Morbidity and mortality

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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:
AA00010654:00148

Related Items

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

Full Text

s NAT L CBLE D E : /CEN
NATION AL COMMUNICABLE DISEASE CENTER


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


Vol. 17, No. 7


WEEKLY

REPORT

Week Ending
February 17, 1968




PUBLIC HEALTH SERVICE


BUREAU OF DISEASE PREVENTION AND ENVIRONMENTAL CONTROL


CURRENT TRENDS
INFLUENZA

Over the past 7 weeks, a sharp rise and fall in excess
mortality has been observed for the United States as a
whole (Figure 1), and for nearly all the nine geographic
divisions (Figure 2). During the seventh week of 1968,
however, there was no excess pneumonia-influenza mor-
tality for the country as a whole.
The Hawaii State Health Department laboratory has
made three isolations of influenza B virus. To date, one
%of these isolates has been confirmed by NCDC, and tests
on the other two isolates, are in progress. The earliest
isolation was made in mid-December 1967. This is con-
sistent with 'known influenza B activity in Taiwan (MMWR,


CONTENTS


TABLE I. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Totals include revised and delayed reports)
7th WEEK ENDED MEDIAN CUMULATIVE, FIRST 7 WEEKS
DISEASE FEBRUARY 17, FEBRUARY 18, 1963 1967 MEDIAN
1968 1967 1968 1967 1963 1967
Aseptic meningitis ....................... 28 27 21 185 197 181
Brucellosis ............................ 1 7 5 6 23 39
Diphtheria .............................. 6 3 12 22 22
Encephalitis, primary:
Arthropod-borne & unspecified ........... 17 20 99 147
Encephalitis, post-infectious ............ 8 10 58 68 ---
Hepatitis, serum ........................ 60 44 453 252 562
Hepatitis, infectious .................... 810 866 1 5.544 5,363 62
Malaria ................................ 29 34 2 306 228 15
Measles(rubeola) ....................... 537 2,246 9,350 3,539 13,292 47,713
Meningococcal infections, total ........... 80 64 64 574 410 410
Civilian .............................. 76 62 545 384 -
Military......................... ... .. 4 2 --- 29 26 -
Mumps ................................. 4,836 --- 32,499 ---
Poliomyelitis, total ..................... -- 1 1 2
Paralytic ............................. 1 1 2
Rubella (German measles) ............... 986 1,288 4,529 5,218 -
Streptococcal sore throat & scarlet fever.... 11,127 12,384 12,023 78,728 80,163 71,323
Tetanus ............................... 3 6 4 13 21 24
Tularemia ...... ...................... 3 4 12 17 31
Typhoid fever .......................... 2 4 5 25 38 38
Typhus, tick-borne (Rky. Mt. spotted fever) 2 3 6 6
Rabies in animals ....................... 56 67 7 485 508 506
TABLE II. NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax: .................................... ...... Rabies in m an: ...................................... -
Botulism: ...................................... Rubella, Congenital Syndrome: La.- ................... 1
Leptospirosis: .................. ................... 2 Trichinosis: N.Y.Up-State-1 ........................... 6
Plague: ........................................... Typhus, marine: ..................................... 2
Psittacosis:* Cal.-1 ............... ............... 5
*Delayed Report: Texas 1 case 1967.






Morbidity and Mortality Weekly Report


Figure 1
MORTALITY IN 122 UNITED STATES CITIES


I EBIA1 R 17, 1968


ALL CAUSES AGE UNDER I


1,100-

1,000'
900

800

700

600
500
400

300


I .i.. I ... I. ...... .. .. I .. .... .. ... ... ... I .. "IJ'l. t. i i I I...
WEEK NO 4 it i .:. IZ i ~ 6 44 Q 4 8 ,' t 24 2 1. !, 40 44 46 !2 4 8 ;. i, :"-7- in :'.* !E 3' 44 P.4 :.2
WK ENDED 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 1 15 13 10 7 5 2 30 28
MONTH J F M A M J J A S 0 N D J F M A M J J A S 0 N D J F M A M J J A S O N 0
1966 1967 1968








FEBRUARY 17, 1968


Morbidity and Mortality Weekly Report


Figure 2
PNEUMONIA-INFLUENZA DEATHS IN 122 UNITED STATES CITIES
1967-1968


WEEK NO. 40 44 48 52 4 8 12 16 20 24 28 32 36 40 44 48 52 4 8 12 16 20 24 28 32 36 40 44 48 52 4 8 12 16 20 24 28 32 36
WK.ENDED 9 6 4 1 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 D J F M A MJ J A S O N 0 J F M A M J JA S O N D J F M A M J J A S
1965 11966 196611967 196711968


