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:
AA00010654:00181

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
NATIONAL COMMUNICABLE DISEASE CENTER


Vol. 17, No. 3


WEEKLY

REPORT


Week Ending

January 20, 1968


U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELF)

BUREAU OF DISEASE PREVENTION AND ENVIRONMENT

EPIDEMIOLOGIC NOTES AND REPORTS I
OUTBREAK OF MENINGOCOCCAL INFECTION Epidemioloe
Mississippi Outbreak


From January 14 ;hro:u-i, 19, 1968, four documented
cases and four suspect cases of meningococcal infection
with three deaths occurred among 56 elderly female pa-
tients, residing on the second floor of a Mississippi state
hospital fpr the mentally ill. The outbreak began on Jan-
uary 14 when two patients suddenly died, and a third
patient was admitted to the institution's infirmary with
purulent n,-rn;rk;; (Figure 1). Clinical and epidemiologic
investigation revealed that the first fatal case had a
temperature of 1070F. before death. Autopsy on the second
fatal case revealed bilateral adrenal hemorrhage. Gram


International Notel
Influenza 1967


. . 2 S


stains of cerebrospinal fluid from the third and fifth pa-
tients showed Gram-negative intracellular diplococci which
was confirmed as meningococci by fluorescent antibody
directed against Group B. This fifth patient died in shock;
she had classical skin lesions of meningococcemia.
Fluorescent antibody studies on autopsy material were
(Continued on page 22)


TABLE I. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous weeks)
3rd WEEK ENDED CUMULATIVE, FIRST 3 WEEKS
MEDIAN
DISEASE JANUARY 20, JANUARY 21, 1963 1967 MEDIAN
1968 1967 1968 1967 1963 1967
Aseptic meningitis ...................... 24 29 32 77 77 87
Brucellosis.............................. 1 3 2 7 10
Diphtheria........... ................... 2 1 2 3 3 11
Encephalitis, primary:
Arthropod-borne & unspecified ........... 17 20 52 59 -
Encephalitis, post-infectious .......... 9 7 28 20 --
Hepatitis, serum ........................ 76 29 778 177 108 2,2
Hepatitis, infectious .................... 814 749 2,167 2,019
Malaria ................... .......... 36 27 5 112 67 5
Measles rubeolaa) ....................... 555 1,473 5,946 1,274 4,039 14,819
Meningococcal infections, total ........... 85 73 63 192 191 191
Civilian ............................ 82 68 --- 188 177 -
Military ................. ........**. 3 5 --- 4 14 -
Mumps .......................... ..... 5,429 --- --- 12,443 -
Poliomyelitis, total ..................... 1
Paralytic............................... -
Rubella (German measles) ................ 603 654 --- 1,351 1,406 ---
Streptococcal sore throat & scarlet fever 11,019 11,927 9,610 30,840 30,501 26,356
Tetanus.......................... 1 3 2 1 6 10
Tularemia ........................... 1 4 4 2 9 15
Typhoid fever ......................... 9 5 5 16 9 12
Typhus, tick-borne (Rky. Mt. spotted fever) 2 3 3
Rabies in animals ....................... 65 71 61 198 205 203

TABLE II. NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax: ........................................... Rabies in man:............. ............... ..... -
Botulism: .... ........ .............. ........... Rubella, Congenital Syndrome: ........................
Leptospirosis: .......................... ........... Trichinosis: Pa.-l ...................... .. 2
Plague:............................................ Typhus, murine: ................................ -
Psittacosis ........................................ 2 Polio. Unsp ......... .. ....... ....... ........... -


LTH SERVICE







Morbidity and Mortality Weekly Report


OUTBREAK OF MENINGIOCOCCAL INFECTION ((ontinuedJ from front ow)


