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:
AA00010654:00119

Related Items

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

Full Text





Morbidity and Mortalit


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

PUBLIC HEALTH SERVICE


Prepared by the


F



63 1f\


For release March 15, 1963 ATLANTA 22, GEORGIA 12, No. 10
PROVISIONAL INFORMATION ON SELECTED NOTIFIABLE DISEASES IN THE UNtTES AND ON
DEATHS IN SELECTED CITIES FOR WEEK ENDED MARCH 9, 1963


INFLUENZA The number of States reporting one or
more outbreaks of influenza-like disease this week remains
at 34. Influenza A2 virus has been isolated or confirmed
by serologic titer rise as the causative agent of one or
more outbreaks in the District of Columbia and 21 States.
States reporting confirmed outbreaks for the first time this
week are Louisiana, Missouri, Pennsylvania, and West
Virginia. The outbreaks reported last week in Arizona
have shown some tendency to spread with increased inci-
dence of febrile respiratory disease now reported from
Pima County. The localized outbreak in Montana has, as
yet, shown little tendency to become more widespread.
The remainder of the Mountain and the West Coast States


continue to report no more than the usual seasonal inci-
dence of acute respiratory disease. No type B outbreaks
have been reported this season.
The number of pneumonia-influenza deaths reported
weekly for 108 cities has remained above the epidemic
threshold since the week ending January 12, and this week
demonstrates a further rise.
The following reports are from areas of the country
currently experiencing new or widening outbreaks of
influenza-like disease.
Arizona In addition to the outbreaks of influenza-
like illness reported from Apache and Navajo Counties
in last week's MMWR (Vol. 12, No. 9), a mild outbreak of


Table 1. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous week)
10th Week Cumuldtive
Ended Ended First 10 weeks
Disease Median
March 9, March 10, 1958 1962 Median
1963 1962 1963 1962 1958 1962
Aseptic meningitis................ 19 15 --- 229 163 --
Brucellosis ...................... 5 4 14 56 59 120
Diphtheria ...................... 8 4 16 64 110 176
Encephalitis, infectious .......... 20 29 24 199 264 231
Hepatitis, infectious and serum... 992 1,265 734 11,123 14,364 7,146
Measles. ....................... 13,875 16,502 16,502 100,908 112,251 112,251
Meningococcal infections ......... 49 45 56 558 520 544
Poliomyelitis, total.............. 2 2 14 31 66 181
Paralytic.................... 2 2 13 28 40 104
Nonparalytic................. .- 1 2 12 55
Unspecified.................. 1 14 22
Streptococcal sore throat
and Scarlet fever ............ 10,942 9,352 -- 97,838 86,998
Tetanus .......................... 2 3 --- 33 27 ---
Tularemia ...................... 4 --- 44 50 ---
Typhoid fever................... 13 16 9 59 82 93
Typhus fever, tick-borne,
(Rocky Mountain spotted)...... --- 3 ---
Rabies in Animals ............... 83 79 79 606 668 790


Table 2. NOTIFIABL DISEASES OF LOW FREQUENCY
_CUM. Cum.
Anthrax: 1 Psittacosis: 16
Botulism: 2 Rabies in Man:
Malaria: 20 Smallpox:
Plague: Typhus, murine: 2


I C NIIL'IC BL DIFAE CNTR


`Z) VA 4;0W17 / f


/








Morbidity and Mortality Weekly Report


AND INFLUENZA-LIKE DISEASE OUTBREAKS, U.S.A.
January I through March 15, 1963 By County


