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:
AA00010654:00128

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


U C 634-5131


For release October 25, 1963 ATLANTA, GEORGIA 30333 Vol. 12, No. 42
PROVISIONAL INFORMATION ON SELECTED NOTIFIABLE DISEASES IN THE UNITED STATES AND ON
DEATHS IN SELECTED CITIES FOR WEEK ENDED OCTOBER 19, 1963


BOTULISM Two cases of botulism, neither fatal, were
reported for the week ending October 19. These cases
occurred in Kentucky and were related to the smoked
whitefish chub outbreak (See MMWR, Vol. 12, pp.. 329,
337). This brings the corrected total for this outbreak to
17 cases, including 7 deaths.
The Kentucky cases involved a couple who ate two
packages of the whitefish chubs for dinner on October 5
(prior to the publicity of the outbreak and withdrawal of
of the product.) About 18 hours later, the wife, who con-
sumed 4% fish, began to experience nausea and vomiting.


Her husband, who ate 1% fish, experienced his initial
gastrointestinal symptoms about 40 hours after ingestion.
Neither victim experienced neurological symptoms. No
fish remained from the meal for laboratory tests. An un-
opened package, purchased at the same time as those
consumed, revealed Clostridium botulinum, type E, ac-
cording to J. Clifford Todd, State Epidemiologist, Ken-
tucky State Department of Health
Since publication of las No. 16
(fatal), a 7-year-old boy i -tsville, t -, has
been retracted as a case rd ~6\lism.\


Table I. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNI T i7^ f ,,:'
(Cumulative totals include revised and delayed reports through previous wee
42nd Week Cumulative
e Ended Ended First 42 weeks
Disease Median
October 19, October 20 1958 1962 Median
1963 1962 1963 1962 1958 1962
Aseptic meningitis ............... 45 65 --- 1,488 2,097
Brucellosis ..................... 8 13 12 302 337 605
Diphtheria....................... 3 8 22 206 348 533
Encephalitis, infectious .......... 22 37 47 1,277 1,543 1,543
Hepatitis, infectious and serum... 771 876 876 35,082 44,547 30,592
Measles ........................ 981 1,325 1,331 362,719 447,932 400,500
Meningococcal infections......... 37 43 43 1,939 1,745 1,849
Poliomyelitis, total .............. 6 27 140 336 702 2,687
Paralytic .................... 6 21 97 285 554 1,845
Nonparalytic.................. 3 22 35 106 571
Unspecified. .................. 3 21 16 42 271
Streptococcal sore throat
and Scarlet fever ............ 5,467 4,401 273,986 253,985
Tetanus ........................ 4 9 -- 221 230
Tularemia...................... 13 3 --- 238 239
Typhoid fever ................... 14 9 21 445 510 676
Typhus fever, tick-borne,
(Rocky Mountain spotted)...... 3 3 --- 170 205
Rabies in Animals ............... 72 40 57 3,083 3,077 3,077


Table 2. NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax: 4 Psittacosis: Ill. 1 67
Botulism: Ky. 2 34 Rabies in Man: 1
Malaria: Mass. 1, N.Y. 1, Ore. 1, Calif. 1 82 Smallpox:
Plague: Typhus, murine: 24


~


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P- 4 -Zf O/ Y.' /,/4VQ4








Morbidity and Mortality Weekly Report


TULAREMIA -'Thirteen cases of tularemia were reported
for the week ending October 19, bringing the cumulative
total for lO63 to 238.
Nine of this week's cases were reported from
Arkansas, representing victims in 7 different counties,
and are believed to represent the increased exposure of
hunters to ticks during this season. Tularemia is usually
a tick-borne disease in Arkansas, according to Dr. Wil-
lian L. Bunch, Jr., Director, Division of Communicable
Disease Control, Arkansas State Health Department, who
states that there is an increase in the tick population
this year due to the warm, dry weather being experienced
in that State.
These 9 cases bring Arkansas' cumulative total to
75 for 1963. For the comparable period of 1962, 51 cases
were reported from that State.


POLIOMYELITIS Six cases of poliomyelitis, all para-
lytic, were reported for the week ending October 19. Three
cases were reported from Virginia, one from California,
one from Arizona, and one from Arkansas.
In Virginia, 2 cases were reported from the Peters-
burg region, both with onsets prior to the mass com-
munity immunization program conducted there on October
12. The third case occurred elsewhere in the State.
The nation's total thus far in 1963 remains well below
one-half that reported for a comparable period last year.


