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:
AA00010654:00141

Related Items

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

Full Text



NATIONAL COMMUNICABLE DISEASE


Vol. 18, No. 45






For

Week Ending

November 8, 1969


U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE / PUBLIC HEALTH SERVICE 'HEALTH SERVICES AND MENTAL HEALTH ADMINISTRATION
DATE OF RELEASE: NOVEMBER 14, 1969 ATLANTA, GEORGIA 30333


EPIDEMIOLOGIC NOTES AND REPORTS
PLAGUE New Mexico

On No. 3, 1969, plague was confirmed in a 15-year-old
boy, a resident of Sandia Park, New Mexico, located about
10 mile- north of Albuquerque. On October 27, the boy had
onset of headache and abdominal pain, followed the next
day b. niu.ea, vomiting, and generalized arthralgia. On
October 29. he was hospitalized with chills, temperature
of 105 F.. and dehydration and was treated with intraven-
ous fluid-. The next day, he was first noted to have tender
erythemarou- swelling in his right groin and was treated
with ampicillin intravenously. By October 31, the mass in
the right groin was larger and a tender mass was noted in
the right lower quadrant which was associated with rebound
tendern_.- guarding, and hypoactive bowel sounds.
Because of a presumptive diagnosis of appendicitis
with abscess formation, the patient underwent exploratory


CONTENTS
Epidemiologic Notes and Repo 1
Plague New Mexico .
Surveillance Summary
Viral Hepatitis Unit
Epidemiologic Year
International Notes i
Influenza Summer 11 lf.


. 393


. 394

. 400


laparotomy. At oper t the appendix bowel
were normal, but the massive iliac addo y with
extensive inflammation. ecrosis. An Jbde was
excised and the wounds '
Microscopic examinati fttion of the
excised node showed inflammaa anges and gram-
negative bacteria. A presumptive diagnosis of plague was
made. Ampicillin was discontinued, and parenteral tetracy-
cline and streptomycin were begun. By November 1, the
patient was much improved.
(Continued on page 395)


TABLE I. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous weeks)
45th UEEK ENjDED C(.iUiLATIVE. FIR.,T45 \IEEKS
-MEDIAN
DISEASE Not-emb r 2. Nov.-rrmbr 9*. 19. 18 MEDi AN
19 6 9 199 6s 1 6i : 9 \ '' I ,'.-.r.4 1 .
Aseptic meningit ll .............. ... .. 94 73 55 3.F068 3'.89( .'
Brucellosis ............ ......... ... 5 4 3 204 1q6 216
Diph heria .............. ....... 7 16 5. 15 5 206i 171
Encephahils prim3rt:
Arthropod-borne & uri;pi ilid ....... 33 22 25 1.123 1.I24 1.689
Encepnalir ts. post-inrectiou .. .... .... 3 3 272 412 652
Hepatitis. seum ............. ............. 126 86 .591 3.960
Heparitis. Iniectir u .. .................. 1.112 884 72 4 1.090 39,266 .' 8
Malaria ........................ ..... 417 2 11 2.680 2.038 .417
Measles sruocolao ........... ..... ..... .284 222 030 21.838 20,813 194,397
Meningococcal Inicctiion Ioral ..... 29 33 42 2,594 ',:1 2.4.03
C i hil ia n .. .. . . .. 2'; 3 0 2. .3 6 ', I "
M ilitar ............... .. ....... .... 2 3 0 0 191
Mutmps ................. ............ 1.336 1.683 7'.276 134.084
Poliomvyllltar lot al .... .. ............. 3 1t 54 54
Paralyric .. ...... ... ... ..- 1 15 54 54
Rubella iGerman mearle i .............. 425 317 51.766 46.086
Streptococcal sore Ihroat & r.arltr I r-... 7.566 8,188 7,201 361, ':. 363,582 361,24
Tetanus ............................... 7 3 4 140 150 194
Tularemia ............................. 1 2 127 159 159
Typhoid fever ......................... 12 10 6 289 348 364
Typhus, tick-borne (Rky. Mt. spotted fever) 3 1 1 437 269 252
Rabies in animals ....................... 44 57 57 2,919 2,994 3,772

