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:
AA00010654:00177

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 .















U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE PUBLIC HEAL TH ERv'Ji E 'MALTH Sl
DATE OF RELEASE: AUGUST 22. 1969 ATLANTA, GEORGIA


EPIDEMIOLOGIC NOTES AND REPORTS
SALMONELLOSIS DUE TO IMPORTED BEEF Maryland

An outbreak of salmonellosis occurred among approx-
imately 100 persons attending a wedding reception in
Wheaton, Maryland, on June 14, 1969. Thirty-three of 68
persons contacted reported onset of symptoms including
diarrhea (70 pren-eni abdominal cramps (61 percent).
nausea (48 percent), fever (48 percent), and vomiting
(30 per,-rnit. 5 to 58 hours after the reception (mean lb
hours; median 16 hours). Stool specimens were obtained
from two of 11 persons who contacted their physicians:
one specimen was positive for Salmonella welikada.
Food specific attack rates implicated cooked beef
as the vehicle of infection (Table 1). Samples of beef
obtained from garbage cans at the site of the wedding
reception, from the homes of several wedding guests, and


Vol. 18, No. 33


I .,.I 's I .
Epidemologic Note and fI I
Salmonelloie Due to Im I
Murine Tphus Texas-
Intlrnational Noit
Malaria Ceylon ............ ..... ........ 2 7
Dengue Puerto Rico .................... ... 2'7



from unopened. packed roasts were all positi e for S. weli-
kada and had high coliform counts.
The beef was imported on June 3 and processed by a
firm in New York ( I. shipped to a distributor in Wash-
ington. D.C.. on June 6. and delivered to a caterer on
June 13. At the caterer's, it was refrigerated overnight and
then sliced on Saturday morning. June 14. The caterer
took it to the wedding reception. where it was served at
(Continued on page 286)


TABLE 1. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous weeks)
33rd WEEK ENDED CUMULATIVE. FIRST 33 WEEKS
MEDIAN
DISEASE August 16, August 17, 1964 1968 MEDIAN
1969 1968 1969 1968 1964- 1968
Aseptic meningitis ...................... 142 202 107 1.428 1.790 1,327
Brucellosis ............................ 2 5 7 115 132 155
Diphtheria............................. 4 2 4 94 103 103
Encephalitis, primary:
Arthropod-borne & unspecified ......... 26 56 45 668 652 1.000
Encephalitis, post-infectious ............. 8 8 8 221 343 550
Hepatitis, serum ........................ 116 103 643 3.337 2.694 25,
Hepatitis, infectious .................. ..855 948 29,434 27.770
Malaria ............................. 51 48 15 1.726 1.346 218
Measles rubeolaa) ....................... 185 226 665 19.861 19.180 187.674
Meningococcal infections, total ......... 29 26 26 2.272 1.895 1.895
Civilian ............................... 29 26 2,070 1,720
Military ................................ 202 175
Mumps ................................. 588 822 66.478 122.773 "
Poliomyelitis. total ..................... 1 9 38 38
Paralytic .......................... .. 1 8 38 38
Rubella (German measles) .............. 336 321 48.035 42.826
Streptococcal sore throat & scarlet fever.... 4,355 4.354 4,079 290.216 287,963 287.963
Tetanus ............................... 5 3 7 92 92 138
Tularemia.............................. 2 3 5 90 126 126
Typhoid fever ......................... 6 9 8 178 204 250
Typhus, tick-borne (Rky. Mt. spotted fever) 16 32 14 325 196 189
Rabies in animals ....................... 53 54 81 2.302 2.327 2.902

TABLE II. NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax: ........................................... 3 Rabies in man: ................ .................... 1
Botulism: .......................................... 11 Rubella congenital syndrome: ..... ............ ........ 6
Leptospirosis: N.C.-1, N.Y. Ups.-l, S.C.-1 ............. 42 Trichinosis:* N.Y. Ups.-1 ............................ 154
Plague: ............................................ .. 3 Typhus, urinee* Ohio-1 ............................. 32
Psittacosis: ....................................... 23 Poliomyelitis, non-paralytic:* ........................ 1
*Delayed reports: Trichinosis: Me. 1
Typhus, murine: Ohio delete 1
Poliomyelitis, non-paralytic: Me. 1