POLIOMYELITIS CUMULATEDD WEEKLY)
1ST THROUGH 42ND WEEK

1963 1962 1961 1960 1959

Paralytic 285 554 700 1850 4704
Total 336 702 1086 2680 7199


POLIOMYELITIS (SIX WEEK TOTALS)
37TH THROUGH 42ND WEEK

Paralytic 80 161 246 650 1587
Total 96 198 404 945 2248




EPIDEMIOLOGICAL REPORTS


Dengue Fever Puerto Rico
During the past week, 1,035 cases of dengue fever
were reported to the Puerto Rico Department of Health
bringing the total number of cases to 16,228 through
October 21, 1963.
A second morbidity survey was conducted in the
township of Guaynabo on October 15 and 16 to determine
the current attack rate of dengue-like illness in that com-
munity. The same 177 households that had been selected
at random for the September 24-25 survey were revisited


(See MMWR, Vol. 12, p. 323). This follow-up survey has
revealed 239 cases of dengue-like illness for the period
August 1 through October 15, in a population of 894 per-
sons, producing an attack rate of 26.7 percent. This at-
tack rate for the Township of Guaynabo is compared
below with attack rates in Barriada Frailes Llanos in the
northern part of Guaynabo and Barriada Marrero in the
southern part of Guaynabo for the same time period.

Dengue.like Attack
Area Population Illness Rate (%)
Guoynabo Township* 894 239 26.7
Borriado Frailes Llanos 488 149 30.5
Barrioad Morrero 209 76 36.4


DENGUE-LIKE ILLNESS
BY WEEK OF ONSET*
GUAYNABO, PUERTO RICO
AUG. 1, 1963-OCT. 15,1963


AUGUST SEPTEMBER OCTOBER
NOTE: DATA INCOMPLETE
FOR WEEK ENDING OCT. 19


The 239 cases in Guaynabo are shown by week of
onset in graph (above). A progressive increase in
cases can be noted in late August and early September,
followed by a peak during the week ending September 21.
In Barriada Marrero, the peak in cases occurred over a
two-week period ending September 28, following which
the incidence dropped sharply. In Barriada Frailes Llanos
the number of cases has remained high during the past
four weeks with no indication that a definite peak has
yet been reached.
(Reported hv Dr. Victor A. Gonzalez, Director, Bureau of
walel/t, Puerto Rico Department of Healith)


346









Morbidity and Mortality Weekly Report


Staphylococcal Food Poisoning Maine


Two visitors to the Bangor Fair experienced vomiting
and diarrhea three hours after eating ham sandwiches at
one of the Fair stands run by an itinerant food handler.
Although both victims recovered, one was hospitalized
overnight. Other members accompanying these two victims
to the Fair ate at the same stand, but did not consume
any ham; none became ill.
Upon investigation, samples of the ham were cultured.
They grew Staphylococcus aureus. One of the food
handlers at this booth was found to have a burn on his
hand, which, on culture, grew Staphylococcus aureus,
as well as Staphylococcus albus. No serological typing
was done. Although other people were known to have
eaten the ham, additional cases of food poisoning were
not reported.

(Reported by Dean Fisher, M.D., Director, Communicable
Disease Control, State Department of Health and Welfare,
Maine, and William M. Shook, Jr., Health Director,
Bangor Health Department.)





Staphylococcal Food Poisoning California

A Los Angeles mother, her two children, and a
neighbor's child became ill from 3-5 hours following a
lunch consisting of cold picnic ham sandwiches. The
mother and her two children all experienced nausea,
vomiting, diarrhea, and weakness three hours after the
meal. Five hours after eating, the neighbor's child
experienced nausea, vomiting, and stomach cramps. All
four victims recovered by the following morning. One was
hospitalized.
Three days prior to the meal, the mother had
purchased a 5-lb. smoked picnic ham from a nearby super-
market. The ham had been refrigerated at 340 in a display
case. The mother brought the ham home and immediately
refrigerated it. Itwas boiled the next morning at 6:00 a.m.
for two hours. The ham was then sliced. At noon that day,
five people ate this ham; none became ill. The ham
remained unrefrigerated at room temperature from 8:00 a.m.
of the morning it was prepared until it was sliced again
two days later for the lunch at which the four victims ate.
Samples of the remainder of the ham were cultured
and grew coagulase positive staphylococcus.
No other reports of illness were received from food
sold at this supermarket.


