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:
AA00010654:00127

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 October 18, 1963 ATLANTA. GEORGIA 30333 Vol. 12, No. 41
PROVISIONAL INFORMATION ON SELECTED NOTIFIABLE DISEASES IN THE UNITED STATES AND ON
DEATHS IN SELECTED CITIES FOR WEEK ENDED OCTOBER 12, 1963


BOTULISM Three additional cases of botulism, in- Fourteen of the victims had eaten the commercially
cluding two deaths, related to the ingestion of smoked prepared plastic wrapped product known as "vacuum
fish products (see MMWR Vol. 12, p. 229) have been' packed smoked whitefish chubs" processed by the H. J.
reported during the week ending October 12. This brings Dornbos and Brother Company of Grand Haven, Michigan
the total to 16 cases and eight deaths for this outbreak, and distributed by Kroger's markets.
The cases reported this week included a.fatality in a Notably, only three of the 16 victims are known to
7-year-old boy from Huntsville, Alabama, and two cases have noted a bad or different taste to the fish. None
from Nashville, Tennessee, one of which was fatal, reported the fish to have a bad odor.
A summary of information pertaining to the 16 cases The whitefish chubs were caught by gill nets in Lake
is shown in the table. The average incubation period, Michigan on September 16. After devisceration, dressing
based on the onset of gastrointestinal symptoms, was 20 and icing aboard the fishing boat, they were reported by
hours, varying from 6% to 21 hours. The average interval Dorbos to have been processed in the following manner:
between ingestion and onset of neurological symptoms they were first ch" at 350 F, then smoked at
was 39 hours, with a range from five to 108 hours. 1800 F room t rAti imum room temperature)



Table 1. CASES OF SPECIFIED N 11 I ABLE 23*E SE jj ]N ED ES
(Cumulative totals include revised and delayed rep t rou previous wee
41st Week five
Ended Ended sAf0t weeks
Disease Median
October 12, October 13, 1958 1962 M '. Median
1963 1962 1962 1958 1962
Aseptic meningitis .............. 58 87 --- 1,443 2,032 -
Brucellosis ..................... 8 4 11 294 324 594
Diphtheria ...................... 9 17 16 203 340 507
Encephalitis, infectious .......... 22 40 45 1,251 1,506 1,506
Hepatitis, infectious and serum... 798 797 797 34,309 43,671 29,648
Measles........................ 857 913 927 361,738 446,607 399,169
Meningococcal infections ......... 29 43 42 1,902 1,702 1,808
Poliomyelitis, total.............. 23 30 121 329 675 2,547
Paralytic .................... 18 26 78 276 533 1,749
Nonparalytic. ................. 4 2 26 35 103 549
Unspecified.. .................. 1 2 17 18 39 249
Streptococcal sore throat
and Scarlet fever ............ 4,608 3,889 -- 268,509 249,584
Tetanus ........................ 15 8 --- 217 221
Tularemia...................... 3 6 --- 225 236
Typhoid fever ................... 20 12 22 432 501 648
Typhus fever, tick-borne,
(Rocky Mountain spotted)...... 2 4 --- 167 202 -
Rabies in Animals ............... 69 57 60 3,010 3,037 3,037

Table 2. NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax: 4 Psittacosis: N.c.-I, Fla.-1, Calif.-1 65
Botulism: Tenn. 3 32 Rabies in Man: 1
Malaria: N.Y.-1, N.J.-1, Pa.-l, Hawaii-3, Fla.-1 78 Smallpox:
Plague: Typhus, murine: Ala. 2, Kans. 1 24


Wekl


I CONINIL'NICABLF DISFASF CENIFR I


*Wt. o/ /./ /.








