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:
AA00010654:00096

Related Items

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

Full Text






Morbidity and Mortali F



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

PUBLIC HEALTH SERVICE j JAN1963
Cro
Prepared by the 6834-54131 )f

For release January 18, 1963 ATLANTA 22, GEORGIA v 2, No. 2

PROVISIONAL INFORMATION ON SELECTED NOTIFIABLE DISEASES IN THE UNITED STATES AND ON
DEATHS IN SELECTED CITIES FOR WEEK ENDED JANUARY 12, 1963


INFLUENZA No confirmed outbreaks of influenza have
as yet been reported this year. However, a recent out-
break of a febrile illness consistent with influenza has
occurred since the beginning of the year in a southeastern
North Carolina county. A report on that outbreak follows.


EPIDEMIOLOGICAL REPORTS

Influenza-Like Illness North Carolina

An outbreak of acute febrile illness, clinically con-
sistent with influenza, has recently been observed among


the residents of Robeson County in southeastern North
Carolina.
Physicians in the area first reported seeing cases
about January 1. They described a syndrome character-
ized by headache, myalgia, chilly sensations, weakness,
fatigue and mild cough of variable duration, but generally
lasting 3-4 days. A small percentage of cases (estimated
at 10%) also complained of nausea and vomiting. Physical
examination typically revealed fever varying from 1000-
1040 p.o., with few other findings.
School absenteeism began to rise above usual levels
for a nonepidemic period (about 5% for the county) on


Table 1. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous week)
2nd Week Cumulative
Disease Ended Ended Medin First 2 weeks
January 12, January 13, 1958 1962 Median
1963 1962 1963 1962 1958 1962
Aseptic meningitis ............... 33 11 --- 48 21 ---
Brucellosis ..................... 3 10 8 6 14 15
Diphtheria ...................... 10 20 20 13 35 44
Encephalitis, infectious .......... 16 19 19 24 37 41
Hepatitis, infectious and serum... 1,073 1,406 797 1,752 2,557 1,384
Measles ........................ 7,347 7,589, 7,695 12,170 13,484 14,527
Meningococcal infections......... 53 56 61 100 102 102
Poliomyelitis, total.............. 6 10 18 7 17 37
Paralytic .................... 5 4 9 6 7 20
Nonparalytic................. 1 1 6 1 4 8
Unspecified................... 5 3 6 9
Streptococcal sore throat
and Scarlet fever ............ 7,743 7,579 -- 13,643 13,566
Tetanus ........................ 8 1 11 3
Tularemia..................... 6 10 -12 20 -
Typhoid fever ................. 5 2 8 7 7 16
Typhus fever, tick-borne,
(Rocky Mountain spotted)...... -- 1
Rabies in Animals............... 63 59 76 105 114 143


Table 2. NOTIFIABLE DISEASES OF LOW FREQUENCY
Own. Cum.
Anthrax: Psittacosis: Conn.-1, N.Y.-1, Ohio-1, Calif.-l 4
Botulism: Rabies in Man:
Malaria: Smallpox:
Plague: Typhus, murine:









