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:
AA00010654:00126

Related Items

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

Full Text
F-s jM tori /dy




Morbidity


J/


and Mortality


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

PUBLIC HEALTH SERVICE


Prepared by the


COMNCBEDSAECNE


For release Octob 3


ATLANTA, GEORGIA 30333


PROVISIONAL INFORMATION ON SELECTED NOTIFIABLE DISEASES IN T
DEATHS IN SELECTED CITIES FOR WEEK ENDED OCTOBER 5,


EPIDEMIC BOTULISM RELATED TO SMOKED FISH
INGESTION

A sharp outbreak of botulism related to the ingestion
of smoked fish products has resulted in a total of 13
cases of the disease with 6 fatalities, The cases which
had onsets from September 29 October 7 occurred among
seven members of three different families in Knoxville,
Tennessee, in 3 unrelated individuals in Nashville,
Tennessee, a boy in Huntsville, Alabama, and in a
husband and wife in Kalamazoo, Michigan,
Pertinent information on each of these cases as
available through noon October 9 is summarized in the
line listing in Table I. Each of the Tennessee cases and
the Alabama- case had consumed varying amounts of a
commercially prepared plastic wrapped product known as


"vacuum packed smoked whitefish chubs" produced by
the H. J. Dorbos and Brother Company of Grand Haven,
Michigan, and distributed by Kroger's supermarkets. The
two Michigan cases had eaten smoked whitefish but the
commercial source of this is as yet uncertain. Therefore,
no clearcut link between the two occurrences exists at
the moment.
Dr. Glenn G. Slocum, Director, Division of Micro-
biology, Food and Drug Administration reports that type E
botulinus toxin has been demonstrated in specimens of
smoked fish remaining in the refrigerator of the Kalamazoo
couple and also in samples of chubs from the same plas-
tic package that contained fish eaten by two of the
Tennessee fatalities (Family B, Knoxville).
From preliminary information regarding distribution
of the commercial product "Dornbos smoked whitefish


Table 1. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous week)
40th Week Cumulative
Ended Ended First 40 weeks
Disease Median
October 5, October 6, 1958 1962 Median
1963 1962 1963 1962 1958 1962
Aseptic meningitis ............... 58 89 --- 1,385 1,945 --
Brucellosis ..................... 8 9 17 285 320 583
Diphtheria ...................... 8 17 17 194 323 497
Encephalitis, infectious .......... 23 47 55 1,220 1,466 1,466
Hepatitis, infectious and serum... 877 947 811 33,507 42,874 28,847
Measles.. : .... ........ 805 1,331 1,026 360,881 445,694 398,286
Meningococcal infections......... 39 32 40 1,873 1,659 1,768
Poliomyelitis, total............... 19 37 130 305 645 2,426
Paralytic..................... 15 34 101 257 507 1,671
Nonparalytic ................. 2 3 24 31 101 523
Unspecified................... 2 5 17 37 232
Streptococcal sore throat
and Scarlet fever ............ 4,649 4,406 --- 263,871 245,695 -
Tetanus ........................ 6 11 --- 202 213
Tularemia ...................... .4 7 -- 221 230
Typhoid fever ................... 19 15 15 410 489 633
Typhus fever, tick-borne,
(Rocky Mountain spotted)...... 3 2 --- 164 198 ---
Rabies in Animals ............... 62 58 58 2,938 2,980 2,977


Table 2. NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax: 4 Psittacosis: Calif. 1 62
Botulism: Tenn. 10, Mich. 2 29 Rabies in Man: 1
Malaria: Conn. 1 71 Smallpox:
Plague: Typhus, murine: 21


---








Morbidity and Mortality Weekly Report


TABLE I
Botulism Cases Tennessee Michigan
Epidemiological Data


Case Identification
I _. ,I i
Case ;1
Case #2
Family B
Case #3

Case #4
Family C
Case #5

Case #6
Case #7
Nashville, Tenn.
Case #8

Case 49

Case #12

Huntsville, Ala.
Case 813

Kalamazoo, Mich.
Family D
Case l10


Age Sex Time Onset Source Food


42 M 10/3
42 F 10;3

32 M 10/5
afternoon
10 F 10 5 after


Ea


Time Food Eaten Other


ch had 1 2 of same whitefish chuh*


10/2 supper Slow progression
102 supper Mild


Each had 1/2 of same whitefish chub* 10/5 breakfast Died 10/7, 7:45 a. m.

oon 10 5 breakfast Died 10 7, 7:30 a.m.


