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:
AA00010654:00023

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. 47







Week Ending

N&in -25, 1967


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

BUREAU OF DISEASE PREVENTION AND ENVIRONMENTAL CONTROL


INTERNATIONAL NOTES
PLAGUE-Naura, Nepal


On October 30. 1967. the Ministry of Health. Govern-
ment of Nepal was notified of an outbreak of illness in
the village of Naura. in northwestern Nepal (Figure 1).
Investigations revealed that the epidemic disease was
plague, with a total of 24 cases occurring from Septem-
ber 24. to November 5, 1967 (Figure 2). There were 17
deaths. No new cases have occurred since Noxember 5.
Naura is a village with an estimated population of
1.500 people located on the eastern slope of an S.000 foot
mountain. The villagers live in stone and plaster homes
scattered up and down the mountain side. The houses are


international Notes v 1'
Pla'ue Naur'. Nepal 393
Epidemioloeic Notes and Reports. a t
Chimpanzoe-A s aociatud tlcpatiti. .... ...... 395

grouped in clusters and consist of apartment-like, multi-
family dwelling units.
The index case x\as a 24-year-old male from Naura
village (Family 1. House A. Figure 3). temporarily living
in Surkemala. a village about 3 miles from Naura. He was
sent to Surkemala to tend cattle and lived in a stable
during his stay. On September 24. ten to 12 days after his
arrival. he became ill, and 2 days later, he returned to
(Continued on page 39.)


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous weeks)
47th WEEK ENDED CUMULATIVE. FIRST 47 WEEKS
MEDIAN
DISEASE NOVEMBER 25, NOVEMBER 26, 1962 1966 MEDIAN
1967 1966 1967 1966 1962- 1966

Aseptic meningitis .................. ... 45 41 41 2,770 2.730 1,964
Brucellosis .............. ........... 4 1 5 226 220 334
Diphtheria............................. 10 12 8 154 184 246
Encephalitis, primary:
Arthropod-borne & unspecified .......... 19 30 -- 1,459 1,978 -
Encephalitis, post-infectious ........... 3 9 701 666
Hepatitis, serum ........................ 76 30 724 2,044 1,310 34,395
Hepatitis, infectious .................... 699 694 34.786 29,090
Malaria ............................. 30 12 2 1,889 441 97
Measles (rubeola)....................... 292 950 2,316 60,490 196,513 371,315
Meningococcal infections, total........... 28 57 42 1,958 3,129 2,518
Civilian ............................ 27 46 -- 1,835 2,826 -
Military............................... 1 11 --- 123 303 --
Poliomyelitis, total ..................... 2 2 2 37 92 108
Paralytic.............................. 1 2 2 27 87 87
Rubella (German measles) .............. ..273 292 42,395 44,135 -
Streptococcal sore throat & scarlet fever 7,390 8,478 6,790 400,377 377,983 350,235
Tetanus................................ 5 5 5 203 176 252
Tularemia.............................. 2 1 4 156 165 261
Typhoid fever .......................... 7 1 8 378 346 411
Typhus, tick-borne (Rky. Mt. spotted fever) 3 2 1 296 245 218

Rabies in animals ....................... 554 57 57 3,856 3,669 3,669

NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax: ... .......... .............................. 2 Rabies in man: .......... .. ...... .. ...... 2
Botulism: ........................................... 2 Rubella, Congenital Syndrome: ...................... 7
Leptospirosis: Cal.-l ..... ............ ..... ..... ..... 39 Trichinosis: .............. .. .. ..... ... ... 54
Plague: ............................................. 2 Typhus, marine: Tex.-1 ....................... ..... 41
P sittacosis: .................... .................. 42 P olio, U nsp...... .. ... .... ...... ......... ...... 9