338


NO. OF ZI '-" o|
CASES |C C .o,
0z -1 0 03




7
Processed d


U. Q.
-~ 8a
"- ,,e


SEPTEMBER OCTOBER


for five hours, then placed in the chill room at 350 F for
1 day. Finally, they were vacuum packaged in clear plastic
wrapping, ready for shipment.
The Kroger shipment left Grand Haven, Michigan on
September 19 by truck. It was delivered to Kroger's ware-
house in Nashville on September 26. Although the ship-
ment left Grand Haven packed in dry ice, it is as yet
uncertain whether it was adequately refrigerated through-
out the trip. It was distributed to 18 Kroger supermarkets
on September 26 and placed on sale in Nashville, Sep-
tember 27, and in Knoxville, September 30 (see figure).
No new case of botulism in. this outbreak has occurred
since Monday, October 7 when news of this incident was
first publicized and the Kroger chain removed the product
from its shelves.
Laboratory studies carried out at the R. A. Taft
Sanitary Engineering Center and at the Food and Drug Ad-
ministration have thus far revealed Clostridium botulinum
Type E and Type E toxin in fish bones recovered from the
home of Family C and from a fish remaining in the Family
B home. Oil from the package from which Case 9 con-
sumed a fish has been shown to contain Type E toxin.
Testing of packages of fish, not yet sold and unrelated
to cases, has revealed Type E toxin in approximately
one-third of the packages.
Two Michigan cases (see MMWR Vol. 12, page 329)
had eaten smoked whitefish. However, there has been no
link established between the two Michigan cases and the
cases in Tennessee and Alabama. Type E botulious toxin
was i cmonstraet in remnants of the fish as well as in


liver and cardiac blood samples from the victims. The
smoked fish eaten by the Michigan couple was a large
whitefish (apparently not the same fish packaged by
Dornbos); it is said to have been purchased from a road-
side stand when the couple took a long weekend trip
through northern Michigan. The source of this whitefish
has not been determined.
CDC has received reports of 32 botulism cases thus
far in 1963, which represents the greatest number of cases
for any one year during the past decade.

BOTULISM 1954.1963
YEAR CASES* YEAR CASES*
1954 18 1959 20
1955 16 1960 12
1956 20 1961 14
1957 26 1962 10
1958 6 1963 32
*Source: State Reports received by Communicable Disease Center.

Of the other 1963 cases, only three have been attribu-
ted to Type E (see MMWR Vol. 12, page 95). This out-
break in Detroit was traced to tuna fish commercially
canned in San Francisco.
tReported hy Dr. Cecil B. Tucker, Director, Division of
Preventable Diseases, ennessee Departnent of Public
Health, Dr. George f1. Aga.te, Epideniologist, Michigan
Department of Health, Pr. (Ginn Slocan, Fo administration, Dr. r. i, 'Smiuth,. Director, Bureau of
Preventable Dissases, labhamai Statue apartment of
IHieaith R. i. 7alt aCrtitari Engineering Center, and the
(t.m ,Vunicable Disease (r'ter.!


1


Morbidity and Mortality Weekly Report




EPIDEMIC CURVE OF BOTULISM RELATED TO SMOKED FISH


# =CASE NUMBER, CASE; =FATAL CASE.








339


Morbidity and Mortality Weekly Report




Table 1

BOTULISM CASES TENNESSEE MICHIGAN ALABAMA
EPIDEMIOLOGICAL DATA

INTERVAL, IN HOURS, FROM INGESTION TO


CASE
Knoxville, Tennessee
Family A
Case #1
#2
Family B
Case #3
#4
Family C
Case #5
#6
#7
Nashville, Tennessee
Case #8
#9
#12
#14
#15
Huntsville, Alabama
Case #13
#16
Kalamazoo, Michigan
Family D
Case #10
#11


AGE SEX DATE, TIME INGESTION


42 M 10/2 6PM
41 F 10/2 6PM

32 M 10/5 10AM
10 F 10/5 10AM

39 F 10/6 1PM
10 F 10/6 1PM
8 F 10/6 1PM

37 M 9/28 11AM
53 M 10/6 5PM
52 F 10/5 2-6fM**
47 M 9/28 11AM
54 M 10/4 -7PM


5 M 10/4 11:30AM
7 M 10/1 *


64 M 10/1 3PM
62 F 10/1 3PM


GI SYMPTOMS NEURO SYMPTOMS DEATH


108 Alive
170 Alive

5 46
18 48


48 Alive
* Died 10/2


13 a
13 24


* Specific information not available yet.
** Ate 3 fish at 2, 4 and 6 PM.


