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:
AA00010654:00165

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. 52



......


iber 28, 1968


U.S. DEPARTMENT OF HEALTH, EDUCATION,

HEALTH SERVICES AND MENTAL

EPIDEMIOLOGIC NOTES AND REPORTS
INFLUENZA United States

Since December 21, 196S (MMWR. Vol. 17, No. 51),
there has been essentially no reported change in influenza
activity in the I'nited States. Widespread occurrence has
been reported in 23 states, regional occurrence in 10 states.
and isolated outbreaks in 14 states. Documented isolated
cases of influenza have occurred in Hawaii, Louisiana,
and Mississippi.
As of December 2h, excess pneumonia-influenza mor-
tality and excess total mortality for 1L22 U.S. cities were
seen for the fourth consecutive week. While excess total
mortality for the 1202 U.S. cities was slightly lower than
the preceding week, excess pneumonia-influenza mortality


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kwas slightly higher. Excess pneuimonia-i nfluenza mortally%
was observed in all geographic dini.-ion- except for the
East South Central and \es.t South ( central Di\is I on-
(Reporicd by HespiraforyT firal Dir a.s C it. \('l) ( .


TABLE I. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous weeks)

52nd IWEEK ENDED CMMI'L NATIVE, FIRST 52 WEEKS
DISEASE MEDIAN
December 28, December 30, 1963 1967 MEDIAN
1968 1967 1968 1967 1963 196I
Aseptic imenngitis ...................... 70 29 29 4,362 2,998 2,135
Brucellosis ............................. 2 8 8 226 252 257
Diphtheria ............................. 2 10 5 243 214 214
Encephalitis, primary:
Arthropod-borne & unspecified ........ 21 19 1,449 1,585
Encephalitis. post-incfctlous ... ...... 5 10 463 760
Hepatitis, scrum ....... ......... ..... 86 71 4.695 2,383
Hepaitiis, infectious ..... 673 695 15 45,522 38,749 37.652
Malaria ....................... 53 83 13 2,367 2,141 107
Measles rubieola) ....................... 205 479 2,800 22,527 62,335 265,501
Meningcoc(al inltctions, total ..... 17 53 53 2.516 2,166 2,813
Civilian .... ............. .......... 17 52 2,307 2,035
Military ...... ......... 1 09 131 -
Mumps ................. 1.... 1,611 148,731
Polionmyelitis total .................. 7 7 57 53 102
Paralytic ............. 4 4 57 37 91
Rubella (German measles) ............... 277 308 48.433 44.161 -
Streptococcal sore throat & scarlet tever... 8.273 10.322 7.752 434.648 448,976 393.846
Totanu.s ..... ............... ........ 1 7 5 159 233 267
Tularemia ........................... 4 11 172 169 247
Typhoid ltev r ......................... 3 4 6 405 396 461
Typhus, tick-borie (Rky. Mt. spotted fever) 2 2 2 279 300 254


TABLE II. NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. CumiT
Anthrax: ................... ....................... 3 Rabies in man: ...... .
Bot tlli, : .......................................... 7 Rubella Congenital Syndrom :... .......... ..
Lepmiospir. is: Fla.-1 .... ................. ... 57 Trichinosis: NY Up-State-1 ...... ............... 65
Plague: .. ..... .. .. ..... .... ........... 3 Typl ihus, nm rin : t ... .... ..-. 33
Psittacosis: Calif.-1 ......... .. .... .... 43


Excludes Report from Oregon Weather Conditions.


dod


. 1791
. ik






Morbidity and Mortality Weekly Report


FOLLOW-UP AND TWO ADDITIONAL OUTBREAKS OF
EPIDEMIC GASTROENTERITIS, POSSIBLE WINTER VOMITING DISEASE
Ohio and Oklahoma


Since the report of epidemic gastroenteritis from Nor-
walk, Ohio, appeared (MMWR, Vol. 17, No. 47), two similar
outbreaks have been reported to NCDC. One of the epi-
demics occurred r.. rli, in a public school in Columbus,
Ohio, and the second in a college in Oklahoma in September.
Both epidemics had certain clinical and epidemiologic
features in common: sudden onset, absence of prodromata,
nausea and vomiting as the principal symptoms, mild fever
in less than 40 percent of cases, little diarrhea, no seque-
lae, and failure to isolate the causative agent or agents.
Illness occurred in primary cases over a 2-3 day span sug-
gesting a common source.
The epidemic in Columbus began in an elementary
school on Wednesday morning, December 4. Over the next
2 days there was an absentee rate of about 25 percent.

Figure 1
81 PRIMARY CASES OF GASTROENTERITIS
BY TIME OF ONSET
COLUMBUS, OHIO DECEMBER 2-6, 1968
38


2 3 4
DEC
12- HOUR PERIODS


The majority of cases occurred in the 24-hour period be-
tween noon December 4 and noon December 5 (Figure 1).
Cases occurred in all classrooms but were concentrated
in the first and second grades, where absentee rates ranged
between 19 and 88 percent. Secondary and tertiary spread
to family contacts was documented; onset of illness was
spread over a 5-day period (Figure 2). No food is served
at the school, and the water is from the Columbus water
supply. Stool cultures on 25 ill school children were nega-
tive for common bacterial pathogens, and viral studies are
in progress. It is of interest that in the early part of the
week the three first grades held joint classes as did the
two second grades.
The Oklahoma epidemic occurred among freshman
girls residing in one dormitory. Of the 300 girls living in the
dormitory, 76 (25 percent) became ill over the weekend of

