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:
AA00010654:00146

Related Items

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

Full Text

FS NAIONL COME D E 1 IA I CE
NATIONAL COMMUNICABLE DISEASE CENTER


Vol. 17, No. 1


WEEKLY

REPORT

Week Ending

bFfary 6, 1968


U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELF)

BUREAU OF DISEASE PREVENTION AND ENVIRONMENTAL


SERVICE


EPIDEMIOLOGIC NOTES AND REPORTS
INFLUENZA State of Washington
.In the state of Washington, sporadic influenza A
activity has recently been documented. A 24-year-old
female employee of King County Hospital in Seattle be-
came ill with an influenza-like disease just prior to the
Christmas holiday. In her household of eight members,
four adults and four children, five persons were ill dur-
ing the last weeks in December. An A2 influenza virus
was isolated from the index case. There is no apparent
source of influenza infection for this family; the family
had not traveled, particularly to the east, prior to the
onset of illness.
An influenza-like illness also occurred in Belling-
ham, Washington. An absentee rate of 18 percent was re-


Epidemiologic Not reports
Influenza- Stte ........
Pertussis Orego 1 '
Salmonellosis-T ... ..
Current Trends
Measles ................................
Influenza-January 1968 .....................
Preliminary Summary
Botulism- 1967 ......... . . .
International Notes
Quarantine Measures . . .


1
6
7
2
4
6
12


ported from one high school for 1 day prior to Christmas.
Subsequently, the absentee rate has been normal. Of four
paired sera obtained from this outbreak during the Decem-
ber 22 to January 2 period, three have showed fourfold or
greater rise in complement fixation antibody titers to
influenza A. No rise in titer to influenza B was detected.
(Continued on page 2)


TABLE I. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous weeks)
1st WEEK ENDED CUMULATIVE, FIRST WEEK
MEDIAN
DISEASE JANUARY 6, JANUARY 7, 1962 1966 MEDIAN
1968 1967 1967 1966 1962- 1966
Aseptic meningitis ................. ... ..28 21 21 28 21 21
Brucellosis ............................. 1 4 3 1 4 3
Diphtheria............. ...... ......... 1 3 1 3
Encephalitis, primary:
Arthropod-borne & unspecified ........... 14 16 14 16 -
Encephalitis, post-infectious ............ 9 5 9 5
Hepatitis, serum ........................ 46 37 6 46 37
Hepatitis, infectious .................... 557 552 557 552 675
Malaria .......... ....................... 19 21 4 19 21 4
Measles (rubeola).......................... 242 1,128 3,884 242 1,128 3,884
Meningococcal infections, total ........... 41 42 46 41 42 46
Civilian ............................ 40 41 40 41 -
Military ................. ............ 1 1 --- 1 1
Mumps ............... .. .............. 2,538 --- --- 2,538 -
Poliomyelitis, total ...................... -
Paralytic............................. -- -
Rubella (German measles) ................ 299 249 299 249
Streptococcal sore throat & scarlet fever .. 8,643 8,320 7.394 8.643 8,320 7,394
Tetanus....................... ......... 1 3 1 3
Tularemia .............................. 2 6 2 6
Typhoid fever .......................... 2 2 2 2 2 2
Typhus, tick-borne (Rky. Mt. spotted fever). 2 3 2 3 -
Rabies in animals ................... .. 65 68 68 65 68 68

TABLE II. NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax: .................................... ....... Rabies in man: ............ ...... ........... -
Botulism: ....................................... Rubella, Congenital Syndrome: ........................ -
Leptospirosis: ................. ...................... Trichinosis ........................ .............. -
Plague: ............................................ Typhus, murine: .................................. .
P sittacosis: Mich.-2 ................................ 2 Polio, Unsp.... ......... ... .. ... ..............


asd






Morbidity and Mortality Weekly Report





INFLUENZA State of Woshington (Cunt I fram jrunt ,a1/


Tu date o iru- has been i-ol aed from this outbreak.
h ^'nerl. huool i al-1ttet ii in l a -.hinttion ha Iino
1 a\i ,--:i1e. \\ckly influtenz' a;inl opidlmic respira-
lort .lil:s rportr aire bein retei\xted alt th -aniut* leel
i i p'ii ol- t sar at thi;- mn.
+lbj t 'I' ] b/ rns I.l)P llua/, ('ettmunt c-


