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:
AA00010654:00024

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. 48


Si, tr



Week Ending
December 2,1967


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


PUBLIC HEALTH SERVICE


BUREAU OF DISEASE PREVENTION AND ENVIRONMENTAL CONTROL


EPIDEMIOLOGIC NOTES AND REPORTS
IlIb I IICklTA 11- ..... J lI.l>J.


CONTENTS


INF-LUN.L- L Micnigan ana rloruaa Epidemiologic Notes and Reports
Intluenza Michigan and Florida ......... 401
Surveillance Summari
The first documented cases of influenza for the 1967-68 Influenza- 1967-6S ..................... 402'
epidemiologic year have been reported to NCDC. The first Current Trends
Measles ........ ....... 402
reported outbreak affected approximately 3,000 of 18,500 InLernational No r-
students at Western Michigan University, Kalamazoo Para-Influenza Port-of-pain. Trinidad . 403
Michigan, between October 23, and November 10 quarantine lMeasures . . .. 40
The peak incidence iwas reached during thf11 ee medical assistance. The illness was characterized
ber 28. The second outbreak occurred in 'he an b v malaise, headache. myalgia. cough, and retro-
Florida, public schools in early November a eak se ain. Laboratory study of -11 paired sera from
incidence on November 8 and 9. stud howed 7 with fourfold rises to influenza A by
At Western Michigan University appro. 3t ly 1,000 com( t-fixation (CF) test, and 4 with fourfold or
students sought medical care at the Uni rot Health y gre ses against recent influenza A2 antigens by
Service, and an estimated 2,000 more were il b id not Z (Continued on page 402)

CASES OF SPEC! DiB BLiED 5: UNITED STATES
(Cumulative totals inclu lb el i;h ports through previous weeks)
48th DEr ED CUMULATIVE, FIRST 48 WEEKS
MEDIAN
DISEASE DECEMBER 2, DECEMBER 3, 1962 1966 MEDIAN
1967 1966 1967 1966 1962 1966
Aseptic meningitis ...................... 57 52 47 2,827 2,782 2,003
Brucellosis ............................. 7 12 7 233 232 337
Diphtheria ........................ ..... 24 2 187 184 249
Encephalitis, primary:
Arthropod-borne & unspecified ........... 15 44 --- 1,474 2,022 --
Encephalitis, post-infectious ........ ... 9 11 --- 710 677 -
Hepatitis, serum ................... .. 84 35 7 2,128 1,345 ,9
Hepatitis, infectious .................... 765 739 35,608 29,829
Malaria ............................... 45 17 1 1,933 458 97
Measles rubeolaa) ....................... 248 1,472 2,327 60,738 197,985 373,642
Meningococcal infections, total ........... 41 48 44 1,999 3,177 2,559
Civilian ............................ 41 46 1,876 2,872 -
Military ........................... -. 2 --- 123 305 -
Poliomyelitis, total .................. ... .2 4 5 39 96 113
Paralytic.............................. 3 4 27 90 90
Rubella (German measles) ................ 263 376 --- 42,658 44,511 -
Streptococcal sore throat & scarlet fever .. 8,690 9,107 6,331 409,239 387,090 358,429
Tetanus................................. 6 9 7 209 185 259
Tularemia.............................. 2 3 4 158 168 269
Typhoid fever .......................... 5 6 8 383 352 422
Typhus, tick-borne (Rky. Mt. spotted fever). 1 1 297 245 220

Rabies in animals ....................... 60 69 69 3,916 3,738 3,738

NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax: ............................................ 2 Rabies in man:................ ..... .................. 2
Botulism: ........................................... 3 Rubella, Congenital Syndrome: Ore.-l .................. 8
Leptospirosis: La.-. ................................. 40 Trichinosis: ....................................... 54
Plague: ............................................. 2 Typhus, marine: Ala.-1 ............................ 42
P sittacosis: .............. ..... ..... ............ 42 Polio, Unsp. C al.-2 ................ ............. 11


