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:
AA00010654:00137

Related Items

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

Full Text

FS ~L


NATIONAL COM UNICABLE DISEASE CENTER


La

Vol. 18, No. 50

WEEKLY

REPORT

For
Week Ending
SDecember 13, 1969


U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE / PUBLIC HEALTH SERVICE 'HEALTH SERVICES AND MENTAL HEALTH ADMINISTRATION
DATE OF RELEASE: DECEMBER 19, 1969 ATLANTA, GEORGIA 30333


EPIDEMIOLOGIC NOTES AND REPORTS
SERUM HEPATITIS Savannah, Georgia

In Savannah, Georgia, since late November 1969, two
teenageri have died with fulminating hepatitis, probably
related to parenteral inoculation of narcotics with unsterile
needles. After these deaths, the incidence of narcotics-
associated hepatitis in Savannah was investigated. A total
of 56 cases with onset in 1969 were uncovered (Figure 1).
Of these 56 cases, 24 were found by review of hos-
pital records, nine by reports from community physicians,
and 23 by interviews with 70 narcotics users in Savannah,
The 70 drug users attended a special clinic set up during
the investigation and were part of a group of approximately
100 teenagers who frequently shared needles. Of the 70
persons, 31 had clinical histories compatible with hepatitis


CONTENTS
Epidemiologic Notes and Reports
Serum Hepatitis Savannah, Georgia ............. 433
Influenza Alaska ............ .... ....... 440
Current Trends
Influenza United States ................ ..... 434
International
Smallpltl (em -West
a tr ... ... 440


abnormal live~SCi( ti V dies (23 nonhospitalized
Se hospitalized). F|B from six of the 31 demon-
Australia antigen, in Berum from one had anti-
A antibody (Table *' e other 39 had no clinical
or Y evidence titis or Australia antigen.
S(Continued on page 434)


TABLE I. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous weeks)
50th WEEK ENDED MEDIAN CUMULATIVE, FIRST 50 WEEKS
MEDIAN
DISEASE December 13, December 14. 1964- 1968 MEDIAN
1969 1968 1969 1968 1964 1968
Aseptic meningitis ...................... 48 55 35 3,410 4,249 2,867
Brucellosis ............................ 2 1 4 221 221 240
Diphtheria .............................. 5 5 5 192 235 199
Encephalitis, primary:
Arthropod-borne & unspecified ........... 29 37 32 1,280 1,400 1.832
Encephalitis, post-infectious ............. 9 4 9 295 452 698
Hepatitis, serum ........................ 124 107 758 5,145 4538 36394
Hepatitis, infectious .................... 1.119 936 46.366 44;078
Malaria ............................... 42 56 24 3.075 2,288 496
Measles rubeolaa) ....................... 597 263 1,437 23.724 22.067 200,780
Meningococcal infections, total ........... 58 59 59 2,819 2,460 2,683
Civilian .............................. 53 47 2.577 2,249 -
Military .............................. 5 12 242 211 -
Mumps ................................. 2,427 2,386 84,662 144.746 --
Poliomyelitis, total .....................- 17 57 60
Paralytic ......... .......... ........- 15 57 57
Rubella (German measles) ............... 549 357 54,111 47,728
Streptococcal sore throat & scarlet fever.... 11.390 11,623 8,887 410.193 415,339 404,864
Tetanus ............................... 7 2 4 162 156 223
Tularemia ............................. 4 3 3 140 169 176
Typhoid fever .......................... 10 12 4 328 394 394
Typhus, tick-borne (Rky. Mt. spotted fever) 1 450 277 260
Rabies in animals ....................... 63 60 64 3.199 3.257 4.068
TABLE II. NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax: ........................ ................. 4 Rabies in man: .................................... 1
Botulism: .......................................... 12 Rubella congenital syndrome: .....................- 15

Plague:.................. ......................... 5 Typhus, murine: ..................................... 48
Psittacosis: Calif.-l, N.Y.C.-2 ..................... 49
*Delayed reports: Psittacosis: Pa. delete 1












