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:
AA00010654:00170

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 COMMUNICABLE DISEASE CENTER


Vol. 18, No. 16







For

Week Ending

April 19, 1969


U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE / PUBLIC HEALTH SERVICE .EALTH SERVICES AND MENTAL HEALTH ADMINISTRATION
DATE OF RELEASE: APRIL 25. 1969 ATLANTA, GEORGIA 30333


EPIDEMIOLOGIC NOTES AND REPORTS
MENINGOCOCCAL DISEASE California

The incidence of meningococcal disease in California
increased ,..,.r. .,'I during the first :1 months of 1969.
During this period 241 case- of meningococcal meningitis
or meningococcemia were reported: (during the first 3 months
of 19i67 and 196S only 99 and St cases. respectirely,
were reported. In 1966i. the last \year in which the inci-
dence of meningococcal disease was significantly ele-
vated. there were 236 cases reported for the first 3 months
(Tahle 1). The cases reported in 1969 were eenly dis-
trihuted 1,r..n,.i,..,, the 3 months in contra-t to 1966 when
March had a higher incidence. The cases in 1969 appear
to he concentrated in the large metropolitan areas, partic-
ularly in Southern California: howe\ er. cases xwere re-
ported from all regions of the -tate.


( )N I I.1 N

I, S io I .i ........ 1. C .


(urrn I i r i -




in anal) si- of the 214 cas report- recei Ied -hittc-ed
that 166 cases (77.6 percent ) occurred in lhI, .- general
civilian population and 4s (22.4 perc nil) tere either in
members of the armed force- or in rilitar di-epemdrnis.
In 196-1-967. 51 percent of case-- ere in children under
5 ,ears of age. Allhougf il. I..I i .ii, 1 ill
observed in the under 5 er-
centage of case-. 41.1 r
age group (Table 2).


TABLE I. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNIT
(Cumulative totals include revised and delayed reports through preN

16th WEEK ENDED


DISEASE


Aseptic meningitis ......................
B rucellosis ............................
Diphtheria ............... .... ......
Encephalitis, primary:
Arthropod-borne & unspecified .........
Encephalitis, post-infectious .............
Hepatitis, serum ........................
Hepatitis. infectious ....................
M alaria ..... .......
Measles rubeola) .............. ........
Meningococcal infections, total .... ......
C civilian ................ .......
M military ....................... .......
M um ps ............................
Poliomyelitis, total ....... .........
Paralytic .............
Rubella (German measles) ..............
Streptococcal sore throat & scarlet fever ....
T etanus ................
Tularemia ............................
Typhoid fever ....... ..... ..... ......
Typhus, tick-borne (Rky. Mt. spotted fever
Rabies in animals ........ ...........


April 19,
1969


1 .1


23
5
116
1,009
50
1.161
103
91
12
2.727


2.214
11.227
3
1
4
1
88


April 20,
1968


26
6
3

12
14
73
799
38
735
55
51
4
4.329


2,000
11.345
3
1
9

88


TABLE II. NOTIFIABLE DISEASES OF LOW FREQUENCY

Cum. Cu
Anthrax: ............... .............. ... ..Rabis i a : ...... .. Rahies i an:
Botulism: ......... .. ........ ..... . 3 Rubella congenital syndrome: Del.-1 .......
Leptospirosis: .. ............ .. ..... .. 12 Trichinosis: Hawaii-1, Minn.-2, N. Mex.-l .... .
Plague: ............. ...... .......... T phus murinp: Calif.-1. P.R.- ..
P sittacosis: ........ ................. 7


,







134


Table 1
Meningococcal Infections by Month of Onset
California, First Quarter 1966-1969

Year January February March Total
1966 40 43 153 236
1967 21 29 49 99
1968 32 25 31 88
1969 82 75 84 241



Between October 1964 and October 1967 the Microbial
Diseases Laboratory of the California State Department
of Public Health routinely received isolates of meningo-
cocci for serogrouping. Group B organisms constituted
about 80 percent of the isolates although an increase in
group C was noted over the 3 years. Cultures are no longer
submitted to the state laboratory on a routine basis; con-
sequently. specific trends in serogroups could not be
calculated for 1969. However, reports from laboratories