Figure 2
CASES OF GASTROENTERITIS IN FAMILY CONTACTS
OF PRIMARY CASES BY DAY OF ONSET
COLUMBUS, OHIO DECEMBER 4-9, 1968


4 5 6 7


8 9


478


DECEMBER 28, 1968


I





Morbidity and Mortali


September 2S'; 11 were hospitalized. gastrointestinall ill-
ness lid not occur in other students, and only three sec-
ondary cases, w-ith ain average incubation proriod of 36
hours could be documented. Sixth y--'is\en (Sh percent) of
the ill students ate the noon meal in he dormitory cafeteria
on Friday. Sptenmlier 27. 7Ho'aer, students who did not
Ibecomen ill we're nrot questioned nor w ere food histories
obtained. Bactrial ultures taken of ithe suspect meal were
negati\ e.
Follow-up studies in Norwalk in early December
showed a 9.5 percent incidence of ga trointestinal illness
in the community after the original investigation. This is
significantly higher than the 3 percent incidence found at
the time of the epidemic. In this latter survey, attack rates
in grade school children (14 percent) and infants (21 per-


DECEMBER 28, 1968


CURRENT TRENDS
GONORRHEA United States*


National case reporting of gonorrhea began in the fis-
cal year ending June 30, 1941: that year, 193.468 cases
were reported. Subsequent case totals increased annually
to a peak of 400,639 in 1917. After 1947, cases decreased
annually to a low of 216,476 cases in 1957. Beginning in
1957, cases increased each year with the exception of
1962 and reached a new high of 431,380 cases in fiscal
year 196s, ending June 30, 1968 (Figure 3).
The twofold increase in cases reported between 1957
and 196b was reflected in cases reported by private medi-


Figure 3
CIVILIAN CASES OF GONORRHEA, BY REPORTING AGENCY
UNITED STATES FISCAL YEARS 1947-1968


FISCAL YEAR


cal facilities as well as in cases reported ib ta\ sup-
ported hospitals and venereal disease clinics. Cases re-
ported from private medical facilitie- during the period
from 1957 to 196b increased bh 232 percent (from 37.29"5
to 123,756) and cases reported by public medical facilities
increased by 71 percent (from 179,ISI to 307,624).
The 431,380 cases reported in the United States in
1968 represented an increase of 55,774 cases or 14l. per-
cent over the number reported in 1967. In 196s, cases re-
ported from private medical facilities, and public medical
facilities increased 14.7 and 14.9 percent. respectir ely.
The total cases reported in 1957. 1967, and 1968 and
current case rates are presented in Table 1. The Pacific
and New England Divisions reported the largest propor-
tional increase in cases from 1957 to 1965. The only dii-
sion that reported fewer cases in 1965 than in 1957 was
the East South Central Division. Only two states reported
fewer cases in 1965 than 1957 and both of these states
(Mississippi and Tennessee) are in the East South Central
Division.
In 1968. 45 states reported more cases than in 1967.
Case rates in 1968 ranged from a high of 425.9 cases per
100,000 population in Georgia to a low of 60.5 cases per
100,000 population in I ..-..

(Reported by the Venereal Disease Program, N('tCD.)


XAll yearly totally referre-d to h in thi t -tirl i airt f i.,( year total- .
The fiscal vear begins on Jul 1 of theu cle ndir r r and end-
on June 30 of tlh .su ceedin \-ear.


(See Table I on page 4i80


ty Weekly Report 179


cnt) \ eri- hiiglih r th art ini a ult i (( p rc nit) and t.icnagI r-
(10 percenrl) No \ iral or bacterial ag nt- go hae it t'n i .-
lat(d to date. \ iroloh i' sludii s c nt ini,.
(Heported by 'alin HP. iNpe' er, 1r .. t't/h l (bii Conm
nmtnicu able Dl is'a e I/.rision, n<./,lrk //. HuK,'ll., ),11 .\t..
Chief[, )irisiion of Veterinary P ubl He, /alth. OhIii, part
meiin of Hlealth, (Carry B. f 'Pa l. a l .I)., t('oimbun S( ho,)
s /ste m Ph ysician; William Irown. .1., )pute y 1a/l
(ommiission er, Columbu.s IHealth De apartment : ieor/e' F.
/ inn, 11.)., Commissioner of Ifealt/., fluroi ('ountiy /)P part-
meint of /Health, \orwaulk, //uron I o'nty/, Ohbio, Lef oy/
Carpenter. il.D., Director, Division of Epidemioo/gy. Okla-
homa State Department of Health: Robert Bowers. f.1D..
School of Health, U'nircr. i/y of Oklahoma, Oklahoma C'ity
and a team of EIS Officers.)






