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:
AA00010654:00085

Related Items

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

Full Text






Morbidity and Mortality


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

PUBLIC HEALTH SERVICE


Prepared by the


I C ONNIUS CA LE ISESE ENI


JUN 1963


^^sCOD


6345131


For release June 7, 1963 ATLANTA 22, GEORGIA Vol. 12, No. 22
PROVISIONAL INFORMATION ON SELECTED NOTIFIABLE DISEASES IN THE UNITED STATES AND ON
DEATHS IN SELECTED CITIES FOR WEEK ENDED JUNE 1, 1963


MENINGOCOCCAL INFECTIONS The 43 cases of
meningococcal infections reported for the week ending
June 1, 1963 brings the total of reported cases for the
first 22 weeks to 1,267, approximately 8 percent above the
corresponding total for any of the previous four years.
The most notable increase in incidence has occurred in
the State of California.
Cumulative cases of meningococcal infections for
the first 22 weeks from 1959-1963 in the United States and
and for California alone, and total U. S. cases for the
years 1959-1962 are shown in the table below:

Cases Through
22d Week 1963 1962 1961 1960 1959
United States 1267 1065 1064 1175 1172
California 186 137 105 101 111
Annual Total
United States 2133* 2232 2259 2180
Provisional


POLIOMYELITIS Three cases of poliomyelitis (one
paralytic) were reported this week, continuing the low
incidence of this disease during 1963. The figure below
demonstrates the comparative incidence of poliomyelitis
in 1958, 1960, 1962, and 1963.
CURRENT US POLIO INCIDENCE
COMPARED WITH YEARS 1958 1960, rnd 196



SI


/\

/ V

A -, A


Table 1. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous week)
22nd Week Cumulative
Ended Ended First 22 weeks
Disease Median
June 1, June 2, 1958 1962 Median
1963 1962 1963 1962 1958 1962
Aseptic meningitis................ 25 16 --- 489 411 ---
Brucellosis ................. .... 9 3 11 145 161 307
Diphtheria ...................... 1 5 9 112 199 307
Encephalitis, infectious .......... 22 32 31 622 648 618
Hepatitis, infectious and serum... 624 904 633 20,953 28,299 16,917
Measles..... .................. 13,000 16,375 15,553 292,431 369,960 316,180
Meningococcal infections......... 43 35 35 1,267 1,065 1,172
Poliomyelitis, total.............. 3 22 22 56 152 331
Paralytic.................... 1 20 20 48 115 237
Nonparalytic................. 2 2 2 21 60
Unspecified.................. 2 6 16 34
Streptococcal sore throat
and Scarlet t/rer ............ 5,508 5,729 --- 195,593 179,432
Tetanu ... .................... 4 4 --- 86 73 ---
Tuarem ia ...................... 6 8 --- 86 105 ---
Typhoid fever ................... 3 13 10 149 193 226
Typhus fever, tick-borne,
(Rocky Mountain spotted)...... 1 6 --- 19 28 --
Rabies in Animals............... 67 72 64 1,731 1,861 1,776


Table 2. NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax: 1 Psittacosis: 27
Botulism: 5 Rabies in Man:
Malaria: Md. 1, Calif. 1 41 Smallpox:
Plague: Typhus, murine: 3


o I


^


160 ff/1 1 aa







Morbidity and Mortality Weekly Report


EPIDEMIOLOGICAL REPORTS
C. Perfringens Outbreaks California

An extensive outb!.Ak of food-borne illness attribu-
ted to -Clostridium perfringens occurred in January in
Riverside County. The outbreak involved children 5 to 14
years of age in eight different schools and followed the
ingestion of a school lunch cooked in a central kitchen
and distributed by truck to the schools.
Of 1200 persons eating the suspect food at lunch,
350 became acutely ill within one to 12 hours later. The
illness was characterized by vomiting, diarrhea, marked
prostration and dehydration.
C. perfringens was isolated in large numbers by
anaerobic culture from samples of turkey served at the
meal.
The outbreak was attributed to the prolonged period
involved between cooking, distribution and serving
coupled with inadequate temperature controls at all
stages.
(Reported by Dr. Philip K. Condit and Dr. Rebecca L.
Proctor, Bureau of Communicable Diseases, California
Department of Public Health.)