APRIL 19, 1969


Table 2
Reported Meningococcal Infections by Age Group
California January-March 1969

Age Group Number Percent
<1 25 11.7
1-4 44 20.6
5-9 24 11.2
10-19 86 40.2
20-29 12 5.6
230 23 10.7

Total 214 100.0

throughout the state indicated a relative predominance of
group C isolates.
(Reported by Philip K. Condit, M.D., M.P.H., Chief,
Bureau of Communicable Diseases, and James Chin, M.D.,
Head, General Epidemiology Section, Bureau of Com-
municable Diseases, California State Department of Pub-
lic Health; and an EIS Officer.)


REYE'S SYNDROME Oklahoma


Between Dec. b, 1968, and March 15, 1969, eight
fatal cases of acute encephalopathy with fatty degenera-
tion of the viscera (Reye's Syndrome) occurred in children
in Oklahoma. Their clinical illnesses were markedly similar
and included profuse vomiting 3 to 5 days after onset of a
prodromal illness. Shortly thereafter all had onset of de-


lirium, combativeness, and hyperactivity. Within 36 hours
after onset of vomiting, all developed I. il.,ri stupor,
and then coma. All had respiratory arrest, within 48 hours
after hospitalization. All had elevated SGOT levels (175
to 2,484, average maximum 1,020) (Table 3). Two of the
eight had decreased blood sugar. Cerebrospinal fluid


Table 3
Data on Eight Cases and Three Suspect Cases of Reye's Syndrome Oklahoma


Patient Prodromal Lab. Autopsy
Case (Age, Race. Set) Illness Onset Findings Outcome i r.
1 5-H-M X arella 12-8-68 SCGOT Fatal Typical +*
j Blood Sugar (5 days) Pancreatitis
2 4-H-F Varicella 12-21-68 I SGOT Fatal Typical
i Blood Sugar (4 days)
3 6-t,-M URI** 2-13-69 t SGOT Fatal Typical
Normal Bloal Sugar (8 days)
4 12-H-M iRI 2-18-69 # SGOT Fatal Typical
Normal Blood Sugar (6 days)
S 14-W-F URI 2-21-69 f SGOT Fatal No Postmortem
Nornmil BIlox Su;gar (7 days)
6 8-H-F None 2-23-69 t SGOT Fatal Typical
Norml Blood Su :ir (4 days)
7 8-H-M URI 2-28-69 4 SGOT Fatal Typical +
Normal Blooil Su B:r (7 days) Pancreatitis
b 9-W-M URI 3-16-69 t SGOT Fatal Typical
Normal Blood Sugar (10 days)
Suspect
Case
1 h- ,-F aricella 1-18-69 Normal Bloio Sugr:u Fatal No Postmortem
(3 days)
2 2-I-iF aricella 2 6-69 Normal Blood Su2ir Fatal No Postmortem
(2 days)
:3 7-\t M I'RI 3-9-69 SGOT Pending Complete
Recovery

I Ri t a


Morbidity and Mortality Weekly Report


MENINGOCOCCAL DISEASE (Continued from front page)






Morbidity and Mortality Weekly Report


pleocytosis was absent in all patients Autopsy on seven
patients showed cerebral edema without inflatnnation and(
marked fatty infiltration of the liter with fatt\ changes in
renal tubules in two partiets an a acd ute hemorrrhagic pan
creatitis in two others.
The patients were from 4I to 11 cars of age: five
were males and three females. Four were from Oklahonma
(ity. two from Tulsa. atnd two from small cities in southern
Oklahoma. Three of these eight lived near Air Force leases
and two of those lied 2 blocks apart. There waas no known
contact aniong an\ of the patients. e \e's sy-ndrome fol-
lowed varicella in two patient and upper respiiratory dis-
ease in fite. The non-xaricella cases occurred between
midd-Felrur and itd-March \whn there was considerable
influenza B activity in Oklahoma (MMIR, Vol. Is. No. 9).
In addition to these eight cases, there were three sus-
pect cases. Two of these followed varicella and one fol-
lowed an upper respirator\ illnes.s. The latter case which
occurred during the influenza B outbreak was the only
sur\vior. His SGOT valuess are pending. Detailed case in-