40 44 48 52 4 8 12 Ip 20 24 28 32 40 44 48 52 4 8 12 16 20 24 28 32 40 44 48 52 4 8 12 16 20 24 28 32 36
196711968 1967 1968 196711968


MOUNTAIN
8 CITIES


50

25


WEEK NO. 40 44 48 52 4 8 12 16 20 24 28 32
1967 11968


PACIFIC
16 CITIES


100



50h


anisal esll~l~tL ati1i 1es 1 us nalun ensio ical


E. S. CENTRAL
8 CITIES


250-

200-


l 150I




~,1,h 1h, hH,1Lh,,h.1h1,l,,1h,,l,1,h~l


MIDDLE ATLANTIC
20 CITIES












n i. In d ...In .Isral,,n n111 ..Is 1 h 1 ..


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


W.S.CENT AL SOUTH ATLANTIC
13 CITIES 150 12 CITIES



,I, h h100



=--- ---- -- 50


_____________________i___________________________ b t lud e ina...e..nse


WEEK NO. 40 44 48 52 4 3 12 16 20 24 28 32 40 44 48 52 4 t 12 16 20 24 28 32 40 44 48 52 4 8 12 16 20 24 28 32 36
196711968 196'11968 196711968


25

L-
0 WEEK NO.
w
E 125
z
100


75


50


25-









Morbidity and Mortality Weekly Report isBU RY 17, 1968




SUMMARY OF REPORTED CASES OF INFECTIOUS SYPHILIS


CASES OF PRIMARY AND SECONDARY SYPHII.S: BY REPORTING AREAS DECEMBER 1967 Ind DECEMBER 1966 PROVISIONAL DATA


Reporting Area

NEW ENGLAND.............
Maine ...............
New Haipshi r .........
Vermon t................
Massachusetts...........
Rhode Island..........
Connecticut..........

MIDDLE ATLANTIC..........
Upstate New York........
New York City...........
Pa. (Excl. Phila.)......
Philadelphia............
New Jersey..............

EAST NORTH CENTRAL.......
Ohio..................
Indiana .............
Downstate Illinois......
Chicago...............
Michigan...............
Wisconsin..............

WEST NORTH CENTRAL.......
Minnesota..............
Iowa..................
Missour ................
North Dakota............
South Dakota............
Nebrask .... ..........
Kansas..................

SOUTH ATLANTIC...........
Delaware ...............
Maryland..............
District I Columbia....
Virgin .............
West Virginia .......
North Carolina..........
South Carohlna..........


Cumulative
Di Smbe r Jnuar y-Decemhe
1l67 1s66 1967 1966


Cumulative
Reporting Area
r ** In I


. I I I


2
22
4
10

iOI
30S
19
160
31
34
61

284
59
28
13
82
102


14
8
5


2

12








IO
4






41
76
200


21?






308
25
189
13
29
2 ,

311


73

116
24



35
I:I
11




6

2

448

43
I0



3.
6 8
77
143


36i
7
9
5
210
35
95

3,599
300
2.094
266
317
602

3,262
639
202
149

1.259
25

382
63
45
143
4
37
08
52

. ,285
71

b64
1,9






i O.
",933


454
i
14
3
304
26
104

3,998
373
2.455
194
272
704

3.279
680
89
18]
1,026
1,212
91

404
34
73
145
4
37

60


517
5l)
;*b8


72
7,09
87>

1 ,891


EAST SOUTH CENTRAL .......
Kentucky...........
Tennessee ... ..
Alaban ..................
Mississippi..............

REST SOUTH CENTRAL........
Arkansas .............
Louisiana................
Oklahoma................
Texas....................

OUNTAIN....... .........
Montana .................
Idaho .............. ....
Wyoming..................
Colorado ...............
New Mexico.. .........
Arizona..................
Utah.................
Nevada .............. .....

PACIFIC........... ........
Washington..............
Oregon..................
California.............
Alaska ................
Hawaii............... ...

i,, ,


1,715
181
304
882
348

3,204
110
672
Ill
2,291

563
8
17
14
60
172
261
8
23

1,768
60
42
1,655
3
8


J,189
142
305
1,233
509

2,772
151
632
137
1,852

478
29
21

48
125
216



1,781



12
26
26


TERRITORIES............... 91 9 974 969
Puerto Ricn............ 19 934 942
Virgin Islands........... 40 27





Note: Cumulative Totals include revised and delayed reports
through previous months.