480 Morbidity and Mortality Weekly Report DECEMBER 28, 1968


Table 1
Reported Civilian Cases of Gonorrhea and Rates per 100,000 Population
United States, Selected Fiscal Years


Case.
Cases Pac C -.a per 100,000
Percent Change
Area 1957 1967 196 in 1968 from Population. 196S
1957 1967 Rate Rank
UNITED STATES 216.860 375,606 431.380 + 98.9 + 14.8 219.2
NE\W ENGLAND 3.271 10,171 12,475 +281.4 + 22.7 111.1
Maine 51 494 862 +964.2 + 74.5 90.1 40
New Hampshire 43 466 416 +867.4 10.7 61.1 49
\ ermont 55 265 281 +410.9 + 6.0 67.7 4S
Massachusetts 1,529 4,925 5,816 +280.4 + 18.1 10(.0 37
Rhode Island 187 405 837 +347.6 +106.7 95.7 39
Connecticut 1.376 3,616 4,263 +209.8 + 17.9 146.4 29
MIDDLE \TLANTIC 22,126 52.23s 60.994 +172.0 + 16.8 165.5
New York 13,399 36,754 40,194 +200.0 + 9.4 219.(i 16
New Jerse\ 4,215 4.922 6,891 + 63.5 + 40.0 99.2 3
Pennsyl) ania 4,812 10.562 13,909 +189.0 + 31.7 119.s 33
EAST NORTH CENTRAL 38.801 77.928 86,130 +122.0 + 10.5 220.s
Ohio 7,044 15.797 20,115 +185.6 + 27.3 192.7 20
Indiana 2.040 5.198 5,855 +187.0 + 12.6 117.4 35
Illinois 20,023 37,485 39,326 + 96.4 + 4.9 363.3 3
Michigan 6.862 16.741 17,.83 + 95.0 + 3.2 201.S 19
\isconsin 832 .,707 3,551 +326.8 + 31.2 84.9 44
\%EST NORTH CENTRAL 9.486 20,937 25,564 +169.5 + 22.1 161.2
\innesota 735 2,640 3.113 +323.5 + 17.9 87.1 43
loa 621 3,193 3,710 +497.4 + 16.2 131.9 30
Missouri 5.214 9,105 11,539 +121.3 + 26.7 252.h 10
North Dakota 188 455 435 +131.4 4.4 69.4 47
South Dakota 443 701 1.041 +135.0 + 48.5 156.1 27
Nebraska 670 1.356 2,167 +223.4 + 59.8 152.4 2s
Kansas 1,615 3.487 3,559 +120.4 + 2.1 157.9 26
SOlTH ATLANTIC 64,726 75,392 86,134 + 33.1 + 14.2 299.4
Delaware 411 1,265 1,534 +273.2 + 21.3 297.9 9
Marvland 7.032 7.228 8,678 + 23.4 + 20.1 240.6 12
District of Columbia 9,732 11.615 12,231 + 25.7 + 5.3 1.544.3:
Virginia 6,751 9.282 9.918 + 46.9 + 6.9 225.6 14
West \ ,r ...,, 1,065 1,129 1,259 + 18.2 + 11.5 70.1 46
North Carolina 10,652 10.417 11,133 + 4.5 + 6.9 226.s 15
South Carolina 6,235 7,765 8,697 + 39.5 + 12.0 344.2 t
Georgia 12,851 15.140 18,688 + 45.4 + 23.4 425.9 1
Florida 9,997 11,551 13,996 + 40.0 + 21.2 237.2 13
EAST SOUTH CENTRAL 27,005 24,705 26,152 3.2 + 5.9 204.0
Kentucky 3,002 3.670 3.733 + 24.4 + 1.7 11s6. 34
Tennessee 12,915 11.582 12,166 5.8 + 5.0 315.8 6
Alabama 3,591 4,245 4,565 + 27.1 + 7.5 130.3 32
Mississippi 7,497 5,20b 5,688 24.1 + 9.2 245.3 11
,EST SOUTH CENTRAL 28,257 44.752 48,255 + 70.8 + 7.8 258.4
Arkansas 4.668 5,996 6,140 + 31.5 + 2.4 313.4 7
Louisiana 5,668 5.910 6,307 + 11.3 + 6.7 174.3 24
Oklahoma 4,040 3,918 3,923 + 2.9 + 0.1 160.4 2.
Texas 13,b81 28,928 31,885 +129.7 + 10.2 299.3 b
MOUNTAIN 4,751 10,433 11,152 +134.7 + 6.9 145.4
Montana 231 449 524 +126.8 + 16.7 75.8 45
Idaho 253 954 804 +217.8 15.7 115.7 36
Wyoming 63 188 188 +198.4 0.0 60.5 50
Colorado 775 2.471 2,570 +231.6 + 4.0 133.5 31
New Mexico 861 1,806 1,880 +118.4 + 4.1 190.9 21
Arizona 2,076 3,157 3,326 + 60.2 + 5.4 207.1 1b
Utah 229 773 911 +297.8 + 17.9 89.5 41
Ne ada 263 635 949 +260.8 + 49.4 217.2 17
PACIFIC 18,137 59.050 74,524 +310.9 + 26.2 301.3
\hashington 1,131 4,765 5,543 +390.1 + 16.3 183.0 23
Oregon 516 3,163 3,659 +609.1 + 15.7 183.5 22
California 16,106 49,547 63,783 +296.0 + 28.7 339.4 5
Alaska 235 1,190 931 +296.2 21.8 391.2 2
Hawaii 149 385 608 +308.1 + 57.9 88.9 42
PUERTO RICO 3,310 2,635 2,481 25.1 5.9 93.4






DECEMBER 28, 1968


Morbidity and Mortality Weekly Report


INDEX VOLUME 17 1968


AFRICAN SLEEPING SICKNESS
Epidemic Reports
Florida, 412
ANTHRAX
Epidemic Reports
California, 279
Connecticut, 102
Massachusetts, 198
Rhode Island, 198
ARSINE GAS POISONING
Epidemic Reports
New Jersey, 350

BOTULISM
Epidemic Reports
Alaska, 169
California, 199, 211, 304, 306, 446
Michigan. 348
Summaries
Annual, 6, 137, 160, 444
Current. 381
Trivalent Botulinus Antitoxin, 444

