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:
AA00010654:00036

Related Items

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

Full Text


















U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
BUREAU OF DISEASE PREVENTION AND ENVIRONMENTAL CONTROL


EPIDEMIOLOGIC NOTES AND REPORTS
CARBON MONOXIDE POISONING CONFUSED
WITH BOTULISM Savannah, Georgia
Shortly after noon on January 12, 1967, three persons
(ages 54, 55, and 76) were found in a state of collapse in
their small Savannah, Georgia home. An ambulance was
summoned and the three were rushed to a local hospital.
During the trip, which took approximately 15 minutes,
oxygen therapy was administered.
On arrival at the hospital the patients were able to
talk to the physician on duty, although all three were
somewhat confused and one appeared quite excited. Vital
signs and pupils were found to be normal but each patient
complained of a dry mouth and showed generalized weak-
ness and flaccidity. As nearly as could be determined,


SVol. 16, No. 5









SWeek Ending
February 4, 1967



PUBLIC HEALTH SERVICE


CONTENTS
Epidemiologic Notes and Reports
Carbon Monoxide Poisoning Confused
with Botulism Savannah, Georgia .............. 33
Current Trends
Measles 1967 .................. ....... 34
Surveillance Summary
Reported Cases of Post-Infectious and Post-
Immunization Encephalitis -
Fourth Quarter 1966 ...................... 38
Salmonellosis November and December 1966 ...... .39

onset began around midmorning with symptoms of nausea,
malaise, a feeling of "tightness" in the head, palpita-
tions, diplopia, giddiness progressing to vertigo, weak-
ness, a sense of constriction in the chest accompanied
by dyspnea, and finally collapse.
(Continued on page 34)


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous weeks)
5th WEEK ENDED CUMULATIVE, FIRST 5 WEEKS
MEDIAN
DISEASE FEBRUARY 4, FEBRUARY 5, 1962 1966 MEDIAN
1967 1966 1967 1966 1962 1966
Aseptic meningitis .................. .. 29 19 19 142 128 130
Brucellosis ......... ................... 1 3 2 15 17 22
Diphtheria................ ......... .... 6 2 4 12 12 22
Encephalitis, primary:
Arthropod-borne & unspecified ........... 13 24 91 113 --
Encephalitis, post-infectious ..... ....... 13 14 -- 44 64 --
Hepatitis, serum .............. ..... ..... 36 26 9 3 174 102
Hepatitis, infectious .................... 835 728 3 3,664 3,475 465
Malaria ................... ... ............ 53 1 1 142 26 10
Measles (rubeola)....................... 2,205 5,857 7,994 7,798 26,003 34,392
Meningococcal infections, total........... 51 65 65 286 354 272
Civilian ............................ 47 265 -
Military................. ........ .... 4 7 --- 21 32 --
Poliomyelitis, total ................ 1 5
Paralytic ................... ......... 3
Rubella (German measles)................ 849 1,154 --- 2,908 4,267 -
Streptococcal sore throat & scarlet fever .. 11,827 10,385 10,212 54;772 46,867 44,074
Tetanus.................................. 3 1 4 13 7 16
Tularemia .............................. 1 3 13 18 33
Typhoid fever ........................... 9 6 6 27 24 33
Typhus, tick-borne (Rky. Mt. spotted fever) 4 7 3

Rabies in animals ................... .69 58 73 352 342 318

NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax ................. ........................ Rabies in man .................................
Botulism ........................................ Rubella, Congenital Syndrome ........................
Leptospirosis: Tex.- ................................. 4 Trichinosis: Conn.-1 ................................ 8
Plague ............................ ....... .. Typhus, murine ................................ -
P sittacosis ......................................... 5 ........... ...... .. ............





Morbidity and Mortality Weekly Report


FEBRUARY 4, 1967


CARBON MONOXIDE POISONING CONFUSED WITH BOTULISM Savannah, Georgia
(Continued from front page)