(Reported by F. A. Listick, Sanitarian, Los Angeles City
Health Department, and Dr. Philip K. Condit, Chief,
Bureau of Communicable Diseases, State Department of
Health, Berkeley, California.)


Salmonellosis North Carolina
Twenty-three of 45 individuals known to have eaten
Sunday dinner at a North Carolina restaurant became ill
with salmonellosis. Their symptoms included fever, head-
ache, vomiting, abdominal cramps, and diarrhea. Five of
the 23 victims required hospitalization. Four remained for
two days; one elderly victim remained for two weeks for
treatment of shock and congestive heart failure, both
attributed in this individual to food poisoning. All five
recovered.
The mean incubation period for the affected individ-
uals was 10% hours, with a range from 4% to 19 hours.
Only those who ate turkey or turkey dressing for this meal
at this restaurant became ill. Others who consumed differ-
ent foods at the same restaurant at the same time did not
become ill.
Fifty stool cultures were obtained on the ill individ-
uals, those who ate the turkey, and all restaurant employ-
ees. From 20 of these, Salmonella irumu was grown. The
same strain also was cultured from one food handler who
had not been ill prior to the meal, but who had eaten the
turkey.
All turkey and turkey dressing had been consumed;
cultures of eggs remaining from the same shipment used in
the preparation of the turkey dressing were negative. The
eggs were traced to the chicken farm from which they had
originally been obtained. No salmonella, however, could
be demonstrated in five chickens selected for sacrifice
nor from chicken droppings in the coops. The turkey could
not be traced adequately.
From a review of the cooking procedures, it appeared
that neither the turkey nor the turkey dressing had been
adequately prepared. The turkey had been received frozen
at 00, immediately placed in a refrigerator, but removed to
thaw after a few hours. Twenty hours after its arrival, the
turkey was cooked for 2% hours at 3500F (oven dial).
The dressing was heated for 15 minutes, only.
Interestingly, first knowledge of this incident resulted
from an anonymous telephone call received by the State
Health Department reporting that five persons in three fam-
ilies had become ill after eating a turkey dinner at a local
restaurant. Its true extent was learned by questioning first
the five victims originally reported who were asked if they
could remember having seen any of their acquaintances
at that meal, or if they knew of others who had become ill
subsequent to the meal. These friends, in turn, were asked
to name acquaintances until no new names could be
added. Several cases were "discovered" in this manner,
as well as individuals who ate dinner there, but who
remained well. In addition, all local hospitals were can-
vassed. As a result, 18 other individuals were found who
had also become ill.
(Reported by Dr. Jacob Koomen, Asst. Secretary and State
Health Director, North Carolina State Board of Health.)


347








3 18


lrbiiili, anil ~l1irtalit% V efklY Hlepirl


THE TWELVE MOST PREVALENT SALMONELLA SEROTYPES IDENTIFIED FROM HUMAN
AND NON-HUMAN SOURCES IN THE UNITED STATES

April 1, 1962 April 1, 1963


Serotypes Human Serotypes Non-Human


1. 5. typhimurium 3851 1. 5. typhimurium 731
2. 5. heidelberg 697 2. 5. heidelberg 185
3. 5. newport 662 3. S. anatum 168
4. 5. inlantis 570 4. 5. cholera suis 168
5. S. enterrtidis 344 5. 5 infants 123
6. 5. saint paul 298 6. S. montevideo 118
7. S montevideo 242 7. 5. derby 112
8. S. derby 200 8. S. saint poul 110
9. 5. oronienburg 199 9. 5. oranienberg 84
10. S. blockley 199 10. 5. bredeney 83
II. 5. thompson 179 II. S. newport 69
12. 5. muenchen 152 12. S. schwarzengrund 63
Total 7593 2014
Other types (82) 2124 (69) 1064
Grand total 9717 3978


SALMONELLA SURVEILLANCE SUMMARY
April 1962 March 1963

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\F.rrFA i % ii i f 'Il It r. p -i r[ita and tig.i -1-
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Human Salmonelloais
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h rii, l, .lurinr L [hi I '-ni,.r h t rl.i. ii1 I I r ,I.

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I h r_ 1 1 i, irr t.II. I iirri rr, r i n I i 111 n h i

:iii ,. r- iii r ri I i L'c .- l I iiriiF i'ir l rh .


