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:
AA00010654:00102

Related Items

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

Full Text





Morbidity and MortalitL


U. S. DEPARTMENT OF HEALTH, EDUCATION, AND WEI
PUBLIC HEALTH SERVICE


Prepared by the


FARE

63 FEB 1963 k!
634-5131 /7


For release January 25, 1963 ATLANTA 22, GEORGIA 12 7. 3
PROVISIONAL INFORMATION ON SELECTED NOTIFIABLE DISEASES IN THE UNITED!K D ON
DEATHS IN SELECTED CITIES FOR WEEK ENDED JANUARY 19, 1963


INFLUENZA Single isolations of A2 (Asian) influenza
virus have been reported from outbreaks of acute febrile
illness which have been occurring in Robeson County,
North Carolina, and in Baltimore, Maryland. These repre-
sent the first influenza isolates obtained from febrile
disease outbreaks during the current influenza season.
Reports of these outbreaks are given below.

EPIDEMIOLOGICAL REPORTS
Influenza Robeson County, North Carolina Follow-up
Report

Type A2 (Asian) Influenza virus has been recovered
from the throat washings of one acutely ill patient in the


current outbreak in Robeson County, North Carolina.
Throat washings of five additional patients have yielded
hemagglutinating agents which have not as yet been
fully identified. Further studies on these isolates and on
acute and convalescent sera are now in progress at the
Respirovirus Laboratory, CDC. The general characteris-
tics of the outbreak in Robeson County were described in
last week's MMWR. (Vol. 12, No. 2, page 9.)
New cases continued to be reported from all parts of
Robeson County during the past week. The outbreak
appeared to have passed its peak in the county seat of
Lumberton and in the neighboring communities of Fair-
mont and Pembroke, where local physicians noted a
gradual decreasing case load. Absentee rates in most


Table 1. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous week)
3rd Week Cumulative
Disease Ended Ended Median First 3 weeks
Disease Median
January 19, January 20, 1958 1962 Median
1963 1962 1963 1962 1958 1962
Aseptic meningitis................ 32 18 80 39
Brucellosis ..................... 6 7 11 12 21 33
Diphtheria ...................... 3 5 21 16 40 64
Encephalitis, infectious.......... 13 31 22 37 68 65
Hepatitis, infectious and serum... 1,183 1,598 735 2,944 4,155 2,098
Measles........................ 8,615 7,306 8,150 20,785 20,790 22,102
Meningococcal infections ......... 59 52 52 159 154 168
Poliomyelitis, total.............. 1 10 15 8 27 53
Paralytic.................... 1 8 9 7 15 34
Nonparalytic.................. 1 4 1 5 9
Unspecified ................. 2 7 10
Streptococcal sore throat
and Scarlet fever ............ 9,800 8,305 -- 23,467 21,871
Tetanus ....................... 2 1 --- 13 4
Tularemia...................... 3 6 -- 15 26
Typhoid fever ................... 5 8 11 12 15 22
Typhus fever, tick-borne,
(Rocky Mountain spotted)...... 1
Rabies in Animals............... 54 57 76 159 171 219

Table 2. NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. CUM.
Anthrax: Psittacosis: Utah-i, Calif.-1
Botulism: Rabies in Man:
Malaria: Hawaii-4, va.-1 5 Smallpox:
Plague: Typhus, murine:


I C NINL'NCABE ISESE LNIR


r 7 I ,' -/ /4 5








Morbidity and Mortality Weekly Report


SUMMARY OF REPORTED CASES OF INFECTIOUS SYPHILIS

DECEMBER 1962 AND DECEMBER 1961


CASES OF PRIMARY AND SECONDARY SYPHILIS:


