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:
AA00010654:00107

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


634.5131


For release May 31, 1963 ATLANTA 22, GEORGIA Vol. 12, No. 21
PROVISIONAL INFORMATION ON SELECTED NOTIFIABLE DISEASES IN THE UNITED STATES AND ON
DEATHS IN SELECTED CITIES FOR WEEK ENDED MAY 25, 1963


POLIOMYELITIS Reported this week was but one case
of paralytic poliomyelitis. It is notable that both total
and paralytic cases thus far reported during 1963 repre-
sent less than half the number recorded during a compar-
able period in 1962. Of the 47 paralytic cases this year,
11 are from Louisiana, but, of these 11, nine represent
delayed reports of cases with onsets in 1962

POLIOMYELITIS CUMULATEDD WEEKLY) THROUGH 21ST WEEK

1963 1962 1961 1960 1959
Paralytic Cases 47 95 113 225 370
Total Cases 53 130 169 312 530
Annual Total 902* 1312 3190 8425
* Provisional


SALMONELLA DERBY EPIDEMIC The interstate hos-
pital-associated outbreak of Salmonella derby infections
(See MMWR, Vol. 12, pages 159, 167) on further appraisal
appears to have some significant, although as yet unde-
fined, communi mpone of May 29, a total of 23
different ho s in living 12 separate com-
munities hm .o orted 121 ca s ,here are, in addition
40 cases StateP nd the Di r c of Columbia, which
clearly ot hos g-acquire a an additional 67
cases u rL nvestigatil All e ide biological evidence
strongly ests a co lon-s6st epidemic pattern.
Intensive t tion by S 't al and Federal offi-
cials is coil s still obscure.
A summary ~solates from symptomatic


Table 1. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous week)
21st Week Cumulative
Disease Ended Ended First 21 weeks
Disease Median
May 25, May 26 1958 1962 Median
1963 1962 1963 1962 1958 1962
Aseptic meningitis................ 20 20 --- 463 395 --
Brucellosis ..................... 6 10 10 136 158 293
Diphtheria ...................... 2 4 11 111 194 297
Encephalitis, infectious .......... 34 52 35 600 616 600
Hepatitis, infectious and serum... 747 1,129 773 20,330 27,395 16,286
Measles........................ 15,956 19,652 18,515 279,431 353,585 300,747
Meningococcal infections......... 50 46 39 1,223 1,030 1,138
Poliomyelitis, total.............. 1 7 13 53 130 312
Paralytic.................... 1 3 10 47 95 225
Nonparalytic................. 4 2 2 19 54
Unspecified ................. 1 4 16 33
Streptococcal sore throat
and Scarlet fever ............ 6,161 6,460 --- 190,085 173,703 .
Tetanus ........................ 6 9 --- 81 69 ..
Tularemia ...................... 8 5 --- 80 97 .
Typhoid fever ................... 10 21 14 146 180 218
Typhufs fever, tick-borne,
(Rocky Mountain spotted)...... 6 3 --- 18 22
Rabies in Animals............... 77 66 74 1,664 1,789 1,720

Table 2. NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. CUm.
Anthrax: 1 Psittacosis: Ga.-2 27
Botulism: 5 Rabies in Man:
Mhsl ar, 39 Smallpox:
Piague- Typhus, murine: 3


W el


f5s a bD/'y. 1/ 0/










Morbidity and Mortality Weekly Report


primary cases, by hospital, is shown in Table 1. Most of
the involved hospitals are, thus far, in the Northeastern


TABLE 1
SUMMARY OF SALMONELLA DERBY ILLNESSES BY HOSPITALS
(Primary Cases)

Confirmed Under Dates of Onset
Hospital Cases Investigation (Confirmed Cases)
New York
1 6 0 3/10- 3/29
2 4 0 4/20-5/16
3 6 0 4/14 5/2
4 2 0 3/25-4/2
5 7 4 3/10- 5/10
6 7 0 4/21 -5/15
7 2 0 4/7- 4/26
New Jersey
1 1 1 4/13
2 4 0 5/5- 5/19
3 1 0 5/16
Indiana
1 1 0 4/10
Pennsylvania
1 12 1 4/11 5/1
2 5 21 4/16 4/21
3 3 0 5/7 -5/23
4 21 0 3/3-4/22
5 2 0 5/9 5/15
6 0 1
7 2 0 5/26
Connecticut
1 1 0 5/2
Delaware
1 1 1 4/23
Ohio
1 1 0 5/8
2 1 0 5/6
Rhode Island
1 2 0 4/23 -5/1
Totals 92 29