POLIOMYELITIS- Twenty-nine cases of poliomyelitis,
23 paralytic, were reported for the week ending October
12. Eight cases were reported from Pennsylvania and
seven from Virginia. No other State reported more than
three cases.
All of Virginia's cases were reported from the Peters-
burg region. A mass community immunization program,


utilizing type I oral polio vaccine from the Communicable
Disease Center epidemic reserve, was conducted October
12 in Petersburg.
Six of Pennsylvania's cases occurred in the metro-
politan Philadelphia area.
The nation's total thus far in 1963 remains below
one-half that reported for a comparable period last year.


TOTAL DEATHS REPORTED IN 108 CITIES

The weekly average number of total deaths in 108 cities
for the four-week period ending October 12 was 11,134
as compared with an expected weekly average of 10,833.






TOTAL DEATHS RECORDED IN 108 UNITED STATES CITIES

WEEK ENDING
_WEEK ENDING 4 Week Weekly
9/21 9/28 10/5 10/12 Total Average

Observed 10,951 10,982 11,313 11,290 44,536 11,134
Expected 10,688 10,777 10,878 10,990 43,333 10,833

Excess 263 205 435 300 1,203 301


(See table, page 343)


! k










310 lorbidity and Miortalili Weekly Reporl


Table ,. CASIS OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

OCTOBER 12, 1963 AND OCTOBER 13, 1962


Poliomyelitis, Aseptic
Poliomyelitis, total cases Poliomyelitis, paralytic nonparalytic Meningitis
Cumulative Cumulative
Area
41st week First 41weeks 41st week First 41 weeks 41st week 41st week

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

UNITED STATES...... 23 30 329 675 18 26 276 533 4 2 58 87

NEW ENGLAND............... 4 7 4 7 2 1
Maine................. 1 1 -
New Hampshire........- -
Vermont ............... 1 1
Massachusetts......... 2 6 2 6 2
Rhode Island........... 1
Connecticut........... 1 -- 1 -

MIDDIE ATLANTIC........... 8 5 104 72 7 4 81 51 1 4 1
New York............... 3 8 55 3 5 37 4 1
New Jersey............. 1 6 1 6 -
Pennsylvania 8 2 95 11 7 1 75 8 1

EAST NORTH CENTRAL....... 1 7 49 87 1 7 37 63 8 9
Ohio.................. 8 17 4 15 1 3
Indiana............... 2 4 16 2 1 12
Illinois.............. 1 1 16 36 1 1 15 24 3
Michigan.............. 3 15 12 3 15 9 4 6
Wisconsin ............. 1 6 6 1 2 3

WEST NORTH CENTRAL....... 1 5 32 1 5 22 3 6
Minnesota............. 4 6 4 6 3 4
Iowa ... .............. 5 2 -
Missouri .............. 9 4
North Dakota.......... 1 4 1 2
South Dakota........... 1 1
Nebraska.............. 1 7 1 7
Kansas................ -- 2

SOUTH ATLANTIC........... 13 4 56 55 9 3 47 48 3 1 1 6
Delaware.............. 1 1 1
Maryland.............. 3 3 1 1 1 1 1 -
District of Columbia.. 2 1
Virginia............... 7 15 7 5 10 7 2 I 1
West Virginia......... 2 5 2 5
North Carolina........ 2 3 10 1 3 8 1 -
South Carolina.. ...... 6 6 5 6 -
Georgia............... 2 2 19 14 2 2 18 13
Florida............... 1 7 10 1 7 7 4

EAST SOUTH CENTRAL....... 1 3 64 63 1 3 60 52 8 4
Kentucky.............. 1 1 26 1 1 20 6
Tennessee ............. 8 9 8 4 1
Alabama............... 1 48 22 1 44 22 1
Mississippi............ 2 7 6 2 7 6 4

WEST SOUTH CENTRAL ...... 6 24 278 4 23 217 1 2 21
Arkansas.............. 1 4 12 1 3 12 1
Louisiana............. 1 14 20 1 14 18 -
Oklahoma .............. 1 16 12 9
Texas ................. 3 6 230 2 6 175 1 2 11

MOUNTAIN ................ 2 4 14 2 3 10 8 1
Montana .............. 1 4 1 3 -
Id.h ................. 1 2 1 1
Wyoming............... 2 1 -
C lora. .............. .. 2 I 1 6 1
Nw Mexic ..i.............. 1
Arizon................ 2 3 2 3
U t h.... .............. 1 -1 2
NIvada................