Equine Influenza Follow-up Report

Outbreaks of febrile respiratory disease in horses,
which first appeared in Florida in mid-February, have
continued to occur at racing meets, horse shows and
stables through the northeast and mid-western parts of
the country. (See MMWR, Vol. 12, pp. 157 and 167.)
Approximately 40 thoroughbred racing meets have
been held since the Florida outbreak. Reports have been
received from 15, of which 11 have had definite outbreaks
of the disease.
Of 24 harness racing meets thus far in 1963, 4 had
completed their racing program by mid-April and reported
no equine influenza. Of the 20 meets held since mid-
April, 16 have had serious epidemics of the disease;
reports have not been received on the remaining 4. The
first harness track affected was in New York on April 12.
In late April and May, the disease appeared at numerous
other tracks in the northeastern, eastern and mid-western
States.
Western racing dates generally fall later in the year
than in the eastern part of the United States, and cases
of respiratory disease in horses have just begun to appear
in States west of the Mississippi.
Viral isolates have been obtained from horses in
Kentucky, Florida and Michigan. All grow rapidly in chick
embryos. Results of complement fixation tests indicate
that the causative agent belongs to the Influenza A virus
group. Results of hcmaigglurination-inhibition tests run
with all available anti-sera are negative, indicating that
this is a previously unknown strain of Type A virus.


There is no evidence of widespread infection in man.
Investigations of possible human illness related to these
outbreaks are currently underway.
(Reported by Drs. E. R. Doll and ]. T. Bryan, University
of Kentucky; Drs. M. M. Ner.' and G. H. Waddell, Univer-
sity of Miami; the Department of Epidemiology, University
of Michigan; the Respiro-virus Unit, Laboratory Branch,
CDC; Veterinarians and Epidemiologists of the State
Health Departments; and teams from the Communicable
Disease Center.)


Salmonella derby Epidemic Follow-up
A total of 115 additional isolations of S. derby have
been reported from the 50 States during the past week. Of
these, 109 have been reported from the State of Pennsyl-
vania (See MMIt R, Vol. 12, pages 167, 173).
In all, 223 hospital-associated S. derby isolations
have been reported from Pennsylvania, 97 from sympto-
matic patients and employees, 98 from asymptomatic
patients and employees; 28 remain under investigation.
A breakdown of this data by hospital is presented in
the table.

ISOLATIONS OF SALMONELLA DERBY FROM PATIENTS AND
HOSPITAL EMPLOYEES IN PENNSYLVANIA
WITH AND WITHOUT SYMPTOMS

Symptomatic Asymptomatic Unknown Total
59 42 24 125
22 33 4 59
9 23 0 32
3 0 0 3
2 0 0 2
2 0 0 2
97 98 28 223

None of the isolations of S. derby from non-human
sources reported in 1963 have as yet revealed an associa-
tion with the present outbreak.





INTERNATIONAL NOTES

Typhoid Fever Zermatt, Switzerland

Supplementary data regarding the recent typhoid epi-
demic originating in Zermatt, Switzerland has been pro-
vided by Dr. Reimert Ravenholt, Epidemiologist, Division
of Foreign Quarantine, Paris.
To date, 347 cases have been reported from 10 differ-
ent countries. There have been three deaths, two in
Switzerland and one in England. The epidemic commenced
on or about February 20, reached a peak on March 3 and
declined through the end of March. The epidemic curve
based on 297 Swiss, British, German, U.S. and Dutch
cases is shown in the accompanying graph.