Carbon monoxide poisoning was briefly considered
as a possible diagnosis until a policeman who had helped
the patients into the ambulance assured the physician
that the heater in the home was working perfectly. Botulism
was then considered. This possible diagnosis was rein-
forced by food histories elicited from the patients. A con-
fused account was given which left the impression that
precooked venison sealed in a glass jar had been given
to the family several days earlier by a friend. The jar of
meat was thought to have been frozen, then thawed and
served cold at the evening meal prior to onset the next
morning.
The physician believed treatment for botulism was
indicated. Botulinum antitoxin (AB) was begun but had to
be discontinued because of anaphylactic reactions in two
patients which responded to adrenaline, steroids, and anti-
histamines. In addition to antitoxin patients received
oxygen and intravenous fluids. Improvement was rapid and
by morning (some 18 hours after admission) the patients
were virtually well with the exception of one who con-
tinued to experience headaches and blurred vision over
the next few days.
The striking improvement overnight suggested that
the illness may not have been caused by botulism. Upon
requestioning the patients it was learned that the suspect
venison, rather than being precooked, was frozen as red
meat and cooked just prior to serving, thus eliminating
this item as a possible source of botulism.
Further investigation revealed that the patients live
in a small, tightly constructed concrete block house heated
by an unvented propane gas heater located in the hallway.
The day prior to onset the heater had gone out briefly
but was relit after switching to an auxiliary propane tank
which had been installed several days earlier. When the


family retired at 11:00 p.m. the heater was turned off.
The next morning around 6:00 a.m. the 54-year-old woman
relit the heater and turned it wide open since the tempera-
ture was 24F., the coldest morning of the winter. The
others got up around 7:30 a.m., opened the doors to their
bedrooms to let the heat enter, and went in to breakfast.
Everyone felt fine and enjoyed a hearty meal.
A short time later the woman who arose first had an
onset of nausea and a "tight feeling in her head". Dysp-
nea became so unbearable that she rushed outdoors. Feel-
ing better in about 10 or 15 minutes, she returned to the
house where after a brief period symptoms began again.
Within an hour the two others were affected. Illness pro-
gressed for several hours and when found by friends
shortly after noon, all three were critically ill and in a
state of collapse. The house was noted to be "hot and
suffocating" at the time and the heater was turned off.
With this added perspective the original suspicion of
carbon monoxide poisoning appeared to be a more rea-
sonable diagnosis. This was confirmed when blood speci-
mens drawn from two of the patients about 4 hours after
admission to the hospital showed high levels of carboxy-
hemoglobin saturation (50 percent in one and 25 percent
in another). Environmental engineers from the State and
County Health Departments duplicated conditions in the
dwelling and found 50 ppm carbon monoxide after 30 min-
utes and 1,000 ppm after 4V/ hours. A parakeet was visibly
affected after an hour in the house when carbon monoxide
concentrations were at least 1,000 ppm.

(Reported by Dr. John McCroan, Chief Epidemiologist,
and Mr. Tom McKinley, Assistant Epidemiologist, Georgia
Department of Public Health; Dr. Walter W. Otto, Assist-
ant Chatham County Health Officer; and an EIS Officer.)


CURRENT TRENDS
MEASLES 1967


There has been a gradual increase in the number of
measles cases reported in the United States during the
first 5 weeks of 1967. The total of 2,205 cases reported
for the week ending February4 is an increase of 545 cases
over the total for the previous week, but is 3,652 cases
less than the 5,857 cases reported for the comparable
week of 1966.
During the first 4 weeks of 1967, 5,593 cases of mea-
sles were reported. This number is the lowest total for
any January ,.. ..r.ir, to records which date back to 1912.
The current total is approximately one-fifth of the mean
number of cases for the same month in the previous 5 years.
Listed in Table 1 are the weekly number of cases by state
for the first 4 weeks of 1967 and the totals for this 4-week
period for 1967 and the preceding 5 years. Fewer measles
cases were recorded in 1967 than for the previous 5 years
in all areas bht the West South Central and Pacific i. ..... n


No cases were reported from New Hampshire or Wyoming;
ten other areas notified 10 cases or less. North Carolina,
Oklahoma, New Mexico and Nevada have reported more
cases thus far in 1967 than in any of the previous 5 years.
Texas and Washington accounted for 30 to 39 percent
of the national total for each of the first 4 weeks of 1967.
The distribution of cases by county within these two states
is shown in Figures 1 and 2. Four counties in Texas (Bexar,
Ector, Galveston, and Travis) reported 45 percent (535 of
1,181) of the state's total for the 4-week period. A similar
situation existed in Washington, where during the same
4-week period, four counties (Benton, Clallam, King, and
Spokane) reported 69 percent (538 of 785) of the total. For
the current week ending February 4, these two states again
are among the three states reporting the highest numbers
of cases. Texas reported 395, 1' i-,i.rt,..,i 271, and Ken-
tucky (.r,.,i.i;n delayed reports) notified 272.
(Test coi'nuril oin a J, )