BOVINE CYSTICERCOSIS
Epidemic Reports
Texas, 140, 168, 241

BRUCELLOSIS
Summary
Annual, 92

CADMIUM FOOD POISONING
Epidemic Reports
Minnesota, 320

CANINE ABORTION, HUMAN INFECTION
Epidemic Reports
New York, 285

CHEMICAL POISONING
Epidemic Reports
Minnesota, 320
New Jersey, 350
Texas, 263, 376
International Notes
Middle East (Qatar, Saudi Arabia), 234

CHINESE FOOD POISONING
Epidemic Reports
Florida, 455

CHOLERA
International Notes, 180
Recommendation of the PHS Advisory Committee on
Immunization Practices Cholera Vaccine, 181

CLOSTRIDIUM PERFRINGENS
Epidemic Reports
New York. 415
Washington, 232
Summaries
Annual, 137, 160
Current, 381


COCCIDIOIDOMYCOSIS
Epidemic Reports
New York, 153, 16h
DIPHTHERIA
Epidemic Reports
Florida. 35h
Georgia, 358
Texas, 397
Summary
Annual. 103
ECHINOCOCCOSIS
Epidemic Reports
New York, 20
ENCEPHALITIS, ARTHROPOD-BORNE
Epidemic Reports
Florida, 414
Illinois, 337
Kentucky, 346
Maryland, 328
New Jersey, 307
United States. 278, 371
Summary
Current. 276, 346
ENCEPHALITIS, PRIMARY AND POST-INFECTIOUS
Summaries
Annual. 71
Current, 183

ENDRIN POISONING
International Notes
Middle East (Qatar, Saudi Arabia), 234
EXCESS MORTALITY
Summary
Current, 288
FOODBORNE DISEASE OUTBREAKS
Epidemic Reports
Colorado, 189
Florida. 7, 455
Mississippi, 348
New Jersey. 321, 455
New York, 452
Ohio, 418
Oregon, 222
Pennsylvania, 121
Texas. 109
Washington, 232
Summaries
Annual, 137, 160
Current, 381
GASTROENTERITIS
Epidemic Reports
Mississippi, 348
New Jersey, 321, 455
New York, 452
Ohio, 434, 478
Oklahoma, 478
Oregon, 222
(Continued on page 482)












Pennsylvania, 121
Texas, 109
Washington, 232
GONORRHEA
Summary
Current, 479
HAND, FOOT, AND MOUTH DISEASE
Epidemic Reports
Maryland, 27S
New York, 279
HEPATITIS
Epidemic Reports
Michigan, 271, 359
New Jersey. 298
W\ashington, 34
Recommendation of the PHS Advisory Committee on
Immunization Practices Immune Serum Globulin, 290
Summary
Current, 122, 390
INFLUENZA
Epidemic Reports
California, 357
Georgia. 329
Hawaii, 357
Illinois, 43. 396
Michigan. 23
Missouri. 43
New Jersey, 357
New York. 13
Ohio. 357
Penns\l ania, 43, 463
United States, 125. 433, 441, 453. 461, 469. 477
'ashington. 1, 33s
Washington, D.C., 43, 357
International Notes
Australia, 345
Canal Zone. 32
Denmark. 31
Federal Republic of Germany. 31
France, 31
Hong Kong. 277, 305. 313
Indonesia. 329
Iran. 35S
Italy. 31
Jamaica. 32
Japan, 2B
Netherlands. 31. tI
Norway. 31
Philippines, 329. 345
Puerto Rico, 133
Singapore, 329
South America (Argentina, Chile), 228
Sweden, 31
Switzerland, 31
Taiwan. 2h, 329
Trinidad. 345
United Kingdom. ,31, 396
Yugoslavia, 31
Pneumonia-Influenza Deaths, 244, 4


DECEMBER 28, 1968


Recommendation of the PHS Advisory Committee on
Immunization Practices Influenza Vaccines 1968-
69, 246; Influenza 1968-69. 323; A2 Influenza Virus
Vaccine, Monovalent, 1968-69, 368; Chemoprophy-
laxis, 1968-69, 368
Summary
Current, 4, 14, 29, 31 (Laboratory Findings), 43, 50
57, 244, 369
KALA-AZAR
Epidemic Reports
Maryland, 110
LEPTOSPIROSIS
Epidemic Reports
Georgia. 286
Summary
Annual, 235
LISTERIOSIS
Summary
Annual, 383
MALARIA
Epidemic Reports
Alabama, 314
California, 270
Delaware, 34
Georgia, 286
Hawaii. 111
Maryland, 339
Minnesota, 351
New York, 211
Oklahoma. 415
Texas. 351, 378
Washington. 297
Washington, D.C., 149
International Notes
Ceylon. 93, 141, 160
Summary
Annual, 201

MARBURG DISEASE
International Notes, 223, 252
MEASLES
Epidemic Reports
California, 230
Illinois. 70, 101
Louisiana, 349
Montana. 112, 136
New Hampshire, 86
North Carolina, 476
Pennsylvania, 446
Rhode Island. 468
Utah, 176
Washington, D.C., 407
International Notes
Nigeria, 362
Summaries
Annual, 22, 215 (Measles Mortality), 379
Current, 2, 32, 41, 42, 43, 49, 61, 62, 76, 79, 85, 95,
102, 113, 123, 129, 153, 163. 168, lb2, 200, 201,
213, 215, 221, ..- 229, 230, 244, 268, 287, 307,
331, 361, 398. 416.