CASES OF PRIMARY AND SECONDARY SYPHILIS: By Reporting Areas January 1968 and January 1967 Provisional Data


January


Reporting Area


NEW ENGI.A.,
Maine....... ............
New Hampshire...........
Vermont..................
Massachusetts...........
Rhode Island...........
onnetiut.........

MIDDLE ATLANTIC..........
Upstate New York........
New York City...........
Pa. (Exc P ila.).......
Philadelphia...........
New Jersey..............

EAST NORTH CENTRAL.......
Ohio...................
Indiana ....... ........
Downstate Illinois......
Chicago ................
Michigan................
iscos. .in... ........

WEST NORTH CENTRAL.......
Minnesota..............
Iowa........... ..........
Misourl ..... ..........
North Dakota............
ou.th Dakota............
Nebrlskl. ..............
tIIna. .............. .

SOITH ATLANTIC...........
Delaware................
Maryland................
District of Columbia.....
Virg nia............ .....
West Virginia........
North Carolina...........
South Carolina...........
Ceorgia..................
Florida.. .... ...........


14

9

269
15
162
22
27
43

268
33
19
20
102
94


15


7


6


452

47
79
16

52
48
71
139


Cumulative


January


Reporting Area


January

Gr i 1 ..'


4 + I- I


%:r ...-T 'i ,T .-.L
Kentucky...............
Tennessee .............
Alabama.................
Mississippi..............

WEST SOUTH CENTRAL........
Arkansas................
Louisiana................
Oklahoma................
Texas....................

MOUNTAIN.................
Montana.... ... ...
Idaho.. .........


New Mxico...............


evada....................

PACIFIC...................
Washington ..............
Oregon...................


awaiC..................

ST- T

erteo Rico................
Vrgtn Ilandsc...........
Virgin Islands...........


13
22
51
26

268
10
62
6
190

35
1



10
20

3

114
4
I
108

1



67
59
8


155
4
4
1444

2



50
48
2


Cumulative
January
1968 I 1967


112
13
22
51
26

268
10
62
6
190

35



I
10
20

3

114
4

108





67
59
8


159
9
24
103
23

261
11
42
16
192

57

3

10
17
27



155

4
144





50
48
2


Note: Cumulative Totals include revised and delayed reports
through previous. months.


__ __ I___a _


'I





FEBRUARY 17, 1968


Morbidity and Mortality Weekly Report


CURRENT TRENDS
MEASLES California


In another step towards national eradication of mea-
sles, the California State Department of Public Health,
in cooperation with local health departments and private
physicians, conducted intensified measles immunization
campaigns in various California counties during 1966 and
1967. The effect of these activities, supported in part by
funds granted under the Immunization Assistance Act, is
seen in the state's markedly reduced number of reported
measles cases for 1967 (Table 1). While accounting for 53
percent of California's 1960 population, those counties.
conducting intensive measles immunization campaigns
(Table 2), reported less than 25 percent of the state's
total measles cases for 1967. Figure 3 shows the reported
number of measles cases by week for California's "mea-
sles year" 1965-66, 1966-67, and 1967-68.
During those 15 years prior to 1963 and introduction
of measles vaccine, the measles cases reported from
California varied from a high of 69.000 in 1955 to a low
of 16,500 in 1950. This wide variation in annual case re-
ports is most likely a reflection of the cyclical nature of
the disease. During 9 of the 15 pre-vaccine years, 40,000
or more cases were reported.
In 1967. only 5,279 cases of measles were reported
in the state. This is the lowest number of cases reported
since. 1929 when 4.420 cases were reported. The popula-
tion of California in 1929 was 5,531,000, and the present
population is estimated at 19,743,000; therefore, the re-
ported case rates for 1929 and 1967 are 80 and 27 per
100,000 population, respectively.


Table 1
Reported Cases of Measles in California
1963 1967

Year Number Measles Cases Reported
1963 23,060
1964 34,310
1965 13,890
1966 15,255
1967 5,279



Table 2
California Counties* Conducting Intensive Measles
Immunization Campaigns During 1966 and 1967

City of Berkeley Placer Siskiyou
El Dorado Plumas Sutter-Yuba
Imperial Sacramento Tehama
Kings San Diego Trinity
Los Angeles San Luis Obispo Tuolumne
Mariposa Santa Cruz Yolo
Nevada
'Includes the City of Berkeley


(Reported by Philip K. Condit, M.D., Chief, Communicable
Diseases, and Mary J. Trudeau, M.D., Head, California
Immunization Project, California State Department of
Public Health.)