By Reporting Area December 1962 and December


1961 Provisional Data


Reporting Area December Cumulative Reporting Area December Cumulative
1962 1961 1962 1961 1962 1961 1962 1961
NEW ENGLAND............... 52 64 551 577 EAST SOUTH CENTRAL......... 96 94 1,181 1,239
Maine .................. 2 2 10 8 Kentucky................. 12 17 135 186
New Hampshire............ 0 1 12 12 Tennessee................ 29 26 334 425
Vermont .................. 1 1 2 7 Alabama.................. 41 38 576 484
Massachusetts............ 32 44 341 396 Mississippi.............. 14 13 136 144
Rhode Island.............. 0 2 27 25
Connecticut............... 17 14 159 129 WEST SOUTH CENTRAL.......... 179 262 2,808 3,303
Arkansas................. 10 17 237 285
MIDDLE ATLANTIC............ 549 518 6,156 5,680 Louisiana................ 46 105 1,086 1,422
Upstate New York......... 58 47 642 583 Oklahoma ................. 19 13 160 95
New York City............ 277 294 3,335 3,384 Texas..................... 104 127 1,325 1,501
Pa. (Excl. Phila.)....... 9 21 162 197
Philadelphia............. 90 69 804 654 MOUNTAIN.................. 28 22 371 239
New Jersey............... 115 87 1,213 862 Montana.................. 1 0 8 3
Idaho..................... 0 0 4 9
EAST NORTH CENTRAL........ 201 142 1,824 1,789 Wyoming .................. 3 0 3 2
Ohio ..................... 41 23 342 247 Colorado.................. 7 5 72 28
Indiana.................. 8 4 95 91 New Mexico............... 9 8 77 53
Downstate Illinois....... 12 12 126 148 Arizona.................. 3 8 130 125
Chicago.................. 91 75 847 927 Utah...................... 0 0 7 5
Michigan.................. 43 24 352 313 Nevada................... 5 1 70 14
Wisconsin ................ 6 4 62 63
PACIFIC................... 186 166 1,910 1,674
WEST NORTH CENTRAL......... 31 35 405 396 Washington............... 10 6 44 86
Minnesota ................ 1 10 57 118 Oregon .................. 3 2 47 38
Iowa..................... 3 2 47 18 California............... 173 157 1,798 1,541
Missouri................. 19 16 190 179 Alaska................... 0 0 5 4
North Dakota............. 1 0 5 5 Hawaii................... 0 1 16 5
South Dakota.............. O 1 30 11
Nebraska ................. 5 1 25 14 U. S. TOTAL............... 1,752 1,723 21.143 19.851
Kansas................... 2 5 51 51
.ERRITORIES............... 39 38 513 414
SOUTH ATLANTIC............ 430 420 5,937 4,954 Puerto Rico................. 31 35 777 380
Delaware ................. 1 3 38 32 Virgin Islands........... 8 3 36 34
Maryland................... 35 56 516 532
District of Columbia..... 50 50 720 619
Virginia ................. 21 36 413 382
West Virginia............. 3 4 47 50
North Carolina............ 81 45 799 551 Note: Monthly figures for 1961 are estimated from quarterly
South Carolina........... 42 54 784 620 reports.
Georgia.................. 74 81 988 1,049 Cumulative Totals include revised and delayed reports
Florida.................. 123 91 1,632 1,119 through previous months.


schools serving these areas also fell from peak levels
of 15-30% during the school week ending January 11 to
approximately 3-8% when surveyed on January 21. During
the period of peak absenteeism, higher absentee rates
were generally observed in the elementary school grades,
as compared to high schools serving the same area.
An increased amount of respiratory illness is still
occurring in three communities located near the county's
northwestern boundary. The village of Maxton reported
peak absentee rates of 16 and 32% in two of its schools
when surveyed on January 21. At the same time, physi-
cians in nearby Red Springs and Parkton reported in-
creasing case loads and were observing a number of
cases among residents of adjacent Hoke and Cumberland
Counties. School and industrial absenteeism has re-
mained at normal levels in Red Springs and Parkton,
however, and there is as yet no evidence of extensive
spread of the epidemic beyond Robeson County.