Morbidity and Mortality Weekly Report


AUGUST 16. 1969


SALMONELLOSIS (Continued from front paye)

Table 1
Food History Data from Persons at Wedding Reception, Wheaton, Maryland, June 14, 1969

Group A Group B
Person- \- ho Ate peci fied Food Persons who Did Not Eat Specified Food

IFood 1 Ir 1 r \..r i-i. t I
IlI P iF, I III ,ilI l
Turk,-\ 20 20 40 50 13 15 2h 46
\' t Ball- 10 13 23 44 2:3 22 45 51
Pot at Snal 1 21 21 12 50 12 14 26 46
Cole- s la\ 10 1 41 4 25 25 50 50
Roii-t Beef 32 15 .17 6h 1 20 21 5


a lbuffot from 6:20 to 11:15 p.m. Approximately 50. percent
of the' bieef wa not consumed and as given to wedding
ntiO s.
'Th New York firm had -hipped smaller amounts of
the heef to Virginia. Ohio. and Florida. These state.
health departiment- were notified. but. to date. no further
isolation of S.. wc(ikiaii haIte been repported. Other con-
trol measures included the follo\\ine: The Washington.
D.C. food dli-tributor \oluntarilt withheld the rest of lthe
shipment from the market t. The foreign re\oew staff of the
'.S. Department of A\riculture (iSD\) :a- notified, and,
in turn. notified the e\porting country. of the contaminated
beef. The food processing procedure in Neo York N as
re iewed, i microhiololical sam ple-s ere collected on
June 27. and production was stopped for 1 week. while
new prociesing metthod-s re developed based on labora-
torN findings. Pre iouo-li processed heeof was reproces--ed
before rteleas-.
(Itepoirt,'d by Stc i, e L ipsn, .1).. Cr ie/f of Epidenmiolu.oy,
I:.i Jum es Io4b, Jr., and r 1. ('laytot Er ine, En iroon-
n al thf/ partm t.: Hlarold J. Garthcr. 1. ., l ". 1/'iioni of Com-
ma ti le )fisesi sf, an.Idi Edit Sccn rcker. Ba ltriologist.
Hirtc i of L. ira ir c c VQlarylanit S/ate Department of


Health: John E. Spauldiny,. P.V'.1.. Head, Torieology
Group. Technical Serrices Division, I.S. Departm ent of
A-riculture; Kenieth R. iLenington, Office of Associate
Commissioner for Compliance, L.S. Food iand Dfrug Al-
ministration: and an EIS '" .
Editorial Comment:
Salmonella outbreaks due to contaminated imported
meats are infrequently reported in the U1nited States. The
heef in this outbreak was probably contaminated prior to
entry into this country in %iew of the fact that since the
institution of the current salmonella surveillance program
at the NCDC in 1962. isolation- of S. reliktadt have not
Iern reported from human or nonhuman sources in the
United States. On the other hand. S. r !ikada is period-
icall isolated from the country front which the beef was
imported.
It is likely that other human cases of salmonellosis
were associated with the consumption of this contami-
nated beef. but since only approximately one out of 100
clinical cases of salmonellosis is seen by a physician
and has a stool culture taken. it is not surprising that
other cases have not been reported to NCDC.
The USDA has initiated procedures which should
minimize the chances of recurrences of -imilar outbreaks.