Thl r. -rx. oIur r i.ak atriT.ur i ble I '. U almlonc llj a tr
it r ni : .i .i .J .*urTjri' rhl 12 month F.triJ. In [en of [hese
SIl Fp-' r r. I, is in ri mit naic l as, the
rtiOl.l t i..-n '.. i au -il rhre ouibrc.k L. E ich
*.i1 x1 i orher .- rf: ri. [f as rt .rF-. ible l r c it st-fpiraire
U c".i' L \ ', i. ., ni '
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* Ic (urt i J Cu brFe '. *., .. i t r r r
.. ., .,, ...* ', ,, ,' j.F ,
1 hr' ..r.I'c Tiber i '' C r ion t tr r s Jatll i.t'd n each eFi-
.*lin: i i, I 'ilh i r in e Irom FhrFcf ro 19i In iourneen
.,i [I -I l rT i -r -,. r -i]..':'m r fl .. t r i 'poF'r F, ul', r f s '., v g 5 and
I.hi.r T.',klli' I.ri"dI -F :, 'er: E.. ith-r hi hl 'uspe:E i or in-
i rTiin 1i'F i l r li : ure LT 11it ih. -. i'monIIella inieccU ons,
'hlte rI iehr r .'J i n ', 't t- WLrL lut- r '* othtr t sources, uch a s
li'II.. h.-,i.nlt ir.. i.~ .E i > h,'irmi-mn3.J ict cream, arl stian
, 11.-. r .inJ r.o r be-'l and han, -an.latiches. In ten the
ou r,.'. "a uii kir.I n. I hu., 'if ihc kno n outbreak.
I-'r a hh th e Fi ui c .)i inicltionn ouul.l he dccFrmined, L4
%Irt.rti. i tr'.e i l r i 'ouIlr. or p'.-, Jllr', pr.roluC:..

Non-human Salmonellosis
[n rl,.n--,,un,.i.n i.1 in Fhijri n-., I --i ill nuiTIbe-r ol stro-
rF'p. tL iu:i. fli ,TI ,II[F .'I ,Jlr-r ellj.I in itc irr.i The
( t, I T,.-.- I l flu. rF ..r .1 rr i nsr h il t repie-
-Lr in llr nl' 'i rI.r Ln t [h,. -.1 Jillt rc t ri [, cs i]..l. ited,
.,: >.,un I r. i r i. r\ nr all rcp rne.. r cot,' ri e of')
..l.ii. r.. lli in ii. -hum ari- during t[hi r :rii.









Morbidity and Mortality Weekly Report



PERCENTAGE AGE DISTRIBUTION OF INDIVIDUALS
REPORTED AS HARBORING SALMONELLA IN THE UNITED STATES
JUNE 1962-MARCH 1963


PERCENTAGE AGE DISTRIBUTION OF U. S.
POPULATION (Estimated 1961 Census)

PERCENTAGE AGE DISTRIBUTION OF
SALMONELLA RECOVERIES, JUN. '62-MAR.'63


YEARS OF AGE


Of the 3,078 non-human isolates of salmonella, 1,612
(52 percent) were from fowl, and 1,023 (33 percent) were
from other animal sources. Of the remaining 443, 186 were
from animal feeds and fertilizers, 130 from human foods,
10 from reptiles, and 114 from other sources.
Human and Non-Human Salmonellosis Comparative
Frequency
There is a striking similarity among the twelve most


common serotypes isolated from both humans and non-
humans.S. typhzmurzum and S. heidelberg are the two most
frequent isolates on both lists.
All but four of those most commonly causing human
infection appear on the list of the twelve most common
non-human isolates. And, of the nine most common human
serotypes, all but one (S. enteriditzs) comprise the most
common non-human isolates.


(EPIDEMIOLOGICAL REPORTS Continued)


Anthrax Massachusetts
A case of anthrax was reported from Worcester, Massa-
chusetts, in a 43-year-old female wool sorter. The woman
noted a small, painless pimple on her left cheek, for which
she was placed on penicillin therapy without prior culture.
During the following days, the lesion increased in size,
became black, and was surrounded by considerable facial
swelling. Her husband, a foreman at the same company,
made a diagnosis of probable anthrax, based upon the
appearance of the lesion. The patient was referred to an
infectious disease specialist. At the time of his examina-
tion, he noted a necrotic skin lesion, characteristic of
anthrax, on her left cheek. Because she developed a
sensitivity to the penicillin, the patient's medication was
changed to erythromycin. She made an uneventful recovery.
The patient had been employed at the same company
for four years, where she had been engaged in wool sort-
ing; usually, she did not come in contact with unscoured


wool. Her husband, who works with unscoured wool at the
same plant, did not become ill.
No cases of anthrax have ever been reported at this
particular plant, which imports mohair and alpaca from
Peru, as well as additional domestic wool from Texas. The
company had not received any wool or goat hair from Asia
or Africa.
The patient had never received vaccination against
anthrax.
Although cultures positive for Bacillus anthracis were
not obtained (presumably due to prior therapy with anti-
biotics), the case has been reported as anthrax because of
the epidemiological history and the characteristics of
the lesion.
(Reported by Heinrich G. Brugsch, M\.D., Occupational
Hygiene Physician, and Nicholas J. Fiumara, M.D.,
Director, Division of Communicable Diseases, State
Department of Public Health, Boston, Mass.)


