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:
AA00010654:00064

Related Items

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

Full Text






Morbidity and Mortali



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

PUBLIC HEALTH SERVICE I I


Prepared by the


I )S CN


For release August 17, 1962


ATLANTA 22, GEORGIA


PROVISIONAL INFORMATION ON SELECTED NOTIFIABLE DISEASES IN THE UNIT
DEATHS IN SELECTED CITIES FOR WEEK ENDED AUGUST 11, 1962


POLIOMYELITIS A total of 27 cases of poliomyelitis
(21 paralytic) was reported in the nation for the week
ending August 11. The decline from the 31 cases (24 para-
lytic) noted during the preceding week is extraordinary
for the season. The comparable week in 1961 brought
reports of 54 cases of poliomyelitis (36 paralytic).
Ten States accounted for the poliomyelitis reported
this week. Texas, once again, submitted the largest
number with 11 cases, including 7 paralytic. The para-
lytic cases in this State stemmed from six different
counties with two from counties which have undertaken
mass administration of oral polio-vaccine as an epidemic
deterrent.


Of the remaining States, Michigan and Virginia each
accounted for three cases. The Michigan cases represent
delayed reports and originate from different counties. In
Virginia, all three cases were from Washington County,
with one from Bristol, Virginia, and two from the small
town of Damascus. Further laboratory and epidemiologic
studies are being performed in these cases.
The total number of reported cases of poliomyelitis
thus far this year remains below the total for the similar
period in any previous year. The number of paralytic
cases, however, is the same as the number of paralytic
cases in 1961. Cumulative totals through the 32nd week
for 1962 and the previous four years is presented in the


Table 1. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous week)
32nd Week Cumulative
Disease Ended Ended First 32 weeks
Disease Median
August 11, August 12, 1957 1961 Median
1962 1961 1962 1961 1957 1961
Aseptic meningitis..... ......... 117 133 --- 1,061 1,289
Brucellosis ..................... 7 10 10 257 378 502
Diphtheria ...................... 6 9 240 339 387
Encephalitis, infectious.. ....... 40 46 58 976 962 999
Hepatitis, infectious and serum... 728 1,022 387 36,078 49,607 13,934
Measles ........................ 1,660 1,746 1,886 437,864 382,274 390,448
Meningococcal infections ......... 34 29 30 1,418 1,414 1,537
Poliomyelitis, total.............. 27 51 199 357 413 1,409
Paralytic.................... 21 35 90 274 274 668
Nonparalytic................. 6 14 83 57 92 512
Unspecified..................- 2 26 26 47 229
Streptococcal sore throat
and Scarlet fever ............. 3,423 3,193 --- 217,225 225,336
Tetanus ........................ 9 --- 148
Tularemia...................... 7 -- --- 184 ~
Typhoid fever ................... 19 15 29 330 421 461
Typhus fever, tick-borne,
(Rocky Mountain spotted)...... 17 --- --- 152 -
Rabies in Animals............... 60 60 71 2,597 2,222 2,449


Table 2. NOTIFIABLE DISEASES OF LOW FREQUENCY

Anthrax: Psittacosis:
Botulism: Rabies in Man:
Malaria: Va. 1 Smallpox:
Plague: Typhus, murine: Ga. 2








250


tabulation shown below: diphtheria cases by State for those cases with onsets
Polio (Cumulated Weekly) Through the 32nd Week (1958-1962) in 1961.
Attack rates for the non-white population in the
1962 1961 1960 1959 1958 United States were four times higher than in the white
Paralytic 274 274 777 1892 716 population. Nearly one-third (32.5 percent) of all diph-
Total 357 413 1074 2924 1457 theria cases occurred in children under five years of age.
_No significant differences were found in distribution of
ccass hbv e'. ThP aoe distrihburinn of cases and aSa


HEPATITIS The total of 728 reported cases of viral
hepatitis for the current week continues the recent trend
toward the low of 601 reached in the week ending July 6.
No significant increase occurred in any of the States.