vestigations failed to implicate exogenous towin- or dlruw-
in the genesis s oif ant case. Viral stunde- are in prolre,--
(RI reported by R/. L. 'Carpr ltlr, 3.f .. it.'I ., Dirr' tr,
1Diision of tEpide'miology, Oklah!oma Sa -c /)- parts,'1,t ,f
Health/: N lurotro/pic Viral /isc,+se ss [ n 10 0 ,+ -
Scl /in,. Epidelmiolo/y Prof/ram, \(}r', and A'.El
Officers.)
Editorial Comment:
.\cute enceplhaalopathy with fatty decen-ration of' ih
viscora occurring in children n r ias first characiterizred a- a
distinct clinico-pathologic entity h\ Reli e ot al in 196:,.1
The .-ndrorme is recognized hi the suddnil on-et rf 'n-
cephalitic s)ymptoni- with a normal lumbar puncture and
marke-dly elevated SGOT lItes. There cause(-) of thIe -sn-
dronei hias not been determined although in certain caiis-,
exogenous toxins, pharmaceuticals. or tirusies have Iben
suggest ted.

It? e fr o T
l evy i, ).(',. t al.: nm l I".ltty I)< --.n.r t m
of th+r. Vis eran. l- in- ft .:7t'-7i 2, 1916-3.


CURRENT TRENDS
MENINGOCOCCAL INFECTIONS United States


For the first quarter of 1969, a total of 1,0S9 cases
of meningococcal infections were reported to the NC'DC.
The monthly rates were comparable Aith those for pre-
vious years 1960-196b. which generally had peaks in
March or April (Figure 1). The rate for March 1969. 2.44
cases per 100,000 population, was less than the rates for
the same month in 1965 and 1966 (2.92 and 3.20), the
peak years between 1960 and 196S.
Serogroups B and C continued to be the most pre-
dominant types of \Vei.sreria meniiigitidis isolated from
cases of meningococcal disease. Of those isolates sub-
mitted to the NCDC for serogrouping and sulfadiazine
senst itiity testing. the number and percentage of group C
strains increased markedly compared with the 2 previous
years and predominated in the first 3 months of 1969.
Since September 1968, the proportion of isolates by
division has corresponded with the distribution of reported
cases by division with two exceptions: 31 of the isolates


Figure 1
MENINGOCOCCAL INFECTIONS, UNITED STATES: MEAN
MONTHLY RATES 1960-1967; MONTHLY RATES
1967-1968 AND SEPTEMBER-MARCH 1968-1969


MEAN MONTHLY RATE 1960 1967
-- MONTHLY RATE 1967 1968
MONTHLY RATE I968- 1969
REP OCT NOV DEC JAN FEB MAR APR MAY JUNE JULr AUG
MONTH


Table 4
Percentage of Submitted Meningococcal Isolates That Were
Inhibited at or Below 1.0 mg per 100 ml Sulfadiazine

Total Group B Group C All Others
Number Number Number Number
Year S Percent s Percent s Percent t s Percent
StrainJ ,trains rain rains
Inhibited Inhibited Inhibited Inhibirt d
STestled Tested Tested I Tested
1966 754 .59.3 53 7 52.- 92 S4.9 125 7o..i
1967 317 56.2 209 49.3 61 62.3 47 7h.7
196h
Jan. through Aug. 426 .50.7 192 60.1 164 25.6 70 2.6
Sept. ir..,,_i Dec. 93 44.1 54 57.I 32 9.1 7 1(10.01
1969
Jan. through March 163 27.6 60 ..3 96 7.3 7 .7

(Texrt conTlinurdi on pag 7 IlV:


APRIL 19, 1969








136 Morbidity and Mortality Weekly Report


TABLE IIl. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED
APRIL 19, 1969 AND APRIL 20, 1968 (16th WEEK)


ApEPTIC ENCEPHALITIS HEPATITIS
MENIN- BRCEL- DIPHTHRI\ Primary including Po's- MALARIA
AREA CITI? LOIS unsp. cases Inf* It Serum Infectious
Cum.

