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:
AA00010654:00139

Related Items

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

Full Text




1 NATIONAL MMUNICABLE DISEASE CENTER E


-,..












U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE / PUBLIC HEALTH SERVICE E HEALTHH SERVICES
DATE OF RELEASE: JANUARY 9, 1970 ATLANTA, GEORGIA 30333


EPIDEMIOLOGIC NOTES AND REPORTS
TYPE B BOTULISM Denver, Colorado

On Dec. 19, 1969, a 41-year-old man had onset of
dysphagia, followed several hours later by diplopia and
dysarthria. He was hospitalized on the following day be-
cause of progression of these symptoms. On admission, he
was afebrile. Physical findings included diplopia and
ptosis of eyelids, palatal paralysis with absent gag re-
flex, respiratory insufficiency, and upper extremity skeletal
muscle weakness. The patient was alert and oriented with
no sensory deficits. His past history included atherosclerotic
cardiovascular disease with angina pectoris. He was
tracheostomized and given supportive care.
A history of ingestion of home-preserved chili peppers
and their juice was elicited; the most recent exposure was


CONTENTS
Epidemiologic Notes and Reports
Type B Botulism Denver, Colorado ............. 457
Influenza- Alaska ........................ 45S
The 53rd Issue ............................ 45s
International Notes
Smallpox West and Central Africa . ..... .. 159
Index Volume 18 1969 . .. ..160




20 hours prior to onset of symptoms. The diagnosis of
botulism was made, and the patient was treated with bi-
valent AB botulinum antiserum on December 20.
The patient's condition after initially stabilizing,
deteriorated, and on December 24, he developed marked
(Continued on page 458)


TABLE I. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous weeks)
53rd WEEK ENDED CUMULATIVE, FIRST
MEDIAN
DISEASE January 3, December 28, 1964 1968 53 Weeks 52 Weeks MEDIAN
1970 1968 1969 1968 1964- 1968
Aseptic meningitis ...................... 35 80 29 3,519 4.374 2.940
Brucellosis ............................ 1 7 8 231 232 252
Diphtheria ............... ............... 1 20 10 214 260 214
Encephalitis, primary:
Arthropod-borne & unspecified ........... 14 23 23 1,334 1.455 1,880
Encephalitis, post-infectious .......... 2 7 10 316 465 713
Hepatitis, serum ......................... 53 105 715 5,412 4,715 37
Hepatitis, infectious .................... 643 685 48,756 45,578
Malaria ................................ 48 55 50 3,264 2,370 559
Measles rubeolaa) ....................... 627 257 1,232 25,271 22,617 203,010
Meningococcal infections, total ........... 43 25 53 2,966 2,521 2,813
Civilian ............................... 40 25 --- 2,705 2.306
Military ............................... 3 -- --- 261 215 --
Mumps ................................. 1,124 1,649 -- 89,499 148,804 -
Poliomyelitis, total ...................... 2 3 17 59 67
Paralytic ............................. .- 2 3 16 59 59
Rubella (German measles) ............... 318 281 55.492 48,446 -
Streptococcal sore throat & scarlet fever.... 5,136 8,594 8,594 431.667 435,136 422.918
Tetanus ............................... 8 3 5 174 163 233
Tularemia ................................ 6 3 9 148 175 192
Typhoid fever .......................... 6 7 7 347 408 408
Typhus, tick-borne (Rky. Mt. spotted fever) 2 2 450 279 262
Rabies in animals ....................... 47 51 60 3,335 3,363 4.172

TABLE II. NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax: ........................................... 4 Rabies in man: ................. .... ....... .... 1
Botulism: ......................................... 14 Rubella congenital syndrome: Colo.-l .................. 17
Leptospirosis: Calif.-l ............................... 92 Trichinosis: ........................................ 175
P league: ............................................ 5 T yphus, marine: ..................................... 49
Psittacosis: Calif.-l ............................... 50










-- -

1. p 1.4 I- i ... ..n. I ir. lIr v..,rrli I, (the patient was on
irii, 1 l .:.,I l .. .I l, l ii i rIcular fibrillation. He
.. t.- .. i l .1. UI.rjlrl1,..il: I ... ver, he remained un-
. ..- .. i.i r ., I -,, i n i .1 I ,pired on Jan. 1, 1970.
I'.. I. ,rir rhr serurm .lj'-a; i, I ours after onset of
i.... .- .alyiz d I.rr i '. botulinrum toxin lby
-* l.,- r,.I 4- i.i.- for type B toxin. Several
i.r 1 |)j Pr-' ]T,.1lj... were tested. No toxicity was
.1. -.. .
I."' S. Mlollohain, iV.D)., chief Seation of Epi-
dimniolo/y, C'olorado State Department of Public Health;
Ana rh'bicr acteriolotly Laboraory,. Bacterial Reference
' ni, Barteriology Se/ioan, lirruobiology Branchr, Labora-
tor Dixi 'ion. \W('TC and an EIS Officer.)
Editorial Comment:
This is the ninth outbreak of botulism reported to the
NCDC in 1969: to date, 15 cases (five fatal) have been re-
ported. Although toxin could not be demonstrated in the