-trIns(~? posultie r \ ,,sUsri, sie;ini/ i. Tl'ti seventh
;:< mrith patient hIad cla wial -kit leb ion1 and hadl
p t-iite nsonpharyn0tal anld Ii ood cultures for sulifonamide-
r,-Itani, Group B menionocovci. (as s I and 6 lere
on ilh Ibll'es of high lg er. leukocyltosis. and

Epmnlmiohlgic ine-stigation reiealld that 34 percent
of lth .1 ; p1i;(nts on the -,econd floor had hadt documented
t, p Iralure elelation- and symptoms attributed to \iral
upper respirator\ lisi-ase behtww(en Januitar) :3 and .Jan
uary 17. On ,hJuari 17. a Group I enininegococal carrier
rule of i percent \\:Is found among tlhe 4S patients, then
reI lin i on the ward. \ll but one isolate (.1 of (6) were
sul IIonani lde-resi -tant. Preli innarn resiult of nasopharlngeal
sal surveys, of comparable male and female ward popu-
Iatils (174 males and I 11 females) conducted at the
in-tsiluion on January 17 and 19. showed type B carrier
rater- ofi' percent or le-.. All these isolates \\re sul-
fonamihe sensitie.
Since ex\idnce implicated a type B resistant mtunincot(cal strain as the demic and (Ias preo talent only in one bui lding. strict quaran-
tine, measure-s i\re impo(sd, and antibitibiotic prophyla\is


Figure 1
NUMBER OF CASES OF MENINGOCOCCAL INFECTION
W BY DATE OF ONSET
S4- MISSISSIPPI JANUARY 1968

3
0 +
2
w I+
C 1

I +
(I _


11 12 13 14 15 16
JANUARY
+ DEATH ONSET


17 18 19 20


\with penicillin was iitiat.ed. Epidemiologic and labora-
tory investigations are continuing.
(R'eported by Williai m ,Iaquith. .I., Jame's Head, M.).,
ailn fanning lfdIon, ,V.1.. Vissiissippi State Ilospita.
i hiltfield. Vississippi;: L. Gray. .ID., V .P.H., Eiecu-
ire Officrr. ani Durard L. i. Blakey. 1.D., M.P.HI.,
Director, Prerentable Disrase Control. Missisppi State
Board of ftealtl: and Epidemiologfic(al Serriest Laboratory
Section, \C(', and a team of EIS Officers.)


SURVEILLANCE SUMMARY
MEASLES United States, 1967


For the first time since reporting of measles began
on a national basis (1912), the reported cases in 1967
w er'e fewer than 100 per 100,000 population. In 1967. the
case rate per 100,000 population was 37.4 as compared(
to 10,1.2 in 196f6.
The frequency distribution of the states according to
the reported imasles cases per 100,000 population for
calendar years 1966 and 1967 is shown in Table 1. The
primary difference between 1966 and 1967 occurs in the
high andl lo levls;: there \\as essentially no change in
the number of states falling into the two middle categories.
However, there was a conhsilrall change by individual
states to a different rate category in the 2 years.
In 1!i967. 29 states, the Districtl of ('olumbia. and Noe
York ('it, showed marked decreases in reported cases of

Figure 2
REPORTED MEASLES CASES PER 100,000 POPULATION
UNITED STATES, 1967
O-t




I i 1
S.... v/-^ j|Llj"\
,-I w I




i j' "" 11t


Table 1
Frequency Distribution of States* According to
Reported Measles Cases per 100,000 Population
Cases per Number of States
100.000 population 1967 196i
Less than 25.0 25) 11
25.0 to 49.9 10 9
50.0 to 99.9 13 14
100.0 or greater 4 16
*Includes the District ot Columbia and New York City.
measles per 100,000 population from the 1966 reports.
This is reflected by the maps in Figures 2 and 3; 10 states
showed a decrease in rates, but the decrease was not
enough to show improvement on thle maps from 1966 to 1967.
(Continued on page 28)

