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:
AA00010654:00026

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. 49


WEEKLY

REPORT


Week Ending

December 9, 1967


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


PUBLIC HEALTH SERVICE


BUREAU OF DISEASE PREVENTION AND ENVIRONMENTAL CONTROL


CURRENT TRENDS

INFLUENZA Recent Reports


Further reports of influenza-like disease ha\e been
received by NCDC. In addition to the confirmed outbreaks
of influenza A2 in Kalamazoo and Lansing (MMWR, \ol. 16.
No. 49), influenza-like disease was reported from southern
and central Michigan. No new outbreaks were reported
from Florida, but hemagglutination inhibition tests further
support the diagnosis of A. influenza in Jacksonville and
North Miami.
In Bergen County. New Jersey, four schools had in-
creases in absenteeism from 10 to 30 percent beginning
the week of November 26. Of six paired sera three showed


CONTENTS


Current Trevnd
Infiuenza-- recent R epot. ,
Mte 1s-- Nation, hi .....
SMe~.; s-(C h i ca .
IEpidmiolooic Notes anii Reports
Co\\ po--lnd iana
Changeo f Di tino.sis .
International Ntes
Qu ar ntine Me ures .


. . 1
................ 411
. . . 1

. . 110

. . 4 16


diagnostic rises to influenza A by the complement fixa-
tion technique: one showed a diagnostic rise to A) influ-
enza by hemagglutination inhibition. Geometric mean titers
were significantly different between unpaired groups of
acute and convalescent sera when tested for A influenza
antigen by complement fixation.
(Continued on page 310)


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous weeks)


Aseptic meningitis ..........
Brucellosis. ............... .
Diphtheria. .........
Encephalitis, primary:
Arthropod-borne & unspeci ........
Encephalitis, post-infectiou .........
Hepatitis, serum ........ ....
Hepatitis, infectious ..... ......
Malaria ................ .....
Measles rubeolaa) .......... .\- *
Meningococcal infections, total Y'..
C civilian ................... .
Military .........................
Poliomyelitis, total .................. ..
Paralytic.............................
Rubella (German measles) ................
Streptococcal sore throat & scarlet fever
Tetanus ................................
Tularem ia .............................
Typhoid fever .........................
Typhus, tick-borne (Rky. Mt. spotted fever).

Rabies in animals .......................


49th WEEK ENDED

MBER 9, DECEMBER 10,
i7 1966


32
9
38
732
14
1.358
53
45
8
1
1
407
9,732
2
4
11
6

65


MEDIAN
1962 1966


CUMULATIVE, FIRST 49 WEEKS

MEDIAN
1967 1966 1962 1966


I. +


38
8
9



770
4
3,071
51
.- .

2
2

7,744
5
4
11


72


2.885
236
197

1.498
724
2.203
36,503
1.984
61,110
2,033
1,909
124
41
27
43,067
419,342
216
160
389
297

4,001


2.834
235
184

2,054
686
1,383
30,561
472
199.343
3,230
2,917
313
97
91
44,918
396.822
187
172
363
251

3.803


2,041
343
262



35,647
101
377,354
2,619


114
91

367,161
266
272
432
220

3,803


NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax: .... ....... ............................... 2 Rabies in man:... .. ..... .. .... ... 2
Botulism: ........................................... 3 Rubella, Congenital Syndrome: Ore.-l.................. 9
Leptospirosis: Mont.- ............... ................. 41 Trichinosis: Calif.-l, Kans.-1, N.Y.C.-1 ............... 57
Plague: ............... ....... ................ ... 2 Typhus, murine: .................................. 42
Psittacosis: Wash.-i ................ ............... 43 Polio. Unsp. Calif.-2 .... ............ .. ..... 13


r' .W/4, a j ? / /TV1,7














There is presumptive evidence that influenza A is
occurring in the greater Chicago area. Throat smears from
two ill students at Northwestern University and from six
ill persons in Kane County. Illinois, were positive by the
experimental fluorescent antibody technique for influ-
enza A. Results of culture studies are pending.
Focal outbreaks of febrile respiratory disease mani-
fested primarily by increased school absenteeism have
occurred in Indiana, Alabama. and Oklahoma. Attempts at
virus isolation are progressing in each area where febrile
illness has been reported, but to date no virus has been
identified.


