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:
AA00010654:00130

Related Items

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

Full Text



NATIONAL COMMUNICABLE DISEASE CENTER


U.S. DEPARTMENT OF HEALTH, EDUCATION, AND Wf /
DATE OF RELEASE: B

EPIDEMIOLOGIC NOTES AND REPORT
MEASLES OUTBREAK Chicago

From Sept. 1 to Nov. 21, 1969, a total of 163 case
measles including two deaths were reported to the Chicago
Board of Health. This represents a marked increase in
mea-sle incidence over the number of cases (25) reported
during the comparable period in 1968.
Earl) epidemiologic investigation showed that approxi-
mately 75 percent of the reported cases were in preschool-
age children. Most of the reported cases have been con-
centrated in the urban, hard-core poverty areas of the south
and west sides of Chicago.
Interviews with administrators of outpatient clinics
and hospitals have revealed underreporting of cases. In-
dividual case investigations are being carried out to help
direct an immunization campaign.


SVol. 18, No. 47






For

Week Ending

November 22, 1969


HEALTH SERVICES AND MENTAL HEALTH ADMINISTRATION
SEORGIA 30333


CONTENTS
Epidemic ttes and Reports
eak- Chicago ................... 409
S piratory Disease Anchorage, Alaska ...... 410
of Reported Cases of Infectious Syphilis ....... 410
Surveillance Summary
Meningococcal Infectious United States
Epidemiologic Year 1969 . ....... 411


(Reported by Jack Zackler, M.D., Acting Commissioner of
Health, and Herbert Slutsky, Ph.D., Senior Epidemiologist,
Chicago Board of Health; Norman Rose, M.D., Chief, Bureau
of Epidemiology, Illinois Department of Public Health; and
two EIS Officers.)


TABLE I. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous weeks)
47th WEEK ENDEDAN CUMULATIVE, FIRST 47 WEEKS
MEDIAN
DISEASE November 22, November 23, 1964 1968 MEDIAN
1969 1968 1969 1968 1964- 1968
Aseptic meningitis ....................... .64 81 48 3,232 4,056 2.730
Brucellosis ............................ 5 8 5 211 207 226
Diphtheria ......................... .. .9 10 10 176 219 184
Encephalitis, primary:
Arthropod-borne & unspecified ........... 24 32 30 1,183 1,308 1,745
Encephalitis, post-infectious ............. 2 7 7 276 439 666
Hepatitis, serum ........................ 100 151 7 4,803 4,189
Hepatitis, infectious ..................... 1,106 1,175 43,302 41,343
Malaria ............................... 80 39 12 2,826 2,147 441
Measles rubeolaa) ....................... 338 251 950 22,482 21,306 196,513
Meningococcal infections, total ........... 46 48 48 2,671 2,318 2,518
Civilian .............................. 45 42 2,459 2,121 -
Military ............................... 1 6 "-- 212 197 -
Mumps ................................. 1,821 2,060 78,805 138,173 -
Poliomyelitis, total ..................... 1 2 16 57 57
Paralytic ............................. 1 1 15 57 57
Rubella (German measles) ............... 491 295 52,706 46,700 --
Streptococcal sore throat & scarlet fever.... 9 794 11,037 7,513 380,390 383,505 377,983
Tetanus ............................... 1 1 5 145 152 203
Tularemia ............................. 6 5 2 134 165 165
Typhoid fever .......................... 13 11 7 304 365 378
Typhus, tick-borne (Rky. Mt. spotted fever) 8 3 2 445 273 258
Rabies in animals ....................... 48 51 55 3,020 3,089 3.870

TABLE II. NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax: .................. ................... .... 3 Rabies in man: ............. ..................... 1
Botulism: ........................................ 12 Rubella congenital syndrome: Tenn.-1 .............. 15
Leptospirosis: Fla.-5, La.- .......................... 80 Trichinosis: ...................................... 170
Plague: ................. .......................... 5 Typhus, marine: ... ................................ 47
Psittacosis: Ohio-1 ................................ 41
*Delayed reports: Rubella cong. synd. La.-1






