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:
AA00010654:00150

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. 17, No. 11







Week Ending
March 16, 1968


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


PUBLIC HEALTH SERVICE


BUREAU OF DISEASE PREVENTION AND ENVIRONMENTAL CONTROL


EPIDEMIOLOGIC NOTES AND REPORTS
MALARIA OUTBREAK Ceylon

Since early 1967, Ceylon (1966 estimated population
11,784,000) has experienced progressively higher nu D A LI
of malaria cases each month. In late 1967, the
reached epidemic proportions.
Prior to 1967. the efforts to eradicate ari from
SCeylon had been among the most productive of tional
programs that collectively make up the world i alari
eradication program. A long history of endemi ~ e e
epidemic malaria led to control efforts beginni -11.
These efforts were periodically enlarged especi a
the 1934-35 epidemic which afflicted 1.5 million e DOG
and caused perhaps 80,000 deaths. A comprehensive p


CONTENTS
International Notes
Malaria Outbreak Ceylon . ... ... 93
Quarantine Measures .................. .... 100
mmary of Reported Cases of Infectious Syphilis ...... 95
NIZt Trends
. .. . . 95
oIsis Beds in Hospitals and Sanatoria 1967 94


'ram :t national control of malaria was launched in
1945. Tti control program and the subsequent Anti-
Malari a 'paign (AMC) were successful in controlling
mala Yi in nearly achieving eradication during the years
o0 read DDT spraying, up to 1963. In April 1963,
K DDT coverage was withdrawn except for half-mile
(Continued on page 94)


TABLE I. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Totals include revised and delayed reports)
llth WEEK ENDED MEDIAN CUMULATIVE, FIRST 11 WEEKS
MEDIAN
DISEASE MEDIAN
March 16, MARCH 18, 1963 1967 MEDIAN
1968 1967 1968 1967 1963 1967
Aseptic meningitis ...................... 33 40 34 298 307 307
Brucellosis ............................ 2 4 6 12 40 47
Diphtheria.............................. 4 29 28 42
Encephalitis, primary:
Arthropod-borne & unspecified ........... 11 22 -158 238 -
Encephalitis, post-infectious ............. 8 25 92 131
Hepatitis, serum ........................ 81 36 859 744 397 9.045
Hepatitis, infectious .................... 863 822 9,022 8,648
Malaria ................................ 26 47 2 491 434 23
Measles(rubeola) ....................... 688 2,834 11,535 6,245 24,507 94,594
Meningococcal infections, total ........... 85 60 80 920 662 667
Civilian .............................. 78 59 -- 841 614 -
Military ............................... 7 1 79 48 -
Mumps ................................. 5,666 55,618 -
Poliomyelitis, total ..................... 2 1 3 11 3 5
Paralytic ............................. 2 1 3 11 3 4
Rubella (German measles) ............... 2,376 1,531 10,550 10,586 -
Streptococcal sore throat & scarlet fever.... 12,010 13,302 13,302 126,750 134,347 122.627
Tetanus ............................... 2 4 2 22 33 37
Tularemia .............................. 1 2 3 16 25 47
Typhoid fever .......................... 4 1 2 42 56 63
Typhus, tick-borne (Rky. Mt. spotted fever) .- 3 8 6
Rabies in animals ....................... 54 84 93 768 863 823

TABLE II. NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax: .......................................... 1 Rabies in man: ...................................... -
Botulism: ... ...................................... Rubella, Congenital Syndrome:......................... 3
L eptospirosis: ...................................... 3 T richinosis: ........................... ... ......... 6
Plague: ..................................... ...... Typhus, marine: ........................... ......... 2
Psittacosis: Tenn.-l ................................ 7
*Delayed Reports: Texas 2 cases 1967