TABLE 2
SALMONELLA DERBY ISOLATIONS BY STATE (Since March 1)

Hospital-Associated Not Under
State Isolates Hospital-Associated Investigation
Ala. 1
Cal if. 9
Conn. 1
Del. 1 1
Go. 1
III. 1
Ind.
Md. 1
Mass. 5 4
Mich. 2 1
Minn, 1
Mo. 1
N. J. 6 1
N. Y. 34 3 7
N.C. 3
Penna. 101 12 26
Ohio 2 4
R. 1. 2 1
Texas 1
Va. 1
Wash. 3
D. C. 1 2
Wiec. 1
Hawaii 12


States; dates of onset of confirmed cases range from
March 10 through May 26. Since March 1, 23 States and the
District of Columbia have reported one or more isolates
of S. derby. Since a continuing low frequency of occur-
rence of S. derby isolates has been observed during
recent years, it is doubtful that all of these are related to
the current outbreak although detailed appraisal of each
is being sought.


INTERNATIONAL NOTES -

Smallpox Stockholm

Four additional cases of smallpox have been identi-
fied in Stockholm with onsets of illness since May 18. All
four presumably acquired their disease as a result of
hospital contact.
The outbreak (See MMWR, Vol. 12, page 172) now
totals 16 cases, with three generations of transmission
following the importation of smallpox by a seaman who
presumably acquired his disease in transit through South-
east Asia. Information on cases to date received from
Dr. Bo Zetterberg, Chief, Epidemiology Division, State
Bacteriology Laboratory, Stockholm, is summarized in
the table below:

SMALLPOX STOCKHOLM
SUMMARY OF CURRENT INFORMATION ON CASES


Case Date of
No. Aye Sex Onset
1 24 M April6
2 58 F April 18
3 80 F April 21
4 24 F April 25
5 20 F Not known
6 53 M May 3
*7 19 M May 5
8 50 F May 5
9 55 F May 5
10 67 F Moy 6 or
11 72 F Moy 8
12 22 M May 11
13 61 M May 18
14 1h F May 19
15 72 F May 24
16 75 F 7 May 24


Presumed Source Last
of Infecion Vocclintion
Southest Asiao 1959
Cose 1 Childhood
Cose eA Childhood
Case A1 1943
Case a1 1950
Case 2 1920
Case a2 Never
Case 0 Childhood
Caso a 1916
SCose a 1918
Case 3 1915
Cose A4 1961
Cose or 6 1949"*
? Case Never"
Case a9 Childhood"
Cose 19 Childhood*


Comment
Modified Illness
Died April 23

Modified Illness
No rosh (Lob diagnosis)
Husband of Case A
Died May 28
Home Nurse of Cose 3
Home Nurse of Cose 1

No known direct contact
Laboratory diagnosis only
Hospital acquired
Hospairocquired
Hospital acquired -
Died May 27
Hospital acquired


*First identified case.
**Revaccinated within 8 days of onset.

The pattern of spread of the illness is presented
diagrammatically in the accompanying figure.
The first case to be identified occurred in an unvac-
cinated 19-year-old bricklayer (Case 7) who had onset of
fever, vomiting, and backache on May 5. He was hospital-
ized three days later and subsequently developed an ex-
tensive maculo-papular rash which became pustular by
May 12. Smallpox was suspected and confirmed the follow-
ing day by the laboratory.
Immediate epidemiologic investigation revealed that
an aunt of the bricklayer (Case 2) had developed on April
18 an acute febrile illness, manifest by hemorrhagic skin
lesions, and had died shortly after admission to the hos-
pital on April 23. Ten other cases of smallpox were identi-
fied May 14-16.