similar illness has now occurred in Tucson (Pima County).
The outbreak was first recognized during the week of
March 4. Laboratory studies are presently under way.
(Reported by Lloyd N. Farner, M.D., Commissioner of
Public Health, Arizona State Department of Health).
Louisiona Five virus isolates, identified as type
A2 influenza, have been obtained from patients in Jack-
son Parish in the northern part of the State. An additional
single isolate has been reported from New Orleans. In
all, a total of 21 of the State's 64 parishes reported out-
breaks last week. These appeared to be clustered in the
northwest and central parts of the State, with only a few
southeastern parishes involved. The epidemic appears to
have reached its peak in most areas and is declining in
Beauregard and Jackson Parishes.
(Reported by John M. Bruce, M.D., Chief, Section of Epi-
demiology, Louisiana State Board of Health).
Maine Outbreaks of influenza-like illness were
reported from six counties during the week ending March 9,
most of these coming from the southern part of the State.
School closings were noted in two neighboring communi-
ties in York County, and one large parochial school in
the city of Lewiston has been closed because of a flu-
like syndrome. The illness is characterized clinically by
fever, chills, myalgia and cough. Laboratory confirmation
is not available as yet.
(Reported by Dr. Dean H. Fisher, Director, Communicable
Disease Control, Bureau of Health, Maine State Depart-
ment of Health and Welfare).


Missouri Influenza A2 virus has been recovered
from two cases seen during the recent outbreak at a mili-
tary base in Jackson County (MMWR, Vol. 12, No. 8).
A virus isolate was obtained in a third case but has not
as yet been identified.
New outbreaks of influenza-like illness were reported
from several communities in Webster County during the
past week. Epidemic respiratory disease seemed to be
waning forthe State as a whole, however.
(Reported by E. A. Belden, M.D., Communicable Disease
Consultant, Missouri Department of Health).
Pennsylvania Outbreaks of influenza-like illness
were reported during the past week, from nine counties,
representing most geographic regions of the State. Exces-
sive school absenteeism, ranging from 15% to 40% was
observed in several of these areas. One industrial popula-
tion in Lancaster County reported 12% absenteeism during
the week ending March 2. Influenza A2 virus has been
recovered from two cases in a recent outbreak among
patients at a large State hospital in Dauphin County. An
overall attack rate of approximately 10% has been reported
from this population in which influenza vaccine was admin-
istered on a voluntary basis last fall.
(Reported by W. D. Schrack. Jr.. M.D., Director. Division
of Communicable Disease Control, Pennsylvania Depart-
ment of Health).
Texas Approximately 14,000 cases of influenza-like
illness were reported for the week ending March 9 as com-


(Continued on page 84)








Morbidity and Mortality Weekly Report


Pneumonia-influenza mortality For the week ending
March 9, excess pneumonia-influenza deaths showed an
upward trend, 564 excess deaths as compared with 507
last week. This was due to the marked increases reported
by the East South Central and West South Central States.
In all other divisions, the number of excess pneumonia-
influenza deaths were the same as last week or were on
the decline.
Along the eastern seaboard, the New England, Middle
Atlantic and South Atlantic States, the numbers reported
this week were less than last week. In the upper tier of
States, the West North Central and East North Central
States, the excess pneumonia-influenza deaths were the
same as last week. The Mountain States reported only a
slight increase, and the Pacific States, still unaffected by
the epidemic, reported somewhat less than the expected
level.
Cumulative excess pneumonia-influenza mortality
since the week ending January 5th has now reached 2,049
deaths. Corresponding numbers for the 1960 influenza A2
epidemic and the 1960 influenza B epidemic were 3,595
and 942 deaths, respectively.
PNEUMONIA-INFLUENZA DEATHS IN 108 CITIES

WEEK ENDING
WEEK ENDING 4 Week Weekly
2/16 2/23 3/2 3/9 Total Average
Observed 759 794 1,049 1,102 3,704 926
Expected 547 545 542 538 2,172 543
Excess 212 249 507 564 1,532 383


Total deaths The number of total deaths reported
for all causes for the past week was 14,625 an excess of
of 2,594 above the expected number. For the preceding
week (week ending March 2), comparable figures were
14,930 total deaths and 2,889 excess deaths. Since the
week ending January 5, excess deaths from all causes
have reached a total of 12,436. During comparable periods
of the 1960 and 1962 epidemics, totals of 12,456 and
5,052, respectively, were recorded.