DIPHTHERIA UNITED STATES, 1961
Individual case reports have been received at the
Diphtheria Surveillance Unit, Communicable Disease
Center, on 582 cases of diphtheria with onset of illness
in 1961. Sixty of these cases were fatal. While the num-
ber of cases in 1961 is one-third below the 1960 total of
873, the 60 deaths reported in 1961 show little change
from the 67 deaths in 1960.
There were no large-scale outbreaks of diphtheria in
10(1. As in previous years, the diphtheria cases occurred
predominantly during the fall and early winter. Three-
fourths of the cases occurred in the Southern States with
almost one-third of all cases from Texas alone. In the
Northern States, north central Minnesota continues to
demonstrate an endemic concentration of cases. The ac-
companying map (Figure I) shows the distribution of


specific attack rates are shown in Table I and Figure II.
TABLE I DIPHTHERIA MORBIDITY BY RACE AND AGE 1961

Age Group White Non-White
0-4 103 86
5-9 106 58
10-14 59 39
15-19 23 10
20-29 28 9
30 + 46 9
Unknown 2 1
Totals 367 212

Three-fourths of the diphtheria cases had received
no diphtheria immunizations. All but one of the deaths
were in individuals who were inadequately immunized or
had not been immunized. The one exception was a 1-year-
old boy who died of diphtheria three months after com-
pleting a primary series; however, this boy had severe
measles along with diphtheria. The immunization status
and severity of illness for 423 cases on which information
is available are shown in Table II.


Morbidity and Mortality Weekly Report




Figure I
DIPHTHERIA CASES AND RATES BY STATE-UNITED STATES
1961








Morbidity and Mortality Weekly Report


Figure II
DIPHTHERIA ATTACK RATES
by RACE and AGE GROUP
1961


NONWHITE"'
._ _Q


EL


TABLE II IMMUNIZATION STATUS


Severity
of Illness Full Lapsed Inadequate None Total
Mild 23 12 23 143 201
Moderate 10 17 11 76 114
Severe 6 4 3 40 53
Fatal 1 0 2 52 55
Total 40 33 39 311 423



Four hundred and sixty-six of the 582 cases were
bacteriologically confirmed. One hundred and eighty-seven
(40 percent) were typed by strain, as shown in Table III.
Of the 301 strains tested for toxigenicity, 17 (6 percent)
were non-toxigenic.


Table III Type of Strain Isolated in 196T
Mitis 115
Gravis 47
Intermedius 11
Indeterminate 14
Total 187


20-29 30+


SUMMARY OF DEATHS AMONG PERSONS 65 YEARS AND OVER IN 108 U. S. CITIES


The weekly average number of deaths among persons
65 years and over in 108 cities for the four-week period
ending August 11 was 5,716 as compared with an ex-
pected 5,795 weekly average.


WEEK ENDING 4 Week Weekly
7/21 7/28 8/4 8/11 Total Average
Observed 5,847 5,705 5,610 5,701 22,863 5,716
Expected 5,822 5,799 5,783 5,775 23,179 5,795
Excess 25 -94 -173 -74 -316 -79


DEATHS AT AGE 65 AND OVER IN 108 U.S. CITIES
Average number per week by four-week periods


Aom- 4 -4-


NUMBER
7,00C
OF


INFLUENZA A2

RECORDED
DEATHS'


DEATHS r "EXPECTED" |
J NUMBER"


5500 -- -- ------------
55,000 -------I W --V
5P(OO IM __ __ IIM I ::::::::_.


PERIOD NUMBER I 7
| 1960
B piancE OFocouftseN


(See Table, page 255)


3.00

2.75

2.50

2.25

O 2.00
0
0
0 1.75
0
a 1.50
n
1.25
W
U) 1.00
4
.


I-


I-


I-


0.751


LII


0-4 5-9 10-14 15-19
AGE GROUP


I \


L "


Aft /


1 7 i s' 7" 11.. .3. 13 1
1961' 1962
"CALc~nlrATCD FRMIS3-s61 aEXPEIEPJCC


96 I
1963








252 Morbidity and li.,rtalitj Weekly Report



Tabcl 3. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

AUGUST 12, 1961 AND AUGUST II, 1962



Poliomyelitis, Aseptic
Poliomyelitis, Total Cases Poliomyelitis, Paralytic Nonparalytic Meningitis