TABLE II. NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax: .......................................... 3 Rabies in man: ...................................... 1
Botulism: ........................................ 12 Rubella congenital syndrome: ......................... 9
Leptospirosis: Ill.-1, La.-1 ............. .. ......... 72 Trichinosis: ........................................ 170
Plague: ............................................ 5 Typhus, murine: ..................................... 47
Psittacosis: Fla.-1, Mich.-1 .......................... 89
*Delayed reports: Leptospirosis: Iowa 1















Spring Quarter Epidemiologic Year 1968-69
In the United States during the spring quarter of epi-
demiologic year* 1968-69 (March 30, 1969 June 28, 1969),
I i,,i.- cases of viral hepatitis were reported for a rate of
6.5 cases per 100,000 population. This is a 5 percent in-
crease over the rate of 6.2 (12,225 cases) reported in the
spring quarter of epidemiologic year 1967-68 (Table 1). Six
of the nine geographic divisions had rate increases in 1969;
these ranged from 2 percent in the East North Central Divi-
sion to 126 percent in the New England Division. Massa-
chusetts and Rhode Island with rate increases of greater
than 100 percent accounted for the major part of the in-
crease in the New England Division. Other states which
also had rate increases of greater than 100 percent were
New Hampshire and Vermont in the New England Division,
South Dakota in the West North Central Division, South
Carolina in the South Atlantic D, .-,...o. and Nevada in the
Mountain Division.
Rate decreases were reported in theWestNorth Central,
West South Central, and Pacific Divisions. California, which
in previous quarters has shown increases in rate, experienced
a 16 percent decrease in rate compared with the previous
spring quarter.
Reported cases of serum hepatitis increased by 15
percent and cases of infectious hepatitis by 6 percent over
the previous spring quarter. All divisions experienced in-
creases in reported serum hepatitis cases except the Pacific
Division. which had a decrease, primarily reflecting the
large decrease in reported cases from California. Five of
the eight divisions with increases in reported serum hepatitis
cases had increases greater than 100 percent. The greatest
increase occurred in the Middle Atlantic Division, largely
due to increases from New York City and New Jersey.
Annual Summary Epidemiologic Year 1968-69
Data for epidemiologic years 1967-68 and 1968-69 are
presented in Table 2 and Figure 1. A total of 52,587 cases
of viral hepatitis were reported in EY 1968-69. The number
of reported cases of viral hepatitis per 100.000 population
for the United States increased from 22.3 cases in 1967-68
to 26.2 in 1968-69. This overall increase in rate for the
United States incorporates rate increases from seven geo-
graphic divisions and rate decreases from two divisions
(\est North Central and West South Central). Four geo-
graphic divisions (New England. Middle Atlantic, Mountain,
and Pacific)experienced increases in rate greater than that
for the United States as a whole. The largest increase in
rate (14.4) occurred in the New England Division where
reported viral hepatitis cases for 1968-69 increased by
1,674 cases (94.6 percent) over 1967-68. The West South
Central Division recorded the largest decrease in rate (2.1).
Figure 2 depicts the cyclic variation in incidence of
reported viral hepatitis cases in the United States by 4-
week periods since July 1952. The progressive increase in
annual incidence observed since epidemiologic year 1967
continued through epidemiologic year 1969.
lHepatitis data are summarized in terms of an epidemiologicc
year" beginning with the 27th week of the calendar year.