Morbidity and Mortality Weekly Report


FEBRILE RESPIRATORY ILLNESS Anchorage, Alaska


NOVEMBER 22, 1969


In November 1969. an outbreak of acute respiratory
disease with 29 cases occurred among the staff and child-
ren at a home in Anchorage, Alaska, for children with be-
havioral disorders. The 38 children at the home range in
age from 6 to 18 years and reside in one of four ( ol i121--
Several staff members also reside in each (cuit ,i-. addi-
tional staff work during the day in an administration build-
ing. The children attend local public schools.
Of the 29 patients, 21 had fever of greater than 1010F.,
and they form the basis of the following analysis. The
index case. a 9-year-old boy, had onset of influenza-like
illness on November the other 20 febrile cases occurred
between November 12 and 17 (Figure 1). Symptoms in the
febrile patients included cough (100 p.ri-r'nil malaise (90
percent), sore throat (86 p,-rn nl). prostration (76 percent),
rhinitis (76 percent), nausea (57 p..re -niill., myalgia (33 per-
cent), vomiting (usually one episode, often post-tussic -
33 pt r. nri and epistaxis (29 percent). Two patients had
pneumonia. Onset of illness was gradual in 12 cases and
abrupt in five; the type of onset was uncertain in four.
Throat swabs and serum samples were collected from
all cases on November 19 and 20. Laboratory results are
pend i ng.
Epidemiologic investigation is continuing.
(Reported by Donald K. Freedman, M.D., Director, Divi-
sion of Public Health, Alaska Department of Health and
Welfare; DOaid R.L. Duncan, M.D., lHealth Officer, Greater


Figure 1
ACUTE RESPIRATORY ILLNESS
ANCHORAGE, ALASKA NOV. 4-20, 1969


Th


NOVEMBER
ONSET


Anchorage Area Borough; the Virology Laboratory and
Epidemiology Section, Arctic Health Research Center,
Ecological Investigations Program, NCDC, 1,.-'"../.
and an EIS Officer.)


Editorial Comment:
Although the causative organism of these illnesses
is not yet established and may ultimately prove not to be
nillij n., i. this is the first report of an influenza-like ill-
ness received from the United States this fall and winter.


SUMMARY OF REPORTED CASES OF INFECTIOUS SYPHILIS

CASES OF PRIMARY AND SECONDARY SYPHILIS: Hv Reporting Areas October 1968 and October 1969 Provisional Data
Cumulative Cumulative
Reporting Area Octoher Jan. Oct. Reporting Area October Jan. Ot.
1969 1968 1969 1968 1969 1968 1969 1968
NEW ENCLAND............... 28 29 312 288 EAST SOUTH CENTRAL........ 73 89 822 1,138
Maine................... 1 8 3 Kentucky................. 13 11 135 101
New Hampshre........... 1 4 8 6 Tennessee................ 24 17 263 267
Venont ................. 1 Alabama.................. 16 33 213 477
Massachusetts........... 1 22 177 185 Mississippi.............. 20 28 211 293
Rhode Iland............ 5 36 26
Connecticut.......... 11 3 82 68 WEST SOUTH CENTRAL........ 324 325 3,039 2,931
Arkansas................. 25 5 186 106
MIDDLE ATLANTIC.......... 351 368 3,240 2,882 Louisiana................ 69 74 596 716
Upstate New York ........ 18 56 224 269 Oklahoma................ 14 10 71 68
Ne. York City........... 226 252 2,214 1,844 Texas................... 216 236 2,186 2,041
Pa. (Excl. Phila.)...... 15 13 121 189
Philadelphia............ 18 16 180 205 MOUNTAIN.................. 57 36 537 406
Neu Jersey .............. 74 31 501 375 Hontana......... .... 8 7
Idaho.................. 1 9 2
EAST NORTH CENTRAL...... 290 260 2,241 2,397 Wyoming................ 2 5 4
Ohio.................. 54 36 336 383 Colorado................. 6 2 41 17
Indiana.................. 48 34 320 294 New Hexico .............. 20 10 227 132
Downstate Illinois...... 28 36 224 178 Arizona.................. 21 20 177 201
Chicago...... ......... 106 88 799 841 Utah..................... 2 15 8
Michigan................ 51 65 541 677 Nevada..................... 7 2 55 35
Wisconsn........... ..... 1 21 24
PACIFIC.................. 211 210 1,712 1,479
WEST NORTH CENTRAL........ 44 41 321 325 Washington............... 10 4 54 39
Minnesota............... 6 6 45 44 Oregon.................. 4 9 37 39
Iua..................... 5 6 35 37 California............... 196 197 1,610 1.394
Hissourt.. ............... 1 20 142 164 Alaska.................. 6 2
North Dakota ........... 1 11 5 Hawaii.......... .... 1 5 5
South Dakota............. 5 20 30
Nebraska.............. 5 3 29 18 S. TOTAL...... ..... 1.838 1,760 161336 16.142
insas...................I 6 6 39 27
KERRITORIES............. 85 107 979 957
SOUTH ATLANTIC............ 460 402 4,112 4.296 Puerto Rico.............. 82 100 965 910
B. lau.ir ...... .. 4 5 37 32 Virgin Islands........... 3 7 14 47
'arylan .............. 39 36 355 388
Distrit of Columbia..... 5St 61 488 512
Virgin ................. 33 25 256 258
West VIgina.T ......... I 15 28
North Carolin......... 62 28 433 492 Note: Cumulative Totals include revised and delayed reports
Snuth Car lina......... 41 48 478 443 through previous months.
C.Grg.i .................. 87 875 760
Florida.................. 135 11 1,175 1,383