JANUARY 3, 1970


vehicles tested in this outbreak, the clinical history and
laboratory analysis of the patient's serum confirmed the di-
agnosis of botulism type B. Since 1899 (1,2), a total of 11
outbreaks of known toxin type have been ascribed to chili
peppers. Of these, eight were due to type A toxin 36
cases (22 fatal) and three to type B 10 cases (three
fatal).
Since lh99. Colorado has reported 45 outbreaks. Type
A botulinum toxin was the causative agent in 12 outbreaks
and type B in one; there were no outbreaks with type E.


References:
(1) Meyer, K. F., and Eddie, B.: Sixty-five Years of luman
Botulism in the Unitted States and Canada: Epidemiology
anl Tabulations of Reported (Car 1899 through 1961.
George \\illiams Hooper Foundation, University of Cl i-
fornia, San Francisco Medical Center, June 1965.
(") National Communicable Disease Ce'nter: Botulism in the
United Stators: tHeview of Ca. ses 1S99-1967 and Handbook
for Epidemiologists, Clinicians, and Laboratory Workers.


INFLUENZA Alaska


The influenza outbreaks which began during the last
week in No\ember in the Northern and South Central re-
gions of Alaska are now on the wane. Absenteeism is re-
turning to normal in the cities involved, and no new out-
breaks have been reported from these areas. Several
studies in theI populations invol ted, rn, I.i,._ serologic
sur\ cs, vaccine protection studies,4 and virus shedding
studies are in progress.


Information, received for the week ending Jan. 3,1970,
indicates that outbreaks of influenza-like illness are just
beginning to be noted in the Southeastern region in Juneau
and Sitka.
reportedd by Donaldl K. Freedman, M.D., Division of Pub-
lic Health, Alaska Department of Healtcrl and Welfare;
Ecological /In, ... IProyram, Alaska Activities,
Arctic Health IResearch Center.)


THE 53rd ISSUE


\ol. Is for 1969 includes data for the week ending
January 3. 1970. This anomaly occurs because the num-
lr'r of lda s in a calendar year is not an integral multiple
of \ et'n. Wh lienet'r the period of time between the last
Saturday in a gi\cn calendar year antd the first day of the


new year is 4 or more days. it is necessary to add the
53rd week and issue. The Annual Supplement on Reported
Incidence of Nolifiable Diseases in 1969 will be pub-
lished in early fall 1970 and will be the 54th issue of
Vol. 16.


Morbidity and Mortality Weekly Report


BOTULISM (Conti )


r If /







JANUARY 3, 1970


Morbidity and Mortality Weekly Report


INTERNATIONAL NOTES
SMALLPOX West and Central Africa


For the first 11 months of 1969, 482 cases of small-
pox were reported from the 20 countries of West and Central
Africa participating in the U.S.-assisted Smallpox Eradi-
cation/Measles Control Program (1). This represents a
91 percent reduction from the 5,203 cases reported during
the comparable period in 1968.
Since August, two outbreaks of smallpox, both in
Dahomey occurred in West and Central Africa. The first
outbreak with 21 cases (five fatal) occurred in Athieme,
Dahomey (MMWR, Vol. 18, No. 37). Laboratory specimens
were submitted on 17 of the 21 cases. Smallpox was con-
firmed in 13 cases, was doubtful in one case, and was
negative in three cases. Control efforts stopped the out-
break within two incubation periods (28 days) after the
report of the index case in early August.


The second reported outbreak occurred in Central
Dahomey. In August, a '-. :ir-old girl was variolated
(inoculated with smallpox virus) by a smallpox fetisher,
developed smallpox, and subsequently infected two family
contacts. A third generation of three cases developed in
the family in September and the first week in October.
No smallpox cases have been reported from Dahomey
or in the total 20-country program area since that time
(Figure 1).

(Reported by the Smallpox Eradication Program, NCDC,
and the World Health Organization.)

Reference
(1) World Health Organization Weekly Epidemiological Record,
44 (51/52):670, Dec. 23, 1969.