Morbidity and Mortality Weekly Report


MALARIA (.'ontinr'ic from frouilt pare)


lharrier- around jungle areai-: een this partial cinerage
wvar disconinuted in \pril 19l4.
\lalria s-urteill since uactixitie- ha\et been oxtonsi\-
with Annual Blood Eximhintion iRati of up to 1.5 p*"rce t.
The reduced incid ienc of malaria i- i\ idrnt in the niumler
of malarria cae-e doterited annual from I }.r through 1966
(Tlable 1) The effectikone-s of attack rtmaslur t* on Pi.-
midiufiti aira eo peciiall., is- e idlent in the clr --.ification
of i-es caiiusied by this parasire (Table 2). The 1965 caoc
rof indigenous P. viiiar nmalaria. the first in ('elon in 35
months, as intensi ely in.estigaterd. but no additional
case- w ere found. In January 1966. t\\io more cases- wero
found in a \illage 20 mile- a:\a from the original case:
later that year. four additional cases %oer found.

Table 1
Confirmed Cases of Malaria in Ceylon, 1958-1966


Slides
Examined(

638 ,hh6
305.,74 0
596.033
78T ,307
1.02Ah.(22
949,9191
1,213.133
1,247,0S
1,455,259


P.


7l1

376
76
14
8
13
19
27


P.
falci-


251
4,.5(i



I3

63i
lh9
161


P.
mala-
riae

3



20



73
100
310


Mixed
Infec-
tions

2
6


Table 2
Classification of Plasmodium vivax Malaria Cases,
1962-1966

Indigenous Imported Total
Year Cases Cases Cases
1962 10 4 14
1963 0 h
1964 0 13 13
1965 1 1S 19
1966 6 21 27

In 1967 additional cases of P. victva malaria were re-
ported in the same central region of the country, and in
October. P. viCax malaria xwas present in a gemn mining
area which attracted many transient gem miners. In spite
of efforts to control the disease and to restrict population
movements in and out of the gem mining area, P. rivax
infections continued to increase in 1967 and also to spread
extensively to other parts of Ceylon. Quarterly case counts


for 1967 (Table 3) demonstrated thei increa-ed incidence of
PI. riars malaria. All but nine of these 3,026 P. ricav
inforcionr we\re indigenous.

Table 3
Confirmed Cases of Malaria 1967*

P'. P. fl- P.ma- Mixed Total
Quarter rii ar ciparl r ltaiie Infections Cases

First 26 17 16i 11
Second 93 78 37 "2(1
Third 6 9 76 385 1 b 01
.' I.... t .I- _'- '-.

Total 3,026 191 24Th 1 41.;

* 1 totl a1 1.15-3,9 I S lid, -r c r, examined in 19617.

In the first 2 months of 196h. the malaria incidence
continued to rise (Table 4). MI.L.n,'.i the number of P.
fa lciparum cases is still small, the focal outbreak of this
disease in January and February is now potentially very
dangerous Iecause the \MC is already steerely stressed
by their efforts to control the I'. cirax malaria epidemic.
As in most epidemic situations the actual number of cases
far exceeds the number of diagnostically confirmed cases.
A feature of this epidemic has been the low mortality. So
far only two deaths have been reported. This seems to in-
dicate that action has been prompt and effective. Surv\il-
lance activities continue at a high level and the Central
Laboratory in Colombo-which is in the non-malaria. un-
affected area of Ceylon-has been enlarged. and two region-
al laboratories have been opened. In 196S. 24 spraying
units were added to the 1h units in operation at the end
of 1967. In addition, the MC( has prepared plans for spray-
ing residual insecticide to all houses in the malarial areas.
With the end of the peak transmission season (in much of
the affected area) in March. the incidence of malaria may
soon be reduced. However, it is fully recognized that sub-
stantial long term efforts \ ill be required to regain control
of malaria in Ceylon.

Table 4
Confirmed Cases of Malaria
January and February 1968

Slides P. P. P. Total
Month Examined vicar falciparum mratariae Cases


January 169132 69 .1
February 169,105 42,056


88 4
104 1
104 1


16,943
42,161


(Report prepared with the assistance of the Department of
Health Services, Colombo, Ceylon, and by two malariaa
Eradication Program Epidemiologists, N'I)C.)