FEBRUARY 4; 1967


Morbidity and Mortality Weekly Report


Table 1
Reported Cases of Measles, United States
Current Four Weeks and Comparable Four-Week Periods, 1962-1967

Week ended 4-week Comparable 4-week period
State Total
Jan. 7 Jan. 14 Jan. 21 Jan. 28 1967 1966 1965 1964 1963 1962


United States
New England
Maine
New Hampshire
Vermont
Massachusetts
Rhode Island
Connecticut
Middle Atlantic
New York City
New York Up-State
New Jersey
Pennsylvania
East North Central
Ohio
Indiana
Illinois
Michigan
Wisconsin
West North Central
Minnesota
Iowa
Missouri
North Dakota
South Dakota
Nebraska
Kansas
South Atlantic
Delaware
Maryland
District of Columbia
Virginia
West Virginia
North Carolina
South Carolina
Georgia
Florida
East South Central
Kentucky
Tennessee
Alabama
Mississippi
West South Central
Arkansas
Louisiana
Oklahoma
Texas
Mountain
Montana
Idaho
Wyoming
Colorado
New Mexico
Arizona
Utah
Nevada
Pacific
Washington
Oregon
California
Alaska
Hawaii
Puerto Rico


1,119


30
3
13
10
4
99
7
20
6
18
48
14

3

9

2
NN
106



23
28
16
1

38
160
25
48
30
57
317
5

51
261
113
45
6

18
7
22
4
11
272
159
52
43
18

43


1,377
16
2


11
2
1
62
10
16
19
17
153
12
21
12
54
54
75
4
11
2
28

30
NN
141

1
4
23
16
27


70
113
8
73
4
28
412
61
9
44
298
121
11
16

15
22
21

36
284
110
88
69
13
4
7


*Includes delayed reports not allocated to week.


1,437
9


3
5

1
68
11
21
26
10
188
16
38
21
45
68
51
1
15
4
12
14
5
NN
163
4
1

20
43
32

8
55
192
32
74
32
54
403
71
4
6
322
106
32
6

9
18
12
6
23
257
160
10
77
8
2


1,660
14
1


10

3
80
10
18
22
30
173
22
17
23
44
67
71
6
9
2
25

29
NN
283
3
5

*133
34
47
2

59
134
21
40
52
21
394
41
6
47
300
127
24
7

52
26
11
2
5
384
248
55
66
7
8


63 53


5,593
47
5

4
31
2
5
240
34
68
77
61
613
57
96
62
161
237
211
11
38
8
74
14
66
NN
693
7
7
4
199
121
122
3
8
222
599
86
235
118
160
1,526
178
19
148
1,181
467
112
35

94
73
66
12
75
1,197
677
205
255
46
14
166


20,146 26,398 21,879 30,020 31,461


277
31
4
109
63
27
43
3,307
1,549
471
302
985
8,376
469
345
1,766
1,305
4,491
710
344
166
34
157
1
8
NN
1,944
35
311
84
121
983
32
93
28
257
2,425
830
1,522
30
43
1,115
22
16
10
1,067
832
198
200
12
61
4
327
26
4
1,160
346
128
667
1
18
248


7,109
904
135
28
4,109
831
1,102
965
120
348
166
331
4,547
1,001
209
147
2,304
886
1,927
33
1,079
175
542
20
78
NN
3,878
66
55
3
585
2,818
69
38
94
150
1,371
84
936
223
128
2,124
25
5
21
2,073
2,306
825
360
56
302
53
57
650
3
2,171
623
473
808
25
242


1,157
114
8
311
254
68
402
4,309
1,629
1,013
716
951
4,285
658
852
1,489
913
373
522
7
134
66
308
3
4
NN
2,525
27
404
46
538
833
62
401
64
150
3,069
1,703
1,219
96
51
1,323
65
1
16
1,241
943
268
140
12
91
53
255
88
36
3,746
1,455
447
1,417
400
27


1,272
161
6
102
328
116
559
2,211
1,127]
379
705
12,504
1,512
526
513
3,129
6,824
3,039
416
1,565
113
895
44
6
NN
2,689
75
72
3
351
1,802
92
45
6
243
1,155
455
649
34
17
1,397
375
13
6
1,003
3,309
625
267
314
883
NN
569
646
5
2,444
552
457
844
47
544