NOVEMBER 22, 1969


Morbidity and Mortality Weekly Report


SURVEILLANCE SUMMARY
MENINGOCOCCAL INFECTIONS United States Epidemiological Year 1969*


For the epidemiologic year (EY) 1969 (Sept. 1, 1968 -
Aug. 31, 1969), a total of 2,870 cases of meningococcal
infection were reported to the NCDC. The monthly inci-
dence rates were similar to those in previous years with
the highest rates in the late winter or early spring months
(Figure 2). The monthly rates for March, April, and May of
1969 were higher than the mean monthly rates for these
months during the 8-year period from 1960-1967, and also
exceeded the rates for March, April, and May of 1968. How-
ever, the peak monthly rates for EY 1969 were still lower
than those for corresponding months during 1966, the year
of greatest overall incidence of meningococcal infection
since 1960.
As in previous years, the number of cases reported in
military personnel (243) remained about 10 percent of the
number reported in civilians (2,627). The monthly number
of cases reported in military personnel paralleled the sea-
sonal variations in civilian incidence.
In EY 1969, 55 percent of the isolates submitted to the
NCDC for serogrouping and sulfadiazine sensitivity test-


Figure 2
MENINGOCOCCAL INFECTIONS UNITED STATES
MEAN MONTHLY RATES 1960-1967
MONTHLY RATES 1967-1968 AND 1968-1969


MEAN MONTHLY RATE 1960-1967
-- MONTHLY RATE 1967-1968
MONTHLY RATE 1968-1969
SEP OCT NOV DEC JAN FEB MAR APR MAY JUNE JULY AUG
MONTH


Table 1
Meningococcal Isolates That Were Inhibited at or Below 1.0 mg per 100 ml Sulfadiazine

Total Group B Group C All Others

Interval Number Percent Number Percent Number Percent Number Percent
Strains Inhibited Strains Inhibited Strains Inhibited Strains Inhibited
Tested Tested Tested Tested
Jan. 1966 through Dec. 1966 754 59.3 537 52.4 92 84.9 125 70.4
Jan. 1967 through Dec. 1967 317 56.2 209 49.3 61 62.3 47 78.7
Jan. 1968 through Aug. 1968 426 50.7 192 60.4 164 25.6 70 82.6
Sept. 1968 through Aug. 1969 414 35.3 161 62.1 227 10.6 26 84.6
*Isolates submitted from cases.