349









Morbidily and Mortality Weekly Report


VENEREAL DISEASE MONTHLY SUMMARY
Syphilis
The number of cases of infectious syphilis reported
in the United States during the first 9 months of 1963
represent an 11 percent increase over the number reported
for the comparable period of 1962.
A peak of 107,000 cases were recorded in 1947.
Thereafter, the number of cases decreased to the 6,399
reported in 1956. A small rise in the number of cases
occurred in 1957. Proportionately greater increases were
noted in successive years until 1960, when there was a
65.8 percent increase.
An increment in the total number of reported cases
occurred in 1961 and 1962, but at a decreasing rate of
increase.


REPORTED CASES OF PRIMARY AND SECONDARY SYPHILIS


PERCENT INCREASE OVER
YEAR NUMBER OF CASES PRECEDING YEAR

1956 6,399
1957 6,581 2.8
1958 7,184 9.2
1959 9,799 36.4
1960 16,145 65.8
1961 19,851 23.0
1962 21,067 6.1
1963* 16,555* 10.8**

* Totals based on reports for first 9 months.
** Percent increase calculated for comparable period (January through
September, 1962).


SUMMARY OF PNEUMONIA DEATHS

The weekly average number of pneumonia-influenza
deaths for the four-week period ending October 19 was
381 as compared with an expected weekly average of 414.


1,00oo


NUMBER '"
OF
DEATHS


,, I
i-T '
j: ti 1.-


WEEK ENDING
4 Week Weekly
9/28 10/5 10/12 10/19 Total Average

Observed 334 407 395 388 1,524 381
Expected 400 408 418 428 1,654 414
Excess -66 -1 -23 -40 -130 -33


PNEUMONIA-INFLUENZA DEATHS IN 108 U.S. CITIES
Average number per week by four-week periods


, N

NFLUENZA A


PERD NU960 1961
B LACr or QCCURHENCE A'ilLOTi FaOM 195a-60 EXRRIENCE


1963


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Morbidity and Mortality Weekly Report


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1,ortidit 1 and lorialitf W\eekly Heport



T.iabc CASiS OF SPE(IFIlI) NOTIFIABI.E DISEASES: INITEI) STATliS

FOR WF IKS INI)FI)

OCTOBER 19, 1963 AND OCTOBER 20, 1962


Poliomyelitis, Aseptic
Poliomyelitis, total cases Poliomyelitis, paralytic nonparalytic Meningitis
Cumulative Cumulative
42nd week First 42 weeks 42nd week First 42 weeks 42nd week 42nd week

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


UNITED STATES.... 6

NEW ENGLAND...............
MLaine.................
Neiw Hampshire........
Vermont...............
MH ssachu .tt ........
Rhode Island... .......
Connecticut ...........

MIDDLE ATLANTIC ..........
New York ..............
Nciw Jer-s y. ... ....
Pennsylvania

EAST NORTH CENTRAL.......
Ohi ....................
Idiana.................
Illinois .............
Michigan..............
Wisconsin .............

WEST NORTH CENTRAL.......
Minnesota .... .......
Iowa ...... .. ........
Missouri...............
North Dakota..........
South Dakota ..........
Nebraska..............
Kansas................

SOUTH ATLANTIC........... 3
Delaware .............
May land .............
District of Columbia..
Virginia.............. 3
West Virginia.........
North Caroliona.......
South Carolina ........
Georgia...............
Florida...............

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

WEST SOUTH CENTRAL....... 1
Arkansa ............. 1
Louisiaia.............
O lahor .............
Telasa.................


O: NTAIN................ 1
Montoaa ................
Idaho ................
Wyoming ..............
i ........ ...