Figure 3
REPORTED MEASLES CASES PER 100,000 POPULATION
mm ( UNITED STATES, 1966


Lmwoo
El


JANUARY 20, 1968

















During the current U.S. influenza epidemic, every
county in Michigan experienced an outbreak of influenza
(Figure 1), although the severity of illness and the pro-
portion of the populace varied by county. Serologic con-
firmation of the outbreaks as influenza A2 was made by
complement fixation tests on specimens from eight coun-
ties, Kalamazoo, Ingham, Calhoun. Washtenaw, Wayne,
Kent, Marquette, and Saginaw. Specimens from patients in
other counties are presently undergoing laboratory inves-
tigation. Although the major Michigan epidemic has sub-
sided, sporadic cases continue to be reported.
Recently, a telephone survey to Michigan county
health departments obtained the dates of onset of influenza
in each county. The progress of influenza through Michigan
was traced by analysis of these data. According to the
survey results and to the dates of outbreaks submitted to
NCDC, the first outbreak occurred at Western Michigan
University in Kalamazoo in the 43rd week, October 21,
of 1967. (MMWR, Vol. 16, No. 48). In the 44th week, in-
fluenza occurred in Battle Creek, Calhoun County, and in
the 46th week, influenza occurred in Lansing. Following
the Thanksgivfing holiday, influenza spread rapidly in all


directions. especially, to the northern and eastern highly
populated counties of Saginaw, Genesee. Wayne, Oakland,
and Macomb. During the 50th week, December 10-16. the
northern half of the lower peninsula and upper peninsula
experienced influenza outbreaks. In the 51st and 52nd
weeks, outbreaks were reported from the western upper
peninsula.
In these county outbreaks, influenza usually was first
noted in the high schools. During the first week, a few
cases of febrile respiratory illness occurred, and by the
second week, school absenteeism from influenza increased
to 25 or 30 percent. By the third week, influenza had
spread to the elementary school children and adults in
the county. By the end of the fourth week. only sporadic
cases occurred, and the county epidemic was over. In the
city epidemics, school absenteeism was also 25 to 30
percent; however, Traverse City reported 50 percent, absen-
teeism, and Hisperia, Newaygo County, reported 70 percent.
(Reported by George H. Agate, M.D., M.S.P.H., Chief
Division of Epidemiology, and Maurice Becker, Ph.D.,
Chief, Laboratory, Michigan Department of Public
Health; and an EIS Officer.)


Figure 4
INFLUENZA AND INFLUENZA-LIKE ILLNESS IN MICHIGAN
BY COUNTY BY WEEK OF ONSET
/ \ OCTOBER DECEMBER 1967





S E50 \
5 ,-.[50 .. 5 1

51







\ 50 50 50
1 /50
50 5. .-


50 50 50 50 50 50
50 50505050


50 50 -50- 50- 50 s

S 50 / 49- 49 s
o 48 48 48 r C I

48 48. 48 48 48 49 49
p48 4847 478

48 48 4

0 20 40 60 49 43 44 48 48 4
MILES J 4 / 5 m... .
4 8 48 48 0
-~~~8 <^4_.-.


JANUARY 20, 1968


Morbidity and Mortality Weekly Report


EPIDEMIOLOGIC NOTES AND REPORTS
EPIDEMIOLOGIC INVESTIGATION OF INFLUENZA
IN MICHIGAN









21 Morbidity and Mortality Weekly Report


TABLE III CASESS OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

JANUARY 20, 1968 AND JANUARY 21. 16,7 (3rd WEEK)


ENCEPHALITIS HEPATITIS
ASEPTIC Primary
HIU (.1-IL,{IM OiPI! IH' HI-V Post- M^T A
AREA MENINGITIS including nfectious Serum Infectious MALARIA
unsp. cases

T ET I -F i i


NEW ENGLAND.......... 2 1 4 44 33
Maine ..............- 3
New Hampshire..... -
Vermont.. ......... -
Massachusetts ...... 13 9
Rhode Island....... 1 1 8 7
Connecticut. ........ 1 3 23 13 1

