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:
AA00010654:00108

Related Items

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

Full Text


~FS Ss,6cy7:f2ey(J


Morbidity and Mortak


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


Prepared by the I U [SEASC


z APR 1963 3


63 31


For release April 5, 1963 ATLANTA 22, GEORGIA Vol. 12, No. 13
PROVISIONAL INFORMATION ON SELECTED NOTIFIABLE DISEASES IN THE UNITED STATES AND ON
DEATHS IN SELECTED CITIES FOR WEEK ENDED MARCH 30, 1963


INFLUENZA -One or more outbreaks of influenza-
like disease have now been reported from 40 States and
the District of Columbia. States reporting outbreaks for
the first time this week are Colorado and North Dakota.
Influenza A2 virus has been isolated or confirmed by
serologic titer rise as the causative agent of one or more
outbreaks in 30 States and the District of Columbia.States
reporting confirmed outbreaks for the first time this week
are California, Colorado, and North Dakota. Two localized
outbreaks, one of them confirmed as influenza A2, have
thus far been reported from northern California. No
community-wide outbreaks of influenza-like illness have
been' recognized in any of the Pacific Coast States to


date. Outbreaks are now subsiding in most affected areas
in the Eastern and Middle Western United States. The
number of pneumonia-influenza deaths reported for 108
cities this week continued to fall sharply for the second
consecutive week, although still remaining above the
epidemic threshold.

California A limited outbreak of laboratory con-
firmed A2 influenza has been reported from the town of
Yountville in Napa County, about 50 miles north of San
Francisco. Cases have been restricted to elderly patients
at a home for war veterans with a total population of about
2,000. Earliest cases were observed in mid-March and the


Table 1. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous week)
13th Week Cumulative
Disease Ended Ended Median First 13 weeks
March 30, March 31, 1958 1962 Median
1963 1962 1963 1962 1958 1962
Aseptic meningitis................ 15 11 --- 284 207 ---
Brucellosis ........... ........ 1 8 11 77 78 157
Diphtheria ...................... 4 5 8 83 134 208
Encephalitis, infectious .......... 30 36 36 293 348 342
Hepatitis, infectious and serum... 846 1,224 840 13,838 18,028 9,589
Measles........................ 15,676 21,948 16,428 144,868 171,094 167,088
Meningococcal infections......... 62 52 54 760 680 739
Poliomyelitis, total.............. 1 4 9 37 76 215
Paralytic.................... 1 4 5 33 49 120
Nonparalytic.................. 3 2 12 65
Unspecified.................. 1 2 15 30
Streptococcal sore throat
and Scarlet fever ............ 9,695 9,295 -- 129,851 114,940
Tetanus .................. .. .... 1 5 -.. 41 35
Tularemia ..................... 2 7 --- 51 65
Typhoid fever ................... 5 5 8 80 103 125
Typhus fever, tick-borne,
(Rocky Mountain spotted)...... .-3 3
Rabies in Animals ............... 72 88 80 855 1,011 1,063

Table 2. NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. cum.
Anthrax: 1 Psittacosis: 18
Botulism: 5 Rabies in Man:
Malaria: 24 Smallpox:
Plague: Typhus, murine: 2


I








Morbidity and Mortality Weekly Report


UNITED rO ,;r


r L' 1
**\ --^ T
'-J^'


epidemic is now believed to be well past its peak- a total
of approximately 100 cases having occurred thus far.
Paired sera obtained from three patients demonstrated
significant titer rises to influenza A2 antigen.
The recent outbreak involving a State hospital in San
Joaquin County (MMWR, Vol. 12, No. 12) is also waning,
with laboratory studies still in progress. No significant
spread to the surrounding community has been observed
in either of the two localized outbreaks reported in the
State thus far.
A total of 13 serologically confirmed, sporadic cases
have been reported from 10 counties in northern California
to date. In addition, influenza A2 virus has been recovered
from a single sporadic case in Los Angeles. No community-
wide epidemics of influenza-like illness have been ob-
served in the State thus far this year.
(Reported by Dr. Philip K. Condit, Chief, Bureau of Com-
municable Diseases, California Department of Public
Health).