174









Morbidity and Mortality Weekly Report


SMALLPOX- STOCKHOLM 1963
DIAGRAMMATIC REPRESENTATION OF THE OUTBREAK


LEGEND:
? CASE
CASE= AGE SEX
DATE ONSET

..... PRESUMED CONTACT
FATAL CaXE
.L__


The original source of the outbreak was a 24-year-old
seaman who after two weeks residence in Australia left
Darwin on March 22 on BOAC Flight #709. In-transit
stops of not more than 50 minutes each were made in
Djakarta, Singapore, Rangoon, Calcutta, Karachi, Teheran,
and Damascus enroute to Zurich. At Zurich, the seaman
deplaned and the following day boarded Swissair Flight
#250, reaching Stockholm March 24. He apparently ac-
quired his disease as a result of in-transit exposure
either at a terminal or on the plane. On April 6, 15 days
after the flight, he developed a moderate fever and mild
rash and remained in the home of his grandmother(Case 3)
throughout his illness. Cases 2, 3, 4, and 5 all had con-
tact with him in the grandmother's home during the course
of his illness. On April 21, the grandmother fell ill, sub-
sequently exposing three women (Cases 8-10) who visited
the home to provide nursing care to the elderly woman
prior to her hospitalization on May 27. She was originally
diagnosed as having chickenpox and recovered unevent-
fully. Another resident of the building (Case 11) who
lived two stories above the grandmother, developed small-
pox but denied acquaintance or contact with the grand-
mother.
Case 2, the first fatality, apparently acquired the ill-
ness from the seaman during a visit to the grandmother's
apartment and subsequently transmitted it to her husband
(Case 6) and her nephew(Case 7) the first identified case.
(Continued on page 176)


TOTAL DEATHS REPORTED IN 108 CITIES

The weekly average number of total deaths in 108
cities for the four-week period ending May 25 was 11,369
as compared with an expected weekly average of 11,375.


TOTAL DEATHS RECORDED IN 108 US CITIES


NULMER
OF
DEATHS


I I I I


(See table page 175)


WEEK ENDING 4 Week Weekly
5/4 5/11 5/18 5/25 Total Average
Observed 11,769 11,416 11,196 11,093 45,474 11,369
Expected 11,504 11,417 11,331 11,247 45,499 11,375
Excess 265 1 -135 -154 -25 -6










176 Morbidity and Mortality Weekly Report



Table 3. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

MAY 25, 1963 AND MAY 26, 1962



Poliomyelitis, Aseptic
Poliomyelitis, total cases Poliomyelitis, paralytic nonparalytic Meningitis
Cumulative Cumulative
Area 21st week First 21weeks 21st week First 21 weeks 21st week 21st week

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


UNITED STATES...... 1 7 53 130 1 3 47 95 4 20 20

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

MIDDLE ATLANTIC.......... 6 30 6 17 3 1
New York............... 4 30 4 17 1
New Jersey............ 1 1 -
Pennsylvania ........ 1 1 3

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

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

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

EAST SOUTH CENTRAL ....... 1 3 4 2 2 1 5 1
Kentucky.............. 1 1 1
Tennessee............. 1 1 2 1 1 1
Alabama............... 2 1 1 1-
Mississippi.......... 4 -

WEST SOUTH CENTRAL....... 1 4 13 44 1 1 13 37 3 3 1
Arkansas.............. 1 1
Louisiana............. 1 11 5 1 11 5
Oklahoma................ 1 1 1 1
Texas................. 3 2 37 1 2 31 2 2 1

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

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

Puerto Rico............... 1 3 5 3 5










Morbidity and Mortality Weekly Report 177


Table 3. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

MAY 25, 1963 AND MAY 26, 1962 (Continued)



Brucellosis Diphtheria Encephalitis, Hepatitis, Measles
infectious infectious and serum
Area
Cumu- Cumu- 21st week
lative lative Under 20 &
21st week 21 weeks 21st week 21 weeks 21st week 20 yr. over Total 21st week
1963 1963 1963 1963 1963 1962 1963 1963 1963 1962 1963 1962
UNITED STATES...... 6 136 2 111 34 52 392 305 747 1,129 15,956 19,652

NEW ENGIAND .............. 4 1 31 19 51 61 607 2,439
Maine................. 17 7 24 13 24 249
New Hampshire.......... 1 1 2 1 11
Vermont............... 1 1 69 146
Massachusetts......... 2 7 8 16 28 257 991
Rhode Island.......... 2 1 3 73 143
Connecticut........... 5 3 8 16 184 899

MIDDLE ATLANTIC.......... 4 19 8 11 75 64 139 158 2,016 3,584
New York............... 3 13 4 8 48 39 87 92 798 2,151
New Jersey............ 1 6 6 12 31 578 1,166
Pennsylvania .......... 1 5 4 3 21 19 40 35 640 267

EAST NORTH CENTRAL....... 10 11 2 1 75 44 124 208 6,500 4,168
Ohio.................. 1 17 10 28 46 555 843
Indiana................ 1 3 6 5 12 25 264 496
Illinois.............. 8 3 14 12 27 54 474 676
Michigan.............. 1 3 2 1 36 15 53 76 2,939 1,642
Wisconsin ............. 1 2 2 4 7 2,268 511