MIDDLE ATLANTIC...... 2 4 4 3 2 32 122 118 6
New York City...... 26 51 19
New York, up-State. 2 2 24 47 1
New Jersey......... 1 1 4 14 21
Pennsylvania....... I 1 4 1 2 33 31 5

EAST NORTH CENTRAL... 2 1 3 2 1 1 153 115 1
Ohio................ 1 2 58 22 -
Indiana........... .. -- 3 5
Illinois............ 34 20
Michigan .......... .. 1 1 2 1 1 42 55 1
Wisconsin.......... 1 16 13

WEST NORTH CENTRAL... 1 1 2 2 56 35 4
Minnesota .......... 19 13
Iowa.................... 2 9 4
Missouri........... 1 2 16 13
North Dakota........ 4 -
Socth Da',ota .. .
Nebra Kansas............ 6 5 4

SOUTH ATLANTIC....... 6 4 2 3 2 2 69 61 12
Delaware........... 2
Maryland........... I I 14 18 3
Dist. of Columbia.. 1 1
Virginia........... 1 1 18 4
West Virginia...... 3 4 11
North Carolina...... 2 2 1 4 6 3
South Carolina..... 1 1
Georgia......... ....... 13 6 4
Florida............. .- 1 1 2 2 14 14 -

EAST SOUTH CENTRAL... 58 69
Kentucky........... 29 30 -
Tennessee........... 1 18 21 -
Alabama ......... .....- 4 11 -
Mississippi........ 7 7 -

WEST SOUTH CENTRAL... 1 1 1 2 2 67 71 1
Arkansas............ 2 7 -
Louisiana........... 1 2 11 9 1
Oklahoma ........... -1 16 4 -
Texas............ .. 1 38 51 -

MOUNTAIN. .......... 1 1 27 72 1
Montana............. 7 4
Idaho .............- 9 5
Wyoming............ I -
Colorado........... 1 1 3 1
New Mexico......... 2 43
A.-,ona............ 5 9
1tah............... 2 8
Nevada.............

PACIFIC................ 11 18 3 9 4 33 218 175 10
Washington ......... I 16 17
Oregon............. 1 16 36 1
California......... 11 15 3 9 3 32 184 121 9
Alaska.............. 2 1 -
Hawaii ............ 3 -

Puert icol ...... 3 2










Morbidity and Mortality Weekly Report 25


TABLE III. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

JANUARY 20, 1968 AND JANUARY 21, 1967 (3rd WEEK) CONTINUED


MEASLES (Rubeola) MENINGOCOCCAL INFECTIONS, MUMPS POLIOMYELITIS RUBELLA
TOTAL
AREA Total Paralytic
AREA Cumulative Cumulative Total Paralytic
Cum.
1968 1968 1967 1968 1968 1967 1968 1968 1968 1968 1968
UNITED STATES... 555 1,274 4,039 85 192 191 5,429 603

NEW ENGLAND........... 16 37 34 2 7 6 556 44
Maine............. 1 2 4 1 20 2
New Hampshire...... 1 7 -
Vermont............ 4 57 -
Massachusetts...... 7 19 21 1 3 3 293 14
Rhode Island....... 2 55
Connecticut........ 8 16 2 1 4 2 124 28

MIDDLE ATLANTIC...... 69 171 191 11 28 29 289 60
New York City...... 12 24 24 5 6 6 84 30
New York, Up-State. 31 106 50 1 9 20
New Jersey.......... 19 33 86 2 8 11 205 10
Pennsylvania....... 7 8 31 4 13 3 -

EAST NORTH CENTRAL... 183 362 440 10 27 15 2,051 117
Ohio................ 29 65 35 4 8 7 293 12
Indiana............. 52 75 79 1 3 1 125 9
Illinois........... 58 132 39 1 4 3 237 17
Michigan........... 8 20 117 3 11 3 610 46
Wisconsin.:........ 36 70 170 1 1 1 786 33

