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:
AA00010654:00155

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//
NATIONAL COMMUNICABLE DISEASE CENTER


ii LO NOTES AND REPORTS
M Koizebue, Alaska
On February 28, 1968, after returning home from a
caribou hunting trip, a 64-year-old male Eskimo complained
of tremors, generalized stiffness, and difficulty in breath-
ing. These symptoms persisted for the next 2 days and
were complicated by generalized myoclonus which neces-
sitated admission to the Alaska Native Hospital in Kotze-
bue. He remained lucid during the motor spasm and had
no postictal depression. Anticonvulsant therapy was
initiated, but his symptoms remained unchanged. The
patient was subsequently transferred to the regional med-
ical center in Anchorage for further evaluation.
When the patient was questioned on admission to the
Anchorage hospital, the patient gave a history of previous


Vol. 17, No. 19







Week Ending

May 11, 1968




PUBLIC HEALTH SERVICE


CONTENTS
Epidcmiologic Notes and Reports
Botulism Kotzebue, Alaska .................. .169
Measles Eureka, Utah .................. ... 176
Summary of Reported Cases of Infectious Syphilis .170
Recommendation of the Public Health Service
Advisory Committee on Immunization Practices
Plague Vaccine . .. . 71


good health. When asked about the foods he ate prior to
his illness, he reported eating cured fish,* whipped seal
oil with fish, and Eskimo ice cream.** On admission, the
patient was fully oriented, and his physical and neurologic
examinations were normal. He was afebrile and remained
so throughout his hospital stay. On the second day, he
(Continued on page 170)


TABLE I. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative.totals include revised and delayed reports through previous weeks)
19th WEEK ENDED CUMULATIVE, FIRST 19 WEEKS
MEDIAN
DISEASE
May 11, May 13, 1963 1967 MEDIAN
1968 1967 1968 1967 1963 1967

Aseptic meningitis ............. ........ 25 36 26 543 564 524
Brucellosis ........................... 7 9 9 5 56 81 77
Diphtheria ............ .................... 1 1 2 68 39 73
Encephalitis, primary:
Arthropod-borne & unspecified .......... 26 32 301 463
Encephalitis, post-infectious ............. 14 29 199 311
Hepatitis, serum ........................ 82 43 79 1.425 723 15
Hepatitis, infectious .................... 929 771 15,974 14,990
Malaria ..................... .. ... ....... 25 27 2 786 721 36
Measles rubeolaa) ....................... 822 2,227 8,944 12.909 44.387 182.245
Meningococcal infections, total ........... 36 50 56 1.349 1,113 1,249
Civilian .............................. 34 49 1,218 1,030 -
Military ............................... 2 1 131 83
Mumps ................................. 4090 93,719 -
Poliomyelitis, total ..................... -- 1 15 6 8
Paralytic ............................. 1 15 5 7
Rubella (German measles) ............... 2.274 2,157 --- 28,087 24.830 -
Streptococcal sore throat & scarlet fever.... 8.876 10,455 9,246 207.645 225,326 202.790
Tetanus ................................ 3 1 4 39 55 72
Tularemia .............................. 34 6 5 59 55 68
Typhoid fever .......................... 7 2 7 92 117 119
Typhus, tick-borne (Rky. Mt. spotted fever) 4 3 3 15 27 12
Rabies in animals' ....................... 74 93 96 1,437 1,704 1,704

TABLE II. NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax: .......................................... 2 Rabies in man: .................................... -
Botulism: ......................................... Rubella, Congenital Syndrome:........................ 3
Leptospirosis: .................. ................... 9 Trichinosis: Hawaii-i, Ohio-1 ......................... 20
Plague: .......................................... Typhus, marine: ..................................... 3
Psittacosis:* ...................................... 13
*Delayed report: Psittacosis: N.Y.Upstate delete 6


HEALTH, EDUCATION, AND WELFARE

BUREAU OF DISEASE PREVENTION AND ENVIRONMENTAL CONTROL







Morbidity and Mortality Weekly Report


BOTULISM (Continued from front pae')


developed difficulty in swallowing, slurred speech, mild
respiratory distress, and urinary retention. The gag reflex
vas absent. but other cranial reflexes were normal. Hy-
poreflexia and generalized motor weakness were present.
The follow ing tests were wi thin normal limits-: skull X-rays.
lumbar puncture. spinal fluid examination. hematocrit.
white blood cell count and differential. electrolytes, blood
urea nitrogen, creiainine.and serum calcium. The lensilon
test for myasthenia gravis was negative.
When botulism was suspected as the probable cause
of illness on the second hospital day. the patient was
immediately treated with 10.000 units of type E antitoxin.
During the next 72 hours he received an additional 5,000
units of typex E and 30,000 units of types A and B anti-
toxins. He improved gradually over the next aweek, and
after 3 weeks, was discharged in good health except for
slight difficulty in phonation.