182









Morbidity and Mortality Weekly Report


DATE OF ONSET- TYPHOID CASES
PRESUMED INFECTED AT ZERMATT


Based on the time periods during which those who
developed typhoid had visited Zermatt, it is believed that
the principle dissemination of the infection took place
between February 13 and 22. In addition to 2000 villagers
and transient workers, there were an estimated 8000
visitors during this period. Because of the relative in-
accessibility of Zermatt, most visitors stay at least over-
night in the town. Although data regarding the nationality
of hotel guests for 1963 are not yet available, published
figures for February, 1962 regarding hotel "guest-nights,"
by nationality, give a rough appraisal of the geographic
dispersion of the visitors.
HOTEL GUEST-NIGHTS, FEBRUARY 1962 AND TYPHOID CASES 1963

Number Hotel
Guest Nationality Guest-nights Reported Cases
Switzerland 20,613 212
Germany 16,533 23
United Kingdom 10,567 73
France 9,940 13
U.S.A and Canada 9,472 12
Belgium 2,416 1
Italy 2,361 4
Netherlands 1,365 5
Austria 584 3
Other European 1,174 1
Other 320 0
Total 75,345 347


At Zermatt, the cases occurred among visitors who
had resided throughout the village during their visit;
there was no apparent concentration in any one area.
The explosiveness of the outbreak and the wide dis-
semination of exposures throughout the town suggested
water as the probable source of infection. Bacteriological
examination of water during March revealed a high content
of coliform organisms. Although chlorination of some
water sources entering Zermatt was routinely carried out,
it was considered inadequate. Chlorine levels were in-
creased fourfold in mid-March when the problem was first
suspected.
The means of contamination of the water is not clear.
Several hundred Italian laborers working on various hydro-
electric projects reside on the Zermatt watersheds. Many
came from endemic areas in Italy; one is known to have
developed typhoid fever during February. In addition to
possible contamination of the watershed coupled with
inadequate chlorination, there may also have been
contamination through the water distribution system. One
major defect was found in a principle water main.
Swiss authorities are actively pursuing their investi-
gations. More complete data will be available in the
future.


Smallpox Stockholm

Three additional cases, two hospital acquired, were
identified last week bringing to 19 the total number of
smallpox cases comprising the current outbreak, accord-
ing to information made available by Dr. Bo Zetterberg,
Chief, Epidemiology Division, State Bacteriology Lab-
oratory, Stockholm.
Two of the three cases are actually part of the
second generation of transmission (See MMWR Vol. 12,
pg. 174), having now been identified retrospectively by
serologic means. Neither patient developed a rash. Both
were nurses in the Stockholm Infectious Disease Hospital
(Continued on page 188)


SUMMARY OF PNEUMONIA AND INFLUENZA DEATHS

The weekly average number of pneumonia-influenza deaths
for the four-week period ending June 1 was 387 as com-
pared with an expected weekly average of 442.



PNEUMONIA-INFLUENZA DEATHS IN 108 CITIES

WEEK ENDING 4 Week Weekly
5/11 5/18 5/25 6/1 Total Average
Observed 422 408 373 346 1,549 387
Expected 457 447 437 428 1,769 442
Excess 35 -39 -64 -82 -220 -55


1.000





NUMBER
OF
DEATHS


PNEUMONIA-INFLUENZA DEATHS IN 108 U.S CITIES
Average number per week by four-week periods







I I 1--

-iH4



Ib.k- 4I


(See table, page 187)


r -


1


I--uany


...en










184 Morbidity and Mortality Weekly Report



Table 3. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

JUNE 1, 1963 AND JUNE 2. 1962



Poliomyelitis, Aseptic
Poliomyelitis, total cases Poliomyelitis, paralytic nonparalytic Meningitis
Cumulative Cumulative
Area
22nd week First 22 weeks 22nd week First22 weeks 22nd week 22nd week

1963 1962 1963 1962 1963 1962 1963 1962 1963 1962 1963 1962

UNITED STATES...... 3 22 56 152 1 20 48 115 2 25 16

NEW ENGLAND............... 1 1 -
Maine................. -
New Hampshire........
Vermont .............. -
Massachusetts......... -
Rhode Island..........-
Connecticut ........... 1 I

MIDDLE ATLANTIC.......... 2 3 8 33 3 6 20 2 2
New York............... 2 4 32 2 4 19 2 1
New Jersey............. 1 1 1 1 1 1
Pennsylvania 2 3 1 1

EAST NORTH CENTRAL ....... 14 10 11 6 2 2
Ohio .................. 4 4 3 4 1 1
Indiana............... 1 3 2 -
Illinois.............. 6 2 5 -
Michigan.............. 2 2 1 1
Wisconsin............. 1 1 1 -

WEST NORTH CENTRAL....... 2 7 2 4 2
Minnesota.............. 1 1 1 1 2
Iowa. ................. 3 2 -
Missouri.............. .- 1 3 1 1
North Dakota........... -
South Dakota........... -
Nebraska................ .
Kansas................ -.