UNITED STATES... 35 4 23 12 5 116 1,009 799 50 745

NEW ENGLAND.......... 1 1 8 73 47 31
Maine ............. 1 2
New Hampshire...... 3 1 2
Vermont............ 2 2
Massachusetts...... 1 5 42 21 25
Rhode Island....... 1 1 12 2 -
Connecticut.............. 2 13 19 4

MIDDLE ATLANTIC...... 3 -2 6 1 47 178 153 3 84
New York City...... 4 32 78 44 8
New York, up-State. 2 1 3 20 35 1 14
New Jersey.......... 3 2 11 36 24 2 29
Pennsylvania....... 1 44 50 33

EAST NORTH CENTRAL... 2 10 3 6 161 119 11 63
Ohio............... 1 7 1 1 38 50 1 9
Indiana............. 9 13 1 5
Illinois........... 2 27 33 7 27
Michigan. ......... 1 3 2 3 72 16 2 21
Wisconsin.......... 15 7 1

WEST NORTH CENTRAL... 1 4 66 33 2 50
Minnesota.......... 1 3 12 11 3
Iowa............... 1 13 4 4
Missouri............. 16 11 13
North Dakota....... 2
South Dakota.......- 6 -
Nebraska........... 15 3
Kansas............. 4 7 2 25

SOUTH ATLANTIC....... 5 1 3 2 3 118 59 10 237
Delaware........... 3 3 1
Maryland............ 1 1 11 16 5
Dist. of Columbia.. 2 1
Virginia........... 1 -2 29 9 10
West Virginia...... 14 2 -
North Carolina..... 1 12 1 3 124
South Carolina..... 4 1 22
Georgia............ 17 16 6 59
Florida............ 3 1 2 2 28 9 1 15

EAST SOUTH CENTRAL... 12 2 64 60 3 25
Kentucky........... 12 16 31 3 20
Tennessee.......... 2 19 16
Alabama............ 17 5 5
Mississippi ........ 12 8

WEST SOUTH CENTRAL... 1 2 1 2 92 101 2 21
Arkansas............ 4 3 5
Louisiana.......... 2 2 21 18 2 14
Oklahoma........... 1 6 21 2
Texas.............. 61 59

MOUNTAIN .............. 1 1 39 40 6 54
Montana............ 3 2 -
Idaho.......... 3 3 1
Wyoming ...........
Colorado........... 1 8 14 6 49
New Mexico........ 1 9 2 2
Arizona..* ......... 10 9 1
Utah.................. 6 10 I
Nevada..... ...... -

PACIFIC.............. 12 2 4 1 2 43 218 187 13 180
Washington.......... 8 22 5
Oregon............. 2 25 20 5
California.......... 12 2 3 2 41 182 145 13 150
Alaska............. -- 3
Hawaii............. 1 20

Puerto Rco. ........ -- 23 18 1


* Delayed reports: Encephalitis, primary: Wyo. 1
Hepatitis, serum: Ariz. 1
Hepatitis, infectious: Me. 3, Ohio delete 1
Kalaria: Mich. 3







Morbidity and Mortality Weekly Report 137


TABLE III. CASES OF SPECIFIED NOTIFIABLE DISEASES IGNITED STATES

FOR WEEKS ENDED

APRIL 19, 1969 AND APRIL 20, 1968 (16th WEEK) CONTINUED


MEASLES (Rubcola) MENINGOCOCCAL INFECTIONS, MUMPS POLIOMYELITIS RUBELLA
TOTAL
AREA Total Paralytic
Cumulative Cumulative rat
i ... .. .______ ,Cu.