Samples, of the foods eaten by the patient on the
hunting trip have been examined at the Anaerobic Labora-
tory. Laboratory Program. N('DC. A botulinum toxin has
been identified in the cured fish, but its type has not yet
been determined.

(Reported by IDonaal K. Frfieedman, 41.9., Director, Division
of P'ulic lrealth, and State Epide biologist, Jun au, Alas-
ka: Keith M. Brouwnsherger, M.I., Chief of Vedi;ine, Alaska
'atfire li., "i Kot ehue, A.1/ska: .Artir' Health Research
('enter, PHS, Anchorage, Alaska; Anaerobic Bacteriology
Laboratory. Laboratory i; ".-,. \(')C: and an EIS Of-
ficer.)


*('ur fisi i i prp;urmd by pt)I. u, fr,-h fish in '.1 oitl .and
tforinL it i n n unldrgrrund rn.friZ,ratto.r for a nu-nml r of months.
**'..kim uiar, sitmon or Ibluborrh


SUMMARY OF REPORTED CASES OF INFECTIOUS SYPHILIS


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

Cumulative Cumulative
Reporting Area April Jan-Apr Reporting Area April Jan-Apr
1968 1967 1968 1967 __1968 1967 1968 1967
NEW ENGLAND ............... 33 25 124 124 EAST SOUTH CENTRAL......... 120 129 488 593
Maine.................... 1 Kentucky................. 10 9 38 38
New Hampshire............ 1 5 Tennessee................ 22 30 99 89
Vermont ................. 2 Alabama .................. 53 68 231 338
Massachusetts........... 16 17 73 77 Mississippi............... 35 22 120 128
Rhode Island............. 4 2 17 8
Connecticut............... 13 5 33 32 WEST SOUTH CENTRAL........ 281 246 1,152 982
Arkansas................. 11 8 46 45
MIDDLE ATLANTIC........... 293 279 1,044 1,169 Louisiana................ 60 52 264 204
Upstate New York......... 13 18 61 86 Oklahoma................. 5 13 23 42
New York City........... 196 167 657 699 Texas .................... 205 173 819 691
Pa. (Excl. Phila.)....... 17 16 85 91
Philadelphia............. 27 26 102 93 MOUNTAIN................... 48 56 172 212
New Jersey................ 40 52 139 200 Montana.................. 2 2 3
Idaho.................... 1 2 3 12
EAST NORTH CENTRAL........ 213 320 1,013 1,089 Wyoming.................. 2 4
Ohio...................... 31 73 174 229 Colorado................. 1 10 8 30
Indiana................... 45 8 113 37 New Mexico................ 14 19 48 60
Downstate Illinois...... 9 16 53 52 Arizona.................. 25 20 91 97
Chicago .................. 61 105 341 331 Utah..................... 2 2 1
Michigan ................ 66 111 326 426 Nevada................... 5 1 18 5
Wisconsin................ 1 7 6 14
PACIFIC................... 160 161 583 670
WEST NORTH CENTRAL........ 36 27 122 87 Washington ............... 9 5 17 22
Minnesota................ 2 2 15 12 Oregon................... 3 12 14
Iowa .................... 8 4 12 10 California............... 148 156 551 629
Missouri................. 14 11 61 28 Alaska................... 1
North Dakota............. 1 Hawaii................... 3 4
South Dakota............. 4 14 11
Nebraska.................. 6 2 14 10 U. S. TOTAL............... 1.595 1,711 6.480 6,929
Kansas................... 2 8 6 15
TERRITORIES............... 93 85 353 297
SOUTH ATLANTIC............ 411 468 1,782 2,003 Puerto Rico.............. 91 79 329 280
Delaware.................. 3 2 12 14 Virgin Islands........... 2 6 24 17
Maryland................. 21 48 151 217
District of Columbia..... 45 49 235 206
Virginia................. 32 24 89 99
West Virginia............ 2 12 6
North Carolina............ 67 56 251 227 Note: Cumulative Totals include revised and delayed reports
South Carolina........... 42 76 192 296 through previous months.
Georgia.................. 73 77 277 313
Florida..................... 128 134 563 625


May 11. 1968







Morbidity and Mortality Weekly Report


RECOMMENDATION OF THE PUBLIC HEALTH SERVICE
ADVISORY COMMITTEE ON IMMUNIZATION PRACTICES

The Public Health Service Advisory Committee on Immunization Practices
meeting on February 15, 1968, issued the following recommendation on
plague vaccine.