105 272 74 1 407


4,956
939
251
45
2,511
315
895
4,399
2,2481
1,584
567
4,457
364
251
2,110
1,127
605
814
78
382
22
242
88
2
NN
2,929
18
276
125
1,259
880
79
35
51
206
3,682
496
2,144
554
488
4,809
190
21
97
4,501
1,161
269
195
55
204
NN
282
130
26
4,254
1,694
601
1,630
304
25





Morbidity and Mortality Weekly Report


Figure 1
REPORTED CASES OF MEASLES IN TEXAS January 1.28, 1967


ILI
I... I_--
I"'-- J-


FEBRUARY 4, 1967


TLI


O 0-4 CASES

l 5-14 CASES
S15-49 CASES
S50+ CASES


Figure 2
REPORTED CASES OF MEASLES IN WASHINGTON January 1.28, 1967


0 0- 4 CASES
Fl 5- 14 CASES
- 15 49 CASES
S50+ CASES


MEASLES 1967 (Text continued from page 34)


Figures 3, 4, and 5 illustrate the secular trends of
measles for the period 1962 through 1966 for the New Eng-
land, Middle Atlantic, and South Atlantic Regions, respec-
tively. In each figure the trends for individual states within
each Region are compared with that for the Region as a
whole. In the New England Regiori, the case rates for the
1965-66 epidemiologic year and the 1966-67 measles sea-
.-on to date are well below the previous non-epidemic year


case rates observed in 1963-64 and 1964-65. This general
pattern of decline in measles incidence has occurred in
each of the six states comprising the Region. In the Middle
Atlantic and the South Atlantic Regions the incidence also
has declined, but less dramatically than noted in the New
England Region.
(Reported by the Childhood Viral Diseases Unit, Epidemi-
ology Program, CDC.)






FEBRUARY 4, 1967


Morbidity and Mortality Weekly Report


Figure 3
MEASLES RATES
BY FOUR-WEEK PERIODS
NEW ENGLAND REGION
BY STATES, 1962-1967


2400
MAINE

2







Saooo
|o



400'

1962 1963 1964 1965
j RHODE ISLAND
Eo


Figure 4
MEASLES RATES
BY FOUR-WEEK PERIODS
MIDDLE ATLANTIC REGION
BY STATES, 1962-1967


NEW HAMPSHIRE


19M 2 1963 1964

MASSACHUSETTS


VERMONT

zooo


16OO




soo


400o



24O-

ICONNECTICUT


MIDDLE ATLANTIC


PENNSYLVANIA
















1962 1963 1964 1965 1966 1967


40 NEW ENGLAND


NEW YORK


1962 1963 964 1965 1966 1967


1966 1967


-1- ^4 -1 1-


2400


1962 1963 1964 1965 1966 1461






Morbidity and Mortality Weekly Report


FEBRUARY 4, 1967


Figure 5
MEASLES RATES
BY FOUR-WEEK PERIODS
SOUTH ATLANTIC REGION
BY STATES, 1962-1967


DELAWARE















1962 1963 1964 1965 1966 1967


MARYLAND



400


FLORIDA

BOo


400


1962 1963 1964 1965 196
DISTRICT OF COLUMBIA


4BOO


1962 1963
GEORGIA

800


1.00


0h ,


SOUTH CAROLINA

800oo


40o


1967 1962 1963 1964 1965 1966 1967
1200
NORTH CAROUNA

wt


REPORTED CASES OF POST-INFECTIOUS AND POST-IMMUNIZATION ENCEPHALITIS
FOURTH QUARTER ENDING DECEMBER 31, 1966 (Weeks 40-52)

State Mumps Measles Chickenpox Other specified

Arizona ............................................ 1.....
Arkansas ........................................ ... ..... ....... .......... Herpes Simplex-1
California ................... ..................... 27 ....... 1
Connecticut ....................................... 1.....
Florida ........................ ................ 12 2 .......... IHerpes-2
Georgia ....................................... 1 .............
Illinois ................................... ...... .7 1 .......... Mononucleosis-1, Influenza-1
Maryland ........................... .............. 3 ......
Massachusetts .................................... 4 ...........
Michigan ...................... .................. 9 1 2
Minnesota ........................ .............. 2 ...... 1 Herpes-1
New York, Upstate ................................ 3 ....... 1
Pennsylvania ..................................... 3 ....... 1
Tennessee ....................................... 5 .................. Pneumonia-1
Texas ............ ...... ............ ..... 4 1 ....
Virginia ............................... ......... 2 ............
Washington...................................... 1 2 1

