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:
AA00010654:00182

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
V_ x. W %/ 1 -W 1 1 1 1


NATIONAL COMMUNICABLE DISEASE CENTER


U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFj

BUREAU OF DISEASE PREVENTION AND ENVIRONMENTAL


CURRENT TRENDS
MEASLES United States


For the week ending February 3, 548 cases of measles
were reported. This is 22 percent of the 2,472 cases re-
ported for the corresponding week of 1967.
During the initial 4 weeks of 1968, measles was re-
ported from 346 counties or health districts, whereas 594
counties reported cases during the comparable period in
1967. Of these 346 areas, 39 (11.3 percent) reported a total
of 10 or more. measles cases (Figure 1) as-contrasted with
164 of 594,counties (27.6 percent) reporting a similar num-
ber of cases during the first 4-week period of 1967 (Fig-
ure 2). In addition, the percentage of areas reporting only


Vol. 17, No. 5


WEEKLY

REPORT


Week Ending
February 3, 1968




M I SERVICE


Current Trends /
Measles Unite .t.. . 41
Measles Rhode l .. 42
Measles -Chicago .. 43
Influenza in Five U.S. . 43
International Notes
Influenza Rotterdam, The Netherlands . .. 4



a single case of measles during the initial 4 weeks of
1968 increased to38 percent from the 25 percent which had
been noted during this corresponding period in 1967.
(Reported by State Services Section and Statistics Section,
NCDC.)


TABLE I. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Totals include revised and delayed reports)
5th WEEK ENDED CUMULATIVE, FIRST 5 WEEKS
MEDIAN
DISEASE
DISEASE FEBRUARY 3, FEBRUARY 4, 1963 1967 MEDIAN
1968 1967 1968 1967 1963 1967
Aseptic meningitis ..................... 31 29 19 137 144 136
Brucellosis ............................ 3 1 3 5 14 19
Diphtheria .............................. 6 4 7 12 15
Encephalitis, primary:
Arthropod-borne & unspecified ........... 8 14 74 93 --
Encephalitis, post-infectious ........... .. 5 13 --- 37 45 -
Hepatitis, serum ....................... 61 39 91 321 177 4,021
Hepatitis, infectious .............. ... .. 831 871 1 3,880 3,701
Malaria ................................ 85 57 1 242 146 12
Measles rubeolaa).. ......... ......... 548 2,472 7,123 2,354 8,433 29.002
Meningococcal infections, total ........... 123 53 65 412 288 288
Civilian ...................... ..... .... 113 49 388 267 -
Military ................... ............ 10 4 24 21 -
Mumps ................................. 4,774 --- --- 22,224 -- -
Poliomyelitis, total ..................... 1- 1 1
Paralytic ............................ .. -- 1 1
Rubella (German measles) ............... 780 853 2,682 2,900 -
Streptococcal sore throat & scarlet fever.... 13.058 11,899 10,385 56.038 55,189 46,867
Tetanus ............................... 2 3 3 8 13 16
Tularemia ............................ 3 2 8 13 22
Typhoid fever ........................... 3 9 6 20 28 28
Typhus, tick-borne (Rky. Mt. spotted fever) 1 3 4 4
Rabies in animals ................... ... 60 69 69 347 352 342

TABLE II. NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
A nthrax: ........................................... R babies in m an: ................................... .
Botulism: ........................................... Rubella, Congenital Syndrome: ....................... -
Leptospirosis: Calif.- ............................ 2 Trichinosis: N.C.-1 ................ .................. 4
Plague: ............................................ Typhus, murine: .....................................
Psittacosis: ...................................... 2 Polio, Unsp.: ................................... -
*Delayed Report: Pa. delete 1 case, 1967.








42 Morbidity and M<


Figure 1
COUNTIES OR HEALTH DISTRICTS REPORTING A TOTAL
OF 10 OR MORE CASES OF MEASLES
DECEMBER 31, 1967 THROUGH JANUARY 27, 1968


ortali


ty Weekly Report FEBRI ARY 3. 196s


Figure 2
COUNTIES OR HEALTH DISTRICTS REPORTING A TOTAL
OF 10 OR MORE CASES OF MEASLES
JANUARY 1 THROUGH JANUARY 28, 1967


4 4 --


~wi' "
tj i'


..... .r
T.- u


,t 3 St R R
I I -



A


i'e3


MEASLES Rhode Island


In Rhode Island from October 1966 hen an intensiv-e
measles surveillance system was initiated through Decem-i
her 1967, 4S case's of measles were reported (Figure 3).
The military. directly or indirectly. accounted for 31 of
these vases ((;( percent): 2 cases occurred in military
personnel: 23 cases occurred in military dependents: 6
civilian cases were secondary to military cases. The mea-
sle- attack rate during this period in Rhode Island was
16.s per 100,000) persons for military personnel and their
dependent-. and was 31.0 per 100,000 persons for the civil-
ian population.