Figure 1
56 NARCOTICS-ASSOCIATED CASES OF HEPATITIS
201 BY MONTH OF ONSET
SAVANNAH, GEORGIA 1969


MEMBERS OF A SINGLE GROUP,
SHARING COMMON NEEDLES

[ OTHER DRUG USERS

T SUBCLINICAL CASES AMONG
GROUP MEMBERS

+ DEATH SECONDARY TO HEPATITIS


JAN. FEB. MAR. APR. MAY JUN. JUL. AUG. SEP OCT. NOV. DEC.
ONSET


DECEMBER 13, 1969


Table 1
Narcotics-Associated Hepatitis Cases
Savannah, Georgia 1969

Method of Number Number Tested Number Percent
Identification Cases for Au Antigen* Positive
Hospital Records 24** 8 2 25
Interview and
Laboratory Data 23 23 4 17
Physician
Records 9 0 0 0
Total 56 31 6 19
*Australia antigen, tested by agar gel diffusion technique.
**Eight hospitalized patients were also interviewed at
special clinic.


Of the total 56 narcotics-associated cases uncovered,
47 (including the two fatal cases) were in Caucasians and
nine were in Negroes. The 47 were close friends and were
part of the previously mentioned 100 teenagers. The :32
boys and 15 girls ranged in age from 14 to 20 years (mean
17.5 years). Most had used drugs parenterally for approxi-
mately 3 months (range 2 to 12 -munth-li and all had been
familiar with marijuana for 1 to 3 years. The majority) i'2
of 32 questioned) identified with the middle socioeconomic
class in their community, two with the upper class, and
two with the lower.

(Reported by John E. McCroan, Ph.D., Director of Epi-
demiologic I',. i ......!t "'. Branch, and an Assistant Ep:-
demiologist, Georgia State Department of Public lilra!t..
Wilbur D. Lundquist, M.D., District Director of P'-b'ic
Health, Chatham County, Georgia; Enteric Virology i.'.t,
Laboratory Division, NCDC; and two EIS Oif':crr',.


CURRENT TRENDS
INFLUENZA United States


During the week ending December 13, 1969, all state
health departments were contacted to survey the present
level of influenza activity. Miljthou many states reported
seasonal increases in upper respiratory illnesses, there
were few reports of outbreaks of influenza-like illness.
Laboratory-confirmed outbreaks of influenza have oc-
curred in Alaska (see accompanying story) and in Puerto
ii, where there have been several small scattered out-
breaks. Laboratory confirmation in Puerto Rico is based
on fourfold rises in h..rn,,iiluilaii-rinhiiurib on antibody
titer. In both Alaska and Puerto Ri[ u. the -eiologit agent
is an AS2Hong Kong-like virus.
Small outbreaks of influenza-like illne--. for which
there has been no laboratory confirmation as yet, have oc-
curred in three counties in West Virginia and in Des
Moines, Iowa.


This fall and winter, there has been no sustained ex-
cess mortality due to pneumonia-influenza in the 122 L'.S.
cities reporting (Figure 2).




(Reported by Donald K. Freedman, M.D., Director, Divim.on
of Public Health, Alaska Department of Health and Welfare;
S. L. Hendricks, D.V.M., Acting irrrectr. Division of Pre-
ventive Medical Services, Iowa State Department of Health,
Dr. Raphael Correa-Coronas, Auxiliary Secretary of Ht aith
for Preventive Medicine, Puerto Rico Department of Health;
and N. Allen Dyer, M.D., State Director of Health, est
I',r.,,...' State Department of Health; and the Statis: .ca
Services Activity and Viral Diseases Branch, Epidemiology
Program, NCDC.)


