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:
AA00010654:00173

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


'. r
-I


a4d


Vol. 18, No. 23






For

Week Ending

June 7, 1969


U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE / PUBLIC HEALTH SERVICE HEALTH SERVICES AND MENTAL HEALTH ADMINISTRATION
DATE OF RELEASE: JUNE 13, 1969 ATLANTA, GEORGIA 30333


EPIDEMIOLOGIC NOTES AND REPORTS
GROUP A MENINGOCOCCAL MENINGITIS
Boston, Massachusetts

Since the first report of a case of Group A meningo-
coccal infection to NCDC since 1967 last week (MMWR,
Vol. 18. No. 22), two cases have been notified from Bos-
ton City Hospital. One case was in a 6-year-old boy hos-
pitalized on May 24 with a 24-hour history of vomiting,
progressive irritability, and neck pain. Physical examina-
tion revealed a febrile (101.4"F.), normotensive, semi-
comatose boy with nuchal rigidity and generalized pete-
chiae. A lumbar puncture yielded cloudy cerebrospinal
fluid, and gram negative intracellular diplococci were
seen on microscopic examination. Intravenous penicillin
was given and within 48 hours, the boy was afebrile and
alert. Group A Neisseria meningitidis was isolated from


C(ONTENTI
Rpidmeniilogi Notes and RIiport.
Group A Meningooc ( cal M,'ningliti
Boston, ii ............ 17

Typhoid F 19T
Foilow-upJ .. -i
Count .A 199
Summary 1 C ass. of I .. .I 1 .. 99
..... .. .. 2 0


two '.1... .r.I- as welas s t -. ...r...r ,,,.,i fluid.
The t.he ase was in a 50- In- man admitted on
May 27 v i ,.-lr'..,r history of"-. t. and progressive
obtundation. 04o Yi. 1 it Aion, the patient was
febrile (100.' ii64 I -: -i"- and no petechiae were
seen. He was semicomatose and combative with marked
nuchal rigidity. Lumbar puncture revealed turbid cere-
(Continued on page 198)


TABLE I. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous weeks)
23rd WEEK ENDED CUMULATIVE, FIRST 23 WEEKS
MEDIAN
DISEASE June 7, June 8. 1964 1968 MEDIAN
1969 1968 1969 1968 1964 1968
Aseptic meningitis ................... ..24 48 24 622 688 654
Brucellosis ............................ 1 3 6 60 66 104
Diphtheria.............................. 3 1 66 84 78
Encephalitis, primary:
Arthropod-borne & unspecified .......... 13 28 28 439 379 573
Encephalitis, post-infectious ............. 5 6 18 132 248 396
Hepatitis, serum ........................ 93 70 62 2.290 1,764
Hepatitis, infectious .................... 825 781 21017 19374 18,591
Malaria ................................ 50 31 9 1,160 929 128
Measles rubeolaa) ...................... 788 583 6,040 15.886 15.812 168.263
Meningococcal infections, total ........... 48 33 43 1,878 1,506 1,506
Civilian .............................. 42 33 1.694 1,360
Military ............................... 6 184 146 -
Mumps ................................. 2,003 3.017 56.000 109,004
Poliomyelitis. total .................. .. 1 1 2 22 17
Paralytic .......................... .- 1 1 2 22 15
Rubella (German measles) ............... 2.218 1,535 39,456 36,112
Streptococcal sore throat & scarlet fever... 6.583 6.906 6,906 241,599 239,890 239.890
Tetanus ..................... .......... 1 3 5 50 55 73
Tularemia .............................. 7 1 5 60 78 78
Typhoid fever ........................... 3 9 8 122 116 151
Typhus, tick-borne (Rky. Mt. spotted fever) 18 9 9 93 55 41
Rabies in animals ...... .......... ... 60 68 87 1,696 1,726 2.054

TABLE II. NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax: ............................................. 2 Rabies in man: ................................... .
Botulism: .......................................... 10 Rubella congenital syndrome: ......... ........... 5
Leptospirosis:* Calif.-4, Va.-1 ..................... .. 29 Trichinosis: Ohio-1 ............... ...... ............. 39
Plague: ........................................... Typhus, murine: Tex.-1 ........ .... .. .............. 7
Psittacosis: ...................................... 13
*Delayed reports: Leptospirosis: La. 1


-: / -, ,
0 : ii

A;.