Figure 3
REPORTED CASES OF MEASLES BY MONTH OF ONSET
RHODE ISLAND OCTOBER 1966-DECEMBER 1967


O N ) J F M A M i d A b 0 N o
1966 1967
ONSET


On four occasions, measles was imported into Rhode
Island i.r,.,.li military dependents who were visiting from
(alifornia. Maryland, Virginia. and Iceland:
California a 6-year-old military dependent, visitingg from
California. became ill with mneasles in Rhode Island. Ap-
proximately 1-1 days later, his 16-year-old aunt. a resident
of Rhode Island. became ill with measles (military-asso-
ciated case No. 1).
Maryland-a military dependent child visited Rhode Island
from Maryland during his prodome of measles. I'pon his
return to Maryland, he developed measles. During his stay
in Rhode Island. four children (two preschool and two
school age) in a military family were exposed to the child
and de eloped measles. The two school age children at-
tended the second and third grades. Approximately 10 to
14 days following their illnesses, five civilian pupils in
the second and third grades also had measles IIII..liiu.
associated casess Nos. 2-'I1.
Virginia a military dependent child visited Rhotde Island
during his prodrome of measles. Measles developed in four
Rhode Island military dependent children approximately 14
days after -ih had contact with the Virginia case. A fifth
child was exposed, hut did not develop measles; he gave
a history of measles vaccination.
Iceland In Rhode Island, 4 days after moving from Ice-
land where measles cases were occurring, a military de-
pendent child developed measles.
Of the 4 measles cases in Rhode Island, 17 cases
were among the ciiilian population who had no known con-
tact with nilit tary cases. Approximately half of these
cases occurred in clusters with several members of a
household developing measles. The remaining sporadic
cases, in some instances, had contact with other measles
cases: however, others had no known contact.
(Reported by Joseph E. Cannon, H..D., !I.P.H., Director,
Rhode Island Department of Health; and an EIS i/,/i';r r.)


\ ,...-r "
I Y jV.<

I






'r


30



25-



20-


U
it

a


MILITARY CASE
CIVILIAN CASE
SECONDARY TO
MILITARY CASE

[ CIVILIAN CASE


11


^


7
'*\


-- --'- ''







FEBRUARY 3, 1968


Morbidity and Mortality Weekly Report


INFLUENZA IN FIVE U.S. CITIES


In the pneumonia-influenza mortality charts previously
published in the MMWR (Ml\ R. Vol. 17, No. 4), a sharp
rise and fall in the excess mortality has been observed.
Within a single geographic region, however, varying pat-
terns of influenza mortality have emerged in different
cities which probably reflect the extent of clinical in-
fluenza in the cities.
These patterns can be seen in Figure 4 which shows
weekly pneumonia-influenza mortality in five cities during
the 1966-67 and 1967-68 influenza seasons. It is note-
worthy that while New York City and the District of Colum-
bia both had peaks in pneumonia-influenza mortality at
about the same time, to date, no increase has been noted
in the city of Philadelphia. Both New York City (MMWR,
Vol. 16, No. 52) and Washington, D.C. '.IllR Vol. 16,
No. 50) reported excess school absenteeism and outbreaks
of influenza-like illness in December 1967. Subsequently,
both cities have reported the occurrence of excess in-
dustrial absenteeism. In Philadelphia, however, although
isolated cases of influenza A2 have been documented, no
significant excess school or industrial absenteeism has
been reported. In the Chicago and St. Louis areas, excess
school absenteeism was first reported in early December
1967. An account in a St. Louis newspaper noted marked
increases in hospital admissions due to influenza and
respiratory disease in the Christmas holiday period.
In each of these five cities, with the exception of
Philadelphia, the number of deaths for 2 or more consecu-
tive weeks was at a higher level than that reported in
corresponding weeks in the preceding 5 years. This large
number of deaths represents excess pneumonia-influenza
mortality. In Philadelphia, in contrast, 3 of the first 5
weeks of this year are at levels below the lowest level
reported for the corresponding weeks in the past 5 years.
(Reported by Respiratory Viral Diseases Unit, Viral Dis-
eases Section, NCDC.)
REFERENCE:
St. Louis Globe Democrat, January 5, 196S.