MURINE TYPHUS Texas


Frot January through Jul\ 19(i!. 2I cases of urine
typhu- were reported from Texas (Table 2): for the com-
parabdle period in I:9',. 9 cases w ere reported from Te\as.
The patients s pito s included headache, feetr, rialai-e
and weakne-s, and influeniza tas often considered in the
differential -. .The patients' scra sho edl titers
to Proteus 0X19 ani the corlpiement fixation !est con-
frmtd orir ri- )iispt. The patient- ranged in aeg fromi
Sito TL i w' ar- () i jiain 19 e-ar. : n1ean 24.1 yea.r-s). and
tiere at-r r reit a i-mai ias-s in feiales as in mahes
I(Tabtile Therapy iith erythrorti n in one cati se and
ietrauc ine: in ll J othrs re-ult(ed in cm ip),lete rcover,\.
\VM-t (*ai-t' Ioccurred in th ( orpu- C(irun aria or in
Ih lower io Grande \alley (Table 1). M\urne t\phus is
tndil i I -iithern T\xas and i appuarently carried hi
ihei fiid i rat. Mi-I of thi palirti-- I alie a hi.-tort of flea


Table 2
Cases of Murine Typhus by Month of Onset
Texas January-June 1969

Caose Month
3 January
1 Flebruary
\I March
3 April
(i; Ma.
9) June


hires but denied contact wx ithr athu r ats had
Ibe,-tn -sc n in thi itcinit? of their homnies. Se-e-ral patients
adrtlitted to being bhitlen by flea- from their per cats,
ug('-sting that house p-ots may he in\ol ed in the trans-
mis-sion of the disease to maiin.


286










Table 3
Cases of Murine Typhus by Age and Sex
Texas January-July 1969

Age Group Male Female
(Years)
<1-5 0 1
6-10 4 2
11-15 1 2
16-20 1 2
21-40 1 5
>40 1 4
Total 8 16

(Reported by James E. Peavy, M.D., M.P.H., Commis-
sioner of Health, M.S. Dickerson, M.D., Chief, Communi-


Table 3
Cases of Murine Typhus by County
Texas January-July 1969

Cases Counties
6 Nueces
11 Hidalgo
4 Cameron
1 Bell
1 Jim Hogg
1 Brooks



cable Disease Services, and J.Y. Irons, D.Sc.. Director,
and Kinch C. Knolle, Serology Division, Laboratories.
Texas State Department of Health; and an EIS Officer.)


INTERNATIONAL NOTES
MALARIA Ceylon*


The recurrence of malaria in Ceylon. noted in the
first months of 1968 (MMWR, Vol. 17, Nos. 11 and 16),
continued :hrouehiiur 1968 and extended into 1969. A
total of 425,937 cases were reported during 1968 and
195,107 cases were reported for the first 3 months of
1969. Mortality has been low. Of the microscopically
positive cases in the first quarter of 1969, 194,845 were
due to Plasmodium vivax, 175 were due to P. falciparum,
2 were due to P. malariae, and 85 were mixed infections
of P. vivax and P. falciparum.
The factors leading to the present epidemic appear to
be: (1) the increasing occurrence from 1964 to 1967 of


P. vivax infections in areas of high transmission potential
which developed due to the lack of control resources; (2)
the abnormally low rainfall in the early months of 1968
which caused pooling in river beds. thus producing many
ideal breeding sites for Anopheles culicifacies mosquitoes:
(3) population movements associated with land dexelop-
ment. gem mining, and pilgrimages in areas of high trans-
mission potential: and (4) the absence of immunity after
years of freedom from infection during the eradication
efforts between 1945 and 1963.
*Source: World Health Organization Weekly Epidemiologrcal
Record. 44(32):489, August 8, 1969.


DENGUE Puerto Rico


The epidemic of dengue in Puerto Rico in continuing
with 714 cases reported for the week ending August 16
(MMWR, Vol. 18, Nos. 27-30). For the weeks ending July
26, August 2, and August 9, totals of 1,485 cases, 1,676
cases, and 1,758 cases, respectively, were reported.
Over 500 cases of dengue-like illness have been
observed in four areas selected for intensive surveillance
to evaluate the effect of aerial spraying (Figure 1, page
292). In Cortes, ultralow volume Malathion* spraying was
initiated during a period of high incidence and was fol-
lowed by a decrease in cases. In Buenavista and Parcela
400, where spraying was started later in the epidemic,
the observed continuing reduction in cases may be unre-
lated to spraying. Although Maria Jimenez was not
sprayed, Aedes aegypti mosquito indices as well as
case rates were lower than in the other three areas during
the entire study period. The overall attack rates for the