Morbidity and Mortality Weekly Report


GROUP A MENINGOCOCCAL MENINGITIS (Continued from front page)


brospinal fluid with a cell count of 8,700. all of which
were polymorphonuclear leukocytes on smear. Gram nega-
tive intracellular diplococci were seen on staining the
cerebrospinal fluid, and intravenous penicillin was begun.
Despite a series of grand mal seizures shortly after ad-
mission, the patient rapidly improved and was alert and
afebrile 36 hours after admission. Group A ,. meningitidis
w:a- isolated from the cerebrospinal fluid.
Both meningococcal isolates were sensitive to sul-
fadiazine being inhibited at or below concentrations of
0.7h ,pg per ml (.07b mg percent).


No connection could be established between these
two persons, and no further cases of Group A meningo-
coccal infection have occurred to date at Boston City
Hospital.
(Reported by Lawrence Stolberg, M.D., I and III Medical
Service, William Cranley, M.D., Pediatric Service, Miss
A. Kathleen Daly, Chief Bacteriologist, and Maxwell Fin-
land, M.D., Hospital Epidemiologist, Boston City Hos-
pital; Nicholas J. Fiumara, M.D., M.P.H., Director, Divi-
sion of Communicable Diseases, Massachusetts Depart-
ment of Public Health; and an EIS Officer.)


TULAREMIA Addison County, Vermont


During the second and third weeks of April 1969. 13
symptomatic. serologically confirmed cases of tularemia
were reported front Addison County. Vermont. This was the
same area where in the spring of 1968, 47 cases had oc-
curred in persons handling muskrats during the trapping
and shooting season. The 196h outbreak was the largest
outbreak of human tularemia associated with aquatic mam-
mals ever reported in North America.1 As in 196b. all
cases were in muskrat handlers. These 13 persons de-
eloped illnesses characterized by painful. slowly healing
hand sores, local 1 mphadenopathy, and fexer and were
found to haxe agglutination titers against Francisella
tl/areniis of 1:3201 or greater. In addition to these 13
cases, one trapper had inapparent infection demonstrated
h.\ a rise in liter. This asymptomatic case and two of the
symptomatic ase- in 1969 had been included in a sero-
logic sur\xe during the 196b outbreak: all three had been
seronegative at that time.
In a sur\e\ conducted during May and June 1969 of 30
muikrat handlers nol not kon to be infected, three persons
who denied symptonts were found to haie diagnostic
tularemia agglutination titers of 1:160 or greater. These
three indimiduals;- were not contacted hy survey in 196x and
may hat be-en infected at that time or earlier or nma repre-
sent inapparent infection, in 1969.
\ll persons with significant antibody had trapped
in three areas which were the principal sources for cases


in the proceeding year's epidemic: Otter Creek, its princi-
pal tributary Dead Creek, and Little Otter Creek, all ofwhich
flow into the eastern shore of Lake champlain. In some in-
stances, trappers ill in 1969 took animals from the identical
legally demarcated trapping areas where patients with tula-
remia inl968 had trapped. As in 1968, there was no evidence
of an animal epizootic; on the contrary, muskrats were in
great abundance and the fur was considered of high quality.
In 1968, F. tularensis had been cultured from 5 percent of
the muskrats as well as mud and water in one trapping area.
Of the 47 patients diagnosed as cases of tularemia in
1968. 14 were known to have trapped again in 1969. One
person in this group developed hand sores, local lymph-
adenopathy. and a fever of several days duration. Two
agglutination titers over a 3-week period showed no change.
and fluorescent antibody studies on exudate from his skin
lesions were equi\ocal.
(Reported by Linus J. Leavens. M.D.. Director. Bureau of
Communicable Disease Control, and Dyinitry Pomar, D.V.M.,
Director. Bureau of Laboratories. Vermont State Depart-
ment of Health; the Bacterial Chemistry Unit and Bacterial
Immunoloyy Ulnit, Laboratory Dirision, NCDC; and a team
of EIS Officers.)
Keference:
Young, L. S., Bicknell, D. S., Archer, B. G., Clinton, J. M.,
Leavens, L.J., Feelox, J.C., and Brachman, P.S.: Tularemia
Epidemic Vermont, 1968: Forty Seven Cases Linked to
Contact with Muskrats. New Eng J Med, 280:1253-1260, 1969.


