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:
AA00010654:00042

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


4ad


U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFAREi LTH FERKVICE
BUREAU OF DISEASE PREVENTION AND Ei ilOijril,1EITAL CONTROL


CURRENT TRENDS
MEASLES 1966

The lowest number of measles cases during the past
21 years was reported in 1966. The preliminary 1966 total
of 202,886 cases is 59,018 less than the 1965 total of
261,904.
The dramatic change is the pattern of measles during
the first quarter of the epidemiologic year 1966-67 is
readily apparent in Figure 1. For the week ending Janu-
ary 7, a total of 1,072 cases of measles was reported,
representing a decrease of 44 cases from the preceding
week and a decrease of 2,812 cases below the total of
3,884 for the first week of 1966. The two states reporting
the most cases were Texas with 261 and Washington with
159. The numbers of measles cases reported by each state
during the past 4 weeks (weeks 50, 51, 52 in 1966 and


CONTENTS
Current Trends
Measles 1966 ............................ 1
Epidemiologic Notes and Reports
Case of Human Babesiosis California . S



week 1 in 1967) are compared to reported cases for the
comparable 4-week periods of the previous 5 years in
Table 1.
No new "epidemics" have been reported this week
(Table 2). Four counties were removed from the list on the
basis of reported incidence falling below the arbitrary
criteria that have been set.
(Reported by the Childhood Viral Diseases Section, Epi-
demiology Program, NCDC.)
(Tables 1 and 2 on pp. a and 3)


Figure 1
REPORTED MEASLES IN THE UNITED STATES
1966-67 COMPARED WITH 1963.64 TO 1965-66


/1963-64
/196-65
/
/ _._1964-65
/
/ ./


I-
I-'


...1965-66


/


/ /.


1- 7
I /






" '.' "
- -,- & .* .* 1 9 6 6 6 7


12,000-




10,000-




n 8,000-

W
Ia
0
- 6,000-
a:



m 4,000
z



2,000


15 22 29 5 12 19 26 3 10 i7 24 31 7 14 21 28 4 II 18 25
OCT NOV. DEC JAN FEB
WEEK ENDING


i //


I







Morbidity and Mortality Weekly Report


Table 2
Counties Reporting "Outbreaks" of Measles*


State


County


Arkansas Ouachita
Colorado Pueble
Michigan Wayne
Mississippi Oktibbeha
Nebraska Richardson
N. Carolina Durham
Oregon Lane
Oregon Washington
Tennessee Maury
Texas Brown
Texas Hutchison
Texas Red River
Texas Travis
Washington Benton
Washington Franklyn
Washington King
Washington Snohomish
.% : hl....-.. Spokane
Wisconsin Waupaca

'Criteria for "outbreaks":


Pop.
(1,000's)


4 -I---


32
119
2,666
26
14
112
163
92
42
25
34
16
212
62
23
935
172
278
35


November
5 12 19


6 26
10 71 16
59
8 41 18
1 34
3 3 1
12 69 56


December
26 3 10 1.7 24

10 3 119 35
11 8 20 18 11
30 35 13 30 32
99 73 58


42 64
25 16
33 31
8 13
7 18
112
10 19
30 36
5 30
4 15
29 50
21 23
49
12 12


Population at least 1,000,000: 25 cases for 2 consecutive weeks.
Population 500,000 999,999: 20 cases for 2 consecutive weeks.
Population 100,000 499,999: 15 cases for 2 consecutive weeks.
Population less than 100.000: 10 cases for 2 consecutive weeks.
immunization program begun according to reports received by MMWR.