Figure 1
REPORTED SMALLPOX CASES BY MONTH, 1960-67 AVERAGE, 1968 AND 1969
WEST AND CENTRAL AFRICA


/ \

/


/ \
/ \


/ 1960-1967 Ae1rage \ C 1960 1967 Aetage
/ \ Includes 20Cour.e \


/\\ /


459


2,000-

1,800.

1.600-

1.400

1,200-

1.2oo-
Z
800

600-

400-

200-


JAN FEB MAR APR I MAY JUNE I JULY I AUG I SEPT OCT I NOV : DEC JAN IFEB MR AP I MAY I JUNE JULY AUG I SEPT I OCT I NOV I DEC
1968 1969
Source: WHO


r-






Morbidity and Mortality Weekly Report


INDEX VOLUME 18 1969


AFRICAN SLEEPING SICKNESS
Epidemic Reports
Florida, 127
l'nited States. 3h)

ANTHRAX
Epidemic Reports
New Jerse.. 212
North (Carolina. 40V
Rhode Island. 294

BABESIOSIS
Epidemic Reports
Mas-achu.setts. 277

BOTULISM
Epidemic Reports
California. 42'6
(olorado. 121. 1-1, 4.57
Illinoi-. ,9
Indiana. 345
Kentucky. 106
North Carolina. 176
Oregon. 69
Texa,. 113, 196
la, hington. 23L-
Summaries
Annual. 21. 97
Current. 34h

BRUCELLOSIS, HUMAN
Summary
annual 114

CARBON MONOXIDE POISONING
Epidemic Reports
Ne% Mexico. ::37?
,\a-hington. ;3I

CHEMICAL POISONING
Epidemic Reports
New SMeico. 37h
\\a hington. f63

CHICKENPOX
Epidemic Reports
I'rah. h.379

CHOLERA
International Notes
Hong Kong. 347
Korea. 3417
Macau. 3;17

CLOSTRIDIUM PERFRINGENS
Epidemic Reports
Tennesee--. 150


DAPHNEE SORE"
Epidemic Reports
Alahama. 359


DENGUE
International Notes
Puerto Rico. 234. 242, 249. 262, 27

DIPHTHERIA
Epidemic Reports
Arizona. 162, 303, 324
California. 214
Florida, 417
Summary
Annual, 151
DYSENTERY
International Notes
Guatemala, 367, 441

ENCEPHALITIS
Summary
Annual. 254, 369

ENCEPHALITIS, ARTHROPODBORNE
Epidemic Reports
United States. 270
Wisconsin. 337
International Notes
El Salvador. 300
Guatemala, 300
Summaries
Annual. 254, 369
Current. .1 325. 337, 451
FEBRILE RESPIRATORY DISEASE
Epidemic Reports
Alaska, 410, 424

FOOD AND DRUG ADMINISTRATION WARNING
Contaminated Detergent Solution. 366

FOOD POISONING
Epidemic Reports
Alaska. 150, 168
California. 426
Colorado. I -.' 140
Connecticut. 46
Florida. 301, 339
Idaho, 235
Illinois. 89, 301, 339
Indiana. 345
Kentucky, 106
Mississippi. h8S
New York. 442
North Carolina, 176
Oregon. 69
Tennessee. 61, 295, 386, 450
Texas, 20, 113, 196
W\ashington. 17, 234
\iisconsin. 21
Summaries
Annual. 21. 97
Current. 34b


JANUARY 3: 1970









GASTROENTERITIS
Epidemic Reports
Alaska, 150, 168
Colorado, 112, 121, 140
Connecticut, 46
Florida, 301, 339
Idaho, 235
Illinois, 89, 301, 339
Kentucky, 106
Maryland 278
Mississippi, 88
New York, 442
North Carolina, 176
Oregon, 403
Tennessee, 61, 295, 386, 450
Texas, 20
United States, 301, 339
Washington, 47
S ,,-, n-r.r in. 21

GENERAL
Explanation of 53rd Week, 458

GLOMERULONEPHRITIS
Epidemic Reports
New Mexico, 235

HEMORRHAGIC FEVER, BOLIVIAN
International Notes
Bolivia, 120

HEPATITIS
Epidemic Reports
Alabama, 19
Georgia, 433
Illinois, 269, 284
Massachusetts, 357
New Hampshire, 368
New Jersey, 62, 70
South Carolina, 358
Tennessee, 63
Washington, D.C., 418
Summaries
Annual, 394
Current, 190
HISTIOCYTOSIS
Epidemic Reports
New Jersey, 107
HISTOPLASMOSIS
Epidemic Reports
Indiana, 377 (Tularemia), 427
INFLUENZA
Epidemic Reports
Alaska, 410, 424, 440, 458
United States, 1, 9, 17, 29, 37, 45, 54, 70, 449
International Notes
Africa, 427
Argentina, 104
Belgium, 96
Bermuda, 23