TYPHOID FEVER Oregon


Late in April 1969.t typhoid fexer was diagnosed among
-i\ members of a miisionary family that was visiting in
Portland. Oregon. enroute from the Philippines to North
Dakota. The family left Cebu ('ity on April 7 after a 4-year
tour of duty They stayed in Pasay ('ity. Manila, from April
7 through 10, and stopped in Hong Kong and Japan between
\pril 10-11 and in Honolulu on April 12. On April 10 the
father had dt e\loped fehrile gastroenteritis and by April


16 five other members had similar illnesses. When examined
in Portland, four members had temperatures of 102-105F.
and appeared acutely ill. Two of these four were extremely
weak and delirious and had rashes thought to be rose
spots. The father and a 10-year-old daughter were afebrile
but weak. Salmonella typhi, phage type B1 was isolated
from blood and, or stool cultures from all six members. The
patients were treated with chloromycetin. Three of the


198


JUNE 7, 1969







JUNE 7, 1969


Morbidity and Mortalit


six ,were treated for less than 10 days and had( relapses.

Chloromycetin ias recommended for them for an additional
.I days.
The source for the family's infection has not been

confirmed. Hloweer, while they stayed in Pasay (ity.
they admitted drinking from the1 city's water supply e\en

though they had been warned that it was contaminated.

(Reported by F4rs. Vivienit Runtle, R.\'., Epidemioogyy
Nurse, and rd'ifford ('ookso,. an/ 1r. Brigitcte Vetealf,

lieroobiologists, Ore gon Statec Board of Health: Varid

Johnson, 11.I., .I.V.I., l.P.H1., Associate Professor of

Public Health and Prerentive liedicine. Ulnicr.sity of


y Weekly Report 199



Oregon; John Donnelly, l.)., i .PI... ffltiornih r ,un.ty

Health Officer; and an EIS Officer.)

Editorial Comment:

The World l/ealth OrTyanirzaion eII ekly Epidfdfmioloyi-

cal Record recently reportedly several 1outhre'ak of typhoid

fever in Manila.1 Between ''ebru'ar'v 17 aind pril 1. 3.

suspected cases w7ere reported from Pasa;y i t('\ Manlla

and by April 10. 28 suspected cases and four ldaths had
heen recorded in the Tondo district of Manila.

Re frenolf
1I orld ft 'ilth Orgnao ,affo i, l\ ,Akly [ ,'pi<-'n)otIo l lei ,or4,
rii;8)::ni.


FOLLOW-UP HUMAN RABIES San Diego County, California


Ralies has been confirmed in the 2 1 ,2-year-old boy

in San Diego County bitten by a rabid bobcat on April 1,

1969 (MMHR. \ol. Ib. No. 1h). Nervous tissue obtained
on May 9 was positive by fluorescent rabies antibody
staining. Indirect fluorescent antibody titers for rabies on

April 24 and May 9 on sera obtained after the child's
course of duck embryo vaccine, were 1:64 and 1:2.)04. re-

spectively., and on cerebrospinal fluid obtained on April

25 and May 9 were l:b and 1:512, respectively. Cultures

of nervous tissue, saliva, cerebrospinal fluid, urine.
stool. throat, and endotracheal washings have been nega-

tive for virus. Mouse inoculation tests on nervous tissue
and saliva are still in progress.


The boy has remained comatose since Aprill 27. is

areflexic, and his breathing is maintained h\ a re-pirator.

An electroencephalogram on IMay 27 was nearl'v i-oolect7ric

indicating profound cerebral damage.

(Reported by George 1.. Humphrey, ).V.l., d. Acii i'lief,
Veterinary Public lHealth, 7nd, Rihard EmmoiI. 1..I..
Public Health Iedical Officer, Bi7reau 7 f ('o9f ,ni b/eic

D)iseases. Calif/ornia Department of P)ublic Hfl!,thI : i .. H.

