREA Cumulative Cumulative Total Paralytic
Cum.
1967 1967 1967 1966 1967 1967 1966 1967 1967 1967 1967


UNITED STATES... 55 176 58,222 190,345 28 1,745 2,784 21 191

NEW ENGLAND............ 2 858 2,279 2 70 123 18
Maine............... 239 211 3 9 6
New Hampshire...... 74 80 2 9
Vermont............ 42 238 1 4
Massachusetts...... 2 351 783 1 33 50 1
Rhode Island...... 62 72 4 14
Connecticut........ 90 895 1 27 37 11

MIDDLE ATLANTIC...... 10 13 2,289 18,036 5 285 340 5 13
New York City...... 4 468 8,293 2 51 48 1 9
New York, Up-State. 3 590 2,536 1 69 95 1 4
New Jersey.......... 5 490 1,848 1 94 101
Pennsylvania....... 5 6 741 5,359 1 71 96 3 -

EAST NORTH CENTRAL... 1 40 5,541 68,843 5 249 439 3 39
Ohio............... 1,150 6,355 80 118 4
Indiana............ 597 5,702 4 40 78 -2
Illinois........... 18 997 11,365 55 82 -- 6
Michigan........... 3 940 14,517 1 57 118 3 7
Wisconsin.......... 1 19 1,857 30,904 17 43 20

WEST NORTH CENTRAL... 8 2,865 8,698 2 75 148 3 20
Minnesota.......... 123 1,643 1 19 34
Iowa............... 749 5,309 1 15 22 1 19
Missouri........... 333 531 15 57
North Dakota........ 870 1,098 1 11 -
South Dakota...... 1 55 40 6 5 1
Nebraska........... 6 641 77 13 8 -
Kansas............. 1 94 NN 6 11 2 -

SOUTH ATLANTIC........ 10 17 6,915 15,315 4 334 467 2 29
Delaware............ 2 48 257 6 4 -
Maryland............ 4 1 162 2,106 43 46 1 1
Dist. of Columbia.. 1 23 383 10 11 1
Virginia........... 1 1 2,192 2,184 41 58 --
West Virginia...... 2 1,392 5,311 1 27 27 14
North Carolina..... 3 856 493 1 71 121 1
South Carolina..... 3 511 657 29 48 1
Georgia............ 2 36 234 1 50 63 -
Florida............. 7 1,695 3,690 1 57 89 12

EAST SOUTH CENTRAL... 22 8 5,221 19,771 5 134 246 1 12
Kentucky............ 21 1,337 4,731 2 37 87 7
Tennessee.......... 7 1,887 12,327 2 57 83 5
Alabama............ 1 1,329 1,689 26 54 -
Mississippi........ 1 668 1,024 1 14 22 1

WEST SOUTH CENTRAL... 4 30 17,469 24,650 1 223 378 7
Arkansas........... 1,404 971 31 35
Louisiana.......... 1 155 99 88 139
Oklahoma............ 3 3,351 487 1 17 19 1
Texas.............. 30 12,559 23,093 87 185 6

MOUNTAIN............ 3 14 4,686 12,004 1 33 87 7
Montana............ 2 289 1,820 1 2 4 2
Idaho............... 1 386 1,585 3 5 -
Wyoming.............. 181 166 1 6 -
Colorado........... 5 1,574 1,315 13 47 5
New Mexico.......... 3 5 591 1,133 3 10 -
Arizona............. 1 1,020 5,300 4 10 -
Utah............... 376 641 4 -
Nevada............. 269 44 3 5 -

PACIFIC.............. 5 44 12,378 20,749 3 342 556 53
Washington.......... 3 17 5,456 3,633 2 31 39 18
Oregon.............. 9 1,618 1,829 27 34 3
California.......... 2 13 4,988 14,623 1 270 464 19
Alaska............. 4 144 524 10 15 6
Hawaii............. 1 172 140 4 4 7
Puerto Rico........... 3 2,129 2.792 1 13 13 1








330 Morbidity and Mortality Weekly Report


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

SEPTEMBER 30, 1967 AND OCTOBER 1, 1966 (39th 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... 5,720 6 164 4 138 9 315 3 277 56 3,343