Canada, 16, 23
Canal Zone, 23
Denmark, 96
Europe, 427, 449
Finland, 96
France, 96
Germany. Federal Republic of. 23
Iceland, 23
Ireland, 96
Italy, 104
Japan, 23
Netherlands, 23
Puerto Rico, 29, 37
Poland, 104
Portugal, 104
Romania, 28
South America, 104, 248
Spain, 28
Sweden, 28
Thailand, 28
United Kingdom, 28
Venezuela. 104
Worldwide, 400, 416
Yugoslavia, 104
Recommendation of the PHS Advisory Committee on
Immunization Practices, 216
Summaries
Annual, 217
Current, 434

KALA-AZAR
Epidemic Reports
Maryland, 127

LASSA VIRUS
Epidemic Reports
Connecticut, 293
New York, 293

LEPTOSPIROSIS
Epidemic Reports
Georgia. 326
Summary
Annual, 179

MADUROMYCOSIS
Epidemic Reports
Florida, 91

MALARIA
Epidemic Reports
California, 309
Connecticut, 169
Florida, 309
Hawaii, 21
Massachusetts, 379
'.I,. hanr,. 250
Mississippi, 425
New Jersey, 188
New York, 142, 188, 271, 379

(Continued on page 462)


JANUARY 3, 1970


Morbidity and Mortality Weekly Report






462


Tennessee, 326
Virginia, 425
International Notes
Ceylon. 287
Summary
Annual. -:05
MEASLES
Epidemic Reports
Florida, 90
Idaho. 122, 148
Illinois. 409
Maryland. 177, 318
New York. 141
North Carolina, 53
Ohio, 303
Oregon, 122, 148
United States, 36
Washington, D.C., 226, 387
Summaries
Annual, 19
Current, 154, 330

MELIOIDOSIS
Epidemic Reports
Maryland. 278
New Mexico. 163
Oklahoma. 346
MENINGOCOCCAL INFECTIONS
Epidemic Reports
California. 133
Georgia. 186
Massachusetts. 197
Summaries
Annual. 38, 411
Current. 135
MENINGOENCEPHALITIS, PRIMARY AMEBIC
Epidemic Reports
Virginia. 241. 260

MUSHROOM POISONING, JACK-O' LANTERN
Epidemic Reports
New York. 412
MYIASIS
Epidemic Reports
Oklahoma. 77
Texas. 77
ORF
Epidemic Reports
Oklahoma. 54
PARATYPHOID FEVER
International Notes
Austria. 15b

PLAGUE
Epidemic Reports
New Mexico. 21 :. 225, 233, 242, I-: 365, 393


JANUARY 3. 1970


International Notes, 262, 284
POLIOMYELITIS, PARALYTIC
Summary
Annual. 82, 215

PSITTACOSIS
Epidemic Reports
Maryland. 161
United States, 171
Summary
Annual, 170

QUARANTINE MEASURES
204, 232, 248, 260, 268, 308, 316, 451
RABIES
Epidemic Reports
California. 149, 199, 328
Washington. 347
International Notes
England, 392
RAT-BITE FEVER
Epidemic Reports
Oklahoma. 367
Texas. 367
RECOMMENDATIONS OF THE PHS ADVISORY COM-
MITTEE ON IMMUNIZATION PRACTICES
Influenza, 216
Prelicensing Statement on Rubella Virus Vaccine, 124
Supplement (Vol. 18, No. 43, Oct. 2'.. 1969)
Yellow Fever. 189

RELAPSING FEVER
Epidemic Reports
Oregon. 123
REYE'S SYNDROME
Epidemic Reports
Oklahoma, 134
ROCKY MOUNTAIN SPOTTED FEVER
Summary
Current
United States, 252

RUBELLA
Prelicensing Statement on Rubella Virus Vaccine, 124
Serologic Testing for Rubella A Warning, 126

SALMONELLOSIS
Epidemic Reports
Alaska, 303
Louisiana, 207
Maryland, 285
Oregon, 1- 260
Tennessee, 61
United -.,t.--. 251
International Notes
Austria, 185
Europe, 317


Morbidity and Mortality Weekly Report


INDEX VOLUME 18 1969 (Continued from page 461)









Summaries
Current, 3, 47, 224, 329, 419

SCHISTOSOMIASIS
Epidemic Reports
Georgia, 170

SEWAGE POISONING
Epidemic Reports
Colorado, 112
Connecticut, 46
Maryland, 278
Massachusetts, 357
Oregon, 187