Morbidity and Mortality Weekly Report


January 7. First to be affected were the towns of Fair-
mont and Pembroke where attack rates of 12-18% were
noted among elementary and high school students. By
January 11, the outbreak had spread to involve most of
the southern portion of the county including the county
seat of Lumberton. A survey of schools throughout the
county on that date revealed absentee rates of 12-31%.
By January 12, physicians serving the Pembroke area
(population 1800) were seeing an estimated total of 60
new cases per day, and had already seen at least 12
cases complicated by pneumonia. Only one patient re-
quired hospitalization and no deaths had been recorded
due to the outbreak.
Robeson County is a predominantly rural area de-
voted largely to tobacco, cotton and corn raising, and
has relatively little industry. There are a few small
textile mills and factories located in Lumberton, how-
ever, and these reported no unusual absenteeism, despite
the fact that physicians in the area were observing a
large percentage of their cases among young and middle
aged adults.
By January 15, school absenteeism had begun to fall
off in the Pembroke schools, and local physicians agreed
that the outbreak was waning in that area. Other parts of
of the county continued to report excessive school absen-
teeism at about the same rate.
Throat washings and acute sera were obtained from
10 acute cases at the Pembroke Elementary School on
January 11. These are currently being processed at the
Respirovirus Laboratory, CDC.
In an effort to obtain additional epidemiologic data,
a telephone survey was undertaken in the village of
Pembroke. A random sample was obtained through se-
lecting every eighth entry in the local telephone direc-
tory, excluding commercial establishments. Interviews
were completed in 58 households, providing information
on 265 individuals (approximately 15% of the total popu-
lation). One adult member of the household usually pro-
vided data for all those residing at that number. A stand-
ard set of questions was asked at each interview
regarding age and sex of all household members, and
pertinent clinical data for household members who had
been ill during the epidemic. A total of 44 cases were
discovered in this sample, giving an overall attack rate
of 17%. Age specific attack rates, and a quantitative
summary of the symptom complex are given in the ac-
companying tables (right).
It is of some interest that Robeson County was also
the first area in North Carolina to report significant out-
breaks during last winter's influenza B epidemic.

(Reported by Jacob Koomen. M.D., Assistant Secretary
and State Health Director, North Carolina State Board of
Health and E. R. Hardin, M.D., County Medical Director,
Robeson County, Lumberton, North Carolina.)


AGE SPECIFIC ATTACK RATES PHONE SURVEY -
PEMBROKE, N. C.


NO. IN CASES IN ATTACK RATE
AGE GROUP SAMPLE SAMPLE FOR SAMPLE
0-4 25 4 16%
5-14 66 10 15%
15-24 44 9 20%
25 -34 26 6 23%
35 49 62 9 15%
50 64 25 4 16%
65 + 17 2 12%

TOTAL 265 44 17%


SYMPTOMS OF INFLUENZA-LIKE ILLNESS PHONE SURVEY -
PEMBROKE, N. C. JANUARY 12, 1963


SYMPTOM NUMBER PERCENT
Weakness and Fatigue 41 93
Cough (mild) 36 82
Headache 35 79
Feverishness 33 75
Chills or Chilly
Sensation 29 66
Myalgia 28 64
Sore Throat 21 48
Nausea 12 27
Vomiting 11 25
Conlunetlvltls (mild) 9 20
Diarrhea 2 4.5
Total No. of Cases 44

Infectious Hepatitis Oregon
An outbreak of infectious hepatitis, apparently water-
borne, was traced to a bowling alley in Marion County,
Oregon, in 1961. Between August and December, 73 in-
dividuals closely associated with a bowling alley became
ill with signs and symptoms of hepatitis. Fifty cases
were icteric and 23 anicteric. All cases occurring after
September were thought to be secondary. The week of
onset for the hepatitis cases is shown in the accompany-
ing graph (page 16).
Food and beverage histories revealed that only two
items were consumed by all who became ill, tap water
and an orange drink made from a concentrated fruit syrup
and tap water. Beverage histories were obtained on 61
persons who had bowled at the center within 30 days
preceding the first known case. The data in the table
below suggest that water may have been the vehicle of
transmission:

Group Total III Not Ill
Drank Water or Orange Drink 51 43 8
Did Not Drink Water or Orange Drink 10 0 10

Total 61 43 18

(Continued on page 16)









Morbidity and Mortality Weekly Report 11





962 HEPATITIS MORBIDITY BY STATE 1961 HEPATITIS MORBIDITY BY STATE
Rate per 100,000 Population R per 100000 Populaon






0-
1 -- -




the 72,733 reported in 1961.
.-- ---' -' '-_ ..



f_ '. -.-p n \a .. .. ,; ,

K f
O 20-0 -- 00 ..9-
to3 2 0.'s"



A preliminary total of 53,255 reported viral hepatitis cases throughout the U.S. in 1962 represents a 27% drop from
the 72,733 reported in 1961.
The hepatitis attack rates by State for 1962 and 1961 are shown in the maps. Significant increases in attack rates in
1962 occurred in Maine and Idaho. Both of these States reported a record number of viral hepatitis cases in 1962.
The geographic pattern of viral hepatitis throughout the U. S. in 1962 remained similar to the 1961 pattern, with a
general decrease in the country.