DECEMBER 9, 1967


(Reported by W. H. Y. Smith. M.D., C.P.H., Alabama State
Department of Public Health; E. Charlton Prather, M.D.,
M.P.H., Florida State Board of Health; Norman J. Rose,
M.D., M.P.H.. and Richard Morrissey, M.P.H., Illinois
Department of Public Health; A. L. Marshall, Jr., M.D.,
and William Turner, M.D., Indiana State Board of Health;
George H. Agate, M.D., M.S.P.H., and Maurice Becker,
M.D., Michigan Department of Public Health; R. Altman,
M.D., and Martin Goldfield. M.D., New Jersey State De-
partment of Health; R. L. Carpenter, M.D., M.P.H., Okla-
homa State Department of Health; and EIS Officers.)


EPIDEMIOLOGIC NOTES AND REPORTS
COWPOX Indiana

Change of Diagnosis


The clinical case of cowpox in a 56-year-old woman
(M.W.) from Indiana .CI'iI\Fl' Vol. 16, No. 46) has now been
attributed to vaccinia virus on the basis of additional
laboratory and epidemiologic evidence. Contrary to the
earlier report, further tissue culture and histopathologic
studies have demonstrated viral characteristics indica-
tive of vaccinia. Epidemiologic investigation, furthermore,
suggested a probable pattern of contact spread of vaccinia
virus from a recently immunized infant.
On October 5, a 1-year-old female infant was vacci-
nated and developed a primary "take" with marked local
reaction. This infant was in intimate contact with members
of two related households; the first includes the infant, her
parents, and threeother children. The second is comprised
of the infant's grandmother (M.W.) and three of M.W.'s
children. About October 15, one of M.W.'s children (D.W.)
developed lesions on the hands, becoming the first known
human infection. Subsequently. the other members of this
household also developed lesions, but M.W. was the only
one to become systemically ill, requiring hospitalization.
None of these persons had been vaccinated previously.
In the other household, which included the vaccinated
infant, no lesions were noted. The infant's parents were
unvaccinated, but the three children had undocumented
histories of smallpox immunization. Between October 10
and 15, one dairy cow of a herd of 20, tended and milked
by hand by members of both households, developed lesions
on the udder. Subsequently, lesions were noted on an
additional 10 to 12 cows of this herd.
Epidemiologic data are insufficient to ascertain defi-
nitely the path of spread of vaccinia virus from the vacci-


nated child. However, it appears that virus from the in-
fant's lesion may have been transferred to the index cow,
with appearance of udder lesions which then produced the
lesions in the unvaccinated human contacts. The remainder
of the herd was then cross-infected during milking. Scrap-
ings from lesions on one of these cows have been sub-
mitted to NCDC for virus isolation. Serologic studies are
also in progress.
Initial laboratory study demonstrated the presence of
pox virus in scrapings from lesions on the hands of M.W.
Electronmicroscopy revealed pox virus particles in tissue
culture; agar gel diffusion test was positive for pox virus
group; and virus from first passage of crust material in
embryonated eggs produced hemorrhagic pocks on the
chorioallantoic membranes (CAM). This morphology was
accepted as characteristic of cowpox, as opposed to vac-
cinia virus. The second passage of crust material, how-
ever, produced pocks most of which were without central
hemorrhage, and were morphologically typical of vaccinia
virus.
Histopathologic sections of the first passage CAMs,
originally diagnosed as typical of cowpox, were subse-
quently found to have the granular and amorphous intra-
cytoplasmic inclusion bodies, similar to the inclusion
bodies of vaccinia and variola. These were distinctly
different from the inclusion bodies of cowpox.

(Reported by A. L. Marshall, Jr., M.D., Director, Division
of Communicable Disease Control, Indiana State Board of
Health; Viral Exanthems Laboratory, and an EIS Officer,
NCDC.)


Morbidity and Mortality Weekly Report




INFLUENZA Recent Reports (Continued from front page)








DECEMBER 9. 1967


CURRENT TRENDS
MEASLES Nationwide


For the week ending December 9. 372 cases of measles
crre reported. This is the twenty-first consecutive week
\with less than 400 cases per week. an occurrence that
has not been previously observed according to records
dating back to 1912 when reporting of measles cases be-
gan on a national basis. The 4-week total for Notembter 11
to December 9 is 1,213 cases (Figure 1), which i-- 25 per-
cent of the cases reported for the same period in 1966.
and 14 percent of the cases reported for the same period-
in 1964 and 1965. B\ this time in the past four \ears a
seasonal increase \\as evident: however, to date no sea-
sonal increase has occurred.