UNITED STATES... 1,161 9,592 10,425 103 1,370 1,205 2,727 1 2,214

NEW ENGLAND.......... 127 490 402 37 60 533 175
Maine.* ............ 2 13 2 4 22 3
New Hampshire...... 85 160 57 6 3 3
Vermont............ 2 1 1 121 1
Massachusetts. ... 13 79 145 19 28 212 103
Rhode Island ....... 9 1 4 4 29 2
Connecticut........ 29 238 185 12 17 146 -- 63

MIDDLE ATLANTIC...... 523 3,205 1,537 23 183 193 197 105
New York City...... 362 2,225 450 1 37 35 149 63
New York, Up-State. 62 337 759 7 32 35 NN 21
New Jersey......... 42 317 266 11 66 70 48 18
Pennsylvania....... 57 326 62 4 48 53 NN 3

EAST NORTH CENTRAL... 94 1,023 2,346 18 175 130 416 403
Ohio............... 14 116 189 10 65 34 27 27
Indiana..t ......... 36 301 372 3 23 18 82 157
Illinois........... 11 180 963 1 30 30 38 41
Michigan..* ........ 7 105 146 4 48 36 114 94
Wisconsin.......... 26 321 676 9 12 155 84

WEST NORTH CENTRAL... 5 272 227 2 67 51 137 183
Minnesota.......... 1 7 12 14 14 12
Iowa................ 153 41 1 10 4 84 140
Missouri........... 2 14 63 1 24 10 24 5
North Dakota....... 6 77 2 10 7
South Dakota....... 4 4 NN -
Nebraska........... 3 98 27 8 4 5 18
Kansas ............. 13 13 1

SOUTH ATLANTIC....... 137 1,492 876 19 251 268 297 411
Delaware............ 22 133 7 4 3 5 8
Maryland........... 13 51 21 16 18 53
Dist. of Columbia.. 6 5 9 29
Virginia............ 79 595 161 2 31 19 43 74
West Virginia.*.... 10 145 149 12 6 133 129
North Carolina..... 2 129 220 4 37 57 NN -
South Carolina .... 6 72 10 4 39 47 10 -- 12
Gorgia ........... 1 3 6 40 47 -
Florida............ 18 404 269 3 62 64 88 106

EAST SOUTH CENTRAL... 1 49 260 6 77 100 116 242
Kentucky........... 21 71 22 40 47 161
Tennessee......... 1 13 45 2 33 30 69 68
Alabama........ 45 3 13 14 -9
Mississippi. ....... 15 99 1 9 16 4

WEST SOUTH CENTRAL... 212 2,266 2,756 16 200 235 308 1 216
Arkansas........... 3 2 22 13 2
Louisiana.......... 4 70 1 4 49 61 14
Oklahoma............ 105 101 1 20 45 20 12
Texas............... 208 2,088 2,654 9 109 116 288 188

MOUNTAIN............... 29 237 491 1 31 15 267 203
Montana............. 4 55 4 2 72 -
Idaho.............. 36 11 5 3 4 3
Wyoming ............ 42
Colorado........... 20 219 6 7 39 132
New Mexico......... 20 107 48 1 6 49 17
Arizona............ 9 68 108 7 1 96 47
Utah............... 1 3 1 7 3
Nevada............. 1 5 2 2

PACIFIC.............. 33 558 1,530 18 349 153 456 276
Washington......... 5 39 381 6 48 25 182 103
Oregon............. 121 321 8 14 7 13
California......... 28 380 800 11 282 105 247 146
Alaska............. 13 4 1
Hawaii ............. 5 28 1 7 9 19 14

Puerto Rico............. 30 253 209 1 7 16 12- 2

* Delayed reports: Measles: Mass. delete 10, Mich. delete 1, W. Va. delete 7
Meningococcal infections: Ind. delete 2
Mumps: Me. 11
Rubella: W. Va. 7