SUMMARY OF PNEUMONIA AND INFLUENZA DEATHS
IN 108 U. S. CITIES


The weekly average number of pneumonia-influenza
deaths for the four-week period ending January 12 was
531 as compared with an expected 523 weekly average.


WEEK ENDING
WEEK ENDING 4 Week Weekly
12-22 12-29 1-5 1-12 Total Average
Observed 507 451 552 612 2,122 531
Expected 510 520 528 535 2,093 523
Excess -3 -69 24 77 29 8


PNEUMONIA-INFLUENZA DEATHS IN 108 U.S. CITIES
Average number per week by four-week periods
1,000

.INFLUENZA A2






NUMBER 70
OF RECORDED
DEATHSS
DEATHS 600


503 ___----- .____------__----- __ \ ----- f
EXPECTED"
NUMBER F




300 -------
PERIOD NUMBER 3 1 7 IS
Ou [__ P 19sO ___U___|_ __1961__ FOM __1962._ __1963________
*YPACE OF OCCURErNCE *CALCULAEO F -OM #954- 60 KXPefENCE


(See Table, page 15)











12 Morbidity and Mortality Weekly Report


Table 3. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

JANUARY 13, 1962 AND JANUARY 12, 1963



Poliomyelitis, Aseptic
Poliomyelitis, total cases Poliomyelitis, paralytic nonparalytic Meningitis
Cumulative Cumulative
Area
2nd week First 2 weeks 2nd week First 2 weeks 2nd week 2nd week
1963 1962 1963 1962 1963 1962 1963 1962 1963 1962 1963 1962


UNITED STATES...... 6 10 7 17 5 4 6 7 1 1 33 11

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

MIDDLE ATLANTIC.......... 5 8 2 3 2 1
New York.............. 5 8 2 3 2 1
New Jersey............
Pennsylvania .

EAST NORTH CENTRAL......... 3 1 3 1 2 1 2 1 1 2
Ohio................... 1 1 1 1 1 1 1
Indiana .............. -
Illinois............... 2 2 2 2 -
Michigan.............. 2
Wisconsin.............

WEST NORTH CENTRAL ....... 2 2
Minnesota .............
Iowa .................. -
Missouri................ 2 2
North Dakota ..........
South Dakota..........
Nebraska..............-
Kansas..................

SOUTH ATLANTIC........... 2 1
Delaware.............. 1
Maryland..............
District of Columbia.. I i
Virginia.............. 1
West Virginia......... -
North Carolina........ -
South Carolina........ .
Georgia ............... .
Florida................

EAST SOUTH CENTRAL....... 6 1
Kentucky.............. 5
Tennessee ............. 1
Alabama ............... -. -1 1 1
Mississippi........... .-

WEST SOUTH CENTRAL....... 2 1 2 1 2 1 2 1 2
Arkansas................ .
Louisiana............. 2 2 2 2-
Oklahoma................
Texas................. 1 1 1 1 2

MOUNTAIN ................. 2 1 5 3
Montana ............... 2 1
Idaho.................. .
Wyoming................
Colorado .............. 2
New Mexico............ 1
Arizona...............
Utah.................
Nevada................

PACIFIC.................. 1 1 2 2 1 2 1 14 5
Washington.............
Oregon............... -
California............ 1 1 2 2 1 2 1 13 5
Alaska....... .........
Hawaii ...............