Morbidity and Mortality Weekly Report


INDEX VOLUME 17 1968 (Continued from page 481)







Morbidity and Mortality Weekly Report


MENINGITIS, ASEPTIC
Epidemic Reports
Florida, 317
llHaaii. (, 62 76
Summary
Annual. 1Il
MENINGOCOCCAL INFECTION
Epidemic Reports
Florida, 3:147
lHawaii. 17n
Mississippi. 21, :132
Oregon, I11
International Notes
Sicily, ")*;
Summaries
annual 33
('urrenl. 50, 62, 7h, S7T, 131, 179, 299
MENINGOENCEPHALITIS, PRIMARY AMEBIC
Epidemic Reports
\ irginia, 330
MORBIDITY REPORTING, 312, 356
MUMPS
Recommendation of thi PHIS \d' isory committeee on
Immunization Practices Mumps Vaccine, 4191
ORGANIC PHOSPHATE POISONING
Epidemic Reports
Texas. 376
PARATHION POISONING
Epidemic Reports
Texas, 263
PERTUSSIS
Epidemic Reports
Oregon. 6(
PLAGUE
Epidemic Reports
\rizona. 269
(olorado, 2.i3, 261, 270
Idaho. 105
International Notes
Indonesia, 21 1
Recommendation of the PHS d\isor\ (Comnittilee on
Immunization Practices Plague \accine. 171
PNEUMONIA
Epidemic Reports
South Dakota, 13:
PNEUMONIA, MYCOPLASMA PNEUMONIAE
Epidemic Reports
G(eorgia, 413
PNEUMONIA, PNEUMOCYSTIS CARINII
Epidemic Reports
Net' Jerse\ 51

POLIOMYELITIS
Epidemic Reports
Missouri. 279
Teas-. 69. 77
\ashinston, D.C.. 4114

QUARANTINE MEASURES
12. 20, 40, 63. n4, 100, 10. 120, 12 14s. i;s.n
1hh,. 203. 252, 304. 412, 424


Method of Rl'cording l)al, of Ini Trnational ( irvilia,
of \ a ("iUation, 213. 22S
RABIES
Epidemic Reports
K a n.a,. 3 >
Pennslviania. 33
Texas, 152
RECOMMENDATIONS OF THE PHS ADVISORY COM-
MITTEE ON IMMUNIZATION PRACTICES
Cholera. Ih1
llepatiti, 290
Influenza 216fi. 323, 3(;h
Miumps. I1!)
Plague. 171
Typhus. 191
RELAPSING FEVER
Epidemic Reports
Oregon. 362
\hashington, 197
SALMONELLOSIS
Epidemic Reports
Florida, 7
Mi souri. 330, 371. 470
New, Jersey. 321. 455
PeInnsvivania. 121
Tennessee. 150, 117
\ is on-in. 231
International Notes
Cuha. 427
Salmonella Contamination of Enz\matic Drain Cleanei
162
Summaries
Annual, 137, 160
Current, 79, 20Sn, 220, 3(i0. 3S1
SCOMBROID FISH POISONING
Epidemic Reports
Ne\, York, 152
SHIGELLOSIS
Epidemic Reports
Ohio, 41h
\ashington. I()
Summaries
Annual. 137, 160
Current,. 2i4, 2is. 3S1
SMALLPOX
International Notes
Africa. 33), 447
U'ruguay, 4(;0
STAPHYLOCOCCAL FOOD POISONING
Epidemic Reports
\Mi- iippi. 34s
Texas, 109
International Notes
Puerto Rico. 377
Summaries
Annual, 137, 160
(Current. 31 1
STREPTOCOCCAL INFECTION
Epidemic Reports
Colorado, 1 N
\v ermon nt. 40(; (('w,,n 7 :. 1. od p.I1i ',


DECEMBER 28, 1968


r,





S"







181 Morbidity and Mortality Weekly Report


TABLE III. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

DECEMBER 28, 1968 AND DECEMBER 30, 1967 (52nd WEEK)


ENCEPHALITIS HEPATITIS
ASEPTIC DPHTHERA Primary Post-
AREA MENINGITIS including infectious Serum Infectious MALARIA
unsp. cases
1968 1967 1968 1968 1968 1967 1968 1968 1968 1967 1968
UNITED STATES... 70 29 2 2 21 19 5 86 673 695 53

NEW ENGLAND.......... 1 1 5 31 27 2
Maine............. 4 2
New Hampshire...... 1 3
Vermont............. 1 -
Massachusetts ...... 8 9 2
Rhode Island........ 1 8 2
Connecticut........ 1 4 10 11 -

MIDDLE ATLANTIC...... 11 2 56 135 104 2
New York City...... 4 1 49 55 36
New York, up-State. 5 3 15 19 2
New Jersey.......... 2 1 2 29 23
Pennsylvania....... 2 36 26

EAST NORTH CENTRAL... 3 2 1 10 1 2 1 98 111 1
Ohio................ 1 4 20 32
Indiana.*.......... 1 2 7 4
Illinois............ 1 18 42
Michigan........... 1 2 4 1 46 27 1
Wisconsin........... I 1 1 7 6

WEST NORTH CENTRAL... 2 1 5 1 28 52 31
Minnesota.......... 2 1 5 17
I ua ............... 7 6
Miisouri........... 1 13 25
North Dakota.......- 2 -
South Dak ta.....- -
Nebraska............ -
Kansas ............. 4 1 3 2 31