No other outbreaks from the State of North Carolina
have come to attention.
(Reported by Jacob Koomen, M.D., M.P.H., Assistant State
Health Director, North Carolina State Board of Health and
E. R. Hardin, M.D., County Medical Director, Robeson
County, Lumberton, North Carolina.)


Influenza Maryland

Baltimore, Maryland, for the last several weeks has
been experiencing sharp outbreaks of acute febrile ill-
ness. An increasing number of visits for febrile illness
has been noted at the Pediatric and Adult Out-Patient
Clinics of a large hospital, while distinct outbreaks have
been noted in the State Penitentiary and in several
schools. An A2 influenza virus has been isolated. The
illness has been characterized by acute onset of chills,
fever and headache, generally followed by myalgia and
weakness, and lasting 3-4 days. A dry cough has occurred








Morbidity and Mortality Weekly Report


in most cases. Sore throats and gastrointestinal com-
plaints have not been part of the clinical picture.
Since the fifth of January, there has been an in-
creasing number of visits to the Pediatric and Adult Out-
Patient Clinics at one large hospital. The peak in number
of visits occurred on January 17, with a slight fall in
cases since that day. Throat washings from five children
seen at the clinic yielded hemagglutinating agents in
two instances. One of these was shown to be Type A2
influenza virus.
Several schools in the Baltimore area have recently
experienced abrupt outbreaks of febrile illnesses clini-
cally compatible with influenza. One high school in
South Baltimore, with 1200 students, showed the fol-
lowing absentee rates: January 14 3%; 15 3%; 16 -
13%; 17 20%; 18 School closed; and 21 2%.
The Maryland State Penitentiary in Baltimore has
also been experiencing a sharp outbreak. The disease
is similar to that occurring in the school system, but
appears to be milder. Approximately 121 cases from the
1600 population have occurred since the beginning of
the year, with most cases within the last two weeks.


Number of cases by week are shown below:
Week Ending
12/30


No. of Cases
0


1/27 (data available 34
through 1/23)
Additional surveys and laboratory studies are in progress.
(Reported by John H. Janney, M.D., Acting Chief, Divi-
sion of Epidemiology, Maryland Department of Health.)



Diphthera Outbreak Iowa

Twelve cases of diphtheria among children 2 to 14
years of age occurred in Sioux City, Iowa between Sep-
tember 10 and September 27, 1962. All children presented
with sore throat, fever and inflamed tonsils or pharynx.
All were hospitalized; one death occurred in a 10-year-old
girl who had onset of sore throat and fever on September

(Continued on page 24)


DEATHS UNDER ONE YEAR OF AGE IN 108 U.S. CITIES

The weekly average number of infant deaths in 108
cities for the four-week period ending January 19 was
769 as compared with an expected 783 weekly average.


WEEK ENDING 4 Week Weekly
12/29 1/5 1/12 1/19 Total Average
Observed 614 764 869 828 3,075 769
Expected 785 784 782 780 3,131 783
Excess -171 -20 87 48 -56 -14


DEATHS UNDER ONE YEAR OF AGE IN 108 U.S. CITIES
Average number per week by four-week periods


I 1960 1 1961 1 1962 1 1963


ay PILCc D OCCUR


NUMBER

OF

DEATHS





PERIOD N
V'.
PERIOD NO


(See Table, page 23)


C~LNYIWFRYI ~s~-.I ~PLIIEKE











20 Morbidity and Mortality Weekly Report


Table 3. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

JANUARY 26, 1962 AND JANUARY 19, 1963



Poliomyelitis, Aseptic
Poliomyelitis, total cases Poliomyelitis, paralytic nonparalytic Meningitis
Cumulative Cumulative
Area
3rd week First 3 weeks 3rd week First 3 weeks 3rd week 3rd week
1963 1962 1963 1962 1963 1962 1963 1962 1963 1962 1963 1962


UNITED STATES..... 1 10 8 27 1 8 7 15 1 32 18

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

MIDDLE ATLANTIC.......... 6 14 5 8 4
New York............... 6 14 5 8 1
New Jersey............ -
Pennsylvania 3

EAST NORTH CENTRAL ....... 1 4 1 1 3 1 3 2
Ohio.................. 1 2 1 1 1 1
Indiana.............. -
Illinois ............. 2 2
Michigan............ 3 2
Wisconsin ...............

