Morbidity and mortality

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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:
AA00010654:00043

Related Items

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

Full Text
2a, Zo/NiV


NATIONAL COMMUNICABLE DISEASE CENTER


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


Vol. 16, No. 13


WEEKLY

REPORT

Week Ending

April 1, 1967



PUBLIC HEALTH SERVICE


BUREAU OF DISEASE PREVENTION AND ENVIRONMENTAL CONTROL


INTERNATIONAL NOTES
SUSPECTED SMALLPOX -Honolulu, Hawaii
On April 3, a 39-year-old man arrived in Honolulu,
Hawaii, and was hospitalized with a febrile illness sug-
gestive of prodromal smallpox. Alert Quarantine Officials
at the Honolulu Airport, in clearing passengers from Japan
Airlines flight 062, noted one traveler who appeared ill.
On questioning him, they learned he had experienced
malaise for 2 days since departing New Delhi. India, on
April 1. Further questioning revealed a distinct exposure
to presumed smallpox 14 days prior to departure. His tem-
perature as recorded at the Quarantine Station was 101 F.
There was no rash. The patient was transported to Tripler


CONTENTS
International Notes
Suspected Smallpox-Honolulu, llawvii
Smallpox- Europe, India and Pakistan .
Epidemiologic Notes and Reports
Streptococcal Infection- Nome, Alaska
I;, I I I, i r, ,.r l ,. ,


10 1
. 102

103
I,'


Hospital, Honolulu, and admitted as a case of suspected
smallpox.
He left Frankfurt, Germany, on March 17, and from
March 18 through p rI areas in India
where smallpox r L Op I i on March 19,
he was iii i of a young male with pre-
sumed -ir I1 iiii. ,'- near Jai
/^ (, ,, page 102)
^ < /lo >1


CASES OF SPECIFIED NOTIFIABLE DISEASES: UI STATES
(Cumulative totals include revised and delayed reports throw vigous weeks)
13th WEEK ENDED S CUM L DfRST 13 WEEKS
DISEASE APRIL 1, APRIL 2, 1962 MEDIAN
1967 1966 1966 1962 -1966
Aseptic meningitis ................... ... 22 27 27 354 370 345
Brucellosis ............................. 5 3 5 49 49 77
Diphtheria........................ ..... 6 4 34 35 57
Encephalitis, primary:
Arthropod-borne & unspecified.......... 19 26 290 307
Encephalitis, post-infectious ............ ..20 13 172 208
Hepatitis, serum ................... .... 48 27 488 297
Hepatitis, infectious .................... 845 650 828 10.385 9,211 12,118
Malaria ...................... ........ 49 7 3 530 75 25
Measles (rubeola)..................... 2.519 9.149 15,679 28,512 94.233 144,796
Meningococcal infections, total........... 64 117 71 767 1.302 817
Civilian ............................ 53 101 --- 705 1,125
Military.............................. 11 16 --- 62 177 -
Poliomyelitis. total ................ ... 1 2 2 6 19
Paralytic............................. 1 1 2 5 14
Rubella (German measles) ................ 1,469 1,648 13,573 17,236
Streptococcal sore throat & scarlet fever .. 11,944 14,144 11,671 159,173 154,722 139,385
Tetanus................................ 4 1 1 36 24 43
Tularemia............................... 5 1 2 32 50 54
Typhoid fever ............................. 7 7 5 70 66 80
Typhus, tick-borne (Rky. Mt. spotted fever). 7 10 3

Rabies in animals ....... ....... ....... 137 132 105 1,095 1,090 1,031

NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax: .................... .... ...... ...... 1 Rabies in man:............ .... ...
Botulism: ........ ....... ...... ..... Rubella, Congenital Syndrome: .....
Leptospirosis: ................ ..... .......... 8 Trichinosis: ......... ...... 19
Plague:.... ..................... ... ......... ...... Typhus, marine: ........................ ........5
Psittacosis: Montana 1................... ......... 10 .. .....