Figure 3
MEASLES BY WEEK OF REPORT CALIFORNIA
1965-66, 1966-67, AND 1967-68


1965-66 -


OCT NOV. DEC. JAN. FEB. MAR. APR. MAY JUNE JULY AUG. SEPT
WEEK NUMBER AND MONTH





Morbidity and Mortality Weekly Report


MEASLES New York City


In New York City during the 5-month period starting
in September 1967 and continuing ilrou.ii January 1968 of
the current measles year*, 117 cases of measles were
reported. This is a 95 percent reduction from the 3,430
cases reported during the comparable 5-month period of
the preceding high measles year (September 1965 through
January 1966).
A steady reduction in the number of measles cases
reported has been noted during comparable high and low
measles years since 1961 (Table 3).

*Mceaslcs year for New York City begins in Septemb-er of the
calendar year and continues through August of the sucm-ieding
vear.


Table 3
Comparison of High and Low Measles Years
1961 1967

No. of No. of
High Measles Years C Low Measles Years
Cases Cases
Sept. 1961-Aug. 1962 30,875 Sept. 1962-Aug. 1963 :.I.M;
Sept. 1963-Aug. 1964 17,081 Sept. 1964-Aug. 1965 C.r1vi
Sept. 1965-Aug. 1966 10,070 Sept. 1966-Aug. 1967 563

(Reported by Mr. Louis Pincus, Assistant Director, Bureau
of Records and Statistics, and Vincent Guinee, M.D., Di-
rector. Bureau of Preventable Diseases, New York City
Department of Health: and an EIS Officer.)


TRENDS IN MENINGOCOCCAL DISEASE 1968


Meningococcal infections continue to be reported with
greater frequency in early weeks of 1968 than for corre-
sponding weeks in 1967. Through the seventh week of
1968, a total of 574 cases has been reported to the NCDC.
This represents an increase of 29 percent when compared
to the 407 cases reported through the seventh week in
1967 (Table 4). Of the 574 cases. 95 percent were civilian.
The South Atlantic and West South Central geographic di-
visions account for over 40 percent of the cases.


(Reported by Bacterial Diseases Section. NCDC.)


Table 4
Meningococcal Infections
First 7 Weeks, 1967 and 1968
Week 1967 1968
Number Civilian Military Total Civilian Military Total
1 41 1 42 39 1 40
2 68 8 76 67 0 67
3 68 5 73 82 3 85
4 41 3 44 89 10 99
5 47 4 51 111 10 121
6 55 3 58 81 1 82
7 61 2 63 76 4 80
381 26 407 545 29 574


EPIDEMIOLOGIC NOTES AND REPORTS
ASEPTIC MENINGITIS Oahu, Hawaii


An epidemic of aseptic meningitis with 174 cases
and no deaths occurred from January to September 1967
on the island of Oahu, Hawaii. Spread occurred throughout
Oahu by contiguous areas. Of the 174 cases, 71 (41 percent)
occurred during May and June (Figure 4).
From 98 of the 174 patients, one or more specimens
(throat swabs, rectal swabs, spinal fluid. or paired sera)
were obtained; in 37 cases a virus was isolated from at
least one of these specimens (Table 5 and 6). An additional
23 cases showed a fourfold or greater rise in antibody
titer, although no virus was isolated. Of these 60 cases
identified by virus isolation or antibody rise, 44 were
associated with ECHO 9'. a variant of ECHO virus Type
9. Another five cases were associated with ECHO virus
Type 6,one with ECHO virus Type 4, two with Coxsackie
Sirus. and eight with mumps virus. Although the ECHO


Figure 4
ASEPTIC MENINGITIS
OAHU, HAWAII
JANUARY-SEPTEMBER 1967


M OTHER CASES
E ECHO 9' CASES


MONTH


FEBRUARY 17, 1968








Table 5
Cases by Type of Virus

Virus Antibody
Category Total
Isolated Rise Only

Number of Cases 174
Cases from whom
Specimens obtained 98
Cases by Type of Virus:
ECHO 9 44 32 12
ECHO 6 5 4 1
ECHO 4 1 0 1
Coxsackie A 1 1 0
Coxsackie B 1 0 1
Mumps 8 0 8
All Viruses 60 37 23


Table 6
Identification of Virus by Source of Specimen

Source of Specimen CSF* Throat Rectal Paired Sera

Specimens submitted 65 71 69 37
Positive for:
ECHO 9 14 18 18 23
ECHO 6 2 0 3 1
ECHO 4 0 0 0 1
Goxsackie A -0 0 1 0
Coxsackie B 0 0 0 1
Mumps 0 0 0 8