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

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

EAST SOUTH CENTRAL....... 1 1 6 3
Kentucky............... .. 4 1
Tennessee ........... .-
Alabama ............... 1 1 1
Mississippi........... 2 1

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

MOUNTAIN................. 2 1 6 1
Montana ............... 2 1 -
Idaho................. ..
Wyoming...............
Colorado.............. 5 1
New Mexico ............
Arizona.................
Utah.................. -
Nevada................

PACIFIC.................. 2 2 4 2 2 2 8 7
Washington............ ..- 1
Oregon................ -
California............ 2 2 4 2 2 2 8 6
Alaska................ .
Hawaii.................

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









Morbidity and Mortality Weekly Report 21


Table 3. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

JANUARY 20, 1962 AND JANUARY 19, 1963 (Continued)



Brucellosis Diphtheria Encephalitis, Hepatitis, Measles
infectious infectious and serum
Area
Area Cumu- Cumu- 3rd week
lative lative Under 20 &
3rd week 3 weeks 3rd week 3 weeks 3rd week 20 yr. over Total 3rd week
1963 1963 1963 1963 1963 1962 1963 1963 1963 1962 1963 1962
UNITED STATES...... 6 12 3 16 13 31 695 401 1,183 1,598 8,615 7,306

NEW ENGLAND.............. 2 106 52 159 109 315 1,172
Maine.................. 1 48 13 61 37 43 317
New Hampshire......... 7 6 14 15 1 52
Vermont ............... 2 1 3 1 34 31
Massachusetts......... 30 20 50 45 65 523
Rhode Island.......... 1 2 3 5 5 37 94
Connecticut........... 17 9 26 6 135 155

MIDDLE ATLANTIC.......... 2 1 2 11 118 107 225 181 656 962
New York............... 2 1 1 6 63 55 118 91 338 489
New Jersey............. 14 22 36 41 79 322
Pennsylvania .......... 1 5 41 30 71 49 239 151

EAST NORTH CENTRAL ....... 3 2 107 73 185 335 4,148 1,337
Ohio................... 2 1 22 34 58 127 298 137
Indiana............... 16 3 19 36 151 80
Illinois.............. 1 12 4 18 61 100 710
Michigan .............. 1 50 31 81 99 1,247 230
Wisconsin............. 7 1 9 12 2,352 180

WEST NORTH CENTRAL....... 6 8 4 2 1 31 16 50 176 595 139
Minnesota ............. 1 1 8 5 15 59 149 24
Iowa .................. 6 7 1 3 3 59 272 63
Missouri................ 7 4 12 30 31 12
North Dakota.......... 1 3 134 35
South Dakota.......... 2 1 1 2 1 9 5
Nebraska.............. 1 4 2 6 1 -
Kansas................ 1 8 4 12 23 NN NN

SOUTH ATIANTIC........... 3 9 1 1 85 30 127 175 652 902
Delaware.............. 1 1 2 15 8
Maryland................ 1 3 1 4 14 21 88
District of Columbia.. 6 6 1 24
Virginia.............. 1 1 18 9 32 37 65 375
West Virginia......... 1 21 2 23 15 497 257
North Carolina ....... 1 1 32 11 43 54 16 17
South Carolina........ 1 4 2 7 16 24 9
Georgia.............. 1 1 2 2 4 8 30
Florida .............. 5 5 2 7 23 13 94

EAST SOUTH CENTRAL ....... 1 1 1 101 34 146 281 291 749
Kentucky ............. 37 48 116 101 102
Tennessee............. 1 48 14 62 84 171 539
Alabama............... 1 1 12 12 24 34 17 38
Mississippi........... 4 8 12 47 2 70

