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:
AA00010654:00133

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 WELFARE / PUBLIC HEALTH SERVICE I
DATE OF RELEASE: DECEMBER 5, 1969 ATLANTA,


EPIDEMIOLOGIC NOTES AND REPORTS
DIPHTHERIA Miami, Dade County, Florida


Between Oct. 29 and Nov. 22, 1969, five confirmed
cases (one fatal) and one probable case of diphtheria oc-
curred among members of two families in Miami, Dade
County, Florida. All five confirmed cases were in previ-
ous l unimmunized children. Three had acute onset of
fe er, sore throat, malaise, and nonproductive cough, the
fourth had nonspecific pharyngitis, and the fifth developed
pharyngitis and was dead on arrival at a hospital. Three of
the children who were hospitalized recovered and had no
clinical residua; the other is still under treatment. All four
hospitalized patients were given diphtheria antitoxin,
penicillin, and diphtheria toxoid immediately after diphtheria
was clir;call) diagnosed. Cultures for Corynebacterium
diphtheriae were initially positive but became negative
after treatment.


Epidemiologic Notes a KB !|
Diphtheria Miami, Dad .iq a .......... 417
Hepatitis Washington, D.C. ..... ............ .. 418
Follow-Up Febrile Respiratory Illness -
Anchorage, Alaska .............. ... ...... .. 424
Surveillance Summary
Salmonellosis July, August, and September 1969 419
International Notes
Yellow Fever West and Central Africa .. 419



The patient with confirmed diphtheria who is still
hospitalized and the hospitalized patient with probable
diphtheria are siblings of the child who died. The probable
case is in his 12-year-old brother who has myocarditis as
manifested by EKG abnormalities and who has a purulent
skin lesion on his foot that has been present for several
weeks. He has had no history of upper respiratory com-
(Continued on page 418)


TABLE I. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous weeks)
48th WEEK ENDED MEDIAN CUMULATIVE, FIRST48 WEEKS
DISEASE November 29, November 30, 1964 1968 MEDIAN
1969 1968 1969 1968 1964- 1968


Aseptic meningitis .......................
Brucellosis ............................
Diphtheria........... ... ... ...... ......
Encephalitis, primary:
Arthropod-borne & unspecified ...........
Encephiliti s. post-infectious .............
Hepatitis, serum ........................
Hepatitis, infectious ...................
Malaria ........... ....................
Measles rubeolaa) .......................
Meningococcal infections, total ...........
Civilian ..............................
Military ................... .........
Mumps ................................
Poliomyelitis, total .....................
Paralytic .............................
Rubella (German measles) ...............
Streptococcal sore throat & scarlet fever....
Tetanus ...............................
Tularemia .............................
Typhoid fever ..........................
Typhus, tick-borne (Rky. Mt. spotted fever) .
Rabies in animals .. .............. ......


43
2
3

33
5
103
866
30
260
28
26
2
1,734


375
8,490
1
1
5
2
56


22
1
93
833
54
226
38
38

1,929


291
9,225
1
1
8
3
49


52
7
2

30
8
774
17
1,472
41



2


8,873
6
1
8
2
RQ


3,278
213
178

1.227
281
4,906
44,179
2,858
22,732
2.699
2,485
214
80,539
16
15
53,015
388,908
147
135
309
447
3 076


4,120
217
227


1,330
440
4,282
42,176
2,201
21.532
2,356
2,159
197
140,102
57
57
46,991
392,730
153
166
373
276
3 138


2,782
232
187


1,775
677
34,952
458
197,985
2,559



57
57

387,090
209
168
382
260
3 l 31


TABLE II. NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax: N.C.-1 .................. .................. 4 Rabies in man: ......................................
Botulism: ......................................... 12 Rubella congenital syndrome: ......................... 15
Leptospirosis: Ohio-1 ................................. 81 Trichinosis: Alaska-2, NYC-1......................... 173
Plague: .................... ....................... 5 Typhus, marine: ..................................... 47
Psittacosis: Calif.-5 ............................... 46


69 3 07 3 13 3 93











plaints, and cultures of the lesion and nasopharynx have
been negative for C. diphtheriae.
The three confirmed cases who recovered were mem-
bers of a family with 10 children. In addition to these
three cases, five other children in the family had cultures
positive for C. diphtheria; they were subsequently treated
with Td or DTP and penicillin and have remained asympto-
maric.
The five cases, one probable case, and five children
with positive cultures attended one of three schools, and
each of these children had contact with at least one of the
other 10 patients. Two of the schools are next to each
other and the third is located within 1 mile of the others.
Between November 18 and 20, a diphtheria vaccination pro-
gram was carried out in these schools. More than 3,000
persons received Td or DTP inoculations. A follow-up


NOVEMBER 29, 1969


vaccination program for booster doses is planned for
February 1970. In addition, all persons in the community
were urged to bring their diphtheria immunization status
up to date.
The epidemiologic investigation of this outbreak is
continuing.