Table 2
Percentage of Meningococcal Cases (1966-1969) and Submitted Isolates (1968-1969)
by U.S. Geographic Divisions

Percent of
Percent of Reported Cases Submitted Isolates
Division Jan.-Aug. Sept. 1968- Sept. 1968 -
1968 Aug. 1969 Aug. 1969
New England 5 4 6 4 7
Middle Atlantic 13 18 18 16 28
East North Central 16 14 12 14 8
West North Central 5 5 5 5 3
South Atlantic 18 20 20 18 16
East South Central 9 9 9 7 5
West South Central 13 11 15 13 19
Mountain 3 2 2 2 3
Pacific 19 17 13 21 10
100 100 100 100 100
Total Isolates
Total U.S. Cases (3,381) (2,161) (1,976) (2,870) Submitted (414)
*Only includes isolates from blood, cerebrospinal fluid, conjunctiva, or joints.

(Continued on page 416)





412 Morbidity and Mortality Weekly Report


TABLE III. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

NOVEMBER 22, 1969 AND NOVEMBER 23, 1968 (47th WEEK)


ASEPTIC ENCEPHALITIS HEPATITIS
MININ- BRUCEL- IPIITIIERIA Primary including Post- MALARIA
AREA GITIS LOSIS unsp. cases Infectious Serum Infectious
Cum.
1969 1969 1969 1969 1968 1969 1969 1969 1968 1969 1969
UNITED STATES... 64 5 9 24 32 2 100 1,106 1,175 80 2,826

NEW ENGLAND............ 5 4 3 124 58 1 92
Maine.............. 12 2 7
New Hampshire...... 1 8 2
Vermont............ 1 5 1 -
Massachusetts...... 2 1 62 22 1 57
Rhode Island....... 5 23 9 10
Connecticut........ 1 1 14 24 16

MIDDLE ATLANTIC...... 10 1 5 4 1 42 210 236 9 331
New York City...... 2 1 27 40 113 22
New York, up-State. 4 2 2 4 40 49 5 74
New Jersey.......... 3 1 10 53 46 4 130
Pennsylvania.*..... 4 1 1 1 77 28 105

EAST NORTH CENTRAL... 16 4 13 11 201 165 8 285
Ohio................ 6 1 9 3 75 36 25
Indiana............. 11 11 1 26
Illinois........... 2 1 43 55 170
Michigan........... 6 1 3 7 65 51 7 63
Wisconsin.......... 2 2 1 7 12 1

WEST NORTH CENTRAL... 1 2 2 2 28 81 6 197
Minnesota.*........ 1 1 3 30 14
Iowa.*............. 1 1 1 6 4 21
Missouri........... 1 11 14 42
North Dakota........ 3
South Dakota....... 1 16 t
Nebraska........... 1 4
Kansas............. 1 7 16 6 112

SOUTH ATLANTIC........ 11 1 4 5 2 5 108 143 19 729
Delaware............ 1 4
Maryland............ 4 1 1 11 23 33
Dist. of Columbia.. 1 3 2
Virginia........... 1 1 9 11 1 27
West Virginia...... 4 3 3 3
North Carolina..... 3 24 2 285
South Carolina..... 5 8 4 62
Georgia............. 1 22 34 2 264
Florida............ 4 4 3 4 32 59 9 49

EAST SOUTH CENTRAL... 9 2 1 3 1 81 71 23 158
Kentucky. ......... 3 1 37 36 21 129
Tennessee.......... 1 1 3 32 23 -
Alabama............ 5 7 4 2 25
Mississippi........ 2 5 8 4

WEST SOUTH CENTRAL... 2 1 2 3 3 2 48 67 2 234
Arkansas........... 6 13
Louisiana.......... 1 2 1 1 2 10 20 1 46
Oklahoma.*......... 1 2 1 4 7 1 74
Texas. ............ 1 1 34 34 101

MOUNTAIN............. 2 1 1 1 45 62 137
Montana............ 2 7 3
Idaho .............. 1 9 5
Wyoming............. 6 1 -
Colorado.*......... 2 1 1 17 30 112
New Mexico......... 1 11 7 9
Arizona............. 8 6 1
Utah............... 2 1
Nevada............. 6