WEST NORTH CENTRAL....... 3 98 31 1 17 24 14 42 105 653 435
Minnesota............. 7 15 1 2 1 3 23 88 82
Iowa .................. 2 71 1 16 2 2 40 178 185
Missouri.............. 4 1 9 11 23 20 296 19
North Dakota........... 1 6 6 3 84 101
South Dakota.......... 1 5 9 1 4 4 1 3 45
Nebraska.............. 5 4 1 4 4 3
Kansas................ 6 3 3 14 NN NN

SOUTH ATLANTIC........... 2 1 21 3 5 46 26 75 148 1,911 1,136
Delaware.............. 1 1 62 20
Maryland.............. 1 1 7 11 18 11 85 176
District of Columbia.. 1 1 3 6 2
Virginia .............. 2 3 4 8 24 633 287
West Virginia........ 1 1 13 4 19 17 908 408
North Carolina........ 1 1 2 15 2 17 60 75 30
South Carolina........ 4 2 2 7 51 25
Georgia............... 1 7 2 1 3 5 37
Florida............... 1 8 1 4 2 6 21 91 151

EAST SOUTH CENTRAL ....... 1 4 9 53 32 85 151 932 1,667
Kentucky......... ..... 11 6 17 105 501 602
Tennessee............. 1 3 2 26 14 40 32 360 957
Alabama............... 1 7 7 4 11 9 44 60
Mississippi............ -- 9 8 17 5 27 48

WEST SOUTH CENTRAL....... 9 13 1 3 18 22 43 79 632 2,218
Arkansas ............. 3 1 1 1 1 2 3 5 40 50
Louisiana............. 2 3 2 5 13 3
Oklahoma.............. 2 5 1 1 6 9 80
Texas................. 4 5 2 14 17 34 55 583 2,085

MOUNTAIN ................. 3 1 3 2 4 5 42 82 1,302 1,475
Montana................. 1 1 3 74 348
Idaho................. 9 8 172 35
Wyoming............... 1 1 1 1, 1 81
Colorado............... 1 14 11 244 511
New Mexico............. 1 3 4 NN NN
Arizona................ 1 8 53 613 378
Utah................... 1 3 1 3 3 6 2 114 200
Nevada ................ 4 3

PACIFIC...................... 2 6 1 2 16 12 66 79 146 137 1,403 2,530
Washington............. 1 1 10 13 24 23 159 798
Oregon ................ 1 2 8 10 18 21 169 613
California............ 3 1 2 15 11 48 56 104 89 989 1,011
Alaska................. 3 10 6
Hawaii................ 1 1 1 76 102

Puerto Rico.............. 9 11 5 16 26 10 183










178 Morbidity and Mortality Weekly Report


Table 3. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

MAY 25, 1963 AND MAY 26, 1962 (Continued)


Meningococcal 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
21st wk. 21 weeks 21st week 21st wk. 21st wk. 21st wk. 21st wk. 21 weeks 21st week 21 weeks
1963 1963 1963 1962 1963 1963 1963 1963 1963 1963 1962 1963

UNITED STATES.... 50 1,223 6,161 6,460 6 6 8 10 146 77 66 1,664

NEW ENGLAND.......... 2 79 873 603 6 17
Maine.............. 1 13 11 169 1
New Hampshire...... 2 3 2 12
Vermont............ 2 12 12 1 4
Massachusetts...... 37 122 79 4 -
Rhode Island....... 7 61 28 -
Connecticut........ 1 18 664 313 -

MIDDLE ATLANTIC..... 3 173 431 341 1 1 1 18 2 44
New York........... 75 286 190 1 14 2 33
New Jersey......... 25 93 75 1 -
Pennsylvania....... 3 73 52 76 1 1 3 11

EAST NORTH CENTRAL.. 11 199 697 627 1 8 13 22 253
Ohio............... 3 57 83 70 2 7 13 151
Indiana............ 24 69 69 1 2 7 26
Illinois........... 1 26 104 115 1 3 3 1 36
Michigan........... 5 66 270 223 1 1 26
Wisconsin.......... 2 26 171 150 1 1 14

WEST NORTH CENTRAL.. 1 72 145 170 1 2 1 9 21 12 382
Minnesota.......... 1 13 16 16 3 8 1 102
Iowa............... 4 39 32 1 4 6 137
Missouri........... 26 8 7 1 2 1 5 4 2 70
North Dakota....... 3 68 65 1 3 11
South Dakota....... 4 4 3 49
Nebraska............ 17 1 5
Kansas............. 5 10 50 8