CURRENT TRENDS
TUBERCULOSIS BEDS IN HOSPITALS AND SANATORIA, 1967


A biennial survey* of the major hospital resources
available in the United States for the care of tuberculosis
l uIt rrul sis ieds in hospitals aind sanatoria, June 30, 1967,
NCDC( ), Tuthrc-ulos i Proalrnr.


patients shows that on June 30, 1967, there were 4 1.111.:
beds assigned for tuberculosis in 348 hospitals (Table 5).
On that day 30,028 of these beds were occupied. In-
cluded in the survey were 267 non-federal hospitals and


MARCH 16, 1968







Morbidity and Mortalit'


81 federal facilities with tuberculosis patients, and six
non-federal hospitals in Puerto Rico and the Virgin
Islands.
Table 5
Hospital Facilities for the Care of Tuberculosis
United States, June 30, 1967

Number of TB Beds

Area Number of Rated Beds
Hospitals Capacity Occupied

Total United States 348 43,069 30,028
Non-Federal' 267 37,208 25,172
Federal 81 5,861 4,856
Puerto Rico and
the Virgin Islands 6 1.867 1,278

\With 10 or more tuberculosis beds.

Only non-federal hospitals with a complement of
10 or more tuberculosis beds were included in the sur-


MARCH 16, 1968


SUMMARY OF REPORTED CASES OF INFECTIOUS SYPHILIS

CASES OF PRIMARY AND SECONDARY SYPHILIS: BY REPORTING AREAS FEBRUARY 1968 AND FEBRUARY 1967 PROVISIONAL DATA
Cumulative Cumulative
Reporting Area February January-February Reporting Area February January-February
1968 1967 1968 1967 1968 1967 1968 1967
NEW ENGLAND ........... 42 36 65 69 EAST SOUTH CENTRAL........ 111 163 223 322
Maine .....- ............... Kentucky................. 8 7 21 16
New Hampshire............ 2 3 Tennessee............... 29 18 51 42
Vermont................. 2 Alabama ................. 48 89 99 192
Massachusetts........... 34 21 48 40 Mississippi.............. 26 49 52 72
Rhode Island............. 4 2 4 4
Connecticut.... ....... 4 11 13 20 WEST SOUTH CENTRAL........ 280 244 548 505
Arkansas................. 11 11 21 22
MIDDLE ATLANTIC......... 267 243 536 569 Louisiana................ 62 55 124 97
Upstate New York......... 11 16 26 38 Oklahoma............... 8 8 14 24
New York City....... 175 147 337 328 Texas................... 199 170 389 362
Pa. (Excl. Phila.) ... 24 14 46 54
Philadelphia............ 28 24 55 44 MOUNTAIN ................ 53 46 88 103
New Jersey............... 29 42 72 105 Montana................ I
Idaho ................... 2 4 2 7
EAST NORTH CENTRAL........ 276 218 544 464 Wyoming.............. -
Ohio. ................... 57 49 90 99 Colorado................ 10 2 11 12
Indiana.................. 27 7 46 12 New Mexico............... 11 15 21 32
Donstat Illinois...... 15 10 35 22 Arizona.................. 26 24 46 51
Chicago................ 89 58 191 134 Utah...............
Michigan................ 86 93 180 192 Nevada.............. 4 -
Wisconsin............. 2 1 2 5
PACIFIC ................... 133 142 247 297
WEST NORTH CENTRAL.... 29 17 44 43 Washington ............... 2 7 6 1
Minnesota...... .. 6 5 6 7 Oregon .................. 5 3 6 7
Iowa................... 2 1 2 4 California............... 125 131 233 275
Missour ................. 16 6 23 14 Alaska............... 1
North ota............ Hawaii .................. 1 1 2 3
South Dakota........ 3 2 4 7
Nebr ska................. 2 3 8 6 U. S. TOTAL............... 1,627 1,622 3.183 31.90
Kansas................. 1 5
TERRITORIES............ 82 72 149 122
SOUTH ATLANTIC............ 436 513 888 1,018 Puerto Rico.............. 73 69 132 117
Delaware................. 5 4 5 8 Virgin Islands........... 9 3 17 5
Maryland............. 47 47 89 113
District of Columbia..... 49 56 128 103
Virginia.............. 17 27 33 51
West Virginia............ 8 8 2
North Carolina........... 65 63 117 130 Note: Cumulative Totals include revised and delayed reports
South Carolina.......... 49 67 97 142 through previous months.
Georgia................. 62 83 133 169
Florida.................. 139 166 278 300