All Viruses 16 18 22 34
*Cerebral Spinal Fluid

virus Type 9' has not been previously identified in Hawaii,
it has been described in other epidemics.
Clinical data were obtained from hospital records for
40 of the 44 cases associated with ECHO virus Type 9'.
Of these 40 patients, 38 had aseptic meningitis; two had
fever and exanthem without meningeal signs, but lumbar
punctures were not performed. The medium duration of
symptoms prior to hospital admission was 24 hours, with
a range up to 7 days. The illness often began with vague
respiratory or gastrointestinal symptoms of mild diarrhea


or abdominal pain which lasted for 1 to 5 days. In most
cases, the first distinctive symptoms then occurred -
simultaneous fever, headache, vomiting, and mild nuchal
stiffness lasting 1 to 2 days with symptoms tappering off
over 3 to 8 days. The triad of headache, vomiting, and
fever were consistent and dependable for diagnosis. In
infants too young to complain of headache, lethargy was
common. No deaths or neurologic complications occurred.
Approximately 21 of the 44 patients with laboratory evi-
dence of infection with ECHO virus 9' gave a history of
other family members with meningitis and significant febrile
illness.
Analysis of ages for 168 of the 174 patients showed
that 38 patients were age 1 year or less; 50 were age 2 to
5 years; 47 were age 6 to 10 years; 30 were age 11 or over.
Of the 174 patients, 125 were males (Table 7).


Table 7
Cases per 100,000 Population by Age and Sex

Number of Cases per
Age in Years 100,000 Population
Males Females

1 or less 126 108
2-5 100 43
6-10 106 23
11 or over 9 3


The age and sex distribution of cases in this epidemic
is characteristic ofECHO9 epidemics reported elsewhere.
The prolonged duration of the epidemic. frequent occurrence
of family illness, and extension to contiguous geographic
areas, are consistent with the direct contact transmission
pattern of other epidemics of aseptic meningitis.

(Reported by A. Osher, M.D., Chief Resident, Kauikeolani
Children's Hospital, Honolulu, Hawaii; A. Oda, B.S.,
Virology Laboratory and I. D. Hirschy, M.D., Executive
Officer, Division of Communicable Disease, Hawaii De-
partment of Health; R. V. Platou, M.D., Professor of Pe-
diatrics, University of Hawaii Medical School; and an EIS
Officer.)


INTERNATIONAL NOTES
QUARANTINE MEASURES


Additional Immunization Information for International
Travel 1967-68 edition Public Health Service
Publication No. 384

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


Page 85
Under New Haven. Connecticut, Clinic Hours.
Delete: Second and Fourth Tuesday, 11 a.m., by appoint-
ment only
Insert: Second and fourth Thursday
(Continued on page 68)


FEBRUARY 17, 1968


Morbidity and Mortality Weekly Report






64 Morbidity and Mortality Weekly Report


TABLE III. (ASIS OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED
FEBRUARY 17, 1968 AND FEBRUARY 18, 1967 (7th WEEK)


ENCEPHALITIS HEPATITIS
ASEPTIC 1 Primary
AREA MENINGITIS 1ncuding Infectious Serum Infectious
unsp. cases


UNITED STATES... 28 27 17 20 8 60 810 866 29

NEW ENGLAND.......... 2 3 1 1 1 33 44 -
Maine.............. *6 3
New Hampshire ......
Vermont .............- 1
Massachusetts ...... 3 1 17 19
Rhode Island....... I 1 4
Connecticut........ 1 -- 1 9 17

MIDDLE ATLANTIC...... 3 I 4 2 1 19 91 106 11
New York City .... 1 2 12 30 35 1
New York, up-State, 1 *5 22 18 *6
New Jersey.......... 1 1 2 15 29
Pennsylvania....... 1 I 1 1 24 24 4

EAST NORTH CENTRAL... 2 2 5 10 2 3 125 142 1
Ohio ............... 1 3 7 38 25
Indiana............ 1 I 2 13
Illinois........... 1 1 1 I 42 50 1
Michigan ........... 1 1 1 1 35 44
Wisconsin.......... 1 1 8 10

WEST NORTH CENTRAL... 1 1 48 35 3
Minnesota.......... ... 1 12 8
Iowa............... 1 15 6 2
Missouri........... 1 9 17
North Dakota....... 2
ouith Da'ota ....
Nebraska ...........
Kansas ............. 1

SOUTH ATlANTIC ......6 i 95 113 5
Delaware............. 2 4 3
Maryland............ 7 -- 1 12 33
Dist. of Columbia.. -
Virginia..........-. 6 25 1
West Virginia...... I 5-
North Carolina..... 1 6 14 3
South Carolina ....
Georgia....... .....- 3 5 16
Florida............. 2 3 17 16