WEST NORTH CENTRAL... 25 55 140 5 15 10 773 52
Minnesota.......... 5 1 1 26 5
Iowa.............. 9 21 29 1 1 2 617 27
Missouri......... 1 6 2 4 3 17 -
North Dakota....... 5 14 49 1 1 83 11
South Dakota....'... 1 2 14 2 1
Nebraska........... 2 3 37 1 2 10 -
Kansas............. 8 14 NN 1 5 1 20 9

SOUTH ATLANTIC....... 35 106 406 27 46 33 392 29
Delaware............. 9 1
Maryland........... 4 8 2 1 1 3 39 5
Dist. of Columbia.. 4 1 -
Virginia........... 6 16 66 4 4 3 101 14
West Virginia...... 10 34 87 2 7 160 -- 3
North Carolina..... 2 75 4 8 7
South Carolina..... 2 1 2 8 1 3 2
Georgia ............ 8 4 5 4
Florida............. 15 44 163 12 17 8 80 -

EAST SOUTH CENTRAL... 8 27 465 1 6 15 272 23
Kentucky........... 1 4 65 2 4 99
Tennessee.......... 2 15 195 1 4 7 147 12
Alabama............ 3 5 66 2 14 11
Mississippi........ 2 3 139 2 12 -

WEST SOUTH CENTRAL... 103 241 1,210 18 37 30 186 16
Arkansas........... 137 -
Louisiana.......... 1 13 7 9 12 2 -
Oklahoma............ 34 179 1 7 3 -
Texas.............. 103 206 881 10 20 18 181 15

MOUNTAIN.............. 15 52 340 2 6 127 89
Montana............ 1 1 88 1 20 4
Idaho .............. 6 28 1 58
Wyoming............. 2 13 16 -
Colorado........... 5 15 42 1 8
New Mexico......... 6 47 3 49 5
Arizona............ 7 11 55 1 40 13
Utah................ 10 2 -
Nevada............. 70 1 -

PACIFIC............... 101 223 813 11 24 47 783 173
Washington.......... 34 66 429 1 2 1 258 73
Oregon.............. 27 58 150 1 3 19 14
California.......... 39 87 189 10 21 42 486 81
Alaska.............. 39 1 9 5
Hawaii............. 1 12 6 11 -

Puerto Rico.......... 9 9 113 25 1








21, % rlbildit' and Mortality Weekly Report


TABLE IlI. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

JANUARY 20. 1968 AN) JANUARY 21, 1967 (srd WEEK) CONTINUED


STREPTOCOCCAL TYPHUS FEVER
SORE THROAT & TETANUS TULAREMIA TYPHOID TICK-BORNE RABIES IN
AREA SCARLET FEVER (Rky. Mt. Spotted) ANIMALS
Cum. Cum. Cum. Cum. Cum.
I IIL- ar I iI' ** [ Ires l r Ld I[ r I Ire L 'Ird LOXn
UNITED STATES... 11,019 1 1 1 2 9 16 2 65 198

NEW ENGLAND.......... 1,400 1 -
Maine ............. .. 27 2
New Hampshire...... 43
Vermont ............ .-
Massachusetts ...... 239 -
Rhode Island....... 85 -
Connecticut ........ 1,006 1 1 -1

MIDDLE ATLANTIC...... 198 4 5 1 1
New York City...... 13 4 4
New York, Up-State. 165 1 1
New Jersey......... NN
Pennsylvania....... 20

EAST NORTH CENTRAL... 1,093 1 1 1 1 1 2 5 18
Ohio............... 179 1 2 1 8
Indiana............ 232 -2 6
Illinois........... 140 1 1 1 1
Michigan........... 292 1 1 --- 1 2
Wisconsin.......... 250 1