PACIFIC.................. 2 19 67 2 16 63 22 38
sh 1 i ngt o....... ...... 2 1 2 1 2 2
iS, on................ 2 5 1 5
Ct i irni ............ 2 16 60 2 14 56 20 38
P Alat k Ri. ............... -
-l- --, i- ........................ 7
l ,ri Rico .................5 32 4 12








Morbidity and Mortality Weekly Report 341



Table 3. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

OCTOBER 12, 1963 AND OCTOBER 13, 1962 (Continued)



Brucellosis Diphtheria Encephalitis, Hepatitis, Measles
infectious infectious and serum
Area
ACumu- Cumu- 41st week
lative lative Under 20 &
41st week 41 weeks 41st week 41 weeks 41st week 20 yr. over Total 41st week
1963 1963 1963 1963 1963 1962 1963 1963 1963 1962 1963 1962
UNITED STATES...... 8 294 9 203 22 40 413 330 798 797 857 913

NEW ENGLAND.............. 1 8 1 75 41 120 102 29 34
Maine................. 34 17 51 32 5 4
New Hampshire.......... 10 7 19 12 4
Vermont............... 1 4 3 7 1 1
Massachusetts......... 6 1 22 7 29 43 7 19
Rhode Island.......... 2 1 3 5 7 1
Connecticut............ 5 6 11 10 9 5

MIDDLE ATLANTIC........... 1 7 1 22 7 5 75 64 139 119 93 51
New York............... 3 13 6 4 35 27 62 55 65 22
New Jersey............. 1 1 4 15 21 36 18 1 12
Pennsylvania .......... 1 3 5 1 1 25 16 41 46 27 17

EAST NORTH CENTRAL........ 1 31 23 3 2 60 46 109 153 176 199
Ohio................... 1 1 1 16 11 30 54 25 31
Indiana................ 1 6 5 9 8 17 8 22 14
Illinois.............. 18 12 1 6 8 14 28 33 20
Michigan .............. 5 3 2 27 19 46 46 56 134
Wisconsin ............. 2 2 2 2 17 40

WEST NORTH CENTRAL........ 5 164 1 39 2 2 17 16 43 29 38 20
Minnesota............. 8 15 2 5 10 6 4 2
Iowa ................ 5 122 1 1 1 1 9 6
Missouri.............. 12 1 1 1 6 2 8 3 3 1
North Dakota.......... 2 1 1 5 6 1 23 14
South Dakota........... 10 1 12 4 4 2 3
Nebraska.............. 6 8 2 3 6 4 -
Kansas................. 6 2 8 6 NN NN

SOUTH ATLANTIC........... 18 4 48 2 13 42 31 80 86 101 97
Delaware.............. 3 1 4 1
Maryland.............. 6 4 10 10 5 9
District of Columbia.. 1 2 1 3 2 1
Virginia.............. 8 1 8 7 20 15 16 7
West Virginia......... 1 1 6 5 1 7 22 61 57
North Carolina........ 4 2 1 10 6 16 21 1
South Carolina........ 17 1 1 2 2 5 4
Georgia................. 3 3 17 1 2 3 4 -
Florida............... 3 1 10 1 5 6 8 15 10 14 17

EAST SOUTH CENTRAL........ 13 16 1 4 45 21 67 74 52 51
Kentucky.............. 3 4 12 6 18 21 27 29
Tennessee............. 6 3 1 22 10 33 26 24 21
Alabama............... 4 10 7 3 10 12 1 -
Mississippi........... 3 4 2 6 15 1

WEST SOUTH.CENTRAL ....... 33 3 38 4 31 28 59 61 80 56
Arkansas .............. 7 2 5 5 10 9 -
Louisiana............. 8 3 21 3 4 7 15 1
Oklahoma.............. 5 6 2 4 6 1 -
Texas ................. 13 9 4 21 15 36 37 79 55

