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:
AA00010654:00167

Related Items

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


This item is only available as the following downloads:


Full Text

NATIONAL COME /DI E

NATIONAL COMMUNICABLE DISEASE CENTER


Vol. 18, No. 2

WEEKLY

REPORT

For

Week Ending

Jaouary 11, 1969


U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE PUBLIC HEALTH SERVICE 9
DATE OF RELEASE: JANUARY 17, 1969 ATLANTA

EPIDEMIOLOGIC NOTES AND REPORTS
INFLUENZA United States


An assessment of the current prevalence of influenza
for the week ending January 11. 1969. indicates that in-
fluenza activity is on the decline in the United States.
Widespread influenza activity was reported in 26 state-.
regional activity in 11 states, isolated outbreaks in eight
states, and isolated cases or no activity in five states
(Figure 1). The states with widespread occurrence are
located predominantly in the South Atlantic, East North
Central, and West North Central Divisions. Although the
Mountain Division reported the greatest decline in influ-
enza activity, the West South Central Di\ision continued
to have the least influenza activity.
State surveillance systems indicate that 26 states
reached their peak influenza activity between December


Influodii I.

lnot'rntiuon. N.
Influeozn ranada


1. 196. and January 4. 1969. An additional 11 states rma
haxe reached the epidemic peak during the week ending
January 11. By December 2h. five of the eight states in
the Mountain Division compared with three of the 16
states in the South Atlantic and in the East and Hi,'t
South Central Divisions had experienced their peak influ.
enza activity.
('ontimn i'n on p(gay 10)


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

2nd IEEK ENDED CEUMUl'ATIVE, FIRST 2 2 WEEKS
MEDIAN
DISEASE January 11. January 13, 1964 198 MEDIAN
1969 1968 1969 1968 1964 1968
Aseptic meningitis ..... ......... ... 14 25 30 32 53 53
Brucellosis ..... .......... ......... 1 2 2 6
Diphtheria ....... .. ....... ........ .. 1 2 4 1 3
Encephalitis, primary:
Arthropod-borne & unspecified .......... 15 21 24 26 35 43
Encephalitis, post-infectious ........ .... 4 10 10 6 19 19
Hepatitis. serum ..................... 84 57 171 103
795 1.460
Hepatitis. infectious .................... 705 759 1.342 1,357
Malaria ................................ 45 57 3 71 76 8
Measles rubeola) ......... ..... ...... 311 482 5,544 473 715 9,428
Meningococcal infections, total........... 81 67 74 119 109 118
C civilian ................ ............ 78 67 113 108 -
Military .. ............ .. ............ 3 6 1 -
Mumps ............. ... ............. 1,881 5,026 3.089 7.616
Poliomyelitis, total ......... -
Paralytic ................. -
Rubella IGerman measles) ............... 333 449 540 753 -
Streptococcal sore throat & scarlet fever ... 10,452 11.184 9.974 18.973 19.983 18.574
Tetanus ........ .................... 1 2 3 3
Tularemia ............................. 2 1 4 5 1 8
Typhoid fre er ......................... 6 5 5 8 7 7
Typhus. tick-borne Rky. Mt. spotted fewer) .- 1 2 2
Rabies in animals ..................... 39 68 70 83 136 136

TABLE II. NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cun.
Anthra\ : .................... ..... .. ....... Rabit, in man: ...... ............
Botulism: .............. ............. ...... .. Rubella congenital syndrome: ..
I-'ptospir ,si: ... ........... ..... .......... Trichinosis: N.J.- R.I.-2 .. .... ..... ... 3
P league: .... ........ ....... ....... ............ ph s m r ......
Psittacosis: Wis.- ........ .. .. ......... ....... 1






Morbidity and Mortality Weekly Report


INFLUENZA -(Continued from front page)


