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:
AA00010654:00144

Related Items

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

Full Text



NATIONAL COMMUNICABLE DISEASE CENTER


Vol. 16, No. 36







Week Ending
September 9, 1967


U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE


PUBLIC HEALTH SERVICE


BUREAU OF DISEASE PREVENTION AND ENVIRONMENTAL CONTROL


INTERNATIONAL NOTES
OBSCURE DISEASE RELATED TO AFRICAN MONKEYS
Germany


CONTENTS
Intern Naoili 'ote.-
Ob C ure Di)s R.. t ,il.i t 0 \fricfn \Monk N Germany
rcmn o nk.\\ -- (;orman .. ........ .... 01
SiinoniIlosi- -~ Gcrm.Lm . 02


A disease of unknown etioloiy in persons having con- '" .p..i. "- ..... :0
tact with African monkeys has been reported ( r tic .1 a;ri i C(e Kentuck . 303
Five (5) definite cases and two (2, Dl ~vA A j, .qi. I' i'mi- O (k l .. ..... .......... :30,0
reported among persons working in ', i- *
of the Paul Ehrlich Institute, Frankft a ain. Sixteen ients and one in a person assisting at an autopsy.
(16) cases occurred in persons ..1f -Tit monkeys 5e an o the-p 2 patients hae d(ied.
monkey cell cultures in Behringwe ~ G.. Mar lur. -A i Initial symptoms include severe prostration. nausea.
suspect case occurred in an animal ndlr works in iting. diarrhea, and muscle aching which is particu-
a laboratory in Biberach near UIlm. In oi n. (here ha\e /~./y e\ere in the lumbar region. ConjunctLi\its occurs
been three cases in medical personnel ( n are of these .n { tinued on paye 302)
V xS;-_-.. .*^S3^/


CASES OF SP E 9lM f E DISEASES: UNITED STATES
(Cumulative totals-include r and delayed reports through previous weeks)


36th WEEK ENDED CUMULATIVE, FIRST 36 WEEKS
MEDIAN
DISEASE SEPTEMBER 9, SEPTEMBER 10, 1962 1966 MEDIAN
1967 1966 1967 1966 1962- 1966
Aseptic meningitis ........ .... .144 141 55 1,764 1,745 1,280
Brucellosis ............................ 3 1 8 178 164 260
Diphtheria. .............................. 3 7 7 73 127 160
Encephalitis, primary:
Arthropod-borne & unspecified ......... 36 71 -- 1,077 1,376 --
Encephalitis, post-infectious ............. 11 11 -- 625 580
Hepatitis, serum ........................ 38 14 568 1,478 946 27,108
Hepatitis, infectious .................... 590 439 26.175 22,163
Malaria ............................... 32 9 2 1,354 249 61
Measles (rubeola)....................... 194 414 541 57,617 189,095 357,669
Meningococcal infections, total .......... 21 24 25 1,676 2,694 2.018
Civilian ............................ 21 24 1,563 2,422
Military.. ......... ........ .... ... 113 272
Poliomyelitis, total ..................... 3 5 5 25 71 73
Paralytic ............................. 2 5 5 21 67 67
Rubella (German measles) ............ .. 123 158 39,723 41,504
Streptococcal sore throat & scarlet fever .. 4,476 3.772 3,772 323,416 305,939 284,579
Tetanus................................ 5 5 5 152 120 181
Tularemia .............................. 2 3 125 118 197
Typhoid fever .......................... 14 7 11 284 252 283
Typhus, tick-borne (Rky. Mt. spotted fever) 18 12 6 248 198 178

Rabies in animals ....................... 78 62 63 3.120 2,979 2,979

NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax: .......... ........... ............. 2 Rabies in man: ..................... 2
Botulism : ........................................... 2 Rubella, Congenital Syndrome: ....................... 4
Leptospirosis: Hawaii-1, Mich.-l, Wash.-1. .............. 28 Trichinosis: .................... ......... ....... 48
Plague: ............................................. 2 Typhus, murine: Tex.-l ............. ............. 31
Psittacosis: Minn.-1 ................................ 31 Polio, Unsp. Calif.-i .. ....... .... ... 4


"~















early, followed by enanthem and exanthem which is scar-
latiniform in appearance. Characteristically there is a
leukopenia in the initial phase, followed by leukocytosis.
Thrombocytopenia is accompanied by a bleeding tendency
from the mucous membranes. During the second phase
there is evidence of involvement of the liver, heart, and
brain. Deaths have usually been occurring from 7 to 12
days after onset.
The cases are associated with at least two (2) ship-
ments of Cercopithecus aethiops from Uganda to the lab-
oratories. At the Paul Ehrlich Institute cases are limited


SEPTEMBER 9, 1967


to persons who work in the animal operating room. At
the Behringwerke cases also occurred among persons
working with tissue cultures derived from monkey kidneys.