MOUNTAIN ................. 9 5 2 14 7 49 36 99 171
Montana............... 3 1 5 2 58 52
Idaho.................. 8 1 6 21
Wyoming................ 1 2 2 1
Colorado................ 3 3 10 9 7 28
New Mexico............ 2 2 5 5 3 NN NN
Arizona ............... 3 12 9 9 36
Utah .................. 5 6 1 7 12 19 31
Nevada................ 2

PACIFIC................... 1 18 4 7 7 54 76 132 137 189 234
Washington ............. 7 11 18 36 32 58
Oregon ............... 3 1 6 10 18 16 21 14
California............ 1 14 4 6 7 38 51 89 79 108 74
Alaska................. 2 1 3 3 28 64
Hawaii................ 1 1 3 4 3 24

Puerto Rico.............. 1 1 12 14 5 19 21 97 46









Morbidity and Mortality Weekly Report


Table 3. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

OCTOBER 12, 1963 AND OCTOBER 13, 1962 (Continued)


Infect

Area
41st wk.
1963

UNITED STATES.... 29

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

MIDDLE ATLANTIC..... 1
New York........... 1
New Jersey.......... -
Pennsylvania....... -

EAST NORTH CENTRAL.. 8
Ohio............... 2
Indiana............
Illinois........... 3
Michigan........... 2
Wisconsin .......... 1

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

SOUTH ATANTIC...... 5
-. i .... ......
Dist. of Columbia..
Virginia............ 2
West Virginia...... 1
North Carolina..... 1
South Carolina.....
Georgia.............
Florida ............ 1

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

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

MOUNTAIN............ 3
Montana.............
Idaho ..............
Wyoming.............
Colorado........... 3
New Mexico.........
Arizona..............
Utah................
Nevada.............

PACIFIC............ 6
VWhin t-..... 1
r. n ............ -
California......... 4
Alaska............ -
Hawaii............. 1


.1
ions

Cumu-
lative
41 weeks


tc r- pt: :al
Sore Throat &
Scarlet Fever


41st week


1963 1963


1,902

117
17
4
4
54
11
27

255
121
36
98

298
79
45
58
87
29

119
23
7
34
13
6
25
11

349
4
50
6
78
19
63
18
28
83

137
30
62
23
22

172
11
70
31
60

63
3
6
4
19
4
10
14
3

392
31
28
312
12
9


4,608

248
13

1
44
14
176

153
93
30
30

341
42
69
49
136
45

163
16
35
12
25
12

63

567
4
12
1
143
247
15
35
3
107

954
117
785
19
33

516
6
2
10
498

809
57
84
30
266
159
85
128


857
247
11
369
58
172


Tetanus


int I b rn.
Typhus
(Rcky Mt.
Spotted)


41st wk- 41st wk.


1962 1963


3,889

318
116
12
5
48
17
120

110
58
35
17

326
43
72
49
117
45

94
12
40
2
16
4

20

349
2
1

110
90
15
18
4
109

640
32
582
13
13

582
1
3

578

818
47
139
9
244
198
111
69
1

652
144
18
470
9
11


15










2


2


4

1



3




1



1

5
1
1
2

2


Tularemia Typhoid Fever Rabies in Animals


41st wk. 41st wk.


Cumu-
lative
41 weeks


41st week


1963 1963 1962


432

11
2

1
6

2

78
38
5
35

50
18
7
10
10
5

25
3
3
15

1
1
2

59
4
10

8
7
7
4
2
17

60
13
22
10
15

80
31
25
5
19

16



6
3
7



53
3
2
45
1
2


57










5
1

4

5


1
2

I



18
6
4
4
1
2
1


6



1
4



1

5
1
3
1


9



9

1




1I




8


8


Cumu-
lative
41 weeks
1963

3,010

28
2
12
13
.1



96
71

25

466
275
42
66
43
40

773
194
289
128
31
86
27
18

431
1
1

162
109
14
8
67
69

237
111
108
18


563
67
43
50
403

123



16
37
56
3
11

293

10
274
9


Puerto Rico........ -7 6 2- 1 12 I 13


342


I _


,









Morbidity and Mortality Weekly Report




Table 4 (A). TOTAL DEATHS IN REPORTING CITIES


343


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

For weeks ending FA or weeks ending
Area 9/ 1 9/28 15 112 9/2Area1 9/ 10/5
9/21 9/28 10/5 10/12 9/21 9/28 10/5 10/12