During the past week, 20 states and the District of
Columbia continued to report some excess school absen-
teeism. and two states reported closed schools or col-
leges because of influenza. Twelhe states and the Dis-
trict of Columbia reported increased industrial absentee-
ism: 19 states noted increased hospital admissions and
demands on outpatient services due to febrile respiratory
illness. These indices suggest a general decrease in the
extent and severity of influenza since the week ending
December 21, 196b (MMI\R. Vol. 17. No. 51.)
Although the degree to which deaths can be directly
attributable to influenza cannot be easily determined,


Figure 1
INFLUENZA, UNITED STATES, JANUARY4-11, 1969


D,


Figure 2
PNEUMONIA-INFLUENZA DEATHS IN 122 UNITED STATES CITIES


W N CENTRAL E N CENTRAL NEW ENGELAND










MWOUNTAiEN ES CENTRAL MIDDLE ATLANTIC
. Es a Es OmEs


PA.C.C
; ,, Pecncl

j > C^E


^-


W S CENTRAL SOUTH ATLANTIC
S ES aeERs2 s



S-9-


JANUARY 11, 1969












isolated report. of death primarily due to influenza in
young, apparently healthy individuals, have been received.
As in the caset of the 1957-5' influenza epidemic, these
deaths have occurred in the younger age groups due to
influenza pneumonia hoth with and without apparent inter-
current bacterial invasion. In such instances, iral isola-
tions frequently ha\e been made from lung tissues and
pathogenic examinations ha\e revealed mxidence of typi-
cal pulmonary viral pneumonia.
Excess total mortality and excess pneumonia-influ-
enza mortality in 122 U.S. cities exceeded the epidemic
threshold for the sixth consecutive week (Figures 2 and
3). This week the reported mortality for all causes was


Ih.02!) and the pneumonia Influenza (deth, totaled I.;hh
Mortality for all causes in the under 1 year age group
exceeded the epidemic threshold during the week ending
January 11. Increased pnieumonia-influenza mortality oc-
curred in all geographic divisions except for the Middle
Atlantic. South Atlantic, and East North Central Dii-ion-
which showed a decrease for t(he first time. Mo-t of the
reported increase in excess mortality was reported from
the smaller cities,while many of the larger cities reported
a decline in pneumonia-influenza deaths.
(Reported by the Staits(tie Sctioin. and the kItR(piratory
Di .eas 'e Uinit. Viral I)iusease S tion, Epidelmiology
Program, N('DC(.)


Figure 3
MORTALITY IN 122 UNITED STATES CITIES


ALL CAUSES


II


SHIGELLOSIS North Carolina


An epidemic of shigellosis involving 158 of 1.456
residents in an institution for the mentally retarded in
North Carolina occurred in mid-September 1968. The ill-
ness was characterized primarily by fever, myalgia, mild
nausea and vomiting. and severe bloody diarrhea. Two
deaths occurred. Shigella flei.reri 2a was cultured from
rectal swabhs or stool specimens obtained from patients
with clinical dysentery. Although the outbreak occurred
almost entirely in residents of the institution, approxi-


mately 22 employees were also affected. The overall
attack rate was 10.6 percent. and sex specific attack
rates were 6.9 percent for males and 14.0 percent for
females. The epidemic curie suggests a common-source
outbreak with an incubation period of 1 to 7 days (Fig-
ure 4).
Invesiatiation found that the population could be di-
vided into three groups according to the diet recei ed,
it'omtinued on paye :1)


JANUARY 11. 1969


Morbidity and Mortality Weekly Report


;"uI'-"








12 Morbidity and Mortality Weekly Report


TABLE III. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

JANUARY 11, 1969 AND JANUARY 13, 1968 (2nd WEEK)


ASEPTIIC ENCEPHALITIS HEPATITIS
MNIN- BRL'UCEL- )pi'I liHI Primary including Post- MALARIA
AREA ITIS LOSIS unsp. cases Inl .s Serum Infectious
Gum.
1969 1969 1969 1969 1968 1969 1969 1969 1968 1969 1969
UNITED STATES... 14 1 15 21 4 84 705 759 45 71