10 7 Each had portions of one whitefish
5:00 a. m. chub*
10/7 5:00 a.m.
10 7 5:00 a.m.


30 M 9 29-a.m. Smoked whitefish chubs*

53 M 10 7 Smoked whitefish chubs*

51 F 10/6-a.m. Smoked whitefish chubs*


5 M 10/5-a.m. Smoked whitefish chubs*



64 M 10/2 Smoked whitefish**


Case 11 62 F 10/2 Smoked whitefish**
*Source Food Dornbos and Brother Company, Grand Haven, Michigan
**Source unknown


chubs," it would appear that all the Tennessee and
Alabama cases could be accounted for on the basis of
one shipment of the product to Kroger's warehouse in
Nashville. This shipment, the first for several months,
was packed in dry ice and left Grand Haven on September
19, arriving in Nashville on September 25. It was then
distributed to 18 Kroger stores in Tennessee as well as
northern Alabama and southern Kentucky. The shipment to
Knoxville arrived September27 and was placed on shelves
for sale on September 30 at the Kingston Pike Kroger
supermarket.
Four Tennessee cases have been treated with Type
E. antiserum. Connaught Medical Research Laboratories,
Toronto, the sole supplier, reports that the supplies of
Type E botulinum antisera are quite limited. These in-
clude both the monovalent Type E and polyvalent ABEF
of Danish manufacture. Usual treatment of clinical cases
consists of an initial dose of two vials (one IV and one
IM). It is suggested that all cases with significant symp-
toms and a history of ingesting smoked fish be treated
with Type E antisera in one of the available forms. Addi-
tional supportive, therapy directed at problems of respira-
tory depression has included tracheotomy as well as the
use of tank respirators.
According to the records of CDC, only six previous
outbreaks of Type E botulism are known to have occurred
in the United States. These outbre iks are summarized in


10/6 1:00 p.m.

10/6 1:00 p.m.
10/6 1:00 p.m.


Severe

Severe
Severe


9/28 supper Adm. Dx. Myasthenia gravis
Died 9/30 Dx. botulism retrospect
106 p. m. Some family members ate small
amounts of fish without ill effect
10 5 p.m. Ate all fish in package
Died 10/6 p. m.

10/4 noon Mother, grandmother also ate
small amount not ill


Died 10/2
Died 10/2


Table II. It will be noted that with the exception of the
San Francisco outbreak in 1941, all of the outbreaks of
Type E botulism in the United States have been related
to fish products and raw white whale flippers (not strictly
a fish product).

TABLE II
KNOWN OUTBREAKS OF C. BOTULISM TYPE E
IN THE UNITED STATES

Number Number
of of Contaminated
Year Cases Deaths Location Food Items
1934 3 1 Westchester, N. Y. Commercially conned
sprats from Germany
1934 3 1 Cooperstown, N. Y. Labrador smoked
salmon
1941 3 1 San Francisco, Mushrooms from Yugo-
Calif. slavia conned in
California
1950 5 0 Point Hope, Alaska Raw white whole
flipper
1960 2 2 Minneapolis, Minn. Plastic vacuum packed
smoked ciscoes caught
in the Great Lakes
1963 3 2 Wayne County, Mich. Tuna fish conned in
California
Total 19 8




POLIOMYELITIS

A total of 19 cases of poliomyelitis, 15 with paralysis,
were reported for the week ending October 5. During the


330








Morbidity and Mortality Weekly Report


corresponding week in 1962, there were 37 cases reported.
Three cases were. reported by Pennsylvania, Michigan,
Georgia and Alabama., two each by Indiana and Arizona,
and single cases from Illinois, Virginia and California.
The cumulative totals, presented below, continue to
reflect about one-half the incidence of polio as compared
to 1962.