PACIFIC ............. 8 1 1 4 34 261 292 12 663
Washington.......... 1 1 31 46 2 7
Oregon.............. 5 20 24 16
California.......... 8 1 3 29 199 221 10 516
AlaskaA.......... 1 1 3
Hawaii............. 10 121

Puerto Rico.*......... 10 23 4
*Delayed reports: Aseptic meningitis: Minn. 22 Hepatitis, serum: Ky. 1
Diphtheria: Tex. delete 1, Colo. 1 Hepatitis, infectious: Okla. 1, Alaska 3, P.R. 1
Encephalitis, post-infections: Pa. delete 1 Malaria: Iowa 1, Okla. 1






Morbidity and Mortality Weekly Report 413


TABLE III. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

NOVEMBER 22, 1969 AND NOVEMBER 23, 1968 (47th WEEK) CONTINUED


MEASLES (Rubeola) MENINGOCOCCAL INFECTIONS, MUMPS POLIOMYELITIS RUBELLA
TOTAL
AREA Cumulative Cumulative Total Paralytic
A-1969 1 -- 1 Cum.
1969 1969 1968 11969 1969 1968 1969 1969 1969 1969 1969


UNITED STATES... 338 22,482 21,306 46 2,671 2,318 1,821 15 491

NEW ENGLAND ......... 16 1,168 1,216 1 106 135 195 2 25
Maine.............. 9 38 7 6 42 1 1
New Hampshire...... 1 244 141 4 8 2 1
Vermont............ 3 2 1 27 -
Massachusetts...... 8 243 373 41 71 41 7
Rhode Island....... 27 23 14 9 27 9
Connecticut........ 7 642 639 1 40 40 56 1 7

MIDDLE ATLANTIC...... 83 7,767 4,489 7 444 416 156 2 29
New York City...... 14 4,994 2,315 85 86 67 4
New York, Up-State. 5 615 1,340 3 86 72 NN 1 10
New Jersey......... 40 1,018 673 2 171 142 89 5
Pennsylvania....... 24 1,140 161 2 102 116 NN 1 10

EAST NORTH CENTRAL... 61 2,635 4,047 8 366 287 688 1 127
Ohio............... 18 480 315 1 134 81 54 11
Indiana........... 2 478 704 2 48 39 68 16
Illinois........... 25 686 1,404 1 52 63 187 1 8
Michigan........... 9 352 313 4 105 84 193 56
Wisconsin.......... 7 639 1,311 27 20 186 36

WEST NORTH CENTRAL... 87 967 407 1 131 126 63 1 37
Minnesota........... 17 18 29 29 3
Iowa................ 1 337 108 1 20 10 44 20
Missouri........... 31 81 53 41 1
North Dakota....... 1 44 138 2 4 7 4
South Dakota....... 3 4 1 5 NN -
Nebras ............ 84 527 48 10 9 3 2
Kansas............. 1 8 10 16 28 9 1 7

SOUTH ATLANTIC....... 15 2,669 1,672 1 467 463 109 1 45
Delaware............ 2 403 17 13 9 2 -
Maryland............ 1 81 103 41 40 7 1
Dist. of Columbia*. 1 32 6 9 17 3 1
Virginia........... 5 912 381 57 44 27 19
West Virginia...... 1 221 312 24 13 58 10
North Carolina..... 4 330 292 87 91 NN 3
South Carolina..... 1 132 21 59 61 4 -
Georgia............. 2 4 77 90 -
Florida............. 556 536 1 100 98 8 1 11

EAST SOUTH CENTRAL... 2 118 503 3 171 208 63 1 21
Kentucky............ 2 68 103 55 94 19 1
Tennessee.......... 20 64 1 70 63 41 19
Alabama.............. 6 95 2 27 27 3 1 1
Mississippi........ 24 241 19 24 -