SHIGELLOSIS
Epidemic Reports
Maryland, 278
North Carolina, 11
Oregon, 187, 403
Utah, 123
International Notes
Guatemala, 367, 441
Summary
Annual, 80

SMALLPOX
Epidemic Reports
Utah, 379
International Notes
Australia, 451
Brazil, 384
Burma, 22
Cameroon, 106
Ghana, 106
Uruguay, 344, 384
West and Central Africa, 76, 105, 143, 178, 196, 227,
319, 440, 459
Worldwide, 8, 271, 284
Summary
Annual. 318
SPOROTRICHOSIS
Epidemic Reports
Oregon, 170

STAPHYLOCOCCAL INFECTION
Epidemic Reports
Ohio, 339
Washington, 186

STAPHYLOCOCCAL FOOD POISONING
Epidemic Reports
Idaho, 235
Mississippi, 88
Tennessee, 295, 386
Washington, 47
Wisconsin, 21

STREPTOCOCCAL INFECTION
Epidemic Reports
New Mexico, 235


SUPPLEMENTS
Recommendations of the PHS Advisory Committee on
Immunization Practices (Vol. 18, No. 43. Oct. 25, 1969)
United States Yellow Fever Vaccination Centers (Vol.
18, No. 53, Jan. 3, 1970)
SYPHILIS
Epidemic Reports
Oregon, 318
Summary
Current (Tables), 22, 83, 114, 163, 199, 251, 279,
328, 371, 410, 443
TETANUS
Epidemic Reports
Guam, 310
Summary,
Annual, 310, 336
TRICHINOSIS
Epidemic Reports
Alaska, 55
Mississippi, 39
Missouri, 31, 71
New York, 184
Ohio, 234, 338
Rhode Island, 214
Vermont, 403
Wisconsin, 55
Summary
Annual, 226
TRYPANOSOMIASIS
Epidemic Reports
Florida, 127
United States, 385
TUBERCULOSIS
Epidemic Reports
Alabama, 401
Colorado, 126
North Dakota, 327
South Carolina. 442
Recommendation NCDC, Preventive Treatment for
Tuberculosis Infection, 153
Summary
Annual, 3, 78
TULAREMIA
Epidemic Reports
Indiana, 377, 427
Pennsylvania, 31
Vermont, 198
TYPHOID FEVER
Epidemic Reports
Connecticut, 448
Massachusetts, 448
Oregon, 198, 260
International Notes
Europe, 317

(Continued on page 468)


JANUARY 3, 1970


Morbidity and Mortality Weekly Report







161 Morbidity and Mortality Weekly Report


TABLE 111. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

JANUARY 3, 1970 AND DECEMBER 28, 1968 (53rd WEEK)


ASEPTIC ENCEPHALITIS HEPATITIS
'I\- BRUICEL- oDII'Hilillll Primary including I st- MALARIA
AREA CITIS LSI unsp. cases lnlr( tls Serum Infectious
Cum.

UNITED ST iT '... 1: 1 I I- .3 ',) r..3l rlj -8 3,B2:

NEW ENGLAND............ 3 1 2 6 77 33 3 106
Maine.............. 9 6 8
New Hampshire ..... 1 1 1 2
Vermont............. 4 -
Massachusetts...... 1 1 32 8 2 62
Rhode Island........ 2 1 20 8 11
Connecticut........ 1 5 11 10 1 23

MIDDLE ATLANTIC...... 13 2 2 18 64 114 4 398
New York City...... 3 1 1 4 9 55 2 30
New York, up-State 15 85
New Jersey.......... 9 1 8 15 8 158
Pennsylvania....... 1 I 6 40 36 2 125

EAST NORTH CENTRAL... 1 5 10 6 110 98 3 333
Ohio................ 3 4 35 20 33
Indiana............. 7 28
Illinois............ 1 1 1 35 18 3 201
Michigan........... 1 1 4 5 35 46 70
Wisconsin.......... 1 5 7 1

WEST NORTH CENTRAL... 2 1 2 1 1 23 42 4 236
Minnesota.......... 1 1 3 14 14
Iowa............... 1 2 5 7 28
Missouri........... 1 9 13 45
North Dakota....... 3 4
South Dakota........ 2
Nebraska............ 1 6
Kansas............. 1 2 8 4 137

SOUTH ATLANTIC....... 2 3 3 48 77 9 820
Delaware .......... 1 5
Maryland.......... 10 14 1 43
Dist. of Columbia.. I 1 4 2
Virginia........... 2 4 7 2
West Virginia...... 2 2 4
North Carolina..... 1 -16 6 8 340
South Carolina..... 4 3 65
Georgia............ 6 280
Florida............ 1 3 11 34 53