SOUTH ATLANTIC....... 4 1 1 1 2 2 3 74 65 8
Delaware........... 1 4
Maryland........... 1 13 19 1
Dist. of Columbia.. 2 -
Virginia........... 1 1 1 2 1 7 25
West Virginia...... -- 2 -
North Carolina..... 6 5 6
South Carolina..... 3 -
Georgia............ 6 6
Florida............. 3 1 3 34 6 1

EAST SOUTH CENTRAL... 30 3 2 1 1 20 28 1
Kentucky............ 1 11 10 -
Tennessee............ 28 1 1 1 12
Alabama............ 1 1 7 4 1
Mississippi........ 2 2 1 2

WEST SOUTH CENTRAL... 1 2 1 39 55
Arkansas. .......... -
Louisiana .......... 1 6 14
Oklahoma........... 1 4 9 -
Texas. ............ 1 1 29 32

MOUNTAIN............ 2 1 4 2 18 64 7
Montana............. 3 9 6 -
Idaho............... 1
Wyoming............ 2 -
Colorado............. 2 34 7
New Mexico......... 2 11 -
Arizona............ 1 1 4 11
Utah ............... 3 1
Nevada............. -

PACIFIC.............. 20 17 1 6 2 19 230 189 1
Washington......... 1 13 9
Oregon ............. --- --- --- --- --- --- --- 9 ---
California.......... 19 13 1 6 2 19 202 171 1
Alaska............. 12
Hawaii............. 3 3

Puert,, Ri,4........... 17 16
*Delayed Reports: Aseptic Meningitis: Tex. 1
Diphtheria: Tex. 1
Encephalitis, post-infectious: Tex. 1
Hepatitis, serum: Tex. 2
Hepatitis, infectious: Maine 9, Indiana delete 1, Tex. 44, P.R. 5






Morbidity and Mortality Weekly Report 18.5


TABLE III. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

DECEMBER 28, 1968 AND DECEMBER 30, 1967 (52nd WEEK) CONTINUED


MEASLES (Rubeola) MENINGOCOCCAL INFECTIONS, MUMPS POLIOMYELITIS RUBELLA
TOTAL
AREA Total Paral -
Cumulative Cumulative Total Paral-

1968 1968 1967 1968 1968 1967 1968 1968 1968 8 1968
UNITED STATES... 205 22,527 62,335 17 2,516 2,166 1,611 37 277

NEW ENGLAND........... 30 1,351 960 139 87 209 1 19
Maine.............. 38 264 6 3 14 -
New Hampshire...... 150 78 8 4
Vermont ............ 3 34 1 2 7 3
Massachusetts...... 1 388 416 74 39 113 1 9
Rhode Island....... 65 62 9 7 18 -
Connecticut........ 29 707 106 41 32 57 7

MIDDLE ATLANTIC...... 31 4,727 2,653 3 447 357 107 1 16
New York City...... 25 2,433 528 1 90 72 24 2
New York, Up-State. 1 1,372 678 1 75 87 NN 1 8
New Jersey.A....... 1 721 658 160 111 83 5
Pennsylvania....... 4 201 789 1 122 87 NN 1

EAST NORTH CENTRAL... 32 4,261 6,373 5 318 296 370 11 92
Ohio................ 2 333 1,220 1 85 96 35 2 6
Indiana............. 6 746 678 45 32 69 3 58
Illinois.* .. ...... 8 1,445 1,306 1 72 70 20 3 1
Michigan........... 10 353 1,048 2 91 76 74 3 15
Wisconsin.......... 6 1,384 2,121 1 25 22 172 12

WEST NORTH CENTRAL... 4 488 3,018 2 141 103 97 -- 3 27
Minnesota.......... 19 139 1 30 23 8 -
Iowa................ 165 825 14 22 86 1 20
Missouri............ 81 340 1 50 22 3 2 5
North Dakota....... 142 896 4 3 2
South Dakota ...... 4 58 5 7 NN -
Nebraska........... 4 67 663 9 16 -
Kansas ............. 10 97 29 10 -

SOUTH ATLANTIC....... 23 1,819 7,399 3 501 425 89 3 27
Delaware............ 3 23 52 12 8 8
Maryland........... 1 104 182 44 60 4 1
Dist. of Columbia.. 6 26 17 19 I
Virginia........... 425 2,346 50 47 14 -
West Virginia...... 11 337 1,486 14 38 30 1 7
North Carolina..... 322 942 99 88 NN 1
South Carolina..... 1 29 517 63 36 8 1
Georgia............. 4 42 2 98 60 -
Florida............ 7 569 1,806 1 104 69 33 10

EAST SOUTH CENTRAL... 508 5,540 222 179 55 1 7
Kentucky........... 107 1,437 98 53 25 1 3
Tennessee.......... 65 2,068 70 77 30 2
Alabama............ 95 1,357 29 32 1
Mississippi........ 241 678 25 17 1

WEST SOUTH CENTRAL... 66 5,380 18,321 3 363 278 120 24 14
Arkansas........... 2 1,404 21 43 1
Louisiana.......... 1 26 159 1 104 105 2 1
Oklahoma........... 132 3,400 56 20 15 -- 2
Texas.4............ 65 5,220 13,358 2 182 110 103 21 13