Fourth Quarter Total
1966 ...................................... 85 7 7
1965.......................................... 67 12 7
Cumulative Total (weeks 1-52)
1966 ..................... ..................... 428 166 77
1965 ............... .......... ........... 424 106 79


240SOUTH TLNTIC
SOUTH ATLANTIC


1962 1963 1964 1965 1966 1967


01


1962 1963 1954 1965 1966 1967


1967


1964 1965 19.6


19652 1963 1964 1965 1966


1967 1962 1963 1964 1965 1966 1967




FEBRUARY 4, 1967


Morbidity and Mortality Weekly Report


SURVEILLANCE SUMMARY
SALMONELLOSIS November and December 1966
For the months of November and December 1966, the while 695 isolations representing 63 serotypes were sent
total numbers of salmonellae reported from human sources by 35 states in December. The seven most frequently re-
were 2,121 and 1,477, respectively. The cumulative num- ported nonhuman serotypes are shown in Table 3.
ber of 20,058 isolations recorded for the 12 months of 1966 (Reported by the Salmonella Unit, Bacterial Diseases Sec-
represents a decrease of 4.0 percent from the total of 20,886 tion, Epidemiology Program, CDC.)
notified for 1965. The November weekly average of 424
isolations and the December one of 369 show increases Table 3
Seven Most Frequently Reported Serotypes
of 8.0 and 0.5 percent, respectively, over the weekly aver- Sen os reuen eore Sro
from Nonhuman Sources
ages of the same months in 1965. These weekly averages, November and December 1966
,ih hat l~s~o tihan thone fnr the nroo ri nc 9 mnnths


illustrate the expected seasonal pattern (Figure 6). The
seven most frequently reported serotypes from human
sources during November and December 1966 are listed
in Table 2.
Reports of 1,026 nonhuman isolations represented by
70 serotypes were received from 37 states in November,
Table 2
Seven Most Frequently Reported Serotypes
from Human Sources
November and December 1966

November December
Serotype Num- Per- k Num- Per-
Rank Rank
ber cent ber cent
S. typhi-murium & 1 628 29.6 1 442 29.9
S. typhi-murium
var. copenhagen
S. newport 2 181 8.5 3 105 7.1
S. heidelberg 3 131 6.2 2 115 7.8
S. enteritidis 4 115 5.4 4 89 6.0
S. infants 5 104 4.9 5 53 3.6
S. saint-paul 6 85 4.0 6 51 3.5
S. blockley 7 68 3.2 7 41 2.8
Total 1,312 61.8 896 60.7
Total all serotypes 2,121 1,477


November December
Serotype Num- Per- Num- Per-
Rank er cent Rank ber cent
S. heidelberg 1 114 11.1 4 45 6.5
S. typhi-murium & 1 114 11.1 1 72 10.4
S. typhi-murium
var. copenhagen
S. derby 3 103 10.0
S. anatum 4 94 9.2 6 34 4.9
S. saint-paul 5 53 5.2
S. schwarzengrund 6 50 4.9 7 25 3.6
S. infants 7 47 4.6 5 35 5.0
S. cubana 2 67 9.6
S. eimsbuettel 1 3 58 8.3
Total 575 56.1 336 48.3
Total all serotypes 1,026 695
Most Common Sources
of Nonhuman Isolations
Swine 1 312 30.4 4 64 9.2
Turkey 2 215 21.0 1 99 14.2
Chicken 3 111 10.8 3 68 9.8
Animal feed 4 61 5.9
Cattle 5 40 3.9
Livestock feed 2 98 14.1
Carmine dye 5 51 7.3


Figure 6
REPORTED HUMAN ISOLATIONS OF SALMONELLA IN THE UNITED STATES


JFM MJ ASONoI' J 'FMAM 'SM 0 N D IJ'F M' A MJ 9 JASONDj JF M' M J JA SO'ND J 'F'MAM J J 0JASO N D
1963 1964 1965 1966 1967


fA


vl""






40 Morbidity and Mortality Weekly Report


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

FEBRUARY 4, 1967 AND FEBRUARY 5, 1966 (5th 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... 29 19 1 6 13 24 13 36 26 835 728