.skew. .1)P., health Director, a/nd )ona/ l Riaimiras. 1.1)..
Assistant Health Director. Son Diego Counity Helalth Ie-

partment: V. Robert All/en, .t1. .. A.ttendiny Pediatricia(n.

and Edwin Protas. .4.I).. Pediatric Reride nt, lni'rers ty

hospital of/ San Diego ('ont/y.)


SUMMARY OF REPORTED CASES OF INFECTIOUS SYPHILIS

CASES OF PRIMARY AND SECONDARY SYPHILIS: Ry Reporting Areas 'av 1969 and May 1U68 Provisional Data


NEk- -.-!'..
Maine............... .
New Hampshire ..........
Vermont ................
Mlassachusetts .... .....
Rhode Island............
Connectcut .............

MIDDLE ATLANTIC..........
Upstate New York........
New York City...........
Pa. (Excl. Phila.)......
Philadelphta............
New Jersey ...........

EAST NORTH CENTRAL.......
Oh o. ........ .........
Indiana.. ...... .......
Downstate Illinois......
Chicago.................
Michigan..... ..........
Wisconsin ..............

WEST NORTH CENTRAL......
MInn sota ..............
Iowa .......... .........
Missour ................
North Dakota...........
South Dakota.........
Nebraska .. .............
Kansas. .................

SOOTH ATLANTIC...........
Delawar .............
Maryland................
District rt Columbia....
Virginia...............
West Virgit ta ..........
North Carolina..........
South Car lina..........
Geor ia ..............
Florida........ ........


Cumulative
J n May


2 2


Reporting Area


"May


Cumulative
Jan May
. I .


Kentucky............... 16 8 91 46
Tennessee...... ... .... 12 <.3 14U 142
Alabama ................. 26 41 97 27U
Mississippi ............. 31 37 128 157

dEST SOUTH CENTRAL ........ 30 335 1.491 1 ,43
Arkansas................ 22 11 66 7
Louislana................ 39 97 276 359
Oklahoma.................. 6 lb( 38 i3
Texa .... ................ 233 211 1 111 1.U28

'OUNTAIN................ 41 45 232 223
Montana............... 1 2 2
Idaho.................... 2 3
Wyming..... ...........
Colorado................ 4 1 24 9
New Hexico............... 14 15 102 63
Arizona.................. 13 27 74 122
Utah ................. .. 5 5
Nevada............ .. 19

PACIFIC........... ..... 159 178 779 741
Washington............... 6 6 20
Oregon................... h 5 20 16
California.................. 144 17 736 99
Alaska .................
Hawaii........... .. 3 1 3

J. S. TOTAL............... 1,621 1.702 7.911 8 1, 6


IERRITORIES...............
Puert Ri ............
Virgin Island ..........


l7 i11
04 I1


Nt Ctnumulitt. Totals include e-itsed
through previous onoths,


and delayed reports








200 Morbidity and Mortality Weekly Report


TABLE II. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED
JUNE 7, 1969 AND JUNE 8, 1968 (23rd WEEK)


ASEPTI( ENCEPHALITIS HEPATITIS
I'NTI- BRI1CEL- I1il 11111 Primary including P-[- MALARIA
AREA GilIS LO unsp. cases Inf u Serum Infectious
Cum.

UNITED STATES... 24 1 3 13 28 5 93 825 781 50 1,160

NEW ENGLAND .......... 1 1 2 57 30 39
Maine ........ ..... 3 2 2
New Hampshire ...... 1 6 1 2
Vermont ............ 1 1-
Massachusetts ...... 23 17 30
Rhode Island....... 1 19 4 1
Connecticut ...... 1 5 6 4

MIDDLE ATLANTIC...... 4 1 11 43 158 140 4 129
New York City...... 6 30 36 42 2 11
New York, up-State. 1 1 18 16 1 23
New Jersey...... 1 2 12 47 43 1 44
Pennsylvania. .... 2 1 3 57 39 51

EAST NORTH CENTRAL... 1 5 6 1 6 123 131 17 111
Ohio............... 3 2 1 29 30 3 13
Indiana............ 1 9 12 7
Illinois........... 1 1 1 1 29 44 13 59
Michigan. .......... 1 4 52 42 1 31
Wisconsin.......... 2 4 3 1