434


Morbidity and Mortality Weekly Report


SERUM HEPATITIS (Continued from front page)









DECEMBER 13, 1969


Morbidity and Mortality Weekly Report


Figure 2
PNEUMONIA-INFLUENZA DEATHS IN 122 UNITED STATES CITIES

ALL CITIES


WEEK NO 40 44 48 52 4 8 12 16 20 24 28 32 36 40 44 48 52 4 8 12 16 20 24 28 32 36 40 44 48 53 4 8 12 16 20 24 28 32 36
WK. ENDED 7 4 2 30 27 24 23 20 18 15 13 10 7 5 2 30 28 25 22 22 19 17 14 12 9 6 4 I 29 331 28 28 25 23 20 18 15 12
MONTH N 0 J FM A M J J A 0 N J F MA M J A 0 N J FM A M J J A S
196711968 196811969 196911970


E. N: CENTRAL
21 CITIES
150-

125-

100-

75-

50-

25-


l..I,,, I,, h, ...I. ..Ih ... i- hl ,h ,l .. ,I ... 1- 1 -.. I... I, ... I .. Id .,1 1, lh1 L
WEEK NO. 40 44 48 53 4 8 12 16 20 24 28 32 40 44 48 53 4 8 12 16 20 24 28 32
1969 1 970 1969 1970


MOUNTAIN
8 CITIES


E. S. CENTRAL
8 CITIES


175-


255



WEEK N 40 44 48 53 4 12 16 20 24 28 32 40 44 48 53 4 8 12 16 20 24 28 32
1969 1970 1969 I 1970


PACIFIC W. S. CENTRAL
16 CITIES 13 CITIES


NEW ENGLAND
14 CITIES















40 44 48 53 4 8 12 16 20 24 28 32 36
1969 11970


MIDDLE ATLANTIC
20 CITIES















40 44 48 53 4 8 12 16 20 24 28 32 36
1969 1 1970


SOUTH ATLANTIC
12 CITIES


-50-


,__ h__ h____ l____ __ h__ _h__h l J ,, ,I, ,,, I h ,,, h ,,h ,hI h ,I, l, I = ,I h Hh.I......... I .. -' 'I 4 4h 5 4h, Ih I f.,I, 2 24
WEEK NO. 40 44 48 53 4 8 1 116 20 24 28 32 40 44 48 53 4 8 1212 20 24 28 32 40 48 53 4 6202428 36
1969 11970 1969 1970 1969 1970


435


W.N. CENTRAL
10 CITIES


300-


- O 5-








136 Morbidilt and Mortality Weekly Report


TAHL.F III CAN S OF SP(.IFIED NOTIFIABLE DISEASES. UNITED STATES

FOR WEEKS ENDED

DECEMBER 14. 19,o9 AND DECEMBER II. 1968 (50Slh WEEK)


,, FIICEPHALITIS HEPATITIS
j i l 1 I Pri-.arv incluaIni P.n IF MALARIA
%REA Ill ,' 'i un p ., :eN I,.,.. ,.,,,. 5eru" Infectious
Lum.
I 14 ___._ I 1. C,_ I jj I'19. j 196, 16* J. h


t ilTED 1ATt.. 48 2 5 29 37 9 124 1,119 936 42 3,075

NEW ECr..LAND.......... 2 I 1 6 1 11 73 4 98
",inE.............. 1 12 I 8
r.-. amp h, r ..... 4 2
V, rm nt ............ 3 -
Ma:i chusrer ..... 1 4 67 32 1 60
Rr.de Island....... 1 8 8 1 11
I .nnectLcut ........ 2 10 14 1 17

MIDDLF ATLAJTIC ...... 7 1 5 3 46 171 188 3 368
Yrli C ...... 2 1 1 1 26 52 69 I 26
c.. r r, .p-n 6 32 29 80
hNe. lJer F ........ 3 5 36 42 151
F ntrr. lnia fI .... 2 4 2 4 7 51 48 2 111

EA T IJ'RTH CENTRAL .. 6 n 13 2 26 245 154 6 320
i, .............. 2 7 9 2 6 5? 33 I 30
I n.l i................ 1 22 13 1 27
i i ... ............. 2 .4 67 34 4 196
M :h,; i r ............ 2 1 3 16 89 53 66
-l : .:, n: .......... -- t- 10 21 I

JE, T roRTlH (FNTRAL... 2 1 5 34 44 6 221
MInr, l .......... 1 4 5 11 14
1 -a. 12 9 25
li ............. 2 8 25