NEW ENGLAND........... 1 2 1 47 20
Maine.............. 8 4
New Hampshire...... 4 -
Vermont.............. 1 1
Massachusetts...... 1 1 27 13
Rhode Island....... 1 1 i
Connecticut........ 1 1 6 1

MIDDLE ATLANTIC...... 2 1 2 7 4 15 16 105 89
New York City...... 1 2 5 12 10 44 15
New York, Up-State. 1 3 27 29
New Jersey.......... 1 1 1 2 20 15
Pennsylvania ....... 1 4 2 1 14 30

EAST NORTH CENTRAL... 2 3 2 5 1 1 130 145
Ohio................ 1 3 1 24 45
Indiana............ 2 10 15
Illinois............ 1 1 23 30
Michigan........... 1 1 1 58 50
Wisconsin.......... 1 1 15 5

WEST NORTH CENTRAL... 1 2 2 65 50
Minnesota........... 2 6 13
Iowa............... 1 12 21
Missouri........... 1 35 5
North Dakota....... 2
South Dakota....... 1 1
Nebraska............ 1 -
Kansas............. 11 9

SOUTH ATLANTIC....... 3 1 3 4 3 1 2 128 71
Delaware............ 2 2
Maryland............ 1 2 1 32 7
Dist. of Columbia.. 1 -
Virginia........... 1 3 7 29
West Virginia...... 10 4
North Carolina..... 1 1 1 6 9
South Carolina..... 1 2
Georgia............ 67
Florida............ 2 3 1 2 18

EAST SOUTH CENTRAL... 6 1 1 1 74 80
Kentucky........... 4 1 41 44
Tennessee.......... 1 1 1 21 19
Alabama............ 7 7
Mississippi......... 1 5 10

WEST SOUTH CENTRAL... 4 2 2 1 1 2 69 58
Arkansas........... 1 1 9
Louisiana.......... 1 2 10 9
Oklahoma ........... 5 1
Texas.............. 4 1 1 1 53 39

MOUNTAIN............. 30 51
Montana............ 2 1
Idaho............... 9 5
Wyoming.............. 2
Colorado............ 7
New Mexico......... 9 23
Arizona............. 7 12
Utah............... 1 1
Nevada............. 2

PACIFIC.............. 13 9 4 2 6 4 17 3 187 164
Washington.......... 1 2 1 26 13
Oregon.............. 23 20
California......... 11 8 2 2 6 3 17 3 134 130
Alaska............. 1
Hawaii.............. 1 1 4

Puerto Rico 13 20





Morbidity and Mortality Weekly Report 41


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

FEBRUARY 4, 1967 AND FEBRUARY 5, 1966 (5th WEEK) CONTINUED



MALARIA MEASLES (Rubeola) MENINGOCOCCAL INFECTIONS, POLIOMYELITIS RUBELLA
TOTAL
AREA Cumulative Cumulative Total "aralytic
Cum.
1967 1967 1967 1966 1967 1967 1966 1967 1967 1967 1967
UNITED STATES... 53 2,205 7,798 26,003 51 286 354 849

NEW ENGLAND.......... 2 36 83 372 2 9 20 129
Maine............... 5 39 1 40
New Hampshire...... 5 7
Vermont............ 9 13 117 1 2
Massachusetts...... 2 15 46 111 1 4 6 33
Rhode Island....... 4 6 29 2 11
Connecticut........ 8 13 71 1 4 4 43

MIDDLE ATLANTIC...... 10 85 325 3,994 6 43 62 32
New York City...... 10 44 1,964 2 9 14 18
New York, Up-State. 1 16 84 504 1 12 12 14
New Jersey.......... 5 21 98 329 3 17 19 -
Pennsylvania....... 4 38 99 1,197 5 17

EAST NORTH CENTRAL... 2 148 761 10,393 9 31 58 126
Ohio................ 2 13 70 604 3 12 20 9
Indiana............ 18 114 403 3 5 5
Illinois............ 15 77 2,151 2 6 6 16
Michigan........... 22 183 1,655 4 8 19 25
Wisconsin.......... 80 317 5,580 2 8 71

WEST NORTH CENTRAL... 66 277 983 4 14 18 65
Minnesota.......... 2 13 408 1 2 3
Iowa................ 10 48 274 2 4 65
Missouri........... 2 10 65 1 4 6 -
North Dakota....... 44 118 225 -
South Dakota........ 1 15 2 2 3 1 -
Nebraska........... 7 73 9 2 1 -
Kansas ............. N N NN 1 3 -