POLIOMYELITIS THROUGH THE 40TH WEEK
FOR PAST FIVE YEARS

1963 1962 1961 1960 1959

Paralytic 257 507 642 1675 4284


Total


305 645 992 2420 6652


The six week totals for 1963 and the previous four
years are listed below:



SIX WEEKS TOTALS (35TH THRU 40TH WEEK)
FOR PAST FIVE YEARS

1963 1962 1961 1960 1959

Paralytic 87 171 260 709 1757


Total


106 209 433 1052 2734



EPIDEMIOLOGICAL REPORTS


Dengue Fever Puerto Rico

There have been 1,493 cases of dengue fever reported
in the lastweek by the Puerto Rico Department of Health,


bringing the total to 14,455 cases as of noon, October 7,
1963. Although 67 of 77 municipios have reported cases,
the predominant number of cases continue to be reported
from relatively few of the municipios; 12 municipios
account for 74 percent of the 14,455 cases.
Naguabo (population:17,195) is the most recent
municipio, and the first one on the eastern end of the
island, to report 250 or more cases. There have been
323 cases reported in Naguabo, of which 135 were
reported during the past week.
Intensive day-to-day surveillance continues in
Barriada Frailes Llanos and Barriada Marrero in the
township of Guaynabo. Attack rates in these population
groups are given below:


Dengue-like Attack
Period Area Population Illness Rate (%)
Aug. 1 thru
Sept. 24 Guaynabo Township* 868 153 17.6
Aug. 1 thru Barriada Frailes
Oct. 7 Llanos 488 115 23.6
Aug. 1 thru
Oct. 7 Barriada Morrero 209 75 35.9
*From Morbidity survey conducted on September 24 and 25; a follow-up
survey is planned on October 15 and 16.



The average duration of illness has ranged from 5.0
days in Barriada Frailes Llanos to 6.1 days in Barriada
Marrero to 6.5 days for the entire township of Guaynabo.
The distribution of clinical symptoms and signs among
patients in these areas is summarized on page 336.


SUMMARY OF DEATHS AMONG PERSONS 65 YEARS AND
OVER IN 108 U. S. CITIES

The weekly average number of deaths among persons 65
years and over in 108 cities for the four-week period
ending October 5 was 6,070 as compared with an expected
weekly average of 6,095.




WEEK ENDING
4 Week Weekly
9/14 9/21 9/28 10/5 Total Average

Observed 5,958 5,993 6,104 6,227 24,282 6,070
Expected 6,024 6,067 6,117 6,171 24,379 6,095
Excess 66 -74 -13 56 -97 -25


DEATHS ATAGE6S AND OVER IN 108 U.S. CITIES
Aroge number per week by four- k periods


(See Table, page 335)


331











*1.12 liorbiditi and Mortaliti Weekly Report



I ab h ( M CASI S MF SPI( 1IFD NOTIIFIABI.E D)ISASES; UNITEDD STATES

FOR WX I KS I ENDED

OCTOBER 5, 1963 AND OCTOBER 6, 1962



Poliomyelitis, Aseptic
Poliomyelitis, total cases Poliomyelitis, paralytic nonparalytic Meningitis
Cumulative Cumulative
40th week First 40 weeks 40th week First 40 weeks 40th week 40th week

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

I,'ITED STATES...... 19 37 305 645 15 34 257 507 2 3 58 89

NEW ENGIAND .............. 4 7 4 7
Maine................. 1 1
Nw liaipshir- ........ -
Ver ont ............... 1 1 -
Massachu s. .......... 2 6 2 6
Rhode I la d ..........-
C ........... 1 1

MIDDLE ATL 'AII............ 3 2 96 67 3 2 74 47 5 -
Sew Y1rl.............. 2 8 52 2 5 34 5
N J r ..... ..... 1 6 1 6
P-n-sylvaliia 3 87 9 3 68 7 -

EAST NORTH CENTRAL....... 6 10 48 80 4 9 36 56 1 16 16
Ohioi................... 1 8 17 1 4 15 5 7
Indiana................ 2 1 4 14 1 1 10 1 2
Illinis ............... 1 8 15 35 1 7 14 23 1 2 4
ichi gan.............. 3 15 9 3 15 6 8 3
Wisconsin............ 6 5 2 2