Figure 4
PNEUMONIA-INFLUENZA MORTALITY
INFLUENZA IN FIVE U.S. CITIES
1966-67 AND 1967-68
200 NEW YOK CITY
18O A 1966-67 ---
161 II 1967 -68 --


60
CHICAGO
50


40


30
PHI LADELPHIA

0,
I I I I I


36 4044 48 52 4 8 12 16 20 24 28 32
S O N 0 J F M A M J J A
WEEK NUMBER AND MONTH


MEASLES Chicago, Illinois


From October 1, 1967 through January 31, 1968, the
City of Chicago recorded 631 cases of measles: 53 in
October; 135 in November; 167 in December; 276 in January.
In October 1967, 21 of Chicago's 75 community areas re-
ported measles, and in January 1968, 46 of these areas
reported measles. For the first 3 weeks of January, 69.3
percent of Chicago's recorded cases occurred in preschool
children with increasing reports from many housing pro-
ject areas.
In addition to the measles vaccine distributed in
Chicago's Board of Health Infant Welfare Clinics, the
Immunization Project of the Chicago Board of Health has
administered 34,252 doses of measles vaccine in the city


schools since mid-October. Of the 21 community areas re-
porting four or more cases in January 1968, 126 public
schools (60 percent of the public schools in these areas)
have conducted measles immunization programs since
October. Plans are now under way for large scale measles
immunization campaigns throughout Chicago on Feb-
ruary 17 and 18.

(Reported by Samuel L. Andelman, M.D., M.P.H., Com-
missioner of Health, William 1. Fishbein, M.D., Medical
Director, Bureau of Health Services, and Hyman G. Orbach,
Ph.D., Epidemiologist, Chicago Board of Health; and an
EIS Officer.)








414 Morbidity and Mortality Weekly Report


TABLI III. CASIS OF SPEI(IFIED NOTIFIABLE DISEASES: 1'NITED S STATES

FOR WEEKS ENDED

FEBRUARY 3, 198 AND FEBRUARY 4. 1967 (5th WEEK)


ENCEPHALITIS HEPATITIS
ASEPTIC Pr imary
RE MENINGITIS i nc I ud ing In tious Serum Infectious AARIA
unsp. cases
1968 1967 1968 1968 .. T ., .... i ,, i .


UNITED STATES... 11 29 ) .

NEW ENGLAND............ 1 I I 32 47
Maine.............. *2 8
New Haemphire...... 4
Vermont .......... -
Massachusetts ...... 1 15 27
Rhode Island........ 9 1
Connecticut........ 1 6 6 1

MIDDLE ATLANTIC...... 2 2 18 81 105 20
New York ity...... 2 10 7 44 2
New York, up-State. 1 29 27
New Jersey......... 7 -*8 20 4
Pennsylvania ...... 1 17 14 13

EAST NORTH CENTRAL... 1 2 -4 2 139 130 4
Ohio ............... 28 24 1
Indiana ............ -- 10 10 -
Illinois.......... i 55 23
Michigan........... I 1 37 58 3
Wisconsin .......... 2 9 15

WEST NORTH CENTRAl.. 1 2 1 66 65 1
Minnesota.......... 1 1 -9 6
1,wa ............... 10 12
Mi s .ri ........ .. 23 35
North Dakota....... *12
t h 'a .. I -
Nebra e, ......... 1
Kans............... 10 11 1

SOUTH ATLANTIC....... 7 3 2 57 128 35
Delaware........... 3 2
Maryland ........... 2 10 32 4
Dist. of Columbia.. I -
Virginia............ 1 2 7
West Virginia...... 3 10 -
North Carolina ..... 6 6 12
South Carolina..... 3 1 5
Georgia............ 21 67 13
Florida........... 3 -- 11 2 1

EAST SOUTH CENTRAL... 6 6 1 88 74
Kentucky........ 4 44 41
Tennessee........... 2 1 1 29 21
Alabama ........... 1 4 7
Mississippi........ 2 1 11 5