CURRENT TRENDS
MEASLES


A total of 672 cases of measles was reported to
NCDC for the week ending March 16. 1968. This is 24
percent of the cases reported for the comparable week in
1967. To date, a total of 6.245 cases has been reported


for the first 11 weeks of 1968; this is 25 percent, 8.3
percent, and 6.6 percent of the cases reported for the
corresponding periods in the years 1967, 1966, and 1965.
respectively. (Continued on page 100)


y Weekly Report 95


vey. Federal hospitals in the survey represent all avail-
able tuberculosis beds reported by the United States
Public Health Service, Division of Indian Health, De-
partment of the Air Force, Department of the Army, De-
partment of the Navy, and the Veterans Administration.
In the past 4 years, there has been a reduction of
47 non-federal and 14 federal hospitals providing care
for tuberculosis patients. Some of the hospitals that dis-
continued services for tuberculosis patients were closed
in their entirety; others converted their facilities to
chronic, mental, other chest diseases, and treatment of
alcoholics.
Use of tuberculosis hospital beds has declined
steadily since 1948. Utilization of tuberculosis beds in
non-federal hospitals was 71 percent in 1967.


(Reported by Statistical Services Unit, Tuberculosis
Program, NCDC.)








96 Morbidity and Mortality Weekly Report


TABLE III. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED
MARCH 16, 198 AND MARCH 18, 1967 (llth WEEK)


ENCEPHALITIS HEPATITIS
ASEPTIC NPi I.OSIS DIPHTHERIA Primary
AREA MENINGITIS including Infectious Serum Infectious
unsp. cases
1968 1967 1968 1968 1968 1967 1968 1968 1968 1967 1968
UNITED STATES... 33 40 2 11 22 8 81 863 822 26

NEW ENGLAND.......... 2 1 1 5 38 33 1
Maine.............. 3 -
New Hampshire....... --- 1
Vermont.............. -
Massachusetts...... 1 1 19 9
Rhode Island....... -1 1 7 9 1
Connecticut........ 1 4 11 11

MIDDLE ATLANTIC...... 2 4 4 3 19 125 134 8
New York City...... 2 3 2 14 32 45
New York, up-State. *- 1 1 2 *21 31 1
New Jersey.......... 2 3 *28 22 5
Pennsylvania........ 1 1 44 36 2

EAST NORTH CENTRAL... 6 2 2 7 2 159 160
Ohio................ 1 1 2 6 42 43
Indiana............ I 15 10 -
Illinois........... 2 1 55 52
Michigan ........... 2 -- 1 2 29 36
Wisconsin........... 18 19

WEST NORTH CENTRAL... 1 3 1 3 46 85 3
Minnesota.......... 1 3 16 6 2
Iowa............... 7 16 1
Missouri............ 1 3 20 52
North Dakota...... -
South Dakota ...... -
Nebraska............ 4
Kansas............. 3 7

SOUTH ATLANTIC....... 7 9 3 1 2 68 103 6
Delaware........... 1 5 -
Maryland............. 1 1 1 1 13 25
Dist. of Columbia.. 2 -
Virginia............ 1 1 1 14 17
West Virginia....... 3 6 13
North Carolina...... 1 1 10 10 4
South Carolina..... 1 3 -
Georgia............ 8 20 2
Florida............. 4 2 1 10 15

EAST SOUTH CENTRAL... 12 5 1 1 68 35
Kentucky........... 36 11 -
Tennessee.......... 3 1 1 23 11 -
Alabama............ 6 4 4 6
Mississippi........ 3 1 5 7