WEST NORTH CENTRAL ....... 2 5 31 2 5 21 1 8
Minnesot a............. 4 6 4 6 1 5
lowa.................. 5 2
Miss ouri.............. 9 4- -
North Dakota........ 3 1 -
Suth Dait........... 1 1
Nebratska.............. 2 1 7 2 1 7 1
KaLsas................ 2

SOUTH ATLANTIC........... 4 5 42 51 3 5 37 45 1 5 4
Dela-ware.............. 1 1 1
Maryland .............. 1 1
District 'f Colunbia. 2 1 1
Virginia .............. 8 7 5 7 1 1
West Virgnia.......... 1 5 1 5 1 1
North Carl ina........ 3 3 8 3 3 7
South Carli n..a........ 1 6 6 1 5 6 1
Georgia............... 3 1 17 12 3 1 16 11 -
Florida............... 6 10 6 7 4 -

EAST SOUT'H CENTRAL ...... 3 2 63 60 3 2 59 49 8 7
Kentuck .............. 1 25 1 19 8 -
Tenncsse. .... .... 8 9 8 4 1
Alaba. ............... 3 47 22 3 43 22 1
M'issisppi ........... 2 7 4 2 7 4 5

WEST SOU1T CENTRAL....... 11 24 272 9 23 213 2 1 12
Arkansa ............. 2 4 11 I 3 11 1
Louisiai. ............. 14 19 14 17 -
tOklah..a.............. 3 15 2 12 1 3
Tex ................ 6 6 227 5 6 173 1 9

:O: TAIN................. 2 4 12 2 3 8 2 3
1 intana ............... 3 2 2
Idaho ................ 1 2 1 1
Wy min:.............. 2 1
Coli ri .............. 1 1 1

Ari a............... 2 2 3 2 2 3 1
ta.......... .. -
vad l ................

PAr II .................. 1 5 19 65 5 16 61 1 20 39
i n........ ... 2 1 2 3 2
S................ 2 5 1 5 1 1
S.:ria............ 1 5 16 58 5 14 54 1 16 36



P t Ri ............ 1 5 12 4 12










Morbidity and Mortality Weekly Report 333


Table 3. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

OCTOBER 5, 1963 AND OCTOBER 6, 1962 (Continued)



Brucellosis Diphtheria Encephalitis, Hepatitis, Measles
infectious infectious and serum
Prea
Cumu- Cumu- 40th week
lative lative Under 20 &
40th week 40 weeks 40th week 40 weeks 40th week 20 yr. over Total 40th week
1963 1963 1963 1963 1963 1962 1963 1963 1963 1962 1963 1962
UNITED STATES...... 8 285 8 194 23 47 475 359 877 947 805 1,331

NEW ENGLAND.............. 1 8 1 70 42 116 97 39 61
Maine................. 36 16 52 28 6 2
New Hampshire......... 11 6 17 19 1 1
Vermont............... 1 4 3 7 2 4 19
Massachusetts......... 6 15 5 21 38 9 21
Rhode Island.......... 2 1 1 2 6 4 4 5
Connecticut............ 3 10 13 6 15 13

MIDDLE ATLANTIC.......... 6 21 9 9 110 94 204 198 117 96
New York............... 3 13 6 6 66 54 120 99 75 46
New Jersey............. 1 3 9 14 23 33 25 15
Pennsylvania.......... 2 5 3 3 35 26 61 66 17 35

EAST NORTH CENTRAL....... 30 23 1 4 73 49 129 174 230 259
Ohio.................. 1 1 2 17 14 33 53 19 22
Indiana............... 5 5 8 4 12 24 43 50
Illinois .............. 18 12 1 13 4 18 45 69 26
Michigan .............. 5 3 1 33 27 60 46 52 72
Wisconsin ............ 2 2 2 6 6 47 89