PLAGUE VACCINE


PLAGUE

Plague is a sylvatic infection of rodents and their
ectoparasites in many parts of the world. In the western
United States, a few human cases occur each year follow-
ing exposure to infected wild rodents. In some countries
of Asia, Africa, and South America, epidemic plague re-
sults when the domestic rat population becomes infected.
Currently the area of most intensive epidemic and epizootic
infection is Vietnam.

PLAGUE VACCINE

Plague vaccines have been used since the late nine-
teenth century, but it has never been possible to measure
their effectiveness precisely. Immunization with plague
vaccine, however, is known to reduce the incidence and
severity of disease.
The plague vaccine licensed for use in the United
States is prepared from P-asteurella pestis grown in arti-
ficial media, inactivated with formaldehyde, and preserved
in 0.5 percent phenol.

RECOMMENDATIONS FOR VACCINE USE
Routine vaccination is not indicated for persons simply
living in plague enzootic areas of the western United
States or for travelers going to most of the countries re-
porting cases.* Selective immunization is advisable for
the following:
1) All persons traveling to Vietnam, Cambodia, and
Laos.
2) All persons whose vocations or field work brings
them into frequent and regular contact with wild
rodents in plague enzootic areas of the western
United States, South America. Africa, or Asia.
3) All laboratory personnel working with the P. pestis
organism or with plague-infected rodents.

*For a current listing, consult the most recent issue of the
World Health Organization's Weekly Epidemiologic Record.


Vaccination Schedule
All injections should be given intramuscularly.
Primary Adults and Children Over 10 Years Old:
The primary series consists of three doses of vaccine.
The first two doses, 0.5 ml. each, should be administered
4 or more weeks apart, followed by a third dose, 0.2 ml.,
4 to 12 weeks after the second injection. When less time
is available, satisfactory but less than optimal results
can be obtained with two 0.5 ml. injections administered
at least 3 weeks apart.
Primary Children Less Than 10 Years Old: The
primary series also is three doses of vaccine, but the
doses are smaller. The manufacturer's guide to propor-
tions of the adult dose for children is: Infants under 1
year 1/5 adult dose; 1-4 years 2/5 adult dose; 5-10
years 3/5 adult dose. The intervals between injections
are the same as for adults.
Boosters: Boosters should be given every 6 to 12
months while individuals remain in an area where the risk
of exposure persists. Satisfactory doses for children and
adults are the same volumes suggested for the third dose
in the primary series. The primary series need never be
repeated for booster doses to be effective.
Summary: The following table summarizes the recom-
mended doses for primary and booster vaccination:

Dose Age (Years)
Number Under 1 1-4 5-10 Over 10
1 & 2 0.1 ml. 0.2 ml. 0.3 ml. 0.5 mi.
3 & Boosters 0.04 ml. 0.08 ml. 0.12 ml. 0.2 ml.



Reactions

Mild reactions consisting of pain, reddening, and
swelling at the injection site are frequently recognized.
With repeated doses, systemic reactions of fever, headache,
and malaise occur more often and tend to become more
pronounced. Sterile abscesses are reported tooccur rarely.
No fatal or disabling complications have been observed.