(Reported by Milton S. Saslaw, M.D., M.P.H., Acting Direc-
tor, Myriam A. Bosch, M.D., M.P.H., Epidemiologist, and
Abraham Bolker, M.D., Acting [.', ',,:.-. Division of Epi-
demiology, Dade County Department of Public Health;
Robert Graves, Director, and Michael Kimerley, Acting
Assistant Director, Miami Regional Laboratory, and E.
Charlton Prather, M.D., M.P.H., Associate Director, Bureau
of Preventable Diseases, Florida Division of Health; and
two EIS Officers.)


HEPATITIS Washington, D.C.


Between Sept. 13 and Nov. 4, 1969, an outbreak of
viral hepatitis occurred among an interdenominational
"missional" cooperative group in Washington, D.C. The
group is composed of 34 persons including six families
(15 adults and 19 children) who live in a multi-room dwell-
ing. Each married couple or single adult has a separate
room and the children are housed in three dormitory-style
rooms. There were 19 cases of hepatitis (eight symptomatic
and 11 asymptomatic).
The eight clinically ill patients had symptoms includ-
ing malaise, abdominal pain, nausea, vomiting, and jaun-
dice and liver function studies consistent with the diag-
nosis of viral hepatitis. These patients were a 2-year-old
girl with onset on September 13, her 38-year-old mother
with onset on September 24 who was subsequently hos-
pitalized. and six other group members with onsets from
October 4 to October 16.
The 11 asymptomatic cases were detected by screen-
ing tests for liver function on sera drawn from 24 of the 26
remaining group members on October 17, 22, 29, and No-
vember 4. All 11 patients had SGOT and/ or SGPT eleva-
tions greater than 100 Sigma Frankel units. The two
individuals who did not have liver function tests were
asymptomatic infants (Table 1).
Tests for hepatitis-associated antigen* were negative
in 18 of the 19 cases; the one exception was a 3-year-old
Korean child with mildly elevated SGOT and a 6-month
history of intermittent fevers and diarrhea.
The 19 patients' ages ranged from 2 to 39 years; the
average age was 16. There were eight males and 11 females.
Cases occurred in all six families, and cases in children
awre evenly distributed among the residents of the three
dormitories. All patients had close contact with other group
members on a day-to-day basis. Questioning revealed no
history of raw shellfish consumption, parenteral drug abuse,


Table 1
Summary of Laboratory Data

SGOT* and/orSGPT** Symptomatic Asymptomatic Totals
Significant Elevation 8 11 19
Borderline Elevation 0 4 4
Normal 0 9 9
Not Tested 0 2 2
Total 8 26 34
*SGOT values Normal, 0 to 28 Sigma Frankel Units
Borderline, 28 to 50 Sigma Frankel Units
**SGPT values Normal, 0 to 35 Sigma Frankel Units
Borderline, 35 to 45 Sigma Frankel Units


transfusions, or exposure to hepatotoxins. No contacts
with known hepatitis cases from outside the ecumenical
unit were documented. The clustering of cases over a 7-
week period suggests a common exposure; however, the
communal setting and close interpersonal contacts like-
wise suggest a person-to-person spread. An environmental
survey revealed an excellent level of sanitation. Water
was supplied from municipal sources; food was prepared
by individual group members. The mother of the first case
prepared a meal on September 16 (8 days before her onset).
The meal was served to all 34 group members; however,
no likely means of contamination was uncovered. Food
histories from both sick and well patients were unrevealing.
Gamma globulin was administered to all asymptomatic
group members from October 15 to 18. No new cases have
been detected by weekly liver function testing since
November 4.
(Reported by William E. Long, M.D., Chief, Epidemiology
Division, District of Columbia Department of Health;
Lewellys F. Barker, Laboratory of Viral Immunology, Divi-
sion of Biological Standards, NIH; and an EIS Officer.)
'I I I. agar gel diffusion and complement fixation techniques.