9 weeks of study in Buenavista and Cortes (22 cases per
100 population and 26 cases per 100 population) are
lower than the attack rate in Parcela 400 (45 cases per
100 population), suggesting that spraying may have inter-
rupted the further progress of the epidemic in these two
areas.
(Reported by Dr. Ernesto Colon-Yordan, Secretary of
Health, Dr. Rapheal Correa-Coronas, Auriliary Secretary
of Health for Preventive Medicine, Dr. Luis Mainardi,
Chief, Communicable Disease Control Program, and Dr.
Angel Alberto Colon, Director, Institute of Laboratories
of Health, Puerto Rico Department of Health; and a team
from NCDC.)

*Trade names are provided for identification only, and inclusion
does not imply endorsement by the Public Health Service or
the United States Department of Health, Education, and Wel-
fare.


AUGUST 16, 1969


Morbidity and Mortality Weekly Report







288 Morbidity and Mortality Weekly Report


TABLE III CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

AUGUST 16, 1969 AND AUGUST 17, 1968 (33rd WEEK)


ENCEPHALITIS HEPATITIS
,i'ui .- l0Pi Primary including P r- MALARIA
AREA i i unsp. cases .i1 .m Serum Infectious
Ofl unp. cJO( I g
Cum.

UNITED STATES... 142 2 4 26 56 8 116 55 948 51 1,726

NEW ENGLAND.......... 1 2 1 1 91 82 1 62
MaineA.............. 5 4
New Hampshire...... 5 2 2
Vermont ............ 1 -
Massachusetts...... 55 36 1 42
Rhode Island ...... 1 2 1 20 29 3
Connecticut........ 1 10 10 11

MIDDLE ATLANTIC...... 43 3 14 3 34 146 140 10 200
New York City...... 2 1 22 59 58 1 17
New York, up-State. 10 1 2 1 31 26 2 JI
New Jersey* ........ 5 1 11 7 1 23 5 80
Pennsylvania....... 26 3 1 4 37 33 2 72

EAST NORTH CENTRAL... 15 9 21 2 12 132 140 4 171
Ohio............... 1 5 18 3 32 53 17
Indiana ............ 3 1 1 2 8 1 15
Illinois........... q 2 1 32 31 3 101
Michigan........... 2 3 9 60 36 37
Wisconsin .......... I 12 1

WEST NORTH CENTRAL... 22 2 4 2 2 31 58 4 115
Minnesota.......... 17 1 2 30 7
Iowa............... 1 1 1 6 6 9
Missouri........... 2 1 9 13 2 31
North Dakota....... 1 -
South Dakota....... 7 1
Nebraska........... 2 1 2 3
Kansas............. 1 2 2 6 5 2 62

SOUTH ATLANTIC....... 20 1 2 2 6 59 104 4 484
Delaware............ 2 3 1 3
Maryland........... 11 1 13 15 3 26
Dist. of Columbia.. 2 1
Virginia........... 2 6 7 18
West Virginia...... 1 7 6 -
North Carolina..... 1 2 3 22
South Carolina..... 3 10 3 42
Georgia ............ 1 27 146
Florida ............ 4 1 2 3 18 40 25

EAST SOUTH CENTRAL... 8 3 3 4 48 56 67
Kentucky........... 9 21 54
Tennessee.......... 6 1 3 1 19 19 -
Alabama............ 1 1 3 1 1 11
Mississippi........ 1 1 19 15 2

WEST SOUTH CENTRAL... 18 3 4 6 72 56 11 9b
Arkansas ........... 3 b
Louisianat ......... 2 2 2 19 16 3 36
Oklahoma............ 6 4 1 7 37
Texas ............. 10 3 4 49 36 1 15