WEST NORTH CENTRAL... 1 3 4 26 36 3 81
Minnesota........ .. 3 8 9 7
Iowa ........ ...... 1 -- 3 6 -
Missouri........... 9 11 23
North Dakota ....... 1 I 2
South Dakota....... 3 -_
Nebraska........... 3 1 3
Kansas .............. 1 2 8 3 40

SOUTH ATLANTIC....... 4 3 1 2 12 82 62 10 366
Delaware........... 5 5 2
Maryland........... 1 1 2 20 17 10
Dist. of Columbia.. 2 1
Virginia ........... 1 5 5 15
West Virginia...... 3 8
North Carolina..... 1 .- 9 7 169
South Carolina..... 1 10 4 29
Georgia ............ 10 1 3 122
Florida............ 1 _1 2 10 25 20 18

EAST SOUTH CENTRAL... 1 2 2 1 59 58 32
Kentucky. .......... 19 23 26
Tennessee........... 1 2 1 19 24
Alabama........ ..- 7 4 6
Mississippi........ 2 14 7 -

WEST SOUTH CENTRAL... 4 1 51 58 1 33
Arkansas........... 1 5
Louisiana.... .... 2 7 5 1 25
Oklahoma ... .... 11 21 3
Texas.............. 2 1 33 31 -

MOUNTAIN.............. 1 3 1 1 41 17 10 86
Montana............ 1 2 8 -
Idaho .............. I 2 2
Wyoming ............. 1
Colorado........... 1 1 11 6 74
New Mexico......... 1 5 4
Arizona ............ 3 13 3 1
Utah............... 6 1 1
Nevada ............. 5 4 4

PACIFIC.............. 9 1 3 25 228 249 5 283
Washington......... 1 1 40 13 5
Oregon............. 1 28 17 6
California......... g I 1 2 23 159 219 5 220
Alaska ............. .. -- --- -- 1 .. --- -
Hawaii............. 1 -- 51

PuIrti Rl-i. *....... 1 I -- 23 15 1
Dlelaved reports: Encephalitis, primary: Pa. delete 1
Hepatitis, infectious: Me. 7, Ala. 1, La. delete 1, Okla. delete 1, P.R. 13
Malaria: N.J. delete 1, Iowa 1








Morbidity and Mortality Weekly Report 201


TABLE III. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

JUNE 7, 1969 AND JUNE 8, 1968 (23rd WEEK) CONTINUED


MEASLES (Rubola) MENINGOCOCCAL INFECTIONS, MUMPS POLIOMYELITIS RUBELLA
TOTAL
AREA Cumulative Cumulative otal Paralytic
Curn.

UNITED STATES... 788 15,886 15,812 48 1,878 1,506 2,003 -2 2,218

NEW ENGLAND.......... 66 800 857 59 78 258 133
Maine ....... ....... 4 30 5 6 10 8
New Hampshire...... 8 224 113 1 7 6 4
Vermont ............ 2 1 1 14 8
Massachusetts.A.... 22 156 263 27 35 126 54
Rhode Island ....... 1 10 1 5 7 25 9
Connecticut........ 35 404 449 21 22 77 50

MIDDLE ATLANTIC...... 316 5,757 2,684 12 298 253 174 104
New York City...... 175 3,936 1,137 51 50 133 42
New York, Up-State. 13 479 1,011 46 42 NN 14
New Jersey... A.... 57 657 444 8 134 90 41 10
Pennsylvania....... 71 685 92 4 67 71 NN 38

EAST NORTH CENTRAL... 57 1,609 3,268 9 250 169 408 571
Ohio ............... 15 266 258 5 88 45 43 22
Indiana............. 9 445 568 3 32 19 65 114
Illinois........... 19 307 1,231 39 39 65 64
Michigan........... 4 150 206 74 51 116 248
Wisconsin.......... 10 441 1,005 1 17 15 119 123

WEST NORTH CENTRAL... 16 457 325 1 97 77 177 145
Minnes.ta .......... 2 13 17 18 1
Iowa.......A...... 15 303 81 1 12 5 62 99
Miss iur L... ....... 16 73 44 26 109 26
North Dakota....... 7 111 3 6 2
South Dakota....... 1 4 1 4 NN -
Nebraska............ 1 124 35 9 6 16
Kansas............. 4 8 14 15 1