NEW ENGLAND............ 2 55 40 4 4
Maine.*............ 1 3
New Hampshire.*.... 2 1
Vermont.!.......... 2 1 -
Massachusetts...... 1 30 19 4 4
Rhode Island....... 1 8 4
Connecticut........ 12 12 -

MIDDLE ATLANTIC..... 3 2 4 1 31 121 100
New York City...... 2 1 19 53 30 -
New York, up-State. 1 2 6 40 5 -
New Jersey.......... 1 5 18 54 -
Pennsylvania....... 2 1 1 10 11 -

EAST NORTH CENTRAL.. 1 4 7 2 89 119 3
Ohio................ 1 5 2 34 52 -
Indiana............. -- 1 4
Illinois........... 3 15
Michigan........... 1 3 1 43 38 3
Wisconsin.......... 9 10 -

WEST NORTH CENTRAL... 24 39
Minnesota.*........ 8 9
Iowa............... 6 10
Missour i........... 5 4
North Dakota ...... 1
South Dakota....... 4 1
Nebraska........... 1 3
Kansas............. 11

SOUTH ATLANTIC...... 1 4 5 102 75 12 21
Delaware........... 1 -
Maryland........... 1 1 18 15
Dist. of Columbiat. -- 1
Virginia.......... 1 8
West Virginia...... 9 4
North Carolina..... 1 3 2 14 6 7 16
South Carolina..... 10 4 4
Georgia............. 24 34 1 1
Florida............. 2 26 6 -

EAST SOUTH CENTRAL... 2 1 50 71 -
Kentucky........... 1 25 37 -
Tennessee.......... 20 23 -
Alabama............ I 1 5 6
Mississippi........ 5

WEST SOUTH CENTRAL... 4 1 3 1 47 65 1
Arkansas.......... 2 1 1 1
Louisiana.......... 1 4 13 1
Oklahoma........... 3 11 -
Texas. ............ 42 40 -

MOUNTAIN............. 3 26 44 4 8
Montana............ 2 5 -
Idaho............. 1 2 8
Wyoming............ 3
Colorado ........... 3 7
New Mexico......... 4 14 1 1
Arizona............ 12 15
Utah............... 1 3 2
Nevada............. -

PACIFIC.............. 4 3 3 3 44 191 206 25 34
Washington........... 9 9
Oregon. ........... 1 1 11 14 1 1
California......... 4 3 2 2 44 167 182 21 25
Alaska ............. 2 1
Hawaii............. 2 3 8

Puerto Rlo ...........

*Delaycd reports (19681: \septic meningitis: Minn. 3
Encephalitis, primary: N.H. 1, Vt. 1
Encephalitis, post-infectious: Tex. 1
Ht'patitis, serum: Minn. 1, Ore. 5
Hepatitis, infectious: Me. 2, Minn. 9, D.C. 2, Ore. 10







Morbidity and Mortality Weekly Report 13


TABLE III. CASES OF SPE(IFIEI NOTIFIABLE DISEASES: UNITED) STATES

FOR WEEKS ENDFD

JANUARY 11, 1969 AND JANUARY 13, 1968 (2nd WEEK) CONTINUED


MEASLES (Rubeola) MENINGOCOCCAL INFECTIONS, MUMPS POLIO MYELITIS RUBELIA
TOTAL
PAREA tvPiraiyl ia
AREA Cumulative Cumulative .. I t.,. i
................ ........... Cum ...


t :,.. I i.L.- L.% L I. I I I .II I' 1 i I r

NEW ENGLAND........... 5 16 25 1 3 5 466 -
Maine..... ..... .... 6 49 4
New Hampshire *.... -
Vermont ............ 189 2
Massachusetts...... 3 6 11 1 2 104 13
Rhode Island....... 1 1 54
Connecticut........ 2 10 8 1 3 69 8