Morbidity and Mortality Weekly Report


DIPHTHERIA (Continued from front page)













During July, August, and September 1969, the total
numbers of salmonella isolations from humans were 2,155,
2,096, and 2,198, respectively, and the weekly averages
for the 3 months were 431, 524, and 550, respectively
(Figure 1). For the same months 673, 721, and 855 isola-
tions from nonhumans were reported (Table 2).
These data demonstrate essentially no change in the
number of human isolations from the same period in 1968
(MMWR, Vol. 18, No. 1). However, the number of nonhuman
isolates for the third quarter of 1969 decreased slightly
compared with the previous year. Part of this decline ap-
pears to be the result of fewer isolations during the month
of July of many serotypes from chickens, cattle, and wild
animals. The reason for the decline is unclear; the reduction
may well represent sampling practices rather than a true de-
cline in the prevalence of salmonella among these animals.
(Reported by the Salmonellosis Unit, Enteric Diseases Sec-
tion, Bacterial Diseases Branch, Epidemiology Program,
NCDC.)


419


Figure 1
REPORTED HUMAN ISOLATIONS OF SALMONELLA
UNITED STATES 1965-1969


A A A r .


Copies of the original reports from which these data were
derived are available on request from
National Communicable Disease Center
Attn: Chief, Salmonellosis Unit, Epidemiology Program
Atlanta, Georgia 30333


Table 2
10 Most Frequently Reported Salmonella Serotypes from Humans and Nonhumans
July, August, and September 1969
HUMAN NONHUMAN
Serotype Number Percent Serotype Number Percent
typhimurium* 1,712 26.5 typhimurium* 354 15.7
enteritidis 566 8.8 cholerae-suis K 208 9.2
newport 557 8.6 heidelberg 204 9.1
heidelberg 445 6.9 anatum 180 8.0
saint-paul 295 4.6 montevideo 88 3.9
infants 284 4.4 saint-paul 84 3.7
thompson 258 4.0 senftenberg 78 3.5
javiana 177 2.7 thompson 74 3.3
typhi 157 2.4 derby 66 2.9
blockley 133 2.1 bredeney 49 .2.2
Subtotal 4,584 71.1 Subtotal 1,385 61.6
Total all Serotypes 6,449 Total all Serotypes 2,249

*Includes var. copenhagen


INTERNATIONAL NOTES
YELLOW FEVER West and Central Africa*


From September through November 1969, yellow fever
has been reported from West and Central Africa (Figure 2).
Yellow fever was first reported in Ghana on September 30.
The source of infection was reported to be local. Five
cases and two deaths occurred in Tamale in the Western
Dagomba District, Northern Region. This was the first
occurrence of yellow fever reported in Ghana in nearly 6
years. In the last 10 years, yellow fever has been reported
twice: in 1959, two cases and two deaths occurred in Tema,
Accra; in 1963, one case and one death occurred in Kumasi


District, Ashanti Region, and two cases and two deaths
in the Gonja District, Northern Region.
In Nigeria, yellow fever was first reported on October
28. Through November 11, 154 cases (three confirmed) and
44 deaths were reported in the Benue Plateau, North Central
and North Eastern States.
In Mali, an outbreak of yellow fever was reported on
November 12 in an area about 50 km from Bamako. Two
fatal cases (laboratory confirmed) and 19 suspect cases
(Continued on page 424)


NOVEMBER 29, 1969


Morbidity and Mortality Weekly Report


SURVEILLANCE SUMMARY
SALMONELLOSIS July, August, and September 1969


I~aa ,


S............ 1......-...,..........