*tb/iil n I) itriii/. I 'a do so, II / ;o Vlrl i 0~ p t i at .
lb a/i i a do~i rIti i'.in tii ~i')r lI) risc(`, i) ( u 7'i~t~


CURRENT TRENDS
MEASLES


For The week ending January 6. 19 is. there w ere -2 :
caes of wn iii reported. lTii1- is 1 pIrconl of the
ca-es reported for the (om:parabl i week a \ear ago. Fig-
ure I c liaro;- tihe n asils cae- rcporled by i teck for
the fir1 1: i'ee'k- of pildemiolotic \ear 1967-(4;* with
c'pidetmiloitli( t r 19 I t6-(7. The marked seasonal in-
crease noted in lt)ti(- 7 ha- not appeared to daet in
1967-6;h.
For the third il -eek period. December 3-30. 1967.
of the epidemioloaie ear 1967-ir;. 309 countitse reported
mieasle ca-se a os compared ilth 474 counties reporting


3,000-




2,500-




2,000-




0 1,500-



z
1,000 -




500,




0
0


for the comparable period in 1906J-67. I n. this 19617-
6I period. 29 counties reported 1i( or more cas i- of iimea-
sles compared with 1'.1 counties or hiahll district re-
porting a total of 10 or more cases in tihe comparable
period in 196(-(67 (Figures -2 and I Of the *2) counties
reporting a total of 10 or more measles cases-. 2-I included
a aInrge metropolitan area.
(Reportd' by 1i1r Stjate, serei.cs Section aind the Sur-
'cillanrc SNerrices C:ni of the Statistics Section. \r('lC.)
h -- I -i + the .

Figure 1
REPORTED CASES OF MEASLES BY WEEK, UNITED STATES
EPIDEMIOLOGIC YEAR 1967-68 COMPARED WITH 1966-67
FIRST 24 WEEKS (OCTOBER-MARCH)


42 44 46 48 50 52 2
NOV DEC JAN
WEEK NUMBER


4 6
FEB.


8 10
MAR


__ I 1 I


.IAN s,\I 6 1968


1967-68







JANUARY 6, 1968


Morbidity and Mortality Weekly Report


Figure 2
COUNTIES OR HEALTH DISTRICTS REPORTING 10 OR MORE CASES OF MEASLES
DECEMBER 4 THROUGH DECEMBER 31, 1966


Figure 3
COUNTIES OR HEALTH DISTRICTS REPORTING 10 OR MORE CASES OF MEASLES
DECEMBER 3 THROUGH DECEMBER 30, 1967







Morbiiity and Mortality Weekly Report


.IJASIARY 6 1968


CURRENT TRENDS
INFLUENZA January 1968


lTh i cw ek, for thi first line. for al infliuetza activity
as I notedi on thi weas toas. i n -:e -sate of a hingiton
( vFuure i ). i report of this occurrence is included in this
i-.nu. Tubi 1 i- I iiii :ir\ of influenza and influenzia-
ik< ;xti\ il\ to da(< lwor it 1967-oIG -eason. It has boen
prepared frmn reports lsubmito d i to th Rei(spiratorr' \ iral
DI) oa (' t 'nilof ( I( bl \ t llr ta l health departnll tlf s.
\r aiur "thidopri-ad" or "S atnered" within each state. This
different tiion is a timn n c,'-nssarili a subjooli\e one.
hut is int iaflutoitz artiiitix n oach s-ati.
Ne' "York City reported an increased number of \x-
tess pneumonia death- for the fourth consecutive week.
and the Middle Atlantic region had excess pneumonia and
influenza mortralit for the second consecutive Neek. In
addition, theri e -as excess pnertumonia and influenza
mortality in I other regions: New England. South Atlantic,
\\iet North Central, and o-st Soouth Central (Figure 5).
This has led to ecess pneumonia and influenza mortality
for the United Stale as a \\hole for the first time this
- ea-ont.


Figure 4
REPORTED INFLUENZA-LIKE DISEASE BY COUNTY
UNITED STATES OCTOBER 29-JANUARY 6, 1968




-^ C'


: i*
I .
I ..




,* .
-- I p .
-4






(Reportr liy Respiratory Di)i.s ar s nit. \C'l) .)

Editorial Note:
The basis of the construction of the National Pneumonia
Influenza Morlalit (Chart is described in '.l'lI Vol. 14.
No. 1.