WEST NORTH CENTRAL....... '4 159 38 3 19 19 38 48 13 278
Minnesota..........;..;. 8 15 1 1 3 4 16 2 7
Iowa.................... 2 117 1 7 6 13 13 6 212
Missouri............... 12 1 1 1 8 9 5 1 20
North Dakota.......... 2 9 9 4 36
South Dakota.......... 2 10 11 1 1 1
Nebraska.............. 6 8 8 2
Kansas................ 6 1 2 3 5 NN NN

SOUTH ATLANTIC........... 3 18 1 44 21 64 30 94 88 101 105
Delaware ............. 4 4 3
Maryland ............. 10 4 14 10 20 9
District of Columbia. 1 1 2 3 2 -
Virginia.............. 1 8 1 14 5 19 15 42 4
West Virginia.......... 1 1 6 4 10 4 31 40
North Carolina........ 4 2 1 10 4 14 21 1 -
South Carolina........ 17 1 6 1 7 4 4 8
Georgia................. 3 1 14 7 5 12 14 1 -
Florida................ 2 3 9 17 6 5 11 18 2 41

EAST SOUTH CENTRAL....... 13 2 16 1 3 27 25 52 80 35 56
Kentucky.............. 3 8 5 13 26 16 15
Tennessee............. 6 3 1 6 13 19 15 15 27
Alabama............... 4 10 11 3 14 24 6
Mississippi........... 2 3 1 2 2 4 6 15 4 8

WEST SOUTH CENTRAL....... 32 5 35 5 21 19 40 63 72 72
Arkansas............... 7 2 3 2 1 3 7 1
Louisiana............. 8 5 18 5 5 10 17 I
Oklahoma.............. 5 6 5 1 -
Texas................. 12 9 2 14 13 27 34 71 70

MOUNTAIN ................ 9 5 2 15 9 53 50 59 227
Montana.. ............. -- 2 4 8 1 17 153
Idaho................. 7 2 8 20
Wyoming...............- 2
Colorado................- 3 3 1 12 17 13 29
New Mexico............ 2 6 3 10 6 NN NN
Arizona ............... 3 2 11 14 6 6
Utah.................. 5 4 1 5 9 15 13
Nevada...... ......... -- 1 4

PACIFIC..................... 1 17 4 6 5 76 72 151 149 139 177
Washington............ 16 5 22 19 28 37
Oregon............... 3 2 8 6 16 19 22 20
California............. 1 13 4 4 5 49 58 107 104 66 56
Alaska.................. 3 3 6 7 20 21
Hawaii................ 1 3 43

Puerto Rico.............. 12 8 3 11 16 20 31










334 Mlorbidit and Mortality Weekly Report


Tnabl i (CASES OF SPECIFIDiD NOTIFIABLE DISEASES: UNITED STATES

FOR WIEKS NI)ED

OCTOBER 5, 1963 AND OCTOBER 6, 1962 (Continued)



Infections Sore Throat & Tetanus Typhus Tularemia Typhoid Fever Rabies in Animals
Scarlet Fever (Rcky Mt.
Ara Cumu- Spotted) Cumu- Cumu-
lative lative lative
40th wk. 40weeks 40th week 40th wk. 40th wk. 40th wk. 40thwk. 40weeks 40th week 40 weeks
1963 1963 1963 1962 1963 1963 1963 1963 1963 1963 1962 1963

UNITED STATES.... 39 1,873 4,649 4,406 6 3 4 19 410 62 58 2,938

NEW ENGLAND......... 4 116 266 292 11 1 27
Maine.............. 17 14 95 2 1 2
New Hampshire...... 4 1 2 12
Vermont............. 4 5 4 1 12
Massachusetts ..... 1 54 69 37 6 1
Rhode Island....... 1 11 15 11 -
Connecticut........ 2 26 162 143 2 -

MIDDLE ATLANTIC..... 2 254 177 136 1 1 3 77 2 11 92
New York............ 1 120 135 90 3 37 1 9 68
New Jersey......... 1 36 28 14 5 -
Pennsylvania....... 98 14 32 1 1 35 1 2 24