Z___







402


hemagglutination inhibition. The Respirovirus Laboratory
at NCDC has confirmed these results.
During the University outbreak, absenteeism also in-
creased in Kalamazoo's public schools. A similar illness
was reported in Lansing, Michigan's public schools. The
peak incidence occurred the week of November 21, when
absenteeism reached 12 to 20 percent. Again paired sera
showed diagnostic rises to influenza A; antigens. Attempts
are presently being made to isolate the virus.
In the Florida outbreak, paired sera from 2 patients
had diagnostic serologic rises by CF tests against in-


DECEMBER 2, 1967


fluenza A. In mid November, one case of influenza was
diagnosed by a local physician in Jacksonville, Florida,
and confirmed by the Florida State Laboratory by CF
serology test against influenza A.
(Reported by George H. Agate, M.D., M.S.P.H., Chief,
Division of Epidemiology, and Maurice Becker, Ph.D.,
Chief, Virology Section. Division of Microbiology, Michi-
gan Department of Public Health; E. Charlton Prather
M.D., M.P.H., Director, Division of Epidemiology, Florida
State Board of Health; Respirovirus Unit, Laboratory
Program, NCDC; and 2 EIS Officers.)


SURVEILLANCE SUMMARY
INFLUENZA 1967-68


A review of pneumonia-influenza mortality reported
to the National Communicable Disease Center by 122
United States cities shows only minor excursions above
the expected number from January through mid November
1967 (Figure 1). Small rises in mortality in mid August
and mid October were observed, but pneumonia-influenza
mortality for the United States as a whole has not reached


epidemic thresholds. Similarly pneumonia-influenza mor-
tality data for the 9 geographic areas in the United States
do not reflect significant or sustained levels of excess
mortality.
Editorial Note: The basis of the construction of the Na-
tional Pneumonia-Influenza Mortality Chart is described
in the MMWR, Vol. 14, No. 1 of January 9, 1965, pp. 8-9.


Figure 1
PNEUMONIA-INFLUENZA DEATHS IN 122 UNITED STATES CITIES


ALL CITIES


EPIDEMIC THRESHOLD -----
EXPECTED NUMBER


WEEK NO 40 44 48 52 4 8 12 16 20 24 28 32 36 40 44 48 52 4 8 126 20 24 28 32 36 40 4448 52 4 8 12 16 20 24 28 32 36
WK. ENDED 9 6 4 1 29 26 26 23 21 18 16 13 10 8 5 3 31 28 25 25 22 20 17 15 12 9 7 4 2 30 27 24 23 20 18 13 10 7
MONTH O N D F J AA S 0 N 0 J F M A M J J A S 0 N oD M J M J A S
196511966 196611967 1967 1968


CURRENT TRENDS
MEASLES


For the 48th week, 248 cases of measles were re-
ported. To date, there have been 60,738 reported cases in
the United States, a substantial reduction from the 197,985
cases reported for the same period in 1966, previously the
record low year.


The decline in the numbers of reported measles cases
since 1962 in 6 states is shown in Figures 2 and 3. State-
wide vaccination programs have been conducted in Rhode
Island, Maryland, and Utah. In each of those states mea-
sles incidence has declined dramatically, even though


Morbidity and Mortality Weekly Report




INFLUENZA Michigan and Florida (Continued from front page)








Morbidity and Mortal


surveillance and case finding efforts have been intensified.
A similar decline in reported cases has also occurred in
Massachusetts. Michigan, and Pennsylvania (Figure 3).
In these states no statewide campaigns were conducted.
however, community-wide and on-going immunization pro-
grams have produced a marked decline in reported measles
cases. Most vaccine utilization in these states has been
associated with intensification of continuing programs of
immunization of preschool and young school aged children.