Table 1
INFLUENZA SUMMARY
October 29, 1967 January 9, 1968
SE R LO Y )( 01 I Cs II I ION
l il';'>!'ln PL"'-d' Group. 1 A\ntihod\ t r u d S.,.r,.
sera U npa irdi iir.t
DOCUMENTED OUTBREAKS OF INFLUENZA


01 1 IRI- Us\ ;
ii\,,I kin


12 67
I67
S7
i 67

1 67
117

I 1 67
I fi7


I 1, 67
1 1 67
Sli7
*t ti7

is 67


INFLUENZA-LIKE ILLNESS
With Documented Individual Cases


12 Ai I'7
-i 11 i7



ii2 1.67
2 I 167
t2 7

1 1 67


I 67
1 7i
1 I 6B


S .1 I1


N l i It.


II(i- ii- i

\Itii iii- i


H lil- iii a ii
\li i-cii




ni iniii


tii xri~

flit ai~ I i:i.i
(iii c
n~i-u i ili'


N-i i h
N it I~







JANUARY 6, 1968


Morbidity and Mortality Weekly Report





Figure 5
PNEUMONIA-INFLUENZA DEATHS IN 122 UNITED STATES CITIES


ALL CITIES


EPIDEMIC THRESHOLD -----
EXPECTED NUMBER -


WEEK NO 40 44 48 52 4 8 12 16 20 24 28 32 36 40 44 48 52 4 8 12 16 20 24 2 32 36 40 44 48 52 4 B 12 16 20 24 B 52 36b
WK ENDED 9 6 4 I 29 26 26 23 21 18 16 13 10 8 5 3 31 28 25 25 22 20 17 15 12 9 7 4 2 30 27 24 23 20 18 15 13 10 7
MONTH 0 N O J F M A M J J A S 0 N 0 J F M A M J J A S O N D J F M A M J J A S
1965 11966 196611967 1967 1968


W.N. CENTRAL
10 CITIES


200


150


100





40 44 48 52 4 8 12 16 20 24 28 32
196711968

&Aft^l NITA IN 150I


8 CITIES ll
8 CITIES


WEEK NO. 40 44 48 52 4
196711968


8 12 16 20 24 28 32


E.N. CENTRAL 125
21 CITIES
100


75

50

25


40 44 48 52 4 8 12 16 20 24
196711968


E.S. CENTRAL
8 CITIES


40 44 48 52 4 8 12 16 20 24 28 32
196711968


NEW ENGLAND
14 CITIES


40 44 48 52 4 8 12
1967 11968


16 20 24 28 32 36


PACIFIC
16 CITIES


WEEK NO 40 44 48 52 4 8 12 16 20 24 28 32
196711968


W.S. CENTRAL
13 CITIES


100




S50




40 44 48 52 4 8 12 16 20 24 28 32
196711968


SOUTH ATLANTIC
12 CITIES













anind unbs II.I I diaritai l


40 44 48 52 4 8 12 16 20 24 28 32 36
196711968


3001


125

100

75


'50
I
S 25

ULL
0 WEEK NO.
(r
Lu
m
2 125-
Z

100


75


50


11~11111~(11111(111111111111111111111111


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Morbidity and Mortality Weekly Report


EPIDEMIOLOGY NOTES AND REPORTS
PERTUSSIS Oregon


Between April and July 1967, 18 cases of prolonged
bronchitis occurred among 33 members of eight Wheeler
Count).. Oregon families overalll attack rate 54.5 percent).
The patients' symptoms were mild fever and accompany-
ing cough. The cough became worse o\er a 2-week period.
usually occurred at night, and consisted of bouts of vio-
lent paroxysms. Many patients experienced wretching or
vomiting at the end of severe coughing episodes. The
cough persisted from 6 to 8 weeks, and the diagnosis of
pertussis was considered. In one acute case, a fluores-
cent antibody slide preparation was positive for Bordetella
pertussis. At the time of epidemiologic investigation.
however, only convalescent cases were available for
study. Of eight slides prepared from nasopharyngeal swabs
of convalescent patients, three were positive by fluores-
cent antibody technique for pertussis. No pertussis organ-
isms were recovered on culture.
Investigation revealed that the disease initially
appeared in two teenage girls, 1 to 2 weeks after their
return from a vacation trip. The disease spread to their
family members and teenage friends in other families. A
12. ...r-.ila woman. a frequent visitor in the home of one
index case, acquired the illness and transmitted it to her
husband. He then spread the infection among his car
pool associates. Of the Ih ill persons. 11 (61 percent)
were 10 to 19 years of age. The high incidence in this
age group may be explained, in part, by the fact that these
families were composed primarily of older children
(Table 2). More than 50 percent of the ill persons had
received 3 or more injections of pertussis vaccine or com-
bined antigens including pertussis vaccine (Table 3).
The high attack rate among teenage family members and
among immunized persons is particularly interesting when
compared to the cases in the recent report from Grand