WEST SOUTH CENTRAL....... 3 43 21 64 109 262 1,149
Arkansas............... 1 2 9 3 12 38 42 26
Louisiana............. 3 2 5 6 6 7
Oklahoma.............. 6 3 9 4 1 11
Texas................. 1 25 13 38 61 213 1,105

MOUNTAIN ................ 1 1 39 11 96 88 943 314
Montana............... 11 1 13 3 221 138
Idaho................. 24 21 103 19
Wyoming............... -
Colorado ............. 11 24 17 244 75
New Mexico............ 1 9 6 15 12 NN NN
Arizona............... 8 21 131 63
Utah .................. 1 8 4 12 13 240 18
Nevada................ 1 4 1

PACIFIC.................. 5 9 65 57 131 144 753 582
Washington ........... 1 10 7 17 20 167 -
Oregon................ 9 18 15 179 123
California............ 5 8 46 46 92 105 281 351
Alaska................ 3 5 105
Hawaii................ 4 4 1 121 3

Puerto Rico.............. 4 19 48










22 Morbidity and Mortality Weekly Report


Table CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

JANUARY 20, 1962 AND JANUARY 19, 1963 (Continued)


Meningococal Streptococcal Tickborne
Infections Sore Throat & Tetanus Typhus Tularemia Typhoid Fever Rabies in Animals
Scarlet Fever (Rcky Mt.
Area Cumu- Spotted) Cumu- Cumu-
lative lative lative
3rd wk. 3 weeks 3rd week 3rd wk. 3rd wk. 3rd wk. 3rd wk. 3 weeks 3rd week 3 weeks
1963 1963 1963 1962 1963 1963 1963 1963 1963 1963 1962 1963

UNITED STATES.... 59 159 9,800 8,305 2 3 5 12 54 57 159

NEW ENGLAND......... 1 14 740 436 -
Maine............... 2 81 7 -
New Hampshire...... 8 6 -
Vermont............. 1 7 20 -
Massachusetts...... 1 4 120 162 -
Rhode Island....... 3 89 23 -
Connecticut........ 4 435 218 -

MIDDIE ATLANTIC..... 7 15 526 418 3 3 2 7
New York........... 2 6 300 264 3 3 2 7
New Jersey ........ 129 79 -
Pennsylvania....... 5 9 97 75 -

EAST NORTH CENTRAL.. 9 24 2,202 659 9 3 23
Ohio............... 3 7 117 104 4 11
Indiana............ 1 4 179 108 2 3 3
Illinois........... 2 1,411 99 -
Michigan........... 4 6 279 206 2 7
Wisconsin.......... 1 5 216 142 1 2

WEST NORTH CENTRAL.. 4 7 202 328 1 9 28 37
Minnesota........... 1 1 16 43 6 11
Iowa............... 96 88 3 16 10
Missouri........... 1 2 3 41 3 7
North Dakota....... 1 1 72 86 2
South Dakota ...... 1 1 3 6 7
Nebraska........... 1 2 -
Kansas............. 14 70 1 -

SOUTH ATLANTIC...... 8 36 859 795 1 2 9 7 28
Delaware........... 4 4
Maryland........... 4 22 13 -
Dist. of Columbia.. 1 4 -
Virginia........... 1 8 310 223 1 2 11
West Virginia...... 2 5 264 109 3 2 6
North Carolina..... 2 6 61 55 1 1 2
South Carolina..... 1 2 98 216 -
Georgia............ 2 10 -
Florida............ 2 10 94 165 1 5 3 9

EAST SOUTH CENTRAL.. 6 13 1,351 1,268 1 1 2 2 4 7 15
Kentucky........... 2 6 176 117 1 3 2 4
Tennessee.......... 3 6 1,119 985 1 2 2 1 5 11
Alabama............. 1 1 15 41 -
Mississippi........ 41 125 -