NOVEMBER 8, 1969


Table 2
Reported Cases and Incidence of Viral Hepatitis
EY 1967-68 and 1968-69


State 1967-68 1968-69 Change
Cases Rate* Cases Rate* in Rate


United States
New England
Maine
New Hampshire
Vermont
Massachusetts
Rhode Island
Connecticut
Middle Atlantic
New York City
Upstate New York
New Jersey
Pennsylvania
East North Central
Ohio
Indiana
Illinois
Michigan
Wisconsin
West North Central
Minnesota
Iowa
Missouri
North Dakota
South Dakota
Nebraska
Kansas
South Atlantic
Delaware
Maryland
District of Columbia
Virginia
xest Virginia
North (Carolina
South Carolina
Georgia
Florida
East South Central
Kentucky
Tennesee
Alabama
Mississippi
West South Central
Arkansas
Louisiana
Ok I lahoma
Texas
Mountain
Montana
Idaho
Wyoming
Colorado
New Mexico
Arizona
Utah
Nevada
Pacific
Washington
Oregon
California
Alaska
Hawai i


44,261
1,769
117
37
II
744
275
585
7,461
2,804
1,376
1,657
1,624
6,631
1,880
506
1,880
1,893
472
2,567
610
475
976
70
27
83
326
4,168
165
800
71
561
348
313
96
995
816
2,913
1,185
953
286
489
3,999
282
737
513
2,467
1,929
271
107
32
536
335
422
206
29
12,824
957
811
10,924
50
82


52,587
3,443
251
121
119
1,518
698
736
9,741
4,074
1,537
1,928
2,202
7,665
1,991
545
1,790
2,858
481
2,392
676
390
685
51
127
95
368
5,257
104
815
69
576
331
516
305
937
1,604
3,015
1,153
1,045
413
404
3,626
199
824
327
2,276
2,278
212
122
50
724
288
483
327
72
15,170
1,353
908
12,676
95
138


+3.9
+14.4
+13.8
+11.8
+25.3
+14.1
+45.6
+4.8
+6.0
+15.9
+1.5
+3.5
+4.8
+2.5
+0.9
+0.7
-1.0
+10.7
+0.2
-1.1
+1.7
-3.0
-6.4
-2.9
+15.4
+0.8
+1.7
+3.4
-11.9
0.0
-0.3
+0.2
-0.9
+3.9
+7.8
-1.7
+12.4
+0.6
-1.2
+2.1
+3.5
-3.7
-2.1
-4.2
+1.9
-7.4
-2.0
+4.2
-8.2
+2.1
+5.9
+8.8
-4.8
+3.2
+11.4
+11.3
+8.3
+11.4
+4.2
+8.1
+16.0
+6.9


*Based on January 1 population estimates (average of U.S.
Bureau of the Census mid-year estimates.)


(Reported by the Hepatitis Section, Viral Diseases Bravi. '.
Epidemiology Program, NCDC.)


Morbidity and Mortality Weekly Report


SURVEILLANCE SUMMARY
VIRAL HEPATITIS United States, Epidemiologic Year 1968-69







NOVEMBER 8, 1969


Morbidity and Mortality Weekly Report


Table 1
Reported Cases and Incidence of Viral Hepatitis by Geographic Divisions
Spring Quarters EY 1967-68 and 1968-69

Spring Quarter Spring Quarter Change from Spring
March 31, 1968-June 29, 1968 March 30, 1969-June 28, 1969 Quarter EY 1968 to
Division Spring Quarter EY 1969
Cases Cases
RRate* Rate** Cases Percent Change
Infectious Serum Total Infectious Serum Total in Rate
United States 11,088 1,137 12,225 6.2 11,721 1,305 13,026 6.5 +801 +5
New England 411 35 446 3.9 920 87 1,007 8.8 +561 +126
Middle Atlantic 1,741 342 2,083 5.7 2,015 467 2,482 6.7 +399 +18
East North Central 1,829 49 1,878 4.8 1,838 116 1,954 4.9 +76 +2
West North Central 717 5 722 4.5 534 16 550 3.4 -172 -24
South Atlantic 1,001 45 1,046 3.5 1,233 81 1,314 4.4 +268 +26
East South Central 634 4 638 4.9 725 12 737 5.6 +99 +14
West South Central 957 17 974 5.1 916 28 944 4.9 -30 -4
Mountain 577 13 590 7.5 591 26 617 7.8 +27 +4
Pacific 3,221 627 3,848 15.3 2,949 472 3,421 13.3 -427 +13
*Based on U.S. Bureau of the Census Population Estimates July 1, 1967. Series P. 25
**Based on U.S. Bureau of the Census Population Estimates July 1, 1968. Series P. 25