(See table, page 83)


PNEUMONIA-INFLUENZA DEATHS IN 108 U S CITIES
Average number pr week by fur-wek periods


NUMBER
OF











80 MI rbiditl and Mortality W weekly Report



Table 3. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

MARCH 9, 1963 AND MARCH 10, 1962



Poliomyelitis, Aseptic
Poliomyelitis, total cases Poliomyelitis, paralytic nonparalytic Meningitis
Cumulative Cumulative
Area
10th week First 10 weeks 10th week First 10 weeks 10th week 10th week
1963 1962 1963 1962 1963 1962 1963 1962 1963 1962 1963 1962


UNITED STATES...... 2 2 31 66 2 2 28 40 19 15

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

MIDDLE ATLANTIC.......... 5 27 5 14 3 1
New York.............. 4 27 4 14 3
New Jersey............ -
Pennsylvania 1 1 1

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

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

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

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

WEST SOUTH CENTRAL....... 9 11 9 8
Arkansas ..............
Louisiana.............. 8 3 8 3
Oklahoma ...........
Texas................. 1 8 1 5

MOUNTAIN................. 5 4 3 3
Montana.................. 2 1 1-
Idaho .................- -
Wyoming................ -
Colorado................ 2 3
New Mexico............- -
Arizona..............., 2 2
Utah................... 1 1
Nevada................

PACIFIC....................... 1 1 5 5 1 1 4 3 4 2
Washington............. -
Oregon................ 1 -
California............. 1 1 4 5 1 1 3 3 4 2
Alaska............... -
Hawaii.................

Puerto Rico.............. 1 1 -- -











Morbidity and Mortality Weekly Report 81


Table 3. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

MARCH 9, 1963 AND MARCH 10, 1962 (Continued)



Brucellosis Diphtheria Encephalitis, Hepatitis, Measles
infectious infectious and serum
Area ------
Cumu- Cumu- 10th week
lative lative Under 20 &
10th week 10 weeks 10th week 10 weeks 10th week 20 yr. over Total 10th week
1963 1963 1963 1963 1963 1962 1963 1963 1963 1962 1963 1962
UNITED STATES...... 5 56 8 64 20 29 546 387 992 1,265 13,875 16,502

NEW ENGLAND.............. 1 3 1 1 62 40 106 57 644 2,027
Maine ................. 34 15 49 15 18 252
New Hampshire......... 4 4 10 3 28
Vermont............... 4 4 2 81 12
Massachusetts.......... 1 2 15 14 33 27 177 942
Rhode Island.......... 1 1 1 24 82
Connecticut........... 9 7 16 3 341 711

MIDDLE ATIANTIC........... 3 7 7 3 116 82 198 156 1,081 2,742
New York............... 2 2 7 2 64 49 113 79 380 1,482
New Jersey............. 1 14 13 27 32 244 835
Pennsylvania.......... 1 4 1 38 20 58 45 457 425

EAST NORTH CENTRAL....... 4 1 4 1 2 108 76 188 244 6,449 1,775
Ohio..................... 26 19 46 85 731 142
Indiana............... 1 2 7 6 13 13 195 215
Illinois.............. 4 2 1 33 29 64 44 343 630
Michigan .............. 1 1 34 20 54 99 1,857 636
Wisconsin............. 8 2 11 3 3,323 152

WEST NORTH CENTRAL....... 4 43 5 21 23 14 40 85 659 764
Minnesota............. 1 4 4 12 5 1 8 23 38 17
Iowa................... 2 31 1 4 3 7 31 311 620
Missouri.............. 1 2 8 4 12 14 104 19
North Dakota.......... 5 200 99
South Dakota........... 2 1 7 2 1 9
Nebraska.............. 2 1 2 3 6 5
Kansas................ 2 6 4 10 4 NN NN