I rrh r i i *[ E ... ... 1 1 4
Sth ,t ....... 3 1 2
F.-tr i ......... 2 2 4
n:a ........ ... 1 12 10 5 127

c LITH AT IT IC....... 5 1 75 99 6 775
D l ,'. ire........... 3 5
M r v r,,d........ .. I 1 1 12 18 1 34
','r ... C lumba 1 1 2
Vr- i ar.ia.......... 13 14 27
W~: VI, rieni .... 1 -- 9 11 4
I .r Cirol Ir.a r ..... 1 15 16 311
Suth r:n..... 1 I 5 8 64
*. -rg 3s ............ .- 6 19 3 277
FI .:rida ........... 2 2 15 9 51

EAFT 1i1.TH rENiTRAL... 3 1 2 2 98 62 181
lk nr.-cky. ........ I 56 28 152
T r.n i ie e ........... I 26 1U -
Al a rnam ............ 7 13 25
Mississipp ........ 3 2 9 11 4

E-'T '~oliT CENTRAL... 3 2 1 I 58 61 11 274
Ar kjncas.4 ......... 6 13
L. us ii na ......... 2 1 1 -1 12 10 46
Ok I s3hm.ma ......... 7 17 2 79
Te.. .............. 3 1 1 39 28 9 136

MC.I.O TAI l ............. 3 1 2 50 12 138
Mntana .............. 1 I 3
lia1r. ............. 3 1 5
,'.,, ng .. ....- .- 3 1 -
i*- I -,rad .. .... ....... 3 1 -. 2 12 112
rN. lMexio ......... I1 9
Arizi na............. 15 1 1
Lit t ................ 8 1
S 3 a. ............. -7

AC IFIC:............. 15 1 1 7 I1 2 34 277 243 8 700
Washinntcon......... I 2 56 28 7
Or- .:-r ............. 1 I 18 19 18
C li r ni n. .. .. ...... 1. I 6 II 2 32 201 191 8 540
Ala ik. .............. 1 2 4
rat.ii- ........... .- I 3 131


,J 'J, ,_1 -. 1 21 8
-'relaved report,: Aseptic er inptl s: Ark. 2 Hepatitis, Infectious: N.H. 1, Wvo. 1, P.R. 1
Brucellois: IOkla. 1 Malaria: Ky. 23
EncephalitLs, post-Infectious: Pa. delete I








Morbidity and Mortality Weekly Report 437


TABLE III. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

DECEMBER 13, 1969 AND DECEMBER 14, 1968 (50th WEEK) CONTINUED


MEASLES (Rubeola) MENINGOCOCCAL INFECTIONS, MUMPS POLIOMYELITIS RUBELLA
TOTAL
AREA Cumulative Cumulative Total Paralytic
Cum.
1969 1969 1968 1969 1969 1968 1969 1969 1969 1969 1969
UNITED STATES... 597 23,724 22,067 58 2,819 2,460 2,427 15 549

NEW ENGLAND.......... 11 1,197 1,299 1 108 139 247 2 18
Maine............... 9 38 8 6 49 1 4
New Hampshire...... 1 245 150 1 5 8 24 2
Vermont ............ 3 3 1 3 -
Massachusetts.*... 10 258 382 41 74 66 5
Rhode Island....... 27 55 14 9 32 1
Connecticut........ 655 671 40 41 73 1 6

MIDDLE ATLANTIC...... 45 7,907 4,632 13 468 433 130 2 26
New York City...... 5 5,016 2,384 2 89 89 102 9
New York, Up-State. 5 625 1,363 2 91 72 NN 1 4
New Jersey.......... 10 1,071 701 7 183 152 28 2
Pennsylvania....... 25 1,195 184 2 105 120 NN 1 11

EAST NORTH CENTRAL... 212 2,950 4,173 9 382 309 656 1 192
Ohio................ 14 525 329 2 138 84 92 18
Indiana............. 5 483 730 2 52 44 90 10
Illinois........... 154 884 1,430 2 54 70 78 1 26
Michigan............ 29 394 328 3 111 89 117 82
Wisconsin.......... 10 664 1,356 27 22 279 56

WEST NORTH CENTRAL... 122 1,114 453 2 139 138 148 1 42
Minnesota........... 1 11 19 29 29 2 3
Iowa............... 338 146 21 14 125 28
Missouri........... 1 32 81 56 48 8 -
North Dakota........ 26 77 138 2 4 6 4
South Dakota....... 3 4 1 5 NN -
Nebraska.* ........ 94 644 55 2 13 9 7 6
Kansas............. 9 10 17 29 1 1