Morbidity and Mortality Weekly Report


APRIL 1, 1967


SUSPECTED SMALLPOX Honolulu, Hawaii
(Continued from front page)


The patient had been vaccinated in infancy and revac-
cinated at ages 5 and 10 years. He was revaccinated in
1959 with an erythematous response, in 1962 with response
not known, and in 1965 without clinical reaction. On
March 29, just prior to leaving India, he was revaccinated
with double insertion of vaccine.
On April 1, he developed a non-specific illness char-
acterized by general malaise. On arrival in Honolulu, he
demonstrated vaccination lesions described as "maximal
reactions," and lymphadenopathy of the related axilla.
Within 12 hours after hospitalization, the patient's tem-
perature returned to normal levels and his symptoms sub-
sided; no eruption appeared. He has remained afebrile
through April 5.




(Reported by Dr. Robert W. Hartly, MOC, U.S. Quarantine
Station, NCDC, Honolulu; Dr. W.B. Quisenberry, Director
of Health. Hawaii Department of Health.)


Editorial Note:
This clinical picture is entirely consistent with a
febrile response to an active vaccinial infection resulting
from revaccination. However, the onset of a febrile illness
in a previously vaccinated individual 14 days after a pre-
sumed exposure to smallpox is suggestive of prodromal
smallpox infection. The absence of a rash does not nec-
essarily preclude such a diagnosis, as smallpox infection
may occur without cutaneous manifestations: variola sine
eruption, a well documented t.1hough infrequent mani-
festation of smallpox infection, is a syndrome char-
acterized by a very brief period of fever, headache, mild
myalgia, and malaise. There is a rapid return to normal
health without the development of an eruption. Patients
with this form of the disease are generally considered not
to be infective dirbolui.> Dixon1 suggests that they may be
infective briefly during the febrile period.
R reference:
IDixon. C.W.: Smallpox. J. & A., Churchill, Ltd., London, 1962,
p. 41.


SMALLPOX Europe, India and Pakistan


As of April 5, 1967, no secondary cases have occurred
among contacts of the three smallpox cases identified in
Germany and C .... li.I... .1IMM \\ R. V-. 16, Nos. 10-12).
Fifteen individuals who were exposed to the third imported
case (Hanover, Germany d. rm..a olu, 1 on Air India fi 4h'
107 on March 23 have been located in the United States,
vaccinated, and placed under surveillance by local health
authorities. As of April 5, none of these persons had
developed any symptoms or signs suggestive of smallpox
infection.
Revised notifications received by the World Health
Organization during the first 10 weeks of 1967 (through
week ending March 11) indicate that a total of 6,459 cases
of smallpox (rn. lui'ng imported cases) were reported from
India. Provisional data compiled from the telegraphic
reports show 268 additional cases for the week ending
March 18, making a provisional total of 6,727 reported
cases of smallpox through the first 11 weeks of 1967, as
compared with 3,637 cases during a comparable period in
1966.
Dramatic increases have been noted in the cities of
Bombay (Maharashtra State), Gaya (Bihar State), and
Visakhapatnam (Andhra Pradesh State). In Bombay, 145
cases were reported for the week ending March 18 and 160
cases for the week ending March 25, bringing the total


for the first 12 weeks of 1967 to 1,145 cases (MMWR,
Vol. 16, No. 12).
In Pakistan, 654 cases of smallpox were reported
during the first 10 weeks of 1967, as compared with 647
for the similar period in 1966. High incidence is occurring
in Karachi, Lahore, and Dacca (Figure 1).