(Reported by Professor Werner Anders, Chief, Epidemi-
ology Department, Max von Pettenkofer Institute, Ministry
of Health, Berlin, Federal Republic of Germany, through
the Foreign Quarantine Program, NCDC.)

Editorial Note:
An intensive international investigation of the source
and causative agent of this obscure disease is in progress.


SALMONELLOSIS Germany


According to an unofficial report of August 9, 1967,
an epidemic of salmonellosis has occurred among patients
and personnel at a church-supported hospital in Unna.
This town is 280 km. north of Frankfurt am Main. Over
200 cases had been reported among the 450 patients and


300 employees. Contaminated food is thought to be the
source. Salmonella braenderup has been isolated from
food samples.

(Reported to Foreign Quarantine Program, NCDC.)


EPIDEMIOLOGIC NOTES AND REPORTS
HEPATITIS Texas


Between June 18 and July 12, 1967, three cases of
infectious hepatitis occurred among persons who had
close contact with two recently imported young chimpan-
zees at the Zoological Gardens in El Paso, Texas. Two
of the cases were in animal handlers (ages 33 and 21)
who had onsets of illness on June 18 and June 23, re-
spectively, after having had close physical contact with
the chimps since the arrival of the animals at the zoo on
April 18, 1967. The third case was in a 37-year-old metal
worker who had physical contact with the chimps on one
day only (June 14) while inspecting their cage. He devel-
oped hepatitis 28 days later on July 12. All three men
experienced malaise, anorexia, and fever followed by
jaundice and abnormal liver function tests. Two were
hospitalized briefly; all recovered with no apparent se-
quelae. None of the men knew of exposure to jaundiced
or ill persons within the two months prior to onset of
illness, none received transfusions of blood or blood
products, and all denied raw shellfish ingestion.
Shortly after arrival at the El Paso Zoo on April 18,
the chimps were treated for upper respiratory and gastro-
intestinal symptoms and had recovered by April 30. There
has been no further clinical disease in the two animals,
and at no time were they jaundiced. SGOT and SGPT
determinations on their sera drawn July 2 were normal.
The chimpanzees were part of a larger group of
chimps r. .i l, imported from Africa, housed .-h. r
at an imal brokerage in another state, and shipped to
vwveral different destinations between April 12 and May


11. Among these, 7 were sent to the NCDC Field Station
in Phoenix, Arizona. These chimps were routinely ex-
amined for evidence of hepatitis. Shortly after arrival,
two of the animals had liver function abnormalities and
liver biopsies compatible with "acute hepatitis." None
had jaundice.
There were no known secondary cases of viral hepa-
titis amongfamily members of the three patients; however,
most of those at risk had received gamma globulin. There
were 13 other cases of hepatitis reported to the El Paso
City-County Health Department between April 1 and
August 18. Nine of these were interviewed. None had
contact with the chimpanzees.
(Reported by L. R. Hutchinson, V.M.D., M.S., Director,
Veterinary Services, City-County Health Department, El
Paso, Texas; M. D. Hornedo, M.D., Director, City-County
Health Department, El Paso, Texas; and an EIS Officer.)
Editorial Note:
Outbreaks of infectious hepatitis associated with
close contact with young chimpanzees have been reported
in the past. (1,2,3,4) The presumed explanation for chim-
panzee-associated cases of infectious hepatitis is trans-
mission of the virus from man to chimpanzee and then
back to man. The chimpanzees are usually acquired from
West African natives, whose practice it is to capture
the chimps as infants and bring them into their homes as
pets. The animals have intimate contact with their captors
and are exposed to the multiple infectious agents endemic
in the community. After purchase by the exporters, the