SOUTH ATLANTIC........ 87 2,946 1,797 5 482 492 172 1 37
Delaware............ 37 508 19 17 12 -
Maryland............ 93 103 41 44 16 2
Dist. of Columbia.. 35 6 9 17 4 I
Virginia........... 41 991 428 1 58 48 36 13
West Virginia...... 1 225 326 24 14 71 10
North Carolina..... 8 354 321 1 89 98 NN 1
South Carolina..... 134 28 1 64 63 2 -
Georgia............. 2 4 1 78 93 1 -
Florida............. 604 562 1 102 103 42 1 10

EAST SOUTH CENTRAL... 5 131 506 3 204 219 103 1 7
Kentucky.!......... 5 75 106 81 98 30 1
Tennessee.......... 21 64 1 75 68 67 6
Alabama............ 11 95 1 28 28 5 1 -
Mississippi........ 24 241 1 20 25 1 --

WEST SOUTH CENTRAL... 65 5,123 5,268 10 372 355 171 6 47
Arkansas........... 16 2 33 21 1 -
Louisiana.......... 125 25 2 100 100 -
Oklahoma............ 1 143 130 36 56 15 -
Texas............... 64 4,839 5,111 8 203 178 155 6 47

MOUNTAIN............. 25 1,141 1,087 59 45 83 44
Montana............ 14 122 58 8 6 12 13
Idaho.............. 90 21 13 12 2 2
Wyoming............ 55 3 5
Colorado............ 141 525 13 14 25 10
New Mexico.......... 2 286 164 8 1 8 2
Arizona............. 9 490 235 10 5 23 5
Utah................ 11 21 5 1 13 7
Nevada............. 1 8 2 3 -

PACIFIC..... ......... 25 1,215 2,852 15 605 330 717 1 136
Washington.......... 1 68 601 2 59 51 481 51
Oregon.............. 1 201 588 1 22 25 25 7
California......... 17 880 1,617 12 503 236 149 1 43
Alaska.............. 14 11 11 4 29 29
Hawaii.............. 6 52 35 10 14 33 6

Puerto Rico.......... 111 2,096 499 19 20 41 2
*Delayed reports: Measles: Mass. delete 1, Nebr. 20
Meningococcal infections: Ky. 23







138 Morbidity and Mortality Weekly Report


TABLE III. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

DECEMBER 13, 1969 AND DECEMBER 14, 1968 (50th 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... 11,390 7 162 4 140 10 328 1 450 63 3,199

NEW ENGLAND........... 1,256 I 16 16 1 1 55
Maine.............. 1 6
New Hampshire...... 40 5
Vermont............ 16 1 33
Massachusetts...... 209 1 8 1 3
Rhode Island....... 53 1 -
Connecticut........ 954 6 8

MIDDLE ATLANTIC...... 573 1 23 5 31 47 13 247
New York City...... 20 14 1 17 -
New York, Up-State. 401 3 4 6 7 13 233
New Jersey......... NN 3 3 15 -
Pennsylvania....... 152 1 3 5 25 14

EAST NORTH CENTRAL... 1,101 19 1 18 36 3 4 232
Ohio................ 219 4 13 2 76
Indiana............. 154 1 6 56
Illinois........... 168 10 5 16 3 40
Michigan............ 449 5 6 9
Wisconsin .......... 111 7 1 2 51

WEST NORTH CENTRAL... 526 1 14 14 10 8 9 606
Minnesota.......... 15 1 6 4 3 164
Iowa................ 176 1 7 2 100
Missouri............ 26 4 10 3 3 145
North Dakota....... 171 1 72
South Dakota....... 30 1 43
Nebraska............ 66 1 1 14
Kansas ............. 42 4 3 1 68