Figure 1
SMALLPOX CASES BY WEEK OF REPORT
DACCA, PAKISTAN
1966* AND 1967


2 3 4 5 6 7 8
WEEK NUMBER


9 10 1I 12


SOURCE: WHO WEEKLY EPIDEMIOLOGICAL RECORD
*NO CASES REPORTED DURING THE FIRST II WEEKS OF 1966


102

















Between December 1:.. 1966, and January 31, 1967,
three cases of rheumatic fe\er and one case of acute
glomerulonephritis occurred among Eskimo residents of
Nome, Alaska. All of the patients were hospitalized in the
Alaska Native Hospital in Kotzebue. Of the three rheu-
matic fe\er patients(t1wo 13-year-old girls and one 26-year-
old male), onl one was found to have beta hemolytic
streptococcus on throat culture. All three, however, had
high \white blood cell counts, elevated r li,... ,. sedi-
mentation rates, and high antistreptolysin-0 titers in addi-
tion to a murmur of mitral insufficiency. The 17-year-old
male with acute glomerulonephritis developed marked pro-
teinuria and was placed on steroids. His throat culture was
positive for beta hemolytic streptococcus.
To determine the prevalence of streptococcal infec-
tion in the school children of Nome, a randomized sample
of approximately one-third of the 922 school children
(grades 1 through 12 in Nome School plus grades 9 through
12 in a vocational school) was selected. The sample cor-
responded to the estimated native-wshite ratio of the Nome


103


population as a whole and to the sex ratio in the school
population. On February 16 and 17, 1967, throat culture
were obtained from the selected children. Beta henimolytic
streptococci were isolated from 113 (46 percent) of the
245 children attending Nome School, and from 10 (20 per-
cent) of the 51 students attending the vocational school
(Table 2). Of the Nome School isolation, 66 percent 1were
group A; 0S percent of those from the vocational school
were group A.
Of the total of 83 group A beta hemolytic streptococcal
isolates, 26 were M-typable; 24 were type 5 and two type
12. Of the M-nontypeable strains, however. 20 were found
to be type 12 by the T-agglutination method. Fifteen addi-
tional strains were identified as type 11 by T-agglutina-
tion. two of which were also M type 12.
On the basis of these : irii,,. a prophylactic pro-
gram was proposed by the personnel of the Arctic Health
Research Center and the Alaska Native Health Area Office.
All school children were given 1.2 million units of benza-
thine penicillin in February 1967.
(Continued on page 108)


SUMMARY OF REPORTED CASES OF INFECTIOUS SYPHILIS
CASES OF PRIMARY AND SECONDARY SYPHILIS: By Reporting Areas February 1967 and February 1966 Provisional Data