May 11, 1968







172 Morbidity and Mortality Weekly Report


TABLE III. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

MAY 11, 1968 AND MAY 13, 1967 (19th WEEK)

ENCEPHALITIS HEPATITIS
ASEPTIC RIA Primary
AREA MENINGITIS including Infectious Seum Infectious MALARIA
unsp. cases
1968 1967 1968 1968 1968 1967 1968 1968 1968 1967 1968
UNITED STATES... 25 36 7 1 26 32 14 82 929 771 25

NEW ENGLAND.......... 1 3 5 1 31 37 2
Maine.............. 1 1
New Hampshire...... 1 3
Vermont............. 2
Massachusetts...... 14 17 2
Rhode Island....... I 2 3 1 11 3
Connecticut........ 1 2 4 11

MIDDLE ATLANTIC...... 3 2 4 4 2 34 140 113 2
New York City...... 1 19 54 34 1
New York, up-State 2 1 4 22 29
New Jersey ......... 1 1 3 4 33 22 1
Pennsylvania....... 1 1 1 1 1 7 31 28

EAST NORTH CENTRAL... 4 1 4 6 1 1 179 121
Ohio................ 1 4 42 28
Indiana............. 1 18 9
Illinois............ I 2 1 1 71 30
Michigan.......... .. 2 1 41 51
Wisconsin .......... 7 3

WEST NORTH CENTRAL... 3 1 1 2 48 86 6
Minnesota........... 1 11 13
Iowa............... 1 1 9 9
Missouri .*......... I 15 59 1
North Dakota....... 3 1
South Dakota ..... 1
Nebraska........... 1 2 1
Kansas............. 10 2 4

SOUTH ATLANTIC....... 2 1 4 6 3 2 3 93 82 6
Delaware........... I 2 2
Maryland ............. 1 2 11 17
Dist. of Columbia.. 2 1
Virginia........... 1 2 10 32
West Virginia...... 1 1 3 1 -
North Carolina..... 3 8 6
South Carolina..... 4 1
Georgia..... ...... 33 6
Florida............ 1 2 1 3 25 14

EAST SOUTH CENTRAL... 6 1 2 57 56 2
Kentucky............ 1 21 27
Tennessee.......... 2 25 15
Alabama............. 4 8
Mississippi........ 5 7 6 2

WEST SOUTH CENTRAL... 4 14 1 4 1 61 82
Arkansas...........- 4 2
Louisiana........... 2 1 2 1 10 8
Oklahoma? ........... 1 2 4
Texas.............. 1 13 1 2 45 68

MOUNTAIN............. 3 1 46 40 1
Montana............ 5 3
Idaho.............. 6 1 1
Wyoming............ 2 1
Colorado........... 3 1 15 16
New Mexico......... 5 6
Arizona............ 9 11
Utah............... 4 2
Nevada.......... -

PACIFIC.............. 11 12 2 8 7 42 274 154 6
Washington......... 17 15 -
Oregon............. 1 1 17 18 -
California.......... 7 11 1 3 7 41 231 121 3
Alaska............. 7
Hawaii............. 4 1 1 4 2 3

Puertr Ki ........... 18 16

*Delnyed reports: Encephalitis, primary: Mo. 1
Herpaitis, infectious: Okla. 1








Morbidity and Mortality Weekly Report 17


TABLE III. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

MAY 11, 1968 AND MAY 13, 1967 (19th WEEK) CONTINUED


MEASLES (Rubeola) MENINGOCOCCAL INFECTIONS, MUMPS POLIOMYELITIS RUBELLA
TOTAL
AREA Cumulative Cumulative Total Para ytic
Cum.
1968 1968 1967 1968 1968 1967 1968 1968 1968 1968 1968
UNITED STATES... 822 12,909 44,387 36 1,349 1,113 4,090 15 2,274

NEW ENGLAND.......... 40 571 540 2 71 49 576 391
Maine*............. 13 140 5 3 23 30
New Hampshire...... 2 71 70 7 2 6 7
Vermont ........... 1 23 1 4 3
Massachusettst..... 21 206 209 2 31 23 238 238
Rhode Island ....... 1 38 6 3 114 -
Connecticut........ 17 279 60 21 18 191 113

MIDDLE ATLANTIC...... 165 2,000 1,495 10 225 170 197 254
New York City...... 90 686 260 4 44 28 125 152,
New York, Up-State. 71 887 344 37 42 NN 41
New Jersey* .... ... 313 362 4 80 67 72 51
Pennsylvania ...... 4 114 529 2 64 33 NN 10

EAST NORTH CENTRAL... 156 2,765 3,560 7 144 128 1,565 577
Ohio................ 12 233 639 2 39 50 39 85
Indiana............. 17 436 428 1 19 15 183 48
Illinois........... 55 1,107 588 2 35 27 193 230
Michigan........... 16 179- 700 2 39 27 706 83
Wisconsin.......... 56 810 1,205 12 9 444 131