Figure 1
NUMBER OF REPORTED CASES OF VIRAL HEPATITIS PER 100,000 POPULATION BY STATE
EPIDEMIOLOGIC YEARS 1967-68 AND 1968-69

S'6 1968-1969 .,


.- *I


PLAGUE (Continued from front page)
Gram-negative bipolar staining organisms were isolated mains well. The epidemiologic investigation is continuing.
from three blood cultures obtained early in the hospitaliza- (Reported by Bruce Storrs, M.D., Director, Division of
tion. These were submitted to the state laboratory, where Medical Services, Daniel Johnson, Ph.D., the Public Health
on November 3 they were confirmed as Pasteurella pestis Laboratory, and Bryan Miller, Chief, and Neil Weber, Mam-
by phage typing and guinea pig inoculation. malogist, General Sanitation Section, New Mexico State
The boy had no known contact with wild animals, but Department of Public Health; U. Hodgin, M.D., David Post,
did have contact with three family cats, one dog, and several M.D., and Ole Peloso, M.D., Physicians, Albuquerque; and
horses, all of which remain well. The boy's family also re- an EIS Officer.)







396 Morbidity and Mortalit Weekly Report


TABLE III. CASES OF SPECIFIED NOTIFIABLE DISEASES:.UNITED STATES

FOR WEEKS ENDED

NOVEMBER 8, 1969 AND NOVEMBER 9, 1968 (45th WEEK)

ASEPTIC ENCEPHALITIS HEPATITIS
MENIN- BRUCEL- DIPHTHERIA Primary including Post- MALARIA
AREA GITIS LOSIS unsp. cases Infectious erum Infectious
Cum.
1969 1969 1969 1969 1968 1969 1969 1969 1968 1969 1969
UNITED STATES... 94 5 7 33 22 1 126 1,112 884 47 2,680

NEW ENGLAND........... 8 2 1 5 134 34 7 89
Maine.............. 12 4 7
New Hampshire...... 8 2
Vermont............ 7 -
Massachusetts...... 8 2 1 83 20 7 56
Rhode Island........ 2 11 1 9
Connecticut........ 1 2 13 9 15

MIDDLE ATLANTIC...... 7 2 2 55 163 105 7 318
New York City..... 36 51 36 22
New York, up-State. 1 1 1 5 15 21 68
New Jersey*........ 3 1 1 10 45 31 5 124
Pennsylvania....... 3 4 52 17 2 104

EAST NORTH CENTRAL... 17 9 5 7 219 188 7 275
Ohio................ 6 3 3 2 41 59 24
Indiana............. 2 12 11 3 24
Illinois........... 3 3 1 2 65 54 3 170
Michigan............ 6 3 1 3 93 48 1 56
Wisconsin.......... 8 16 1

WEST NORTH CENTRAL... 11 1 1 3 1 58 37 5 187
Minnesota.......... 9 1 1 1 1 10 17 13
lowat.............. 1 1 8 4 19
Missouri........... 2 18 10 42
North Dakota..... 1 3
South Dakota........ 1 1 1
Nebraska........... 11 4
Kansas............. 1 9 5 5 105