MOUNTAIN............. 1 52 40 2 121
Montana............ 3 3
Idaho.............. 1 1 5 3
Wyoming............. -
Colorado............. 16 2 102
New Mexico......... 4 4 7
Arizona............. 22 20 1
Utah............... 5 8 1
Nevada............. 3 4

PACIFIC.............. 15 4 10 51 224 272 15 410
Washington.......... 3 1 1 13 25 5
Oregon............. 1 17 18 1 9
California......... 11 2 4 50 188 226 14 312
Alaska............. I 2
Hawaii.............. -- 5 3 82

Puert Ric..........- 43 33 2

*nelaved reports: iHepatitis, infections: Me. 4, Tex. delete 1
"alaria: N.J. delete 1 La. delete 1








Morbidity and Mortality Weekly Report


TABLE III. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

AUGUST 16, 1969 AND AUGUST 17, 1968 (33rd WEEK) CONTINUED


289


MEASLES (Rubeola) MENINGOCOCCAL INFECTIONS, MUMPS POLIOMYELITIS RUBELLA
TOTAL
AREA Cumulative Cumulative Total Paralytic
P ....


UNITED STATES...

NEW ENGLAND.........
Maine*..............
New Hampshire......
Vermont............
Massachusettst.....
Rhode Island.......
Connecticut ........

MIDDLE ATLANTIC......
New York City......
New York, Up-State.
New Jersey.........
Pennsylvania .......

EAST NORTH CENTRAL...
Ohio................
Indiana ...........
Illinois ..........
Michigan..........
Wisconsin..........

WEST NORTH CENTRAL...
Minnesota .........
Iowa................
Missouri...........
North Dakota.......
South Dakota.......
Nebraska...........
Kansas.............

SOUTH ATLANTIC.......
Delaware ..........
Maryland...........
Dist. of Columbia..
Virginia ..........
West Virginia......
North Carolina.....
South Carolina.....
Georgia............
Florida............

EAST SOUTH CENTRAL...
Kentucky.*.........
Tennessee ..........
Alabama............
Mississippi........


E T *I' NT. .. ..
L u ir. .. .....



MOl iA i .. ..... .
M ..n ...........
IJ.h ...... ...

r-,I r .- .. .. .

-,- l . ...
ri rl .............
P .- '- .... ......



I .I H .... .. .. .

'r .r, a ... .

1.r.. r. .. .. ...

H I .... ......
Hi6. .. .......


1969 196) 1968 1964


19,861

1,082
7
238
3
208
23
601

7,397
4,862
591
873
1 ,071

2,099
367
465
479
238
550

511
5
328
22
11
3
135
7

2,459
373
74

882
185
313
112
1
519

107
63
17
4
23



I r,






5.0
.11 I
Ir


i


1969 69 1 9 4Ih 19(69 1969
588 8 33b

103 27
4 -
A -


19,180

1,139
37
141
2
354
5
600

3,899
1,994
1,210
585
110

3,706
289
653
1 ,356
260
1 ,148

378
16
96
81
131
4
40
10

1,476
15
94
6
293
280
281
12
4
491

487
99
61
93
234



I I
Il


1969 1968
2,272 1,895

80 101
6 6
2 7
1
33 48
9 8
30 31

371 341
73 69
66 59
150 122
82 91

312 227
117 62
34 27
44 51
95 67
22 20

116 101
25 24
15 6
51 32
-. 3
1 5
9 6
15 25

395 385
8 8
36 28
9 14
49 31
18 10
66 76
55 56
69 73
85 89

140 162
49 65
53 52
.3 24
15 21

S 300
20
85
49
146

29
3



1 -
11





3


:.5l 249
S 37
S 19
.1- 180
1 | 2
I,, 11


50 1 19

5 4
- 1
131
13 -
21 9
NN -


2 1 5

42 1 27
6 5
24 20
11 1 1
1 1

42 4 38




42 4 38

46 33



4 2
11 I
20 20
6 4


89 57
9 3
3 3
53 34
5 3
19 14


I,


- I., Ij


r .... I ,.*. I 19 25 15

a" livpn report;: "'.;': l : L i: l lC te 1

rui el l a: "I I j I.: t i..