Table 2
Pertussis Attack Rates in Eight Families
by Age Groups

Age Number Number Attack Rate
Group Exposed III (Percent)

0-9 3 1 33.3
10-19 14 11 7h.6
20-39 6 2 33.3
Over 40 10 4 40.0

Total 33 18



Table 3
Pertussis Attack Rates in Eight Families
by Immunization Status

Immunization Number Number Attack Rate
Status Exposed I11 (P. ri, nil

Vaccinated* 16 9 56.2
Unvaccinated 13 8 61.5
History of
Disease 4 1 25.0

Total 33 18
*Vaccinated history obtained from patient of 3 or more injec-
tions of pertussis vacc iine or combined antigens including per-
tussis vacine.

Rapids, Michigan, (MMWR, Vol. 16, No. I i. where 80
percent of the pertussis cases for the first 10 months of
1967 were in persons over age 10; 75 percent of whom
had received prior immunization.
(Reported by Edward L. Goldblatt, M.D., M.P.H., Director,
Section of Epidemiology, Oregon State Board of Health;
and an EIS Officer.)


PRELIMINARY SUMMARY
BOTULISM 1967


In 1967. three outbreaks of botulism with six cases,
including one death, were reported. All cases were due
to improperly home-canned foods. In Chicago, Illinois,
three cases resulted from home-preserved gefillte fish,
made from whitefish caught in the Great Lakes. One of
these patients died (MMIWR. Vol. 16, No. 24). In Colorado.
a woman died after eating home-canned green beans; the
type of botulism was not determined. In Bronx, New York,
two men survived type B botulism which had its onset 2
and 3 days after they ate home-canned peppers (MMWR,
Vol. 16, No. .",i.
A total of 19 requests for botulinum antitoxin or
epidemic investigation of suspect outbreaks of botulism
were received by NCDC in 1967. On investigation, 16 of
these outbreaks were found not to be botulism (Table 4).
(Reported by Enteric Diseases Unit, NCDC.)


Table 4
Final Diagnosis of 19 Cases Initially Diagnosed as Botulism
1967
Number of
Final Diagnosis Outbrea
Outbreaks
Botulism 3
Probable staphylococcal food poisoning 4
Ate spoiled food, no disease resulted 4
Cerebral vascular accident 2
Carbon monoxide poisoning 1
Guillain-Barr4 Syndrome 1
Myocardial infarction 1
Hyperventilation syndrome 1
C. perfringens gangrene confused
with botulism 1
No final diagnosis made 1


JANUARY 6, 1968







JANUARY 6, 1968


Morbidity and Mortality Weekly Report


EPIDEMIOLOGIC NOTES AND REPORTS
SALMONELLOSIS-Tampa, Florida


An outbreak of gastroenteritis occurred in mid-Sep-
tember in a junior high school in Tampa, Florida. Of 484
students who ate the suspect noon meal in the school caf-
eteria on Wednesday, September 13, at least 300 had one
or more of the symptoms listed in Table 5. Only 124 of the
300 ill students had diarrhea. Stool specimens were col-
lected on Friday, September 15, from 20 patients ill with
diarrhea, and 19 were positive for Salmonella thompson.
Table 5
Frequency of Symptoms
(Among 300 ill children)

Symptoms Number Percent


Abdominal Pain 220 73
Diarrhea 124 41
Fever 117 39
Nausea 88 29
Vomiting 78 26
Chills 78 26
Headache 55 18


To obtain information about foods eaten in the cafe-
teria, tinMe of onset, and symptoms, questionnaires were
completed by 770 of the 876 students enrolled in the
school. The attack rate for diarrhea among the 484 students
who ate the Wednesday lunch in the cafeteria was 26 per-
cent, approximately 4 times greater than the 6 percent at-
tack rate for the 110 students who did not eat the Wednes-
day lunch. The students eating Tuesday luncheon had an
attack rate of 24 percent, compared with 11 percent for
those who did not eat Tuesday lunch. Ninety-five percent
of the children who ate the Wednesday lunch also ate the
Tuesday lunch. The epidemic peak for the 124 children
with diarrhea occurred Thursday afternoon approximately
24 hours after the Wednesday luncheon (Figure 6).