SOUTH ATLANTIC....... 11 2 2 5 14 121 82 9 698
Delaware........... 3 3
Maryland........... 5 2 15 14 1 33
Dist. of Columbia.. 2 4 2
Virginia........... 1 2 1 14 1 26
West Virginia ..... 8 7 -
North Carolina..... 2 1 10 2 1 274
South Carolina..... 1 3 5 58
Georgia............ 14 26 1 262
Florida............ 3 1 4 11 55 20 6 40

EAST SOUTH CENTRAL... 12 5 3 6 56 67 135
Kentucky........... 1 21 32 108
Tennessee.......... 4 2 3 6 20 14 -
Alabama............. 7 10 11 23
Mississippi........ 1 2 5 10 4

WEST SOUTH CENTRAL... 5 5 2 1 3 48 65 6 219
Arkansas........... 1 2 13
Louisiana........... 3 2 1 2 3 15 45
Oklahomas.......... 1 1 11 70
Texas.............. 1 3 1 34 48 6 91

MOUNTAIN............. 1 2 1 25 40 2 133
Montana............ 1 3 2 3
Idaho......*....... 2 5
Wyoming ............ .- -
Colorado.............. 2 5 110
New Mexico.......... 4 6 7
Arizona.A*.......... 6 14 1
Utah................ 1 3 6 1
Nevada............. 9 5 2 6

PACIFIC.............. 22 2 5 7 1 34 288 266 4 626
Washington ........ 3 31 36 5
Oregon............. 1 2 12 13 16
California......... 18 1 5 4 1 34 242 200 4 493
Alaska............. 1 1 8 3
Hawaii............. 1 2 9 109

Puerto Rico.......... 30 27 4

*Delayed reports: Aseptic meningitis: Ariz. 1, Wash. 6
Encephalitis, primary: Iowa 1, N. Dak. 1, W. Va. 14, Ariz. 1
Hepatitis, infectious: N.J. delete 1, Wash. 18
Malaria: bkla. 1






Morbidity and Mortality Weekly Report 397


TABLE III. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

NOVEMBER 8, 1969 AND NOVEMBER 9, 1968 (45th 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... 284 21,838 20,813 29 2,594 2,251 1,386 15 425

NEW ENGLAND.......... 4 1,133 1,185 4 105 133 158 2 27
Maine.............. 9 38 7 6 32 1 2
New Hampshire...... 1 242 141 4 8 10 -
Vermont............ 3 2 1 2 -
Massachusetts...... 3 229 370 3 41 69 54 19
Rhode Island....... 27 6 14 9 7 2
Connecticut........ 623 628 1 39 40 53 1 4

MIDDLE ATLANTIC ...... 28 7,652 4,346 5 432 400 83 2 37
New York City...... 8 4,971 2,271 82 81 37 9
New York, Up-State. 610 1,287 82 72 NN 1 1
New Jersey.......... 18 961 669 2 168 136 46 18
Pennsylvania....... 2 1,110 119 3 100 111 NN 1 9

EAST NORTH CENTRAL... 56 2,490 3,990 1 351 280 447 1 116
Ohio............... 12 414 312 1 132 77 30 10
Indiana............. 4 474 699 45 38 74 36
Illinois........... 27 643 1,394 49 63 72 1 5
Michigan........... 6 332 301 100 82 95 25
Wisconsin.......... 7 627 1,284 25 20 176 40

WEST NORTH CENTRAL... 97 843 399 128 123 55 1 23
Minnesota......... 8 17 18 28 29 -
Iowa................ 336 104 19 8 38 14
Missouri........... 31 81 53 40 6 2
North Dakota........ 11 33 138 2 4 9 2
South Dakota....... 3 4 1 5 NN -
Nebraska............. 78 416 44 9 9 2 4
Kansas............. 7 10 16 28 1 1