WEST NORTH CENTRAL... 21 282 1,938 64 49 451 229
Minnesota.......... 2 10 94 16 11 18 2
Iowa............... 13 64 501 4 10 361 201
Missouri*.......... 65 139 18 11 8 1
North Dakota....... 6 103 693 2 56 13
South Dakota....... 4 46 4 6 NN
Nebraska........... 28 464 6 9 5 1
Kansas............. 8 1 14 2 3 11

SOUTH ATLANTIC....... 33 1,025 5,142 5 298 215 202 204
Delaware............ 1 9 35 1 4 5 4 4
Maryland............ 3 62 88 18 27 29 19
Dist. of Columbia.. 6 12 1 11 7 1
Virginia........... 12 206 1,615 21 18 41 24
West Virginia*..... 6 169 972 7 16 65 53
North Carolina..... 2 256 768 58 45 NN -
South Carolina*.... 10 418 51 20 18 3
Georgia............. 3 23 57 33 -
Florida............ 9 304 1,211 3 71 44 44 101

EAST SOUTH CENTRAL... 40 373 4,283 7 113 104 222 100
Kentucky........... 1 104 1,092 1 42 29 57 37
Tennessee.......... 48 1,459 5 38 44 150 47
Alabama*............ 7 60 1,113 16 19 15 16
Mississippi........ 32 161 619 1 17 12 -

WEST SOUTH CENTRAL... 198 3,424 14,810 1 244 165 358 7 115
Arkansas........... 1 1,359 15 19 3 -
Louisiana.......... 2 117 1 64 63 1 1
Oklahoma*.......... 101 3,279 45 10 1 -
Texas............... 198 3,320 10,055 120 73 353 7 114

MOUNTAIN............ 50 623 3,369 19 21 227 80
Montana............ 63 234 2 28 -
Idaho.............. 11 328 6 1 14 2
Wyoming............. 44 21 2 -
Colorado............ 28 283 967 7 10 75 50
New Mexico......... 1 53 490 3 6 4
Arizona............. 20 145 786 1 2 89 23
Utah............... 1 19 279 3 13 1
Nevada............. 5 264 3 2 -

PACIFIC.............. 119 1,846 9,250 4 171 212 292 8 324
Washington.......... 19 450 4,395 27 21 231 63
Oregon.............. 15 367 1,232 1 16 18 33 12
California.......... 85 996 3,419 3 118 164 8 229
Alaska.............. 112 8 6 11
Hawaii.............. 33 92 10 1 22 9

Puerto Rico.......... 14 269 1,526 15 8 16 -- 5


*Delayed reports: Measles: Mass. delete 9, N.J. delete 2, Pa. delete 29, W.Va. delete 5, S.C. delete 8, Ala. delete 23, Okla. 1
Meningococcal infections: Pa. delete 3, Mo. 7, Okla. 1
Mumps: Okla. 2
Rubella: Me. 5, Pa. 28, Mo. 19, W.Va. 5, S.C. 8, Ala. 23







171 Morbidity and Mortality Weekly Report


TABLE III CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

MAY 11, 1968 AND MAY 1., 1967 (19th WEEK) CONTINUED


STREPTOCOCCAL TYPHUS FEVER
SORE THROAT 6 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... 8,876 3 39 34 59 7 92 4 15 74 1,437

NEW ENGLAND ......... 1,036 1 32 32 1 3 1 54
Maine ............ 24 1 49
New Hampshire...... 27 2
Verm nt ............ 32 32 2
Massachusetts...... 246 1 2 1
Rhode Island....... 136 -
Connecticut........ 603 1 1

MIDDLE ATLANTIC...... 351 2 8 1 1 10 1 1 1 12
New York City...... 27 1 4 6 6
New York, Up-State. 287 1 4 1 1 1 1 8
New Jersey......... NN -
Pennsylvania....... 37 3 1 1 4

EAST NORTH CENTRAL... 877 3 4 1 14 11 115
Ohio.............. .. 161 1 1 1 4 50
Inaiana............ 127 1 6 37
Illinois........... 193 2 -2 1 11
Michigan .......... 266 1 1 1 7
Wisconsin.......... 130 1 10

WEST NORTH CENTRAL... 440 2 5 1 5 1 14 325
Minnesota.......... 44 4 89
Iowa............... 126 -- 5 58
Missouri .......... 28 2 3 3 3 59
North Dakota....... 101 53
South Dakota....... 26 1 1 1 34
Nebraska........... 79 1 2 18
Kansas ............. 36 1 14