SOUTH ATLANTIC........... 6 11 5 9 4 3
Delaware.............. 1
Maryland.............. -
District of Columbia.. -
Virginia............... 1 2 1 2 2
West Virginia......... -
North Carolina........ 2 2 2 2 -
South Carolina........ .
Georgia.............. 1 2 2 -
Florida............... 2 4 2 3 3 1

EAST SOUTH CENTRAL....... 1 3 5 1 2 3 1
Kentucky............... 1 2 1 2
Tennessee............. 1 2 1
Alabama ............... 2 1 1 1 1- -
Mississippi............ -

WEST SOUTH CENTRAL ....... 1 18 14 62 1 16 14 53 2 3
Arkansas .............. 1 1
Louisiana............. 1 12 5 1 12 5
Oklahoma................ 1
Texas................. 18 2 55 16 2 47 2 3

MOUNTAIN ................. 7 6 4
Montana................ 2 1
Idaho.................
Wyoming...............1 1
Colorado...............
New Mexico............
Arizona................ 3 3
Utah................... -
Nevada...............

PACIFIC.................. 9 16 8 13 11 5
Washington ........... -
Oregon............... 1 1 1 1
California.............. 8 15 7 12 11 5
Alaska...... ........ -
Hawaii............ -

Puerto Rico.............. 1 3 6 1 3 6 4










Morbidity and Mortality Weekly Report 185


Table 3. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

JUNE 1, 1963 AND JUNE 2, 1962 (Continued)



Brucellosis Diphtheria Encephalitis, Hepatitis, Measles
infectious infectious and serum
Area
Area Cumu- Cumu- 22nd week
lative lative Under 20 &
22nd week 22 weeks 22nd week 22 weeks 22nd week 20 yr. over Total 22nd week
1963 1963 1963 1963 1963 1962 1963 1963 1963 1962 1963 1962


UNITED STATES...... 9 145 1 112 22 32 324 278 624 904 13,000

NEW ENGIAND............... 4 1 3 32 25 62 40 477
Maine................ 1 20 13 33 16 11
New Hampshire......... 3 1 4 1 2
Vermont ............. 61
Massachusetts......... 2 3 5 7 15 18 212
Rhode Island.......... 2 2 1 40
Connecticut........... 4 4 8 4 151

MIDDLE ATLANTIC.......... 4 19 5 13 63 86 149 145 2,329
New York............... 3 13 1 6 33 52 85 62 957
New Jersey............ 1 3 12 15 19 546
Pennsylvania .......... 1 5 4 7 27 22 49 64 826

EAST NORTH CENTRAL....... 10 11 2 6 58 53 112 193 5,615
Ohio ................. 1 1 1 10 13 24 65 539
Indiana................ 1 3 10 8 18 23 216
Illinois.............. 8 3 1 3 5 7 12 38 684
Michigan...-........... 1 3 32 23 55 65 1,862
Wisconsin............. 1 2 1 2 3 2 2,314

WEST NORTH CENTRAL....... 4 102 1 32 1 6 8 14 37 319
Minnesota............ 7 15 2 3 5 16 44
Iowa.................. 4 75 1 1 1 2 9 124
Missouri .............. 4 1 1 2 3 4 78
North Dakota...*....... 1 1 1 73
South Dakota .......... 5 9 1 1 1
Nebraska.............. 5 1 5 2
Kansas................ 6 1 1 1 2 5 NN

SOUTH ATLANTIC............ 2 4 21 5 35 18 53 143 1,054
Delaware................- 1 1 51
Maryland .............. 2 4 3 7 13 65
District of Columbia. 2 2 4 2
Virginia.............. 2 2 3 2 5 30 213
West Virginia......... 1 13 2 15 5 511
North Carolina........ I 1 10 5 15 52 98
South Carolina........ 4 1 1 1 7 13
Georgia............... 7 1 1 10 8
Florida............... 1 8 1 1 5 6 22 93