SOUTH ATLANTIC........... 11 2 4 52 31 93 154 1,046 1,173
Delaware ............. 3 3 1 33 9
Maryland.............. 4 4 9 12 27 90
District of Columbia.. 1 4 4 3 30
Virginia.............. 1 2 6 5 11 40 301 476
West Virginia......... 11 4 17 29 325 267
North Carolina....... 1 19 8 27 31 84 14
South Carolina*........ 3 1 2 11 74 68
Georgia............... 2 3 3 3 4 2
Florida............... 4 1 2 5 6 17 27 195 217

EAST SOUTH CENTRAL....... 1 1 8 2 48 30 78 170 644 1,651
Kentucky.............. 17 7 24 67 260 395
Tennessee............. 1 1 17 5 22 42 266 1,011
Alabama............... 1 1 7 10 13 23 32 106 162
Mississippi........... 1 4 5 9 29 12 83

WEST SOUTH CENTRAL....... 1 4 9 5 36 19 56 104 1,016 3,173
Arkansas.............. 2 1 4 1 1 6 13 60
Louisiana............. 7 7 14 5 4 32
Oklahoma.............. 1 2 4 3 2 5 5 4 111
Texas.................. 4 1 25 10 36 88 995 2,970

MOUNTAIN ................ 1 3 27 7 71 97 983 777
Montana................ 1 5 1 7 9 83 267
Idaho.................. 12 16 265 53
Wyoming.............. 1 2 2 2 16 2
Colorado.............. 4 3 11 24 255 239
New Mexico............ 16 1 17 7 NN NN
Arizona................ 1 20 27 226 92
Utah .................. 1 2 2 11 123 106
Nevada ................ 1 15 18

PACIFIC.................. 1 9 9 74 88 162 198 1,353 2,420
Washington ............ 2 1 19 14 33 37 203 741
Oregon ................ 14 13 27 17 294 417
California ............ 1 7 8 40 59 99 113 612 1,225
Alaska................. 1 2 3 30 27 15
Hawaii................ 1 217 22

Puerto Rico............... 1 3 8 4 12 32 19 107








82 Morbidity and Mortality Weekly Report


Table 3. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITID STATES

FOR WEEKS ENDED

MARCH 9, 1963 AND MARCH 10, 1962 (Continued)


Meningococcal Streptococcal Tickborne
Infections Sore Throat & Tetanus Typhus Tularemia Typhoid Fever Rabies in Animals
Scarlet Fever (Rcky Mt.
a Cumu- Spotted) Cumu- Cumu-
lative lative lative
10th wk. 10 weeks 10th week 10th wk. 10th wk. 10th wk. 10th wk. 10 weeks 10th week 10 weeks
1963 1963 1963 1962 1963 1963 1963 1963 1963 1963 1962 1963

UNITED STATES.... 49 558 10,942 9,352 2 13 59 B3 79 606

NEW ENGLAND......... 1 41 1,067 563 2 -
Maine.............. 1 9 15 21 -
New Hampshire...... 2 3 -
Vermont............. 1 52 70 -
Massachusetts...... 17 133 104 2 -
Rhode Island....... 4 94 49 -
Connecticut........ 10 771 316 -

MIDDLE ATLANTIC..... 6 76 707 608 5 1 2 22
New York........... 2 35 460 380 5 1 2 16
New Jersey......... 10 134 86 -
Pennsylvania....... 4 31 113 142 6

EAST NORTH CENTRAL.. 9 91 1,545 1,056 1 3 11 16 78
Ohio................ 1 26 259 160 1 1 5 4 30
Indiana............ 14 245 159 2 6 8
Illinois........... 2 14 189 252 2 2 17
Michigan........... 4 26 442 243 4 3 17
Wisconsin.......... 2 11 410 242 1 6

WEST NORTH CENTRAL.. 3 32 351 303 2 23 22 145
Minnesota.......... 1 6 26 55 8 4 46
Iowa............... 102 63 1 9 12 44
Missouri........... 1 15 5 24 1 4 3 28
North Dakota...... 1 107 121 2
South Dakota........ 2 3 4 2 3 24
Nebraska............ 1 8 1
Kansas............. 108 36 -