SOUTH ATLANTIC....... 21 2,618 1,597 7 458 447 154 1 44
Delaware............ 395 16 13 9 3
Maryland........... 77 103 41 39 6 1
Dist. of Columbia*. 28 6 9 16 1 -
Virginia........... 17 906 343 1 56 43 82 3
West Virginia...... 214 308 2 21 13 50 16
North Carolina..... 2 325 284 84 85 NN -
South Carolina .... 1 127 14 1 59 58 1
Georgia............. 2 4 77 89 -
Florida............. 1 544 519 3 98 95 15 1 20

EAST SOUTH CENTRAL... 116 501 4 165 202 49 1 27
Kentucky............ 66 103 1 55 92 14 -
Tennessee.......... 20 62 3 68 60 35 24
Alabama............ 6 95 25 27 1 2
Mississippi........ 24 241 17 23 1

WEST SOUTH CENTRAL... 42 4,820 5,037 2 343 326 100 6 43
Arkansas........... 16 2 32 20 -
Louisiana.......... 124 24 1 92 93 -
Oklahoma............ 142 125 34 52 25 8
Texas.............. 42 4,538 4,886 1 185 161 75 6 35

MOUNTAIN.............. 20 1,027 1,033 1 51 39 63 26
Montana*.......... 8 72 58 8 6 6 2
Idaho............... 90 21 11 11 3 -
Wyoming............. 54 3 -
Colorado............ 141 518 1 9 11 34 3
New Mexico......... 270 130 6 2 -
Arizona........... 11 442 226 10 4 17 17
Utah................ 1 11 21 5 1 1 4
Nevada............. 1 5 2 3 -

PACIFIC.............. 16 1,139 2,725 5 561 301 277 1 82
Washington ........ 1 67 579 1 57 47 34 11
Oregon.............. 200 553 1 19 23 23 8
California......... 14 814 1,547 3 464 214 116 1 45
Alaska.............. 13 11 11 3 90 14
Hawaii.............. 1 45 35 10 14 14 4

Puerto Rico.......... 30 1,766 466 19 20 30 -
*Delayed reports: Measles: D.C. 2, S.C. delete 1, Mont. delete 2, Wash. 3
Mumps: Wash. 49
Poliomyelitis, paralytic: Ill. 1
Rubella: Ariz. 3, Wash. 29







398 Morbidity and Mortality Weekly Report


TABLE III. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

NOVEMBER 8, 1969 AND NOVEMBER 9, 1968 (45th 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... 7,566 7 140 127 12 289 3 437 44 2,919

NEW ENGLAND............ 721 1 16 1 15 1 1 41
Maine.............. 16 1 6
New Hampshire...... 5
Vermont............. 20 16 1 19
Massachusetts...... 227 I 1 8 1 3
Rhode Island....... 43 1 -
Connecticut........ 415 -. 5 8

MIDDLE ATLANTIC...... 217 17 5 2 31 2 46 9 208
New York City...... 35 9 1 2 17 -
New York, Up-State. 104 3 4 6 7 8 194
New Jersey.......... NN 3 3 15 -
Pennsylvania....... 78 2 5 2 24 1 14

EAST NORTH CENTRAL... 738 1 19 15 1 32 3 2 213
Ohio............... 106 4 11 71
Indiana............. 142 4 50
Illinois........... 142 1 10 4 1 15 3 2 36
Michigan........... 210 5 5 7
Wisconsin........... 138 7 1 49

WEST NORTH CENTRAL... 405 11 14 10 8 5 552
Minnesota.......... 8 3 4 3 146
Iowa............... 165 1 7 2 85
Missouri........... 16 4 10 3 130
North Dakota....... 98 69
South Dakota.*..... 18 I 43
Nebraska............ 82 1 1 13
Kansas.............. 18 4 3 1 66

SOUTH ATLANTIC....... 873 3 27 22 5 46 246 11 692
Delaware........... 3 2 3 -
Maryland........... 156 1 4 48 3
Dist. of Columbia.. 1 2 2 -
Virginia........... 211 1 1 4 1 81 4 345
West Virginia...... 269 1 2 2 5 3 100
North Carolina..... NN 2 6 3 9 64 5
South Carolina..... 34 1 2 1 30 -
Georgia............. 7 7 4 11 15 2 81
Florida............. 192 2 12 4 2 14 2 158