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous weeks)
1st WEEK ENDED CUMULATIVE, FIRST WEEK
MEDIAN
DISEASE JANUARY 7, JANUARY 8, 1962 1966 MEDIAN
1967 1966 1967 1966 1962 1966
Aseptic meningitis ..................... .21 30 19 21 30 19
Brucellosis............. .............. 4 3 4 3
Diphtheria.......... ..... .... ... 1 3 1 3
Encephalitis, primary:
Arthropod-borne & unspecified ........... 16 19 16 19 --
Encephalitis, post-infectious .. ........ .. 5 9 5 9 -
Hepatitis, serum ....................... 37 10 | 37 10 6
Hepatitis, infectious .................... 552 665 688 552 665 688
Malaria .............................. ....... 21 5 2 21 5 2
Measles rubeolaa) ....................... 1,072 3,884 4;822 1,072 3,884 4;822
Meningococcal infections, total ........... 42 64 46 42 64 46
Civilian ............................ 41 59 -- 41 59 -
Military.............................. 1 5 1 5 -
Poliomyelitis, total .............. ...... 1 1 1 1
Paralytic................. .. .... ........
Rubella (German measles) ................ ..249 396 249 396 -
Streptococcal sore throat & scarlet fever .. 8,314 7,394 I 6,810 8,314 7,394 6.810
Tetanus.. ............................ .. 1 3 3 1 3 3
Tularemia ...................... ..... ... 2 4 7 2 4 7
Typhoid fever .......................... 2 3 2 2 3 2
Typhus, tick-borne (Rky. Mt. spotted fever) 3 5 3 5 -

Rabies in animals .................. 68 72 55 68 72 55

NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax ..... Rabies in man ............... ....... ........ .. -
Botulism ......................................... Rubella, Congenital Syndrome ..... .........
Leptospirosis: Calif-1........ .... ....... ......... 1 Trichinosis; NYUpS-2 ................... ........... 2
Plague ............................................ Typhus, marine .................................... -
Psittacosis: Ark-1, Calif-1 .............. ........... 2 .........................


JANUARY 7, 1967







JANUARY7, 1967 Morbidity and Mortality Weekly Report 3


Table 1
Reported Cases of Measles, United States
Current Four Weeks and Comparable Four-Week Periods, 1961-62 through 1965-66

Week ended 4-week Comparable 4-week period
State Dec. 17, Dec. 24, Dec. 31, Jan. 7, Total
1966 1966 1966 1967 1966-67 1965-66 1964-65 1963-64 1962-63 1961-62
United States 1,437 998 1,116 1,072 4,623 12,935 14,504 13,810 16,714 18,506
New England 12 12 20 8 52 303 4,182 778 733 3,051
Maine 3 4 6 2 15 37 582 21 55 864
New Hampshire 1 205 4 48 186
Vermont 1 3 1 5 67 54 178 61 13
Massachusetts 5 8 5 18 137 1,914 320 273 1,372
Rhode Island 2 2 21 319 17 54 193
Connecticut 1 8 3 12 40 1,108 238 242 423
Middle Atlantic 50 70 17 30 167 2,927 685 3,072 1,567 2,751
New York City 7 4 5 3 19 1,157 127 1,751 711 1,581
New York Up-State 8 24 7 13 52 307 223 'J '
New Jersey 20 22 5 10 57 905 53 643 244 790
Pennsylvania 15 20 4 39 558 282 678 612 380
East North Central 167 167 137 99 570 4,976 2,230 2,208 6,605 2,604
Ohio 4 15 40 7 66 266 407 455 776 187
Indiana 13 15 2 20 50 102 126 399 237 75
Illinois 15 3 17 6 41 1,059 61 675 365 1,437
Michigan 63 66 35 18 182 744 1,088 452 1.519 518
Wisconsin 72 68 43 48 231 2,805 548 227 3,708 387
West North Central 38 55 42 14 149 414 929 400 1,519 613
Minnesota 3 4 2 9 207 7 9 234 55
Iowa 18 12 15 3 48 72 415 170 1,024 288
Missouri 1 1 38 105 50 55 10
North Dakota 15 25 25 9 74 85 369 170 189 184
South Dakota 1 15 1 12 75
Nebraska 1 14 2 17 11 18 5 1
Kansas NN NN NN NN NN NN NN NN NN NN
South Atlantic 129 127 120 106 482 1,307 1,503 1,898 1,580 1,700
Delaware 1 1 10 16 16 28 5
Maryland 2 1 7 10 182 25 279 24 151
District of Columbia 66 1 67 7 95
Virginia 6 8 3 23 40 141 200 417 225 717
West Virginia 19 20 18 28 85 522 1,048 805 1,070 431
North Carolina 68 48 41 16 173 17 56 50 59 56
South Carolina 1 1 123 20 212 6 21
Georgia 2 1 3 37 7 30 5 2
Florida 32 49 50 38 169 209 130 22 156 222
East South Central 136 41 92 160 429 1,271 716 1,670 470 2,056
Kentucky 18 17 8 25 68 400 90 1,199 201 516
Tennessee 41 21 49 48 159 847 480 429 238 1,152
Alabama 19 1 34 30 84 5 82 19 22 185
Mississippi 58 2 1 57 118 19 64 23 9 203
West South Central 521 218 477 270 1,486 513 1,065 704 570 2,164
Arkansas 174 14 207 5 400 9 5 30 50 351
Louisiana 3 41 44 14 2 1 5 9
Oklahoma 29 7 10 4 50 11 28 57 2 33
Texas 315 197 219 261 992 479 1,030 616 513 1,771
Mountain 43 98 73 113 327 550 1,623 770 1,968 1,033
Montana 3 20 2 45 70 66 545 302 605 261
Idaho 13 8 4 6 31 142 291 182 192 126
Wyoming 1 1 2 12 27 9 9 72
Colorado 2 4 32 18 56 57 160 63 542 126
New Mexico 12 37 13 7 69 8 182 5 NN NN
Arizona 11 6 10 22 49 235 42 134 253 264
Utah 1 21 4 4 30 26 354 46 363 158
Nevada 2 7 11 20 4 22 29 4 26
Pacific 341 210 138 272 961 674 1,571 2,310 1,702 2,534
Washington 197 108 57 159 521 201 574 630 327 962
Oregon 92 20 49 52 213 107 256 472 206 390
California 35 71 32 43 181 352 587 901 725 851
Alaska 17 10 18 45 10 18 295 8 310
Hawaii 1 1 4 136 12 436 21
Puerto Rico 50 47 79 43 219 232 199 314 64 144