SOUTH ATLANTIC....... 9 310 1,003 2,431 8 52 65 58
Delaware............ 6 13 35 2 2 6
Maryland............ 6 13 390 1 7 8 1
Dist. of Columbia.. 4 99 -
Virginia........... 43 242 186 6 5 3
West Virginia...... 114 235 1,191 8 3 5
North Carolina..... 103 225 35 9 13 -
South Carolina..... 1 1 4 115 2 13 -
Georgia............. 8 1 9 34 4 8 5
Florida............ 36 258 346 1 10 18 43

EAST SOUTH CENTRAL... 16 469 1,068 3,330 7 26 15 110
Kentucky............ 12 272 358 1,336 3 9 5 51
Tennessee.......... 148 383 1,892 4 11 8 30
Alabama............ 4 41 159 41 2 2 29
Mississippi........ 8 168 61 4 -

WEST SOUTH CENTRAL... 2 463 1,989 1,648 8 47 35 4
Arkansas........... 21 199 23 4 -
Louisiana.......... 19 18 5 22 8 -
Oklahoma........... 2 47 195 10 2 2 -
Texas............... 395 1,576 1,597 3 23 21 4

MOUNTAIN ............. 134 601 1,117 2 8 14 65
Montana............ 12 124 233 2 3
Idaho.............. 17 52 224 -
Wyoming............. 12 12 19 -
Colorado............ 12 106 109 2 3 10 33
New Mexico.......... 23 96 4 3 1
Arizona.............. 26 92 488 22
Utah............... 7 19 36 7
Nevada............... 25 100 4 1 1 -

PACIFIC.............. 12 494 1,691 1,735 5 56 67 260
Washington.......... 2 271 948 534 1 5 70
Oregon.............. 2 36 241 180 1 5 3 17
California.......... 7 181 436 999 4 48 49 168
Alaska.............. 1 2 48 2 2 8 -
Hawaii.............. 4 18 20 2 5
Puerto Rico.......... 74 240 278 1 1








42 Morbidity and Mortality Weekly Report


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

FEBRUARY 4, 1967 AND FEBRUARY 5, 1966 (5th 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... 11,827 3 13 13 9 27 4 69 352

NEW ENGLAND......I... 2,626 1
Maine.............. 96 1
New Hampshire...... 34 -
Vermont ............ 76 -
Massachusetts ...... 426 -
Rhode Island....... 177 -
Connecticut........ 1,817 -

MIDDLE ATLANTIC...... 404 1 1 1 5 9
New York City...... 19 3 -
New York, Up-State. 275 1 6
New Jersey......... NN -
Pennsylvania....... 110 1 1 1 3

EAST NORTH CENTRAL... 1,183 2 1 4 17
Ohio................ 171 1 2 10
Indiana............. 245 1 3
Illinois........... 130 2 3
Michigan........... 296 1 1
Wisconsin.......... 341 -

WEST NORTH CENTRAL... 637 1 3 24 110
Minnesota.......... 26 1 6 26
Iowa................ 246 6 13
Missouri........... 31 i 2 25
North Dakota....... 158 8 21
South Dakota....... 16 1 11
Nebraska........... 2 4
Kansas............. 158 2 1 10

SOUTH ATLANTIC....... 1,034 1 3 2 1 3 5 41
Delaware........... 47 -
Maryland........... 298 -
Dist. of Columbia.. 6 -
Virginia........... 227 1 2 4 21
West Virginia...... 233 6
North Carolina..... 18 1 2
South Carolina..... 31 2 -
Georgia............ 8 1 1 9
Florida............. 166 1 5

EAST SOUTH CENTRAL... 1,825 3 2 1 4 1 16 82
Kentucky............ 392 5 22
Tennessee.......... 1,105 3 2 1 1 10 58
Alabama............ 125 1 3 1 1
Mississippi........ 203 1

WEST SOUTH CENTRAL... 866 1 1 1 4 8 18 66
Arkansas........... 32 3 11
Louisiana.......... 4 8 1 6
Oklahoma.......... 76 1 4 15
Texas............... 758 1 1 10 34