EAST NORTH CENTRAL.. 6 290 316 366 1 1 8 47 9 6 459
Ohio .............. 77 26 43 1 1 16 6 2 269
Indiana............. 2 45 72 85 -- 7 1 42
Illinois........... 2 55 42 77 9 1 2 65
Michigan........... 1 85 122 77 7 10 1 43
Wisconsin.......... 1 28 54 84 1 5 1 1 40

WEST NORTH CENTRAL.. 2 117 116 145 2 1 24 16 12 752
Minnesota........... 1 23 6 9 1 3 5 189
Iowa................ 7 26 32 1 1 3 6 8 285
Missouri........... 34 25 13 14 3 2 122
North Dakota....... 1 13 54 83 29
South Dakota....... 5 3 1 1 2 82
Nebraska........... 24 1 1 1 27
Kansas............. 11 2 7 2 18

SOUTH ATLANTIC...... 7 345 545 378 1 1 1 53 14 7 419
Delaware............ 4 1 3 3 1
Maryland........... 50 7 9 9 -
Dist. of Columbia.. 6 1 2 -
Virginia........... 2 77 149 76 1 8 9 3 154
West Virginia...... 1 18 219 121 6 2 4 108
North Carolina..... 2 62 7 17 1 1 7 2 14
South Carolina..... 18 33 50 3 1 8
Georgia............ 28 7 5 2 65
Florida............. 2 82 121 95 15 69

EAST SOUTH CENTRAL.. 1 135 763 627 1 2 58 7 4 235
Kentucky........... 29 62 49 1 12 2 111
Tennessee.......... 1 61 650 528 21 5 4 107
Alabama............ 23 26 14 1 10 17
Mississippi ........ 22 25 36 1 15 -

WEST SOUTH CENTRAL.. 2 170 579 688 1 3 4 75 3 7 557
Arkansas........... 11 4 1 3 4 29 3 1 66
Louisiana.......... 1 70 6 2 22 42
Oklahoma........... 1 31 9 1 -- 5 1 49
Texas............. 58 560 685 19 5 400

MOUNTAIN ............ 60 1,026 1,040 16 4 4 117
Montana............. 3 24 30 -
Idaho............... 6 45 82 -
Wyoming............ 4 10 7 -
Colorado .......... 16 407 369 6 16
New Mexico......... 4 277 386 3 2 37
Arizona............. 10 188 88 7 2 4 53
Utah............... 14 72 72 -
Nevada............. 3 3 6 11

PACIFIC.............. 15 386 861 734 49 6 7 280
Washington ......... 2 30 295 218 2 -
Oregon............. 1 28 11 35 2 1 8
California......... 12 308 384 456 42 6 6 263
Alaska............. 12 24 5 1 9
Hawaii............. 8 147 20 -- 2 -
Puerto Rico......... 7 4 1 12 1 4 13









Morbidity and Mortality Weekly Report





Table 4 (D). TOTAL DEATHS AMONG PERSONS 65 YEARS AND OVER IN REPORTING CITIES



(Tables 4(A), 4(B), 4(C), and 4(D) will be published in sequence covering a four-week period.)o


335


Area For weeks ending -Area For weeks ending

9/14 9/21 9/28 10/5 9/14 9/21 9/28 10/5


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, Ofio...............
Canton, Ohio...............
Chicago, Ill ..............
Cincinnati, Ohio..........
Cleveland, Ohio............
Columbus, Ohio............
Dayton, Ohio...............
Detroit, Mich.............
Evansville, Ind.........,.
Flint, Mich...............
Fort Wayne, Ind...........
Cary, 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.............