SOUTH ATLANTIC..... 7 221 460 516 2 1 30 12 6 276
Delaware........... 1 9 1 -
Maryland........... 33 36 21 3 -
Dist. of Columbia.. 4 1 -
Virginia............ 2 54 213 151 1 4 4 3 100
West Virginia...... 1 13 82 150 5 1 3 82
North Carolina..... 1 38 8 64 3 4
South Carolina..... 13 33 36 2 6
Georgia............ 1 12 3 5 1 1 2 3 33
Florida............ 2 53 85 79 10 4 51

EAST SOUTH CENTRAL.. 7 99 882 923 2 2 1 13 3 5 137
Kentucky............ 1 21 78 77 1 1 2 1 67
Tennessee.......... 4 45 725 731 1 8 1 4 58
Alabama............ 2 17 15 2 2 1 4 12
Mississippi........ 16 64 113 -

WEST SOUTH CENTRAL.. 6 130 680 547 2 5 3 26 22 15 353
Arkansas........... 8 1 3 3 12 2 22
Louisiana.......... 4 53 3 3 1 I 5 2 34
Oklahoma........... 26 15 12 1 2 2 2 31
Texas............... 2 43 661 532 1 7 16 13 266

MOUNTAIN............ 40 1,007 986 2 30
Montana............. 3 29 59 -
Idaho............... 3 129 60 -
Wyoming............. 1 29 1 -
Colorado............ 11 577 374 1 -
New Mexico.......... 2 156 1 15
Arizona............. 6 140 174 15
Utah................ 11 103 160 -
Nevada............... 3 2 -

PACIFIC............. 13 210 986 1,747 1 3 34 4 6 172
Washington ......... 1 16 381 399 1 -
Oregon.............. 11 12 16 2 1
California......... 12 173 546 1,288 3 29 4 6 162
Alaska.............. 5 33 14 9
Hawaii............. 5 5 14 30 2 -
Puerto Rico......... 4 22 3 2 1 7 1 1 6











Morbidity and Mortality Weekly Report




Table 4 (A). TOTAL 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


Area For weeks ending eFor weeks ending
Area 5/11 5 5/25 5/4 Area11
5/4 5/11 5/18 5/25 5/4 5/11 5/18 5/25


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


248
36
25
27
57
20
38
33
47
57
14
47
22
45


45
43
158
50
32
33
70
92
1,737
40
408
326
54
92
20
44
57
39
33
22


64
38
753
159
200
115
62
424
40
42
48
22
33
148
19
125
28
23
51
103
49


63
29
38
125
24
119
74
257
67
37


230
49
45
26
52
30
26
29
36
56
13
34
28
45


50
30
140
50
27
31
63
77
1,713
43
486
143
32
103
19
34
71
54
26
39


75
40
734
163
184
113
68
320
53
53
40
41
68
162
35
150
33
35
51
98
61


67
35
44
145
24
91
86
226
73
61


237
41
27
41
45
24
27
21
58
66
12
46
31
48


60
41
143
42
33
43
60
81
1,599
34
509
195
35
95
26
42
54
56
18
31


74
37
755
151
191
121
71
349
48
40
32
21
46
149
32
118
27
30
45
88
53


58
35
39
121
40
99
73
245
78
56


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


149
261
29
77
73
54
82
35
87
91
193
42


83
40
53
172
116
54
30
74


31
33
21
131
42
69
206
65
152
87
89
53
44


218
29
27
18
51
16
26
23A
41
51
9
46
24
51


35
33
137
46
31
44
67
136
1,546
43
427
149
48
106
18
28
56
42
24
28


53
40
742
166
213
128
78
3561
30
49
39
32
51
149
35
123
37
32
44
97
69


44
21
41
120
241
105
74
234
72
49


117
245
38
61
82
45
107
42
59
73
190
48


81
40
31
69
122
39
31
77


46
31
32
138
36
62
161
63
170
62
91
39
74


32
20
126
18
108
12
59
46


147
263
28
50
58
53
65
35
77
61
193
40


73
41
39
126
144
41
34
86


38
37
32
129
36
54
132
53
168
78
93
35
54


25
25
114
20
89
10
41
37


140
238
35
53
77
40
73
35
68
74
187
50


122
43
45
106
138
46
28
94


29
33
17
135
35
77
182
72
137
76
90
54
54


25
17
101
14
63
12
62
48


19 16 19
51 47 46
36 43 41
38 41 37
54 52 64
507 499 535
100 115 106
31 36 36
86 132 113
65 64 52
100 74 85
222 185 190
44 39 39
152 123 135
53 56 1 54
38 50 46

18 32 35


OCurrent Week Mortality for 108 Selected Cities

4(A) Total Mortality, all ages................... 11,093
4(B) Pneumonia-Influenza Deaths, all ages........ 368
4(C) Total Deaths under 1 Year of Age............ 764
4(D) Total Deaths, Persons 65 years and over..... 6,094


NOTF: All deaths by place of occurrence.