Colorado Delayed report of a localized outbreak of
laboratory confirmed type A2 influenza was received this
week. An estimated several hundred cases occurred among
troops at a large military base in El Paso County during
the first two weeks of February. The outbreak did not


spread to involve civilian employees on the base or the
residents of surrounding communities. Influenza A2 virus
has been recovered from throat washings obtained in five
cases.
(Reported by Dr. C. S. Mollohan, Chief, Epidemiology,
Colorado State Department of Health).


Montana The recent outbreak of influenza-like ill-
ness in Deer Lodge County (MMWR, Vol. 12, No. 12) con-
tinues to smolder, with 100 additional cases reported
during the past week. Laboratory studies on this outbreak
are still pending. Serologic confirmation of recent influ-
enza A2 infection has been obtained, however, in two
sporadic cases recently seen in Big Horn County in the
southern part of the State.
(Reported by Dr. Mary E. Soules, Director, Disease Con-
trol, Montana State Board of Health).

Nebraska Serologic confirmation of recent influ-
enza A2 infection was reported for three sporadic cases
last week. Two of these were seen at the Student Health
Service of the University of Nebraska in Lancaster County.
The third was a resident of neighboring Gage County in
the southeastern part of the State. These are the first
laboratory confirmed cases reported from Nebraska this


106


-- -- -- I- - -- --
~ -








Morbidity and Mortality Weekly Report


season. No outbreaks of influenza-like illness have been
observed in the State this year.
(Reported by Dr. E. A. Rogers, Director of Health, Nebra-
ska State Department of Health).

North Dakota Outbreaks of influenza-like illness
have recently been reported from six counties representing
widely separated geographic regions within the State.
Case reports seemed to indicate a peak of epidemic activ-
ity during the week ending March 23 for all areas involved,
with clear evidence that outbreaks have been subsiding
since then. Serologic confirmation of recent infection with
influenza A2 virus has been obtained in two or more cases
from Cass and Ward Counties.
(Reported by Kenneth Mosser, Director, Division of Pre-
ventable Diseases, North Dakota State Department of
Health).


HEPATITIS Reported cases of viral hepatitis continue
to show a decline from the peak of 1,233 reported during


the week ending February 22, 1963. If the present trend
continues, total cases for 1963 should be well below the
highest years of 1961 and 1962.


Pneumonia-influenza mortality During the week
ending March 30, the number of pneumonia-influenza deaths
reported by the 108 cities decreased to 816, an excess of
298 deaths, which is 69 percent of the previous week's
excess 431 deaths.
In the Eastern divisions New England, Middle
Atlantic, and South Atlantic, mortality has decreased
almost to expected seasonal levels. Excess mortality was
lowered in all the four Central divisions, but remained
well above expected levels for this time of the year. In-
creases occurred in the Western divisions, with excess
mortality continuing above the epidemic threshold in the
Mountain States and in the Pacific States closely approach-
ing, but not exceeding, the epidemic threshold.
Deaths from all causes During the current week
12,763 deaths were reported, an excess of 873 above ex-
pected seasonal levels. During the past four weeks, as
shown in the Table and bar chart the total number of excess
deaths in the 108 cities was 6,939, an average weekly
excess of 1,735 deaths.
Comparison with 1960 A2 Epidemic Cumulative
excess mortality since the week ending January 5th is
compared with the 1960 data in the following table:

CUMULATIVE EXCESS MORTALITY SINCE THE FIRST WEEK
OF THE YEAR

PNEUMONIA- ALL CAUSES OF DEATH
INFLUENZA 65 AND OVER ALL AGES
1963 1960 1963 1960 1963 1960

3,369 4,126 10,110 7,902 16,683 13,983


Although cumulative excess pneumonia-influenza
mortality has been less to date in 1963 than in 1960, total
excess mortality has been greater, especially in the age
group 65 and over.