WEST NORTH CENTRAL... 491 1 2 12 26
Minnesota.......... 56 1 5
Iowa............... 155 5 7
Missouri........... 7 -- 1 2 4 7
North Dakota ....... 184 1 4
South Dakota....... 44 -
Nebraska........... 3 1 1
Kansas.............. 42 2

SOUTH ATLANTIC....... 1,106 1 2 7 24
Delaware........... 21 -
Maryland............ 152 1
Dist. of Columbia.. -
Virginia ........... 448 2 2 10
West Virginia...... 203 2 4
North Carolina..... 37 -
South Carolina..... 13 -
Georgia............ 15 1 3
Florida............ 217 2 7

EAST SOUTH CENTRAL... 1,427 1 3 23 81
Kentucky........... 79 9 25
Tennessee.......... 1,196 1 3 12 53
Alabama........... 102 2 3
Mississippi ........ 50 -

WEST SOUTH CENTRAL... 1,227 13 37
Arkansas........... 7 2 3
Louisiana.. ...... 1 1 3
Oklahoma ........... 132 4 11
Texas.............. 1,087 6 20

MOUNTAIN.... ........ 2,012 -- 1 1 2
Montana............ 59 -
Idaho............... 146 -
Wyoming............ 162 -
Colorado........... 1,134 -
New Mexico........ 294 -
Arizona............. 130 1 2
Utah............... 87 1
Nevada.. ........... ..

PACIFIC .............. 2,065 1 2 3 7
Washington........ 670 -
Oregon.............. 179 -
California......... 1,158 1 2 3 7
Alaska...... ..... .. 34 -
Hawaii.. ............. 24 -

Puerto Rico.......... 2 -







Morbidity and Mortality Weekly Report






TABLE IV. DEATHS IN 122 UNITED STATES CITIES FOR WEEK ENDED JANUARY 20, 1968


(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 Ia yea
Ages and over Influenza All Influenza Al
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, 9. 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.--------


1,068
374
47
45
59
61
39
33
34
66
108
12
70
31
89

4,209
63
34
184
43
48
49
119
114
2,188
54
563
256
58
146
31
44
80
65
34
36

3,195
71
43
997
188
242
184
100
380
52
39
47
46
50
180
33
162
42
49
63
154
73

1,147
73
14
57
198
46
151
107
345
75
81


680
219
30
30
42
34
27
21
25
42
74
8
45
21
62

2,644
33
16
118
26
32
30
78
54
1,390
33
349
144
35
101
20
32
59
42
24
28

1,899
45
27
575
114
124
108
57
208
39
17
36
21
37
111
18
103
28
40
46
96
49

815
50
11
32
145
40
110
74
236
54
63


102
34
11

4
1
3
3
2
4
18
2
8
1
11

308
6
1


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.---
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.----------


842
85
198
28
50
60
33
59
41
80
52
138
18

547
99
34
55
94
89
42
27
107

975
41
31
18
168
27
88
113
49
152
80
98
50
60

321
32
21
102
17
56
20
36
37

1,146
15
33
24
23
59
382
53
20
95
48
51
122
32
123
37
29


103
9
19
11
4
2
5

10
7
9
22
5

92
19
9
6
20
7
10
9
12

208
14
10
6
45
5
9
12
9
26
16
10
21
25

54
13
5
9
2
15
2
3
5

55

2
2
1
1
11
2

3
2
5
5
2
16
3


Total 16,004 9,869 1,177 622
I ~ .... 1


7.933


656


Cumulative Totals
including reported corrections for previous weeks

All Causes, All Ages -------------------------46,229
All Causes, Age 65 and over-------------------28,245
Pneumonia and Influenza, All Ages------------- 3,038
All Causes, Under 1 Year of Age--------------- 1,850


Week No.
3


13,b14


Estimated expected no.