Figure 2
REPORTED CASES OF MEASLES BY 4-WEEK PERIODS
IN 3 STATES CONDUCTING A STATEWIDE CAMPAIGN
1962 1967


RHODE ISLAND
960 POP 09 MILLION)
O0 CCINE LICENSED
MARCH 1963
CAIM16N

A Z0




0m


DECEMBER 2. 1967


MASSACHUSETTS
J960 POP 51 MILLION)


165 1966 196


MARYLAND
(I90 POP 30 MILLION)

CAMPAIGN
0o MAY7. 14,2t. I67




1962 193 964 1965 1919 967 196


INTERNATIONAL NOTES
PARA-INFLUENZA Port-of-Spain, Trinidad


A para-influenza epidemic with five deaths among
more than 250 hospitalized children occurred in Port-of-
Spain, Trinidad, between October 1, and November 26,
1967. Over 50 percent of the patients were under age 2.
Clinical illnesses ranged from severe upper respiratory
infections to bronchitis, bronchiolotis. and bronchopneu-
monia. Severely ill children developed variable degrees of
fever, productive cough, pharyngitis, dyspnea, rales,
rhonchi, and brochospasm. Axillary temperatures were
usually under 102F, however several children had higher
temperatures accompanied by febrile convulsions. X-rays


of children with pneumonia showed diffuse bilateral peri-
bronchial infiltration. With treatment most children re-
covered within a week from onset.
Virus obtained from throat swabs of acutely ill chil-
dren produced hemadsorption in Rhesus monkey kidney
tissue cultures. Lab results from the Trinidad Regional
Virus Laboratory and NCDC confirmed the agents as mem-
bers of the para-influenza group. Since October 1, 20 iso-
lates were typed; 15 were para-influenza I; 5 were para-
influenza III. Epidemiologic and laboratory studies are
continuing. (Continued on page 408)


ity Weekly Report 403




Figure 3
REPORTED CASES OF MEASLES BY 4-WEEK PERIODS
IN 3 STATES WITH ON-GOING AND COMMUNITY-WIDE
IMMUNIZATION PROGRAMS
1962 1967


1962 196I 1964


I 9W







404 Morbidity and Mortality Weekly Report


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED
DECEMBER 2. 1967 AND DECEMBER 3, 1966 (48th 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... 57 52 7 24 15 44 9 84 35 765 739

NEW ENGLAND .......... 4 2 3 38 28
Maine.............. 2 3
New Hampshire ...... -
Vermont............ 1
Massachusetts...... 2 1 2 12 13
Rhode Island....... 1 1 2 4
Connecticut........ 1 22 7

MIDDLE ATLANTIC...... 12 19 1 1 10 1 35 16 101 113
New York City...... 3 4 1 6 22 13 37 29
New York, Up-State. 2 1 -- 4 2 12 21
New Jersey.......... 5 3 1 4 7 1 23 29
Pennsylvania....... 2 11 1 2 29 34

EAST NORTH CENTRAL... 5 3 1 2 6 1 2 1 128 133
Ohio................ 2 1 4 25 16
Indiana............. 12 13
Illinois........... 1 1 1 1 1 37 25
Michigan........... 1 1 1 1 1 1 39 54
Wisconsin............. 1 1 1 15 25

WEST NORTH CENTRAL... 5 1 7 53 26
Minnesota.......... 1 1 17 7
Iowa................ 3 1 16 12
Missouri............... 1 12 4
North Dakota....... 2
South Dakota........ -
Nebraska ........... -
Kansas ............. 6 6 3

SOUTH ATLANTIC....... 12 3 4 5 7 5 2 2 92 60
Delaware........... 1 5 2
Maryland........... 2 1 13 20
Dist. of Columbia.. 2
Virginia........... 1 1 10 7
West Virginia...... 2 1 13 4
North Carolina..... 1 1 2 2 3 4
South Carolina ..... 1
Georgia............. 34 12
Florida............ 6 1 3 3 5 5 1 1 11 10

EAST SOUTH CENTRAL... 12 4 4 1 1 57 71
Kentucky............ 19 24
Tennessee.......... 4 1 1 1 20 26
Alabama............. 2 4 2 12
Mississippi........ 6 3 16 9