Area


UN

NEW ENGL
Maine
New H
Vermo
Massa
Rhode
Conne

MIDDLE A
New Y
New J
Penns

EAST NOR
Ohio.
India
Illin
Michi
Wisco

WEST NOR
Minne
Iowa.
Misso
North
South
Nebra
Kansa

SOUTH AT
Delaw
Maryl
Distr
Virgi
West
North
South
Georg
Flori

EAST SOU
Kentu
Tenne
Alaba
Missi

WEST SOU
Arkan
Louis
Oklah
Texas

MOUNTAIN
Monta
Idaho
Wyomi
Color
New M
Arizo
Utah.
Nevad

PACIFIC.
Washi
Orego
Calif
Alask
Hawal

Puerto F


Cumulative Cumulative
32nd week First 32 weeks 32nd week First 32 weeks 32nd week 32rd week


1962 1961 1962 1961 1962 1961 1962 1961 1962 1961 1962 1961

ITED STATES...... 27 51 357 413 21 35 274 274 6 14 117 133

AND.............. 1 6 5 1 6 5 2 22
................. -
ampshire.........
ont............... 1 1
chusetts......... 4 2 4 2 1 10
Island.......... 1 11
cticut............ 1 2 2 1 2

TLANTIC.......... 2 7 37 39 1 7 23 36 1 2 8
'ork............... 2 6 36 18 1 6 22 16 1 2 6
rersey.......... 1 1 15 1 1 14 -
ylvania 6 6 2

TH CENTRAL....... 5 7 31 39 5 3 21 22 3 9 21
................. 1 8 14 7 6 1 5
na............... 1 5 4 1 4 3 1 1
iois.............. 1 3 11 12 1 1 5 7 2 1C
gan .............. 3 1 5 4 3 1 5 4 3 12
nsin............. 2 2 5 1 2 -

.TH CENTRAL....... 3 15 25 1 8 11 2 7 8
sota............. 3 3 3 3 6 7
................ 2 5 5 1 2 2 1 1
ouri.............. 5 8 2 2
Dakota.......... 1 2 1 1 1
SDakota.......... -
ska.............. 3 2
s............ 5 2 1

LANTIC........... 5 15 24 81 4 14 20 61 1 7 9
mare.............. 2 1 -
and............... 3 11 3 11
ict of Columbia.. 1 1 1 1
nia.............. 3 2 6 3 3 2 6 3 4 8
Virginia......... 4 3 11 3 3 7 -
SCarolina....... 2 7 1 5
SCarolina........ 1 2 8 1 2 7 1
;ia.............. 2 3 4 22 1 3 3 16 1
da................ 2 6 16 2 5 10 2

TH CENTRAL ...... 1 17 37 1 13 19 3 7
cky............... 8 18 6 4 2
ssee............. 1 4 8 1 2 4 2
ma............... 3 5 3 5 -
ssippi........... 2 6 2 6 5

[TH CENTRAL ...... 13 10 180 72 9 4 142 36 4 6 42 15
sas.............. 2 4 3 2 4 1 2 1
iana............. .- 7 10 22 3 8 15 4 -
oma.............. 3 2 1 -
................. 11 3 163 45 7 1 129 20 4 2 40 14

................. 3 10 35 1 8 20 2 3 4
na............... 3 3 2 2 4
................ 2 1 11 1 5 2
ng.............. 1 1 -
ado................ 1 1 4 1 4 2
fexico ............. 3
na................ 3 7 3 5 -
1 7 1 4 1
................. .. 7 i 4 I -
a ................

................. 1 5 37 80 1 4 33 64 1 42 36
ngton............ 1 12 1 12 5
n ............... 2 5 10 1 5 3 1 -
ornia............ 1 2 31 56 1 2 27 47 42 31
a................
i................ 1 2 1 2

ico.............. 8 5 8 5 -









Morbidity and Mortality Weekly Report 253


Table 3. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

AUGUST 12, 1961 AND AUGUST 11, 1962 (Continued)


Brucellosis Diphtheria Encephalitis, Hepatitis, Measles
Infectious Infectious and serum
Area
Cumu- Cumu- 32nd week
lative lative Under 20 &
32nd week 32 weeks 32nd week 32 weeks 32nd week 20 yr. over Total Total 32nd week
1962 1962 1962 1962 1962 1961 1962 1962 1962 1961 1962 1961