MIDDLE ATLANIC ...... 104 154 96 15 21 16 50 -
New York City...... 51 78 12 1 41 7
New York, Up-State. 22 23 75 5 6 1 NN 6
New Jersey......... 9 22 9 6 9 6 9
Pennsylvania....... 22 31 4 5 9 NN

EAST NORTH CENTRAL... 27 38 178 9 14 17 378 47
Ohio............... 2 2 36 3 3 4 40 4
Indiana............. 6 9 23 2 42 -
Illinois........... 1 5 73 2 3 15 -6
Michigan........... 1 2 12 5 8 8 94 7
Wisconsin.......... 17 20 34 1 1 187 1

WEST NORTH CENTRAL... 45 63 24 8 8 10 257 74
Minnesota ......... 9 3 3 1 2
Iowa............... 3 7 9 218 27
Missouri........... 39 39 1 4 4 2 1 41
North Dakota....... 9 26 3
South Dakota....... 1 2 NN -
Nebraska........... 3 8 1 1 1 1 11 I
Kansas. ............ 3 -- 4

SOUTH ATLANTIC....... 42 65 71 15 22 19 64 37
Delaware........... 2 2 12
Maryland........... 4 2 3 13 2
Dist. of Columbia. I 1
Virginia........... 7 18 10 -- 6 3
West Virginia...... 5 11 24 1 2 23 6
North Carolina..... 3 5 2 2 2 4 NN
South Carolina..... 9 12 2 3 4 6 11 6
Ceorgia ........ ... 3 3 1
Friday ............. 18 19 29 3 7 5 11 -

EAST SOUTH CENTRAL... 2 2 24 4 5 5 96 16
Kentucky............ 3 1 1 2 30 4
Tennessee .......... 2 2 13 3 4 3 52 12
Alabama ............ 7 12
Mississippi ........ -

WEST SOUTH CENTRAL... 48 84 138 12 15 22 264 50
Arkansas........... 1 42
Louisiana ........ 1 4 5 2 2
Oklahima........... 1 1 34 1 1 9 9 10
Texas.............. 47 83 103 7 9 10 211 40

MOUNTAIN............ 16 21 37 5 8 2 105 37
Montana............ 18 3
Idaho .............. 6 1 1 -1 -
Wyoming ........... 11 -
Colorad o........... 10 17 5
New Mexico......... 6 7 6 1 2 24 3
Arizona............ 10 14 4 2 2 1 27 19
Utah...............- 1 1 18 6
Nevada.............

PACIFIC............... 22 30 122 12 23 13 201 30
Washington ......... 2 2 32 1 1 1
Oregon ........... 5 9 31 1 16 4
California......... 14 18 48 10 20 11 133 16
Alaska.............. 1 1 38
Hawaii.............. 11 1 2 14 16


Puert Rico ........... 8 13 10

*Delayed report (1968): Me, Iis: La. i, Ore. 2
MN ningo t cal infection-: Minn. 2, D.C. 1, Ore. 1
Mumps: N.H. 4, Ore. 9
Rubella: La. ielete 1, 1f 3







14 Morbidity and Mortality Weekly Report


TABLE III. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

JANUARY 11, 1969 AND JANUARY 13, 1968 (2nd WEEK) CONTINUED



STREPTOCOCCAL TYPHUS FEVER
SORE THROAT & TETANUS TULAREMIA TICK-BORNE
AREA SCARLET FEVER FFVER (Rky. Mt. Spotted) ANIMALS
Cum. Cum. Cum. Cur Cum.