SOUTH ATLANTIC....... 45 2,089 1,156 6 330 317 220 378
Delaware.......... 25 288 12 4 5 1 1
Maryland............ 1 32 72 1 32 21 24 28
Dist. of Columbia.. 1 6 9 11 11 12
Virginia... ...... 824 237 37 23 27 115
West Virginia...... 3 159 183 14 8 105 154
North Carolina. ... 12 207 264 2 57 62 NN -
South Carolina..... 2 102 12 1 48 54 12 9
Georgia............ 1 3 1 57 58 1 -
Florida............ 2 475 367 1 72 75 39 59

EAST SOUTH CENTRAL... 5 82 411 3 113 130 96 77
Kentucky........... 4 47 91 1 39 49 26 23
Tennessee.......... 15 54 1 41 44 68 53
Alabama ..... ..... 1 69 19 18 I
Mississippi........ 1 19 197 1 14 19 2 -

WEST SOUTH CENTRAL... 208 3,690 4,162 4 262 258 158 2 257
Arkansas........... 29 2 27 15
Louisiana.......... 103 2 70 68
Oklahoma........... 6 125 105 25 48 38 55
Texas.............. 202 3,433 4,053 4 140 127 120 2 202

MOUNTAIN.............. 51 563 816 1 35 24 131 150
Montana ............ 8 57 4 2 6 -
Idaho............... 6 54 15 6 10 4 1
Wyoming............ 49 1 -
Colorado........... 8 112 416 6 7 21 98
New Mexico......... 6 182 77 6 25 15
Arizona............ 31 203 178 1 9 1 68 30
Utah .............. 3 19 2 1 6 6
Nevada............. 1 5 2 3 -

PACIFIC............... 24 839 2,133 12 434 200 381 403
Washington......... 53 491 50 33 116 82
Oregon............. 3 175 412 10 16 16 17
California......... 20 585 1,195 11 354 139 234 280
Alaska.... f........ --- 6 1 --- 11 1 --- --- --- ---
Hawaii ............. 1 20 34 1 9 11 15 24

Puerto Rico.. ..... 90 799 309 13 17 62 6
*Delayed reports: Measles: Mass. delete 5, N.J. delete 2, Iowa 18, Mo. delete 3, Va. delete 30, N.C. delete 1, Alaska delete 5, P.R. 55
Meningococcal infections: Ala. 2
Mumps: Me. 2, P.R. 29
Rubella: Me. 4, Mo. 3, Va. 30, Alaska 6, P.R. 7








202 Morbidity and Mortality Weekly Report


TABLE III. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

JUNE 7, 1969 AND JUNE 8, 1968 (23rd WEEK) CONTINUED


STREPTOCOCCAL TYPHUS FEVER
SORE THROAT & TETANUS TULAREMIA TICK-BORNE RABIES IN
AREA SCARLET FEVER FEVER (Rky. Mt. Spotted) ANIMALS
Cum. Cum. Cum. Cum. Cum.
I69_ !_ 69 149694 1969 1969 1969 196 19 69 16 96 1969 196
UNITED STATES... 6,583 1 50 7 60 3 122 18 93 60 1,696

'SE ESGLAND........... 982 4 8 2 6
Maine......* ....... 11 1 4
New Hapshire....... 32 -
Veront........ 57 4 8 1
Massachusetts..... 214 1 -
Rhode Island....... 71 -
Connecticut........ 597 1

MIDDLE ATLANTIC...... 447 1 8 2 12 1 5 3 55
New York City....... 51 5 1 6
New York, Up-State. 285 2 I 4 3 52
Nev Jersev ....... N 1 1 -
Pennsylvania....... 111 2 1 5 3

EAST NORTH CENTRAL... 500 7 4 1 11 4 105
Ohi................ 86 6 -- 30
Indiaa......... 78 1 2 30
Il in is........... 150 5 2 1 2 19
Michigan........... 115 2 3 -- 2
Wisonsin .......... 71 1 1 24

-EST CRTH CENTRAL... 177 2 6 4 1 14 303
Minnesota.......... 5 1 2 76
I.a....... ....... 59 2 41
Missour ........... 3 3 2 3 94
North Dakta...... 38 2 39
outh Dakta....... 11 1 13
Nebraska........... 12 1 1 10
Kansas............. 49 2 3 4 30

