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:
AA00010654:00191

Related Items

Preceded by:
Weekly mortality index
Preceded by:
Weekly morbidity report
Succeeded by:
Morbidity and mortality weekly report

Full Text


NATIONAL COM NICABLE DISEASE CENTER


Vol. 17, No. 27


WEEKLY

REPORT


Week Ending

July 6, 1968


. AND WELFARE

AL HEALTH ADMINISTRATION


EPIDEMIOLOGIC NOTES ApA t -'~WIffd
PRESUMPTIVE BUBONIC PLAGUE olorado

A 6-year-old female, living in the East Central sec-
tion of Denver, was admitted to the Children's Hospital on
June 11, 1968, with high fever, painful, enlarged left
axillary swelling, inflamed left eardrum, and a beefy-red
throat. She was initially treated with penicillin and sulfi-
soxazole. The day following admission, the axillary swell-
ing had tripled in size, and the patient was started on
methicillin. A culture of blood drawn on June 11 later was
positive for Gram-negative, bipolar staining rod organisms
which appeared to be Pasteurella pestis by colonial char-
acteristics, phage typing, and mouse inoculation and


PUBLIC HEALTH SERVICE


CONTENTS
Epidemiologic Notes and Reports
Presumptive Bubonic Plague Denver, Colorado ...... 253
Trichinosis Hawaii ........................260
Surveillance Summary
Shigella July-December 1967 . ..... .. 254
Summary of Reported Cases of Infectious Syphilis .255


fluorescent antibody tests. Additional animal inoculation
studies are presently underway.
The patient was discharged from the hospital 2 weeks
after admission, but was readmitted on June 26 with
fluctuant left axillary nodes. These nodes were excised
and drained. The exudate contained abundant Gram-negative
(Continued on page 260)


TABLE I. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous weeks)
27th WEEK ENDED MEDIAN CUMULATIVE, FIRST 27 WEEKS
MEDIAN
DISEASE July 6, July 8, 1963 1967 MEDIAN
1968* 1967 1968 1967 1963 1967
Aseptic meningitis ...................... 60 41 33 942 930 796
Brucellosis .............................- 7 3 5 99 136 136
Diphtheria .............................. 1 3 5 89 56 84
Encephalitis, primary:
Arthropod-borne & unspecified ....,. ..,-. 23 31 457 694 -
Encephalitis, post-infectious ............. 13 14 289 481 -
Hepatitis, serum ........................ 88 55 59 2,136 1,077
Hepatitis, infectious .................... 671 538 22, 552 20,321 22
Malaria ................................ 54 43 2 1,106 1,037 50
Measles rubeolaa) ....................... 234 530 2,594 17,881 55.157 230,081
Meningococcal infections, total ........... 32 32 32 1,691 1,437 1,634
Civilian .............................. 29 32 1,525 1,333
Military ............................... 3 166 104
Mumps ................................. 1,132 --- 117,093 --
Poliomyelitis, total ..................... 4 4 26 11 30
Paralytic ................... .......... 4 4 26 9 28
Rubella (German measles) ............... 608 617 40,484 37,487 -
Streptococcal sore throat & scarlet fever.... 3,772 4,967 4, 291 260,660 281,960 255,384
Tetanus ............................... 4 4 4 73 95 118
Tularemia .............................. 9 3 6 102 82 122
Typhoid fever .......................... 4 7 7 147 201 190
Typhus, tick-borne (Rky. Mt. spotted fever) 11 22 6 91 113 87
Rabies in animals ....................... 56 73 64 1 906 2 .3 7 9 '87
TABLE II. NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax: .................. ........................ 2 Rabies in man: ..... ..........................
Botulism: N.Y.Ups.-1 .......................... ..... 3 Rubella. Congenital Syndrome: ........................ 3
Leptospirosis: ...................................... 13 Trichinosis: Wash.-1. ........................... 37
Plague: .......................... ................. Typhus, marine: Tex.-l, P.R.- ....................... 10
Psittacosis: Calif.-1, Conn.-l. ........................ 26
*No report from N.Mex. Holiday


dad






Morbidity and Mortality Weekly Report


SURVEILLANCE SUMMARY
SHIGELLA July-December 1967*


During the last 6 months of 1967, a total of 6,556
isolations of shigella from humans was reported to NCDC.
'his rwas an increase of 35.2 percent over the 4,849 iso-
lations reported during the first 6 months of 1967 and an
increase of 1.7 percent over the 6,448 isolations reported
for the last half of 1966. Utilizing the population esti-
mates for July 1967. the overall U.S. attack rate was 3.3
cases per 100,000 population for the last 6 months of
1967 (Figure 1). Of the shigella isolates reported for the
last half of 1967, 68.8 percent were from children under
under 10 years of age, and a preponderance of isolates
occurred in male infants compared with females of the
same age and in adult females, particularly in the child-
bearing years. compared with males of the same age
(Table 1).
Figure 1
ATTACK RATES OF SHIGELLOSIS BY STATE
JULY 1-DECEMBER 31, 1967

-






e,,0-...
El o-


Table 1
Age and Sex Distribution of Individuals Infected with
Shigellae in the United States
July through December 1967

Age (Years) Male Female Unknown Total
1 202 160 4 366
1-4 873 925 9 1,807
5-9 504 514 6 1,024
10- 19 271 331 3 605
20 -29 138 270 408
30-39 83 104 187
10 -49 38 69 107
50-059 26 40 66
60 69 15 27 42
70- 79 14 11 25
St. 5 9 141

Subtotal 2.169 2,160 22 i. '.1
Child (un-pec.) 55 4)0 2 97
\dult (unspec.) 11 23 7 -14
U known 698 81)3 263 1,761-

Total 2.9316 3,326 294 6,556

S'Pr, Itmi nAr daL u.