420 Morbidity and Mortality Weekly Report

TABLE III. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED
NOVEMBER 29, 1969 AND NOVEMBER 30, 1968 (48th WEEK)


ASEPTIC ENCEPHALITIS HEPATITIS
MENIN- BRUCEL- DIPIITHtIA Primary including Post- MALARIA
AREA CITIS LOSIS unsp. cases Infectious Serum Infectious
Cum.
1969 1969 1969 1969 1968 1969 1969 1969 1968 1969 1969
UNITED STATES... 43 2 3 33 22 5 103 866 833 30 2,858

NEW ENGLAND.......... 3 5 4 90 65 1 93
Maine.............. 10 8 7
New Hampshire...... 3 2 2
Vermont............ 2 -
Massachusetts...... 1 2 1 47 34 1 58
Rhode Island....... 2 1 16 8 10
Connecticut........ 2 3 12 13 16

MIDDLE ATLANTIC...... 4 1 1 1 44 156 144 4 335
New York City...... 1 1 24 41 64 22
New York, up-State. 2 1 10 52 27 1 75
New Jersey......... 10 36 12 130
Pennsylvania....... 1 1 27 41 3 108

EAST NORTH CENTRAL... 9 15 7 8 178 142 6 291
Ohio............... 12 4 45 61 3 28
Indiana............. 1 21 8 26
Illinois........... 2 23 18 3 173
Michigan........... 5 2 2 8 80 46 63
Wisconsin.......... 2 1 9 9 1

WEST NORTH CENTRAL... 4 1 3 1 28 25 9 208
Minnesota.*......... 4 1 9 15 14
Iowa.*............... 2 1 4 4 23
Missouri........... 14 1 3 45
North Dakota ...... 1 4
South Dakota....... -
Nebraska.*........... 1 3 4
Kansas.............. 1 2 5 117

SOUTH ATLANTIC....... 3 3 3 8 76 88 2 731
Delaware........... 1 3 1 1 5
Maryland........... 2 2 17 15 33
Dist. of Columbia.. 2
Virginia ........... 7 14 27
West Virginia ...... 8 7 3
North Carolina..... 8 7 285
South Carolina..... 3 7 62
Georgia......... .... 17 17 264
Florida............. 1 2 6 13 20 1 50

EAST SOUTH CENTRAL... 1 2 45 51 158
Kentucky ........... 1 14 29 129
Tennessee.......... 1 27 12 -
Alabama............ 1 3 6 25
Mississippi........ 1 4 4

WEST SOUTH CENTRAL... 1 3 3 2 1 2 48 32 2 236
Arkansas........... I 4 13
Louisiana. ........ 3 1 7 7 46
Oklahoma........... 1 2 1 1 1 1 75
Texas.*............ 1 2 36 24 1 102

MOUNTAIN............. 2 1 1 33 53 137
Montana............. 2 1 1 3
Idaho............... .- 1 5
Wyoming............ 1 -
Colorado.............. 21 25 112
New Mexico......... 5 14 9
Arizona ........... 4 3 1
Utah............... 3 8 I
Nevada............. 6

PACIFIC............... 19 4 6 3 35 212 233 6 669
Washington ......... 3 1 1 30 17 7
Oregon.............. 1 2 13 20 16
California.......... 15 4 5 3 32 161 192 6 522
Alaska.............. -- 1 3
Hawaii ............ 7 4 121

Puerto Rico.*.........- 2 17 46 -
*Delayed reports: Aseptic meningitis: Minn 2, Iowa Hepatitis, infectious: Neb. 1, La. 10, P.R.
iphtheria: Tex. delete 1 Malaria: Iowa 2
Encephalitis, primary: Minn. 7, Iowa 4







Morbidity and Mortality Weekly Report 421


TABLE II. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

NOVEMBER 29, 1969 AND NOVEMBER 3, 1968 (48th WEEK) CONTINUED


MEASLES (Rubeola) MENINGOCOCCAL INFECTIONS, MUMPS POLIOMYELITIS RUBELLA
TOTAL
AREA i Total Paralytic
AREA Cumulative Cumulative Total Paralytic
Cum.
1969 1969 1968 1969 1969 1968 1969 1969 1969 1969 1969
UNITED STATES... 260 22,732 21,532 28 2,699 2,356 1,734 15 375

NEW ENGLAND.......... 5 1,171 1,241 1 107 137 263 2 24
Maine.............. 9 38 1 8 6 24 1 2
New Hampshire...... 244 141 4 8 29 2
Vermont ......... -3 3 1 1 2
Massachusetts.*..... 2 243 375 41 72 75 7
Rhode Island....... 27 39 14 9 19 2
Connecticut........ 3 645 645 40 41 115 1 9