UNITED STATES...... 7 257 6 240 40 46 378 313 728 1,022 1,660 1,746

NEW ENGLAND.............. 1 1 3 36 19 56 33 113 119
Maine ................. 11 4 15 12 16
New Hampshire......... 11 2 13 9 1
Vermont................ 2 2 6 1 2
Massachusetts......... 1 10 5 15 11 55 70
Rhode Island.......... 3 2 12 1
Connecticut........... 1 4 6 11 5 32 30

MIDDLE ATLANTIC.......... 6 1 5 12 12 68 69 137 115 231 403
New York.............. 2 1 3 12 8 35 35 70 52 169 200
New Jersey............ 1 1 9 15 24 23 52 114
Pennsylvania .......... 3 1 4 24 19 43 40 10 89

EAST NORTH CENTRAL ....... 1 62 6 4 1 59 60 124 169 354 309
Ohio.................. 1 2 15 21 37 43 23 39
Indiana............... 5 3 1 5 7 10 7 7
Illinois.............. 1 46 2 1 18 16 36 45 48 81
Michigan .............. 3 3 24 16 40 62 155 102
Wisconsin ............. 7 1 2 4 9 121 80

WEST NORTH CENTRAL....... 2 100 55 2 9 17 23 43 62 65 76
Minnesota.............. 1 9 17 2 3 5 9 12 2
Iowa.................. 59 1 2 3 5 19 18 14
Missouri............... 3 5 2 5 7 15 14 8 48
North Dakota.......... 1 7 9 3 3 1 23 11
South Dakota......... 4 11 1 1 4 4
Nebraska.............. 1 11 13 3 6 9 14 1
Kansas................ 13 1 2 3 5 1 NN NN

SOUTH ATLANTIC........... 20 4 47 2 3 68 38 107 156 124 197
Delaware .............. 3 1 1
Maryland .............. .- 1 8 4 12 11 8 39
District of Columbia.. 1 4 1 5 3 1 1
Virginia.............. 10 9 6 11 18 20 47 54
West Virginia......... 8 2 10 16 32 36
North Carolina ........ 2 4 1 1 26 8 34 26 1 9
South Carolina ........ 5 1 10 10 9 2 6
Georgia............... 2 4 8 1 3 4 5 -
Florida............... 6 19 1 5 9 14 63 32 51

EAST SOUTH CENTRAL ....... 1 12 16 2 4 54 23 77 134 74 120
Kentucky ............. 1 18 2 20 38 8 30
Tennessee............. 4 7 1 24 14 38 49 59 87
Alabama............... 1 6 3 3 3 6 35 3 1
Mississippi............ 1 6 1 4 9 4 13 12 4 2

WEST SOUTH CENTRAL....... 1 21 1 91 3 4 41 22 65 102 123 155
Arkansas .............. 1 4 10 11 2 13 25 1
Louisiana.............. 4 8 1 2 3 11 1
Oklahoma .............. 2 6 1 1 1 5 11
Texas................. 11 1 67 3 3 28 18 48 61 123 142

MOUNTAIN................. 9 9 2 2 5 5 28 42 187 128
Montana............... 1 6 1 1 2 3 61 15
Idaho.................. 1 2 5 15 13
Wyoming............... 1 4 4
Colorado .............. 2 8 17 36 66
New Mexico............. 2 1 2 3 5 4 NN NN
Arizona............... 2 1 1 7 49 17
Utah.................. 2 1 2 1 3 9 26 13
Nevada. ............. i

PACIFIC .................. 1 26 10 10 11 30 54 91 209 389 239
Washington............. .- 2 7 9 21 18 28 12
Oregon ................ 1 2 1 1 5 6 28 48 86
California ........... 22 5 9 9 21 39 62 149 167 128
Alaska................ 1 5 1 1 2 14 34 4
Hawaii ................ 1 112 9

Puerto Rico................ 3 32 6 1 7 14 63 15









Morbidity and Mortality Weekly Repori


Tahkle ( CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

AUGUST 12, 1961 AND AUGUST 11, 1962 (Continued)


UNITED STATES...