290 Morbidity and Mortality Weekly Report


TABLE II. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

AUGUST 16, 1969 AND AUGUST 17, 1968 (33rd WEEK) CONTINUED


STREPTOCOCCAL TYPHUS FEVER
SORE THROAT & TETANUS TULAREMIA THOITICK-BORNE RABIES IN
AREA SCARLET FEVER FEVER (Rky. Mt. Spotted) ANIMALS
Cum. Cum. Cum. Cum. Cum.
1969 1969 1969 1969 1969 1969 1969 1969 1969 1969 1969
UNITED STATES... 4,355 5 92 2 90 6 178 16 325 53 2,302

NEW ENGLAND.......... 578 14 1 7 1 18
Maine. ............ 4 1 1 6
New Hampshire...... 30 4
Vermont............ 41 14 -- 2
Massachusetts ...... 59 4 -- 1
Rhode Island....... 71 1 -
Connecticut........ 373 1 1 5

MIDDLE ATLANTIC...... 195 13 4 2 19 4 34 6 108
New York City...... 12 6 1 1 9 -- -
New York, Up-State. 161 3 3 5 5 6 101
New Jersey......... NN 2 1 1 3 9 -
Pennsylvania....... 22 2 4 1 20 7

EAST NORTH CENTRAL... 258 1 12 7 20 1 1 3 154
Ohio ............... 59 1 7 44
Indiana............ 72 1 42
Illinois ........... 41 7 2 9 1 1 26
Michigan........... 49 1 4 4 5
Wisconsin.......... 37 4 3 37

WEST NORTH CENTRAL... 171 1 7 1 12 8 8 7 432
Minnesota.......... 5 2 3 3 112
Iowa............... 33 7 62
Missouri........... 4 1 1 8 3 1 111
North Dakota....... 62 55
South Dakota...... 4 1 24
Nebraska........... 5 1 1 1 11
Kansas ............. 58 1 4 3 1 2 57

SOUTH ATLANTIC....... 455 18 20 30 5 187 15 590
Delaware........... 3 2 3 -
Maryland........... 45 1 4 1 41 1
Dist. of Columbia.. 2 1 1 1 -
Virginia............ 95 4 2 56 7 304
West Virginia...... 125 1 2 I 5 3 90
North Carolina..... NN 2 5 6 45 4
South Carolina.*... 38 1 2 2 1 24 -
Georgia............. 5 2 3 7 12 3 57
Florida ............ 144 9 4 7 2 134

EAST SOUTH CENTRAL... 981 15 9 3 20 3 40 2 337
Kentucky........... 69 6 1 3 1 6 2 178
Tennessee.......... 670 4 8 2 14 2 33 114
Alabama............ 103 4 1 1 42
Mississippi........ 139 1 1 2 3

WEST SOUTH CENTRAL... 478 1 17 1 16 22 3 36 9 321
Arkansas........... 1 1 10 6 24
Louisiana.......... 1 6 4 2 3 26
Oklahoma........... 4 1 6 1 23 46
Texas .............. 473 1 9 1 5 9 3 7 6 225

MOUNTAIN ............. 907 1 3 8 22 14 5 104
Montana............ 26 1 -
Idaho........ ....... 111 3 4-
Wyoming............. 5 2 5 50
Colorado............ 435 1 2 3 8 3
New Mexico......... 178 1 5 2 13
Arizona............. 76 5 22
Utah............... 76 5 2 1 4
Nevada............. 1 2 12

PACIFIC............. 332 1 7 30 5 5 238
Washington......... 169 1 1 3 3
Oregon............. 65 6 1 3
California......... --- 1 6 23 2 4 232
Alaska ............ 24 -
Hawaii............. 74 -