NEW ENGLAND.......... 667 2 1 1 5 1 2 89
Maine.............. 32 1 17
New Hampshire...... 11 1 44
Vermont..... ...... 57 22
Massachusetts...... 65 1 1 2 1 4
Rhode Island....... 49 1 2
Connecticut........ 453 1 1 2 -

MIDDLE ATLANTIC...... 137 12 1 31 34 1 74
New York City...... 12 6 1 16 -
New York, Up-State. 102 1 9 9 1 64
New Jersey......... NN 1 3 15
Pennsylvania....... 23 4 3 10 10

EAST NORTH CENTRAL... 277 17 12 3 29 22 2 324
Ohio ....... ........ 49 4 1 7 11 110
Indiana............. 16 3 2 10 1 74
Illinois........... 57 8 10 3 10 1 63
Michigan........... 94 2 1 7 21
Wisconsin.......... 61 1 2 1 56

WEST NORTH CENTRAL... 396 1 11 21 17 4 16 779
Minnesota.......... 8 3 1 1 3 153
Iowa............... 65 1 1 3 1 105
Missouri........... 16 1 6 8 8 1 2 144
North Dakota....... 48 1 135
South Dakota....... 28 1 2 94
Nebraska........... 81 4 2 4 54
Kansas.............. 150 10 1 5 94

SOUTH ATLANTIC....... 806 1 39 9 49 1 112 6 423
Delaware........... 1 -
Maryland............ 141 2 20 3
Dist. of Columbia.. 2 5
Virginia........... 147 1 10 6 27 183
West Virginia...... 176 1 2 1 1 1 58
North Carolina..... 8 6 3 44 3
South Carolina..... 7 1 2 10 5
Georgia............ 7 3 4 14 1 15 3 103
Florida............ 319 18 1 11 2 68

EAST SOUTH CENTRAL... 1,198 3 29 9 53 49 12 638
Kentucky........... 51 3 1 22 14 3 149
Tennessee.......... 956 8 6 9 23 9 440
Alabama............ 88 1 10 10 12 40
Mississippi........ 103 2 8 2 12 9

WEST SOUTH CENTRAL... 622 1 36 4 72 2 36 2 35 14 721
Arkansas........... 5 1 42 2 11 2 12 2 97
Louisiana.......... 4 1 4 1 7 14 2 63
Oklahoma........... 71 2 1 18 7 15 5 258
Texas.............. 547 25 1 5 4 8 5 303

MOUNTAIN.............. 806 1 9 2 19 9 1 106
Montana.............. 26 1 1 2 -
Idaho .............. 66 -
Wyoming............ 46 2 5
Colorado........... 372 1 12 9 10
New Mexico......... 198 1 1 2 31
Arizona............ 56 3 48
Utah............... 42 5 3
Nevada.............. 1 9

PACIFIC................. 811 17 5 76 11 2 189
Washington......... 256 2 1 2 1
Oregon.............. 71 1 1 3 3 4
California ......... 350 13 2 69 6 2 184
Alaska............. 75 -
Hawaii............ 59 3 3

Puerto Rico.......... 5 1 16 5 2 29









Morbidity and Mortality Weekl Report






DEATHS IN 122 UNITED STATES CITIES FOR WEEK ENDED SEPTEMBER 30, 196-

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


All Causes Pneumonia Under All Causes Pneumonia Under
Area Al 65 y and 1 year Area All 65 years nza ar
Ages and over luenza Ages and over il Ae
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.--------


704
226
53
20
34
48
28
19
23
55
49
19
55
29
46

3,138
47
36
151
31
26
32
77
86
1,583
11
483
199
41
117
23
27
65
54
25
24

2,514
58
48
746
185
197
102
71
323
37
45
63
22
49
153
29
117
38
36
45
98
52

840
66
34
34
134
37
105
67
225
68
70


425
133
35
14
17
27
14
15
16
35
29
11
32
17
30

1,804
28
23
90
18
20
21
41
45
892
5
265
115
25
73
14
19
44
34
16
16

1,386
36
30
380
107
107
50
42
185
17
24
35
8
27
83
17
76
21
20
24
59
38

515
43
22
22
81
22
66
38
134
47
40


SOUTH ATLANTIC:
Atlanta, Ga.-----------
Baltimore, Md.---------
Charlotte, N. C.-------
Jacksonville, Fla.-----
Miani, 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, rex.-----------
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.-----------