NEW ENGLAND........
Maine.............
New Hampshire.....
Vermont...........
Massachusetts.....
Rhode Island......
Connecticut.......

MIDDLE ATLANTIC....
New York..........
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...........
Dist. of Columbia..
Virginia...........
West Virginia...,..
North Carolina.....
South Carolina....
Georgia............
Florida.............

EAST SOUTH CENTRAL..
Kentucky...........
Tennessee..........
Alabama............
Mississisppi........

WEST SOUTH CENTRAL..
Arkansas...........
Louisiana..........
Oklahoma...........
Texas.............

MOUNTAIN ...........
Montana............
Idaho..............
Wyoming...........
Colorado..........
New Mexico.......
Arizona...........
Utah...............
Nevada..,..........

PACIFIC.............
Washington........
Oregon............
California ........
Alaska..........
Hawaii.............


-n n- .c .e 11
In .*cr I .-ns

Cumu-
IJ t 'iv.
32n.id u. 32 u(ce.


34

I







7
1
4
2

9
3

4
1
1











7

1

5



1








2
1


1

1






1


7


7


1,418

86
12
3
2
36
8
25

243
107
66
70

288
87
24
66
90
21

77
15
10
20
6
4
12
10

230
30
14
7
51
12
54
12
9
41

88
19
37
18
14

116
13
53
6
44

46
3
3
4
8
3
13
7
5

244
18
15
201
6
A


,tr. pto .- .il
Sore Throat &
Scarlet Fever


j32nd 1.- k


I bl I'H I


3,423

101
4
2
1
19
9
66

83
68
10
5

195
10
48
44
52
41

82
5
28
4
44
1



362

6

77
77
8
8
87
99

849
11
755
17
66

598
1
I


596

673
19
99
6
235
178
99
37


480
60
7
387
11
i


3,193

69
4
2

15

48

87
69
9
9

166
30
26
9
54
47

119
6
10
36
64
1

2

390

17
1
79
41
3
28
1
220

735
43
670
1
21

539

2
4
533

872
33
44

371
222
114
88


216
49
20
128
19


TicL-tornr
Tetanus Typhus Tularemia Typhoid Fever
(Rky Mt.
.putt. J) Cu',.-


1 2 6,d .'

1 16: 6s


Rabies in Animals


3J2 .n-i Lt.


146-


Cumt.u-

32 ..-sk s


1961 1962

60 2,597









84
S 57

27

8 627
317
171
4 81
2 29
2 29

18 663
2 147
11 267
2 108
1 45
1 76
1 16
4

7 230

1

1 94
5 87


1 6
42

11 283
3 100
4 163
4 20


11 493
57
17
S 22
11 397

1 22



1
11
1 10



4 195

S 10
4 185


Puerto Rico ........ 81 1 4 6 I 1 4 13


3J/.o,1 k. 32,'., uk. jl2 1 t-lr








Morbidity and Mortality Weekly Report


255


Table 4 (D). TOTAL DEATHS AMONG PERSONS 65 YEARS AND OVER IN REPORTING CITIES



(Tables 4(A), 4(B), 4(C), and 4(D) will be published in sequence covering a four-week period.0


Area For weeks ending Area For weeks ending
7/21 7/28 8/4 8/11 _7/21 7/28 8/4 8/11


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............


128
20
12
14
18
11
17
11
19
37
13
31
16
26


15
21
73
20
11
16
35
59
791
12
329
79
14
80
17
21
40
26
16
26


34
14
34
99
98
68
54
167
29
14
32
10
20
71
10
73
13
11
25
46
19


30
11
25
76
17
76
47
105
34
24


114
19
22
1.7
22
15
12
11
26
31
12
13
12
34


16
15
104
9
16
19
27
48
824
16
259
118
10
63
16
16
23
14
15
15


19
22
338
91
89
46
41
151
22
20
19
16
23
54
12
81
9
e15
S 22
55
27


32
20
15
61
22
58
37
114
48
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.............