394


Figure 1
MAP OF NEPAL WITH VILLAGE
AFFECTED BY PLAGUE


A-





*KATHMANDU






Naura. His illness was described as consisting of high
fever and cough with black and bloody sputum. No "swel-
lings" were reported. He died on September 28.
Subsequent cases were confined to a cluster of four
houses and eight families (Figure 3). After the second
death in house A, a strict quarantine was established by
the other villagers. isolating affected families from their
neighbors. However.there was free transit between houses
A and B throughout the epidemic. Therefore houses A and
B constituted a single epidemiologic unit. Attack rates
for the illnesses in the four houses are given in Table 1.
All 17 fatal cases were characterized by abrupt onset
of fever, and in 10 cases, the appearance of painful swel-
lings in the inguinal, axillary, or cervical region. Persis-
tent high fever was a constant finding and in 13 cases
cough, productive of black and bloody sputum, was re-
ported. Death occurred between three and eight days
after the onset of fever. Two patients were also reported
as having multiple "black spots" scattered over the body
shortly before death. Three patients were also said to have
had "open sores."
The seven non-fatal cases were characterized by the
abrupt onset of fever with a skin lesion, satellite lympha-
denopathy. and bubo formation. The skin lesions ranged


NOVEMBER 25, 1967


Figure 3
DIAGRAM OF EPIDEMIC AREA
NAURA, NEPAL 1967


NUMBERED HOUSES HAVE HAD RECENT ILLNESS OR DEATH
LETTER REFERS TO HOUSING UNITE FAMILY WITH PLAGUE CASES
NUMBER REFERS TO FAMILY UNIT


Figure 2
HUMAN CASES OF PLAGUE IN NAURA, NEPAL
BY DATES OF ONSET


SEPTEMBER OCTOBER
NUMBER REFERS TO FAMILY LOCATION 1967

E] 111.L C-St
%M yIIUfI i


Morbidity and Mortality Weekly Report


PLAGUE Naura, Nepal (Continued from front page)


B


D
C


A

3 2


6f


NOVEMBER


11^ fl n
f fl [


Ple


in


n n











Table 1
Attack Rates and Fatality Rates Plague
Naura, Nepal

Number l Cases Deaths
Total
House of Me s C.F.R.*
Families Total % Total %

A-B 6 20 18 90 15 75 83
C 1 4 2 50 0 0 0
D 1 8 4 50 2 25 50

TOTAL 8 32 24 75 17 53 71

'Case Fatality Ratio

from small pustules to large ulcerations. Pulmonary symp-
toms were present in only one case.
Swabs from the skin lesions of two patients yielded
a gram negative bipolar staining, non-motile rod. These
isolates were pathogenic for mice and have presumptively
been identified as Pasteurella pestis.
Five other cases of illness including three deaths
occurred in Naura during the epidemic period. These cases
were not felt to be part of the epidemic on both clinical
and epidemiologic grounds. Six other villages within an
approximate radius of five miles from Naura were visited,
and no illness similar to that seen in Naura was found.
Rodent deaths were seen only in Surkemala where two
villagers noted three "rat" carcasses in July and August.
An uncle of the index case who lived at Surkemala did see


a dead "rat" in the stable where the index case was
living.
In the absence of a known rodent epizootic in Naura,
a vector other than the rat flea must be considered in
those cases which were obviously bubonic. Houses were
examined and __,..i." for fleas, but none was found.
This was presumably the result of emergency spraying of
all houses with carbolic acid on November 4-6.
The high attack rate among family members in houses
A and B may be related to the intimacy of contact, the
degreeofexposure to infected fleas, and in some instances
to airborne spread. The high case fatality ratio observed
in houses A and B is most probably the result of focal
pneumonic spread of P. pcstis in some cases.
In retrospect, the most i 1 chain of events began
when the index case was infected at Surkemala where a
rodent die-off occurred. He then returned to Naura where
he developed secondary pneumonic plague. Subsequent
spread presumably resulted from airborne and flea trans-
mission producing both pneumonic and bubonic cases.
Some of the cases of bubonic plague apparently developed
secondary pneumonic involvement.
Thus, the epidemic appears to have resulted from two
routes of infection and to have been contained by self-
imposed quarantine and carbolic acid spraying of the
village houses.
(Reported by the Ministry of Health and the Public Health
Laboratory, Government of 'epal. Kathmandu, Nepal;
U.S. AID Mission to Nepal and a team from NCDC).