138 Morbidity and Mortality Weekly Report


TABLE IIl. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

APRIL 19, 1969 AND APRIL 20, 1968 (16th WEEK) CONTINUED


STREPTOCOCCAL TYPHUS FEVER
SORE THROAT & TETANUS TULAREMIA TYPHOID TICK-BORNE RABIES IN
AREA SCARLET FEVER FEVER (Rky. Mt. Spotted) ANIMALS
Cum. Cum. Cum. Cum. Cum.
1969 1 196 1969 1969 1969 1969 1969 1969 1969 1969 1969
UNITED STATES... 11,227 3 32 1 27 4 62 1 2 88 1,225

NEW ENGLAND........... 2,014 1 1 4
Maine.. ............ 6 3
New Hampshire...... 47
Vermont............. 3 1
Massachusetts...... 395 1 1 -
Rhode Island....... 97 -
Connecticut........ 1,466

MIDDLE ATLANTIC...... 738 5 1 2 9 4 36
New York City...... 50 3 1 1 6
New York, Up-State. 539 2 1 3 34
New Jersey......... NN
Pennsylvania....... 149 1 2 1 2

EAST NORTH CENTRAL... 886 3 2 6 5 69
Ohio. *............. 172 4 17
Indiana............. 250 I 2 17
Illinois........... 151 1 1 13
Michigan........... 225 2 2 1
Wisconsin.......... 88 3 21

WEST NORTH CENTRAL... 293 1 4 16 225
Minnesota.......... 18 5 54
Iowa............... 123 1 31
Missouri........... 13 3 5 73
North Dakota....... 53 4 33
South Dakotar. ..... 24 13
Nebraska ........... 62 8
Kansas............. 1 1 1 13

SOUTH ATLANTIC....... 1,800 1 8 11 6 22 371
Delaware............ 25
Maryland............ 293 2 -
Dist. of Columbia.. 2 -
Virginia........... 933 6 216
West Virginia...... 140 1 1 2 5 59
North Carolina..... 16 1 4 1 1 4
South Carolina...... 102 1 1 -
Georgia............. 24 1 1 3 27
Florida............ 267 3 4 1 7 65

EAST SOUTH CENTRAL... 1,459 4 1 5 8 1 18 221
Kentucky........... 92 2 10 125
Tennessee.......... 1,220 2 1 5 7 1 5 74
Alabama............ 99 3 22
Mississippi........ 48 -- I -

WEST SOUTH CENTRAL... 624 2 6 2 7 12 164
Arkansas........... 26 4 12
Louisiana.......... 5 1 4 13
Oklahoma............ 33 1 2 1 26
Texas............... 560 1 1 3 11 113

MOUNTAIN ............. 2,331 2 10 28
Montana............. 15 -
Idaho.............. 176 -
Wyoming............ 232 5 11
Colorado........... 1,349 1 2
New Mexico......... 196 1 2 7
Arizona............ 191 1 5
Utah.......... .. ... 172 -
Nevada............. 1 3

PACIFIC.............. 1,082 5 1 15 1 1 11 107
Washington......... 356 1 -
Oregon............. 99 -
California......... 603 4 1 14 1 1 11 107
Alaska ............ 14 -
Hawaii ............ 10 -

Puerto Rico .......... 3 1 7


* Delayed reports: SST: Me. 25, Ohio 3
Rabies in animals: S. Dak. 13








Morbidity and Mortality eekl Recport


Week No. TABLE IV. DEATHS IN 122 UNITED STATES CITIESS FOR WEEK ENI)ED) APRIL 19, 1969
16
(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 and I yar
Ages and over Influenza All Ages and over Inluenza 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, 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.--------


722
238
48
30
25
55
32
20
23
54
68
11
43
19
56

3,343
49
55
162
44
29
48
55
84
1,636
34
499
206
55
143
26
42
61
60
26
29

2,590
73
27
740
158
200
131
83
342
35
56
46
32
48
176
24
126
40
38
42
96
77

843
55
19
47
127
39
115
78
241
77
45


433
136
30
22
15
32
24
14
16
27
36
8
29
7
37

1,988
29
32
89
19
19
28
36
38
989
15
302
111
38
90
13
25
42
37
19
17

1,515
49
15
406
106
101
71
39
215
24
31
26
17
33
100
16
71
24
30
23
60
58

498
34
15
28
74
21
71
48
127
59
21


*Estimate based on average percent of divisional total.