WEST SOUTH CENTRAL... 4 1 16 1 2 1 2 2 89 58
Arkansas........... 2 1 22 3
Louisiana .......... 1 1 1 2 18 3
Oklahoma............. 6 11
Texas.............. 2 15 1 1 1 43 41

MOUNTAIN............. 1 3 13 85
Montana............ 7 11
Idaho............... 24
Wyoming............ 2 2
Colorado........... i 6
New Mexico.......... 2 26
Arizona............. 12
Utah............... 3 3
Nevada............... 2 1

PACIFIC............. 23 7 5 6 1 39 13 194 165
Washington......... 20 22
Oregon.............. 1 i 1 12 27
California......... 21 7 5 5 1 38 13 161 115
Alaska.............. -
Hawaii............. 2 -

Puerto Rico 2 1 22 23







Morbidity and Mortality Weekly Report 40;


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

DECEMBER 2, 1967 AND DECEMBER 3, 1966 (48th WEEK) CONTINUED



MALARIA MEASLES (Rubeola) MENINGOCOCCAL INFECTIONS, POLIOMYELITIS RUBELLA
AREA Cumulative Cumulative Total Paralytic
SC 1967 1966 1967 1967 1966 197 um.
1967 1967 11967 1967 967 1967 1966 1967 1967 1967 1967


UNITED STATES...


NEW ENGLAND.......... 1 8
Maine............... -
New Hampshire......
Vermont ............ -
Massachusetts...... 7
Rhode Island........
Connecticut......... 1 1

MIDDLE ATLANTIC...... 9 33
New York City...... 1 11
New York, Up-State. 7
New Jersey.......... 4 11
Pennsylvania....... 4 4

EAST NORTH CENTRAL... 2 63
Ohio ............... 2
Indiana............. 1 10
Illinois............ 24
Michigan........... 1 5
Wisconsin.......... 22

WEST NORTH CENTRAL... 1 3
Minnesota .......... -
Iowa............... 2
Missouri...........
North Dakota....... 1
South Dakota........
Nebraska...........
Kansas.............. 1

SOUTH ATLANTIC........ 14 20
Delaware ........... 1
Maryland ...........
Dist. of Columbia..
Virginia........... 1
West Virginia......
North Carolina..... 10
South Carolina..... 1
Georgia............. 1
Florida............. 2 18

EAST SOUTH CENTRAL... 12
Kentucky............ 2
Tennessee.......... 8
Alabama............ -
Mississippi........ 2

WEST SOUTH CENTRAL... 2 41
Arkansas ........... -
Louisiana.......... 1
Oklahoma ........... 1
Texas.............. 41

MOUNTAIN ............. 2 17
Montana ...... ..... -
Idaho............... -
Wyoming............ 7
Colorado............ 7
New Mexico......... 1 2
Arizona............. 1 1
Utah .............. -
Nevada ...... ...... -

PACIFIC.............. 14 51
Washington.......... 6 16
Oregon.............. 9
California......... 8 25
Alaska............. 1
Hawaii............. -