Figure 1
REPORTED CASES OF MEASLES IN THE UNITED STATES
4-WEEK TOTALS JULY-DECEMBER 1964-1967

a,) --- 965
g q_ 55


N --


26 28' 3 32 34 3' 4C 4 4:


MEASLES Chicago


In the Chicago area from January to Seplember 1967.
312 measles cases were reported. Investigation revealed
11.2 percent (35 cases) to be other diseases. Of the re-
maining 277 confirmed cases (147 males and 130 females).
h0 percent were preschool children and 5.2 were children
under 10 months of age (Table 1). Of the confirmed cases.
42 percent were hospitalized. Complications of otitis media.
pharyngitis. and pneumonia occurred in 17 percent of the
cases. No measles encephalitis was confirmed: however.
encephalitis occurred in a person with positive rneasles
serology but no clinical evidence of measles. Death from
pneumonia occurred in two children, ages b and 11 months.

Table 1
Confirmed Measles by Race and Age*
Chicago, Illinois January-September 1967

Race
Age Groups Total Total
White Negro

Under 10 months 17 35 52 20
10 months-4 years 28 132 160 60
5-14 years 16 37 53 20
15 years and older 1 0 1 <1

Total 62 204 266 100

*Race and or Age Unknown 11 cases

Diagnosis of 97 percent of the 277 cases was by a
visit to the patient's home, physician's office, private
clinic, or hospital. Telephone calls established diagnosis
in 3 percent. Of the diagnosed cases. 96 percent had not
been immunized. Among eleven persons giving a history
of immunization, eight had been immunized. In most cases
the source of exposure to measles was difficult to deter-
mine; however, 44 children were exposed at school, 18


exposed at home. and 40 were exposed to neighborhood
playmates. Only 2 percent iere exposed outside the Chi-
cago area.
In August and Septemher 1967. a Preschool Child Im-
munization Index Surr.e\ 1 by -ocio-economic -tatus, was
conducted in 7Tb households in 200 city blocks. Results
indicated that children under ae 5 in the middle and lower
socio-economic groups were most -u-ceptihle to measles
as determined \ a history of mea-Iles or measles vaccina-
tion (Figure 2). Although Chicago has had an active immu-
nization program for 4 years, approximately 11.000 chil-
dren per month are being \accinated to decrease the number
of susceptible children.

Figure 2
PERCENT OF MEASLES IMMUNES BY SOCIO-ECONOMIC
GROUPS AND AGE CHICAGO, ILLINOIS, SURVEY
AUGUST AND SEPTEMBER 1967


1 UPPER
S MIDDLE
SLOWER


AGE GROUPS (YEARS)


(Continued on page 416)


Morbidity and Mortality Weekly Report


44a 46 48 50 52e
NOV DEC








412 Morbidity and Mortality Weekly Report


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED
DECEMBER 9, 1967 AND DECEMBER 10, 1966 (49th WEEK) CONTINUED


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

1967 1966 1967 1967 1967 1966 1967 1967 1966 1967 1966
UNITED STATES... 58 52 3 10 25 32 14 75 38 895 732

NEW ENGLAND.......... 1 3 1 3 1 2 28 48
Maine.............. 2 10
New Hampshire..... 1 1
Vermont.............. 1 -
Massachusetts...... 1 2 12 25
Rhode Island....... 2 3 3 1
Connecticut........ 1 11 11

MIDDLE ATLANTIC...... 8 2 1 9 1 28 22 157 102
New York City...... 2 1 6 17 15 72 27
New York, up-State. 1 2 4 4 11 32
New Jersey......... 5 4 3 25 24
Pennsylvania....... 1 1 1 1 3 49 19

EAST NORTH CENTRAL... 6 9 8 4 2 124 129
Ohio............... 7 6 1 48 31
Indiana............. 1 13 2
Illinois........... 1 1 2 22 24
Michigan........... 4 1 1 2 1 35 39
Wisconsin.......... 1 -- 6 33

WEST NORTH CENTRAL... 2 1 1 1 1 1 53 51
Minnesota........... 1 1 1 1 26 9
Iowa................ 2 1
Missouri............ 1 20 30
North Dakota....... 8 -- 8
South Dakota ...... 1 -
Nebraska............. 2 1
Kansas............. 4 2