MIDDLE ATLANTIC...... 34 7,801 4,548 6 450 419 74 2 27
New York City...... 5 4,999 2,342 1 86 86 57 9
New York, Up-State. 1 616 1,353 2 88 72 NN 1 14
New Jersey......... 17 1,035 688 3 174 142 17 1
Pennsylvania ...... 11 1,151 165 102 119 NN 1 3

EAST NORTH CENTRAL... 49 2,684 4,082 3 369 294 431 1 79
Ohio .............. 12 492 320 2 136 82 55 6
Indiana............ 478 709 48 40 30 2
Illinois........... 22 708 1,410 52 64 48 1 7
Michigan........... 8 360 317 1 106 88 81 30
Wisconsin.......... 7 646 1,326 27 20 217 34

WEST NORTH CENTRAL... 959 410 4 135 126 114 1 36
Minnesota.*........ 9 19 29 29 36 7
Iowa.......... 337 108 1 21 10 58 20
Missouri.......... 31 81 3 56 41 8 5
North Dakota....... 44 138 2 4 8 -
South Dakota....... 3 4 1 5 NN -
Nebraska............ 527 50 10 9 1 -
Kansas............. 8 10 16 28 3 1 4

SOUTH ATLANTIC....... 78 2,747 1,724 4 471 474 229 1 27
Delaware............. 39 442 18 4 17 12 5 1
Maryland........... 7 88 103 41 40 8 1
Dist. of Columbia.. 32 6 9 17 1 -
Virginia........... 16 928 396 57 44 107 10
West Virginia...... 221 312 24 13 63 11
North Carolina..... 12 342 317 87 94 NN -
South Carolina..... 2 134 24 59 61 5 -
Georgia............. 2 4 77 93 -
Florida............ 2 558 544 100 100 40 1 4

EAST SOUTH CENTRAL... 4 122 503 1 172 209 120 1 16
Kentucky............ 68 103 55 94 26 1
Tennessee.......... 20 64 1 71 64 88 14
Alabama............ 4 10 95 27 27 6 1 1
Mississippi........ 24 241 19 24 -

WEST SOUTH CENTRAL... 67 4,998 5,155 2 356 336 170 6 42
Arkansas............ 16 2 32 20 -
Louisiana.......... 125 25 1 98 94 -
Oklahoma............ 142 128 36 55 43 9
Texas............... 67 4,715 5,000 1 190 167 127 6 33

MOUNTAIN............. 4 1,076 1,058 2 58 43 59 24
Montana............ 92 58 8 6 7 5
Idaho............ 90 21 13 11 8 1
Wyoming.*........... 54 3 -
Colorado............ 141 521 2 12 13 8 3
New Mexico.......... 279 143 8 1 7 -
Arizona ............ 4 462 233 10 5 20 10
Utah................ 11 21 5 1 9 5
Nevada............. 1 7 2 3 -

PACIFIC.............. 19 1,174 2,811 5 581 318 274 1 100
Washington.......... 67 588 57 50 94 51
Oregon.............. 200 577 20 25 11 2
California.......... 19 849 1,600 5 483 225 126 1 37
Alaska.............. 13 11 11 4 27 6
Hawaii.............. 45 35 10 14 16 4

Puerto Rico.......... 45 1,937 488 19 20 11-
*Delayed reports: Measles: Mass. delete 2, Minn. delete 8
Rubella: Tenn. delete 60, Wyo. 5, Ariz. delete 11







122 Morbidity and Mortality Weekly Report


TABLE III. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

NOVEMBER 29, 1969 AND NOVEMBER 30, 1968 (48th WEEK) CONTINUED


STREPTOCOCCAL TYPHUS FEVER
SORE THROAT & TETANUS TULAREMIA TYPHOID .TICK-BORNE RABIES IN
AREA SCARLET FEVER FEVER (Rky. Mt. Spotted) ANIMALS
Cum. Cum. Cum. Cum. Cum.
1969 1969 1969 1969 1969 1969 1969 1969 1969 1969 1969


UNITED STATES... 8,490 1 147 1 135 5 309 2 447 56 3,076

NEW ENGLAND.......... 1,261 1 16 16 1 1 54
Maine.............. 11 1 6
New Hampshire...... 30 5
Vermont............. 31 16 1 32
Massachusetts...... 198 1 8 1 3
Rhode Island....... 68 1 -
Connecticut........ 923 6 8