Morbidity and Mortality Weekly Report




OBSCURE DISEASE RELATED TO AFRICAN MONKEYS Germany
(Continued from front page)












chimpanzees are shipped together. thus allowing possible
iiral transmission from animal to animal. Assuming an
average incubation period of 30 da ys for both man and
chimpanzees. the day of infection for the first two human
cases must have been about May 20. 32 days after the
chimps arrived at the zoo. Therefore it eems likely that
the chimpanzees acquired their infection from the other
chimps at the brokerage rather than in Africa. However.
it is possible that chimpanzees infected with hepatiti-
continued to excrete the virus intermittently and for long
periods of time. and acquisition of infection in Africa
cannot be excluded with certainty.
The typical clinical picture of human infectious
hepatitis is not a common occurrence in the chimpanzees,


303


and it is presumed that they m a\ ser\e as sources of
infectious hepatitis in their contact- xiilhout manifesting
the disease themsel es.
S-KFi i : N('ES:
l. li- i\. I.: An outbrl of nfctlo h ti .imon
cx hi .ni x x,. t-ndifr- v a Uni td Stta.- Air For, -, R .- : rII-,
J 1116 73:1.;- .
2. I).Vv*...), r. '. I, -n.*,-..., \.. C hr:.
.-.-o, !< l l ,t.' i' in hu \ns. m -'r J iF midt'1 83: 1 -1 ].

:. .sl, J. i. i,. h r t. 11. P.. In ld I. F. H.: Chim-
I : Z.-. ( ,-l i JAMA 1 99: -1;Mh45 7, 1ili7.
1. \ ild J,. LR.:; Al h 'A \I : nh-I11;in

\nnu.d lV\I \:1 -."-: \.,


CRYPTIC' MALARIA CASE Kentucky


A case of malaria \was recently reported in a 41-year-
old carpenter who resides in Bo\nling Green. Kentucky.
The patient experienced fexer. myalgia, and headache on
July 9, 1967, accompanied by shaking chills on the follow-
ing day. Since the fever persisted despite administration
of antibiotics, he was admitted to the hospital on Jul\ 12
as a suspect case of malaria. The diagnosis of malaria
\\as confirmed that same day when a practing physician
and a pathologist identified PlaismodiIm ria.r parasites
in a peripheral blood smear. The blood smears were not
available for renewx. but the diagnosis \\as supported hly
the National Institute of Allergy and Infectious Diseases
(National Institutes of Health) here fluorescent anti-
bodies against P. ,rica. were noted in a dilution of 1:,h0.
The patient had not been outside the United States
and had no history of blood transfusions or use of commonly
shared syringes. \.\ i ..lI, he reportedly had had malaria
20 years ago. he has had no unexplained feoer episodes
since that time. He lives in a \ell-screened, air-conditioned
home in a modern suburban area. His only travel outside
Bowling Green during the 2 months prior to the onset of
illness in\ioled two fishing trips. On June 16. 1967, he
fished at a lake 110 miles west of Bowling Green, and on
June 30. 1967. he went to a reservoir 30 miles east of
Bowling Green. Neither of the two family members who
accompanied him on these trips have developed any illness.


Epidemiologic investigation included a search for
additional cases through personal interview s with 9S
general practitioners. internists. and pediatricians who
practice in the area of Bowling Green and the two lakes.
A total of eight patients were uncovered with a history
compatible x\ith malaria. Results of blood smear examina-
lion- and fluorescent antibody determinations were all
negative. A survey of medical laboratories in the area. and
of fishermen frequenting the tio lakes. did not result in
the identification of an\ additional malaria cases.
The place and source of infection of this isolated
case remain unclear. One of two setricemen x ho acquired
malaria in Kentuck\ in 1967 (\MMl' R. \ol 16. No. 29.
p. 239). also had been fishing. but at a site 40 miles away
from the closest of the abo(e two lakes.
In the absence of any associated cases, this episode
has been classified as a crpptict case of malaria.

(Reported by Dr. ('Cali r Hrae Director. Divrcc ision of
Epidemiology, Dr. J. II. Skaij. A.tiing Director. Office
of Communicable DisCease.s, and Ir. J. Clifford Todd,
Director, Field Inieextigtionis 'nit. all with the Kentucky
State Department of iHalth: anId 4a canm from \CDC.)


"Cryptic mi u-i cai an i
i lted iit Fo t-.r\ 4 o; n.
epidemioiooic, a in, estiatilon.