Figure 6
SALMONELLA GASTROENTERITIS TAMPA, FLORIDA
BY TIME OF ONSET OF DIARRHEA


Analysis of food histories demonstrated a strong cor-
relation between diarrheal illness and roast beef, mashed
potatoes, and gravy at the Wednesday meal, and less cor-
relation with sliced ham served on Tuesday (Table 6).
Analysis of attack rates for those children who ate various
combinations of roast beef and the other "suspect" foods
showed that only roast beef significantly altered the ob-
served attack rate when added to or substracted from the
other foods.
Table 6
Food History

GHROLP A GROUP I1
Persons who ate Persons who did not eat
-pecified food specified food
Food or Beverage Attack Attack
Attc Not
II Not Total Rate III Total Rate
S Percent Percent
TUESDAY
Ham 31 61 92 34 89 331 400 22
Ham Sandwich 16 87 103 15 104 285 392 27
Cuban Sandwich 44 147 191 23 76 225 301 25
Donuts 35 166 201 17 85 206 291 29
Jello 27 117 144 18 93 255 348 27
Any food (Tuesday 120 372 492 24 11 91 102 11
lunch)
WEDNESDAY
Roast Beef 107 107 214 50 17 253 270 6
Mashed Potatoes 108 160 268 40 16 200 216 7
GraNy 111 153 264 42 13 207 220 6
Ham Sandwich 7 52 59 12 117 306 425 26
Cuban Sandwich 14 102 116 12 110 258 368 30
Mustard Greens 10 10 20 50 114 350 464 25
Pear & Cheese 9 2t0 29 31 115 340 455 25
Jello 32 122 154 20 92 23S 330 2b
Donuts 33 143 176 19 91 217 308 29
Pie 36 122 151 2L3 8S 23S 326 27
Cake 29 89 llb 25 95 271 366 26
Milk 103 319 423 24 21 41 62 34
Water 77 267 344 22 47 93 140 34
Lettuce & Tomatoe 14 49 63 22 110 311 421 26
Tossed Salad 11 19 30 37 113 311 454 25
Any food (Wednes- 124 360 484 26 7 103 110 6
day lunch)
Ill Dirrhea
N i Ill No symptoms of Gastroentermti.

Investigation showed that the meats had been inspec-
ted and passed by the USDA, and had been adequately
cooked. On Tuesday morning the ham had been sliced on
an electric meat slicer and placed in warming trays in the
cafeteria. About 25 leftover servings of ham were served
on Wednesday. The roast beef was cooked and refrigerated
on Tuesday; it was sliced ;A. -r. e--lj morning on the same
meat slicer, which had not been cleaned in the interim.
Of the foods tested, only the remainder of the sliced
ham served at the Tuesday and Wednesday luncheons was
positive for S. thompson, and only a few organisms were
found. There was no leftover roast beef, mashed potatoes,
and gravy from the Wednesday meal to culture. However,
samples of roast beef and ham from the same lots as those
used for the lunches, and the food items used in the prep-
aration of the gravy and mashed potatoes were all cultured
and found negative.
(Continued on page 12)







8 lorbildity amid %lirtalit Wrekhl Report


TABLEI III. (CASE OF SPI( II IID NOTIFIABI.IE ISI-AEA I NITlD STATES

FOR WIEIKS ENDED

JANI ARY 6. 1968 AND JAN\ ARY '. lX (Ist WEEK)











NEW ENAFD.......... 3 I

V r I I

Ma si, use t...... 2 i
ARh.x Isliand.... .. I .
C on ecticut ....... 5

MID LE ATIA TIC...... 86 8 i
New Y rk City...... 28 17
New y rk, p-Sta 19
Nei r se .. ..... 3. 18 1
P- ..nn. 2

EAST NORTH CENTRAL... 66 7 2
Ohio. .. ...... 26 11 2
Indiana. ...... -
Illinois........... .
Michigan........... 5
Wis insin... ....... 19