179


MOUNTAIN:
Albuquerque, N. Mex. ...... 30
Colorado Springs, Colo. ... 18
Denver, Colo. ............. 122
Ogden, Utah................ 18
Phoenix, Ariz. ........... 77
Pueblo, Colo. ............. 11
Salt Lake City, Utah....... 58
Tucson, Ariz. ............. 41

PACIFIC:
Berkeley, Calif. .......... 20
Fresno, Calif. ............ 51
Glendale, Calif. ......... 34
Honolulu, Hawaii........... 32
Long Beach, Calif. ........ 60
Los Angeles, Calif. ....... 570
Oakland, Calif. ........... 129
Pasadena, Calif. .......... 30
Portland, Oreg. ........... 118
Sacramento, Calif. ........ 67
San Diego, Calif. ......... 100
San Francisco, Calif. ..... 192
San Jose, Calif ........... 41
Seattle, Wash. ............ 148
Spokane, Wash. ............ 40
Tacoma, Wash. ............. 40

San Juan, P.R. .............. 38


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




UNIVERSITY OF FLORIDA

illI HI 1Ill l II II l ll l li 1111311 I
3 1262 08864 1401


Morbidity and Mortality Weekly Report


Case 12 who had only fever and serologic evidence of in-
fection, acquired his disease presumably from his fiancee,
Case 4.
The appearance of cases among hospital contacts is
more consistent with the previously observed patterns of
imported smallpox in Western countries.Case 13 is a gar-
dener at the Infectious Disease Hospital where Cases 3
and 6 were admitted as presumptive chickenpox on April
27 and May 7, respectively. He is thought to have handled
laundry from these patients prior to the first suspicion of
smallpox on May 12. He was initially employed by the
hospital only two months previous and had not yet been
vaccinated in the hospital's annual revaccination program.
Case 14 was a patient admitted to the Infectious
Disease Hospital with whooping cough on April 30. She
was located in the same hospital vicinity as Case 6,
although there was no connection between the rooms
housing these patients. Cases 15 and 16 were patients
on the same hospital ward to which Case 9 was admitted
on May 9. Case 9 was originally thought to have a toxic
drug eruption prior to her diagnosis of smallpox on May 15.
With the exception of Case 12 who had an exception-
ally mild illness, it is apparent that spread of the disease
to date has been primarily among individuals vaccinated
at times far distant in the past. Of the three fatalities to
date, one occurred in a person never vaccinated and the
other two in persons vaccinated more than 50 years prior
to exposure. The absence of additional spread to hospital
personnel is probably related to efforts in Sweden to
emphasize revaccination of hospital personnel at frequent
intervals. Notably, the last four cases have occurred in
persons already identified and isolated by virtue of being
known contacts.
Some 8,000 persons living in neighborhoods of the
earlier cases have been vaccinated. In addition, vaccina-
tion has been provided for other residents of Stockholm on
request and to date some 300,000 persons have availed
themselves of this protection.


Erratum
The credits for the report Equine Influenza, MMIR.
Vol. 12, No. 19, Page 157, erroneously identified Dr.
James Nichols with the State of New Jersey instead of
Florida. Credit for this report, in addition to those cor-
rectly designated, should have read and included:
Dr. Oscar Sussman, Chief, Bureau of Veterinary Pub-
lic Health, New Jersey State Department of Health.
Dr. James Nichols, Director, Division of Veterinary
Public Health, Florida State Board of Health.
Dr. Donald Dean, Assistant Laboratory Director,
Division of Laboratories and Research, New York
State Department of Health.


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QUARANTINE MEASURES


Inmunization 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:
CENTER:


CLINIC HOURS:
FEE:


San Pedro, California
San Pedro Outpatient Clinic
825 South Beacon Street
Tel. TE 2-0213
Monday-Friday, 1-3 p.m,
No