__|1~


27










1
1



9

2
5
2


4
1
1



















3



3

7

2
1
4


SI -


554

7



6

1

52
38
6
8

71
15
14
28
11
3

25
7
2
5
2
1
8


49

1
1
8
5
8
6
13
7

54
20
4
22
8

221
12
20
12
177

10
3
1
1
1








)a









Morbidity and Mortality Weekly Report 353


Table 3. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

OCTOBER !9, 1963 AND OCTOBER 20, 1962 (Continued)


Brucellosis Diphtheria Encephalitis, Hepatitis, Measles
infectious infectious and serum
Area
Cumu- Cumu- 42nd week
lative lative Under 20 &
42nd week 42 weeks 42nd week 42 weeks 42nd week 20 yr. over Total 42nd week
1963 1963 1963 1963 1963 1962 1963 1963 1963 1962 1963 1962
UNITED STATES...... 8 302 3 206 22 37 409 317 771 876 981 1,325

NEW ENGIAND.............. 1 8 2 69 36 108 101 97 67
Maine................... 35 19 54 25 2 15
New Hampshire........... 14 6 23 25 6
Vermont............... 1 2 1 3 2 -
Massachusetts......... 6 1 11 6 17 45 21 26
Rhode Island.......... 2 1 1 35 -
Connecticut........... 7 4 11 3 39 20

MIDDLE ATLANTIC........... 7 22 8 6 80 65 145 163 148 159
New York............... 3 13 5 4 46 29 75 76 82 37
New Jersey............. 1 4 6 15 21 37 44 38
Pennsylvania .......... 3 5 3 2 28 21 49 50 22 84

EAST NORTH CENTRAL........ 5 36 23 3 4 69 60 130 145 234 319
Ohio................... 1 2 1 14 23 38 47 42 19
Indiana................ 6 5 2 2 4 16 48 5
Illinois.............. 18 12 1 3 14 9 23 28 54 45
Michigan.............. 5 3 34 26 60 42 50 100
Wisconsin............. 5 7 2 5 5 12 40 150

WEST NORTH CENTRAL....... 164 39 4 3 7 13 27 48 20 123
Minnesota............. 8 15 1 2 4 8 4 7 10
Iowa................... 122 1 2 2 4 6 16 10 34
Missouri.............. 12 1 3 3 8 22 -
North Dakota.......... 2 1 1 1 2 3 75
South Dakota........... 10 12 4
Nebraska.............. 6 8 1 1 4 -
Kansas................ 6 1 1 2 2 NN NN

SOUTH ATLANTIC........... 18 1 49 1 6 52 21 75 70 75 99
Delaware.............. 6 9 7
Maryland.............. 1 4 5 9 9 8 5
District of Columbia.. 1 1 1
Virginia............... 8 4 4 9 9 4 16
West Virginia......... 1 4 4 8 13 33 61
North Carolina......... 4 2 5 30 1 31 25 8 1
South Carolina....... 17 3 1 5 6 5
Georgia................ 3 3 18 4 4 1- 4
Florida................ 3 10 1 3 5 8 7 7 4

EAST SOUTH CENTRAL....... 13 2 18 1 8 34 20 56 69 91 36
Kentucky.............. 3 1 4 5 4 11 17 16 1
Tennessee............. 6 3 1 21 11 32 31 56 33
Alabama............... 4 2 12 3 2 5 5 5 1
Mississippi........... 3 3 5 3 8 16 14 1

WEST SOUTH CENTRAL........ 1 34 38 1 3 17 16 33 52 50 96
Arkansas.............. 1 8 2 1 3 1 2 3 6
Louisiana............. 8 21 6 4 10 7 1
Oklahoma.............. 5 6 4 1
Texas.................. 13 9 10 10 20 35 48 96

MOUNTAIN ................ 9 5 2 15 5 50 68 97 137
Montana............... 2 3 2 5 8 63 62
Idaho................. 13 4 13 19
Wyoming............... 1 5 -
Colorado................ 3 2 10 12 4 18
New Mexico............ 2 7 7 10 NN NN
Arizona............... 3 9 27 14 22
Utah.................. 5 3 3 6 2 3 16
Nevada....,,......... -

PACIFIC.................. 2 20 4 4 3 66 81 147 160 169 289
Washington ............ 8 11 19 34 26 115
Oregon................ 3 5 6 11 15 39 34
California............ 2 16 4 4 3 47 60 107 94 79 68
Alaska................- 6 4 10 12 22 38
Hawaii.................. 1 5 3 34

Puerto Rico............... 1 12 10 7 17 16 59 11











1lorbidil and 1Mrrtality Weekly Report


lab.i ( CASES OF SPF(IIID NOTIFIABLI DISIASIS: ('NIT I) STATES

FOR WEEKS MINDED


OCTOBER 19, 1963 AND OCTOBER 20, 1962 (Continued)


UNITED STATES....