Morbidity and Mortality Weekly Report


MEASLES United States ',int nii from paf/r 2:2)

\n increnia in case rales o\lr I)fi6 was noted in 11 I saes.
Hotwe\ er. only two states (Oklahoma and Nebraska) showed
increase- of magnitude to change to a different cIassifica-
tion n 0te iinaps. In somni of these 11 states. the higher
rats are due to imppro ed reporting.
Of the Ih states with reported measles cases of 1(t)
or greater per 10, ,ii.'' i-...I,*'! ;. i. n 1966. three showed
ease rates greuatr thart'i100 in 196(7 (North Dakota, Texas,
and Wa-hington). In 196i. (lit ca.4e -rate ranged Irom
1):.7 to 73s.5I for these Ix states. In 1967. the case rates
for the four -tales wihi a rate greater than 100 per 100.000
population ranged from 122.9 to l h4.2.
In 196,T. of the 25 slates reporting fewer than 25 mea-
sles cases per 100,000 population, 16 (64 percent) had
rates less than 10: of the 11 states in 1966 with a rate
less than -.5. five (15 percent) reported fewer cases than
10 per i100, 00 population.
(Khepor"ted hby ,ir Sta Rti Serriie. Section and the Stalisic.s
SIcT( u \('I) rj





INTERNATIONAL NOTES
INFLUENZA 1967


The world d Health Organization has received official
reports of infliienza activity from the following Asian
countries:

Japan: (information dated 7 December) Since mid-
November. outbreaks of influenza-like disease have been
reported in several primary and middle schools in Tokyo
and Aichi Prefectures. In the Tokyo area, the epidemic
has a tendncty to spread gradually.
A strain of \irus A2 has been isolated from sick chil-
dren in a school in Tokyo. It is antigenically almost
identical with those isolated in Japan (luring the epi-
demics of 196ti and early 1967.
Further reports from Japan: (information datod 21
December 1967) The influenza epidemic which started
in Tokyo and Aichi Prefectures seems to he gradually
spreading from cast to west. Scattered outbreaks, mostly
in primary and middle schools. have recently been reported
from the western part of Japan. especially from Kyushu
District.
Strains of virus A2 have been isolated in Tokyo and
Yokohama. and Kyoto Prefecture.
rl,.:',, I evidence of infection with Virus A2 has
been obtained in Aicthi. Hyogo and Sailamna Prefecture.
Taiwan: Sporadic cases of influenza-like illness
were reported in children and adults in late November and
early December 1967. Strains preliminarily identified as
virus B have been isolated from specimens collected in
the Taipei city area.
(C'ompiled from the Weekly Epidemiological Record, WiltO,
Vol. 42, Na. 50, and I'ol. 43, No-. 1-2.)


JANIARY 20, 1968


THE "..,- *T AND MORTALITY WEEKLY REPORT. WITH A C-RCULA-
T1ON .' IS w ,r .- -HE NATIONAL COMMUNICABLE
DISEASE CENTER AT .,- a c .
DIRECTOR, NATIONAL COMMUNICABLE DISEASE .r *"S M
** SENCER, M.D.
CHIEF, EPIDEMIOLOGY PROGRAM A.D. -* "'. ,ui M*D.
A TING CHIEF STATISTICS SECTION IDA L, C ,.. M.S.
EDITOR MICHAEL B GREG SMD

IN ADDITION TO THE ESTABLISHED PROCEDURES FOR REPORTING
S. r -..: ..- .. .- :t 1a L DISEASE
i' WHICH ARE OF CURRENT INTEREST T' M L
WHICH ARE DIRECTLY ,: ", 7 E .-:IaI,:'L
S. .. .. -.. DISEASES SUCH .,.. .r : I, .IU C
NATIONAL --. DISEASE CENTER
ATLANTA. .
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
ON SATURDAY; COMPILED DATA ON A NATIONAL BASIS ARE RELEASED
ON THE SUCCEEDING FRIDAY


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