EAST SOUTH CENTRAL....... 4 9 1 57 23 80 102 510
Kentucky.............. 8 3 11 24 166
Tennessee............. 3 2 21 6 27 46 326
Alabama................ 1 7 23 3 26 17 17
Mississippi........... 1 5 11 16 15 1

WEST SOUTH CENTRAL....... 1 10 13 1 3 19 10 29 76 442
Arkansas.............. 3 1 1 1 2 3 15 41
Louisiana............. .- 2 4 2 6 16 27
Oklahoma .............. 2 5 1 3 -
Texas................. 1 5 5 1 1 14 6 20 42 374

MOUNTAIN ................. 1 4 1 1 4 3 22 32 1,170
Montana........... 1 1 3 36
Idaho................. 4 1 115
Wyoming ................ 1 2 19
Colorado................ 4 7 379
New Mexico............ .- 1 1 2 1 3 5 NN
Arizona................ 1 2 7 5 501
Utah.................. 1 1 2 3 8 120
Nevada................ 1

PACIFIC.................. 1 7 2 7 5 50 52 103 136 1,084
Washington ........... 2 7 9 17 26 75
Oregon ................ 2 2 5 3 8 21 -
California............. 1 4 2 5 3 36 40 76 88 902
Alaska .............. 2 2 1 3
Hawaii................. 1 104


16,375

2,310
245
7
115
985
195
763

3,255
1,521
1,410
324

3,151
621
332
778
969
451

416
94
100
62
156

4
NN

1,060
29
141
6
341
341
12
49
6
135

933
206
679
28
20

1,420
5
1
17
1,397

1,319
436
67
51
393
NN
190
110
72

2,511
948
584
929
8
42

86


Puerto Rico.............. 9 6 2 8 25 5


I










186 Iiirbidity and lMortality Weekly Report


Table 3. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

JUNE 1. 1963 AND JUNE 2, 1962 (Continued)


Meningococcal Streptococcal Tickborne
Infections Sore Throat & Tetanus Typhus Tularemia Typhoid Fever Rabies in Animals
Scarlet Fever (Rcky Mt.
AreaCumu- Spotted) Cumu- Cumu-
lative lative lative
22nd wk. 22 weeks 22nd week 22nd wk.22nd wk. 22nd wk. 22nd wk. 22 weeks 22nd week 22 weeks
1963 1963 1963 1962 1963 1963 1963 1963 1963 1963 1962 1963

UNITED STATES.... 43 1,267 5,508 5,729 4 1 6 3 149 67 72 1,731

NEW ENGLAND......... 79 649 384 6 1 18
Maine............... 13 108 16 1
New Hampshire...... 2 14 2 12
Vermont.............. 2 8 1 1 5
Massachusetts...... 37 123 93 -- 4 -
Rhode Island....... 7 42 16 -
Connecticut........ 18 354 257 -

MIDDLE ATLANTIC..... 3 176 456 291 1 18 1 2 45
New York............ 1 76 271 180 14 33
New Jersey......... 1 26 66 39 1 -
Pennsylvania....... 1 74 119 72 1 3 1 2 12

EAST NORTH CENTRAL.. 4 203 667 549 8 14 15 267
Ohio............... 2 59 48 57 2 6 10 157
Indiana............. 24 89 69 1 4 4 30
Illinois........... 2 28 72 155 3 3 1 39
Michigan........... 66 235 117 1 26
Wisconsin.......... 26 223 151 1 1 15

WEST NORTH CENTRAL.. 3 75 192 131 I 9 21 18 403
Minnesota.......... 13 13 25 3 5 107
Iowa............... 4 52 37 1 10 10 147
Missouri............ 1 27 4 1 5 4 3 74
North Dakota....... 3 86 55 1 3 12
South Dakota....... 4 13 3 2 49
Nebraska ........... 2 19 1 6
Kansas............. 5 24 10 1 8

SOUTH ATLANTIC...... 11 232 391 397 1 31 2 3 278
Delaware............. 1 2 4 12 1 -
Maryland........... 4 37 50 28 3
Dist. of Columbia.. 4 2
Virginia........... 4 58 118 131 4 2 1 102
West Virginia...... 13 123 62 5 1 82
North Carolina..... 1 39 16 8 1 4 4
South Carolina..... 13 11 6 2 6
Georgia............ 12 3 4 2 33
Florida............ 1 54 64 146 10 1 51