WEST SOUTH CENTRAL... 2 4 2 1 1 64 74 1
Arkansas........... 3
Louisiana.......... 1 2 1 1 17 17 1
Oklahoma........... 1 I *16 5
Texas.............. 1 1 *- 1 31 49

MOUNTAIN............. 1 1 48 34 3
Montana............ 2 3
Idaho............... 1 7
Wyoming............. 3 2
Colorado............ 1 7 1 3
New Mexico......... I 6 8
Arizona............ *20 6
Utah............... 8 6
Nevada........... 1 1 -

PACIFIC .............. 4 16 1 3 2 3 47 247 164 4
Washington.......... 2 2 25 12 -
Oregon............. 1 14 13 -
California......... 4 14 1 3 2 3 44 203 134 4
Alaska.............- -
Hawaii............. *5 5

Puerto Ri ............ 1 26 21

*Delayed reports: Aseptic Meningitis: N.Y. Ups. 1 case 1967
Brucellosis: Tex. 1 case 1967
Hepatitis, infectious: N.Y. Ups. 1, N.J. delete I case, Okla. 5, Ariz. 10, Hawaii 4







Morbidity and Mortality Weekly Report 97


TABLE III. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

MARCH 16, 1968 ANDMARCH 18, 1967 (llth 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... 688 6,245 24,507 85 920 662 5,666 2 2 11 2,376

NEW ENGLAND.......... 54 306 262 2 43 24 677 327
Maine.............. *1 10 48 2 1 *48 *35
New Hampshire...... 5 46 63 2 1 17 -
Vermont ............. 5 20 1 26 -
Massachusetts...... 30 156 83 22 12 369 162
Rhode Island....... 1 3 21 4 *122 -
Connecticut........ 17 86 27 2 12 10 95 130

MIDDLE ATLANTIC...... 130 812 773 27 159 83 238 168
New York City...... 27 149 119 12 61 15 77 84
New York, Up-State. 67 447 169 4 14 25 NN 33
New Jersey.......... *31 160 215 10 45 32 161 48
Pennsylvania....... 5 56 270 1 39 11 NN 3

EAST NORTH CENTRAL... 149 1,635 1,982 11 89 61 1,698 1,157
Ohio............... 3 112 298 1 20 25 162 53
Indiana............. 21 250 226 2 12 5 175 10
Illinois........... 65 724 314 4 20 13 264 997
Michigan........... 4 100 441 4 28 13 547 35
Wisconsin.......... 56 449 703 9 5 550 62

WEST NORTH CENTRAL... 13 130 1,082 1 39 32 930 102
Minnhesota.......... 1 3 46 6 5 45 1
Iowa................ 38 216 3 6 694 91
Missouri............ 3 9 29 1 7 9 39 -
North Dakota....... 4 51 452 2 65 6
South Dakota....... 3 38 4 4 NN -
Nebraska............ 5 19 301 4 7 18 2
Kansas............. 7 NN 13 1 69 2

SOUTH ATLANTIC....... 39 472 2,437 12 194 135 262 113
Delaware........... 2 4 20 1 1 5 44 -
Maryland............ 3 35 49 1 12 18 23 41
Dist. of Columbia.. 4 8 2 7 5 -
Virginia............ 8 95 678 14 11 30 26
West Virginia...... 12 123 482 1 4 12 97 15
North Carolina..... 5 50 554 1 42 28 NN -
South Carolina..... 16 60 1 39 9 16 15
Georgia.............. 3 9 2 34 28 -
Florida............. 9 142 577 3 41 24 47 16

EAST SOUTH CENTRAL... 15 115 2,858 9 71 65 285 42
Kentucky............ 3 40 937 3 27 18 *103 11
Tennessee.......... 16 864 5 20 28 158 17
Alabama............ 8 30 601 12 12 22 14
Mississippi........ 4 29 456 1 12 7 2 -

WEST SOUTH CENTRAL... 162 1,510 9,089 7 192 117 380 1 1 5 116
Arkansas........... 1,184 10 10 -
Louisiana.......... 1 50 2 46 46 1 2
Oklahoma............ 4 47 2,740 *1 39 7 6 -
Texas............... 158 1,462' 5,115 4 97 54 373 1 1 5 114