Puerto Rico.......... 4 1 6 2 20

*Delayed reports: SST: Me. 3, S.C. 19








Morbidity and Mortality Weekly Report 291






Week No. TABLE IV. DEATHS IN 122 UNITED STATES CITIES FOR WEEK ENDED AUGUST 16, 1969
33
(By place of occurrence and week of filing certificate. Excludes fetal deaths)

All Causes Pneumonia Under All Causes Pneumonia Under

Area All 65and 1 year Area All 65 years and 1 yea
AreaA 65 years Influenza All
Ages and over fluenza All Ages and over All Ages Causes
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, I11.---------
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------

JEST 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.--------


671
218
42
21
17
41
27
22
26
56
61
5
49
25
61

3,160
55
36
104
51
36
34
57
76
1,617
27
502
147
43
115
32
38
94
35
32
29

2,443
47
43
660
157
181
121
93
344
61
52
36
22
42
152
33
139
30
33
43
100
54

805
43
21
56
122
29
102
75
231
74
52


397
118
29
11
13
20
21
15
20
29
33
5
27
16
40

1,815
30
26
72
29
21
22
33
34
927
9
269
73
27
74
17
20
59
24
25
24

1 ,392
28
31
363
92
97
64
49
205
36
24
25
7
24
82
21
88
20
18
20
64
34

473
29
12
27
76
21
59
37
135
44
33


SOUTH ATLANTIC:
Atlanta, Ga.----------
Baltimore, Md.---------
Charlotte, N. C.------
Jacksonville, Fla.----
Miami, Fla.-----------
Norfolk, Va.----------
Richmond, Va.----------
Savannah, Ga.----------
St. Petersburg, Fla.---
Tampa, Fla.------------
Washington, D. C.------
Wilmington, Del.-------

EAST SOUTH CENTRAL:
Birmingham, Ala.-------
Chattanooga, Tenn.-----
Knoxville, Tenn.-------
Louisville, Ky.--------
Memphis, Tenn.----.---
Mobile, Ala.-----------
Montgomery, Ala.-------
Nashville, Tenn.-------

WEST SOUTH CENTRAL:
Austin, Tex.----------
Baton Rouge, La.-------
Corpus Christi, Tex.---
Dalla, T.-----------
El Paso, Tex.------
Fort kWrth, 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 ,167
119
245
38
100
102
53
78
29
109
72
182
40

657
116
55
45
130
135
58
30
88

1,130
35
64
37
162
48
81
230
52
141
88
101
43
48

471
43
32
129
15
116
11
57
68

1 ,563
21
51
22
37
107
455
105
46
126
63
113
162
43
133
59
20


Total 12,067 6,785 39b 600


Cumulative Totals
including reported corrections for


previous weeks


All Causes, All Ages ------------------------ 435,660
All Causes, Age 65 and over------------------- 250,226
Pneumonia and Influenza, All Ages------------- 21,102
All Causes, Under 1 Year of Age--------------- 20,204







Morbidity and Mortality Weekly Report


Figure 1
DENGUE-LIKE ILLNESS IN RELATION TO
AERIAL SPRAYING PUERTO RICO
JUNE 7-AUGUST 9, 1969


JUNE JULY
WEEK OF REPORT


AUGUST 16, 1969


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.

EDITOR MICHAEL B. GRECC M .
MANAGING EDITOR PRISCILLA B. -OLuIN

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 .C aL th
OFFICIALS AND WHICH ARE DIRECTLY RELATED TO THE CONTROLL
OF COMMUNICABLE DISEASES. SUCH COMMUNICATIONS SHOULD BE
ADDRESSED TO:
NATIONAL COMMUNICABLE DISEASE CENTER
ATTN: THE EDITOR
MORBIDITY AND MORTALITY WEEKLY REPORT
ATLANTA, GEORGIA 30333

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.


AUGUST


PARCELA 400


C SPRAYING N


7 14 21 28 5 12 19 26 2
JUNE JULY AUGUST
WEEK OF REPORT

S4i *
MARIA JIMENEZ




2,






JUNE JULY AUGUST
WEEK OF REPORT
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