4 Morbidity and Mortality Weekly Report


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED
JANUARY 7, 1967 AND JANUARY 8, 1966 (IstWEEK)


ENCEPHALITIS HEPATITIS

ASEPTIC Primary
AREA MENINGITIS BRCELLOSIS DIPHTHERIA including Post- Serum Infectious
AREA MENINGITIS Infectious

1967 1966 1967 1967 1967 1966 1967 1967 1966 1967 1966
UNITED STATES... 21 30 4 16 19 5 37 10 552 665

NEW ENGLAND........... 1 3 1 1 2 52 34
Maine.............. 12 6
New Hampshire...... 1 3
Vermont............ 1
Massachusetts...... 1 1 16 10
Rhode Island ....... 2 1 1 16 6
Connecticut........ 1 1 6 9

MIDDLE ATLANTIC...... 5 2 2 6 5 2 23 2 89 72
New York City...... 2 1 3 8 17
New York, up-State. 1 1 7 21 25
New Jersey......... 4 2 4 8 1 18 21
Pennsylvania....... 1 1 2 1 33 26

EAST NORTH CENTRAL... 5 3 1 2 2 76 147
Ohio............... 1 3 11 40
Indiana............ 2
Illinois........... 6 6
Michigan........... 4 1 2 2 51 84
Wisconsin.......... 8 15

WEST NORTH CENTRAL. .. 3 18 28
Minnesota.......... 4 3
Iowa............... 5 12
Missouri.............. 2 8 5
North Dakota....... 1 1
South Dakota.......
Nebraska........... 1
Kansas............. 1 6

SOUTH ATLANTIC....... 1 2 2 2 1 2 63 45
Delaware............ 1 3
Maryland............ -- 1 1 1 14 9
Dist. of Columbia.. 1
Virginia........... 1 2 1 8 11
West Virginia...... 9 1
North Carolina ..... 3 6
South Carolina ..... 3 4
Georgia.............. 23 4
Florida............ 1 1 2 7

EAST SOUTH CENTRAL... 2 1 46 125
Kentucky............ 1 1 22 26
Tennessee........... 11 93
Alabama............ 10 5
Mississippi......... 3 1

WEST SOUTH CENTRAL... 2 3 1 1 1 37 74
Arkansas........... 2 11
Louisiana.......... 1
Oklahoma........... -
Texas.............. 2 3 1 1 1 -35 62

MOUNTAIN................ 1 23 29
Montana............. 1 5 2
Idaho.............. 2
Wyoming............ 1 1
Colorado........... 1
New Mexico......... 7 13
Arizona............. 7 6
Utah................ 3 1
Nevada ............. 3