MOUNTAIN ............. 39 326 1,489 2 12 16 340 60
Montana............ 62 174 1 11 -
Idaho .............. 10 159 2 1 9 4
Wyoming............. 1 31 12 28 -
Colorado............ 13 110 371 2 6 7 144 22
New Mexico.......... 4 36 205 3 23 3
Arizona............. *20 73 319 1 2 *119 *31
Utah............... 1 2 85 1 6 -
Nevada............. 2 164 2 2 -

PACIFIC.............. 87 939 4,535 14 121 129 856 1 1 6 291
Washington.......... 21 275 2,292 3 19 10 193 87
Oregon............... 13 220 522 1 11 10 17 25
California.......... 51 421 1,606 9 82 107 584 **1 **l 6 165
Alaska.............. 64 2 6 8
Hawaii.............. 2 23 51 1 9 56 6

Puerto Rico.......... 12 104 713 1 13 7 8

*Delayed reports: Measles: Me. 1, N.J. 1, Ariz. 14
Meningococcal infections: Okla. 1
Mumps: Me. 9, R.I. 74, Ky. 49, Ariz. 68
Rubella: Me. 9, Ariz. 14
**Poliomyelitis, paralytic: Calif. 1 case out of state







98 Morbidity and Mortality Weekly Report


TABLE II. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

MARCH 16, 1968 AND MARCH 18, 1967 (llth 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... 12,010 2 22 1 16 4 42 3 54 768

NEW ENGLAND............ 1,933 2 5 22
Maine.............. *47 5 22
New Hampshire...... 3 -
Vermont...... ..... 41 -
Massachusetts ...... 291 -
Rhode Island....... 168
Connecticut........ 1,383 1

MIDDLE ATLANTIC. ..... 465 5 6 1 8
New York City ...... 33 3 4 -
New York, Up-State. 367 2 1 4
New Jersey......... NN -
Pennsylvania........ 65 1 1 4

EAST NORTH CENTRAL... 1,405 2 3 2 7 3 42
Ohio............... 393 1 1 5 20
Indiana............ 225 1 8
Illinois........... 200 1 1 I 2 6
Michigan .......... 306 1 1 3
Wisconsin .......... 281 1 1 5

WEST NORTH CENTRAL... 722 1 4 2 7 146
Minnesota.......... 63 2 38
Iowa.............. 178 1 34
Missouri............ 41 1 2 2 1 31
North Dakota....... 131 2 30
South Dakota....... 58 I -
Nebraska........... 33 1 6
Kansas............. 218 I 7

SOUTH ATLANTIC....... 1,309 2 1 4 1 11 2 5 91
Delaware .......... 4 -
Maryland............ *220 3 2
Dist. of Columbia.. 2 -
Virginia........... 542 1 1 1 1 2 2 3 50
West Virginia...... 213 1 10
North Carolina..... 19 1 2 2 2
South Carolina..... 97 -
Georgia............. 13 1 1 1 6
Florida............ 199 3 21

EAST SOUTH CENTRAL... 1,451 2 3 7 1 11 261
Kentucky........... 86 1 I 7 117
Tennessee.......... 1,082 2 5 4 134
Alabama............. 198 1 10
Mississippi........ 85 1 1 1 -

WEST SOUTH CENTRAL... 662 2 5 2 16 145
Arkansas........... 24 4 15
Louisiana.......... 5 2 4 1 18
Oklahoma............ *108 1 *8 44
Texas.............. 525 1 *- 4 68

MOUNTAIN ............ 2,504 2 1 1 10
Montana .......... 71 -
Idaho............. 94 -
Wyming............ *272 1
Colorado.......... 1,518 1 1 1
New Mexico........ 241 4 4
Arizona............ *201 5
Utah ............... 107 1 -
N va da............ -

PACIFIC............. 1,559 5 4 6 43
Washington......... 401 -
Oregon.............. 183 -
California......... 859 5 4 6 43
Alaska .... ....... 23 -
Hawaii............. 93 -