SOUTH ATLANTIC....... 1,080 8 5 2 23 3 12 5 161
Delaware........... 15 -
Maryland........... 207 4 3
Dist. of Columbia.. 53 1 1 -
Virginia............ 358 2 1 3 2 9 2 73
West Virginia...... 233 20
North Carolina..... 6 2 2 2 2 4
South Carolina..... 6 1 1 1
Georgia............ 30 1 7 I 15
Florida............. 172 2 1 2 6 2 46

EAST SOUTH CENTRAL... 1,707 4 1 5 2 13 1 16 382
Kentucky........... 143 1 1 1 2 9 180
Tennessee.......... 1,077 3 1 8 7 187
Alabama.......... 78 1 15
Mississippi........ 409 2 1 1 3 1 -

WEST SOUTH CENTRAL... 473 1 6 5 8 18 268
Arkansas........... 12 1 2 30
Louisiana.......... 20 4 I 2 30
Oklahoma .......... 4 1 1 8 88
Texas.............. 437 1 2 3 5 6 120

MOUNTAIN............. 1,543 2 7 2 27
Montana............. 31 -
Idaho...... ..... ... 124 -
Wyoming?........... 61 1 1
Colorado ........... 954 1 2 1
New Mexico......... 123 4 1 14
Arizona............. 180 1 11
Utah ............... 69 -
Nevada ............

PACIFIC.............. 1,369 7 9 6 93
Washington ......... 210 -
Oregon............. 131 2 1
California......... 858 7 7 6 92
Alaska .......... .. 56 -
Hawaii ............. 114 -


Puerto Rico.......... 5 1 13

*Delayed reports: SST: Me. 2, Mo. 19, Okla. 27, Wyo. 1








Morbidity and Mortality Weekly Report






TABLE IV. DEATHS IN 122 UNITED STATES CITIES FOR WEEK ENDED MAY 11, 1968

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


All Causes Pneumonia Under All Causes Pneumonia Under

A r e a A s I a n d r y ea r A r e a esa n d 1 y e a r
Area All 65 years and 1 year Area All 65 years and yearly
Ages and over Influenza All Ag and Influenza All
SAll Ages Causes All Ages Causes


NEW ENGLAND:
Boston, Mass.---------
Bridgeport, Conn.-----
Cambridge, Mass.------
Fall River, Mass.-----
Hartford, Conn.-------
Lowell, Mass.----------
Lynn, Mass.-----------
New Bedford, Mass.----
New Haven, Conn.------
Providence, R. I.-----
Somerville, Mass.-----
Springfield, Mass.----
Waterbury, Conn.------
Worcester, Mass.------

MIDDLE ATLANTIC:
Albany, N. Y.---------
Allentown, Pa.--------
Buffalo, N. Y.--------
Camden, N. J.---------
Elizabeth, N. J.------
Erie, Pa.-------------
Jersey City, N. J.----
Newark, N. J.---------
New York City, N. Y.--
Paterson, N. J.-------
Philadelphia, Pa.-----
Pittsburgh, Pa.-------
Reading, Pa.----------
Rochester, N. Y.------
Schenectady, N. Y.----
Scranton, Pa.---------
Syracuse, N. Y.-------
Trenton, N. J.--------
Utica, N. Y.----------
Yonkers, N. Y.--------

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

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


730
226
43
27
26
63
23
18
21
66
61
15
46
25
70

3,401
46
42
139
57
44
35
65
118
1,707
46
506
183
59
108
22
37
83
42
29
33

2,507
73
51
717
152
172
124
85
349
60
47
31
22
51
134
38
118
46
28
47
104
58

845
55
19
42
146
23
110
99
233
70
48


438
122
25
17
18
29
12
16
18
37
33
13
35
19
44

1,945
27
27
80
31
31
16
41
40
961
19
292
103
40
78
18
22
51
24
22
22

1,438
43
27
392
96
87
67
44
211
38
28
17
12
35
81
18
64
25
22
29
61
41

514
37
14
23
94
14
69
58
140
40
25


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


1,180
152
240
49
75
117
51
83
33
89
77
187
27

601
102
66
38
110
149
39
24
73

1,163
40
44
31
133
32
77
210
59
182
95
117
75
68

446
41
27
106
15
110
21
68
58

1,573
28
42
23
54
95
493
71
31
146
65
96
165
33
151
37
43


Total 12,446 7,096 413 594

Cumulative Totals
including reported corrections for previous weeks

All Causes, All Ages ------------------------- 254,389
All Causes, Age 65 and over------------------. 149,630
Pneumonia and Influenza, All Ages------------- 12,031
All Causes, Under 1 Year of Age--------------- 11,331