PACIFIC............... 10 17 8 1 9 4 148 111
Washington......... 2 5
Oregon.............. 1 41 14
California......... 7 17 7 9 4 106 89
Alaska............. 1
Hawaii............. -

Puerto Rico -









Morbidity and Mortality Weekly Report 5


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

JANUARY 7, 1967 AND JANUARY 8, 1966 (1st WEEK) CONTINUED


MENINGOCOCCAL INFECTIONS,
MALARIA MEASLES (Rubeola) TOTAL POLIOMYELITIS RUBELLA
AREA Total Paralytic
AREA Cumulative Cumulative Total Paralytic
Cum.
1967 1967 1967 1966 1967 1967 1966 1967 1967 1967 1967
UNITED STATES... 21 1,072 1,072 3,884 42 42 64 249

NEW ENGLAND.......... 8 8 46 5 43
Maine.............. 2 2 7 10
New Hampshire...... 1
Vermont ............ 1 1 17 -
Massachusetts...... 5 5 6 1 6
Rhode Island....... 6 4
Connecticut........ 9 3 23

MIDDLE ATLANTIC...... 16 30 30 865 7 7 11 23
New York City...... 3 3 291 2 2 2 13
New York, Up-State. 1 13 13 207 1 2 10
New Jersey ......... 10 10 190 4 4 5 -
Pennsylvania....... 15 4 4 177 2

EAST NORTH CENTRAL... 99 99 1,266 3 3 10 48
Ohio................ 7 7 119 2 2 4 4
Indiana............ 20 20 49 2 14
Illinois........... 6 6 125 1 10
Michigan........... 18 18 196 1 1 2 6
Wisconsin.......... 48 48 777 1 14

WEST NORTH CENTRAL... 14 14 139 1 1 6 10
Minnesota.......... 65 2 1
Iowa................ 3 3 24 1 8
Missouri ........... 11 -
North Dakota....... 9 9 35 1
South Dakota........ -
Nebraska........... 2 2 3 1 1 1 -
Kansas............. NN NN MN 2

SOUTH ATLANTIC....... 5 106 106 520 16 16 13 35
Delaware........... 7 -
Maryland........... 57 1 10
Dist. of Columbia.. 17 -
Virginia............ 3 23 23 10 1 1 -- -1
West Virginia...... 28 28 309 3 3 8
North Carolina...... 1 16 16 10 & 4 2 -
South Carolina..... 1 1 1 28 2
Georgia............ 10 4 4 4
Florida............ 38 38 72 4 4 4 16

EAST SOUTH CENTRAL... 160 160 436 2 2 18
Kentucky............ 25 25 68 1 1 10
Tennessee.......... 48 48 351 1 1 8
Alabama............. 30 30
Mississippi........ 57 57 17 -

WEST SOUTH CENTRAL... 270 270 239 7 7 4 3
Arkansas........... 5 5 2 3
Louisiana.......... 1 2 2
Oklahoma.......... 4 4 -
Texas.............. 261 261 236 5 5 4

MOUNTAIN ............. 113 113 159 1 1 10
Montana............ 45 45 32 -
Idaho............... 6 6 8 -
Wyoming.............. 6
Colorado........... 18 18 5 3
New Mexico......... 7 7 2 1 1 -
Arizona............ 22 22 98 6
Utah............... 4 4 4 1
Nevada............. 11 11 4 -

PACIFIC.............. 272 272 214 5 5 15 59
Washington......... 159 159 76 1 23
Oregon.............. 52 52 34 1 1 1 9
California.......... 43 43 102 4 4 12 25
Alaska.............. 18 18 -
Hawaii............. 2 1 2

Puerto Rico.......... 43 43 49 -








6 Morbidity and Mortality Weekly Report


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

JANUARY 7, 1967 AND JANUARY 8, 1966 (1st WEEK) CONTINUED


STREPTOCOCCAL TYPHUS FEVER
SORE THROAT & TETANUS TULAREMIA TYPHOID TICK-BORNE ABIES
AREA SCARLET FEVER (Rky. Mt. Spotted) ANIMALS
AREA
1967 1967 Cum. 1967 Cum. 1967 Cum. 1967 Cum. 1967 Cum.
1967 1967 1967 1967 1967
UNITED STATES... 8,314 1 1 2 2 2 2 3 3 68 68