MOUNTAIN............. 5 1,100 5,060 46 41 121 1 26
Montana............ 58 339 7 6 28 2
Idaho.............. 21 413 12 3 9 -
Wyoming............ 55 207 3 1
Colorado............ 1 526 1,771 14 13 26 12
New Mexico.......... 4 176 612 1 5 19 1
Arizona.. ......... 235 1,066 5 6 34 1 5
Utah................ 21 383 1 4 5 6
Nevada............. 8 269 3 3 -

PACIFIC............... 14 2,893 13,011 1 339 400 443 12 49
Washington.......... 2 607 5,689 1 52 39 17 1 10
Oregon............. --- 592 1,717 --- 25 32 --- --- ---
California......... 12 1,648 5,282 244 314 394 11 35
Alaska.............. 11 141 4 11 22 3
Hawaii............... 1 35 182 14 4 10 1

Puerto Rico.......... 12 524 2,245 21 15 13 1
*Delayed Reports: Measles: N.J. Delete 1, Tex. 44
Meningococcal infections: Tex. 2
Mumps: Tex. 170, Ariz. 2
Poliomyelitis, paralytic: 111. 1
Rubella: Tex. 23, Ariz. delete 1







486 Morbidity and Mortality Weekly Report


TABLE III. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

DECEMBER 28, 1968 AND DECEMBER 30, 1967 (52nd WEEK) CONTINUED


STREPTOCOCCAL TYPHUS FEVER
SORE THROAT & TETANUS TULAREMIA TYPHOID TICK-BORNE RABIES IN
AREA SCARLET FEVER (Rky. Mt. Spotted) ANIMALS
Cum. Cum. Cum. Cum. Cum.
1968 1968 1968 1968 1968 1968 1968 1968 1968 1968 1968
UNITED STATES... 8,273 1 159 172 3 405 2 279 36 3,317

NEW ENGLAND........... 1,465 4 47 13 2 74
Maine. ............ 11 2 55
New Hampshire...... 1 1 2
Vermont............ 6 47 11
Massachusetts...... 158 i 7 2 5
Rhode Island........ 47 -
Connecticut........ 1,243 2 3 1

MIDDLE ATLANTIC...... 270 19 10 35 22 55
New York City...... 8 11 18 -
New York, Up-State. 199 4 7 8 5 45
New Jersey......... NN 1 4 7
Pennsylvania....... 63 3 3 5 10 10

EAST NORTH CENTRAL... 616 1 18 11 50 9 1 285
Ohio................ 110 2 1 20 7 93
Indiana............ 79 2 1 7 90
Illinois........... 91 8 8 20 2 39
Michigan........... 213 1 4 1 1 17
Wisconsin.......... 123 2 2 1 46

WEST NORTH CENTRAL... 373 15 17 46 9 6 829
Minnesota.......... 5 2 2 1 266
Iowa............... 81 4 2 1 1 126
Missouri........... 1 5 8 30 3 2 126
North Dakota....... 139 1 2 137
South Dakota ..... 19 1 3 2 4 97
Nebraska........... 75 3 1 5 1 27
Kansas............. 53 5 4 50

SOUTH ATLANTIC....... 1,023 32 12 2 66 1 143 9 412
Delaware........... 19 1
Maryland.......... 138 3 1 10 18 6
Dist. of Columbia.. 1 2 1 2
Virginia........... 486 4 3 10 1 45 6 147
West Virginia...... 151 2 1 1 2 1 52
North Carolina..... 10 2 3 4 39 12
South Carolina.*... 61 4 4 9
Georgia............ 18 3 4 15 27 83
Florida............ 139 12 2 21 3 2 109

EAST SOUTH CENTRAL... 749 19 11 50 1 58 17 717
Kentucky............ 169 1 2 12 10 13 391
Tennessee.......... 438 8 7 22 39 3 291
Alabama............ 120 7 3 5 28
Mississippi........ 22 3 2 13 1 4 7

WEST SOUTH CENTRAL... 668 31 51 54 30 1 498
Arkansas........... 5 15 20 6 62
Louisiana.......... 1 10 7 6 1 48
Oklahoma............ 80 12 15 14 125
Texas*.............. 587 16 17 13 9 1 263

MOUNTAIN............. 2,302 1 9 22 5 92
Montana............ 35 -
Idaho.............. 297 -
Wyoming ............ 30 1 1 4
Colorado........... 1,368 3 5 4 4
New Mexico.......... 196 9 40
Arizona............. 173 I 6 40
Utah.... ......... 203 5 1
Nevada............. 1 3

PACIFIC.............. 807 20 4 1 69 1 2 355
Washington.......... 102 1 2 2
Oregon............. --- --- I --- I --- 5 --- --- 6
California......... 637 18 3 1 61 1 2 347
Alaska ............. 19 1- ---
Hawaii.............. 49 -

Puerto Rico .......... 13 5 20

*Delayed Reports: SST: Maine 122, S.C. 5, Tex. 1,007
Rabies in Animals: Tex. 3







Morbidity and Mortality W'eekl Report 18;






Week No. TABLE IV. DEATHS IN 122 IINITEI) STATE'S CITIES FOR WEi K ENI)EI) DECEMBER 28, 1968

52
(By place of occurrence and week of filing certificate. Excludes fetal deaths)
I I I II I I I


Area


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, I11.-----------
Rockford, Ill.--------
South Bend, Ind.-------
Toledo, Ohio----------
Youngstown, Ohio------