1,043
111
Ill
212
41
64
102
52
75
23
89
55
180
39

589
87
41
48
132
114
40
22
105

1,098
38
24
27
157
37
65
195
58
153
98
108
68
70

450
46
20
138
33
92
31
49
41

2,048
13
47
33
41
69
1,068
72
20
104
52
100
168
31
141
45
44


544
43
103
19
34
60
26
38
9
78
31
84
19

306
37
23
37
64
59
22
12
52

559
22
9
11
88
15
33
84
36
68
58
54
38
43

243
19
11
75
20
48
19
28
23

1,229
11
25
22
21
46
622
46
15
71
38
57
93
18
80
35
29


3
3
2
11
1
2
3
4

40
6
1
1
3
2
2
6
1
1
3
3
4
7

18
3
2
3
8

1
1


37

2
1


16
3
1


2
4
2
4
1
1


Total 12,424 7,011 402 666

Cumulative Totals
including reported corrections for previous weeks

All Causes, All Ages ------------------------- 480,328
All Causes, Age 65 and over------------------- 273,916
Pneumonia and Influenza, All Ages----------- 16,890
All Causes, Under 1 Year of Age--------------- 24,527


Week No.













INTERNATIONAL NOTES
OBSCURE DISEASE RELATED TO AFRICAN MONKEYS
Importation and Use of Monkeys in U.S.

The recent outbreak in Germany of an obscure disease
in persons who had contact with tissue of African green
monkeys (MMWR, Vol. 16, Nos. 36, 37, 38) has been of
particular concern in the United States. Large numbers of
these animals are imported to provide tissue used in cell
cultures for vaccine production as well as for various
research purposes. During the months of July and August
1967, an estimated 2,000 African green monkeys were im-
ported into the U.S. from Kenya, Ethiopia, and Somali Re-
public; none were imported during this period from Uganda,
the source of the shipments to Germany. To date, informa-
tion has been obtained on the final destination and fate
of approximately 600 of these animals, of which 500 have
been used in various laboratories to provide kidneys for
cell cultures. At least 23 persons have been identified
who assisted with the nephrectomy of these monkeys or in
the mincing and trypsinization of their kidneys. Approxi-
mately 1,700 persons are known to have been exposed to
operated monkeys or their kidney tissue; none of these
persons has experienced an unusual febrile illness to date.
The Government of Uganda has placed an embargo on
the exportation of monkeys from that country until investi-
gations have defined the likelihood of future outbreaks
being associated with any subsequent shipments.
(Reported by the Foreign Quarantine Program, NCDC.)



TYPHOID FEVER Toronto International Airport

On September 22, 1967, a case of typhoid fever was
diagnosed in a 16-year-old male who had been employed at
the Toronto International Airport from September 10-16,
1967. During this time the boy had sold sandwiches and
coffee from a mobile trolley on the departure level of the
airport. He noted onset of illness on September 16, but
completed his work shift for that day. Six days later he
was admitted to a Toronto hospital where a diagnosis of
typhoid fever was established by a positive blood culture.
The patient gave a history of having vacationed in Italy
during August of this year.
All food items sold from the cart were wrapped. The
only operation carried out by the employee which would
seem to pose even a remote hazard was the fitting of tops
to plastic drinking cups containing coffee.
(Reported by the Director General, Medical Services Dept.,
National Healti 6 Welfare Service. Ottawa, Canada.)
Editorial Note:
With the increasing volume of international travel,
the number of infections acquired abroad may be expected
to increase also. Recognition of such incidents, however,
depends upon: (1) the physician eliciting an appropriate
travel history; and (2) the physician promptly reporting
rn..,-i, official channels any possible exposures abroad.


SEPTEMBER 30, 1967
UNIVERSITY OF FLORIDA

III I1262 08864IIII 1880
3 1262 08864 1880


THE MORBIDITY AND MORTALITY WEEKLY REPORT, WITH A CIRCULA-
TION OF O7,000, 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 COMMUNICABLE DISEASE CENTER
ATLANTA, GEORGIA 30333
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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