WEST SOUTH CENTRAL... 49 4,931 5,130 9 354 331 119 .- 6 64
Arkansas........... 16 2 32 20 -
Louisiana ......... 125 25 4 97 94 1 --
Oklahoma............ 142 128 2 36 53 35 13
Texas............... 49 4,648 4,975 3 189 164 83 6 51

MOUNTAIN............. 16 1,072 1,056 4 56 41 121 35
Montana*........... 92 58 8 6 6 3
Idaho.............. 90 21 2 13 11 9 4
Wyoming............. 54 3 1
Colorado............ 141 520 1 10 12 41 1
New Mexico.......... 4 279 143 1 8 1 20 8
Arizona............. 12 458 233 10 4 21 15
Utah................ 11 21 5 1 24 3
Nevada............. 1 6 2 3 -

PACIFIC.............. 9 1,155 2,786 12 576 311 307 1 108
Washington......... 67 583 57 47 106 28
Oregon.............. 200 572 20 25 21 7
California.......... 9 830 1,585 12 478 222 158 1 51
Alaska ............. 13 11 11 3 22 21
Hawaii............. 45 35 10 14 1


Puerto Rico.......... 108 1,892 485 19 20 19 -
*Delayed reports: Measles: D.C. 3
Mumps: Alaska 18
Rubella: La. delete 1, Mont. delete 1, Alaska 3






414 Morbidity and Mortality Weekly Report


TABLE III. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

NOVEMBER 22, 1969 AND NOVEMBER 23, 1968 (47th WEEK) CONTINUED


STREPTOCOCCAL TYPHUS FEVER
SORE THROAT & TETANUS TULAREMIA TYPID TICK-BORNE RABES IN
AREA SCARLET FEVER FEVER (Rky. Mt. Spotted) ANIMALS
Cum. Cum. Cum. Cum. Cum.
I',t. lar 14t,- I IM 1 > UNITED STATES... 9,794 1 145 6 134 13 304 8 445 48 3,020

NEW ENGLAND.......... 1,180 1 16 1 16 1 4 53
Maine.............. 19 I 6
New Hampshire...... 12 5
Vermont............ 2 16 4 31
Massachusetts...... 154 1 8 1 3
Rhode Island....... 85 I -
Connecticut........ 908 1 6 8

MIDDLE ATLANTIC...... 404 1 19 5 31 46 10 222
New York City...... 16 1 11 1 17 -
New York, Up-State. 314 3 4 -, 6 7 10 208
New Jersey......... NN 3 3 15 -
Pennsylvania....... 74 2 5 24 14

EAST NORTH CENTRAL... 722 19 1 16 3 35 3 3 219
Ohio............... 61 4 1 12 72
Indiana............. 176 1 5 1 53
Illinois........... 126 10 4 1 16 3 1 37
Michigan........... 256 5 1 6 1 8
Wisconsin .......... 103 7 1 49

WEST NORTH CENTRAL... 354 11 14 10 8 9 568
Minnesota.......... 16 3 4 5 153
Iowa............... 158 1 7 1 89
Missouri........... 11 4 10 3 1 133
North Dakota....... 122 69
South Dikota....... 22 1 43
Nebraska........... 6 1 1 1 14
Kansas............. 19 4 3 1 1 67

SOUTH ATLANTIC....... 926 28 1 23 1 47 5 251 10 714
Delaware........... 4 1 1 2 3 -
Maryland............ 66 1 4 48 3
Dist. of Columbia.. 10 2 2 -
Virginia........... 264 I 4 1 81 351
West Virginiaf..... 271 1 2 2 5 1 103
North Carolina..... NN 3 6 9 2 66 5
South Carolina..... 144 1 2 1 2 32 -
Georgia............ 14 7 4 11 15 4 87
Florida............. 153 12 4 1 15 1 1 5 165

EAST SOUTH CENTRAL... 1,490 22 14 1 46 2 65 3 383
Kentucky............ 186 7 8 13 1 196
Tennessee.......... 921 4 13 1 20 2 43 2 129
Alabama............ 179 6 4 6 52
Mississippi........ 204 5 1 14 3 6