SOUTH ATLANTIC...... 10 123 905 836 2 1 14 15 4 113
Delaware............ 1 23 8 -
Maryland........... 2 20 27 10 2 -
Dist. of Columbia.. 1 3 2 -
Virginia........... 4 30 312 224 4 3 43
West Virginia...... 1 8 240 192 5 7 1 41
North Carolina..... 20 71 16 3 4
South Carolina..... 1 10 15 153 2 2
Georgia............. 6 2 1 1
Florida............. 1 25 213 233 2 1 3 2 22

EAST SOUTH CENTRAL.. 5 42 1,788 1,562 6 9 15 62
Kentucky.......... 2 13 217 219 1 1 7 25
Tennessee.......... 2 19 1,423 1,199 4 8 8 33
Alabama ........... 1 7 90 48 1 4
Mississippi........ 3 58 96 -

WEST SOUTH CENTRAL.. 7 56 1,040 755 4 12 15 17 112
Arkansas........... 4 26 2 1 7 2 7
Louisiana.......... 3 19 25 3 3 3 2 1 16
Oklahoma............ 2 13 4 30 8
Texas.............. 2 20 985 720 2 13 14 81

MOUNTAIN............. 1 18 2,077 1,735 2 9
Montana ............ 68 76 -
Idaho.............. 160 117 -
Wyoming ............ 1 1 21 155 -
Colorado............. 3 1,015 782 -
New Mexico......... 2 439 230 1 4
Arizona............ 4 248 186 5
Utah............... 7 115 188 -
Nevada............. 1 11 1 -

PACIFIC............. 7 79 1,462 1,934 7 13 9 3 65
Washington......... 1 7 449 810 -
Oregon............. 3 19 38 1 1
California......... 6 65 880 954 7 12 9 3 64
Alaska.............. 4 95 103 -
Hawaii............. 19 29
Puerto Rico......... 4 3 7 1 3 2 1









Morbidity and Mortality Weekly Report





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
2/16 2/23 3/2 3/9 2/16 2/23 3/2 3/9


NEW ENGLAND:
Boston, Mass .............. 3 18 28 23
Bridgeport, Conn.......... 5 4 14 7
Cambridge, Mass ........... 0 0 0 0
Fall River, Mass.......... 0 4 6 9
Hartford, Conn............. 4 6 5 7
Lowell, Mass.............. 0 1 2 2
Lynn, Mass............... 3 1 9 6
New Bedford, Mass.......... 4 5 1 6
New Haven, Conn............ 2 4 4 6
Providence, R.I........... 3 4 9 7
Somerville, Mass.......... 0 0 5 4
Springfield, Mass......... 6 4 7 2
Waterbury, Conn............ 1 1 2 1
Worcester, Mass............ 4 4 9 12

MIDDLE ATLANTIC:
Albany, N.Y................ 4 0 1 3
Allentown, Pa............. 0 1 5 4
Buffalo, N.Y.............. 11 12 8 18
Camden, N.J................ 4 5 4 4
Elizabeth, N.J............ 1 7 4 1
Erie, Pa.................. 4 4 7 4
Jersey City, N.J.......... 3 5 13 11
Newark, N.J................ 8 10 14 4
New York City, N.Y......... 171 126 126 101
Paterson, N.J.............. 4 4 7 3
Philadelphia, Pa.......... 17 56 53 53
Pittsburgh, Pa............ 5 9 12 32
Reading, Pa............... 0 2 7 6
Rochester, N.Y............. 21 14 16 19
Schenectady, N.Y.......... 1 0 0 1
Scranton, Pa.............. 3 5 15 4
Syracuse, N.Y.............. 4 2 2 4
Trenton, N.J.............. 9 11 8 15
Utica, N.Y................. 3 1 3 2
Yonkers, N.Y............... 4 2 3 2