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


All Causes

All 65 years
Ages land over


942
283
60
38
28
95
56
30
40
75
73
21
46
29
68

4,185
58
36
208
30
31
47
64
88
2,376
47
417
190
81
148
42
55
115
59
36
57

3,244
96
46
982
148
265
154
110
517
34
53
52
55
55
182
25
131
46
55
27
126
85

924
59
24
41
181
20
116
86
252
82
63


588
156
40
26
21
56
42
17
26
45
41
13
32
23
50

2,451
33
26
139
15
19
27
42
49
1,353
24
239
102
57
93
24
40
69
36
28
36

1,851
54
30
516
96
143
90
61
299
19
31
33
26
43
103
15
82
21
31
18
85
55

565
42
13
23
110
15
69
47
140
59
47


Pneumonia
and
Influenza
All Ages


Under
1 year
All
Causes


*Estimate based on average percent


Area


SOUTH ATLANTIC:
Atlanta, Ca.----------
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.---------n
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.----------


All Causes

All 65 years
Ages and over


1,229 665
113 50
272 144
42 21
76 43
126 74
59 32
110 55
30 16
99 80
75 41
183 89
44 20

417 243
67 34
37 20
27 19
112 76
87 48
32 16
21 12
34 18

1,043 554
38 21
48 24
16 10
165 88
51 31
77 46
141 58
40 25
184 87
77 43
112 66
50 26
44 29

557 332
64 28
38 23
120 70
15 8
172 104
27 17
58 36
63 46

1,523 914
23 20
67 43
29 20
53 26
103 63
379 239
81 51
34 20
115 77
71 39
99 52
195 113
48 29
128 64
67 40
31 18


Pneumonia
and
Influenza
All Ages


Total 14,064 8,163 1,168 505


Cumulative Totals
including reported corrections for


Under
1 year
All
Causes

37
7
4
3
6
4
3
3

2
1
4


previous weeks


All Causes, All Ages ------------------------ 665,999
All Causes, Age 65 and over------------------- 382,536
Pneumonia and Influenza, All Ages------------- 27,550
All Causes, Under 1 Year of Age--------------- 31,176


of divisional total.







188 Morbidity and M(


INDEX-VOLUME 17-1968 (Coininued from page S,3)

Summaries
Annual. 1:17. 160
Current. :;.sl
SYPHILIS
Epidemic Reports
Alahama. 32:2
Summaries
annual 426
Current (Tables). 14. 60. .)5. 130, 170. 212. 2).55. 363.
407. 426. 471
TAENIASIS
Epidemic Reports
Rhode Island. 209

TETANUS
Summary
Annual. 131. 1.52. 1f6 179
TICK PARALYSIS
Epidemic Reports
Oregon. 2s(;
TRICHINOSIS
Epidemic Reports
Haw aii. 2i60
Ohio. 210. 22s
Summary
Annual, S n
TUBERCULOSIS
Epidemic Reports
(Georgia a. 2'
Neov, York. 270
Summaries
annual 114. 3)l s
( urrent. 94
TULAREMIA
Epidemic Reports
iooraia, :213
\ r\ YoIrk. 177. 2(;>i
\Vermonl. 161, 190. 262
TYPHOID FEVER
Epidemic Reports
\li-souri. 3:30, 371. 470
Tenne-' ee. 150. 417
International Notes
Cuba. 127
TYPHUS, LOUSE-BORNE
Recommendation of the PHS Ad\ i-or\ ('onmittee ion
Inmi unization Practi(e-, T\phus vaccine 191
TYPHUS, MURINE
Epidemic Reports
\lar land. Ai I
TYPHUS, SCRUB, SUSPECT
Epidemic Reports
Kan-a-. ,79
UNKNOWN ETIOLOGY
Epidemic Reports
\frian \Monke\-, erniin\: See, \arhurI Dis-ia--
Fehrile Illnes.- \lic ietan, 31.,
(ia troiinter-inal Illne.'.-. Ohio. 434. 471 ,: Oklahoma. 47ITs
VACCINIA
Epidemic Reports
Indiana, 1 ; G
VACCINIA NECROSUM
Epidemic Reports
Oreon. 3u12


rtality Weekly Report


DECEMBER 28, 1968 <
0--qO


THE MORBIDITY AND MORTALITY WEEKLY REPORT, WITH A CIRCULA-
TION OF 17 000 IS PUBLISHED AT THE NATIONAL COMMUNICABLE
DISEASE CENTER, ATLANTA, GEORGIA,
DIRECTOR. NATIONAL COMMUNICABLE DISEASE CENTER
DAVID J. SENCER, M.D.
CHIEF, EPIDEMIOLOGY PROGRAM A. D. LANGMUIR, M.D,
CHIEF. STATISTICS SECTION IDA L. SHERMAN, M.S5
EDITOR MICHAEL B GREGG, M.D
MANAGING EDITOR PRISCILLA B HOLMAN

IN ADDITION TO THE ESTABLISHED PROCEDURES FOR REPORTING
MORBIDITY AND MORTALITY, THE NATIONAL COMMUNICABLE DISEASE
CENTER WELCOMES ACCOUNTS OF INTERESTING OUTBREAKS OR CASE
INVESTIGATIONS WHICH ARE OF CURRENT INTEREST TO HEALTH
OFFICIALS AND WHICH ARE DIRECTLY RELATED TO THE CONTROL
OF COMMUNICABLE DISEASES. SUCH COMMUNICATIONS SHOULD' BE
ADDRESSED TO-
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 WEEK CONCLUDES
AT CLOSE OF BUSINESS ON FRIDAY, COMPILED DATA ON A NATIONAL
BASIS ARE RELEASED ON THE SUCCEEDING FRIDAY.


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