EAST SOUTH CENTRAL... 55 20 1 199
Kentucky........... 17 11 169
Tennessee.......... 27 1 -
Alabama............ 6 7 1 26
Mississippi........ 5 1 4

WEST SOUTH CENTRAL... 2 1 5 67 43 12 301
Arkansas........... 1 13
Louisiana.......... 12 6 1 47
Oklahoma........... 1 10 8 1 82
Texas.............. 2 5 44 29 10 159

MOUNTAIN ............ 4 2 38 18 138
Montana............ 3 9 3
Idaho.............. 5
Wyoming............ 1 6 -
Colorado........... 1 6 112
New Mexico......... 7 2 9
Arizona............ 1 13 4 1
Utah................. 6 3 1
Nevada............. 7

PACIFIC.............. 12 1 3 1 1 13 161 240 12 733
Washington......... 1 14 13 7
Oregon............. 1 14 10 3 22
California.......... 11 3 1 1 12 127 202 8 568
Alaska............. 2 12 4
Hawaii............. 1 4 3 1 132

Puerto RIco.......... 12 17 4

*Delaved reports: Encephalitis, primary: Md. 1


Hepatitis, in


fectious: N.H. 1, N.Y. Ups. 27, P.R. 13







Morbidity and Mortality Weekly Report 465


TABLE III. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

JANUARY 3, 1970 AND DECEMBER 28, 1968 (53rd 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... 627 25,271 22,617 43 2,966 2,521 1,124 16 318

NEW ENGLAND............ 6 1,218 1,379 2 116 139 144 2 24
Maine............... 10 38 8 6 9 1 4
New Hampshire...... 248 150 5 8 3 -
Vermont............. 3 4 1 3 -
Massachusetts ..... 6 273 386 1 45 74 32 5
Rhode Island....... 27 94 15 9 28 6
Connecticut........ 657 707 1 43 41 69 1 9

MIDDLE ATLANTIC...... 73 8,123 4,743 7 487 443 89 2 23
New York City...... 7 5,046 2,433 1 90 90 50 11
New York, Up-State* 634 1,388 98 75 NN 1 -
New Jersey ........ 14 1,139 721 6 192 156 39 2
Pennsylvania....... 52 1,304 201 107 122 NN 1 10

EAST NORTH CENTRAL... 304 3,592 4,261 5 401 318 273 1 91
Ohio.*............. 11 579 333 3 143 85 16 37
Indiana............. 501 746 53 45 9 3
Illinois............ 275 1,404 1,445 1 58 72 52 1 7
Michigan........... 4 406 353 118 91 60 14
Wisconsin.......... 14 702 1,384 1 29 25 136 30

WEST NORTH CENTRAL... 1 1,261 488 4 146 143 31 1 22
Minnesota.......... 11 19 29 32 1 -
Iowa. ............. 360 165 4 25 14 17 9
Missouri........... 32 81 57 50 -
North Dakota....... 1 82 142 2 4 3
South Dakota....... 51 4 .1 5 NN -
Nebraska........... 716 67 14 9 1 2
Kansas ............ 9 10 18 29 12 1 8

SOUTH ATLANTIC....... 115 3,157 1,862 7 517 505 118 1 26
Delaware........... 35 557 23 17 12 4 I
Maryland............ 24 124 104 43 44 13 -
Dist. of Columbiat. 58 6 9 20 2 2
Virginia........... 7 1,018 460 60 50 17 6
West Virginia...... 2 228 337 1 26 14 48 4
North Carolina..... 40 413 322 1 101 99 NN 1
South Carolina..... 6 140 31 2 71 63 11 1
Georgia.............. 2 4 78 98 -
Florida............. 1 617 575 3 112 105 23 1 11

EAST SOUTH CENTRAL... 4 136 508 2 213 222 111 1 10
Kentucky........... 75 107 85 98 3 1
Tennessee.......... 4 25 65 77 70 107 9
Alabama............ 12 95 2 30 29 1 -
Mississippi........ 24 241 21 25 -

WEST SOUTH CENTRAL... 98 5,325 5,381 10 397 365 105 6 52
Arkansas........... 16 2 34 22 -
Louisiana*......... 125 27 5 110 104 -
Oklahoma............ 143 132 36 57 2 1
Texas............... 98 5,041 5,220 5 217 182 103 6 51

MOUNTAIN............. 21 1,203 1,100 59 46 81 1 21
Montana ........... 122 58 8 7 17 1 1
Idaho.............. 90 21 13 12 20 1
Wyoming............. 55 3 5
Colorado............ 142 526 13 14 13 13
New Mexico......... 3 293 176 8 1 9 1
Arizona............. 18 544 235 10 5 12 -
Utah .............. 11 21 5 1 10 -
Nevada ............. 1 8 2 3