.itd I. ,se ol malriar n t a o-
d Iite 1ni ned through appropriate


MEASLES EPIDEMIC Oklahoma


Eleven cases of rubeola. including one death from
measles encephalitis, confirmed by autopsy, were reported
to the Oklahoma State Health Department from the USPHS
Indian Hospital at Lawton. Oklahoma. for the week ending
August 19. 1967. A request was made from the Oklahoma
State Health Department's Division of Epidemiology to
the NCDC for measles vaccine from the epidemic control
stockpile. The USPHS hospital through its clinics in
Lawton. Anadarko. and Carnegie. Oklahoma. serves a


twelve-county area \with an Indian population of approxi-
mately 1.000 children in the 1-10 year age range suscepti-
ble to measles. In thepast year. approximately 250 doses
of Edmonston vaccine ha\e been administered to Indian
Hospital outpatients. Through the State immunization
program. approximately 5.270 doses have also been dis-
tributed to both Indians and non-Indians for the twelve-
county population of 63.667 in the 1-10 year age group.
(Continued on page 308)


SEPTEMBER 9, 1967


Morbidity and Mortality Weekly Report









304 Morbidity and Mortality Weekly Report


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

SEPTEMBER 9, 1967 AND SEPTEMBER 10, 1966 (36th WEEK)

ENCEPHALITIS HEPATITIS

ASEPTIC Primary
AREA MENINGITIS BRUCELLOSIS DIPHTHERIA including Post- Serum Infectious
Infectious
unsp. cases
1967 1966 1967 1967 1967 1966 1967 1967 1966 1967 1966
UNITED STATES... 144 141 3 3 36 71 11 38 14 590 439

NEW ENGLAND.......... 4 14 I 44 18
Maine.............. 5 2
New Hampshire...... -
Vermont ............-
Massachusetts...... 2 6 26 7
Rhode Island....... 2 8 1 7 3
Connecticut........ 6 6

MIDDLE ATLANTIC...... 19 15 3 13 5 81 67
New York City...... 5 9 4 38 14
New York, Up-State. 1 3 11 21
New Jersey.......... 14 10 1 1 20 13
Pennsylvania....... 5 2 12 19

EAST NORTH CENTRAL... 24 12 21 21 2 4 1 89 69
Ohio................ 9 3 19 19 11 21
Indiana............. 3 6
Illinois........... 11 4 2 1 1 36 16
Michigan........... 3 5 2 3 1 34 19
Wisconsin.......... 1 1 5 7

WEST NORTH CENTRAL... 6 7 1 2 18 3 35 38
Minnesota.......... 4 5 1 3 10 4
Iowa............... 1 2 3 19
Missouri........... 1 1 9 13
North Dakota....... 2 1 2
South Dakota....... -- 2 -
Nebraska............ 1 1 I
Kansas.............. -- 12 11

SOUTH ATLANTIC....... 49 15 2 3 2 1 3 54 59
Delaware........... 1 1 3 2
Maryland............ 43 1 11 10
Dist. of Columbia.. 1
Virginia........... 4 3 1 1 1 11 18
West Virginia...... 8 1 1 4
North Carolina..... 1 2 2 2 12
South Carolina..... 3 1
Georgia........... ...- 16 6
Florida............ 1 1 1 2 7 5

EAST SOUTH CENTRAL... 7 1 2 1 2 1 1 29 23
Kentucky........... 1 11 6
Tennessee.......... 3 1 2 1 10 10
Alabama............ 2 2 1 5 3
Mississippi....... 1 3 4

WEST SOUTH CENTRAL... 5 41 1 1 12 1 73 34
Arkansas............ 16 5
Louisiana.......... 4 4 1 6 1 16 5
Oklahoma............. 1 6 1 3 4
Texas.............. 31 3 37 24

MOUNTAIN.............. 2 4 5 31 19
Montana............ 2 8 1
Idaho............... 7 2
Wyoming ............ 2 2
Colorado........... 1 1 1 1
New Mexico......... 1 1 8
Arizona............ 2 1 14 3
Utah............... 1 2
Nevada ............. -

PACIFIC.............. 30 34 1 6 6 3 20 3 154 112
Washington........... 1 3 1 1 10 9
Oregon............... 2 12 9
California......... 22 30 1 6 5 2 20 3 130 88
Alaska............ 2 6
Hawaii............. 5 1 -