Cumulative Cumulative
Reporting Area February Jan. Feb. Reporting Area February Jan. Feb.
1967 1966 1967 1966 1967 1966 1967 1966
NEW ENGLAND.............. 36 50 69 98 EAST SOUTH CENTRAL........ 163 190 322 375
Maine.................... 1 1 Kentucky................. 7 13 16 24
New Hampshire............ 2 3 3 3 Tennessee................ 18 19 42 50
Vermont .................. 2 Alabama.................. 89 85 192 184
Massachusetts............ 21 33 40 65 Mississippi............... 49 73 72 117
Rhode Island............. 2 1 4 4
Connecticut............. 11 12 20 25 WEST SOUTH CENTRAL........ 244 203 505 443
Arkansas.................. 11 16 22 34
MIDDLE ATLANTIC.......... 243 338 569 681 Louisiana................ 55 41 97 96
Upstate New York........ 16 26 38 61 Oklahoma.................. 8 12 24 31
New York City........... 147 224 328 429 Texas .................... 170 134 362 282
Pa. (Excl. Phila.) ...... 14 14 54 41
Philadelphia............. 24 23 44 43 MOUNTAIN .................. 46 27 103 66
New Jersey............... 42 51 105 107 Montana.................. 1 2 1 5
Idaho .................... 4 7
EAST NORTH CENTRAL........ 218 247 464 488 Wyoming..................
Ohio..................... 49 41 99 89 Colorado................. 2 2 12 9
Indiana................... 7 8 12 14 New Mexico................ 15 9 32 16
Downstate Illinois ....... 10 15 22 36 Arizona .................. 24 12 51 33
Chicago .................. 58 79 134 155 Utah..................... 1 2
Michigan................... 93 93 192 170 Nevada .................. 1 1
Wisconsin................ 1 11 5 24
PACIFIC................... 142 146 297 334
WEST NORTH CENTRAL........ 17 47 43 100 Washington ................ 7 1 11 8
Minnesota................ 5 3 7 5 Oregon ................... 3 3 7 5
Iowa..................... 1 9 4 15 California............... 131 140 275 317
Missouri ................ 6 15 14 46 Alaska.................... 1 1 2
North Dakota............. 3 4 Hawaii................... 1 1 3 2
South Dakota.............. 2 11 7 13
Nebraska................. 3 1 6 7 S. TOTAL............... 1] 62 I 78R 1Q A6-6
Kansas................... 5 5 10
.ERRITORIES............... 72 78 122 162
SOUTH ATLANTIC...... ..... 513 535 1,018 1,051 Puerto Rico............... 69 77 117 159
Delaware ................. 4 8 3 Virgin Islands............ 3 1 5 3
Maryland ................. 47 44 113 79
District of Columbia..... 56 22 103 68
Virginia................. 27 27 51 45
West Virginia............. 6 2 15
North Carolina........... 63 96 130 175 Note: Cumulative Totals include revised and delayed reports
South Carolina........... 67 67 142 154 through previous months.
Georgia................... 83 117 169 199
Florida.................. 166 156 300 313


APRIL 1, 1967


Morbidity and Mortality Weekly Report




EPIDEMIOLOGIC NOTES AND REPORTS
STREPTOCOCCAL INFECTIONS Nome, Alaska








104 Morbidity and Mortality Weekly Report


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

APRIL 1, 1967 AND APRIL 2, 1966 (13th WEEK)


ENCEPHALITIS HEPATITIS
ASEPTIC Primary
AREA RUCOMENINGITIS l OIS DIPHTHERIA including Post- Serum Infectious
unsp. cases ectous
1967 1966 1967 1967 1967 1966 1967 1967 1966 1967 1966
UNITED STATES... 22 27 5 6 19 26 20 48 27 845 650

NEW ENGLAND.......... 1 1 1 2 2 45 33
Maine.............. 7 4
New Hampshire...... -- 3 1
Vermont ............ -
Massachusetts...... 1 1 1 1 14 12
Rhode Island....... 1 1 7 9
Connecticut........ 1 14 7

MIDDLE ATLANTIC...... 4 1 7 6 2 20 11 153 101
New York City...... 3 2 3 5 4 29 20
New York, up-State. 1 3 13 4 30 26
New Jersey......... 1 3 55 14
Pennsylvania....... 1 5 2 1 39 41

EAST NORTH CENTRAL... 5 3 5 7 4 3 135 119
Ohio............... 2 1 20 17
Indiana............. 2 35 19
Illinois........... 2 1 2 4 2 1 28 17
Michigan............ 1 1 1 2 2 2 41 64
Wisconsin.......... 1 11 2

WEST NORTH CENTRAL... 1 1 2 51 37
Minnesota.......... 1 2 13 6
Iowa............... 1 2 6
Missouri............. 24 20
North Dakota ...... 2
South Dakota....... 1
Nebraska............ 3 1
Kansas............. 6 4

SOUTH ATLANTIC....... 2 2 1 2 1 3 100 70
Delaware............ -- 3
Maryland............ 1 1 18 17
Dist. of Columbia.. -
Virginia........... 1 20 13
West Virginia..... 6 3
North Carolina..... 2 5 2
South Carolina... 3
Georgia............ 38 10
Florida............. 1 1 1 10 22