NEW ENGLAND.........
'laine.............
New Hampshire......
Vermont ...........
Massachusetts......
Rhode Island .......
Connecticut........

MIIDDLE ATLANTIC.....
New York............
New Jersey.........
Pennsylvania.......

EAST NORTH CENTRAL..
Ohio................
Indiana............
Illinois............
Hichigan ..........
Wisconsin..........

WEST NORTH CENTRAL..
Minnesota.........
Iowa...............
Missouri...........
North Dakota.......
South Dakota.......
Nebraska...........
Kansas.............

SOUTH ATIANTIC......
Delaware...........
Maryland...........
Dist. of Columbia..
Virginia ..........
West Virginia......
North Carolina....
South Carolina ....
Georgia............
Florida............

EAST SOUTH CENTRAL..
Kentucky,...........
Tennessee..........
Alabama...........
Mississippi........

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

MOUNTAIN ...........
Montana............
Idaho .............
Wyoming............
Colorado............
New Mexico.........
Arizona............
Utah..............
N.vada.............


Meningococcal
Infections

Cumu-
lative
42nd wk 42weeks


'I t


37

2








13
4
5
4

3
1

2



1




1



8



2

1
2
1
1

2
1
1



1

1


PACIFIC ............. 7

Orgon.............. 1
California......... 5
Alaska.............
Hawaii.............


1,939

119
17
4
4
56
11
27

268
125
41
102

301
80
45
60
87
29

120
23
7
34
13
7
25
11

357
4
51
6
80
19
64
20
29
84

139
31
63
23
22

173
11
71
31
60

63
3
6
4
19
4
10
14
3

399
32
29
317
12
9


Puerto Rico......... 1 8


Streptococcal
Sore Throat & Tetanus
Scarlet Fever


42nd week 42nd wk.


5,467 4,401

467 348
126 119
6
1 3
42 40
28 16
270 164

186 142
121 84
34 26
31 32

422 530
53 55
87 43
75 68
147 292
60 72

125 144
20 19
44 43
1 15
50 47
10 4

S 16

510 319
6 2
19 38
2 2
101 76
171 124
35 14
58 36
2 1
116 26

1,145 610
85 34
966 503
48 18
46 55

468 646
4
17 7
8 12
439 627

1,104 970
58 44
72 55
33 112
446 309
338 208
76 190
81 52


1,040 692
252 146
16 15
525 470
52 7
195 54

21


i Ls3 1


Tickborne
Typhus
(Rcky Mt.
Spotted)

42nd wk.


3
















1


1


Tularemia] Typhoid Fever I Rabies in Animals


42nd wk.


Cumu-
lative
42ndwk. 42weeks


-~ I I


14

1





1
- 6



6
5

1

2
2


Cumu-
lative
42nd week 42 weeks


40










2
1

1

7
4


3


14
7
5


2



9




5



4

2
1
1


3,083

30
2
14
13
1



99
74

25

474
280
43
66
44
41

800
203
293
136
32
89
28
19

439
1
1

164
110
14
9
70
70

239
112
109
18


1 12 13


t:











Morbidity and Mortality Weekly Report





Table 4 (B). REPORTED PNEUMONIA-INFLUENZA DEATHS IN REPORTING CITIES


355


(Tables 4(A), 4(B), 4(C), and 4(D).will be published in sequence covering a four-week period.)0


For weeks ending For weeks ending
Area Area

9/28 10/5 10/12 10/19 9/28 10/5 10/12 10/19


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


2
2


1
2
1


1
2
4







7
3
3
1
3
2
55

13
7
3
8

3
2
7







35
5
8
1
1
14
2

5

3
1



2
4
2
1


3

2
4
1
4
2
6
S 1
7


SOUTH ATLANTIC:
Atlanta, Ga............... 4 3 10 9
Baltimore, Md............. 5 8 7 4
Charlotte, N.C........... 3 8
Jacksonville, Fla......... I 1 1 1
Miami, Fla............... 1 -
Norfolk, Va.............. 5 1 3 5
Richmond, Va............. 2 3
Savannah, Ga.............. 2 3 4 4
St. Petersburg, Fla...... 3 5 8 3
Tampa, Fla............... 1 7 2 2
Washington, D.C.......... 7 15 11 9
Wilmington, Del.......... 3 2 3