DEATHS FROM ALL CAUSES

WEEK ENDING
WEEK ENDING 4 Week Weekly
3/9 3/16 3/23 3/30 Total Average
Observed 14,625 13,989 13,422 12,763 54,799 13,700
Expected 12,031 11,993 11,946 11,890 47,860 11,965

Excess 2,594 1,996 1,476 873 6,939 1,735


(See table, page 111)









108 Morbidily and Mortality Weekly Report



Table 3. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

MARCH 30, 1963 AND MARCH 31, 1962



Poliomyelitis, Aseptic
Poliomyelitis, total cases Poliomyelitis, paralytic nonparalytic Meningitis
Cumulative Cumulative
Area
13th week First 13 weeks 13th week First 13 weeks 13th week 13th week

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

UNITED STATES...... 1 4 37 76 1 4 33 49 15 11

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

MIDDLE ATLANTIC........... 6 28 6 15 3 2
New York............... 4 28 4 15 I
New Jersey............. 1 1 -
Pennsylvania 1 1 2 2

EAST NORTH CENTRAL ....... 1 8 9 1 7 6 2 1
Ohio.................. 2 4 1 4
Indiana............... 1 3 1 2 -
Illinois.............. 4 2 4 1 1
Michigan.............. 2 2 1I
Wisconsin............. -

WEST NORTH CENTRAL ....... 1 5 1 2
Minnesota............. .
Iowa................... 3 2
Missouri .............. 1 2 1
North Dakota.......... -
South Dakota..........
Nebraska..............
Kansas................

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

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

WEST SOUTH CENTRAL ....... 3 10 15 3 10 12
Arkansas.............. .- -
Louisiana............. 9 4 9 4
Oklahoma..............
Texas................. 3 1 11 3 1 8

MOUNTAIN................. 5 4 1
Montana................ 2 1
Idaho.................
Wyoming...............
Colorado.............. 1
New Mexico............ -
Arizona............... 2 2
Utah................... 1 1 1
Nevada...... ..... ....

PACIFIC.................. 1 7 6 1 6 4 6 5
Washington............. 1
Oregon................ 1 1 1
California............ 1 6 6 1 5 4 5 4
Alaska.................. -
Hawaii............... -

Puerto Rico............... 1 2 3 1 2 3









Morbidity and Mortality Weekly Report 109


Table 3. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
FOR WEEKS ENDED

MARCH 30, 1963 AND MARCH 31, 1962 (Continued)



Brucellosis Diphtheria Encephalitis, Hepatitis, Measles
infectious infectious and serum
Area Cumu- Cumu- 13th week
lative lative Under 20 &
13th week 13 weeks 13th week 13 weeks 13th week 20 yr. over Total 13th week
1963 1963 1963 1963 1963 1962 1963 1963 1963 1962 1963 1962
UNITED STATES...... 1 77 4 83 30 36 432 362 846 1,224 15,676 21,948

NEW ENGLAND .............. 3 4 49 48 99 69 514 2,389
Maine................. 1 34 20 54 15 17 309
New Hampshire......... 4 1 6 1 47
Vermont ............... 88 66
Massachusetts.......... 2 1 7 15 23 44 132 1,243
Rhode Island............ 1 1 4 4 1 43 94
Connecticut........... 1 4 8 12 8 234 630

MIDDLE ATLANTIC........... 4 2 11 5 8 93 93 186 174 1,432 4,238
New York............... 3 2 6 2 4 52 50 102 78 421 2,658
New Jersey............. 1 14 27 41 50 535 1,173
Pennsylvania .......... 1 4 3 4 27 16 43 46 476 407

EAST NORTH CENTRAL....... 5 1 7 3 2 69 51 125 254 6,735 2,208
Ohio ................. 1 18 19 38 91 658 502
Indiana ............... 1 3 12 4 18 32 290 355
Illinois.............. 5 2 2 7 10 17 37 308 442
Michigan .............. 1 2 27 18 45 88 1,574 730
Wisconsin ............. 1 5 7 6 3,905 179

WEST NORTH CENTRAL....... 1 60 28 6 13 14 31 92 920 1,186
Minnesota............ 1 6 15 1 3 5 24 309 45
Iowa.................. 44 1 4 4 21 384 934
Missouri.............. 3 1 4 8 5 14 26 34 98
North Dakota.......... 3 188 104
South Dakota.......... 3 7 1 2 3
Nebraska.............. 2 4 2 4 5 2
Kansas................ 2 1 4 2 6 12 NN NN