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


254
36
19
24
56
25
19
35
48
53
10
48
31
51


48
34
129
43
39
35
66
98
1,486
33
402
161
56
105
26
36
60
42
30
27


70
27
757
150
211
113
87
366
27
42
48
19
43
137
24
133
25
22
41
106
55


52
30
32
115
21
92
69
230
58
48


266
50
25
31
53
25
27
29
64
59
14
38
30
47


41
36
127
36
22
40
74
67
1,665
33
491
179
35
106
25
43
55
37
23
30


55
34
710
142
186
108
90
302
37
55
36
29
55
162
25
105
28
37
40
107
43


48
26
34
124
31
132
65
231
70
36


223
29
31
26
43
29
21
26
45
65
14
34
32
51,


45
36
140
57
40
35
64
82
1,639
34
520
188
49
112
19
45
63
50
23
24


60
40
750
152
195
109
86
396
38
36
40
16
43
169
34
116
25
27
42
91
59


45
23
24
114
26
109
53
233
69
38


260
30
31
23
52
31
20
18
56
44
17
S32
30
68


48
39
135
56
34
33
83
88
1,684
33
404
200
43
96
30
29
50
47
22
18


56
23
755
158
228
122
79
363
37
38
38
28
47
166
13
114
32
22
39
99
59


55
25
40*
133
29
118
90
207
71
57


SOUTH ATLANTIC:
Atlanta, Ga. .............. 125 124 111 146
Baltimore, Md. ............ 238 235 283 255
Charlotte, N.C. ........... 35 37 48 21
Jacksonville, Fla. ........ 65 48 67 63
Miami, Fla. ............... 76 80 92 72
Norfolk, Va. .............. 46 53 54 53
Richmond, Va. .............. 70 79 91 94
Savannah, Ga. .............. 25 26 31 40
St. Petersburg, Fla. ...... 60 52 85 65
Tampa, Fla. ............... 84 54 63 57
Washington, D.C. .......... 182 190 228 201
Wilmington, Del. .......... 49 32 34 26

EAST SOUTH CENTRAL:
Birmingham, Ala. .......... 81 75 68 103
Chattanooga, Tenn. ........ 34 40 31 43
Knoxville, Tenn. .......... 47 28 22 37
Louisville, Ky. ........... 150 109 116 67
Memphis, Tenn. ............ 101 86 122 104
Mobile, Ala. .............. 36 30 44 46
Montgomery, Ala. .......... 36 27 39 18
Nashville, Tenn. .......... 87 81 87 85

WEST SOUTH CENTRAL:
Austin, Tex. .............. 37 32 33 43
Baton Rouge, La. .......... 38 41 28 40
Corpus Christi, Tex. ...... 21 21 21 30
Dallas, Tex. .............. 135 128 131 135
El Paso, Tex. ............. 37 35 31 37
Fort Worth, Tex. ......... 71 60 59 65
Houston, Tex. ............. 171 191 162 154
Little Rock, Ark. ......... 56 55 64 81
New Orleans, La. .......... 130 164 172 176
Oklahoma City, Okla. ...... 69 72 63 71
San Antonio, Tex. ......... 96 99 98 98
Shreveport, La. ........... 61 37 45 57
Tulsa, Okla. .............. 54 28 55 59

MOUNTAIN:
Albuquerque, N. Mex. ...... 29 24 39 25
Colorado Springs, Colo... 20 12 9 11
Denver, Colo. ............. 113 121 135 124
Ogden, Utah................. 16 13 13 17
Phoenix, Ariz. ............ 85 94 83 90
Pueblo, Colo. ............. 13 14 9 15
Salt Lake City, Utah....... 56 56 51 63
Tucson, Ariz. ............. 42 34 43 40