EPIDEMIOLOGIC NOTES AND REPORTS
CHIMPANZEE-ASSOCIATED HEPATITIS


A description of three cases of infectious hepatitis
in persons who had had contact with chimpanzees appeared
in MMWR, Vol. 16, No. 36. Recently three additional human
cases of infectious hepatitis associated with imported
chimpanzees and five additional cases of hepatitis in
chimpanzees have been reported. Both the chimps associ-
ated with human disease and the chimps who developed
hepatitis were purchased from the same animal brokerage
that supplied the chimps responsible for the initial outbreak.
Only one person with infectious hepatitis (Case 1)
had direct contact with a chimpanzee belonging to the orig-
inal shipment of animals. The other two human cases
(Cases 2 and 3) had contact with chimpanzees housed in
the same brokerage.
Case No. 1: On May 9, a Boston zoo purchased a young
chimpanzee from this animal brokerage. A 24-year-old fe-
male animal handler developed infectious hepatitis 52 days
after beginning daily initial contact with the chimpanzee.
She denied recent blood transfusion, self-administration of
parenteral drugs, and known contact with jaundiced persons
during 6 weeks prior to onset. Liver function tests per-
formed on the chimpanzee 10 days after onset of the human
case were normal.


Case No. 2: On April 1, 1967. two 6-month-old chimpan-
zees were purchased from the animal brokerage by the
Children's Zoo, Des Moines, Iowa. On May 1, the veteri-
narian who treated one of the young chimpanzees for cough,
nasal discharge, and poor appetite approximately four
weeks earlier, developed an illness diagnosed as infec-
tious hepatitis. No liver function tests were performed on
the chimpanzee.
Case No. 3: On July 24, 1967, a Chicago, Illinois, family
purchased a young chimpanzee from the animal brokerage.
Thirty days later, on August 27, 1967, a 15-year-old female
family member developed hepatitis. Liver function tests
performed on both the chimpanzee and the other three
family members were normal.
In addition to the 3 cases of hepatitis in humans, five
cases of hepatitis developed in chimpanzees. On July 20,
1967, 10 chimpanzees were purchased from the animal
brokerage by a research facility in Louisiana. Weekly
serial liver function tests and liver biopsies performed on
the animals revealed acute hepatitis in three animals 21,
28, and 43 days respectively after arrival. Two other ani-
mals purchased from the same brokerage on August 30.
(Continued on page 400)


NOVEMBER 25, 1967


Morbidity and Mortality Weekly Report








396 Morbidity and Mortality Weekly Report


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

NOVEMBER 25, 1967 AND NOVEMBER 26, 1966 (47th 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... 45 41 4 10 19 30 3 76 30 699 694

NEW ENGLAND.......... 1 1 1 3 28 48
Maine.............. 1 1 11
New Hampshire...... 1
Vermont.............
Massachusetts...... 1 1 9 15
Rhode Island....... 2 5 11
Connecticut....... I 13 10

MIDDLE ATLANTIC...... 4 15 5 37 12 155 101
New York City...... 1 1 8 9 40 17
New York, up-State. 7 1 11 1 31 30
New Jersey......... 3 7 3 15 1 65 33
Pennsylvania....... 1 3 1 19 21

EAST NORTH CENTRAL... 11 3 11 3 1 2 1 138 103
Ohio............... 1 7 1 46 18
Indiana............. 2 1 27 11
Illinois........... 2 1 1 1 2 18 9
Michigan............ 4 1 1 1 36 55
Wisconsin.......... 5 1 11 10

WEST NORTH CENTRAL... 1 2 3 9 23 29
Minnesota........... 1 2 2 7 1
Iowa............... 1 1 7 10
Missouri........... 1 2 16
North Dakota..... -
South Dakota......- -
Nebraska............. 1
Kansas............. 6 6 2

SOUTH ATLANTIC....... 6 4 1 2 3 1 2 48 144
Delaware........... 1 1 1 1
Maryland........... 4 1 2 1 15 16
Dist. of Columbia.. 3
Virginia........... 1 I 1 14 9
West Virginia...... 7 4
North Carolina...., 1 1 1 6
South Carolina..... -
Georgia............. 2 101
Florida............ 3 1 8 4