SOUTH ATLANTIC........... 14 10 8 58 34 94 140 1,250 1,303
Delaware.............. 1 1 1 2 1 124 10
Maryland.............. 6 1 8 3 11 12 54 99
District of Columbia.. 1 7 8 4 40
Virginia.............. 1 6 9 15 34 420 400
West Virginia.......... 1 1 11 5 16 12 377 500
North Carolina........ 1 2 4 17 2 19 44 33 13
South Carolina........ 3 4 1 5 7 69 25
Georgia............... 4 5 5 2 3 32
Florida................ 4 3 5 6 13 24 170 184

EAST SOUTH CENTRAL....... 1 8 1 51 32 90 160 859 1,762
Kentucky............... 11 12 30 77 372 324
Tennessee............. 1 27 7 34 53 339 1,188
Alabama .............. 1 7 7 2 9 14 99 46
Mississippi............ 1 6 11 17 16 49 204

WEST SOUTH CENTRAL....... 5 10 1 3 33 26 59 111 1,253 4,425
Arkansas............... 2 1 1 1 3 1 4 7 341 4
Louisiana............. 4 8 12 37 17 2
Oklahoma.............. 2 4 3 3 4 8 103
Texas................. 1 5 2 23 17 40 63 887 4,316

MOUNTAIN................. 1 1 1 17 8 54 55 1,230 1,006
Montana............... 4 4 11 3 145 228
Idaho...................... 6 4 339 23
Wyoming............... 1 14 3
Colorado............... 5 15 18 289 419
New Mexico............ 1 1 6 1 7 1 NN NN
Arizona............... 9 19 326 240
Utah.................. 1 2 3 5 10 111 90
Nevada................ 6 3

PACIFIC.................. 1 1 5 10 49 56 108 169 1,483 3,431
Washington ............ 8 3 11 30 249 1,321
Oregon................ 6 10 16 23 215 709
California............ 1 1 5 10 35 43 78 110 932 1,377
Alaska................ 3 5 27 14
Hawaii................ 1 60 10

Puerto Rico.............. 1 6 11 4 15 33 37 130








110 Morbidity and Mortality Weekly Report


Table 3. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

MARCH 30, 1963 AND MARCH 31, 1962 (Continued)


Meningococcal Streptococcal Tickborne
Infections Sore Throat & Tetanus Typhus Tularemia Typhoid Fever Rabies in Animals
Scarlet Fever (Rcky Mt.
SreaCumu- Spotted) Cumu- uu-
lative ---- lative lative
13th wk. 13 weeks 13th week 13th wk. 13th wk. 13th wk. 13th wk. 13 weeks 13th week 13 weeks
1963 1963 1963 1962 1963 1963 1963 1963 1963 1963 1962 1963

UNITED STATES.... 62 760 9,695 9,295 1 2 5 80 72 88 855

NEW ENGLAND.......... 3 53 1,243 574 1 4 2 3
Maine.............. 9 61 53 -
New Hampshire...... 2 8 2 -- 2 3
Vermont............ 1 11 1 -- 1 -
Massachusetts...... 3 23 183 117 2 -
Rhode Island....... 6 114 39
Connecticut........ 12 866 362 1 1 -

MIDDLE ATLANTIC..... 8 101 618 607 2 9 1 26
New York........... 5 45 355 374 7 1 17
New Jersey......... 1 16 184 85 -
Pennsylvania....... 2 40 79 148 2 2 9

EAST NORTH CENTRAL.. 11 127 1,258 908 1 1 5 10 8 104
Ohio................ 4 35 232 111 1 5 45
Indiana............ 1 17 159 144 1 2 8 14
Illinois........... 17 173 192 1 3 20
Michigan........... 4 40 413 242 1 1 1 18
Wisconsin.......... 2 18 281 219 1 7

WEST NORTH CENTRAL.. 4 44 216 339 1 3 19 15 197
Minnesota........... 1 9 27 37 1 2 2 57
Iowa................ 1 2 86 93 1 6 7 62
Missouri........... 19 4 16 1 1 8 3 42
North Dakota....... 1 96 119 2 2 4
South Dakota....... 1 3 1 1 28
Nebraska........... 1 9 1 1
Kansas.............. 1 3 73 3

SOUTH ATLANTIC....... 12 158 814 615 1 15 9 16 153
Delaware............ 1 10 4 -
Maryland............ 2 25 36 23 2 -
Dist. of Columbia.. 3 5 2 -
Virginia............ 1 37 268 243 1 4 8 59
West Virginia...... 9 195 161 5 3 7 56
North Carolina..... 24 45 38 3 4
South Carolina..... 1 11 129 35 5
Georgia............ 2 10 1 2 1 1 1 4
Florida............. 6 38 125 107 3 1 1 25