UNITED STATES... 10,452 1 3 2 5 6 8 1 39 83

NEW ENGLAND........... 1,003
Maine. ............ 45 -
New Hampshire.*.... 22 -
Vermont. ......... 90 -
Massachusetts...... 191 -
Rhode Island....... 86
Connecticut........ 569

MIDDLE ATLANTIC...... 394 1 1 1 1
New York City...... 9 -
New York, Up-State. 364 1 1 1 1
New Jersey ........ -
Pennsylvania ....... 21

EAST NORTH CENTRAL... 691 1 1 3
Ohio................ 82 1 1
Indiana............. 147 -
Illinois........... 110 -
Michigan........... 261 1
Wisconsin.......... 91 1

WEST NORTH CENTRAL... 313 1 4 8
Minnesta. ........ 5 2 2
Iowa............... 95 1 3
Missouri........... 5 I 1 3
North Dakota....... 120 -
South Dakota....... 31
Nebraska ........... 57
Kansas.* ........... -

SOUTH ATIANTIC....... 1,302 1 1 1 1 13 28
Delaware........... 13 -
Maryland............ 285 -
Dist. of Columbia. 1 -
Virginia............ 196 9 18
West Virginia...... 193 1 1 2 4
North Carolina..... 15 -
South Carolina..... 412 1 1 -
Georgia .......... .. 14 2
Florida............ 173 2 4

EAST SOUTH CENTRAL... 1,962 1 2 1 1 8 19
Kentucky........... 182 6 11
Tennessee.......... 1,464 1 2 1 1 1 6
Alabama............ 176 1 2
Mississippi........ 140 -

WEST SOUTH CENTRAL... 1,302 3 3 9 13
Arkansas........... 24 3 3 1 1
Louisiana ........ 32 3 3
Oklahoma ........... 50- -
Texas..?........... 1,196 5 9

MOUNTAIN ............. 2,438 1 2 8
Montana ............ 36 -
Idaho............. 203 -
yoming............. 457 1 2
Colorado........... 1,091 -
New Mexic......... 247 1 3
Arizona............ 166 -
Utah ....... ....... 237 -
Nevada............. 1 3

PACIFIC.............. 1,047 1 2 1 2 1 3
ashington ........ -
Oregon.*........... 50 -
California......... 818 1 2 1 2 1 3
Alaska. ............ 53 -
Hawaii............ 126

Puerto Rico.......... 3

*DelayeJ report (1968): SST: Me. 65, N.H. 2, D.C. 2, Ore. 114
Tetanus: Tex. 1
yphoid fever: Vt. 1
Rabies in animals: Minn. 9, Kans. I







Morbidity and Mortality Weekly Report


Week No. TABLE IV. DEATHS IN 122 UNITED STATES CITIES FOR WEEK ENDED JANUARY 11, 1969

2
(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 year Area All 65 years an yar
Ages and over Influenza All Ages and over Influenza All
All Ages Causes All Ages Causes


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

MIDDLE ATLANTIC:
Albany, N. Y.----------
Allentown, Pa.--------
Buffalo, N. Y.--------
Camden, N. J.----------
Elizabeth, N. J.------
Erie, Pa.-------------
Jersey City, N. J.----
Newark, N. J.---------
New York City, N. Y.--
Paterson, N. 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, IlI.----------
Rockford, II.--------
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.--------


1,050
262
57
44
53
85
58
31
55
77
95
20
67
43
103

4,857
72
43
216
76
30
47
88
129
2,102
55
1,096
322
93
153
27
53
126
46
33
50

3,837
110
47
984
238
346
190
126
462
73
69
69
24
80
233
71
237
75
50
60
206
87

1,230
91
28
61
188
41
166
102
368
129
56


674
163
33
32
41
45
42
24
40
42
54
12
44
28
74

2,878
48
29
138
39
21
28
46
65
1,225
36
633
177
60
100
21
33
92
33
23
31

2,179
57
30
509
147
181
111
76
248
53
35
39
11
57
132
35
155
50
35
34
137
47

779
61
18
44
124
29
108
67
209
84
35


31
8
1





2
8
2

1
2
2

203
3

7
4
1
2
5
7
98
3
35
15
3
8

1
3
5
2
1

184
6
1
51
18
12
9
4
23
1
6
5
2
3
12
7
7
4
2
3
5
3

47
1
1
2
7
1
12

12
5
6


SOUTH ATLANTIC:
Atlanta, Ca.-----------
Baltimore, Md.----------
Charlotte, N. C.-------
Jacksonville, Fla.-----
Miami, Fla.------------
Norfolk, Va.----------
Richmond, Va.-----------
Savannah, Ca.-----------
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.-----------