SOUTH ATLANTIC....... 8 8 4 6 1 1 2 1 74 85
Delaware........... I 4
Maryland............ 4 1 2 10 16
Dist. of Columbia.. 2 2
Virginia........... 4 6 14
West Virginia...... 8 5
North Carolina..... 2 1 2 1 12 5
South Carolina..... 2 4 3
Georgia............. 18 26
Florida............. 5 2 1 2 14 10

EAST SOUTH CENTRAL... 8 2 1 1 92 47
Kentucky........... 1 40 13
Tennessee.......... 1 1 I 1 26 26
Alabama............ 1 9 4
Mississippi........ 6 17 4

WEST SOUTH CENTRAL... 1 12 5 1 3 3 4 2 75 66
Arkansas........... 1 3 1 1 2 3
Louisiana.......... 1 1 1 1 2 13 13
Oklahoma............ -- 10 6
Texas.............. 11 2 1 2 1 52 44

MOUNTAIN ............. 2 1 25 50
Montana............ 5 4
Idaho............... 4 2
Wyoming............ 1 1 -
Colorado............ 4 5
New Mexico.......... 2 8 19
Arizona............ 3 10
Utah............... -- 10
Nevada............. -

PACIFIC.............. 26 25 1 5 5 2 38 10 267 154
Washington.......... 2 1 18 17
Oregon............. 2 1 I 1 18 21
California......... 24 21 5 4 2 37 10 227 115
Alaska.............. 3 1
Hawaii............. 1 1

Puerto Rico 9 28









Morbidity and Mortality Weekly Report 413


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

DECEMBER 9, 1967 AND DECEMBER 10, 1966 (49th WEEK) CONTINUED


MENINGOCOCCAL INFECTIONS,
MALARIA MEASLES (Rubeola) NIN OCOCCAL NFECTI POLIOMYELITIS RUBELLA
TOTAL
AREA Total Paralytic
AREA Cumulative Cumulative Total Paralytic
Cum.
1967 1967 1967 1966 1967 1967 1966 1967 1967 1967 1967
UNITED STATES... 51 372 61,110 199,343 34 2,033 3,230 2 27 409

NEW ENGLAND.......... 4 935 2,560 1 81 149 41
Maine.............. 262 294 3 12 --- 5
New Hampshire...... 1 78 80 3 9
Vermont............. 42 344 1 4 4
Massachusetts...... 393 831 1 37 62 9
Rhode Island....... 62 73 6 19 10
Connecticut........ 1 98 938 31 43 13

MIDDLE ATLANTIC...... 11 35 2,517 18,480 6 337 429 5 38
New York City...... 6 514 8,365 2 62 65 1 13
New York, Up-State. 629 2,648 1 82 113 1 3
New Jersey.......... 8 20 595 1,986 2 110 129 21
Pennsylvania....... 3 9 779 5,481 1 83 122 3 1

EAST NORTH CENTRAL... 2 62 6,090 70,154 2 279 509 6 114
Ohio............... 4 1,181 6.452 2 94 147 19
Indiana............. 9 656 5,804 31 88 3 8
Illinois........... 2 3 1,165 11,520 61 91 8
Michigan........... 11 1,017 15,057 72 130 3 37
Wisconsin.......... 35 2,071 31,321 21 53 42

WEST NORTH CENTRAL... 10 2,953 9,251 1 94 166 3 29
Minnesota.......... 1 134 1,681 21 36 2
Iowa................ 8 784 5,433 19 22 1 23
Missouri........... 340 538 1 19 64 -
North Dakota....... 886 1,374 3 11 4
South Dakota....... 58 40 7 6
Nebraska............ 1 657 185 15 11 -
Kansas ............. 94 NN 10 16 2

SOUTH ATLANTIC....... 17 81 7,295 16,012 11 399 548 2 22
Delaware............ 1 51 267 8 7
Maryland............ 3 4 178 2,123 55 49 -
Dist. of Columbia.. 1 25 390 15 15 -
Virginia............ 3 61 2,315 2,259 43 68 11
West Virginia...... 6 1,463 5,523 1 38 43 9
North Carolina..... 10 1 927 670 6 86 139
South Carolina..... 1 513 664 32 54 -
Georgia............ 42 241 2 59 77
Florida............ 1 6 1,781 3,875 2 63 96 2

EAST SOUTH CENTRAL... 3 27 5,487 20,568 6 162 277 2 13
Kentucky........... 1 2 1,430 4,834 45 96 5
Tennessee.......... 21 2,023 12,643 4 72 93 8
Alabama............ 3 1,357 1,788 29 59 -
Mississippi........ 2 1 677 1,303 2 16 29 2 -