SOUTH ATLANTIC....... 942 2 30 23 50 253 17 760
Delaware........... 20 1 2 3 -
Maryland........... 138 1 4 48 3
Dist. of Columbia.. 3 2 3 -
Virginia........... 370 1 2 4 1 81 3 371
West Virginia...... 221 1 2 2 5 5 111
North Carolina..... NN 3 6 11 67 5
South Carolina..... 37 1 2 I 32 -
Georgia............ 8 1 8 4 11 16 7 100
Florida ............ 145 12 4 15 1 2 170

EAST SOUTH CENTRAL... 1,865 2 25 1 15 4 51 65 3 391
Kentucky........... 168 7 3 12 13 2 201
Tennessee........... 1,199 4 1 14 1 21 43 1 131
Alabama............ 194 1 8 4 6 53
Mississippi........ 304 1 6 1 14 3 6

WEST SOUTH CENTRAL... 860 30 1 25 1 35 1 51 8 463
Arkansas........... 33 2 5 14 7 33
Louisiana.......... 6 7 1 5 4 1 40
Oklahomat.......... 3 1 9 1 32 2 70
Texas.............. 818 20 6 1 17 12 5 320

MOUNTAIN.............. 3,058 7 18 32 17 1 123
Montana........... 44 1 3 -
Idaho.............. 217 4 6 -
Wyoming.#.......... 136 4 5 55
Colorado........... 2,022 2 3 9 3
New Mexico......... 294 1 10 1 22
Arizona............. 184 4 6 22
Utah............... 161 13 2 5
Nevada ............. 1 16

PACIFIC.............. 1,209 1 13 1 6 5 67 5 7 322
Washington......... 852 1 2 1 3 3 4
Oregon............. 172 1 2 6 4
California ......... -- 1 12 2 1 49 2 7 314
Alaska............... 43 -
Hawaii............. 142 3 9 -

Puerto Rico.......... 13 7 29
*Delayed reports: SST: Wyo. 9
Tularemia: Okla. 1






Morbidity and Mortality Weekly Report


439


Week No. TABLE IV. DEATHS IN 122 UNITED STATES CITIES FOR WEEK ENDED DECEMBER 13, 1969
50
(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 65 years nand year
Ages and over Influenza All 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.---------
Kana3: City, Kans.----
Kansas City, Mo.---
Lincoln, Nebr.--------
Minneapolis, Minn.---
Omaha, Nebr.----------
St. Louis, Mo.--------
St. Paul, Minn.-------
Wichita, Kans.--------


806
248
48
28
30
75
35
19
33
59
55
18
55
32
71

3,706
70
47
159
52
34
45
96
95
1,765
46
601
227
57
126
22
53
79
52
34
46

2,812
60
43
771
156
234
129
79
391
68
56
53
27
59
162
40
164
37
35
41
126
81

870
47
30
48
151
36
108
71
258
67
54


499
136
31
23
22
45
16
12
20
35
33
13
37
26
50

2,159
45
32
104
27
23
28
52
55
1,023
31
323
122
35
87
14
31
44
25
28
30

1,610
33
27
411
111
139
69
45
192
44
29
31
20
38
95
22
101
24
25
24
78
52

539
27
18
23
85
29
71
49
150
54
33


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.----------


1,332
148
247
48
144
122
68
81
52
109
64
197
52

708
118
59
33
148
173
43
34
100

1,391
53
58
42
203
65
92
255
66
179
85
127
77
89

458
40
17
116
25
108
21
80
51

1,819
19
52
46
51
110
480
106
47
188
75
107
178
44
172
83
61


677
60
130
24
63
61
32
51
21
78
35
96
26

377
61
39
20
79
97
26
15
40

743
35
28
22
106
27
48
131
30
98
43
73
43
59

265
26
11
74
13
56
13
45
27

1,084
13
30
31
28
59
298
66
38
111
48
60
91
27
100
45
39


Total 13,902 7,953 562 653

Expected Number 13,122 7,650 484 544


Cumulative Total
(includes reported corrections
for previous weeks)


648,409


370,737


28,746


30,831


*Mortality data are being collected from Las Vegas, Nev., for possible inclusion in this
Las Vegas, Nev.* 15 5 4 4 table, however, for statistical reasons, these data will be listed only and not included in
I1 the total, expected number, or cumulative total, until 5 years of data are collected.