EAST SOUTH CENTRAL... 2 6 2 2 1 4 53 75
Kentucky............ 1 2 1 1 15 25
Tennessee.......... 1 1 1 4 18 37
Alabama.......... 2 5 6
Mississippi....... 1 2 15 7

WEST SOUTH CENTRAL... 2 1 1 5 2 2 1 4 72 62
Arkansas........... 1 3 15
Louisiana.......... 2 1 4 10 11
Oklahoma ........... 3 3
Texas.............. I 1 1 5 2 56 33

MOUNTAIN............... 3 1 2 45 29
Montana.............. 8 2
Idaho.............. 5 3
Wyoming.............. 1 3
Colorado........... 1 16 4
New Mexico......... 3 5
Arizona............ 2 1 4 5
Utah............... 1 8 5
Nevada............. 2

PACIFIC ............. 11 7 1 1 2 4 6 20 7 191 124
Washington......... 1 1 1 30 5
Oregon............. 1 1 14 11
California.......... 6 7 1 2 4 5 19 6 147 102
Alaska............. 3
Hawaii............. 4 3

Puerto Rico 1 26 40









Morbidity and Mortality Weekly Report 105


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

APRIL I, 1967 AND APRIL 2, 1966 (13th WEEK) CONTINUED


MENINGOCOCCAL INFECTIONS,
MALARIA MEASLES (Rubeola) TOTAL POLIOMYELITIS RUBELLA
AREAToal Paray
Cumulative Cumulative Total Paralyt i
Cum.
1967 1967 1967 1966 1967 1967 1966 1967 1967 1967 1967
UNITED STATES... 49 2,519 28,512 94,233 64 767 1,302 2 1,469

NEW ENGLAND.......... 1 60 348 1,138 2 28 64 123
Maine............... 24 73 143 1 6 18
New Hampshire...... 1 62 12 1 7 4
Vermont............ 4 25 166 2 -
Massachusetts...... 24 131 432 13 26 36
Rhode Island....... 21 53 5 9
Connecticut........ 1 7 36 332 2 13 18 56

MIDDLE ATLANTIC...... 9 80 923 11,906 12 97 132 1 67
New York City...... 18 148 6,016 2 18 23 1 25
New York, Up-State. 32 218 1,317 4 29 32 40
New Jersey......... 6 10 239 1,272 5 38 41 -
Pennsylvania....... 3 20 318 3,301 1 12 36 2

EAST NORTH CENTRAL... 2 165 2,302 36,447 6 76 190 281
Ohio................ 27 363 2,700 1 31 51 15
Indiana............. 1 16 260 2,267 3 11 29 -- 58
Illinois........... 1 24 350 7,650 2 16 40 28
Michigan........... 37 498 5,854 13 54 87
Wisconsin.......... 61 831 17,976 5 16 93

WEST NORTH CENTRAL... 29 1,187 4,287 2 36 67 88
Minnesota.......... 4 52 1,193 1 8 15 2
Iowa................ 5 248 2,055 1 7 11 83
Missouri........... 39 303 9 27 1
North Dakota....... 18 499 691 3 2
South Dakota....... 1 39 3 5 2 -
Nebraska........... 1 310 42 6 3 -
Kansas............. NN NN NN 1 6 -

SOUTH ATLANTIC....... 24 287 3,089 7,456 8 155 212 105
Delaware............ 24 99 5 2 -
Maryland............ 4 60 1,188 18 21 15
Dist. of Columbia.. 1 10 295 6 1
Virginia........... 2 80 920 697 13 27 39
West Virginia...... 72 577 2,987 1 13 8 4
North Carolina..... 15 30 614 135 2 32 41 -
South Carolina..... 1 21 111 333 12 30 13
Georgia............. 3 4 14 152 2 30 34 -
Florida............. 3 75 759 1,570 3 32 43 33

EAST SOUTH CENTRAL... 185 3,265 10,644 9 79 111 148
Kentucky........... 10 1,019 3,391 1 21 53 61
Tennessee .......... 79 1,028 6,025 6 36 33 84
Alabama............ 47 695 749 13 19 3
Mississippi........ 49 523 479 2 9 6 -