WEST SOUTH CENTRAL... 965 27 2 23 3 32 1 49 7 437
Arkansas........... 39 2 2 5 13 7 30
Louisiana.......... 4 7 4 3 1 37
Oklahoma........... 61 1 8 1 30 1 67
Texas............... 861 17 6 3 16 12 5 303

MOUNTAIN............. 2,589 6 1 18 1 29 17 118
Montana............ 59 1 2 -
Idaho.............. 221 4 6 -
Wyoming............. 585 4 5 55
Colorado............ 1,071 2 3 9 3
New Mexico......... 407 1 1 8 17
Arizona............ 84 3 6 22
Utah............... 162 1 13 2 5
Nevada.............- 1 -- 16

PACIFIC.............. 1,164 12 1 5 3 58 5 2 306
Washington......... 919 1 2 2 3 4
Oregon............. 143 1 6 4
California......... --- 11 1 2 1 44 2 2 298
Alaska ............ 31 -
Hawaii .............. 71 2 6 -

Puerto Rico ......... 12 7 28
*Delayed reports: SST: W. Va. delete 41, Alaska 74






Morbidity and Mortality Weekly Report


415


Week No. TABLE IV. DEATHS IN 122 UNITED STATES CITIES FOR WEEK ENDED NOVEMBER 22, 1969

47 (By place of occurrence and week of filing certificate. Excludes fetal deaths)

All Causes Pneumonia Under All Causes Pneumonia Under
Area All 65 years and 1 year Area All years and 1 year
Ages and over Influenza All Ages and over Influenza All
All Ages Causes All Ages Causes


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.-------.


740
236
50
26
34
49
21
26
30
51
58
17
47
38
57

3,509
35
34
160
52
33
35
63
79
1,757
39
589
211
54
122
27
43
71
31
39
35

2,758
73
41
804
191
213
120
73
349
43
41
49
34
52
173
45
137
33
38
41
144
64

940
70
29
38
161
26
107
105
278
77
49


435
115
35
14
21
31
14
17
25
24
38
12
29
20
40

2,083
19
20
94
33
16
18
33
38
1,047
21
335
124
42
80
20
29
47
21
28
18

1,567
50
27
437
108
111
58
42
203
29
22
29
10
36
94
23
88
16
26
32
88
38

564
40
17
18
99
20
72
62
162
48
26


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.----------


Total 13,553 7,838 537 603

Expected Number 12,765 7,401 443 532


Cumulative Total
(includes reported corrections
for previous weeks)


608,750


347,968


27,204


28,930


1,375
140
266
58
97
158
68
82
38
103
86
229
50

749
89
41
61
181
155
54
38
130

1,276
44
52
27
177
59
67
247
59
205
68
131
62
78

432
56
27
102
27
88
15
47
70

1,774
22
52
35
48
96
585
85
35
147
62
98
219
48
135
50
57


749 62 61
67 5 10
140 7 12
28 1 3
50 1 3
94 7 3
30 7 3
46 5 2
26 2 1
88 5 -
51 11 6
104 7 16
25 4 2

435 48 34
53 1 6
27 4 -
42 7 2
105 26 11
83 3 6
37 2 1
21 4 3
67 1 5

681 52 71
20 4 -
29 4
21 2
95 8 8
25 5 13
37 3 2
120 6 5
31 2 3
94 9 16
42 2 3
83 1 9
37 5 1
47 7 5

235 18 28
24 4 3
16 1 4
53 2 7
17 4 1
39 1 3
10 1
31 2
45 6 7

1,089 36 66
11 1
31 1 1
28 1
19 2 5
56 3 4
375 13 22
54 1 3
26 -
105 5 3
31 4
61 6
113 9 6
27 1
74 9
43 -
35 1 1


*Mortality data are being collected from Las Vegas. Nev., for possible inclusion in this
Las Vegas, Nev.* 22 7 table, however, for statistical reasons, these data will be listed only and not included in
the total, expected number, or cumulative total, until 5 years of data are collected.