1,593
100
354
107
105
141
121
123
58
97
92
238
57

997
142
107
62
212
235
47
63
129

1,772
61
71
63
250
71
130
330
97
213
115
218
62
91

612
71
20
150
23
159
25
68
96

2,342
22
71
40
59
137
683
123
40
203
81
173
262
52
217
113
66


819
47
190
48
56
72
47
71
23
75
50
106
34

539
79
58
41
108
122
27
35
69

934
35
37
32
130
32
69
162
52
122
59
117
31
56

352
31
10
90
15
87
17
41
61

1,438
15
46
28
29
90
429
66
29
125
55
99
146
25
139
71
46


Cumulative Totals
including reported corrections for previous weeks

All Causes, All Ages ------------------------- 34,540
All Causes, Age 65 and over------------------- 19,954
Pneumonia and Influenza, All Ages------------- 3,212
All Causes, Under 1 Year of Age--------------- 1,431


i I







Morbidity and Mortality Weekly Report


SHIGELLOSIS -(Cootiniud from page 1)

Figure 4
FOODBORNE SHIGELLOSIS BY DATE OF ONSET IN AN
INSTITUTION, NORTH CAROLINA
SEPTEMBER 10-28, 1968


0 12 .3 14 15 16 7 18 .9 21 22 23 24 25 26 27 28

ONSET

ohich is determined hb severity of retardation. Food his-
tories revealed an attack rate of 3.b percent for those on
a regular diet. 5.2 percent for those on a bowl diet, and
23.0 percent for those on the ground diet. The ground diet
is entire\ different in content and or preparation from the
other diets and in\olves more handling.
Although no definite source for contamination of the
incriminated common vehiclee was found, several break-
downs in accepted sanitary procedures were noted. Ex-
posed soiled diapers Nwere stored adjacent to cottage kit-
chens. limited quantities of garbage were returned from
the cottage kitchens to the central kitchen for disposal.
and flies were present. Environmental cultures from the
kitchen and cultures from 114 full-time food handlers
\were negative. No food was available for culture. It was
postulated that contamination was probably transmitted
from the cottages, where shigellosis has occurred previ-
ously. to the central kitchen and then redistributed
through food to the residents.
Control measures for the outbreak included antibiotic
therapy for acute clinical cases, isolation of patients
with dysentery insofar as practical, and renewed efforts
at better sanitary practices in the institution.
(Reported by Dorothy Shearin, M.D., Medical Director,
Murdock (enter, and the Medical Staff at iurdock Center,
North Carolina; Martin P. Hines, M.D., D.V.M., Director,
Division of Epidemiology, and J. '. VacCormack, M.D.,
Consultant in Communicable Diseases, North Carolina
State Board of Health; and two EIS Officers.)



INTERNATIONAL NOTES
INFLUENZA Conada

The first documented outbreaks of A2 Hong Kong 68
influenza in Canada ha\e been reported from five Pro-
vinces during December 196h. Viral isolates from Quebec.
Ontario. Manitoba. Alberta. and British Columbia were
confirmed as A2 Hong Kong 6b-like viruses during the
week ending January 4. The outbreaks are currently re-
ported as isolated.
(Reported by FredeIrick P. \iayler, II.D. Chief, Virus
Labiioryatr Loratlory of lHy!iiene. Department of National
lHalh am1l IWelfare, Ottau'a. Canada.)


JANUARY 11, 1969


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.S.
EDITOR MICHAEL B. GREGG, M.D.
MANAGING EDITOR PRISCILLA B. HOLMAN

IN ADDOTiON 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 OFFICIALLY RELEASED TO THE PUBLIC ON THE SUCCEED-
ING FRIDAY.


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