WEST SOUTH CENTRAL... 845 9,720 9,928 7 129 205 1 39
Arkansas........... 53 1,253 322 2 12 12 -
Louisiana.......... 6 63 59 49 84 -
Oklahoma........... 15 1,661 179 7 7 -
Texas............. 771 6,743 9,368 5 61 102 1 39

MOUNTAIN............. 4 304 1,995 4,855 16 41 137
Montana............ 1 178 729 3 6
Idaho.............. 32 203 537 1 1 6
Wyoming............ 13 82 -
Colorado........... 4 47 447 550 7 22 97
New Mexico......... 59 333 236 3 6 -
Arizona.............. 73 427 2,558 2 7 26
Utah............... 79 217 156 1 2
Nevada.............. 13 177 7 2 1 -

PACIFIC.............. 9 564 5,683 7,572 18 151 280 481
Washington.......... 357 2,922 1,627 4 15 16 113
Oregon............... 46 636 609 2 12 12 44
California......... 9 158 1,988 5,257 12 122 237 315
Alaska.............. 1 74 26 2 12 2
Hawaii............. 2 63 53 3 7





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


125 945 1.101


5








106 Morbidity and Mortality Weekly Report


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

APRIL 1, 1967 AND APRIL 2, 1966 (13th 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... 11,944 4 36 5 32 7 70 7 137 1,095

NEW ENGLAND .......... 2,050 6 23
Maine .............. 118 1 5
New Hampshire...... 28 5 12
Vermont............. 7 6
Massachusetts ...... 334 -
Rhode Island....... 149 -
Connecticut........ 1,414 -

MIDDLE ATLANTIC...... 525 4 2 11 2 22
New York City...... 27 2 1 7 -
New York, Up-State. 421 1 2 2 15
New Jersey......... NN 1 1-
Pennsylvania....... 77 1 1 7

EAST NORTH CENTRAL... 1,379 2 1 5 1 4 1 8 80
Ohio............... 168 1 2 1 4 38
Indiana............. 330 1 2 17
Illinois........... 191 2 1 4 2 15
Michigan........... 462 1 1
Wisconsin.......... 228 1 9

WEST NORTH CENTRAL... 524 1 8 2 27 229
Minnesota.......... 19 1 9 57
Iowa............... 140 1 2 19
Missouri........... 1 3 8 52
North Dakota....... 160 1 44
South Dakota....... 15 4 29
Nebraska........... 1 2 12
Kansas............. 188 4 3 16

SOUTH ATLANTIC....... 1,026 2 8 5 1 7 4 25 146
Delaware ........... 28 -
Maryland ........... 246 -
Dist. of Columbia.. -
Virginia........... 260 2 2 17 79
West Virginia...... 311 I I 3 21
North Carolina..... 19 2 1 3 1
South Carolina..... 22 2 -
Georgia ............ 6 1 1 2 1 1 1 4 27
Florida............. 134 1 3 2 1 18

EAST SOUTH CENTRAL... 1,512 9 1 3 1 9 1 34 297
Kentucky........... 113 4 5 56
Tennessee.......... 1,223 5 2 1 2 1 23 218
Alabama............ 106 3 3 6 21
Mississippi........ 70 1 1 1 2

WEST SOUTH CENTRAL... 1,101 2 6 3 7 16 23 202
Arkansas........... 6 1 1 3 2 34
Louisiana.......... 2 2 2 11 3 22
Oklahoma............ 160 3 5 44
Texas ............. 933 2 6 1 2 13 102

MOUNTAIN ............. 2,162 4 8 3 25
Montana............. 67 1 -
Idaho.............. 209 -
Wyoming............. 216 -
Colorado........... 1,146 5 3
New Mexico......... 267 5
Arizona............ 111 2 3 17
Utah............... 141 2 -
Nevada............. 5 -