EAST SOUTH CENTRAL. 100 773 593 13 9 8 146
Kentucky........... 21 7 27 1 4 4 71
Tennessee.......... 45 725 517 8 5 4 63
Alabama............ 18 19 4 12
Mississippi......... 16 22 49 -

WEST SOUTH CENTRAL.. 5 135 559 620 1 1 5 1 27 10 24 363
Arkansas........... 8 3 5 1 13 1 5 23
Louisiana.......... 2 55 15 1 5 1 35
Oklahoma........... 1 27 1 2 1 2 32
Texas............... 2 45 544 616 1 7 7 17 273

MOUNTAIN............ 2 42 929 1,052 2 7 37
Montana............ 3 14 28 -
Idaho ............. 3 79 150 -
Wyoming ............ 1 9 28 -- -
Colorado........... 11 331 401 1 -
New Mexico......... 1 3 281 222 1 6 21
Arizon ............. 1 7 104 144 1 16
Utah................ 11 111 73 -
Nevada............. 3 6 -

PACIFIC............. 15 225 892 1,712 2 1 35 2 2 174
Washington.......... 16 248 483 -
Oregon.............. 2 13 13 12 1 2 1 I
California.......... 13 186 530 1,148 1 1 30 2 1 164
Alaska............. 5 60 1 9
Hawaii............. 5 101 9 2 -
Puerto Rico......... 4 13 7 2 1 8 6











Morbidity and Mortality Weekly Report 187





Table 4 (B). REPORTED PNEUMONIA-INFLUENZA DEATHS IN REPORTING CITIES


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


For weeks ending For weeks ending
Area5/11 5/18 /2 Area 5/ 5/

5/11 5/18 5/25 6/1 5/11 5/18 5/25 6/1


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


0
3
28
3
4
4
1
10
3
1
6
3
0
2
0
3
0
2
1
9
1


1
0
0
5
1
1
3
6
4
4


SOUTH ATLANTIC:
Atlanta, Ga.............. 2 5 4 5
Baltimore, Md............. 3 4 5 1
Charlotte, N.C........... 2 1 1 2
Jacksonville, Fla........ 2 1 0 1
Miami, Fla............... 1 0 0 0
Norfolk, Va.............. 3 4 0 2
Richmond, Va ............. 5 1 1 4
Savannah, Ga.............. 3 2 3 3
St. Petersburg, Fla...... 6 2 3 3
Tampa, Fla............... 3 2 7 4
Washington, D.C............ 7 9 8 5
Wilmington, Del.......... 0 5 6 2

EAST SOUTH CENTRAL:
Birmingham, Ala.......... 0 1 3 1
Chattanooga, Tenn........ 4 0 2 1
Knoxville, Tenn........... 0 2 1 0
Louisville, Ky............ 4 8 7 2
Memphis, Tenn............ 1 3 6 7
Mobile, Ala............... 1 3 0 0
Montgomery, Ala .......... 1 5 3 3
Nashville, Tenn.......... 0 5 4 5

WEST SOUTH CENTRAL:
Austin, Tex.............. 4 3 5 5
Baton Rouge, La.......... 2 1 3 3
Corpus Christi, Tex...... 0 0 0 0
Dallas, Tex .............. 2 3 5 5
El Paso, Tex............ 2 2 4 3
Fort Worth, Tex.......... 0 1 4 3
Houston, Tex.............. 4 3 0 9
Little Rock, Ark......... 1 3 5 4
New Orleans, La.......... 7 4 3 0
Oklahoma City, Okla...... 3 1 2 1
San Antonio, Tex......... 1 1 3 3
Shreveport, La........... 1 5 2 3
Tulsa, Okla............... 7 4 6 4

MOUNTAIN:
Albuquerque, N. Mex...... 3 3 2 4
Colorado Springs, Colo... 3 1 1 5
Denver, Colo............. 5 2 4 7
Ogden, Utah............... 0 2 2 1
Phoenix, Ariz............ 5 3 2 2
Pueblo, Colo.............. 0 1 1 1
Salt Lake City, Utah..... 3 0 1 1
Tucson, Ariz.............. 1 0 0 0