120
12
13
16
32
16
15
20
23
30
7
19
19
30


28
28
81
24
8
25
31
45
822
14
279
114
27
57
13
24
41
28
16
15


19
17
369
104
108
67
43
185
18
29
20
19
40
76
15
77
12
13
30
61
35


45
20
19
73
26
60
41
112
34
29


132
19
14
14
27
17
13
20
27
31
5
27
20
30


25
19
73
23
19
15
41
47
874
17
237
89
41
67
16
25
36
19
22
15


36
17
401
99
112
62
41
187
17
22
21
5
35
71
8
69
15
11
28
58
35


36
21
17
72
15
47
39
124
41
23


148
29
16
22
24
17
17
20
32'
37
10
23
18
30


26
23
60
21
13
23
33
40
972
17
285
103
27
70
12
25
34
21
14
14


35
20
388
75
105
53
47
151
24
28
20
12
31
88
11
74
15
19
30
65
26


32
18
15
76
20
74
43
120
44
17


121
24
25
14
26
15
13
23
24
37
12
22
18
30


27
24
80
27
16
12
29
46
921
24
282
108
32
76
11
32
37
27
15
15


26
23
383
87
124
67
55
217
21
16
24
10
30
93
24
73*
11
17
23
57
42


28
20
10
59
19
60
34
126
35
19


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


46
91
23
21
37
21
42
12
60
24
84
13


43
23
27
60
73
21
17
54


30
19
14
62
16
34
76
24
64
36
57
27
40


10
15
63
6
40
4
28
20


44
111
12
28
39
21
36
15
47
49
93
20


33
19
24
81
48
21
21
37


24
14
11
68
13
38
84
29
65
37
49
27
25


16
10
61
10
44
10
32
18


53
135
15
16
45
27
39
12
45
32
72
17


31
18
17
60
38
14
17
43


10
17
8
58
18
30
92
30
77
42
61
20
12


13
8
63
9
50
5
34
11


11
27
28
10
38
320
53
20
81
32
55
110
17
73
33
22


45
143
20
26
48
28
38
10
61
26
99
11


34
18
11
66
56
16
15
42


15
15
8
63
13
30
81
29
89
34
50
19
36


26
7
64
9
36
6
29
19


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


OCurrent Week Mortality for 108 Selected Cities

4(A) Total Mortality, all ages.................... 11,318
4(B) Pneumonia-Influenza Deaths, all ages........ 407
4(C) Total Deaths under 1 Year of Age............. 762
4(D) Total Deaths, Persons 65 years and over..... 6,227


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

NOTE: All deaths by place of occurrence.




UNIVERSITY OF FLORIDA

II1111111IIIIII IIIII
3 1262 08864 0494


Morbidity and Mortality Weekly Report


Borriodo Froiles Llanos Barriodo Marrero
Total patients
(from 13 to 59 years
of age 43 38
Distribution of Symptoms
Percent
Fever 95 97
Headache 91 92
Muscle Pain 86 89
Frontal Headache 84 71
Chills 81 89
Conjunctivitis 79 42
Joint Pain 72 82
Neck Pain 72 82
Back Pain 70 92
Orbital Pain 70 66
G.I. Symptoms 65 58
Rash 49 50
Nausea or Anorexia 44 39
Upper Respiratory
Involvement 42
Lymphadenopathy 35 34


(Reported by Victor Gonzalez, M.D., Director, Bureau of
Health. Puerto Rico Department of Health, and a team /rom
the Communicable Disease Center.)





INTERNATIONAL NOTES

Dengue Fever Jamaica

Nine cases of dengue fever with onset in the first
two weeks of September have been reported bringing the
total cases thus far in 1963 to 466 cases.
The distribution of these cases according to parishes
is as follows: Kingston 121, St. Catherine 118, St. Andrew
195, Portland 52, St. Thomas 27, Clarendon 22, St. James
11, Trelawney 7, St. Elizabeth 5, Manchester 4, St. Mary
3, St. Anne 1. The parishes most affected are in the
southeastern part of the island; the two most western
parishes have not reported cases. The greatest number of
cases reported for any week was 68 during the week
ending August 24.
(Reported in Weekly Epidemiological Report of Pan
American Sanitary Bureau.)


Notes: These provisional data are based on weekly telegram ms t he Coamn.i-
cable Disease Center by the individual State health departatents.
Symbol: --- Data not available
QOantity zero
Procedures for cooatrctios of various mortality carves may be obtaled from
Stattisic Section, Commaunicable Disease Center, Public Health Service,
U. S. Department of Health. Education. and Wellare, Atlanta 22 Georgia.


ra NT a ,

U- --S. DEPOSITORY
;U.S. DEPOSITORY I


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336