MIDDLE ATLANTIC...... 367 19 5 31 1 47 5 227
New York City...... 24 11 1 17 -
New York, Up-State. 340 3 4 6 7 5 213
New Jersey......... NN 3 3 15 -
Pennsylvania....... 3 2 5 1 25 14

EAST NORTH CENTRAL... 364 19 1 17 35 3 6 225
Ohio............... 47 4 12 2 74
Indiana............. 108 5 1 54
Illinois........... 96 10 1 5 16 3 2 39
Michigan............ 5 6 1 9
Wisconsin.......... 113 7 1 49

WEST NORTH CENTRAL... 341 12 14 10 8 10 578
Minnesota.f........ 23 4 4 1 154
Iowa............... 123 1 7 2 91
Missouri........... 20 4 10 3 4 137
North Dakota....... 80 2 71
South Dakota....... 17 1 43
Nebraska............ 72 1 1 14
Kansas............. 6 4 3 1 1 68

SOUTH ATLANTIC....... 1,010 28 23 3 50 1 252 14 728
Delaware........... 19 1 2 3 -
Maryland............ 99 1 4 48 3
Dist. of Columbia.. 3 2 1 3 -
Virginia............ 206 1 4 1 81 8 359
West Virginia...... 276 1 2 2 5 3 106
North Carolina..... NN 3 6 2 11 66 5
South Carolina..... 134 1 2 1 32 -
Georgia............. 8 7 4 11 1 16 2 89
Florida............ 265 12 4 15 1 1 166

EAST SOUTH CENTRAL... 1,344 22 14 46 65 3 386
Kentucky........... 136 7 8 13 2 198
Tennessee.......... 896 4 13 20 43 1 130
Alabama............ 192 6 4 6 52
Mississippi........ 120 5 1 14 3 6

WEST SOUTH CENTRAL... 647 1 28 23 1 33 49 10 447
Arkansas........... 10 2 5 13 7 30
Louisiana.......... 2 7 4 1 4 2 39
Oklahoma............. 6 1 8 30 1 68
Texas.............. 629 1 18 6 16 12 7 310

MOUNTAIN............. 2,158 6 18 1 30 17 118
Montana............ 48 1 1 3 -
Idaho.............. 310 4 6 -
Wyoming .......... 268 4 5 55
Colorado........... 1,154 2 3 9 3
New Mexico......... 174 1 8 17
Arizona........... 118 3 6 22
Utah............... 86 13 2 5
Nevada.............. 1 16

PACIFIC................. 998 12 5 58 5 7 313
Washington......... 714 1 2 2 3 4
Oregon ............. 170 1 6 4
California......... -- 11 2 44 2 7 305
Alaska.............. 51 -
Hawaii............. 63 6 -


Puerto Rico.......... 1 1 12 7 I 1 29


*Delayed reports: SST: Wyo. 28
Tetanus: Minn. 1






Morbidity and Mortality Weekly Report


TABLE IV. DEATHS IN 122 UNITED STATES CITIES FOR WEEK ENDED NOVEMBER 29, 1969

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


423


All Causes Pneumonia Under All Causes Pneumonia Under
Area As 16 y nand Ca r s a and II year
Area All 65 years and 1 Area All 65 years Influenza All
Influenza All Influenua All
Ages and over All Ages Causes Ages and over All Ages Causes
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.------


702
226
38
17
18
62
30
24
25
60
52
13
57
22
58

2,919
43
33
133
31
19
50
53
54
1,580
24
403
105
54
110
24
33
84
30
15
41

2,366
61
50
697
160
193
92
76
328
38
36
31
25
58
159
25
97
29
40
24
97
50

753
43
22
28
125
23
131
66
199
68
48


424
139
26
15
12
30
17
17
21
33
33
11
29
6
35

1,790
24
24
82
16
11
33
32
25
990
12
239
59
36
72
15
21
46
15
10
28

1,306
32
35
363
93
87
53
46
175
23
15
21
11
37
96
13
63
13
28
11
61
30

469
25
16
13
67
18
75
36
140
49
30


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.----------


941
132
200
46
71
81
44
71
25
66
54
103
48

580
90
40
39
133
148
37
21
72

967
27
21
25
179
23
95
154
38
163
55
72
64
51

406
29
25
102
15
100
30
59
46

1,444
23
57
17
50
90
339
102
37
123
43
95
178
68
134
57
31


36
9
5
1
1
3
6
2


1
5
3

30
5
1

4
10
2
2
6

55
1

2
9

12
3

12
3
5
6
2

24
1
1
6

5
1
4
6

69
1
6
1
5

16
6

4
2
9
7
2
6
2
2


Total 11,078 6,401 423 490

Expected Number 12,891 7,488 457 538


Cumulative Total
(includes reported corrections
for previous weeks)


619,828


354,369 27,627


29,420


Week No.
48


*Moirtalitr data are being collected from Las Vegas, Nev., for possible inclusion in this
Las Vegas, Nev.* 15 10 3 1 table, hovfeer, 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.