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










Morbidity and Mortality Weekly Report 13


Table 3. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

JANUARY 13, 1962 AND JANUARY 12, 1963 (Continued)



Brucellosis Diphtheria Encephalitis, Hepatitis, Measles
infectious infectious and serum
Area
Cumu- Cumu- 2nd week
lative lative Under 20 &
2nd week 2 weeks 2nd week 2 weeks 2nd week 20 yr. over Total 2nd week
1963 1963 1963 1963 1963 1962 1963 1963 1963 1962 1963 1962
UNITED STATES...... 3 6 10 13 16 19 612 371 1,073 1,406 7,347 7,589

NEW ENGLAND............... 1 2 89 66 157 90 436 1,067
Maine................. 50 20 70 20 74 141
New Hampshire......... 1 7 8 8 1 68
Vermont ............... 2 2 5 4 26 5
Massachusetts......... 1 30 21 51 41 153 587
Rhode Island.......... 1 1 5 11 16 6 16 70
Connecticut........... 1 5 7 11 166 196

MIDDLE ATLANTIC.......... 2 2 1 1 6 113 82 195 196 731 1,414
New York.............. 2 2 1 1 4 71 47 118 94 417 719
New Jersey............ 5 15 20 45 135 552
Pennsylvania .......... 2 37 20 57 57 179 143

EAST NORTH CENTRAL....... 1 94 60 159 306 2,787 1,094
Ohio.................. 18 13 33 131 305 75
Indiana............... 7 1 8 16 96 79
Illinois.............. 8 9 17 20 120 388
Michigan ............. 1 54 34 88 120 689 413
Wisconsin ............. 7 3 13 19 1,577 139

WEST NORTH CENTRAL ....... 1 2 3 4 2 33 16 51 160 709 219
Minnesota.............. 1 1 1 1 2 2 6 61 142 30
Iowa................... 1 1 1 4 1 5 47 213 105
Missouri............... 2 20 6 26 22 26 5
North Dakota.......... 2 2 7 312 74
South Dakota........... 1 2 8 16 5
Nebraska.............. 4 2 6 2 -
Kansas................ 3 3 6 13 NN NN

SOUTH ATLANTIC........... 6 6 4 2 78 46 137 144 891 653
Delaware.............. 2 2 21 5
Maryland.............. 2 2 7 25 82
District of Columbia.. 3 2 42
Virginia .............. 1 2 17 20 40 41 142 272
West Virginia......... 24 29 39 544 224
North Carolina ........ 23 11 34 31 33 8
South Carolina........ 1 1 1 5 2 9 12 5 6
Georgia ............... 1 I 14
Florida............... 5 5 2 4 13 17 11 121

EAST SOUTH CENTRAL ....... 1 1 2 82 19 117 217 212 1,013
Kentucky .............- 29 45 99 102 105
Tennessee............. 1 35 9 44 76 107 684
Alabama................ 1 -1 1 13 4 17 28 81
Mississippi........... 5 6 11 14 3 143

WEST SOUTH CENTRAL ....... 1 1 46 17 65 92 407 785
Arkansas .............. 1 7 3 10 23 162 2
Louisiana............. 6 6 4 4 10
Oklahoma ............... 2 2 5 2 12
Texas ................. 1 31 14 47 60 239 761

MOUNTAIN................. 1 24 4 65 54 570 375
Montana............... 15 1 18 9 74 131
Idaho................. 6 11 51 124
Wyoming................. 1 1 1 -
Colorado.............. 3 14 14 204 40
New Mexico............. 4 4 3 NN NN
Arizona................ 18 13 130 53
Utah ........... ....... 1 2 2 4 3 111 27
Nevada...............

PACIFIC................ ... 7 7 53 61 127 147 604 969
Washington........... 1 1 11 6 18 13 169 303
Oregon................- 17 29 13 129 159
California............ 6 6 21 55 76 114 171 357
Alaska...... ........ 4 4 6 6 148
Hawaii................ 1 129 2

Puerto Rico.............. 1 1 2 3 23 104










14 Morbidity and Mortality Weekly Report


Table 3. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

JANUARY 13, 1962 AND JANUARY 12, 1963 (Codtinued)


Mnine:.: ,*:-l Streptococcal Tickborne
InfractL,:n Sore Throat & Tetanus Typhus Tularemia Typhoid Fever Rabies in Animals
Scarlet Fever (Rcky Mt.
AreaCumu- Spotted) Cumu- Cumu-
lative lative lative
2nd wk. 2 weeks 2nd week 2nd wk. 2,d 2nd wk. 2nd wk. 2 weeks 2nd week 2 weeks
1963 1963 1963 1962 1963 1963 1963 1963 1963 1963 1962 1963