WEST SOUTH CENTRAL... 4 1 2 1 74 69 2
Arkansas........... 1
Louisiana.......... 1 13 10 -
Oklahoma........... 16 5 2
Texas.............. 4 1 2 45 53 -

MOUNTAIN............. 1 1 28 30 9
Montana............ 6 2 -
Idaho.............. 1 9
Wyoming............. 2 -
Colorado........... I 5 9
New Mexico......... 7 9 -
Arizona............ 4 7
Utah....... ...... .. 5 1 -
Nevada............... -

PACIFIC.............. 15 13 1 1 3 2 39 266 223 11
Washington......... 21 26 4
Oregon ............. 1 13 23 -
California.......... 15 11 1 1 3 1 39 229 170 7
Alaska............. -
Hawaii............. 1 3 4


Puerto Ri .....E. I I i j -( I I 1 2 13

*Delayed Reports: He titits infectious: Me. 2; N.J. delete 1; N.D. 12








Morbidity and Mortality Weekly Report 4i


TABLE III. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

FEBRUARY 3,1968 AND FEBRUARY 4, 1967 (5th WEEK) CONTINUED



MEASLES (Rubeola) MENINGOCOCCAL INFECTIONS, MUMPS POLIOMYELITIS RUBELLA
TOTAL
AREA Total Paralytic
AREA Cumulative Cumulative Total Paralytic
1968 1968 1967 1968 1968 1967 1968 1968 1968 1 1968
1968 1968 1967 1968 1968 1967 1968 1968 1968 1968 1968


UNITED STATES...

NEW ENGLAND..........
Maine ..............
New Hampshire......
Vermont.............
Massachusetts......
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....f......
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 ........

WEST SOUTH CENTRAL...
Arkansas ...........
Louisiana..........
Oklahoma ..........
Texas..............

MOUNTAIN ............
Montana.............
Idaho...............
Wyoming ...........
Colorado ..........
New Mexico.........
Arizona ...........
Utah................
Nevada.............


PACIFIC..............
Washington .........
Oregon.............
California .........
Alaska..............
Hawaii..............

Puerto Rico...........

*Delayed Reports: Me
Me
Mu
Po
Ru


4,774

846
*61
10
83
490
57
145

93
93
NN

NN

964
115
207
146
496


548

34

7
5
14

8

79
12
42
15
10

132
12
14
59
10
37

9

2
1
3

3
*-

55


2
17
8
8
1

19

3
1

2


95



95

27
4

3
11
4
3

2

114
25
38
51


2,354

95
7
10
5
41
1
31

287
44
173
49
21

695
81
102
319
41
152

60

25
4
19
3
6
3

198

12
4
36
55
11
5
2
73

42
9
15
10
8

454

1
36
417

99
6
6
20
37
11
17

2

424
112
114
184

14


8,483

117
5
34
13
46
6
13

356
44
84
129
99

761
70
114
77
183
317

284
13
,48
10
118
15
80
NN

999
9
13
4
242
235
225
4
9
258

1,068
358
383
159
168

2,587
334
19
658
1,576

601
124
52
12
106
96
92
19
100

1,710
948
241
455
48
18


288

9
1


4


4
43
9
12
17
5

31
12
3
6
8
2

14
2
2
4

3
2
1

52
2
7

6
8
9
2
8
10

26
9
11
2
4

47

22
2
23

8


1
3
3


1

58
1
5
50
2


144
18
17
28
35
46

43
2
28
1
2


10

34

3

5
8



18

66
27
28
11


8 23 240 1 11 4

asles: Kans. delete 11
ningococcal infections: Me. 2
mps: Me. 9
liomyelitis, paralytic: N.M. 2 cases 1967
bella: Me. 9


8 23 240 I

asles: Kans. delete II
ningocoecal infections: Me.
raps: Me. 9
liomyelitis, paralytic: N.M. 2 cases 1967
bella: Me. 9