Morbidity and Mortality Weekly Report


DECEMBER 13, 1969


EPIDEMIOLOGIC NOTES AND REPORTS
INFLUENZA Alaska

During the last 3 weeks, influenza-like illness has
spread from the Anchorage metropolitan area to involve ex-
tensively many communities in the South Central and North-
ern regions and has largely spared the Southeastern region.
Large outbreaks were reported between November 23 and
December 6 in Homer, Anchor Point, and Minilchik. Further
outbreaks between December 6 and 15 were reported in the
Nome and Kotzebu area and in Fairbanks. Influenza activity
has just begun in Bethel. School absenteeism reached 15-20
percent in Anchorage and Homer, both of which were in-
volved with A2/H,.ng Kong/68 ipfluneza in 1968. In Anchor
Point and \ln.i. hik. w .ehl' pIv trf,ylvblved in 1968,
school absenl.-.- r-m r-I l.pflp"-rAt Vt.Jru- i-olldist
have been (n.f'irI,.4--. \.. HO- l .-rni-ai, lnfluhnza
Center for^'lt- \ ,ni.'r, t ?. b*in~n g-s~ ,t T, A o H)ron
Kunr 'R.*'E; I. in-'.' ,'F '~, I r e1g1I iflfe ,a rogre--
in tIh-* il.i il airetmp ip Int lui- urtL. i '.aSt ..Iru-
1- IIItlAR u l'Fro l.Ml S. -e, -.' ,d inltn'.It/I l. atIon of



- ..,t ,t' r ,, PEH DHET .
4 l'."_ iI 1Tow /' h 1 [f re ra r*corn-






C.i';.i;-. .*1..'-.j. and the Medical Epidemiologist, Ecologi-
cal r I', '.l.',..* Program, Alaska Activities and Arctic
Health Research Center.)




INTERNATIONAL NOTES
SMALLPOX ERADICATION PROGRAM
West and Central Africa

In November 1969, the 100 millionth smallpox vacci-
nation was administered in the West and Central African
Smallpox Eradication Program. The program, sponsored
by the U.S. Agency for International Development and the
National Communicable Disease Center, began vaccina-
tions in January 1967, with the objective of eradicating
smallpox in a 20-country area in West and Central Africa
with a population of 119 million persons. The program has
resulted in a dramatic reduction in smallpox incidence
rates in these countries which in 1967 were the highest
in the world. Since the first week of October 1969, there
have been no reported smallpox cases in the 20-country
area.
(Reported by the Smallpox Eradication Program, NCDC.)


TNE MORBIDITV AND MORTALhITV *EEKLY REPORT -iTH A CIRCULA"
T1ON OF iu IS PUBLSMED AT T -E NATIONAL COMMUNICABLE
DISEASE CENTER ATLANTA GEORGIA
DIRECTOR NATIONAL COMMUNCABLE DISEAsE CENTER
AVID J SENCER M.D.
DIRECTCP EPL''-FIL'i1 PROGRAM A D. LI NGMU'R M.D.
EDITOR MICMAEL B GREGG M D
MANAGING ED' TOR PRISCLLA B. HOLMAN
IN ADDITION TO THE ESTABLISHED PROCEDURES FOR REPORTING
MORBIDITY AND MORTALITY, THE NATIONAL COMMUNrICABLE DISE AE
CENTER WELCOMES ACCOUNTSOF INTERESTING OUTBREAKS OR CASE
INVESTIGATIONS WHICH ARE OF CURRENT INTEREST TO HEALTH
OFFICIALS AND WHICH ARE DIRECTLY ELATED TO THE CONTROL
OF COMMUNICABLE DISEASES. SUCH COMMuNCA TONS SIOuLD 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 PROVISIONAL AND ARE
BASED ON WEEKLY TELEGRAMS TO THE NCDC B1 THE INDI-IDUAL
STATE HEALTH DEPARTMENTS. THE REPORTING WEEK CONCLUDES
AT CLOSE OF BUSINESS ON FRIDAY; COuMPLED DATA ON A NATIONAL
BASIS ARE OFFICIALLY RELEASED TO THE PUBLIC ON THE SuCCEED-
ING FRIDAY


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