EAST SOUTH CENTRAL... 6 4 -2 92 8 84
Kentucky........... 2 39
Tennessee.......... 2 2 2 20-
Alabama. .......... I -- -) I
Mississippi........ I 2 1 14

WEST SOUTH CENTRAL... 2 I 8 116
Arkansas........... 15
Louisiana.......... 1 15 5
Oklahoma .......... 12 3
Texas............. 2 3 3

MOUNTAIN................ 1 4-- 6 6
Montana ............- 4
Idaho............... 8
Wyomi ng............ 2
Colorado........... 13
New Mexico.......... 12
Arizona............ 1 7 11
Utah............... 10
Nevada ............- 2

PACIFIC.............. 6 9 4- 1 2I 00 164 8
Washington......... .. 4 7 2
Oregon............. I -- 7 22
California......... 5 5 11 i 13 2
Alaska ............... -
Hawaii............. 1 4

Pu l 3, Ri -........... 3 33 7 35

* Dcl-yed Rrport : lhvpltil n S Hp. tills In.cliu: M1in
*l~i Flr : N.Y. tp-St 5 t 1 12- I, I1 .- 1 947







Morbidity and Mortality Weekly Report 6


TABLE 111. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

FEBRUARY 17, 1968 AND FEBRUARY 18, 1967 (7th WEEK) CONTINUED



MEASLES (Rubeola) MENINGOCOCCAL INFECTIONS, MUMPS POLIOMYELITIS RUBELLA
TOTAL
AREA Cumulative Cumulative Total Paralytic
Cum.
1968 1968 1967 1968 1968 1967 1968 1968 1968 1968 1968
UNITED STATES... 537 3,539 13,292 80 574 410 4,836 986

NEW ENGLAND.......... 16 152 174 2 30 13 883 189
Maine.............. 7 8 2 1 *38 *6
New Hampshire....... 1 16 48 2 19 5
Vermont............. 5 16 1 67 -
Massachusetts...... 12 83 64 1 13 5 418 77
Rhode Island....... 1 20 2 *132 18
Connecticut........ 3 40 18 1 10 7 209 83

MIDDLE ATLANTIC...... 91 427 506 14 73 55 195 165
New York City...... 14 69 68 5 17 10 69 49
New York, Up-State. 45 232 121 4 18 NN 12
New Jersey......... 24 83 145 4 23 20 126 102
Pennsylvania....... 8 43 172 5 29 7 NN 2

EAST NORTH CENTRAL... 145 976 1,149 9 61 40 1,302 179
Ohio................ 3 91 163 1 15 13 33 18
Indiana............ 4 117 156 9 5 51 7
Illinois........... 79 475 130 3 11 8 241 30
Michigan............ 11 61 255 4 20 10 424 55
Wisconsin.......... 48 232 445 1 6 4 553 69

WEST NORTH CENTRAL... 21 96 470 2 28 21 614 83
,Minnesota........... 2 2 17 5 5 33 10
) Iowa............... 5 33 106 2 2 491 51
Missouri........... 4 15 4 5 4 -
North Dakota....... 11 38 229 1 29 4
South takota....... 3 15 3 3 NN -
Nebraska ............ 9 88 1 5 17 -
Kansas............. 3 7 NN 2 12 1 40 18

SOUTH ATLANTIC....... 46 277 1,357 17 130 80 293 86
Delaware........... 13 4 18 -
Maryland............ 8 20 26 2 9 11 22 7
Dist. of Columbia.. 4 4 3 13- --
Virginia........... 2 42 342 2 12 9 60 64
West Virginia...... 7 71 334 3 10 97 15
North Carolina..... 9 33 295 3 28 15 NN -
South Carolina..... 5 12 12 3 22 4 7 -
Georgia............ 2 9 3 17 10 -
Florida............ 15 93 322 4 36 17 76 -

EAST SOUTH CENTRAL... 13 69 1,645 10 44 41 162 40
Kentucky............ 10 25 556 4 12 13 15
Tennessee.......... 15 583 2 14 19 120 25
Alabama............ 1 15 298 3 7 4 24 -
Mississippi........ 2 14 208 1 11 5 18 -

WEST SOUTH CENTRAL... 133 818 4,614 16 143 72 360 -- 51
Arkansas........... 875 3 7 1 2 -
Louisiana.......... 1 23 3 36 30 4 4
Oklahoma............ 36 1,221 24 2 1 -
Texas............... 133 781 2,495 10 76 39 353 47