424


Morbidity and Mortality Weekly Report


YELLOW FEVER (Continued from page 419)


Figure 2
COUNTRIES REPORTING YELLOW FEVER
WEST AND CENTRAL AFRICA
SEPTEMBER-NOVEMBER 1969


with 10 deaths have been reported. This is the first report
of yellow fever from Mali since 1948 when one fatal case
was recorded.
In Togo, a fatal case of suspect yellow fever was re-
ported on November 13 from a village in the Circonscription
of Dapango (Rigion des Savanes). This area is adjacent to
Upper Volta where yellow fever was reported in the be-
ginning of November.
*Source: World Health Organization Weekly Epidemiological
Record 44(41, 47, and 48):578, 637, and 650. Oct. 10,and
Nov. 21 and 28, 1969.











EPIDEMIOLOGIC NOTES AND REPORTS
FOLLOW-UP FEBRILE RESPIRATORY ILLNESS
Anchorage, Alaska


Isolates obtained from the outbreak of febrile respira-
tory illness which occurred in November in a children's
home in Anchorage (MMWR, Vol. 18, No. 47) have been
identified as influenza A2 (Hong Kong-like) strains.
(Reported by Donald K. Freedman, M.D., P:re(c'or, Division
of Public Health, Alaska Department of Health and Wel-
fare; David R. L. Duncan, M.D., Health Off[i-.r. Greater
Anchorage Area Borough; Arctic Health Research Center,
Environmental Control Administration, CPEHS, USDHEW,
College, Alaska.)


NOVEMBER 29. 196S


THE MORBIDITY AND MORTALITY WEEKLY REPORT, WITH A CIRCULA-
TION OF 18.S00 IS PUBLISHED AT THE NATIONAL COMMUNICABLE
DISEASE CENTER, ATLANTA. GEORGIA.
DIRECTOR, NATIONAL COMMUNICABLE DISEASE CENTER
DAVID .J. SENCER. M D.
DIRECTOR, EPIDEMIOLOGY PROGRAM A. D. LANGMUIR. M.D.
EDITOR MICHAEL 5. GREGG. M.D.
MANAGING EDITOR PRISCILLA B. HOLMAN
IN ADDITION TO THE ESTABLISHED PROCEDURES FOR REPORTING
MORBIDITY AND MORTALITY. THE NATIONAL COMMUNICABLE DISEASE
CENTER WELCOMES ACCOUNTS DF INTERESTING OUTBREAKS OR CASE
INVESTIGATIONS WHICH ARE OF CURRENT INTEREST TO HEALTH
OFFICIALS AND WHICH ARE DIRECTLY RELATED TO THE CONTROL
OF COMMUNICABLE DISEASES. SUCH COMMUNICATIONS SHOULD BE
ADDRESSED TO'
NATIONAL COMMUNICABLE DISEASE CENTER
ATTN: THE EDITOR
MORBIDITY AND MORTALITY WEEKLY REPORT
ATLANTA GEORGIA 30313

NOTE: mnE DATA IN THIS REPORT ARE PRO.iSIONAL AND ARE
BASED ON *EEK4L TELEGRAMS TO THE NCDC BT THE INDIVIDUAL
STATE HEALTH DEPARTMENTS THE REPORTING WEEK CONCLUDES
AT CLOSE OF BUSINESS ON FRIDAY. COMPILED DATA ON A NATIONAL
BASIS ARE OFFICIALLY RELEASED TO THE PUBLIC ON THE SUCCEED-
ING FRIDAY.


i E__ -Ia

o -
Oz







aWWWmIa


r
im
z
a r-
m


M .






Z )II. l
4c C5 C
t z "NIm






-4 r
r r



z" 5'WN


C

ion


4-
az
ma
r Z
Om