Puerto Rico.......... 11 8

*Delayed reports: SST: Me. 24, Md. 22 cases 1967, Okla. 44, Wyo. 165, Ariz. 79
Rky. Mt. Spotted Fev.: Tex. 1 case 1967
Robtes in Animals: Okla. 4








Morbidity and Mortality Weekly Report


TABLE IV. DEATHS IN 122 UNITED STATES CITIES FOR WEEK ENDED MARCH 16, 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 Area 65 years and
Area All 65 years Influenza All
Ages and over All Ages Causes Ages and over Influenza Causes
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, Paw-----
Pittsburgh, Pa.-------
Reading, Pa.-----------
Rochester, N. Y.------
Schenectady, N. Y.----
Scranton, Pa.---------
Syracuse, N. Y.-------
Trenton, N. J.--------
Utica, N. Y.-----------
Yonkers, N. Y.--------

EAST NORTH CENTRAL:
Akron, Ohio-----------
Canton, Ohio----------
Chicago, Ill.---------
Cincinnati, Ohio------
Cleveland, Ohio-------
Columbus, Ohio--------
Dayton, Ohio----------
Detroit, Mich.--------
Evansville, Ind.------
Flint, Mich.-----------
Fort Wayne, Ind.-------
Gary, Ind.------------
Grand Rapids, Mich.---
Indianapolis, Ind.----
Madison, Wis.---------
Milwaukee, Wis.-------
Peoria, Ill.-----------
Rockford, Ill.--------
South Bend, Ind.------
Toledo, Ohio----------
Youngstown, Ohio------

WEST NORTH CENTRAL:
Des Moines, Iowa------
Duluth, Minn.--------
Kansas City, Kans.----
Kansas City, Mo.------
Lincoln, Nebr.--------
Minneapolis, Minn.----
Omaha, Nebr.----------
St. Louis, Mo.--------
St. Paul, Minn.-------
Wichita, Kans.---------


782
241
56
36
34
65
39
22
27
50
66
12
54
25
55

3,485
38
32
150
39
39
41
78
65
1,868
26
516
186
53
104
32
39
61
48
31
39

2,632
50
39
755
175
233
117
74
399
45
54
38
38
51
143
30
134
38
17
44
97
61

846
60
32
37
133
41
99
80
249
72
43


*Estimate based on average percent of divisional total.


484
138
29
25
22
37
25
16
20
32
43
10
32
15
40

2,102
23
20
87
20
24
27
44
33
1,117
18
303
110
38
66
27
29
36
30
21
29

1,494
27
17
400
125
121
65
49
231
26
30
21
15
22
90
13
80
17
9
24
66
46

540
44
20
19
84
30
61
49
154
49
30


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, Otah---
Tucson, Ariz.----------

PACIFIC:
Berkeley, Calif.-------
Fresno, Calif.---------
Glendale, Calif.-------
Honolulu, Hawaii-------
Long Beach, Calif.-----
Los Angeles, Calif.----
Oakland, Calif.--------
Pasadena, Calif.-------
Portland, Oreg.--------
Sacramento, Calif.-----
San Diego, Calif.------
San Francisco, Calif.--
San Jose, Calif.-------
Seattle, Wash.---------
Spokane, Wash.---------
Tacoma, Wash.----------


Total 12,929 7,517 537 602

Cumulative Totals
including reported corrections for previous weeks

All Causes, All Ages ------------------------ 154,777
All Causes, Age 65 and over------------------- 92,419
Pneumonia and Influenza, All Ages------------- 8,474
All Causes, Under 1 Year of Age--------------- 6,714


Week No.
11


1,248
133
250
47
75
135
59
84
41
99
85
212
28

578
111
45
34
88
130
47
31
92

1,307
53
36
38
165
44
87
248
66
206
99
130
62
73

486
37
23
138
22
113
22
60
71

1,565
17
51
42
46
78
535
89
39
90
51
101
176
38
135
43
34


a












MEASLES- ('- i I Iti ii iro p* /1 95)

lhe a:lhrn:ltlin patiern Of gthi and 'iOH" \Oears
o r pordtiy Eita;--!es arc1 ht, ti 'har1ii itn rctt'-nt \ rI-l
( imur*e I). in ^ neral^. thei nrine geo(' raphic divisions of
tho I nitcld i l lir refh t'c a similar change since the
t1,* 'i r>0r u 1''. of it';ls s \ laccin*l la h inning in 1096) .