NEW ENGLAND.......... 1,460 -
Maine............... 70
New Hampshire...... 12
Vermont............ 67 -
Massachusetts...... 167 -
Rhode Island....... 134 -
Connecticut........ 1,010 -

MIDDLE ATLANTIC...... 305 3 3
New York City...... 16 -
New York, Up-State. 222 2 2
New Jersey......... NN -
Pennsylvania....... 67 1 1

EAST NORTH CENTRAL... 572 3 3
Ohio............... 85 1 1
Indiana............ 137 -
Illinois........... 109 2 2
Michigan........... 112 -
Wisconsin .......... 129 -

WEST NORTH CENTRAL... 429 1 1 24 24
Minnesota.......... 9 1 1
Iowa................ 121 3 3
Missouri........... 5 5 5
North Dakota....... 201 6 6
South Dakota....... 17 4 4
Nebraska........... 1 1
Kansas ............ 76 1 1 4 4

SOUTH ATLANTIC....... 1,075 1 1 3 3 9 9
Delaware ........... 12 -
Maryland.......... 177 -
Dist, of Columbia..- -
Virginia........... 304 4 4
West Virginia...... 223 2 2
North Carolina..... 15 2 2
South Carolina..... 32 1 1 -
Georgia............ 9 1 1 3 3
Florida............. 303 -

EAST SOUTH CENTRAL... 1,195 1 1 17 17
Kentucky........... 17 5 5
Tennessee.......... 932 1 1 12 12
Alabama............ 215 -
Mississippi........ 31

WEST SOUTH CENTRAL... 994 10
Arkansas ........... -
Louisiana .........
Oklahoma .......... 53 -5 5
Texas............... 941 -5 5

MOUNTAIN ............. 1,577 2 2 2 2
Montana............ 61 1 1 -
Idaho .............. 151 -
Wyoming............ 26
Colorado........... 713 -
New Mexico......... 312 -
Arizona............ 196 1 1 2 2
Utah............... 115 -
Nevada ............. 3 -

PACIFIC............. 707 -
Washington......... 378 -
Oregon.............. 49 -
California ......... 199 -
Alaska............. 50 -
Hawaii ............ 31 -

Puerto Rico ..........









Morbidity and Mortality Weekly Report






DEATHS IN 122 UNITED STATES CITIES FOR WEEK ENDED JANUARY 7, 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 and 1 year Area All 65 years and f year
Ages and over Inluenza Cals Ages and over fl nza
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.--------


763
190
35
43
27
67
23
22
43
76
67
14
51
40
65

3,564
63
27
165
45
34
43
99
98
1,813
52
484
236
45
100
14
41
65
59
33
48

2,812
72
51
801
171
216
138
90
358
63
47
45
22
47
170
37
201
43
37
37
115
51

928
50
41
76
141
42
100
80
282
66
50


478
110
25
33
18
37
19
18
24
40
41
10
32
28
43

2,039
35
16
90
32
19
23
50
45
1,030
28
272
121
31
74
11
27
38
38
25
34

1,594
48
22
429
95
121
71
56
188
44
30
23
8
35
95
19
121
29
27
24
74
35

545
32
25
40
99
24
60
46
150
44
25


*Estimate based on average percent of divisional total.


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------------
Phcenix, 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, Washt----------


1,342
127
275
50
79
118
68
84
31
104
96
257
53

668
114
40
33
114
137
59
51
120

1,284
59
57
38
185
34
106
234
30
202
75
133
57
74

453
42
28
100
20
100
18
60
85

1,638
18
49
37
47
60
513
55
60
137
74
94
176
65
160
50
43


706
58
138
25
.34
67
33
36
14
87
63
122
29

335
57
16
22
57
74
25
26
58

660
41
24
14
94
20
58
106
14
100
39
70
31
49

258
23
20
53
11
53
13
33
52

1,049
13
30
27
30
35
333
39
42
92
45
59
110
41
93
31
29


Total 13,452 7,664 592 691

Cumulative Totals
including reported corrections for previous weeks

All Causes, All Ages ------------------------- 13,452
All Causes, Age 65 and over------------------- 7,664
Pneumonia and Influenza, All Ages------------- 592
All Causes, Under 1 Year of Age-------------- 691


Week No.