MOUNTAIN ............. 19 139 854 1 6 10 163 48
Montana............ 2 9 153 1 44 6
Idaho............... 6 97 2 1 8
Wyoming............ 2 24 12 2 -
Colorado............ 3 45 160 1 2 3 41 5
New Mexico........ 7 23 131 3 17 -- 4
Arizona............ 5 29 151 1 1 47 31
Utah............... 1 31 1 4 2
Nevada............. 2 119 -- I

PACIFIC.............. 53 585 2,523 9 59 78 864 145
Washington.......... 20 186 1,396 1 9 2 319 42
Oregon............. 16 148 345 2 5 7 25 17
California.......... 16 231 701 5 43 67 483 74
Alaska.............. 55 2 27 8
Hawaii.............. 1 20 26 1 2 10 4

Puerto Rico.......... 5 42 349 3 3 4 5 -

* Delayed Reports: Mumps: Maine 24, Rhode Island 57
Rubella: Maine 1








66 1Morbidity and Mortality Weekly Report


TABLE II. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

FEBRUARY 17, 1%8 AND FEBRUARY 18, 1967 (7th WEEK) CONTINUED



STREPTOCOCCAL TYPHUS FEVER
SORE THROAT & TETANUS TILAREMIA TYPHOID TICK-BORNE RABIES IN
AREA SCARLET FEVER (Rky. Mt. Spotted) ANIMALS
Cume. CurT. Cun. Cum. Cum.

I'ITED STAES... 11,127 3 13 12 2 25 3 56 485

NEW ESNGAND........ 2,023 2 7
Mlin. ............ *73 7

............
1 b s t ...... 312 1
Rhde i lad....... *256 -
(31mw t -u t i ........ 1,369

MIDDLE ATIANTIC...... 368 2 5 5 3
Si Yrrk City...... 26 2 3 4
New Ynrk, Up-StIat,. 282 2 1 2
New Jersey......... NN-
Pennsylvania....... 60 I

EAST NORTH CENTRAL... 1,247 1 4 2 29
Ohio ......... .. 143 4 1 15
Indiana ..... ...... .. 148 6
Illinois........... 333 1 1 4
Michian.......... 397 1 2
is onsin.......... 226 2

WEST NORTH CENTRAl.... 450 1 4 2- 18 95
Minnes ta.......... 41 8 25
I owa ............... 123 -- 1 22
M' ss uri........... 12 1 2 6 24
North Dakota...... 235 2 16
urh Dakot ........ 27 1 -
Nebraska ....... 6 4
Kansas............. 6 1 4

SOUTH ATLANTIC....... 1,245 1 1 3 2 4 2 10 58
Delaware ........... 10 -
Maryland........... 184 1
Dist. of Columbia.. 9 -
Virginia............ 409 1 1 1 1 2 6 32
West Virginia...... 228 6
North Carolina..... 12 2 1 1 2 2
South Carolina..... 25 -
Georgia .......... 27 1 1 4
Florida............ 341 1 14

EAST SOUTH CENTRAL... 1,457 1 2 4 1 8 167
Kentucky........... 139 8 67
Tennessee.......... 1,145 2 4 92
Alabama............. 103 1 8
Mississippi......... 70 1

WEST SOUTH CENTRAL.... 796 -1 1 14 95
Arkansas........... 11 6
Louisiana ........ 1 I 6 11
Oklahoma........... 28 31
Texas.............. 756 1 7 47

MOUNTAIN............. 1,598 2 1 6
Montana........... 71
Idaho............. .. 161 -
Wyoming ............ *311 *- -
Colorado.......... 545 -
New Mexico......... 241 1
Arizona............. 167 1 5
Utah............... 102 1 -
Nevada.......... -

PACIFIC.............. 1,943 2 3 3 25
Washington......... 514 -
Oregon............. 195 -
California......... 1,098 2 3 3 25
Alaska ............. 51
Hawaii.............. 85 -

Puerto Rico.......... 9 2

* Delayed Reports: SST: Maine 55, Rhode Island 143, Wyoming 170
Rabies in animals: Wyoming I case 1967






Morbidity and Mortality Weekly Report


TABLE IV. DEATHS IN 122 UNITED STATES CITIES FOR WEEK ENDED FEBRUARY 17, 1968


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

All Causes Pneumonia Under All Causes Pneumonia Under
Area d Infd yearI Can
Area All 65 years and 1 year Area All 65 years and I yea,
Ages and over Influena All Ages and over Influenza I 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.-----
P1ttsburgh, 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.--------