WEST NORTH CENTRALL. 18 -

WI a .. .. ..... ... -3 3
Miss ui ... ........ 2 8 -
M'rin Dta.......... 1


Ncbrams a. ... .- .
Kan .e .............. I 3

SOLTH ATLANTIC....... 1 1 8
DelaN ware ... .. .. .. 4
Maryand............ 5 2 i 1
Dist. of Columbia.. I
Virginia............ i 14
est Virginia ......
North Car I ina. ... 2
South Carolina .... 3
GeMrgia............ 10 23
Florida.............. 1 ? 2

EAST SOUTH CENTRAL... 68 -
Kentucky.............. 1 37 22
Tennessee........... 14 11
Alabamna... ......... 11 1]
Mississippi........ -6 3

WEST SOUTH CENTRAL... 2 1 1 1 46 37 I
Arkansas. .......... I -
Louisiana.... -
Oklahoma .......... 6
Texas.............. 2 1 I 39 35

MOUNTAIN ............. 1 0 23
Montana............ I 5
Idaho...
SWyoming. ............
Colorado...........
New Mexico......... 3 7
Arizona............ 7 7
ltah............... 3
Nhevada. ...........

PACIFIC............... 15 10 4 3 26 158 148 12
Washington ......... 14 2
Oregon............ I 1 3 17 41
California......... 12 7 3 23 112 106 10
Alaska............. 4 1
Hawaii............. i 1 -
Colo, r ado .. .. ..









Morbidity and Mortality Weekly Report 9


TABLE III. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

JANUARY 6, 1968 AND JANUARY 7. 1967 (1st WEEK) CONTINUED



MEASLES (Rubeola) MENINGOCOCCAL INFECTIONS, MLUMS POLIOMYELITIS RUBELLA
TOTAL
AREA Total Paralytic
AREA Cumulative Cumulative Total Paralytic
Cum.
1968 1968 1967 1968 1968 1967 1968 1968 1968 1968 1968
UNITED STATES... 242 242 1,128 41 41 42 2,538 299

NEW ENGLAND.......... 6 6 8 3 3 394 43
Maine.............. 2 25 7
New Hampshire...... -
Vermont............ 1 77 2
Massachusetts...... 6 6 5 2 2 212 6
Rhode Island ....... 80 5
Connecticut........ 1 1 23

MIDDLE ATLANTIC...... 32 32 33 5 5 7 235 27
New York City...... 6 6 3 1 1 2 40 22
New York, Up-State. 12 12 13 1 4
New Jersey.......... 14 14 13 2 2 4 195
Pennsylvania....... 4 2 2 1

EAST NORTH CENTRAL... 43 43 99 6 6 3 457 52
Ohio.............. 8 8 7 2 2 2 152 3
Indiana............ 16 16 20 1 1 57 2
Illinois........... 5 5 6 72 5
Michigan........... 2 2 18 3 3 1 176 13
Wisconsin........... 12 12 48 29

WEST NORTH CENTRAL... 10 10 14 3 3 1 417 18
Minnesota........... 2
Iowa............ .. 3 3 3 351 13
'Missouri.... ...... 1 1 12 1
North Dakota........ 6 6 9 37 2
South Dakota ....... 1 1 -
Nebraska........... 2 1 15 2
Kansas ............ NN 2 2 -

SOUTH ATLANTIC....... 28 28 106 7 7 16 209 -23
Delaware........... 9 1
Maryland............ 1 1 8 1
Dist. of Columbia.. 1 1 1
Virginia........... 5 5 23 1 22 2
West Virginia...... 13 13 28 1 1 3 129 11
North Carolina..... 16 4
South Carolina..... 1 1 1 4
Georgia............ 4
Florida............. 9 9 38 4 4 4 36 8

EAST SOUTH CENTRAL... 10 10 160 2 2 2 173 23
Kentucky ......... 2 2 25 1 1 1 107 -
Tennessee.......... 8 8 48 1 1 1 17 21
Alabama ............ 30 39 2
Mississippi........ 57 10

WEST SOUTH CENTRAL... 52 52 323 7 7 7 82
Arkansas........... 5 1 1 -
Louisiana.......... 1 1 2
Oklahoma........... 6 6 57 2 2 I -
Texas .............. 46 46 261 3 3 5 81