Figure 1
REPORTED CASES OF MEASLES BY 4-WEEK PERIODS
UNITED STATES, 1962-1968


( .,.
,',port'ed byh State Seri.-cgs Scction and Statistjics See-




INTERNATIONAL NOTES
QUARANTINE MEASURES


ldd~itional Immuniza:tion Information for Inlernatiional
Tra'el. 19ti7-6;8 edition. I'aublic Health Serrice
IPublicatiion \o. 384


The fI'lloino information should be included in Section 5:


AMERICA
Brazil Page 42
Inortl: \ ac nation againsi-l poliomyelitis is required*
front children : nionlhs to 6; years oif age (a) when a visa
i- needed lor entr\ into Brazil. (h1) w 1hen the child is a
national of Brazil. The dosage of vaccinee nmuslt hl clearly
indicated on the (ertiricate.

Cayman Islands Page 43
In-,rt (tayman Islands and add the following information:
- ,11l,, \ vaccination i- required from all arrivals, except
arrival- from Jainaica aid the Vnited States f \imerica.

El Salvador Page 45
\dd under ellow fiver: Yellow fever vaccination is re-
quired fr tl or ai all 6rritd (; months and over when arriving
lromn infelle'd local areas.

Trinidad and Tobago Page 49
Dele)re all infornltion concerning smallpox. Insert: Small-
po\ \acrinatio nrequiired from all arrivals.

S-ir-.tir o iln Iii.tt. r n. Iir*r -titth lir IcEk .i ion. Isaty h t up ni'
to r ii h l it th< h 11+ H .rbl lii i r.lli.; il i ;> n ic in (tmuni(a-.


MARCH 16, 1 96


THE .'** 'I "* AND MORTALITY WEEKLY REPORT, WIT A CICU LA.
TION -' "HE NATIONAL COMMUNICABLE
DISEASE CENTER, L r r. :' .
DIRECTOR, NATIONAL COMMUNICABLE DISEASE '. t"
r- E' CrE- M.'
CHIEF, EPIDEMIOLOGY PROGRAM i l '. jMu'" M .E,
ACTING CHIEF STATISTICS SECTION IDA L. SHERMAN. M
EDITOR MICHAEL B GREGG. M

IN ADD ITON TO THE ESTABL SHED PROCE e O*..~ "e. O:. '
... v 'L ., TIALITY. THE NATIONAL *.C. A', sALE D. -_
r,.- -. ..'i; CCOUNTSOFINTERESTI :.'. r B ."C *:
S.. "' d- i .: WHICH ARE OF CURR-'. ." T ME-L '
-.. -. WHICH ARE DIRECTLY : Fi.i. .* 'IE Ci' C .
OF COMMUNICABLE DISEASES. SUCH COMMUNICATIONS 'I*Ou*LL Br
ADDRESSED 0T:
NATIONAL .-i' M.': ':-' DISEASE CENTER
ATLANTA, t- '
ATTN: THE EDITOR
MORBIDITY AND MORTALITY WEEKLY REPORT

NOTE: THE DATA IN THIS REPORT ARE PROVISl toL ND a-
BASED ON WEEKLY TELEGRAMS TO THE NCDC BY T-F ''..". C.
STATE HEALTH DEPARTMENTS THE REPORTING WEEI- 2ON _I-
ON SATURDAYi COMPILED DATA ON ANATONAL BASIS ARE ELt .. I
ON THE SUCCEEDING FRIDAY


S U I FV O FL LI~
DOCur.SEPrITS DPT






U.S. 3EPO0ITO(R'Y


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Morbidity and Mortality Weekly Report