Puerto Rico 14 16








Morbidity and Mortality Weekly Report 305


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

SEPTEMBER 9, 1967 AND SEPTEMBER 10, 1966 (36th WEEK) CONTINUED


MENINGOCOCCAL INFECTIONS,
MALARIA MEASLES (Rubeola) TOTAL POLIOMYELITIS RUBELLA
TOTAL
AREA Total Paralytic
AREA Cumulative Cumulative Total Paralytic
SCum.
1967 1967 1967 1966 1967 1967 1966 1967 1967 1967 1967
UNITED STATES... 32 194 57,617 189,095 21 1,676 2,694 3 2 21 123

NEW ENGLAND........... 3 3 848 2,250 68 118 25
Maine.............. 2 238 198 3 9 4
New Hampshire...... 74 80 2 9
Vermont............ 42 232 1 4 2
Massachusetts...... 1 3 343 778 32 48 1
Rhode Island....... 62 72 4 13 -- 6
Connecticut........ 89 890 26 35 12

MIDDLE ATLANTIC...... 20 9 2,255 17,986 3 273 322 5 8
New York City...... 1 3 453 8,278 48 45 1 4
New York, Up-State. 5 583 2,528 1 67 91 1 2
New Jersey.......... 7 486 1,846 93 97 -
Pennsylvania....... 12 1 733 5,334 2 65 89 3

EAST NORTH CENTRAL... 45 5,387 68,523 2 237 418 2 2 3 13
Ohio................ 1,139 6,335 1 80 115 2
Indiana............. 593 5,676 34 74 -
Illinois........... 10 952 11,338 54 77 2
Michigan........... 2 921 14,372 1 53 110 2 2 3 9
Wisconsin.......... 33 1,782 30,802 16 42

WEST NORTH CENTRAL... 6 2,837 8,670 1 72 144 3 2
Minnesota.......... 1 121 1,639 1 18 34 -
Iowa............... 1 748 5,305 14 22 -- 1 2
Missouri........... 1 333 531 15 55 -
North Dakota....... 1 862 1,079 1 11 -
South Dakota ....... 52 40 6 4
Nebraska............. 2 628 76 12 8
Kansas............. 93 NN 6 10 2 -

SOUTH ATLANTIC....... 3 16 6,870 15,192 6 321 453 2 18
Delaware............. 1 46 257 6 4
Maryland............ 1 3 157 2,103 2 41 46 I
Dist. of Columbia.. 22 382 10 11 -
Virginia........... 1 7 2,188 2,171 39 54 2
West Virginia...... 1 1,383 5,232 3 24 23 6
North Carolina..... 1 848 482 1 67 115 I
South Carolina..... 1 511 656 29 48 3
Georgia............. 34 234 49 63 -
Florida............. 1 2 1,681 3,675 56 89 7

EAST SOUTH CENTRAL... 10 5,177 19,660 1 129 236 1 14
Kentucky........... 4 1,325 4,701 35 85 1
Tennessee.......... 2 1,864 12,267 1 55 78 13
Alabama............ 3 1,325 1,681 26 51 -
Mississippi........ 1 663 1,011 13 22 1

WEST SOUTH CENTRAL... 52 17,336 24,416 218 371 7
Arkansas........... 1,404 971 30 35 -
Louisiana.......... 2 155 99 86 137 -
Oklahoma ........... 3,351 484 16 18 I
Texas............... 50 12,426 22,862 86 181 6

MOUNTAIN ............. 19 4,632 11,930 30 85 16
Montana............. 282 1,812 4 -
Idaho.............. 2 380 1,562 3 5
Wyoming............ 1 181 159 1 6
Colorado............ 9 1,555 1,310 13 46 10
New Mexico......... 2 581 1,132 3 10 -
Arizona............. 1 1,015 5,284 4 10 4
Utah................ 4 369 628 4 2
Nevada............. 269 43 2 4

PACIFIC............... 6 34 12,275 20,468 8 328 547 1 27
Washington......... 3 5,422 3,527 1 29 37
Oregon............. 1 14 1,593 1,770 25 34 7
California.......... 1 7 4,954 14,534 7 261 457 1 18
Alaska.............. 1 5 138 501 9 15 -
Hawaii ............. 3 5 168 136 4 4 2
Puerto Rico.......... 5 2,108 2,669 12 11