EAST NORTH CENTRAL:
Akron, Ohio............... 4 1 4 5
Canton, Ohio.............. 5 4 16 13
Chicago, Ill.............. 54 53 92 78
Cincinnati, Ohio.......... 8 13 23 21
Cleveland, Ohio........... 4 8 12 14
Columbus, Ohio............ 8 2 7 5
Dayton, Ohio.............. 7 6 5 12
Detroit, Mich................. 17 28 49 39
Evansville, Ind........... 2 9 7 12
Flint, Mich............... 2 3 1 8
Fort Wayne, Ind........... 3 5 7 6
Gary, Ind................. 0 4 8 10
Grand Rapids, Mich........ 3 4 5 7
Indianapolis, Ind......... 4 7 17 25
Madison, Wis............... 2 1 2 0
Milwaukee, Wis............ 3 10 9 9
Peoria, Ill............... 2 0 0 3
Rockford, Ill............. 6 3 8 7
South Bend, Ind........... 0 2 1 3
Toledo, Ohio.............. 5 2 7 3
Youngstown, Ohio.......... 1 2 4 3

WEST NORTH CENTRAL:
Des Moines, Iowa.......... 0 3 5 2
Duluth, Minn.............. 1 0 0 0
Kansas City, Kans......... 9 4 9 3
Kansas City, Mo........... 11 11 21 10
Lincoln, Nebr............. 2 1 7 0
Minneapolis, Minn......... 3 7 7 6
Omaha, Nebr............... 2 3 4 5
St. Louis, Mo............. 12 10 19 37
St. Paul, Minn............ 1 2 3 4
Wichita, Kans............. 9 5 3 3

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

NOTE: All deaths by place of occurrence.


SOUTH ATLANTIC:
Atlanta, Ga.............. 10 8 28 20
Baltimore, Md............ 31 20 9 14
Charlotte, N.C........... 4 8 11 7
Jacksonville, Fla........ 3 4 6 5
Miami, Fla............... 2 4 2 3
Norfolk, Va.............. 10 19 15 21
Richmond, Va.............. 22 16 13 9
Savannah, Ga.............. 3 2 6 4
St. Petersburg, Fla...... 7 6 7 6
Tampa, Fla............... 1 1 2 2
Washington, D.C............ 23 19 15 12
Wilmington, Del........... 9 4 8 8

EAST SOUTH CENTRAL:
Birmingham, Ala.......... 1 2 7 11
Chattanooga, Tenn........ 6 3 5 11
Knoxville, Tenn.......... 4 1 2 4
Louisville, Ky............ 16 18 18 40
Memphis, Tenn............ 1 10 9 23
Mobile, Ala.............. 1 2 4 2
Montgomery, Ala.......... 1 6 14 10
Nashville, Tenn.......... 2 4 8 16

WEST SOUTH CENTRAL:
Austin, Tex.............. 4 3 4 9
Baton Rouge, La.......... 2 1 2 3
Corpus Christi, Tex...... 1 0 3 2
Dallas, Tex.............. 5 3 6 10
El Paso, Tex............... 0 2 2 4
Fort Worth, Tex.......... 4 2 2 9
Houston, Tex.............. 2 8 11 7
Little Rock, Ark......... 14 7 12 11
New Orleans, La.......... 4 6 11 29
Oklahoma City, Okla...... 2 3 9 6
San Antonio, Tex......... 5 5 11 9
Shreveport, La........... 6 5 6 9
Tulsa, Okla.............. 6 7 5 9

MOUNTAIN:
Albuquerque, N. Mex...... 0 6 2 7
Colorado Springs, Colo... 1 2 3 2
Denver, Colo.............. 11 12 6 12
Ogden, Utah............... 3 1 3 0
Phoenix, Ariz............. 2 4 3 5
Pueblo, Colo.............. 0 0 0 0
Salt Lake City, Utah..... 0 2 3 1
Tucson, Ariz ............. 0 1 4 0