MOUNTAIN ............. 1,290 3 2 7
Montana............ 53 -
Idaho.............. 194 -
Wyoming............. 105 -
Colorado........... 372 -
New Mexico......... 283 4
Arizona............ 142 1 3
Utah............... 139 2 -
Nevada............. 2 -

PACIFIC .............. 1,962 4 3 6 2 19
Washington......... 736 -
Oregon.............. 69 -
California......... 1,015 3 3 6 2 19
Alaska.............. 58 -
Hawaii............. 84 -

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





Morbidity and Mortality Weekly Report






DEATHS IN 122 UNITED STATES CITIES FOR WEEK ENDED FEBRUARY 4, 1967


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

All Causes Pneumonia Under All Causes Pneumonia Under

Area All 65 years an yar Area All years and year
Ages and over Influenza All Ages and 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.--------


713
246
41
31
29
56
26
18
21
53
57
14
38
28
55

3,327
54
36
146
45
38
45
69
76
1,636
35
584
188
51
95
13
48
51
46
29
42

2,627
55
29
838
172
226
122
65
343
31
45
48
21
51
138
39
145
44
27
38
86
64

821
60
7
13
156
36
111
84
237
74
43


454
142
26
24
20
33
18
12
15
32
32
11
34
17
38

1,966
21
21
90
30
21
31
43
35
961
24
343
97
36
57
8
31
33
31
18
35

1,463
32
20
445
112
114
58
33
175
22
19
26
14
33
81
25
93
26
16
21
54
44

477
33
7
5
91
24
78
49
119
46
25


1
2

3


41
3


8

4
6
12
3
4


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.-----------


1,155
118
260
41
78
94
57
81
45
82
70
188
41

646
103
57
41
109
152
37
44
103

1,121
51
39
30
160
35
83
198
52
161
93
103
45
71

390
45
13
95
20
100
19
49
49

1,866
24
37
44
54
100
606
113
44
126
84
111
223
52
158
43
47


622
60
129
28
39
57
24
42
24
70
44
85
20

333
39
31
23
71
79
18
28
44

585
24
21
11
80
17
43
103
23
75
60
59
27
42

240
26
11
55
12
60
12
33
31

1,121
17
20
33
26
60
363
65
30
80
55
67
122
31
90
33
29


5
14
3
13
1
2
3
6

20
1

5
3
3

3
5

96

3


Total i 12,666 7,261 1 552 638


All C;
All C1
Pneumi


Cumulative Totals
including reported corrections for previous weeks

sa, All Ages ------------------------ 66,963
ss Aze 65 3,d over-------------------- ,7


Week No.


49
19
46
25







Morbidity and Mortality Weekly Report FEBRUARY 4; 1967

UNIVERSITY OF FLORIDA

111111_II Il Alill 1 IIIIII AII 11111U111111

3 1262 08864 2318

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

IN ADDITION TO THE ESTABLISHED PROCEDURES FOR REPORTING
MORBIDITY AND MORTALITY, THE NATIONAL COMMUNICABLE DISEASE
CENTER WELCOMES ACCOUNTS OF INTERESTING OUTBREAKS OR CASE
INVESTIGATIONS WHICH ARE OF CURRENT INTEREST TO HEALTH
OFFICIALS AND WHICH ARE DIRECTLY RELATED TO THE CONTROL OF
COMMUNICABLE DISEASES. SUCH COMMUNICATIONS SHOULD BE
ADDRESSED TO:
THE EDITOR
MORBIDITY AND MORTALITY WEEKLY REPORT
ST7 .:. N ,. COMMUNICABLE DISEASE CENTER
aTL.riT GEORGIA 30333

NOTE: THE DATA IN THIS REPORT ARE PROVISIONAL AND ARE
BASED ON WEEKLY TELEGRAMS TO THE NCDC BY THE INC*i i.IU L
STATE HEALTH DEPARTMENTS. THE REPORTING WEEK C :Nl: LL'CE
ON SATURDAY; COMPILED DATA ON A NATIONAL BASIS ARE RELEASED
ON THE SUCCEEDING FRIDAY.


0
-n



r



m














UNIV. OF FL LIE.
DOCUMENTS DEPT.








U.S. DEPOSITOR '


m





m
c




r
01

n -
m o
o >








r- -4
mI m ;a C







Szz <
r


* r0- >-4 ni > -u
m -< 5






SZm
o =z


-40 r

MZZ
m
m m
>m
m
n 4
z
-4


















C

v3



m




m



-U 4"