WEST SOUTH CENTRAL... 2 73 18,078 26,433 3 261 431 9 3
Arkansas........... 1,404 994 1 47 37 -
Louisiana.......... 156 100 1 99 163 -
Oklahoma............ 2 3,359 630 18 23 1
Texas.............. 73 13,159 24,709 1 97 208 7 3

MOUNTAIN............. 8 22 4,870 12,571 40 94 29
Montana............ 3 331 1,910 5 5 1
Idaho............... 4 399 1,690 3 5 -
Wyoming.............. 202 234 1 6
Colorado............ 8 9 1,626 1,429 13 49 13
New Mexico......... 606 1,220 5 10 -
Arizona............ 5 1,053 5,359 6 13 15
Utah............... 1 384 664 4 1 -
Nevada............. 269 65 3 5 -

PACIFIC.............. 8 58 12,885 23,314 4 380 627 2 120
Washington......... 31 5,654 4,980 37 54 36
Oregon............... 4 1,702 2,435 30 41 8
California.......... 5 23 5,206 15,116 4 298 510 2 58
Alaska.............. 141 619 11 18 16
Hawaii............. 3 182 164 4 4 2
Puerto Rico.......... 5 2,241 3,412 15 18 2








414 Morbidity and Mortality Weekly Report


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

DECEMBER 9, 1967 AND DECEMBER 10, 1966 (49th 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... 10,028 7 216 2 160 6 389 297 85 4,001

NEW ENGLAND.......... 1,136 1 3 1 10 1 4 103
Maine .............. 55 24
New Hampshire...... 30 1 48
Vermont............ 6 3 25
Massachusetts...... 201 I 1 6 1 4
Rhode Island....... 140 1 2
Connecticut........ 704 1 2 -- 3-

MIDDLE ATLANTIC...... 194 2 16 1 1 40 35 2 97
New York City...... 13 1 9 1 21 -
New York, Up-State. 147 1 1 11 9 2 81
New Jersey......... NN 1 4 15
Pennsylvania....... 34 1 5 4 11 16

EAST NORTH CENTRAL... 984 26 15 1 42 22 2 372
Ohio................ 68 4 14 11 131
Indiana............. 188 3 2 11 1 84
Illinois........... 166 13 13 1 7 10 2 71
Michigan........... 412 5 8 23
Wisconsin.......... 150 1 2 63

WEST NORTH CENTRAL... 463 16 22 21 4 24 946
Minnesota.......... 29 5 2 1 5 189
Iowa............... 139 2 1 3 3 128
Missouri........... 38 7 9 10 1 4 170
North Dakota....... 174 7 166
South Dakota....... 47 1 2 116
Nebraska...........- 4 2 4 70
Kansas............. 36 1 10 2 1 107

SOUTH ATLANTIC....... 1,077 1 46 1 11 1 63 119 3 475
Delaware........... 4 -
Maryland........... 95 2 21 4
Dist. of Columbia.. 85 3 6
Virginia........... 436 10 1 1 1 9 28 3 205
West Virginia...... 327 1 2 2. 1 62
North Carolina..... 31 7 4 47 3
South Carolina..... 4 1 2 10 5 2
Georgia............. 16 4 5 21 17 115
Florida............. 79 1 23 1 12 78

EAST SOUTH CENTRAL... 1,603 2 33 12 64 53 22 762
Kentucky............ 116 4 2 24 15 5 173
Tennessee.......... 1,239 8 7 11 26 15 529
Alabama............. 169 11 I 12 12 2 50
Mississippi........ 79 2 10 2 17 10

WEST SOUTH CENTRAL... 1,108 1 51 81 2 42 43 24 896
Arkansas........... 11 1 7 48 12 14 2 113
Louisiana.......... 6 4 8 1 17 2 1 68
Oklahoma........... 48 4 18 1 8 16 14 353
Texas............... 1,043 36 7 5 11 7 362

MOUNTAIN.............. 2,029 3 1 11 21 9 113
Montana............. 74 1 2 2 -
Idaho.............. 64
Wyoming............. 191 2 1 5
Colorado............ 1,257 2 1 12 9 10
New Mexico......... 298 1 2 34
Arizona............. 76 4 52
Utah............... 67 6 3
Nevada............... 2 9