Week No.
19







Morbidity and Mortality Weekly Report


EPIDEMIOLOGIC NOTES AND REPORTS
MEASLES Eureka, Utah


1Be3-wn \March b and April 25. 19. 15.' cas'e of mea-
,>le- rie rel prted froi Eureka. I'tah (population 771), a
relati\el\ i slated i dining community\ in Juab County.
central 'tah. The index oase. diagno-ed on March was i
in a ;5- ear-old boy who was \vsiting from out of state.
Thi os bo I I had had measlec s 10 days prior to the
family's arrival in U'ah. On March 24. the second case
occurred in a 14-year-old boy who had been exposed to
Ih' index cas-' on March ,. During the next 5 weeks, !:
additional cases were identified (I _, -.I 1).Of these cases.
12 were in children between 12 and I5 years of age and
one was in a i-year-old sibling of a patient in the 12 to
15i-year-old age group. The patients' symptoms included
fe\er. cough. (ory.za. tconjunctivtiis, and rash. and one
patient, a I- -year-old girl who had a temperature of 106I.,
required hospitalization. The local health officer who saw
many of the cases confirmed the illness as rubeola. None
of the 15 patients gae a history of receiving measles
\accine.


Figure 1
MEASLES CASES BY WEEK OF ONSET
EUREKA, UTAH, MARCH-APRIL, 1968


2 9 16 23 30 6 13 20 27 4 I
MARCH APRIL MAY
WEEK ENDING
On April 15, following the spring holidays, a special
measles immunization program was held in Eureka. Vac-
cine was made available to all susceptible over 1 year of
age. Of the children immunized, 60 were students in the
junior and senior high schools.
A statewide measles immunization program for all
children between 1 and I _- Ir- of age had been conducted
in 'tah on May 13, 1967. The occurrence of only one case
in a child under 12 years of age during this epidemic
(excluding the index case) may indicate the effectiveness
of the campaign in Juab ( ..,,,r Prior to this limited out-
break, only four cases of measles had been reported from
Itah during the 1967-6b epidemiologic year.

(Reported by G. I). Carlyle Thompson, M.I0., M.P.H., Di-
rector. Division of Health, and Robert W. Sherwood, M.I.,
4I.P.II., Director, Viris ion of Preventir'e Medicine, Utah
Department of Health and Welfare;, John G. Steele, M),.,
Juab countyy Health OOfficer; and an EIS Officer.)


THE MORBIDITY AND MORTALITY WEEKLY REPORT, WITH A CIRCULA-
TON OF 7.000, IS PUBLISHED AT THE NATIONAL COMMUNICABLE
DISEASE CENTER, ATLANTA, GEORGIA.
DIRECTOR NATIONAL COMMUNICABLE OiSEASE CENTER
DAViD J -F-tre 1 r
CHIEF, EPIDEMIOLOGY PROGRAM A.D. L 'l.i 1 C.
ACTING CHIEF, STATISTICS SECTION IDA L ,-u
EDITOR MICHAEL B GREGG, MD.

IN ADDITION TO THE ESTABLISHED PROCEDURES FOR REPORTING
MORBIODTY AND MOR i 'L = HE h H '.;'.L C. ;*".'. i. JL '- D" & '
CENTER WELCOMES -.: OT F -i *' -. 0. -
INVESTIGATIONS WHi-n rE "F rC.'' g INTEREST TO -t Lt-
OFFICIALS AND WHIC- -* : -iE: TO THE (::'.' .L
OF COMMUNICABLE *: .i- ..*: : ...* ,,* TONS SHOULD BE
ADDRESSED TO:
NATIONAL COMMUNICABLE DISEASE CENTER
ATLANTA, GEORGIA 30333
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 WEE : -- .-LC
ON SATURDAYi COMPILED DATA ON A NATIONAL BASIS AP r i '
ON THE SUCCEEDING FRIDAY.


MAY 11, 1968


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