EAST SOUTH CENTRAL.. 2 61 1,441 1,504 7 3 15 86
Kentucky ........... 2 25 240 123 2 1 4 35
Tennessee.......... 25 1,118 1,253 4 1 11 41
Alabama............ 7 24 4 1 1 10
Mississippi........ 4 59 124 -

WEST SOUTH CENTRAL.. 13 84 794 980 1 19 18 21 176
Arkansas........... 5 2 6 7 1 2 12
Louisiana .......... 12 36 1 3 1 5 1 3 21
Oklahoma........... 15 18 55 2 11
Texas.............. 1 28 773 916 5 16 16 132

MOUNTAIN............ 2 25 1,816 1,829 2 2 2 16
Montana............ 65 102 -
Idaho.............. 185 144 -
Wyoming............ 1 24 135 -
Colorado........... 1 6 709 835 -
New Mexico......... 2 422 270 1 2 7
Arizona............ 5 194 200 2 9
Utah................ 1 10 215 143 -
Nevada............. 1 2

PACIFIC............. 7 107 1,495 1,939 16 9 10 94
Washington......... 11 500 800 -
Oregon.............. 1 5 23 54 2 1
California......... 6 85 899 1,041 13 9 10 93
Alaska.............. 4 69 16 -
Hawaii............... 2 4 28 I -
Puerto Rico......... 9 1 3 3 1 4










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

For weeks ending For weeks ending
Area ___ 3/16 3/3 3/30 3/9 3Area/16 3 3

3/9 3/16 3/23 3/30 3/9 3/16 3/23 3130


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


394
42
32
52
61
30
32
39
52
94
13
39
40
82


58
53
180
52
28
43
104
83
1,841
37
736
313
30
133
22
39
78
68
27
28


80
59
999
250
259
172
117
518
65
56
56
53
58
255
33
191
43
26
57
128
72


57
19
41
161
25
153
79
411
79
59


324
54
36
45
64
46
27
41
58
75
10
64
39
73


55
49
191
39
40
41
80
119
1,792
42
734
149
30
127
36
52
71
79
38
43


75
46
954
178
265
176
95
432
62
43
49
34
85
226
42
174
44
43
47
146
71


67
25
34
144
31
132
79
328
96
48


304
47
42
33
55
34
29
36
55
61
15
44
34
69


45
56
175
64
32
49
81
106
1,734
39
638
246
35
124
29
33
77
44
35
33


74
39
802
154
215
123
89
411
55
70
53
37
54
212
25
158
92
38
44
130
70


62
28
78
156
23
134
96
302
89
74


288
29
34*
36
66
26
32
28
57
78
17
56
24
49


45
29
151
46
32*
48
73
94
1,660
33
647
418
27*
106
41
45
74
52
23
40


61
39
762*
167
148
126
101
314
43
60
42
33*
62
161
34
122
34
27
31
111
62


73
26
32
130
35
131
75
279
107
37


SOUTH ATLANTIC:
Atlanta, Ga. ..............
Baltimore, Md. ...........
Charlotte, N.C. ...........
Jacksonville, Fla. ........
Miami, Fla. ...............
Norfolk, Va. ..............
Richmond, Va. .............
Savannah, Ga. .............
St. Petersburg, Fla ......
Tampa, Fla. ...............
Washington, D.C. ..........
Wilmington, Del. ..........

EAST SOUTH CENTRAL:
Birmingham, Ala. ..........
Chattanooga, Tenn. ........
Knoxville, Tenn. ..........
Louisville, Ky. ...........
Memphis, Tenn. ............
Mobile, Ala...............
Montgomery, Ala. ..........
Nashville, Tenn. ..........

WEST SOUTH CENTRAL:
Austin, Tex ..............
Baton Rouge, La. ..........
Corpus Christi, Tex ......
Dallas, Tex. ..............
El Paso, Tx. .............
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, Col .............
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. .............