306 Morbidity and Mortality Weekly Report


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

SEPTEMBER 9, 1967 AND SEPTEMBER 10, 1966 (36th WEEK) CONTINUED

STREPTOCOCCAL TYPHUS FEVER
SORE THROAT & TETANUS TULAREMIA TYPHOID TICK-BORNE RABIES IN
AREA SCARLET FEVER ___ (Rky. Mt. Spotted) ANIMALS
1967 1967 Cum. 1967 Cum. 1967 Cum. 1967 Cum. 1967 Cum.
1967 1967 1967 1967 1967
UNITED STATES... 4,476 5 152 2 125 14 284 18 248 78 3,120

NEW ENGLAND.......... 621 2 1 1 4 1 2 80
Maine .............. 88 16
New Hampshire...... -- 1 42
Vermont............ 79 18
Massachusetts...... 38 1 1 2 1 2
Rhode Island....... 37 1 1 -- 1 2
Connecticut........ 379 1 1 -

MIDDLE ATLANTIC .... 76 12 1 25 2 27 1 67
New York City...... 5 6 1 13 -
New York, Up-State. 69 1 7 7 1 57
New Jersey......... NN 1 2 2 12
Pennsylvania....... 2 4 3 8 10

EAST NORTH CENTRAL... 187 1 17 12 2 25 2 22 3 306
Ohio............... 11 4 6 11 3 106
Indiana............. 38 3 2 2 10 1 69
Illinois........... 23 1 8 10 2 2 10 61
Michigan........... 64 2 6 20
Wisconsin.......... 51 1 50

WEST NORTH CENTRAL... 368 10 21 1 16 3 12 731
Minnesota.......... 3 1 3 141
Iowa............... 92 1 1 2 2 98
Missouri........... 5 8 1 8 1 4 135
North Dakota....... 81 1 129
South Dakota....... 10 1 2 92
Nebraska............ 102 4 2 1 49
Kansas............. 83 10 1 1 87

SOUTH ATLANTIC....... 505 2 36 9 6 46 8 103 9 402
Delaware ........... 7 -
Maryland........... 88 2 1 19 2
Dist. of Columbia.. 1 2 -
Virginia........... 126 1 8 1 4 1 24 1 181
West Virginia...... 157 1 2 1 1 57
North Carolina..... 5 6 3 1 41 3
South Carolina..... 21 1 2 9 4 -
Georgia............ 6 3 4 1 14 5 14 4 96
Florida............. 95 1 17 1 3 11 4 63

EAST SOUTH CENTRAL... 966 1 24 9 2 47 2 45 20 597
Kentucky............ 30 3 1 2 20 1 14 4 136
Tennessee.......... 688 8 6 9 23 16 413
Alabama............... 138 9 9 1 8 39
Mississippi........ 110 1 4 2 9 9

WEST SOUTH CENTRAL... 545 34 2 61 32 2 29 23 669
Arkansas........... 5 36 9 1 8 92
Louisiana.......... 2 3 1 5 13 3 59
Oklahoma........... 41 2 1 16 6 14 14 236
Texas.............. 502 24 4 4 1 7 6 282

MOUNTAIN ............. 717 8 1 17 8 5 100
Montana.............. 43 1 .1 -
Idaho ............. 64 -
Wyoming............. 6 2 5
Colorado........... 327 1 1 12 8 10
New Mexico......... 136 1 29
Arizona............ 72 3 2 45
Utah.............. 69 3
Nevada............. 3 8

PACIFIC ............. 491 1 17 4 72 2 10 3 168
Washington......... 18 2 1 1 2 1
Oregon.............. 43 1 1 2 3
California........ 336 13 2 68 6 3 164
Alaska.............. 54 -
Hawaii............. 40 1 3 3 -

Puerto Rico.......... 3 11 4 26








Morbidity and Mortality Weeklh Report


DEATHS IN 122 UNITED STATES CITIES FOR WEEK ENDED SEPTEMBER 9, 1967

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


All Causes Pneumonia Under All Causes Pneumonia Under
Area All 65 yea nd 1 ear Area All 65 years nf nza 1 ea
SInfenza All ya Influenza All
Ages and All Ages Causes Ages d r 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, Il.---------
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.--------


746
238
48
29
38
41
44
24
24
60
68
8
45
28
51

2,925
42
44
137
37
25
30
58
63
1,525
43
448
157
33
78
36
36
60
36
17
20

2,333
56
28
719
110
202
102
58
306
42
65
36
44
56
138
33
121
26
38
15
88
50

726
46
26
32
120
28
101
51
211
62
49


449
129
34
19
24
23
31
16
17
36
35
6
29
16
34

1,663
16
27
78
21
17
18
41
34
859
26
253
84
19
45
20
26
35
21
10
13

1,272
36
19
392
68
91
48
26
154
25
33
20
19
36
75
10
78
18
25
11
61
27

430
34
16
12
70
17
61
26
125
45
24


*Estimate based on average percent of divisional total.