WEST SOUTH CENTRAL.. 9 19 871 966 1 2 13 6 28
Arkansas........... 2 2 6 1 2 4
Louisiana.......... 1 3 8 2 1 1 2
Oklahoma............ 4 5 26 1 3 3
Texas.............. 2 9 837 957 1 7 6 19

MOUNTAIN............ 2 6 1,811 1,803 1 2 1
Montana............. 138 45 -
Idaho.............. 208 498 -
Wyoming............ 47 5 -
Colorado........... 2 574 411 -
New Mexico......... 493 415 1 -
Arizona............. 1 101 246 1 1 1
Utah................ 2 3 249 179 -
Nevada............. 1 4 -

PACIFIC ............. 13 25 1,238 1,632 1 2 2 6 2 20
Washington......... 2 2 410 686 -
Oregon............. 1 2 14 56 1
California......... 9 18 787 824 1 2 2 6 2 19
Alaska............. 1 3 11 35 -
Hawaii.............. 16 31 -
Puerto Rico......... 2 -









Morbidity and Mortality Weekly Report 23





Table 4 (C). TOTAL DEATHS UNDER 1 YEAR OF AGE 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
12/29 1/5 1/12 1/19 12/29 1/5 1/12 1/19


NEW ENGLAND:
Boston, Mass.............. 19 9 16 12
Bridgeport, Conn.......... 2 6 1 2
Cambridge, Mass........... 0 0 0 2
Fall River, Mass........... 2 3 1 1
Hartford, Conn............. 6 11 1 7
Lowell, Mass.............. 0 3 0 3
Lynn, Mass................. 0 0 0 0
New Bedford, Mass......... 0 1 0 1
New Haven, Conn............ 0 3 1 8
Providence, R.I........... 2 3 3 4
Somerville, Mass.......... 0 0 0 0
Springfield, Mass......... 0 2 0 1
Waterbury, Conn............ 2 2 1 1
Worcester, Mass............ 5 3 2 5

MIDDLE ATLANTIC:
Albany, N.Y................ 1 2 3 4
Allentown, Pa............. 1 1 0 4
Buffalo, N.Y............... 1 16 12 7
Camden, N.J............... 3 3 5 4
Elizabeth, N.J............ 2 1 0 3
Erie, Pa.................. 6 2 3 1
Jersey City, N.J.......... 1 7 1 4
Newark, N.J............... 5 4 5 12*
New York City, N.Y......... 83 106 102 81
Paterson, N.J............. 7 7 1 9
Philadelphia, Pa.......... 7 9 16 67
Pittsburgh, Pa............ 4 6 11 10
Reading, Pa............... 0 1 1 1
Rochester, N.Y............. 10 8 9 7
Schenectady, N.Y.......... 0 0 1 0
Scranton, Pa.............. 1 1 0 2
Syracuse, N.Y.............. 3 1 7 5
Trenton, N.J.............. 3 4 4 4
Utica, N.Y................. 0 2 1 2
Yonkers, N.Y.............. 1 0 2 2

EAST NORTH CENTRAL:
Akron, Ohio ............... 4 2 2 6
Canton, Ohio.............. 3 1 1 3
Chicago, Ill.............. 39 61 74 30
Cincinnati, Ohio.......... 7 12 22 11
Cleveland, Ohio........... 19 12 24 10
Columbus, Ohio ............ 7 8 8 19
Dayton, Ohio............... 2 2 3 4
Detroit, Mich............. 19 19 21 20
Evansville, Ind........... 0 2 1 4
Flint, Mich............... 2 6 5 5
Fort Wayne, Ind........... 2 1 2 1
Gary, Ind................. 0 2 4 1
Grand Rapids, Mich........ 2 1 4 8
Indianapolis, Ind......... 4 8 13 11
Madison, Wis.............. 3 6 5 4
Milwaukee, Wis............ 6 2 10 6
Peoria, Ill............... 4 5 0 0
Rockford, Ill............. 2 2 1 1
South Bend, Ind........... 1 1 1 2
Toledo, Ohio.............. 4 7 4 4
Youngstown, Ohio.......... 2 2 3 2