3 --








16 Morbidity and Mortality WXeekly Report



TABLE III. ( ASS OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

FEBRUARY 3, 1968 AND FEBRUARY 4, 1967 (5th WEEK) CONTINUED


STREr TOCi OA TYPHUS FEVER
SOR- TliROAi 6. TETANUS TULAREMIA TYPHOID TICK-BORNE RABIES IN
AREA SCARET FEVER (Rky. Mt. Spotted) ANIMALS

i_968 1968 1968 1968 1968 1968 1968 1968 1968 1968 1968
INITED SIATES... 1,058 2 8 3 8 20 1 3 60 347

EW ENGLAND........ 17 1 6
Yaine .............. "19 3 (6

V 1................... ..
!ir havse t r ...... 2 33
Rhii I l and.. ..... 102
Inn t ut ........ 1, 128 1

MIDD I. ATLANTIC...... 357 1 3
Nw Y Lrk City...... 17 -
S w Y rk, Up- tar. 271 1 2

Pennsylvania....... 69 -

EAS NORTH CENTRAl ... 1,405 2 1 1 4 20
hio ......... ..... 268 1 4 8
Indiana.. ........ .. 260 -- 6
Illins ........... 391 1- 2
Michi an ........... 277 -1 1 2
Wi ns in .......... 209 2

vEST NORTH CENTRAl.... 530 1 1 1 2 2 11 61
Minne o ta .......... 22 -- 3 13
I wa ............... 144 2 18
Missouri.......... 13 1 1 2 2- 12
N rth Dak ta....... 149 3 11
Suh Dakoti ....... 43 1 -
Ne ra ka........... 154 4
Kans s............. 5 1 3

SOUTH ATLANTIC........ 1,122 2 1 2 2 7 38
Delaware....... ... 7
Maryland.......... 156 -
Dist. of Columbia.. 12 -
Virginia........... 381 2 4 21
West Virginia...... 231 2 6
North Carolina..... 15 -
S.uth Carolina..... 1
Geore i a........... 26 1 3
Florida............ 283 1 8

EAST SOUTH CENTRAL... 2,106 1 1 1 3 1 1 21 134
Kentucky........... 581 6 48
Tennessee ......... 1,373 1 1 3 13 80
Alabama............. 134 2 6
Mississippi........ 18 1

WEST SOUTH CENTRAL... 913 1 14 66
Arkansas........... 10 *- 1 5
Louisiana.......... 5 1 5
Oklahoma............ 46 5 23
Texas............... 852 *- 7 33

MOUNTAIN............. 2,918 2 4
Montana.............. 69 -
Idaho............... 143 -
Wyoming............ *355 -
Colorado........... 1,813 -
New Mexico......... 349 -
Arizona............. 82 4
Utah............... 87 -
Nevada.............. 20 -

PACIFIC .......... ... 1,977 I 2 1 3 4 15
Washington......... 658 -
Oregon..... ....... 183 -
California......... 964 1 2 1 3 4 15
Alaska............. 55 -
Hawaii............. 117

Puerto Rico.......... 5- 1

*Delayed Reports: SST and Scarlet Fever: Me. 5; Nebr. 149; Wyo. 169
Tularemia: Tex. I case 1967
Typhoid: Ark. delete I case 1967; Tex. 2 cases 1967








Morbidity and Mortality Weekly Report 47






Week No. TABLE IV. DEATHS IN 122 UNITED STATES CITIES FOR WEEK ENDED FEBRUARY 3, 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
Lis 165 years Ayears fluenza y All
InfluenzaInfluenza All
Ages and over Influenza 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, P.-------------
,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.--------


911
270
65
42
51
74
28
35
38
53
81
17
57
26
74

3,555
49
56
145
42
39
39
76
113
1,877
38
445
185
70
116
37
44
72
48
28
36

2,813
79
39
807
198
215
137
115
383
53
51
45
34
48
149
36
141
27
33
43
113
67

976
68
38
44
143
30
126
104
260
100
63


598
162
45
30
36
45
18
25
22
36
50
11
41
18
59

2,214
30
38
83
28
21
24
47
59
1,159
21
276
112
54
76
28
34
46
34
21
23

1,635
45
23
446
129
129
75
73
207
39
18
31
17
33
80
17
91
17
20
28
65
52

619
49
23
24
93
20
86
71
151
67
35


*Estimate based on average percent of divisional total.