UNITED STATES.... 53 100 7,743 7,579 8 6 5 7 63 59 105

NEW ENGAND.......... 8 13 818 393 1 1
Maine............... 2 2 84 15 -
New Hampshire...... 4 1
Vermont............. 1 25 25 -
Massachusetts...... 1 3 115 98 1 1 -
Rhode Island ...... 1 3 126 33 -
Connecticut........ 4 4 464 221 -

MIDDLE ATLANTIC..... 5 8 376 453 2 3 2 3 4
New York............ 2 4 216 267 2 3 2 2 4
New Jersey......... 80 64
Pennsylvania....... 3 4 80 122 1 -

EAST NORTH CENTRAL.. 8 15 568 551 6 5 14
Ohio............... 2 4 59 7
Indiana............. 2 3 84 101 1 4 1
Illinois........... 1 2 101 149 -
Michigan........... 2 238 134 4 5
Wisconsin.......... 3 4 145 108 1

WEST NORTH CENTRAL.. 1 3 226 232 20 18 28
Minnesota.......... 10 17 10 1 11
Iowa............... 65 63 3 9 7
Missouri........... 1 10 7 2 4 4
North Dakota....... 95 51 2 3 2
South Dakota....... 1 2 2 3 1 4
Nebraska............ 1 I -
Kansas............. 44 86 -

SOUTH ATLANTIC...... 18 28 909 585 5 2 1 1 11 4 19
Delaware............ 11 4 -
Maryland........... 3 4 13 8 -
Dist. of Columbia.. 1 4 -
Virginia........... 2 7 248 121 3 3 10
West Virginia...... 1 3 287 216 2 1 3
North Carolina..... 3 4 89 39 2 1 2 2
South Carolina..... 1 1 72 112 1 -
Georgia............. 1 15 -
Florida............ 8 8 188 66 2 1 1 4 4

EAST SOUTH CENTRAL.. 3 7 1,013 1,418 1 4 7 6 11
Kentucky........... 2 4 162 121 2 1
Tennessee.......... 1 3 788 1,244 1 4 7 3 10
Alabama............ 2 6 -
Mississippi........ 61 47 -

WEST SOUTH CENTRAL.. 4 10 931 1,090 1 1 2 10 11 15
Arkansas............ 5 2 1 1 2 1 2
Louisiana.......... 1 2 5 1 1
Oklahoma........... 1 7 8 2 -
Texas............. 3 7 914 1,079 1 1 8 8 12

MOUNTAIN............. 4 1,506 1,549 -
Montana............ 33 46 -
Idaho.............. 150 122 --
Wyoming............ 54 -
Colorado........... 2 565 326 -
New Mexico......... 370 663 -
Arizona............ 1 201 273 -
Utah.............. 1 133 119 --
Nevada.............. -

PACIFIC............. 6 12 1,396 1,308 1 7 11 14
Washington.......... 426 468 -
Oregon.............. 1 20 35 1 1
California.......... 4 9 854 724 1 6 11 13
Alaska............. 2 2 27 79 -
Hawaii................ 69 2 -
Puerto Rico........ -










Morbidity and Mortality Weekly Report 15





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.)o


For weeks ending For weeks ending
Area Area
12/22 12/29 1/5 1/12 12/22 12/29 1/5 1/12


NEW ENGLAND:
Boston, Mass.............. 6 16 9 5
Bridgeport, Conn........... 7 0 4 1*
Cambridge, Mass........... 0 4 0 0
Fall River, Mass.......... 0 2 1 1
Hartford, Conn............ 2 2 6 2
Lowell, Mass.............. 5 1 0 1
Lynn, Mass................. 1 0 1 1
New Bedford, Mass......... 0 1 0 2
New Haven, Conn.......... 0 1 1 1
Providence, R.I........... 4 1 2 3
Somerville, Mass.......... 1 1 1 2
Springfield, Mass.......... 5 3 9 4
Waterbury, Conn............ 0 1 0 0
Worcester, Mass............ 10 7 8 7