Of the total of 6,556 isolations, 4,918 were classified
by serotype (Table 2). These -4 I shigella isolations
represented 23 serotypes. The six most 'rreuei-nt re-
ported serotypes during the 6-month period are presented
in Table 2. Shigella sonnei accounted for approximately
70 percent of the typed isolations.
Table 2
The Six Most Frequently Reported Serotypes
of Shigella from Humans
July-December 1967

Serotype Number Reported Percent
S. sonnei 3,432 69.8
S. flexneri 2a 601 12.2
S. flexneri 6 359 7.3
S. flexneri 3a 188 3.8
S. flexneri 2b 183 3.8
S. flexneri 40 155 3.1
Subtotal 4,918 100.0
Specimens not typed 1,638
Total 6,556

Prior to the last 6.months of 1967, more isolates of
S. flexneri (group B) were obtained than S. sonnei (group D)
in the Southeast and Southwest with the opposite occurring
in the Northeast and Northwest. However, in the last 6
months of 1967, a preponderance of S. sonnei isolates
over S. flexneri was also noted in the Southeast. This
reversal resulted from an absolute increase in S. sonnei
and a simultaneous decrease in S. flexneri in both Georgia
and Florida, while the proportion of group B/D remained
essentially unchanged in the other seven states of the
Southeast. In Georgia, S. sonnei increased from 37.3 per-
cent to 72.1 percent, and S. fle.rleri decreased from 62.7
percent to 27.9 percent of the combined group B and D
isolates; in Florida, S. sonnei increased from 35.4 percent
to 66.7 percent, and S. flexneri decreased from 64.6 per-
cent to 33.3 percent. Investigation is now in progress to
determine the cause for these changes. S. flexneri -has an
apparent seasonal pattern which is more evident in the
Southern states as is shown in Figure 2.

Figure 2
SEASONAL DISTRIBUTION OF SHIGELLA ISOLATIONS
BY SEROTYPE AND REGION
15 STATES WHICH HAVE REPORTED SINCE JANUARY 1964

STATES NORTH OF DIVIDING LINE



A, I. .........
STATES SOUTH OF DIVIOWI6 LINE
f- ^/\ ^ ^ '1- '^/ -*A


JULY 6, 1968








JULY 6, 1968


Morbidity and Mortalit


In the last 6 months of 1967, one common-source food
outbreak of shigella was reported (Table 3). In addition
to this outbreak, 12 other confirmed food or waterborne
common source outbreaks of shigellosis have been re-
ported to NCDC since 1964.
There were only five nonhuman isolations of shigella
reported during the last 6 months of 1967, emphasizing
the host specificity of shigella strains for man.

Table 3


y Weekly Report 255



(Reported by Enteric Diseases Unit, Bacterial Diseases
Section, and Statistics Section, Epidemiology Program,
NCDC.)


A copy of the original report from which these data were
derived is available on request from:
National Communicable Disease Center
Atlanta, Georgia 30333
Attn: Chief, Enteric Diseases Unit, Bacterial Diseases
Section, Epidemiology Program


Confirmed Common-Source Food or Woterborne Outbreaks of Shigellosis
Reported to NCDC, 1964-1967

Number Number Attack
Year Serotype Persons Persons Rate Location Food
Ill at Risk (Percent)


100 300 33 California Potato salad
17 N. Carolina Water
220 526 42 Georgia Unidentified
22 N. Carolina Unidentified
13 25 52 Hawaii Potato salad
67 96 69 Iowa Water
230 Kansas Unidentified
196 320 61 Texas Potato salad
250 New York Shrimp salad
20 21 95 Hawaii Macaroni salad
and/or rice
201 326 62 Hawaii Unidentified
99 Florida Milk
84 Pennsylvania Apple cider