PACIFIC................ 5 1,256 2,895 6 630 340 172 1 49
Washington.......... 69 607 1 62 52 5 4
Oregon............... 201 594 1 26 26 22 11
California.......... 5 920 1,648 4 521 244 87 1 17
Alaska.............. 14 11 11 4 24 13
Hawaii............ 52 35 10 14 34 4

Puerto Rico.*........ 41 2,188 524 20 21 5

*Delayed reports: Measles: N.Y. Ups. 1, N.J. delete 1, Iowa 22, D.C. 23, P.R. 16
Meningococcal infections: N.Y. Ups. 1, P.R. 1
Mumps: P.R. 17
Rubella: N.Y. Ups. 7, Ohio 1, La. delete 2







166 Morbidity and Mortality Weekly Report


TABLE III. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

JANUARY 3, 1970 AND DECEMBER 28, 1968 (53rd WEEK) CONTINUED


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

I1.-,i if TF'.. : 1 8 la t, 1.8 b 3- .50 47 3,335

NEW ENGLAND.......... 820 1 16 16 1 3 60
Maine............. 1 6
New Hampshire...... 5
Vermont........... 26 16 3 38
Massachusetts...... 1 8 1 3
Rhode Island....... 66 1 -
Connecticut........ 728 6 8

MIDDLE ATLANTIC...... 66 6 30 5 33 47 5 261
New York City...... 6 20 1 17 -
New York, Up-State. 3 4 6 7 5 247
New Jersey......... NN 4 4 15 -
Pennsylvania....... 66 3 6 25 14

EAST NORTH CENTRAL... 399 19 3 21 37 3 1 234
Ohio................ 63 4 2 2 2 13 76
Indiana............ 6 56
Illinois........... 109 10 1 6 17 3 40
Michigan........... 148 5 6 1 11
Wisconsin.......... 79 7 1 51

WEST NORTH CENTRAL... 297 14 14 10 8 12 636
Minnesota.......... 6 4 5 171
Iowa................ 70 1 7 2 105
Missouri ........... 2 4 10 3 4 153
North Dakota....... 150 1 78
South Dakota....... 10 1 43
Nebraska........... 6 1 1 14
Kansas............. 59 4 3 1 72

SOUTH ATLANTIC ...... 505 31 23 52 253 18 803
Delaware........... 15 1 2 3 -
Maryland........... 2 4 48 3
Dist. of Columbia.. 2 3 -
Virginia............ 355 2 4 1 81 6 381
West Virginia...... 126 1 2 2 5 6 120
North Carolina..... NN 3 6 13 67 5
South Carolina..... 1 2 1 32 -
Georgia............. 9 8 4 11 16 6 117
Florida............. 12 4 15 1 177

EAST SOUTH CENTRAL... 1,409 26 2 17 1 54 65 2 400
Kentucky............ 128 8 12 13 1 207
Tennessee.......... 1,163 4 2 16 1 24 43 131
Alabama............ 8 4 6 1 56
Mississippi........ 118 6 1 14 3 6

WEST SOUTH CENTRAL... 27 1 31 26 1 39 51 5 480
Arkansas........... 16 2 5 1 16 7 2 38
Louisiana.......... 5 1 8 6 4 42
Oklahoma........... 6 1 9 32 75
Texas.............. 20 6 19 12 3 325

MOUNTAIN ............. 1,450 7 1 20 32 17 124
Montana............ 69 1 3 -
Idaho............. 281 1 1 4 6 -
Wyoming* .......... 4 5 56
Colorado............ 735 2 3 9 3
New Mexico......... 184 1 10 22
Arizona............. 51 4 6 22
Utah............... 130 14 2 5
Nevada............. 1 16

PACIFIC............... 163 1 15 6 4 74 5 1 337
Washington......... 137 1 2 3 3 4
Oregon............. 1 2 6 4
California......... 12 2 4 55 2 1 329
Alaska............. .- -
Hawaii.............. 26 1 1 10 -

Puerto Rico......... 1 14 9 1 30

*Delayed reports: SST: N.Y. Ups. 259, Wyo. 1
Rabies in animals: N.Y. Ups. 2







Morbidity and Mortality Weekly Report






TABLE IV. DEATHS IN 122 UNITED STATES CITIES FOR WEEK ENDED JANUARY 3, 1970


(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 and 1 year
Influenza All Influenza All
Ages and over All Ages Causes 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----------
Youngstpwn, 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.--------