167
303
66
62
128
81
111
37
128
82
220
52


133
75
45
198
177
44
54
98


54
33
18
190
40
102
186
59
286
101
143
65
94


52
18
131
15
106
17
56
40


19
61
31
51
58
540
91
36
113
67
83
229
37
145
43
34


146 167
296 275
29 42
57 69
101 95
78 65
97 83
42 39
109 110
96 110
205 192
38 37


130 84
48 68
58 51
221 212
187 184
48 54
49 32
120 106


44 54
42 32
27 21
165 160
41 41
79 71
207 294
86 98
250 206
115 90
125 126
74 58
51 92


47 26
18 25
141 153
16 14
94 121
13 13
47 58
70 70


20 14
41 44
41 29
31 41
61 74
558 574
117 150
40 22
123 119
60 65
104 79
221 209
40 40
138 137
49 47
46 39


San Juan, P.R. .............. 21 32 16 (---)


OCurrent Week Mortality for 108 Selected Cities

4(A) Total Mortality, all ages.................... 12,763
4(B) Pneumonia-Influenza Deaths, all ages........ 816
4(C) Total Deaths under I Year of Age............ 710
4(D) Total Deaths, Persons 65 years and over..... 7,389


NOTF* All deaths by place of occurrence.


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









Morbidity and Mortality Weekly Report


EPIDEMIOLOGICAL REPORT
Typhoid Fever Five additional cases of typhoid
fever have occurred in the United States among persons
returning from Zermatt, Switzerland. This brings the total
to nine reported to date. Data concerning all nine are
listed in the table below:

Dates In
Case Location Age Sex Onset Zermatt

1 New York, N. Y. 24 M March 3 Feb. 15-23
2 Berkeley, Calif. 40 M March 1 Feb. 19-26
3 East Hartland, Conn. 18 F March 7 Feb. 7-17
4 Allentown, Pa. 23 F March 3 Feb. 16-23
5 Pittsburgh, Pa. 57 M March 14 Feb. 9-23
6 Beverly Hills, Calif. 43 F March 2 Feb. 2-22
7 Santa Monica, Calif. 36 F March 3 Feb. 14-21
8 Westchester, N. Y. 27 F March 2 Feb. 9-18
9 New York, N. Y. 32 M March 12 March 8-19

All cases except number 8 have been confirmed by
positive cultures. Five of the isolates of Salmonella typhi
have been identified as phage type E-1.
Case number 9 did not arrive in Zermatt until March 8.
This indicates infection from exposure much later than has
been found from other cases and suggests that additional
cases may still be seen.
(Reported by Dr. Rebecca Proctor. Epidemiology Section,
Bureau of Communicable Diseases, California State Depart-
ment of Health; Dr. Robert M. Albrecht, Director, Office
of Epidemiology, New York State Department of Health;
Dr. Tibor Fodor, Epidemiologist, Bureau of Preventable
Diseases, New York City Health Department; and Dr.
William D. Schrack, Jr., Director, Division of Communi-
cable Disease Control, Pennsylvania State Department
of Health.)


INTERNATIONAL NOTES QUARANTINE MEASURES

Typhoid Fever Zermatt, Switzerland
Additional data concerning cases of typhoid fever
exposed in Zermatt, Switzerland, have been provided by
Dr. Reimert Ravenholt, Epidemiologic Consultant, Euro-
pean Area, Division of Foreign Quarantine, Paris. Two
hundred and seventy cases with three deaths are now
known to have occurred in European countries. Of these,
190 have been in Switzerland.
Dr. Daniel Thomson, Deputy Chief Medical Officer,
Ministry of Health for Great Britain, has reported 46
bacteriologically confirmed cases of typhoid fever in
England traced to Zermatt. The earliest known departure
date from England among this group was February 22. The
latest known arrival in Zermatt among these same cases
was also February 22.
Precise dates of onset are known for 35 of the cases
in England, as well as the nine cases in the United
States. An epidemic curve based on these data is shown
in graph (top right column).


REPORTED TYPHOID FEVER
TRACED TO ZERMATT, SWITZERLAND
1963


16 23
February


mI-- erllith Comn
SAmerican Caes


9 6 23 30 6 a -do
March April
Dae of Onset


S,. F F'_ L'e
_-' .ME JT r.E D





| U'S DFP. -, ".,,


112


UNIVERSITY OF FLORIDA


3 1262 08864 1443


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