SOUTH ATLANTIC:
Atlanta, Ca.-----------
Baltimore, Md.---------
Charlotte, N. C.-------
Jacksonville, Fla.-----
Miami, Fla.------------
Norfolk, Va.-----------
Richmond, Va.-----------
Savannah, Ca.-----------
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.----------


1,022
133
205
58
46
87
47
87
26
52
74
158
49

524
70
33
29
133
95
48
41
75

980
36
32
16
126
25
83
172
47
169
67
106
49
52

385
39
23
115
11
87
10
50
50

1,281
21
44
35
40
62
384
66
45
71
63
97
141
24
115
40
33


Total 10,922 6,083 314 511

Cumulative Totals
including reported corrections for previous weeks

All Causes, All Ages ------------------------- 443,788
All Causes, Age 65 and over------------------- 253,232
Pneumonia and Influenza, All Ages------------- 15,762
All Causes, Under 1 Year of Age--------------- 22,533


Week No.
36








308


MEASLES EPIDEMIC Oklahoma
(Continued from page 303)


This was generally below the level of vaccine distri-
bution to comparable populations across the state. Since
there is no segregation of educational facilities, a pro-
gram was set up in which 2,000 susceptible non-Indian
and Indian children in three population centers were
immunized using live measles vaccine (Swartz strain).
(Submitted by Dr. Leroy Carpenter, Oklahoma State Epi-
demiologist, and an EIS officer.)


ERRATUM: Vol. 16, No. 24, p. 286
In the article "Shigellosis Vermont," the last sen-
tence in the first paragraph on p. 286 is incomplete. It
should read: "In the second wave, however, there appeared
to be a greater risk of infection among employees working
in the camp stables, as 8 of 21 (38 percent) were affected
in contrast to 17 of 107 (16 percent) employees working
in other areas of the camp."


THE MORBIDITY AND MORTALITY WEEKLY REPORT, WITH A CIRCULA-
TION OF 17,000, IS PUBLISHED AT THE NATIONAL COMMUNICABLE
DISEASE CENTER. ATLANTA, GEORGIA.
DIRECTOR, NATIONAL COMMUNICABLE DISEASE CENTER
DAVID J. SENCER, M.D.
CHIEF, EPIDEMIOLOGY PROGRAM AD. LANGMUIR, M.D.
ACTING CHIEF, STATISTICS SECTION IDA L. SHERMAN, M.S.

IN ADDITION TO THE ESTABLISHED PROCEDURES FOR REPORTING
MORBIDITY AND MORTALITY, THE NATIONAL COMMUNICABLE DISEASE
CENTER WELCOMES ACCOUNTS OF INTERESTING OUTBREAKS OR CASE
INVESTIGATIONS WHICH ARE OF CURRENT INTEREST TO HEALTH
OFFICIALS AND WHICH ARE DIRECTLY RELATED TO THE CONTROL OF
COMMUNICABLE DISEASES. SUCH COMMUNICATIONS SHOULD BE
ADDRESSED TO:
THE EDITOR
MORBIDITY AND MORTALITY WEEKLY REPORT
NATIONAL COMMUNICABLE DISEASE CENTER
ATLANTA, GEORGIA 30333

NOTE: THE DATA IN THIS REPORT ARE PROVISIONAL AND ARE
BASED ON WEEKLY TELEGRAMS TO THE NCDC BY THE INDIVIDUAL
STATE HEALTH DEPARTMENTS. THE REPORTING WEEK CONCLUDES
ON SATURDAY; COMPILED DATA ON A NATIONAL BASIS ARE RELEASED
ON THE SUCCEEDING FRIDAY.




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Morbidity and Mortality Weekly Report


SEPTEMBER 9, 1967
UNIVERSITY OF FLORIDA


3IIII I I1262 08864 1898I IIIil
3 1262 08864 1898