50
96
12
35
38
24
39
13
51
33
79
14


59
23
16
73
62
33
23
29


17
20
20
74
9
28
75
30
124
46
61
33
34


15
6
88
7
47
5
19
19


39
104
13
22
65
30
32
10
62
34
67
17


39
21
13
64
41
12
29
41


30
29
6
57
21
39
98
33
82
27
61
30
22


15
17
39
8
42
7
27
20


6
21
32
15
16
267
35
32
72
25
42
99
22
79
29
24


San Juan, P.R.............. 13 21 11 15


OCurrent Week Mortality for 108 Selected Cities

4(A) Total Mortality, all ages................... 10,498
4(B) Pneumonia-Influenza Deaths, all ages........ 343
4(C) Total Deaths under 1 Year of Age............ 761
4(D) Total Deaths, Persons 65 years and over..... 5,701


*Estimate based on average percent of divisional total
Totals for previous weeks include reported corrections.

NOTE: All deaths by place of occurrence.




UNIVERSITY OF FLORIDA

II II11II Ill2 IIl61I41 60 ll0
3 1262 08864 1690


Morbidity and Mortality Weekly Report


EPIDEMIOLOGICAL REPORT

Paralytic Shellfish Poisoning from Oysters California
The first incident in California of shellfish intoxi-
cation following the ingestion of oysters has been re-
ported by the California Department of Public Health.
Four residents of Solano County became ill on
August 1 with tingling of the lips, numbness of the
extremities, muscular incoordination and difficulty in
walking. They had consumed raw oysters purchased the
same day from a restaurant on the coast about 50 miles
north of San Francisco. The oysters had been harvested
from a commercial oyster bed in Drakes Bay, Marin
County.
Samples of the oysters were examined by the Cali-
fornia State Department of Public Health, Division of
Laboratories, on August 3 and were found to contain
9600 mouse units of toxin per 100 grams, or approxi-
mately 24 times the maximum safe level of 400 mouse
units per 100 grams. (Levels as low as 2400 mouse units
per 100 grams have on occasion proved lethal to humans.)
The Health Department prohibited further shipments
of oysters from the incriminated bed and all oysters from
this bed which had been distributed commercially were
recalled. Oysters from nearby Tomales Bay showed
toxicity levels of nearly 200 mouse units, somewhat
below the symptom-causing quantity. Oysters obtained
from other nearby beds showed no toxin.
The toxicity of shellfish on the West Coast usually
arises as a result of their consumption of Gonyaulax
cantanella, a microscopic unicellular plankton organism.
These organisms are sometimes present during the
summer months in large numbers and may impart a deep
rust color to the sea, the so-called "red tide." A quar-
antine order is issued annually by the California Health
Department prohibiting the sale of mussels and warning
against eating the dark meat of clams during the period,
May 1 to October 31. Ordinarily, shellfish in bays and
estuaries, such as oysters, are less affected by the
organism than are those on the open shoreline.
Oysters were first incriminated in outbreaks of
shellfish poisoning in British Columbia in 1957 where
34 of 61 cases were attributed to oyster consumption.
Since first recognition of the problem of paralytic
shellfish poisoning in 1793, about 800 cases and 175
deaths have been recorded in various parts of the world.
Principally involved have been mussels and soft-shelled
clams.* Most cases have been reported from the West
Coast including California, Oregon, Washington, British
Columbia and Alaska. Smaller outbreaks have been re-
corded in Nova Scotia, New Brunswick, Quebec and
Maine.
(Reported by Dr. Vernon B. Link, Head, General Epidemi-
ology Section, California Department of Public Health.)

* Ref.:McFarren,et al. Public Health Significance of Paralytic
Shellfish Poison. Adv. in Food Research 10:135-179, 1960.


INTERNATIONAL NOTES QUARANTINE MEASURES
No Report.

I -, .,' DEP





S. )EPOSITORV




Nole. Thee. p.rawl oi l at. are based on ...kly cle a.rm l he C.mUls.
cable Die.e. Conser by the Individ.l 51 1m health depnrtmnu.
Syjbol.- -.- Data Da avaJlable
QuaIImT7 ro
Plrcedu..r for coDntrIeIlon of sauoa mnorn. lty rean may b. obtalkd Irm
iatll.ca. Ser-l. Communicsble DIre.. Cealr. Publlr BHelt Servie,
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