775
248
41
40
30
51
41
26
19
63
64
15
63
19
55

3,328
46
33
153
44
38
53
64
105
1,729
41
421
200
62
100
33
39
47
51
34
35

2,828
70
41
829
183
239
138
99
365
43
55
49
39
49
178
44
115
48
29
30
125
60

796
36
35
34
145
29
107
81
216
71
42


489
153
28
26
21
38
28
15
11
39
34
10
39
11
36

1,996
28
23
86
25
26
30
32
53
1,020
23
254
110
39
78
21
31
33
38
25
21

1,639
42
26
462
116
131
83
60
198
30
29
29
24
38
106
22
70
34
16
16
74
33

508
21
25
17
93
23
66
52
119
59
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.----------"


1,278
146
277
55
71
97
57
89
57
113
85
201
30

653
98
72
42
135
143
51
43
69

1,346
63
43
34
166
56
82
245
54
192
101
136
106
68

511
53
42
116
15
117
29
62
77

1,543
24
56
25
57
71
389
123
37
120
72
98
197
38
114
61
61


Total 13,058 7,658 643 618

Cumulative Totals
including reported corrections for previous weeks

All Causes, All Ages -------------------------102,129
All Causes, Age 65 and over------------------- 61,575
Pneumonia and Influenza, All Ages ------------ 6,257
All Causes, Under 1 Year of Age--------------- 4,339


Week No.
7






Morbidity and Mortali


QUARANTINE MEASURES
((riiniu.'Ir froan paiyf/ 63)

Page 89
Under NeIx Orleans. Louisiana. Brow ne-McHardy Clinic

Delete: Graxier Street Division, 630 Gravier Street 70130
Insert: 2223 Carondelet Street 70130


Page 94
Hinder Oklahoma.

Insert: City Enid. Oklahoma 73701
Center Garfield County Health Department
211 1 Lahoma Road
Telephone 233-0650
Clinic Hours Tuesday, I p.m. to 4 p.m.
Fee No


Page 97
Under Texas.

Insert: City Houston. Texas
Center City of Houston Health Department
1115 N. MacGregor
Telephone 222-4201
Clinic Hours Tuesday
Fee No


Page 97
Under Texas,

Insert: City Houston. Texas
Center Harris countyy Health Department
Clinic Hours Monday and Friday, 2 p.m.. by ap-
pointment
Fee Yes


Page 97
Under Dallas, Texas. Clinic Hours, and under fee

Delete: Friday. 1 p.m. to 4 p.m.
Insert: Tuesday and Friday. 1 p.m. to 4 p.m.

Delete: No
Insert: Yes


Page 98
Under Texas,

Insert: City San Antonio. Texas
Center Minter Clinic
1702 Nix Professional Building
414 Navarro Street
Telephone CA 2 1317
Clinic Hours By appointment only
Fee Yes


Page 98
Under Seattle, Washington, Clinic Hours

Delete: Wednesday, 10 a.m. to 11 a.m.
Insert: Friday, 2:30 p.m. to 3 p.m.


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ty Weekly Report FEBRUARY 17, 1968



THE MORBIDITY AND MORTALITY WEEKLY REPORT, W r. a ICIuL C. *
TION OF 17,000. IS '.,ALI.L- E THE NATIONAL .:OMM...N CABLE
DISEASE CENTER. AITL. N OA a. .
DIRECTOR, NATIONAL COMMUNICABLE DISEASE CENTER 0
C.A.'Do E'.E:ER aDO 5
CHIEF. EPIDEMIOLOGY PROGRAM A LI. APGMUlR M D
ACTING CHIEF. STATISTICS SECTION IDA L. iMaN M.S.
EDITOR MICHAEL 6 GREGG. MO 9 N9

IN ADDITION TO THE ESTABLISHED 'i FDOuFi .' I a REPORTING -1
*A..r.e. L ., crEJC. : Tl T THE r.r *O A L COMMur C eLi DISE AS
.7 rT a I*e ouL'G *r. .UN IT OF .'TERM .ES T BR f. A CR CaSt A ) lE
'-N.- I,'la.':' WHICH ARE OF CURRE'PT iNTFl EET 10 'EALI -
*.'iF .L .5 ND WHICH ARE DIRECTLY RELarTEV 1I THrE CONTROLL
OF COMMUNICABLE DISEASES. SUCH ;COMM ..'. l-'N 50nu.D .BE E m
ADDRESSED TO:
NATIONAL :OMMU'; ABLt DISEASE CENTER
ATLANTA. EC Ra ...A 03).
ATTN: THE EDITOR
MORBIDITY AND 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 DEPARTMENTS THE REPORTING WEEK CONCLuDES
ON SATURDAY COMPILED DATA ON A NATIONAL BASIS ARE RELEASED.
ON THE SUCCEEDING FRIDAY.