Morbidity and Mortality Weekly Report


MENINGOCOCCAL INFECTIONS
(Coiiuied from page 411)

ing from civilian and ilI lir' cases were serogroup C
strains (Table 1). This is in contrast to previous years
when serogroup B was the predominant type.
Sulfadiazine resistance of strains has continued to
increase. This overall trend mainly reflects the increasing
percentage of serogroup C isolates that were submitted to
NCDC from cases of meningococccal disease. The frequency
of sulfonamide resistance in serogroup C, in contrast to
other serogroups, has increased significantly (Table 1).
Since September 1968, the proportion of isolates sub-
mitted from different geographic divisions has corresponded
to the proportion of cases reported by these divisions
(Table 2) with two exceptions: 59 isolates in EY 1969
were submitted from an army base in the Middle Atlantic
Division and no isolates were received from California
although the state reported an unusually high incidence of
meningococcal disease during 1969 i1lMl R. Vol. 18, No. 16).
(Reported by the Bacterial Diseases Branch, Epidemiology
Program, and the Bacterial Reference Unit and the Bac-
terial Immunology Unit, Laboratory Division, NCDC.)


*Since Sept. 1, 1968, data on meningococcal infections have been
analyzed at the NCDC on the Tbais of an epidemiologic year
rather than a calendar year. Bacteriologic data prior to Septem-
ber 1968 are not readily available on an epidemiologic year
basis and therefore are presented on the basis of the calendar
year.





















ERRATUM, Vol. 18, No. 45, p. 400
In the article "Influenza Summer and Fall 1969,"
the terms summer and fall, as used, refer to seasons in the
northern hemisphere. This period corresponds to winter and
spring in the southern hemisphere; thus influenza ..liiil\
in Uruguay, Chile, Australia, and New Zealand should be
recognized as occurring during their winter and spring
months.





Editor's Note:
In an effort to keep our nm.iling list current, we are
including in the address section of this week's "Mor-
bidity and Mortality Weekly Report" a short statement
which may be used to change subscriptions. This state.
ment will reappear periodically.


NOVEMBER 22, 1969


THE MORBIDITY AND MORTALITY WEEKLY REPORT, WIU I A CIRCULAR*
TION OF 18,500 IS PUBLISHED AT THE NATIONAL COMMUNICABLE
DISEASE CENTER. ATLANTA, GEORGIA.
OIRECTDO NATIONAL COMMUNCCABLE DISEASE CENTER
DA ID J SENCER. M.D
DIR-i: i:' E'oDEMU OLC'.3u eAC AM A D LANGMUIR D
EDITOR MICH-EL B GREGG MD
EDITiO p rfrmr ALAN P MINMAN M D.
MAN .tINCG EcICR ,,S'.LLA B .OLMAN
IN .OEDIT,,N TO TE ESTABLiEi-ED PROCEDUREf FOR REPORTING
MORBIDITY AND MORTALITY, THENA-TICN AL COMMUNICABLE DISE ASE
CENTER WELCOMES ACCOUNTS OF INTERESTING OUTBREAAS OR C S5E
INVESTIGATIONS WHICH ARE OF CURRENT INTEREST TO EALTH
OFFICIALS AND WHICH ARE DIRECTLY RaLATED TO THE CONTROL
OF COMMUNICABLE DISEASES. SUCH CO-MMuNICATIONS GuLD BE
ADDRESSED TO:
NATIONAL COMMUNICABLE DISEASE CENTER
ATTN: THE EDITOR
MORBIDITY AND MORTALITY WEEKLY REPORT
ATLANTA, GEORGIA 30333

NOTE: THE DATA IN THIS REPORT ARE PROISIONAL AND ARE
BASED ON WEEKLY TELEGRAMS TO THE NCDC BI THE INDOIVIDUL
STATE HEALTH DEPARTMENTS. THE REPORTINC EEA CONC.LDES
AT CLOSE OF BUSINESS ON FRIDAY; COMPILED DATE ON A NATIONAL
BASIS ARE OFFICIALLY RELEASED TO THE PUBLIr ON TYE SUCCEED-
ING FRIDAY.


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