PACIFIC.............. 1,434 22 6 1 86 11 4 237
Washington........ 384 2 2 2 2
Oregon.............. 114 1 1 3 3 4
California......... 781 17 3 1 78 6 4 231
Alaska............. 83 -
Hawaii............. 72 4 3

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








Morbidity and Mortality Weekly Report






DEATHS IN 122 UNITED STATES CITIES FOR WEEK ENDED DECEMBER 9, 1967


415


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

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


760
221
54
19
37
71
26
19
23
60
63
19
37
40
71

3,599
45
38
153
47
31
32
82
97
1,824
44
551
202
50
118
29
52
66
63
34
41

2,786
60
34
770
220
226
138
95
369
44
57
37
28
77
177
51
142
59
29
21
100
52

826
54
34
49
116
27
113
66
268
69
30


475
128
36
11
24
46
17
9
16
35
42
11
31
28
41

2,134
28
26
86
24
16
15
47
44
1,073
28
324
117
33
77
18
39
38
44
24
33

1,579
33
19
395
137
138
80
58
202
25
31
26
17
49
106
24
79
31
13
17
62
37

519
30
27
32
75
20
73
39
162
44
17


*Estimate based on average percent


SOUTH ATLANTIC:
Atlanta, Ga.-----------
Baltimore, Md.----------
Charlotte, N. C.-------
Jacksonville, Fla.-----
Miami, Fla.------------
Norfolk, Va.-----------
Richmond, Va.-----------
Savannah, Ca.-----------
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.----------


1,249
133
241
53
82
123
64
75
30
84
93
225
46

740
114
67
57
150
170
44
48
90

1,218
35
35
36
170
46
94
211
62
163
102
113
66
85

392
47
22
93
20
92
9
52
57

1,627
25
58
32
42
65
520
80
32
111
59
89
215
49
154
53
43


623
54
126
20
28
65
29
48
19
70
52
86
26

402
51
37
38
87
91
24
28
46

660
31
20
14
93
18
53
97
32
89
57
60
41
55

221
27
14
51
7
48
6
32
36

980
16
33
23
26
33
326
39
22
73
27
49
134
30
86
33
30


Total 13,197 7,593 488 670

Cumulative Totals
including reported corrections for previous weeks

All Causes, All Ages ------------------------ 603,355
All Causes, Age 65 and over------------------- 344,537
Pneumonia and Influenza, All Ages------------- 21,101
All Causes, Under 1 Year of Age--------------- 30,605


Week No.
49


of divisional total.









Morbidity and Mortality Weekly Report


MEASLES Chicago (Continued from. page 411)


In the years 1962, -64, and -66, for Chicago and
Illinois, the peak incidence of measles occurred in early
spring preceded in the late fall and winter by increases
in reported measles cases (Figure 3). To date this ex-
pected early seasonal increase has not occurred.

Figure 3
REPORTED CASES OF MEASLES BY MONTH
.0001 ILLINOIS AND CHICAGO, 1961-67


1961 1962 t96 1964 1965 196 967
TEflR


(Reported by Samuel L. Andelson, M.D., M.P.H., Commis-
sioner of Health, IIilliam I Fishbein. M.D.. Medical Direc-
tor, Bureau of Health Services, and Hyman G. Orbach,
Ph.D., Epidemiologist. Chicago Board of Health.)

REFERENCE
1Srflin Robert E. and Sherman. Ida, L.: Attribute Sampling
Methods, United States Government Printing Office, \\ashing-
ton, D.C., 1965




INTERNATIONAL NOTES
QUARANTINE MEASURES


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


Section 5

OCEANIA
Nauru Islands Page 78
SMALLPOX
Delete all previous information. Insert: Smallpox vaccina-
tion is required from all arrivals. except Australia and
Tasmania, British Solomon Islands, Christmas (Indian
Ocean) and Cocos (Keeling) Islands, Fiji, Gilbert and
Ellice. Heard. Kerguelen, Lord Hooe, Macquarie, New
Zealand. Norfolk and Ocean Islands, Australian Territory
of Papua and New Guinea. Tonga, provided travelers have
not, been outside these areas for at least 14 days before
arrival and these areas are free of smallpox. Nauru re-
serves the right, in respect of arrivals. from other areas,
to isolate any person who arrives without certificate and
refused to he vaccinated.


UNIVERSITY OF FLORIDA

I11 II I 1 11 111 II II l 1111 1 III
3 1262 08864 1971

DECEMBER 9, 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. SHERMAN. 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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