MOUNTAIN............. 14 14 113 2 2 1 55 1
Montana............ 45 1 1 3
Idaho.............. 4 4 6 3 -
Wyoming............ 7 7 23 -
Colorado........... 2 2 18 -
New Mexico......... 7 1 5
Arizona............ 1 1 22 1 1 19 -1
Utah................ 4 2 -
Nevada............. 11 -

PACIFIC.............. 47 47 272 6 6 5 516 112
Washington.......... 15 15 159 234 37
Oregon.............. 13 13 52 1 1 1 15 22
California......... 16 16 43 5 5 4 247 29
Alaska.............. 18 7 22
Hawaii............. 3 3 13 2

Puerto Rico.......... --- 43 --- --- --- ---








1( Morbidity and Mortality Weekly Report


TABLE Ill. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

JANUARY 6. 1968 AND JANUARY 7, 1967 (Ist WEEK) CONTINUED



STREPTOCOCCAL TYPHUS FEVER
SORE THROAT & TETANUS TULAREMIA TYPHOID TICK-BORNE RABIES IN
AREA SCARLET FEVER (Rky. Mt. Spotted) ANIMALS
Cum. Cum. Cum. Cum. Cum.
1968 1968 1968 1968 1968 1968 1968 1968 1968 1968 1968
UNITED STATES... 8,643 2 2 2 2 65 65

NEW ENGLAND.......... 1,115 1 1
Maine............... 118 1 1
New Hampshire......
Vermont............ 27 -
Massachusetts...... 181 -
Rhode Island....... 114 -
Connecticut........ 675 -

MIDDLE ATLANTIC...... 255 -
New York City...... 10 -
New York, Up-State. 228 -
New Jersey......... NN -
Pennsylvania....... 17 -

EAST NORTH CENTRAL... 615 4 4
Ohio................ 104 4 4
Indiana............ 103 -
Illinois ........... 110 -
Michigan ........... 156 -
Wisconsin.......... 142 -

WEST NORTH CENTRAL... 400 1 1 6 6
Minnesota .......... 36 -
Iowa............... 135 1 1
Missouri........... 4 1 1 2 2
North Dakota....... 120 2 2
South Dakota ....... 34 -
Nebraska ........... 53 -
Kansas.............. 18 1 1

SOUTH ATLANTIC....... 914 2 2 7 7
Delaware ........... 3 -
Maryland .......... 116 -
Dist. of Columbia.. -
Virginia........... 359 2 2 5 5
West Virginia....... 181 -
North Carolina..... 15 -
South Carolina..... 17 -
Georgia............ 8 11
Florida............ 215 -

EAST SOUTH CENTRAL... 1,692 32 32
Kentucky .......... 182 5 5
Tennessee........... 1,281 26 26
Alabama............ 147 1 1
Mississippi ... .. 82

WEST SOUTH CENTRAL.. 959 14 14
Arkansas........... 2
Louisiana .........
Oklahoma ........... 60 6 6
Texas.............. 897 8 8

MOUNTAIN............. 1,388
ontean. ............ 37
Idaho ...... ..... .. 167
nWyo.ing........ ... 24
Colorado........... 831
N.*w Mexico......... 150
Arizona............ 79
Utah ............. 100
Nevada. ..........

PACIFIC................ 1,305 1 1 1 1
Washington........ 414
Or on. ............ Ill
California......... 620 1 1 1 1
Alaska............. 104 -
Hawaii............. 56

Puerto Ri --............- --- !








Morbidity and Mortality Weekly Report


TABLE IV. DEATHS IN 122 UNITED STATES CITIES FOR WEEK ENDED JANUARY 6, 1968


(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 lez a ll
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. ..-------
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, Neby.---------
Minneapolis, ,Minn.----
Omaha, Nebr.-----------
St. Louis, Mo.--------
St. Paul, Minn.------
Wichita, Kans.--------