PACIFIC:
Berkeley, Calif.......... 0 0 0 0
Fresno, Calif............ 4 1 2 1*
Glendale, Calif.......... 1 0 0 0
Honolulu, Hawaii......... 1 3 1 1
Long Beach, Calif........ 0 0 0 2
Los Angeles, Calif....... 23 19 14 7
Oakland, Calif........... 5 5 2 2
Pasadena, Calif.......... 0 0 1 2
Portland, Oreg........... 2 5 0 0
Sacramento, Calif........ 2 0 0 1
San Diego, Calif......... 3 3 3 1
San Francisco, Calif..... 7 4 2 3
San Jose, Calif .......... 8 4 7 4
Seattle, Wash............. 8 3 4 3
Spokane, Wash............ 0 1 1 0
Tacoma, Wash............. 0 1 1 0

San Juan, P.R............... 3 5 2 1


OCurrent Week Mortality for 108 Selected Cities

4(A) Total Mortality, all ages.................... 9,817
4(B) Pneumonia-Influenza Deaths, all ages........ 346
4(C) Total Deaths under 1 Year of Age............. 748
4(D) Total Deaths, Persons 65 years and over..... 5,376


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

NOTE: All deaths by place o o ccurrece.








188 Morbidity and M




in close contact with the smallpox cases admitted there.
The first, a 44-year-old female, cared for Case No. 3 from
April 27 to May 7 daily, including bathing and local treat-
ment of the lesions. On May 9, the nurse developed fever
and headache, as well as nausea and low back pain. Ex-
cept for May 13 and 14, she continued to work throughout
her illness until isolated on May 18. She was found to
have a very high hemagglutination inhibition antibody
titer suggesting recent infection. Her last vaccination
prior to onset of illness was in 1962. She was also in
daily contact with Cases 6 and 14, and directly or in-
directly may have transmitted the disease to Case 14.
The second nurse, a 22-year-old female, also em-
ployed in the Stockholm Infectious Disease Hospital, had
daily contact with Case No. 2 during the period April 27-
May 7. On May 11, she experienced onset of headache,
fever, and sore throat and was absent from work May 11
through May 13. No rash developed. A high HAI titer
verified the diagnosis of smallpox. She had previously
been vaccinated in 1950 but at the time of exposure had
not yet been revaccinated under the hospital's annual re-
vaccination program.
The final additional case is that of a 47-year-old man
who had onset of illness May 21 while already isolated
as a contact. He is the father of Case 7, the first identi-
fied case. He had never been vaccinated until 7 days
before onset of illness.
The total number of hospital-acquired cases now
stands at 6, one-third of the secondary indigenous cases.
The evidence supports close contact as the primary requi-
site for spread both in the hospital and in the community.
The disease has spread among persons vaccinated more
than 7 years prior to the time of their exposure with 2
notable exceptions, both patients with mild disease with-
out rash. The table below presents data on the vaccina-
tion status of the 18 indigenous cases:


ortal


I'l, 'EF ,l ly CF F1 RIDA
SIl U llml 11 iii 1111 1111 11 H I I liiii lll fi ll i ll I ll f1 11
3 1262 08864 1260
lity Weekly Report





INTERNATIONAL NOTES QUARANTINE MEASURES
Immunization Information for International Travel
1962 Edition
Public Health Service Publication No. 384
The following information should be added to the list of
Yellow Fever Vaccination Centers in Section 6:
CITY: New York, New York
CENTER: Washington Heights District Health Center
New York City Department of Health
600 W. 168th Street
Tel. WA 7-6300
CLINIC HOURS: Monday-Friday, 10-11 a.m.
FEE: No


Time Lapse Since Indigenous Clinical Characteristics
Last Vaccinated Cases Rash No Rash Deaths
7 yrs. or less 2 2 -
8-14 yrs. 3 1 2 -
15-24 yrs. 2 2 -
25-50 yrs. 4 3 1 -
More than 50 years 4 4 2
Never 3 3 1
Totals 18 13 5 3


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