EAST SOUTH CENTRAL... 3 3 6 1 3 1 50 33
Kentucky........... 16 10
Tennessee.......... 2 5 1 3 1 17 11
Alabama........... 1 1 1 3 5
Mississippi........ 2 14 7

WEST SOUTH CENTRAL... 2 1 3 1 2 2 64 25
Arkansas ........... 4 2
Louisiana.......... 1 1 2 2 19 4
Oklahoma............. 3 3
Texas............... 2 1 2 38 16

MOUNTAIN.............. ...... 1 1 35 50
Montana............ 8 3
Idaho.............. 3 10
Wyoming............. 2
Colorado............. 7 5
New Mexico......... 1 5 20
Arizona............ 1 9 7
Utah............... 2 3
Nevada............. 1

PACIFIC.............. 17 13 5 8 1 27 12 158 161
Washington......... 2 32 8
Oregon............. 2 6 9 37
California......... 15 13 5 6 1 21 12 112 114
Alaska.............. 4
Hawaiil............. -I 1

Puerto Rico 25 23








Morbidity and Mortality Weekly Report 397


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

NOVEMBER 25, 1967 AND NOVEMBER 26. 1966 (47th WEEK) CONTINUED


MENINGOCOCCAL INFECTIONS,
MALARIA MEASLES (Rubeola) MENINGOCOCCAL NFECTONS, POLIOMYELITIS RUBELLA
TOTAL
AREA Cumulative Cumulative Total Paralytic
Cum.
1967 1967 19.67 1966 1967 1967 1966 1967 1967 1967 1967
UNITED STATES... 30 292 60,490 196,513 28 1,958 3,129 2 1 27 273

NEW ENGLAND.......... 1 6 923 2,491 2 78 144 26
Maine............... 1 262 274 3 12 4
New Hampshire...... 77 80 3 9 -
Vermont............ 42 317 1 4 -
Massachusetts...... 4 384 821 36 61 6
Rhode Island....... 62 73 4 17 -
Connecticut........ 1 1 96 926 2 31 41 16

MIDDLE ATLANTIC...... 7 26 2,449 18,348 3 322 404 5 18
New York City...... 6 497 8,354 56 64 1 8
New York, Up-State. 9 622 2,603 2 81 107 1 7
New Jersey.......... 3 10 564 1,934 105 118 2
Pennsylvania....... 4 1 766 5,457 1 80 115 3 1

EAST NORTH CENTRAL... 4 86 5,965 69,852 7 274 494 6 69
Ohio............... 3 1,175 6,415 2 92 143 3
Indiana............ 11 637 5,782 31 85 3 10
Illinois............. 3 47 1,138 11,473 61 89 7
Michigan........... 1 15 1,001 14,945 3 69 127 3 15
Wisconsin........... 10 2,014 31,237 2 21 50 34

WEST NORTH CENTRAL... 21 2,940 9,039 93 161 3 17
Minnesota.......... 9 133 1,669 21 35 2
Iowa............... 3 774 5,363 19 22 1 14
Missouri............ 1 340 537 18 63
North Dakota....... 7 885 1,274 3 11 -
South Dakota........ 58 40 7 5
Nebraska............. 1 656 156 15 9 1
Kansas............. 94 NN 10 16 2

SOUTH ATLANTIC....... 7 34 7,194 15,812 6 376 531 2 19
Delaware............ 50 262 7 5 1
Maryland............ 2 2 174 2,121 53 49 1 2
Dist. of Columbia.. 24 388 1 15 14
Virginia........... 14 2,253 2,238 43 67
West Virginia...... 1 1,457 5,481 1 36 37 10
North Carolina..... 9 926 601 2 75 133 1
South Carolina..... 3 512 661 1 31 54 1
Georgia............ 2 41 240 1 57 77
Florida.......... 2 6 1,757 3,820 59 95 5