60,738

931
262
77
42
391
62
97

2,482
508
629
575
770

6,028
1,177
647
1,162
1,006
2,036

2,943
133
776
340
886
58
656
94

7,214
50
174
24
2,254
1,457
926
512
42
1,775

5,460
1,428
2,002
1,354
676

18,005
1,404
156
3,359
13,086

4,848
328
395
202
1,617
606
1,048
383
269

12,827
5,623
1,698
5,183
141
182


197,985 41

2,518 2
285
80
323
825
73 2
932

18,413 9
8,360 4
2,621
1,968 3
5,464 2

70,001 3
6,444
5,787
11,486
15,008 3
31,276

9,128
1,674
5,408
538
1,311
40
157
NN

15,891 12
263 1
2,123 2
390
2,247
5,494 1
621 5
663 1
241
3,849 2

20,397 1
4,809
12,607 1
1,762
1,219

26,106 12
982 9
99 1
578
24,447 2

12,497
1,903
1,676
233
1,407
1,210
5,351
662
55

23,034 2
4,860
2,338
15,059 2
615
162
3,356


3,177

147
12
9
4
62
17
43

413
64
112
119
118

501
145
88
89
128
51

165
35
22
64
11
6
11
16

536
5
49
14
67
41
134
54
77
95

275
95
92
59
29

425
36
161
22
206

94
5
5
6
49
10
13
1
5

621
52
40
507
18
4


263

30
3


6
3
18

29
13
4
12


77
1
4
8
37
27

11

9



2


19
1


5
2

1

10

19
1
18



1
1




8
2


3

3



69
16
20
20
11
2


15 17


Puerto Rico.......... 5 2,236


1







406 Morbidity and Mortality Weekly Report


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

DECEMBER 2, 1967 AND DECEMBER 3, 1966 (48th WEEK) CONTINUED


STREPTOCOCCAL TYPHUS FEVER
SORE THROAT & TETANUS TULAREMIA TYPHOID TICK-BORNE BABIES 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... 8,690 6 209 2 158 5 383 1 297 60 3,916

NEW ENGLAND............ 879 2 1 10 1 1 99
Maine.............. 31 24
New Hampshire...... 7 1 47
Vermont............. 41 22
Massachusetts...... 194 1 1 6 1 4
Rhode Island....... 86 1 2
Connecticut........ 520 1 3 -

MIDDLE ATLANTIC...... 244 1 14 1 1 39 35 2 95
New York City...... 8 1 8 1 20 -
New York, Up-State. 216 1 1 11 9 2 79
New Jersey......... NN 1 4 15
Pennsylvania....... 20 4 4 11 16

EAST NORTH CENTRAL... 815 26 1 15 1 41 22 4 370
Ohio............... 21 4 1 14 11 131
Indiana............. 198 3 2 11 1 3 84
Illinois........... 268 13 1 13 6 10 1 69
Michigan............ 219 5 8 23
Wisconsin.......... 109 1 2 63

WEST NORTH CENTRAL... 415 16 22 21 4 15 922
Minnesota.......... 9 5 2 1 4 184
Iowa............... 136 2 1 3 2 125
Missouri........... 8 7 9 10 1 1 166
North Dakota....... 72 4 159
South Dakota....... 53 1 2 116
Nebraska............ 120 4 2 3 66
Kansas ............. 17 1 10 2 1 106

SOUTH ATLANTIC....... 1,336 3 45 10 1 62 119 9 472
Delaware .......... 6 -
Maryland............ 145 2 21 4
Dist. of Columbia.. 41 3 6
Virginia........... 359 10 1 8 28 6 202
West Virginia...... 318 1 2 2 1 62
North Carolina..... 144 7 4 47 3
South Carolina..... 61 1 2 10 5 2
Georgia............. 14 4 5 21 17 1 115
Florida............. 248 3 22 1 12 2 78

EAST SOUTH CENTRAL... 1,620 31 12 64 53 9 740
Kentucky............ 32 4 2 24 15 4 168
Tennessee.......... 1,287 8 7 11 26 4 514
Alabama............ 289 11 1 12 12 1 48
Mississippi........ 12 8 2 17 10

WEST SOUTH CENTRAL... 824 2 50 1 81 1 40 1 43 8 872
Arkansas........... 21 1 6 1 48 12 14 3 111
Louisiana.......... 2 4 8 1 16 2 67
Oklahoma............ 59 1 4 18 7 16 2 339
Texas............... 742 36 7 5 1 11 3 355

MOUNTAIN............. 1,570 3 10 1 21 9 2 113
Montana............. 71 1 2 -
Idaho.............. 39 -
Wyoming............ 273 2 1 5
Colorado............ 768 2 1 12 9 10
New Mexico......... 230 1 2 34
Arizona............. 86 1 4 2 52
Utah............... 103 6 3
Nevada ............. 9