EAST SOUTH CENTRAL:
Birmingham, Ala........... 2 4
Chattanooga, Termn........ 1 5 1 1
Knoxville, Tenn........... -
Louisville, Ky........... 6 13 5 9
Memphis, Tenn............. 8 6 8 4
Mobile, Ala.............. 1 3
Montgomery, Ala.......... 2 4 5 2
Nashville, Tenn......... 3 1 4 2

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

MOUNTAIN:
Albuquerque, N. Mex...... 2 2 1 2
Colorado Springs, Colo... 2 1
Denver, Colo ............. 2 9 5 3
Ogden, Utah.............. 1 2 3
Phoenix, Ariz ............ 2 2 2 4
Pueblo, Colo.............. 1 2
Salt Lake City, Utah ..... 1 2
Tucson, Ariz ............. 1

PACIFIC:
Berkeley, Calif.......... -
Fresno, Calif............ 1 2 2*
Glendale, Calif.......... 1 2 1
Honolulu, Hawaii.......... 1 1 -
Long Beach, Calif........ 3 2 3
Los Angeles, Calif....... 19 22 17 15
Oakland, Calif........... 1 2
Pasadena, Calif.......... 1 2 1
Portland, Oreg........... 2 3 2 2
Sacramento, Calif ........ 2 2 1 1
San Diego, Calif......... 1 3 3 2
San Francisco, Calif ..... 4 3 1 3
San Jose, Calif........... 6 1
Seattle, Wash........... 2 2 7
Spokane, Wash............. 2 2
Tacoma, Wash............ 1 1 1*

San Juan, P.R............... 9 i 5 4


0Current Week Mortality for 108 Selected Cities

4(A) Total Mortality, all ages.................... 11,349
4(B) Pneumonia-Influenza Deaths, all ages........ 388
4(C) Total Deaths under 1 Year of Age............. 703
4(D) Total Deaths, Persons 65 years and over..... 6,306


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

NOTE: All deaths by place of occurrece.




UNIVERSITY OF FLORIDA

111111111111111111111111
3 1262 08864 0502


Morbidity and Mortality Weekly Report


INTERNATIONAL NOTES

Dengue Fever Jamaica
Eighty-seven cases of dengue fever were reported
from Jamaica for the week ending October 5. The cumula-
tive total now stands at 686 cases for 1963.
(Reported in I'eekliv epidemiological Report, Pan American
5anitary Bureau, October 16. I l63.)


Polio Canada

Six cases of paralytic poliomyelitis, five from the
Province of Quebec, were reported in Canada for the week
ending October 17. The sixth case was reported from New
Brunswick.
To date, 91 cases have been reported in the country,
84 of which have occurred in Quebec.
In '.2 84 cases were reported from Canada for a
comparable period. Quebec had 49 cases. For a comparable
period of 1961, 160 Canadian cases were reported. Ninety-
five occurred in Quebec.
(Reported in weekly Statistics Report o/ Canadian Depart-
ment of \ national Health and Welfare.)


Cholera Vaccination
A valid certificate of vaccination against cholera is
required now of all persons leaving the following coun-
tries and ports which have been declared either endemic or
epidemic cholera regions: Burma, Korea, Hong Kong, India,
Indonesia, Macao, Malaya, Pakistan, Philippines, and
Thailand.
Persons who do not have a valid certificate are re-
quired in most instances to be vaccinated and to wait six
days before departing from the infected area.


No-, rto-.. ;.'.. ..,.'I .ao..0 t : l. I:-r l h irlr hIb..I.....
call. I.ai.n I r.0i. Li- I ,uni..i1sI| iir ballib ,Jd~I*- rn.
Symbols: --- Dta oo available
QOuItily eo
Procedures for construction of various mortality carves may be obtained from
Statistics Section, Commtnicable Disease Center, Public Health Service,
U. S. Department of Health, Education, and Welfare. Atlanta 22. Geogia.


UrgIb i L LI
SDCCUMENrT DEr-
"*-- *




U.S, DEPOSITORY
jU ;SD POSITORY:
;E RJY


QUARANTINE MEASURES

Immunization Information for International Travel
1962 Edition
Public Health Service Publication No. 384

The following information should be added to the list
of Yellow Fever Vaccination Centers in Section 6:
Page 76

CITY: Clemson, South Carolina
CENTER: Student Health Service Clemson College
CLINIC HOURS: Wednesday, 1:00 p.m.
FEE: Yes


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