855
242
53
24
32
86
33
32
41
57
65
12
56
47
75

3,737
55
43
122
45
42
52
90
83
1,994
40
426
201
66
137
40
47
119
58
33
44

2,879
87
51
861
184
236
142
80
370
39
47
35
44
56
151
28
118
44
55
59
126
66

922
45
23
33
188
42
127
50
258
106
50


527
144
33
19
24
39
23
21
30
34
29
8
34
36
53

2,235
37
31
70
19
25
30
55
47
1,189
21
244
114
42
86
28
29
82
28
26
32

1,672
56
34
490
110
124
83
44
207
29
30
23
13
43
86
15
73
24
34
43
71
40

570
30
13
16
107
31
95
33
155
68
22


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 13,687 8,014 617 584


Expected Number


Cumulative Total
(includes reported corrections
for previous weeks)


13,304


7,780


I I


685,771 1392,582 30,322


32,497


Week No.
53


1,427
116
285
68
103
136
72
109
33
113
90
236
66

645
88
61
51
104
159
40
37
105

1,106
17
47
39
164
51
94
162
57
178
108
111
49
29

489
66
25
128
15
121
19
55
60

1,627
24
66
29
50
157
428
72
32
100
50
112
189
58
165
56
39


*Mortality data are being collected from Las Vegas. Nev., for possible inclusion in this
Las Vegas, Nev.* 14 7 1 1 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


INDEX VOLUME 18 1969 (Contiued from page ;:- ;


TYPHUS, MURINE
Epidemic Reports
Texas. 26(;

VIBRIO PARAHAEMOLYTICUS
Epidemic Reports
Florida. 301, 339
Illinoi.. .301. 339
I'nited (Stai 301. 339

VIRUS, "LASSA"
Epidemic Reports
(onnefcticut. 293
New York. 293

YELLOW FEVER
International Notes
Weost and Central Africa. 419
Recommendation of the PHS Advisory Committee on
Immunization Practice, 189
Supplement. I'nitcdd States Yellow Fever Vaccination
Centers (Vol. Ih. No. 53, Jan. 3, 1970)


ULNIVER Irv OF FLORIDA

llI 1262 08l53 22lillil 87iillillil11111
3 1262 08853 2287


THE MORBIDITY AND MORTALITY WEEKLY REPORT, WITr A C'ACuLA-
TION OF 20,000 IS PUBLISHED AT THE NATIONAL IOMMNuhm-BLE
DISEASE CENTER, ATLANTA. GEORGIA.
DIRECTOR, NATIONAL COMMUNICABLE DISEASE CENTER
DAVID J iENCE- D.
DIRECTOR. EPIDEMIOLOGY PROGRAM A. D. L ANGMR M.D
EDITOR MICHAEL B. :. EIGG M D.
MANAGING: EDE..T- PPi 1 L L B MOLMAN
IN ADDITION TO THE ESTABLISHED PROCED.u-R rFGo nEE;aRTn.G
MORBIDITY AND MORTALITY. THE NATIONAL : Muun IaL E DlitE ASE
CENTER WELCOMES ACCOUNTS OF INTERESTING. 0. T arEr. S OR CASE
INVESTIGATIONS WHICH ARE OF CURRENT INTEREST rTO nEALTI.
OFFICIALS AND WHICH ARE DIRECTLY RELATED TO TIE CONTROL.
OF COMMUNICABLE DISEASES. SUCH COMML.nC a1.ONS E.OUt.ID BE
ADDRESSED TO:
NATIONAL COMMUNICABLE DISEASE CENTER
ATTN: THE EDITOR
MORBIDITY AND MORTALITY 'EETL REPORT
ATLANTA, GEORGIA 30333

NOTE: THE DA'A .1 T.i R-:-,Rt &AE iaRo.iICNAL AND aRE
BASED ON WEEKLY TELECR Ma 0 TrE NI:L-: rT TE INDO'DIIuAL
STATE HEALTH E CARIMNTT T.IE RE'0RT1'.l *EEC CONCLuDES
AT CLOSE OF BUS'N ES c ON "'RIA COMP' .ED EDAT A ON a NATIONAL
BASIS ARE OFFICIaLL~ RELEaSEOD r rt. PuJBLI: O I( TE SUCCEED-
ING FRIDAY.


m


o r




m
n m















5
a0














U S DEPOSITORY
r _
w n I-
i mc C
o o rm1,.








IIm
0 -I












8NiV OF FL UB






US DEPOSITORY
-4 0
lBS b BII

~I z r


US ~~ mEOIT


c

0
m
M >
-11
> a

mo
*0




>r~