PACIFIC.............. 987 22 6 85 11 10 233
Washington......... 236 2 2 2 2
Oregon............. 160 1 1 3 3 4
California......... 516 17 3 77 6 10 227
Alaska.............. 21 -
Hawaii.............. 54 4 3

Puerto Rico.......... 19 18 8 32








Morbidity and Mortality Weekly Report


DEATHS IN 122 UNITED STATES CITIES FOR WEEK ENDED DECEMBER 2, 1967

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


407


All Causes Pneumonia Under All Causes Pneumonia Under
Area All 65 years and 1 year Area All 65 years and I year
Age and over Influenza All Ages and overInuenza 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.--------


822
255
55
28
34
59
36
29
33
63
57
14
56
40
63

3,769
56
35
186
50
51
31
69
103
1,839
55
556
262
56
114
37
67
63
67
29
43

2,829
77
32
813
180
225
124
90
323
50
59
62
37
56
180
30
177
47
28
57
117
65

971
67
24
43
159
35
105
89
303
80
66


513
146
34
21
23
33
23
20
21
36
37
11
36
30
42

2,249
30
22
108
28
31
16
43
48
1,107
36
329
150
40
69
24
41
40
39
18
30

1,667
47
23
472
115
127
74
52
187
36
31
36
21
33
99
14
104
32
19
41
63
41

582
40
13
18
104
30
72
57
163
52
33


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.----------


1,241
147
281
56
59
97
56
80
39
79
84
230
33

694
125
53
54
139
136
68
46
73

1,377
35
52
32
171
42
94
287
60
182
124
144
49
105

486
50
23
126
23
120
26
51
67

1,582
17
62
27
54
73
466
83
36
135
67
92
193
44
143
47
43


Total 13,771 8,307 477 697

Cumulative Totals
including reported corrections for previous weeks

All Causes, All Ages -------------------------590,158
All Causes, Age 65 and over-------------------336,944
Pneumonia and Influenza, All Ages------------- 20,613
All Causes, Under 1 Year of Age--------------- 29,935


Week No.
48


LO














PARA-INFLUENZA Port-of-Spain, Trinidad
(Continued from page 403)

Previous studies by TRVL implicated para-influenza
viruses in sporadic respiratory illness and respiratory
syncytial virus as the principal cause of epidemics among
pediatric patients. In 1964, an outbreak of respiratory
syncytial virus infections occurred among infants in Port-
of-Spain. Over 60 cases were documented by virus isola-
tions or serologic studies. During 1964-66. para-influenza
viruses were isolated sporadically from children with
respiratory diseases. For the 3-year period, 6 isolates of
para-influenza I, 1 isolate of para-influenza II, and 24
isolates of para-influenza III were recorded. However, the
occurrence of a large epidemic due to para-influenza agents
is an epidemiologic pattern not previously recognized in
the Eastern Caribbean.
(Reported by Dr. L. .M. Comissiony, Chief Medical Officer,
Ministry of Health, Government of Trinidad and Tobago;
Dr. L. Spence, Director, Trinidad Regional Virus Labora-
tory, University of the WIest Indies; and an EIS Officer.)







QUARANTINE MEASURES


Immunization Information for International Travel
1967-68 edition-Public Health Service Publication No. 384


Section 5
AMERICA
St. Pierre and Miquelon Islands Page 48
SMALLPOX
Insert: Smallpox vaccination required of arrivals from in-
fected areas, and from countries in Africa, in America
(Except Canada and United States of America), and in Asia.


CHOLERA
Insert: Cholera vaccination required of arrivals from in-
fected areas by air, 6 months of age and over.












ERRATUM, Vol. 16, No. 47, p. 394
InI Figure 2 delete block representing fatal case on
October 11.


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.
EDITOR, MN.WR 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.


I


SUNIV. OF FL LIB.
DOCUMENTS DEPT.







U.S. DEPOSITORY


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Morbidity and Mortality Weekly Report


DECEMBER 2, 1967


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