EAST SOUTH CENTRAL... 2 16 5,448 20,168 2 155 269 2 20
Kentucky............ 1 7 1,426 4,777 45 95 -
Tennessee.......... 3 1,994 12,540 2 67 92 19
Alabama............ 6 1,354 1,752 29 58 1
Mississippi........ 1 674 1,099 14 24 2

WEST SOUTH CENTRAL... 3 57 17,964 25,748 3 246 418 2 1 9
Arkansas........... 1,404 982 1 37 36 1
Louisiana.......... 156 99 2 97 159 1
Oklahoma........... 3 3,359 538 18 21 1
Texas.............. 57 13,045 24,129 94 202 1 1 7

MOUNTAIN.............. 2 9 4,831 12,388 1 40 94 8
Montana............ 2 328 1,890 5 5
Idaho.............. 395 1,671 3 5
Wyoming............ 2 195 219 1 6 -
Colorado............ 1 1,610 1,392 13 49 5
New Mexico......... 604 1,159 5 10 -
Arizona............ 2 4 1,047 5,345 1 6 13 3
Utah............... 383 657 4 1
Nevada............. 269 55 3 5

PACIFIC.............. 4 37 12,776 22,667 4 374 614 96
Washington......... 17 5,607 4,662 1 37 48 29
Oregon............. 2 4 1,689 2,213 30 40 6
California......... 2 16 5,158 15,028 3 292 504 31
Alaska............. 140 606 11 18 30
Hawaii............. 182 158 4 4 -
Puerto Rico.......... 1 5 2,231 3,285 1 15 17








398 Morbidity and Mortality Weekly Report


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

NOVEMBER 25, 1967 AND NOVEMBER 26, 1966 (47th WEEK) CONTINUED


STREPTOCOCCAL TYPHUS FEVER
SORE THROAT & TETANUS TULAREMIA TYPHOID TICK-BORNE RABIES IN
ARSCARLET FEVER (Rky. Mt. Spotted) ANIMALS
AREA
1967 1967 Cum. 1967 Cum. 1967 Cum. 1967 Cum. 1967 Cum.
1967 1967 1967 1967 1967
UNITED STATES... 7,390 5 203 2 156 7 378 3 296 54 3,856

NEW ENGLAND.......... 1,120 2 1 10 1 1 98
Maine...........:.... 10 1 24
New Hampshire...... 4 46
Vermont............ 27 22
Massachusetts...... 155 1 1 6 1 4
Rhode Island....... 80 1 2
Connecticut........ 844 1 3 -

MIDDLE ATLANTIC...... 179 13 1 1 38 35 93
New York City...... 4 7 1 19 -
New York, Up-State. 153 1 1 11 9 77
New Jersey......... NN 1 4 15
Pennsylvania....... 22 4 4 11 16

EAST NORTH CENTRAL... 766 3 26 14 40 22 3 366
Ohio............... 111 4 13 11 1 131
Indiana............. 167 3 2 11 1 81
Illinois........... 103 2 13 12 6 10 68
Michigan........... 297 1 5 8 23
Wisconsin.......... 88 1 2 2 63

WEST NORTH CENTRAL... 430 17 22 21 4 21 907
Minnesota.......... 19 5 2 1 6 180
Iowa................ 136 2 1 3 4 123
Missouri........... 4 8 9 10 1 5 165
North Dakota....... 122 2 155
South Dakota ..... 46 I 2 116
Nebraska............. 77 4 2 3 63
Kansas............. 26 1 10 2 1 105

SOUTH ATLANTIC....... 774 1 42 10 3 61 3 119 6 463
Delaware ........... 7 -
Maryland............ 131 2 21 4
Dist. of Columbia.. 30 3 6
Virginia........... 214 10 1 7 28 3 196
West Virginia...... 165 1 2 2 I 62
North Carolina..... 32 7 4 1 47 3
South Carolina..... 50 1 -2 10 5 2
Georgia............. 15 4 5 2 21 2 17 1 114
Florida............ 130 1 19 1 12 2 76

EAST SOUTH CENTRAL... 871 31 2 12 64 53 12 731
Kentucky............ 14 4 1 2 24 15 3 164
Tennessee.......... 728 8 7 11 26 8 510
Alabama............ 74 11 1 1 12 12 1 47
Mississippi........ 55 8 2 17 10