EAST SOUTH CENTRAL... 1,417 20 14 1 45 63 5 375
Kentucky............ 151 7 8 13 4 193
Tennessee.......... 785 4 13 19 41 126
Alabama............ 268 6 4 6 1 50
Mississippi........ 213 3 1 1 14 3 6

WEST SOUTH CENTRAL... 712 2 27 20 29 1 48 5 421
Arkansas............ 16 2 2 13 7 30
Louisiana.......... 2 7 4 3 1 33
Oklahoma.*......... 30 1 8 29 1 64
Texas.............. 664 2 17 6 13 1 12 3 294

MOUNTAIN.............. 1,596 6 17 28 17 117
Montana ............ 19 1 2 -
Idaho.............. 224 4 6 -
Wyoming............. 151 4 5 54
Colorado........... 978 2 3 9 3
New Mexico......... 24 1 7 17
Arizona............ 88 3 6 22
Utah .............. 109 12 2 5
Nevada............. 3 1 16

PACIFIC ............. 887 1 12 4 2 53 5 6 300
Washington. ....... 605 1 2 2 3 4
Oregon............. 166 1 6 4
California......... --- 1 11 1 2 41 2 6 292
Alaska ............ 55 -
Hawaii.............. 61 4 -

Puerto Ric.......... 4 12 1 7 25
*Delayed reports: SST: Wash. 599
RMSF: Okla. 1
Rabies in animals: S. Dak. 19






Morbidity and Mortality Weekly Report






Week No. TABLE IV. DEATHS IN 122 UNITED STATES CITIES FOR WEEK ENDED NOVEMBER 8, 1969


399


(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 year Area All 65 years and I 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.--------


710
210
53
34
31
61
33
18
29
59
42
12
44
24
60

3,115
52
55
120
29
42
48
56
67
1,613
49
404
143
57
112
21
46
82
40
33
46

2,618
66
33
744
139
217
128
91
371
21
52
33
18
57
145
45
141
57
45
25
122
68

883
73
18
45
160
21
102
90
252
67
55


430
113
38
21
18
33
23
13
23
31
24
7
26
18
42

1,834
27
35
72
18
27
30
29
28
973
24
221
76
37
79
13
21
50
20
25
29

1,474
49
15
401
79
109
65
48
214
14
31
22
8
37
67
24
90
30
34
13
81
43

545
46
9
25
97
14
68
62
148
43
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.----------


1,356
135
273
70
76
111
68
93
43
92
85
256
54

643
112
43
51
122
145
54
26
90

1,173
33
23
18
200
44
78
215
58
170
84
116
64
70

434
49
31
113
17
111
25
53
35

1,590
26
41
29
50
85
507
73
48
133
53
99
187
48
136
38
37


Total 12,522 7,095 448 633

Expected Number 12,508 7,222 416 532


Cumulative Total
(includes reported corrections
for nrevinus weeks)


582,567 332,813


26,194


27,717


*Mortality data are being collected from Las Vegas, Nev., for possible inclusion in this
Las Vegas, Nev.* 19 8 1 table, however, for statistical reasons, these data will be listed only and not included in
Sthe total, expected number, or cumulative total, until 5 years of data are collected.