SO TH A .TANTIC....... 728 10 1 17 2 21 11 47 22 491
Delaar........ 10 1 -
Marsyand........... 122 3 7 15
Dist. of Ciutbaa.. 14 2 1 -
Virginia........... 177 1 2 11 4 254
West Virginia...... 154 1 2 1 3 5 78
north Carolia..A. 1 1 5 1 4 1 15 4
Sth Carolina..... 146 1 2 1 1 3
GeCrgia............ 7 1 3 7 5 43
Fl rida............ 97 5 4 1 3 8 112

EAST OTHE CENTRAL... 1,112 4 8 12 1 17 2 274
Kentucky........... 83 2 2 1 1 151
Tennessee.......... 828 2 7 8 1 15 93
Alaba-a............ 63 1 1 30
Mississippi........ 138 1 2 -

WET SOTTH CENTRAL.. 608 13 2 8 17 3 14 7 227
Arkansas........... 8 1 8 3 17
Luisiana.......... 13 5 13
lahoma........... 77 1 1 5 2 8 1 37
exas............... 510 7 1 2 9 1 3 6 160

Mr TAIN............. 1,352 -- 7 17 1 6 5 76

Idaho......... .. .. 96 1 1 -
Sy-ig.. .. ...- 2 5 1 41
Cord.............. 881 2 5 1 3
e1 Mexico ........ 166 1 5 8
Arizona........... 103 3 2 19
tah .85 4 1 2
Nevaa. ............ I 3

ACIFIC................ 677 6 26 1 3 3 159
ashi .. ....... 518 1 1 1 2 -
ren................ 97 .- 6 -
Cali r a......... --- 5 -- 19 1 3 159

: ....... -62

Pert c-..,... .. 2 2 3 2 15
*Delayed reports: SST: Me. 7, WVo. 3, P.R. 2
VRSF: N.C. 1
Rabies in ani-als: P.R. 1








Morbidity and Mortality W'eekly Report






TABLE IV. DEATHS IN 122 UNITED STATES CITIES FOR WEEK ENDED JUNE 7, 1969


(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 year
Ages and over nfluenza Allges and over Influenza I 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, IlI.---------
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.--------


767
248
49
23
36
57
28
20
31
71
66
11
46
36
45

3,637
60
31
157
53
35
42
66
85
1,909
43
492
207
66
125
29
52
87
30
21
47

2,772
75
30
757
185
241
133
77
360
55
65
41
38
58
148
45
136
44
38
46
116
84

959
61
18
54
152
33
142
96
255
92
56


437
135
23
14
26
38
13
9
19
42
39
7
32
13
27

2,156
30
24
101
33
24
19
44
47
1 ,137
17
279
106
40
94
19
32
47
17
18
28

1 ,538
39
21
388
112
127
63
40
208
35
26
19
24
39
81
21
87
30
27
26
74
51

554
41
13
24
80
23
92
50
141
57
33


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, Cole.
Denver, Col.----------
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 ,304
106
264
68
118
111
60
78
44
82
80
229
64

660
121
53
46
143
119
46
33
99

1 ,209
36
50
31
149
47
103
274
55
148
87
124
59
46

491
48
32
95
29
125
29
66
67

1 ,784
25
48
42
55
92
557
118
35
124
80
87
199
34
172
72
44


692
55
150
30
59
61
28
37
23
62
49
109
29

358
70
23
27
90
53
22
22
51

619
23
28
20
73
26
53
145
24
63
53
50
34
27

262
26
15
48
16
65
18
36
38

1,053
21
26
27
25
53
323
59
27
82
39
49
120
25
94
52
31


Total 13,583 7,669 454 652


Cumulative Totals
including reported corrections for previous weeks

All Causes, All Ages ------------------------ 313,335
All Causes, Age 65 and over------------------- 181,134
Pneumonia and Influenza, All Ages------------- 16,868
All Causes, Under 1 Year of Age--------------- 14,184


Week No.
23







Morbidity and Mortality Weekly Report


INTERNATIONAL NOTES
QUARANTINE MEASURES



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