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


1,361
18'
263
46
73
117
69
91
56
97
96
225
43

770
110
65
45
172
153
58
62
105

1,451
42
37
36
185
49
77
327
68
202
115
162
80
71

581
57
35
166
19
126
32
64
82

1,751
19
49
41
59
85
619
99
36
124
66
96
182
46
120
66
44


745
87
137
20
35
69
36
54
29
89
52
109
28

459
58
42
29
112
93
25
34
66

799
27
23
21
109
26
45
155
37
111
66
99
45
35

381
34
23
101
15
92
27
43
46

1,055
13
27
29
27
52
378
50
27
74
43
53
110
33
67
42
30


Total 14,169 8,505 881 606

Cumulative Totals
including reported corrections for previous weeks

All Causes, All Ages ------------------------- 75,926
All Causes, Age 65 and over------------------- 46,113
Pneumonia and Influenza, All Ages------------- 4,934
All Causes, Under 1 Year of Age--------------- 3,148










Morbidity and Mortality Weekly Report


FEBRUARY 3. 196s


INTERNATIONAL NOTES '" .
NFLUENZA Rotterddan, The Netherlands


A notable inlcrteas0 i in :rilll I, i t.a reportd(l froniI
it( trdam in1 Docelier 1 '".'." sI. j') physicians. Influepnza
X2 i iru 1'.- isoliated from fo1ur p .tiqt l in DecembeIr, and
s'rolo i ic evid(ncet of A2 influit*ria vIr a ot trained from five
other paitionts.
In October andl Nov\ n or, 1th' iii; Jh\sI ins h) id r( -
po|rterld fI'e\\r than 41) 00 cacs of influnz; oi hiirt month; huuw-
rc (r. iIn Deci't'emii, r 1l 9 h79) c(. -ses \\ert noted. These h79
<(a.-s art( more, than t\\ic(e thO number of case, recorded
il Dec(mnhiier of 1965 and 19611. For the ,winter of 11)67. it
ao al)-pears that thi, upl.ard trend of influenza Ibegan ap-
pro\'in mitly 1 month earlier than in the winters of 1915.
and 1966 (Figure 5).
In Fohruary and March of 19)65 and !966. both :\2 and
B influenza iruse- were isolaOtd: however. in Februar\
and March 196i7.only \2 \virus i\as isolated. The antigenic
structure of the \2 \ ru-s identified in December 1967 does
not appear to be markedly different from Ihe A2 strains
isolated during the previous influenza season.


2.000



1,800



1,600



1.400



v/ 1.200















400

200

200


Figure 5
INFLUENZA
ROTTERDAM, THE NETHERLANDS
1965, 1966, AND 1967


- 1965
1966
-- 1967


4 8 12 16 20 24 28 32 36 40 44 48 52
4-WEEK PERIODS

(Kepiort'ed by Dr. .. lui1man1, 1 ( '. Ytiviision of Epidemi-
oogy, rand IDr. (i. J. P. Scna/p, Rotterdam City Health
DIeparmi'tii.t ad Dr. J I. f P. 1Hers, U niversity of Leiden,
Tt e \ thperlands.)


THE MORBIDITY AND MORTALITY WEEKLY REPORT, WITH A CIRCULA-
TION OF 17,000. IS P-.'BL .LC riHE NATIONAL COMMUNICABLE
DISEASE CENTER. ATL. r. .. ;,
DIRECTOR NATIONAL COMMUNICABLE DISEASE CENTER
.- J SENCER, M.D.
CHIEF. EPIDEMIOLOGY PROGRAM C LANGMUIR. M..
ACTING CHIEF, STATISTICS SECTION IDA L. SHERMAN. M.S
EDITOR MICHAEL B GREGG. MD

IN ADDITION TO THE ESTABLISHED PROCEDURES FOR REPORTING
MORBIDITY AND MORTALITY, THE NATIONAL COMMON' ,:I-LE D' UASt 'E
CENTER WELCOMES ACCOUNTS OF INTERESTING OUT 5 i a : -'
INVESTIGATIONS WHICH ARE Oi- C'.i A rE IF.= T i Fj n LI.
OFFICIALS AND WHICH ARE :B :1i- E' r':. .:.rJTAC L
OF COMMUNICABLE DISEASES, SUCH COMMUNICATIONS t-10'L- BF
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 TF Cn BY THE INDIVIDUAL
STATE HEALTI- C.*'- T. F ITS. THE 'E .. r: *rF L,,: :
ON SATURDAY; -..' r: rA ON A NATIONAL aA rLE F.%6C.
ON THE SUCCEEDING FRIDAY








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