956
321
64
42
35
90
12
29
30
57
98
8
47
42
81

4,046
58
41
160
37
42
30
126
109
2,316
,13
409
212
53
133
26
40
73
50
51
'67

2,764
73
42
639
138
240
121
90
481
63
68
60
18
67
145
26
169
41
45
48
125
65

1,018
70
15
44
161
39
125
85
326
77
76


639
216
42
33
23
61
8
16
23
42
58
7
28
31
51

2,542
32
26
95
23
26
22
80
51
1,485
5
238
127
38
95
15
31
43
29
38
43

1,631
38
26
361
83
148
71
52
274
43
28
34
15
50
84
13
118
24
27
35
68
39

667
48
8
26
98
26
89
56
216
50
50


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.-----------


1,454
135
301
53
95
97
48
91
54
123
117
269
71

609
77
55
41
114
116
85
42
79

1,311
44
46
33
221
41
109
205
55
220
89
129
52
67

466
43
25
117
14
131
26
58
52

1,410
23
45
28
38
83
423
53
39
118
61
86
179
53
111
43
27


780
59
146
26
51
58
22
48
19
99
67
142
43

334
39
29
32
65
59
51
16
43

681
32
25
13
120
17
68
90
32
108
41
67
27
41

296
20
18
72
10
78
22
40
36

890
20
32
21
19
47
258
28
28
76
44
48
110
36
75
29
19


Total 14,034 8,460 797 574

Cumulative Totals
including reported corrections for previous weeks

All Causes, All Ages ------------------------- 14,034
All Causes, Age 65 and over------------------- 8,460
Pneumonia and Influenza, All Ages------------- 797
All Causes, Under 1 Year of Age--------------- 574


Week No.
1






12 Morbidity and Mo





SALMONELLOSIS Tampa, Florido
continued d from page 7)

A month prior to the epidemic, soven of the nine cafe-
teria foodhandlers were routinely cultured for salmonella,
and at that time all stools were negative. I),.rr.- the epi-
demic, stxols from five foodhandlers were found positive
for S. thompson. Only one foodhandler of these five had
not eaten roast hoef: however. she had helped prepare both
the ham atnd the roast beef.
The following control measures were instituted: all
possibly contaminated foods were discarded; utensils,
meat slicer. se ring equipment. and work areas were
cleaned: and instructions in personal hygiene were given
to the students andi staff.
S. thompson \was the principal etiologic agent in the
epidemic, and roast beef was the principal vehicle of
transmission. The source of the contamination is not
known; however, the data favor one or more foodhandlers
as the primary source of infection.
(Reported by lillsborough County Health Department:
E. ('Charlton Prather. 1..., Director. )i vision of Epidem-
iology, and the Tampa Regional Laboratory, Florida State
Board of Health; and an EIS 0" .)


INTERNATIONAL NOTES
QUARANTINE MEASURES

Additional Immunization Information for International
Travel 1967-68 edition Public Health Service
Publication ,'o. 3841

The following information should be added to the list of
Yellow Fever Vaccination Centers in Section 6:

Page 85
Delete:


City and State

Center




Clinic Hours

Fee


Insert:

City and State

Center


rtali


New Haven, Conn. 06510

New Haven Department of Health
10 Clinton Street
Telephone 562-0151, Extension 437

By Appointment

None




New Haven, Conn. 06510

New Haven Department of Health
One State Street
Telephone 5621-0151, Extension 137. 438,
or 330


Clinic Hours Second and Fourth Tuesday
11 a.m., by appointment only

Fee None


ity Weekly Report JANUARY 6. 19 6






.k -f .BRCIT T, AND.ORTAI.T, *EEIL. REPORT WrTH A C "CULA C1
T,,Qr C. P i, PeljLISMED AT TIE NATIONAL, COMMUNICABLE
tc, .t :r rEE a~ LtuiTA *EORG'- i Ir
r : .i T 'G.: OM.UNICA Bi.E DiiEASE CENTER I
DVlID, SENCER MO
-i. t .*DE.'LC" ao.IRAM A oD L ANGMUIR M
.. "i E CN T. 01l C-A L -.ERMANI|. Wi M s
E_,, : M :.,:- EL B GREGG MOD

I.I :. T.. 1.-. E tE i AT c I ... FL F C .' OR REPOlTiN
7.' i T L 1 T T -t I ILE ,T L u mi 1C ABLE DISE &aSE
--* i L .L t .. :GU', 5 iCr E ETS ; TOE3T 0... TBREA S OR CASE
'. t T. E_ I. C L .RiE.T TN Et i 1T0 ME ALTH
A- L it A- r : i U' .*l REL TFiF TO IT E CONTROL
r A ..:. N'O.r.. A i:* i-.ra 5m IJ.D BE
NATIONAL .. :..,,.,_ E. DISEASE CENTER
ATLANTA EL A .:-
ATTN: TI- .L : '-
*.' i.. .I MORTALITY WEEKLY REPORT

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


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