PACIFIC:
Berkeley, Calif. .......... 12 14 23 15
Fresno, Calif. ............ 35 53 53 49
Glendale, Calif. .......... 35 39 42 29
Honolulu, Hawaii............ 41 35 39 43
Long Beach, Calif. ........ 55 64 73 78
Los Angeles, Calif. ....... 566 556 615 526
Oakland, Calif. ........... 95 82 95 79
Pasadena, Calif. .......... 44 28 30 37
Portland, Oreg. ........... 96 128 99 93
Sacramento, Calif. ......... 45 68 70 59
San Diego, Calif. ......... 83 84 113 121
San Francisco, Calif. ..... 190 192 153 163
San Jose, Calif. .......... 34 31 30 35
Seattle, Wash. ............ 149 120 126 130
Spokane, Wash. ............ 45 50 41 56
Tacoma, Wash. ............. 41 35 39 32

San Juan, P.R. .............. 2 5 3 4


OCurrent Week Mortality for 108 Selected Cities

4(A) Total Mortality, all ages.................... 11,290
4(B) Pneumonia-Influenza Deaths, all ages........ 396
4(C) Total Deaths under 1 Year of Age............ 789
4(D) Total Deaths, Persons 65 years and over..... 6,201


NOTF: All deaths by place of occurrence.


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




UNIVERSITY OF FLORIDA

3lllllll II Ill 1111262 08 4 0II 61IIIIII III
3 1262 08864 0381


Morbidity and Mortality Weekly Report


EPIDEMIOLOGICAL REPORTS

Meningococcal Meningitis New Jersey
Three cases of meningococcal meningitis, including
one death, have been reported from Ft. Dix, New Jersey.
Two cases, involving members of the same company,
occurred on October 2 and one, involving a member of
another company, occurred on October 6.
Since the administration of prophylactic sulfadiazine,
no additional cases have been reported from Ft. Dix.
(Reported by Dr. W. J. Dougherty, Director, Division of
Preventive Disease, New Jersey Stale Department of
Health).

Dengue Fever Puerto Rico
During the past week, a total of 738 cases of dengue
fever were reported to the Puerto Rico Department of Health.
The total reported to date is 15,193 cases. Based on
reported cases, disease incidence would appear to be
declining.
(Reported by Dr. Victor A. Gonzalez, Director, Bureau of
Health, Puerto Rico Department of Health).



INTERNATIONAL NOTES
Dengue Fever Jamaica
Fifty-one cases of dengue fever were reported in
seven parishes for the week ending September 28. This
brings the cumulative total to 599 cases in Jamaica
thts far in 1963.
(Reported in the Weekly Epidemiological Report, Pan
American Sanitary Bureau, October 9, 1963).

Poliomyelitis Canado
Eighty-five cases of paralytic poliomyelitis have
been reported in Canada through October 5. Of these,
79 cases have occurred in the Province of Quebec, with
most of the cases occurring in the southeastern region
of this province. Approximately 65 percent of the popu-
lation under forty years of age in this epidemic area had
previously received Salk vaccine.
Most of the isolations have been Type III poliovirus.
Trivalent oral vaccine was distributed in the areas re-
porting cases during the week ending August 10.




The Morbidity and Mortality Weekly Report is published
by the Communicable Disease Center, Atlanta, Georgia,
and as of October 12, 1963, had a circulation of 10,400
copies.


Chief, Communicable Disease Center
Chief, Epidemiology Branch
Chief, Statistics Section
Asst. Chief, Statistics Section
Chief, Surveillance Section
Editor, MMWR


In addition to the established procedures for reporting
morbidity and mortality, the Communicable Disease Center
welcomes accounts of interesting outbreaks or cases.
Such accounts should be addressed to:
Lawrence K. Altman, M.D., Editor
Morbidity and Mortality Weekly Report
Communicable Disease Center
Atlanta, Georgia 30333


,LIN O' CITL LI
IC'LMENTS DEPTH





U.S. DEPOSITORY


0
0
>g
E" f

n
- SC

oSi


s'1


James L. Goddard, M.D.
A. D. Longmuir, M.D.
R. E. Serfling, Ph.D.
I. L. Sherman, M.S.
D. A. Henderson, M.D.
L. K. Altman, M.D.


344