PACIFIC:
Berkeley, Calif.......... 0 1 1 0
Fresno, Calif............. 2 2 0 2
Glendale, Calif........... 1 0 0 1
Honolulu, Hawaii.......... 0 3 3 1
Long Beach, Calif........ 3 2 1 1
Los Angeles, Calif....... 21 17 26 18
Oakland, Calif........... 4 2 1 1
Pasadena, Calif.......... 1 2 0 2
Portland, Oreg............ 6 2 7 3
Sacramento, Calif........ 1 4 3 1
San Diego, Calif......... 3 5 3 2
San Francisco, Calif ..... 6 2 3 3
San Jose, Calif.......... 6 6 9 5
Seattle, Wash............ 8 3 4 8
Spokane, Wash........... 1 0 2 0
Tacoma, Wash.............. 0 1 1 1

San Juan, P.R.............. 2 3 1 0


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.....


14,625
1,102
870
8,369




UNIVERSITY OF FLORIDA


3 1262 08864 1328


Morbidity and Mortality Weekly Report


pared to a total of about 18,200 for the previous week.
Total number of counties reporting one or more outbreaks
also decreased this week from 16 to 10. Outbreaks thus
far have been clustered in two major areas: one in the
southeastern corner of the State and a second in the Pan-
handle. Single A2 virus isolates have been obtained in
each of three counties to date. Outbreaks of influenza-like
illness have been reported from only one of these areas,
however, (Travis County), the other isolates having been
obtained from sporadic cases.
(Reported by Dr. Van C. Tipton, Director, Communicable
Disease Division, Texas State Department of Health).
West Virginia Laboratory confirmation of influenza
A2 infection has been obtained for two cases seen during
recent outbreaks in Kanawha County. Twenty-five of the
State's 55 counties have reported one or more outbreaks
thus far. Laboratory studies on specimens from other
areas are currently under way.
(Reported by Dr. L. A. Dickerson, Director, Disease
Control, West Virginia State Health Department).


INTERNATIONAL NOTES QUARANTINE MEASURES

Designated Yellow Fever Vaccination Center

The Dulles International Airport Yellow Fever Vac-
cination Center, Herndon Medical Center Annex, Dulles
International Airport, Chantilly, Virginia, has been desig-
nated as a Yellow Fever Vaccination Center. The total
number of centers remain as 176; of these, 117 are open
to the public and listed in section 6 of the booklet "Immun-
ization Information for International Travel."
The new center has indicated that they will serve
the public instead of a "specific employee group" as
mentioned in a previous report.










7-
i ST~


PLAGUE INFECTION IN DOMESTIC RAT -
SAN FRANCISCO

A dead domestic rat (rattus rattus alexandrinus) found
in a residential area in San Francisco on February 23 was
found on laboratory examination to be infected with,plague
bacilli.
The rat was found in the yard of a residence approxi-
mately three blocks south of the yacht harbor, about two
miles distant from the commercial dock area. The rat was
taken to the Public Health Service Hospital and subse-
quently examined at the Communicable Disease Center
Plague Laboratory in San Francisco. Initial autopsy of the
rat revealed no gross pathology. However, inoculated
guinea pigs revealed definite gross lesions of plague.
Presence of the organism was confirmed by culture, sero-
logic evidence, complement fixation and phage typing.
Preliminary observations reveal no gross evidence
of an epizootic in the area. Forty sanitarians from the
San Francisco County Health Department have begun an
intensive program of investigation and rat trapping in a
twelve block area proximal to the site where the dead rat
was found. For administrative purposes, this has been
designated as the "local infected area".
Although the site in question is not contiguous to
international traffic facilities, the Division of Foreign
Quarantine is taking more stringent measures to protect
shipping.
(Reported by Dr. Ellis Sox, Director of Public Health.
San Francisco County Health Department; Dr. Henry Ren-
teln, California State Department of Public Health and
The Communicable Disease Center Plague Laboratory).


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