WEST NORTH CENTRAL:
Des Moines, Iowa.......... 0 1 3 1
Duluth, Minn.............. 0 1 0 1
Kansas City, Kans......... 3 2 7 3
Kansas City, Mo........... 8 6 6 11
Lincoln, Nebr................ 1 0 5 3
Minneapolis, Minn......... 7 13 5 5
Omaha, Nebr .............. 5 5 5 7
St. Louis, Mo............. 9 16 14 7
St. Paul, Minn............ 3 4 9 5
Wichita, Kans.............. 1 9 7 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..............
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.............


10
16
5
2
1
10
15
3
3
8
25
0


10*
5
3
23
14
5
5
8


4
2
4
12
7
12
8
4
12
5
11
1
7


6
5
15
1
6
2
11
2


0
3*
0
6
2
37
1
1
5*
4*
8*
5
3
6*
1
1*


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


12,632
633
828
7,203




UNIVERSITY OF FLORIDA


3 1262 08864 1492


24 Morbidity and Mortality Weekly Report




10 and who subsequently developed respiratory and renal p INTERNATIONAL NOTES- QUARANTINE MEASURES
difficulties; she died on September 21. Cultures from all
No additional pertinent information or changes.
cases were reported positive for C. diphtheria toxigenic


gravis strains.
Five of the 12 cases had received no diphtheria vac-
cination while the immunizations of three others were
considered inadequate. An immunization survey approxi-
mately four months before the outbreak showed that 91
percent of Sioux City public school children through the
sixth grade had received a diphtheria series or booster
within the past 5 years.
All cases occurred in students or siblings of students
attending a junior high school or an elementary school
which sends its students to the junior high. Cultures of
siblings of cases at the junior high school revealed car-
riers at a second elementary school. Throat culture sur-
veys of the junior high and the two grade schools were
carried out between September 26 and September 28.
Twelve hundred and fifty students and teachers at these
schools were cultured. A total of 33 positives (2.6%) were
found in the three schools. Carriers were found in each
of the nine classrooms in which cases of diphtheria had
occurred. In addition, there were 19 classrooms of ap-
proximately 25 students each in which one or more car-
riers were found while 24 classrooms yielded no positive
cultures. An additional 1986 throat cultures were taken
from children in three other Sioux City schools shortly
after the initial school survey. These three schools had
had no cases of diphtheria reported. No positive cultures
were found among the 1986 throat cultures.
Contacts of cases and carriers were cultured and
observed. Fifteen additional carriers were found in this
way among families of cases and carriers. For all car-
riers, therapy was instituted as soon as possible after a
positive culture report and consisted in most instances of
a course of penicillin. Known carriers were placed under
quarantine until two successive cultures at least 24 hours
apart were negative. The families of the carriers were
restricted in their activities while contacts of the car-
riers were permitted full activity but kept under surveil-
lance until culture reports were returned.
Further investigation failed to reveal the original
source of the outbreak.
(Reported by Dr. Ralph Heeren, Deputy Commissioner of
Public Health, Iowa State Department of Health; Mr. T. E.
Corrothers, Director, Sioux City Health Department; Dr.
William Hausler, Jr., Assistant Director, State Health
Department Hygienic Laboratory; and a team from the
Communicable Disease Center.)


Notes: Thla. p=rvl.ant dse ar based o weekly telesgu to the Commelb-
cable Diesee Ce ter by tnhe idlvide l State. heal departments.
Symbols: --- Dta noet .allble
Qulrtr tro
Procedusa for construction of v*ri.o mortality cuves m*ay be obtked fr
Stisetle.c Sectao, Commulcble Dies.e Ceeter, Public Health Serice.
U. S Department of Helth, Educatin., ad Welfare. Atlmts 212 Georgie.


- 1*


m
>
Im







1 0 > m



r-r
a n






Cl













Ot!a