EPIDEMIOLOGIC NOTES AND REPORTS
CASE OF HUMAN BABESIOSIS California

On August 24, 1966, an epidemiologic case history of
malaria and a stained blood smear were received by the
National Communicable Disease Center from the California
State Department of Public Health. As microscopic exam-
ination revealed the presence of erythrocytic parasites of
unusual morphology, additional blood specimens were sub-
mitted for study. The patient, a 46-year-old white male
resident of San Francisco, had become ill with chills and
fever in early June. Treatment with chloroquin was followed
by prompt recovery. His medical history contained no record
of previous malaria and he had not been out of the United
States since 1960. Of interest was prolonged hereditary
spherocytosis which led to a splenectomy in 1964.
Microscopic examination of blood smears and serologic
examination ofsera revealed that the patient was suffering
from babesiosis. but the species identification of the
Babesia was undetermined. Animal inoculations with blood
taken approximately 90 days after the onset of illness
yielded negative results. The indirect fluorescent nr,,...,.
test of the patient's sera, performed by the Laboratory of
Parasite Chemotherapy, NIH, Chamblee, Georgia, was neg-
ative against 10 Plasmodium antigens. Sera from this same
sample was found to contain Babesia antibodies by the
Department of Veterinary Pathology and Hygiene, College
of Veterinary Medicine, University of Illinois, and by the
Parasitological Laboratory, USDA.
This serologic evidence for a diagnosis of babesiosis
was supported by the distinct morphological appearance of
the mature parasites in infected erythrocytes. The para-
sites were in typical clusters of four pyriform organisms
arranged in a rosette pattern, each between 1-1/3 and 3
microns long. The parasites were unpigmented and early
pre-division forms had spherical and ameboid shapes re-
sembling the trophozoite states of Plasmodium species.
(Reported by Dr. Erwin Braff, Chief, Bureau of Disease
Control, C' and County of San Francisco, Department of
Public Health; Dr. Philip Condit, Chief, Bureau of Colm-
municable Diseases, California State Department of Pub-
lic Health; and an EIS Officer.)
Editorial Note:
Babesiosis piroplasmosiss) is a common disease of
domestic and wild animals, especially in tropical areas.
It normally results from the bite of infected ticks but me-
chanical transmission can occur. In the United States the
parasite is usually found in horses and dogs. One species
causes Texas Tick Fever, the disease for which Theobald
Smith demonstrated the arthropod vector in 1893.
The present case is the second documentation of hu-
man babesiosis in the world. The first case occurred in
1956 in a Yugoslavian male who had also been splenecto-
mized some years before; his illness was fatal.' The im-
portance of this parasite as a iuman -:ii .. :'i is minor,
but the fact that it can be confused with malaria and is
apparently a zoonotic disease, at least under special cir-
cumstances, makes the observations recorded here of
special interest.
1Skrai;alo, Zd(,nko ind )Deanovic, Zivan: Piroplasmosiu, in mamn.
-tpo.rt ofai :^'. torcuimi, ta ,dc Medi' ina Guograpihica ot 'Tropica
q:1 1-16, 1957.


3 1262 08864 2169

JANUARY 7, 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.
IN ADDITION TO THE ESTABLISHED PROCEDURES FOR REPORTING
MORBIDITY AND MORTALITY, THE NATIONAL COMMUNICABLE DISEASE
CENTER WELCOMES ACCOUNTS OF INTERESTING OUTBREAKS OR CASE
INVESTIGATIONS WHICH ARE OF CURRENT INTEREST TO HEALTH
OFFICIALS AND WHICH ARE DIRECTLY RELATED TO THE CONTROL OF
COMMUNICABLE DISEASES. SUCH COMMUNICATIONS SHOULD BE
ADDRESSED TO:
THE EDITOR
MORBIDITY AND MORTALITY WEEKLY REPORT
NATIONAL COMMUNICABLE DISEASE CENTER
ATLANTA, GEORGIA 30333
NOTE: THE DATA IN THIS REPORT ARE PROVISIONAL AND ARE
BASED ON WEEKLY TELEGRAMS TO THE NCDC BY THE INDIVIDUAL
STATE HEALTH DEPARTMENTS. THE REPORTING WEEK CONCLUDES
ON SATURDAY; COMPILED DATA ON A NATIONAL BASIS ARE RELEASED
ON THE SUCCEEDING FRIDAY.




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