PACIFIC .............. 1,665 6 2 13 1 9 71
Washington.......... 609 -
Oregon............. 55 1
California.......... 916 5 2 12 1 9 70
Alaska............. 82 -
Hawaii............. 3 1 1

Puerto Rico.......... 3 1 3 4 I 2 9








Morbidity and Mortality Weekly Report






DEATHS IN 122 UNITED STATES CITIES FOR WEEK ENDED APRIL 1, 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 yeas and year
Ages and over Influena Caes 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.----
Neu 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.--------


782
251
52
23
29
54
22
29
25
64
66
22
42
46
57

3,548
55
46
154
53
35
44
75
111
1,749
36
570
217
55
104
30
42
52
50
30
40

2,753
69
43
737
179
227
135
96
356
46
50
45
50
48
165
38
150
46
36
56
99
82

897
57
40
49
118
27
122
85
245
98
56


480
137
35
13
20
28
17
16
18
39
36
19
28
32
42

2,137
25
34
107
24
19
30
41
53
1,062
19
329
134
37
62
17
34
35
33
22
20

1,562
37
29
396
117
120
75
54
201
27
19
31
29
34
79
19
101
22
27
35
61
49

542
37
27
20
73
20
80
49
141
58
37


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.----------


1,178
120
258
67
46
75
61
75
32
101
67
218
58

659
97
69
51
139
143
59
32
69

1,076
47
35
36
142
26
58
180
54
178
75
128
55
62

406
40
19
109
26
100
16
56
40

1,555
12
40
33
44
74
478
94
39
129
74
92
183
33
152
38
40


Total 12,854 7,407 476 686

Cumulative Totals
including reported corrections for previous weeks

All Causes, All Ages ------------------------- 169,929
All Causes, Age 65 and over------------------- 98,335
Pneumonia and Influenza, All Ages------------- 6,873
All Causes, Under 1 Year of Age--------------- 8,620


Week No.
13









Morbidity and Mortality Weekly Report


UNIVERSITY OF FLORIDA

1111IIIIIIII 111111111 1 1
3 1262 08864 2227

APRIL I, 1967


STREPTOCOCCAL INFECTIONS Name, Alaska
(Continued from page 103)


Table 2
Prevalence of Beta Hemolytic and Group A Streptococcus
from School Children in Name, Alaska Feb. 16-17, 1967


Nome
School

Grade


Total


Vocational
School
9
10
11
12

Total


Number of
Children


26
12
7
6

51


Beta hemolytic
streptococcus


Number


Percent


Group A
strep-
tococcus*

81.3
78.6
64.3
54.5
58.3
46.2
77.h
66.7
75.0
100.00
33.3
50.0


100.0
0
100.0
0


*Percent of beta hemolytic streptococci

Serologic studies on blood specimens obtained from
291 children in the selected group are in progress. Pre-
liminary results of these studies have shown sharply in-
creased antihyaluronidase titers among individuals positive
for either type 5 or type 12 streptococci, and elevated
antistreptolysin-0 titers, particularly among individuals
who carried type 12 streptococci. In addition, type 12-
specific antibody titers, as measured by the type-specific
hemagglutination test, was sharply increased among in-
dividuals who carried type 12 strains. The weight of both
bacteriologic and serologic evidence suggests that an
extensive outbreak of type 12 streptococcal infection had
occurred in Nome, and that type 5 streptococci had also
been prevalent in that area.
A follow-up survey is planned in April to determine
the prevalence of beta hemolytic streptococcal infection
following penicillin administration, and to obtain follow-
up blood specimens.

(Reported by Dr. Holman Wherritt, Alaska \Natie Health
Area Director: Dr. Thomas McGowan, Director, Alaska
Division of Public Health; Dr. James Maynard, Chief,
Epidemiology Section. Arctic Health Research Center;
and a team from NCDC.)


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