MIDDLE ATLANTIC:
Albany, N.Y................ 2 3 2 4
Allentown, Pa............. 1 2 0 2
Buffalo, N.Y.............. 10 7 5 11
Camden, N.J................ 3 0 3 3
Elizabeth, N.J............ 0 2 1 0
Erie, Pa................... 4 1 1 5
Jersey City, N.J.......... 13 5 7 5
Newark, N.J............... 7 5 4 1
New York City, N.Y........ 71 72 95 100
Paterson, N.J............ 3 6 5 5
Philadelphia, Pa.......... 9 11 13 12
Pittsburgh, Pa............ 3 4 6 3
Reading, Pa............... 1 0 1 0
Rochester, N.Y............. 14 13 6 20
Schenectady, N.Y........... 1 1 1 0
Scranton, Pa............. 1 0 3 5
Syracuse, N.Y............. 0 2 1 2
Trenton, N.J.............. 5 2 1 2
Utica, N.Y................ 4 3 3 3
Yonkers, N.Y............... 1 0 0 4

EAST NORTH CENTRAL:
Akron, Ohio................ 1 0 1 3
Canton, Ohio............... 3 2 2 3
Chicago, Ill.............. 42 41 44 48
Cincinnati, Ohio.......... 3 1 7 5
Cleveland, Ohio............ 4 2 4 4
Columbus, Ohio............ 5 7 3 4
Dayton, Ohio.............. 1 3 5 5
Detroit, Mich.................. 10 11 19 24
Evansville, Ind........... 0 1 4 1
Flint, Mich............... 4 5 6 4
Fort Wayne, Ind........... 4 4 4 .1
Gary, Ind................... 0 12 1 3
Grand Rapids, Mich........ 0 2 5 3
Indianapolis, Ind......... 6 7 8 18
Madison, Wis.............. 0 0 0 2
Milwaukee, Wis............ 5 1 4 4
Peoria, Ill............... 0 5 0 0
Rockford, Ill............. 5 4 2 3
South Bend, Ind........... 3 3 1 7
Toledo, Ohio.............. 6 1 5 5
Youngstown, Ohio.......... 0 0 0 0

WEST NORTH CENTRAL:
Des Moines, Iowa.......... 1 0 1 4
Duluth, Minn.............. 1 0 0 0
Kansas City, Kans......... 1 2 1 3
Kansas City, Mo........... 13 6 3 9
Lincoln, Nebr............. 0 0 4 3
Minneapolis, Minn......... 4 1 4 2
Qmaha, Nebr............... 0 1 4 1
St. Louis, Mo............. 13 9 6 14
St. Paul, Minn ............ 2 3 7 4
Wichita, Kans............. 3 4 3 2

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

NOTE: All deaths by place of occurence.


SOUTH ATLANTIC:
Atlanta, Ga .............. 8 4 5 4
Baltimore, Md............ 4 8 11 14
Charlotte, N.C........... 3 5 7 1
Jacksonville, Fla........ 3 2 2 3
Miami, Fla............... 0 2 2 2
Norfolk, Va.............. 6 1 5 5
Richmond, Va............. 1 1 5 2
Savannah, Ga.............. 2 3 2 9
St. Petersburg, Fla...... 6 3 3 4
Tampa, Fla................. 2 0 2 2
Washington, D.C.......... 7 9 15 14
Wilmington, Del.......... 1 3 1 2

EAST SOUTH CENTRAL:
Birmingham, Ala.......... 2 1 2 4
Chattanooga, Tenn........ 7 3 7 4
Knoxville, Tenn.......... 2 0 0 2
Louisville, Ky............ 10 8 12 13
Memphis, Tenn............ 3 7 5 3
Mobile, Ala.............. 4 0 0 2
Montgomery, Ala.......... 3 1 1 6
Nashville, Tenn.......... 3 1 5 3

WEST SOUTH CENTRAL:
Austin, Tex............... 7 5 2 11
Baton Rouge, La.......... 4 1 1 2
Corpus Christi, Tex...... 0 0 1 0
Dallas, Tex.............. 4 4 12 1
El Paso, Tex............. 3 4 5 6
Fort Worth, Tex.......... 2 2 2 1
Houston, Tex............. 5 5 7 7
Little Rock, Ark......... 3 2 1 0
New Orleans, La.......... 5 9 3 3
Oklahoma City, Okla...... 2 2 0 2
San Antonio, Tex......... 8 6 10 8
Shreveport, La........... 5 4 4 5
Tulsa, Okla.............. 2 4 3 9