Morbidity and Mortality Weekly Report


INTERNATIONAL NOTES
INFLUENZA Summer and Fall 1969'

The epidemic of A2 Hong Kong influenza, which was
first recognized in July 196b in Hong Kong and which then
spread rapidly I.r,.l, l ,i Southeast Asia, to the United
States. and to Europe during the fall and winter of 1968,
diminished in late spring 1969 in most areas of the world.
.\lri.ii'Al little or no activity was reported in the northern
hemisphere after that, smoldering activity continued in the
southern hemisphere. In South America, Uruguay reported
widespread epidemic activity during June 1969 with school
and industrial absenteeism reaching 50 and 20 percent, re-
spectively: schools were closed on June 18 for the rest of
the month duc to influenza. Chile reported influenza-like
disease of epidemic proportions in Santiago and the central
provinces with the peak occurring during the third week of
July and the epidemic waning by mid-August. Strains from
both Uruguay and Chile as well as strains isolated in
Argentina during the same period were confirmed as closely
related to A2/ H.iri Kong/68 by the World Health Organiza-
tion International Influenza Center for the Americas.
Thailand. which also reported influenza A2 activity
in late summer 1968, had an increase in .,1 I; ;. beginning
in mid-September 1969. Recently isolated strains were
closely related to A2 Hong Kong/68.
Sporadic cases of a mild influenza-like disease con-
firmed by virus isolation, have been reported from Senegal
since April 1969. with epidemic levels being reached in
August and September.
During September and October, an increase in influenza-
like illness was noted in Hawaii, and a number of cases
were confirmed by serology and by isolation of a Hong
Kong-like virus.
In Australia, influenza activity was first reported in
the northern provinces in late summer 1968, and epidemics
were reported in Melbourne and .' Jrr*, in August 1969;
marked diminution in severity had been noted by the end
of the month. New Zealand reported A2 influenza activity
:ir..Ijlbr.,r the summer with a decrease by mid-September
1969.
At present, an epidemic of major proportions is occur-
ring in remote areas of the Papua-New Guinea highlands.
A large number of cases have been reported with an esti-
mated I .'11, deaths as of October 22. Pneumococcal pneu-
monia has been a major complication. An A2/Hong Kong-
like virus was isolated at the International Influenza Center
for the Americas from the throat washings of several pa-
tients in New Guinea. Australian army and territorial
personnel are participating in evaluation of the epidemic.
(Reported by Dr. Anthony Morris and Dr. Carlton Gajdusek,
Division of Biologics Standards, National Institutes of
Health; the World Health Organmizatioun International In-
fluenaa Center for the Americas, Atlanta, Georgia; and the
Kr.spiralory Diseases Unit, Viral Diseases Section, Epi-
demiology Proyrami, Ni')C.)

S' alth Organization treekly Epidemiological
Record 4413 1, 3:-; 6, anl 1 I15):1 52. 508. 511, 519, 529, 612,
rnd 61!1, Aug us -Nov\ mber 1969.


NOVEMBER 8. 1968


THE MORBIDITY AND MORTALITY WEEKLY REPORT. WITH A CIRCULAR'
TION OF 18,500 IS PUBLISHED AT THE NATIONAL COMMUNICABLE
DISEASE CENTER, ATLANTA, GEORGIA.
DIRECTOR, NATIONAL COMMUNICABLE DISEASE CENTER
DAVID J. SE'I ER M D
DIRECTOR. EPIDEMIOLOGY PROGRAM A. D. LAtli.Mu. M D.
EDITOR MICHAEL B. GRtIG M D.
EDITOR pro tam ALAN R. ,.IMAN M D.
MANAGING EDITOR PRISCILLA B. HOLMAN
IN ADDITION TO THE ESTABLISHED PROCEDURES FOR REPORTING
MORBIDITY AND MORTALITY. THE NATIONAL COMMUNICABLE D'SE SE
CENTER WELCOMES ACCOUNTS OF INTERESTING OUTBREAKS OR CA SE
INVESTIGATIONS WHICH ARE OF CURRENT INTEREST T0 HEALTH
OFFICIALS AND WHICH ARE DIRECTLY RELATED TO THE CONTROL
OF COMMUNICABLE DISEASES. SUCH COMMUNICATIONS S.OUL.D 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 NCOC BY 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.


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