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.---
qan Antonio, Tex.------
Shreveport, La.--------
Tulsa, Okla.-----------

MOUNTAIN:
Albuquerque, N. Mex.---
Colorado Springs, Cilo.
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.----------


1,138
137
244
45
76
114
42
82
45
88
61
150
54

737
98
43
43
174
149
63
61
106

1,238
43
41
22
180
34
92
242
79
164
95
114
59
73

486
52
22
106
22
144
27
55
58

1,733
24
49
40
54
116
580
77
27
135
56
108
160
61
134
47
65


627
60
139
22
42
61
22
46
25
74
36
76
24

407
54
22
27
96
80
34
31
63

649
29
20
13
87
19
46
118
37
64
57
73
42
44

283
22
14
70
16
76
19
32
34

1,077
17
25
30
26
83
361
56
14
80
38
65
93
45
71
30
43


T tal 12,830 7,477 523 543


Cumulative Totals
including reported corrections for


previous weeks


All Causes, All Ages -------------------------- 225,475
All Causes, Age 65 and over------------------- 131,015
Pneumonia and Influenza, All Ages------------- 13,731
All Causes, Under 1 Year of Age--------------- 10, 48








140


MENINGOCOCCAL (Continued from /ipa/c 135)

Were submitted Irom ian Army chase in the M\iddle A.tlantic
divlision no i-o latos er1 ( recei ed from (ali forni a. al-
though the tatl reported an unusually high incidence of
meningococcal disease for the first 3 months of 1969 (see
acIomi panI ing epid lnolo gic note).
For the firTh 3 ilonths of 1969. the percentage of ub-
litted isolates from cases of meningococcal disease in-
hihited iby -ulfadiazine concentrations of I lmg percent
or lesi decrleased to '27.6 percent (Table 4). This reflects
the increased percentage of group C isolates along w ith
the marked decrease in percent of group C strains inhibited
by that concentration of sulfadiazine. For the first 3 months
of 1969, 92.7 percent t of the group C isolates were resist-
ant to sulfadiazine. The percentage of group B sulfadia-
zinc resistant isolates has not changed -_..... I,.Ily
although the relate proportion of group B isolates sub-
mitted to NCDC for sensitivity testing has decreased.
(Reported by the Bacte'rial Diseases Branch and the
Statistics Section, Epide/niology Program, and the Bac-
terial Ref/erence Unit and Bacterial Serology Unit, Lab-
oratory Div isioni, N('O)'.)







EPIDEMIOLOGIC NOTES AND REPORTS
FOLLOW-UP BOTULISM Colorado


Intensive epidemiologic and laboratory studies have
not found the exact source of contamination in the out-
break of botulism in which six individuals became ill
after eating potato salad at a bar-restaurant near Denver
(M1MhR,. Vol. 1h. No. 15). Type A toxin was found in the
blood of the two most recent cases. All six patients are
recovering: no new cases hae been found.
There were four commercial r- I. .1- used in the
salad, two of whichh pickles and mustard, were available
for lahororatory tests and were found negative. The bottles
of mayonnaise and relish used in the salad were no longer
available. Two unopened jars of relish from the same lot
were tested and found free of toxin. It vas not possible
to rule out contamination during preparation of the salad.
(Reported by 0. S. 410/Ioll h 1M.1 .. f.P.l., 'Chief, Section
of Epidemio ll/logy. CI'olorado State Department of Public
llHn/th; The Food and Drii Administration; the Anaerobic
Bacterioloqy Laboratory, laboratory Division, NC('CO and
a teain of 'EIS Officers.)


APRIL 19, 1969 9-

0 _- A


THE MORBIDITY AND MORTALITY WEEKLY REPORT, WITH A CIRCULA-
TION OF 18,500 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 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 OFFICIALLY RELEASED TO THE PUBLIC ON THE SUCCEED-
ING FRIDAY.


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