MOUNTAIN:
Albuquerque, N. Mex...... 5 7 8 2
Colorado Springs, Colo... 2 1 3 2
Denver, Colo............. 6 3 12 12
Ogden, Utah.............. 0 0 0 4*
Phoenix, Ariz............. 4 4 3 9
Pueblo, Colo............. 0 2 1 1
Salt Lake City, Utah..... 1 1 2 1
Tucson, Ariz............. 2 1 0 2

PACIFIC:
Berkeley, Calif.......... 2 0 0 0
Fresno, Calif............ 2 1 2 3*
Glendale, Calif.......... i 0 2 2
Honolulu, Hawaii.......... 1 0 2 0
Long Beach, Calif........ 1 0 0 1
Los Angeles, Calif....... 19 10 11 20
Oakland, Calif........... 4 4 3 5
Pasadena, Calif.......... 1 0 2 1*
Portland, Oreg........... 2 0 3 5
Sacramento, Calif........ 1 3 4 3*
San Diego, Calif......... 1 4 3 4
San Francisco, Calif ..... 6 4 6 6
San Jose, Calif.......... 3 3 1 7*
Seattle, Wash............. 6 1 5 3
Spokane, Wash............. 0 3 0 4
Tacoma, Wash.............. 2 2 3 1

San Juan, P.R............... 6 1 2 (---)


oCurrent Week Mortality for 108 Selected Cities


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


13,313
612
868
7,469




UNIVERSITY OF FLORIDA

3 1262 08lilIIII864 1500I
3 1262 08864 1500


Morbidity and Mortality Weekly Report


HEPATITIS CASES
traced to
Oregon bowling alley
Aug -Dec 1961


INTERNATIONAL NOTES QUARANTINE MEASURES

Immunization Information for International Travel
1962 edition
Public Health Service Publication No. 384
The following corrections should be made to the list of
Yellow Fever Vaccination Centers in Section 6:
PAGE 70
CITY: California, San Luis Obispo
CENTER: San Luis Obispa County Health Department


CLINIC HOURS
FEE:
PAGE 72
CITY:
CENTER:

CLINIC HOURS:
FEE:


2191 Johnson Avenue
Tel. LI 3-1200
Monday, 1-3 pm, by appointment
Yes

Indiana, Indianapolis
Indiana University Medical Center
1040 West Michigan Street
Tel. MElrose 4-8431, Ext. 441
Friday, 11-12 (CDT), by appointment
Yes


Confirmatory evidence was supplied by two cases
who had had minimal exposure at the bowling alley one
was a small boy, who had accompanied his mother to the
bowling alley and was given an orange drink; the second
was an older boy, who had stopped in for a drink of water
while on a bicycle trip.
The possible source case was an individual with on-
set of hepatitis on August 11, and who spent many hours,
up to 18 each day on the bowling alley premises, during
the prodromal and early infectious period of his illness
(August 4-18). During this time, the bowling center toilet
facilities were used by this patient for the disposal of
fecal and urinary wastes.
Water for the bowling establishment was supplied by
means of a well which was drilled in 1956. There was a
history of repeated troubles from excess amounts of air
and lowered water pressure in the water lines. Persons
interviewed told of dirty and foul-smelling water obtained
from all faucets, including the drinking faucet. Water
samples from all outlets showed contamination for both
Escherichia coli and Streptococcus fecalis.
The sewage disposal system consisted of a 1,000
gallon tank located on the opposite side of the building
from the well and an effluent line of unknown construction
to a tile field located in a former orchard behind this
building. The tile field reportedly consisted of four tile
lines, each 100 feet long. The exact location was not
determined but was assumed to be at least 50 feet from
the well.
(Reported by Dr. Grant Skinner, Epidemiologist, Oregon
State Board o/ Health.)