WEST SOUTH CENTRAL... 556 48 80 1 39 42 10 864
Arkansas........... 2 5 47 12 14 108
Louisiana.......... 2 4 8 15 2 67
Oklahoma............ 18 3 18 7 16 8 337
Texas............... 534 36 7 1 5 10 2 352

MOUNTAIN............. 1,373 2 10 20 9 111
Montana............. 43 1 2 -
Idaho......... .... 68
Wyoming............. 159 2 1 5
Colorado........... 851 1 1 12 9 10
New Mexico......... 92 1 2 34
Arizona............ 77 3 50
Utah............... 83 6 3
Nevada..............- 9

PACIFIC.............. 1,321 1 22 6 2 85 11 1 223
Washington......... 337 2 2 2 2
Oregon.............. 145 1 1 3 3 4
California......... 608 1 17 3 2 77 6 1 217
Alaska.............. 187 -
Hawaii.............. 44 4 3 -

Puerto Rico.......... 6 1 18 1 8 I 1 31








Morbidity and Mortality Weekly Report






DEATHS IN 122 UNITED STATES CITIES FOR WEEK ENDED NOVEMBER 25, 1967

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


399


All Causes Pneumonia Under All Causes Pneumonia Under
Area A 65 years and year Area All 65 years and I year
Agells 65and over Influenza All Influenza All
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.--------


751
267
43
27
27
55
14
29
28
60
61
14
49
22
55

3,269
42
42
142
42
16
32
73
67
1,734
28
554
138
44
118
15
28
61
30
32
31

2,379
55
30
751
124
187
119
75
369
46
40
34
13
41
138
27
75
36
40
33
86
60

724
45
19
37
126
35
92
68
210
60
32


469
165
24
15
18
34
9
24
18
35
34
10
29
14
40

1,994
21
28
84
27
11
17
51
40
1,069
18
319
75
29
76
10
14
42
19
22
22

1,342
35
S19
406
77
104
74
36
182
30
28
22
7
26
76
13
51
22
25
23
57
29

447
29
10
26
84
23
52
44
116
41
22


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.----------


1,080
127
209
36
54
87
40
89
29
52
86
226
45

610
82
43
53
140
122
53
28
89

923
34
14
23
160
33
68
152
38
161
67
75
49
49

362
29
19
95
19
84
15
41
60

1,348
15
35
24
44
71
401
75
32
97
56
105
150
39
114
45
45


Total 11,446 6.650 416 528

Cumulative Totals
including reported corrections for previous weeks

All Causes, All Ages -------------------------576,384
All Causes, Age 65 and over------------------- 328,904
Pneumonia and Influenza, All Ages------------- 20,142
All Causes, Under 1 Year of Age--------------- 29,235


Week No.
47














CHIMPANZEE-ASSOCIATED HEPATITIS
(Continued from page 395)

1967, developed liver enzyme abnormalities and biopsy
changes of acute hepatitis four weeks after arrival. None
of these animals was jaundiced.
(Reported by S. L. Hendricks, D.V.M., Director, Veterinary
Public Health, Iowa State Department of Health; N. J.
Fiumara, M.D., M.P.H., Director, Division of Communica-
ble Diseases, Massachusetts Department of Public Health;
Norman J. Rose., M.D., M.P.H., Chief, Bureau of Epidemi-
ology, Illinois Department of Public Health; Dr. A. William
Holmes, Director of Section of Hepatology, Department of
Medicine, Presbyterian-St. Luke's Hospital, Chicago,
Illinois; The Delta Primate Research Center, Covington,
Louisiana; and an EIS Officer.)


3 1262 08864 1989

NOVEMBER 25, 1967


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. SHFRMAN. M.S.
EDITOR, MMWR MICHAEL B. GREGG, M.D.

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:
NATIONAL COMMUNICABLE DISEASE CENTER
ATLANTA, GEORGIA 30333
ATTN: THE EDITOR
MORBIDITY AND MORTALITY WEEKLY REPORT

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