SUMMARY OF REPORTED CASES OF INFECTIOUS SYPHILIS
CASES OF PRIMARY AND SECONDARY SYPHILIS:" By Reporting Areas June 1968 and 1967 Provisional Data
Cumulative Cumulative
Reporting Area June Jan-June Reporting Area June Jan-June
1968 1967 1968 1967 1968 1967 1968 1967
NEW ENGLAND........... 18 17 166 181 EAST SOUTH CENTRAL........ 126 145 741 917
Maine.................... 2 Kenucky ...... .... 12 70 58 75
New Hampshire............ 1 5 Tennessee................ 42 22 184 130
Vermont............... 2 Alabama............. 40 63 310 511
Massachusetts............ 10 13 99 112 Mississippi .............. 32 40 189 201
Rhode Island..... ....... 2 2 21 17
Connecticut............. 6 2 43 45 WEST SOUTH CENTRAL....... 222 279 1,705 1,556
Arkansas................. 10 7 67 67
MIDDLE ATLANTIC........... 279 284 1,562 1,757 Louisiana................ 60 47 419 309
Upstate New York......... 17 21 102 139 Oklahoma................. 4 9 43 66
New York City........... 182 162 1,001 1,035 Texas.................... 148 216 1,176 1,114
Pa. (Exl. Phila.)...... 28 18 108 123
Philadelphia............ 8 28 121 150 MOUNTAIN.................. 41 50 264 306
New Jersey............. 44 55 230 310 Montana.................. 4 4
Idaho.................... 1 3 14
EAST NORTH CENTRAL........ 193 226 1,456 1,577 yoming............... 1 4 1 11
Ohio.................... 26 34 233 314 Colorado................ 1 9 38
Indiana.................. 25 16 176 62 New Mexico.............. 12 12 75 82
Downstate Illinois ...... 13 19 85 88 Arizona.............. 20 31 142 144
Chicago.................. 76 66 513 473 Utah.................... 5 1 7 5
Michigan................. 51 90 437 624 Nevada.................. 3 23 8
Wisconsin................ 2 1 12 16
PACIFIC............. ..... 103 140 844 935
WEST NORTH CENTRAL........ 24 27 182 143 Washington............... 2 2 25 29
Minnesota................ 2 1 18 20 Oregon................ 3 6 19 26
Iowa.................... 3 2 19 14 California............... 98 132 797 874
Missouri ................. 9 12 87 48 Alaska................ 1
North Dakota............. 4 1 6 2 Hawaii.................. 3 5
South Dakota............. 4 4 23 18
Nebraska................. 1 17 16 U. S. TOTAL............... 1,384 1,785 9,551 10,459
Kansas.................. 1 7 12 25 5
TERRITORIES............... 117 91 583 381
SOUTH ATLANTIC............ 378 617 2,631 3,087 Puerto Rico............ 113 87 552 360
Delaware................. 1 5 18 29 Virgin Islands........... 4 4 31 21
Maryland................ 37 53 222 315
District of Columbia..... 50 89 324 354
Virginia................. 26 27 143 144
West Virginia....... ... 5 3 19 10
North Carolina........... 38 74 343 357 Note: Cumulative Totals include revised and delayed reports
South Carolna.......... 32 68 263 431 through previous months.
Georgia......... ........ 52 92 400 463
Florida................ 137 206 899 984


1964
1964
1964
1964
1964
1965
1965
1965
1965
1965


1966
1966
1967


S. flexneri 4a
S. flexneri
S. flexneri 6
S. sonnei
S. flexneri 2a
S. sonnei
S. sonnei
S. flexneri 4a
S. flexneri
S. flexneri la


S. flexneri 2a
S. flexneri 2a
S. sonnei






256 Morbidity and Mortality Weekly Report


TABLE 11. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

JULY 6, 1968 AND JULY 8, 1967 (27th WEEK)

ENCEPHALITIS HEPATITIS
ASEPTIC Primary
AREA MENINGITIS N .. lliiIEI including Post- MADTA
AREA MENINGITIS including Infectious Serum Infectious MALARIA
unsp. cases
1968 1967 1968 1968 1968 1967 1968 1968 1968 1967 1968
UNITED STATES... 60 41 7 1 23 31 13 88 671 538 54

NEW ENGLAND.......... 3 1 2 4 28 22
Maine.............. -
New Hampshire...... 1 1 1
Vermont........... 1
Massachusetts...... 3 1 1 20 9
Rhode Island....... 1 2
Connecticut ........ 3 4 12

MIDDLE ATLANTIC...... 3 4 2 7 3 31 113 91 7
New York City...... 2 1 2 1 18 21 39
New York, up-State. 5 1 3 30 27
New Jersey........ 2 1 10 36 12 3
Pennsylvania....... 1 1 2 26 13 4

EAST NORTH CENTRAL... 8 1 3 5 2 2 105 64 3
Ohio............... 5 2 5 1 18 16
Indiana............ 21 6
Illinois........... 2 1 23 19 1
Michigan............ 1 -2 1 31 18 2
Wisconsin.......... 1 12 5

WEST NORTH CENTRAL... 1 2 2 1 42 37 3
Minnesota.......... 1 1 1 11 11
Iowa................ 1 9 4
Missouri........... 7 14 2
North Dakota...... 3 -
South Dakota..... 1 -
Nebraska........... 1 1 4
Kansas............ 11 4 1
Kansas.............. II 4 1

SOUTH ATLANTIC....... 5 4 5 4 2 4 13 84 90 19
Delaware.......... 4 2
Maryland........... 1 1 1 3 9 12 1
Dist. of Columbia.. -
Virginia........... 2 5 1 1 10 32 2
West Virginia 1...... 7 1
North Carolina..... 1 11 6 12
South Carolina..... 3 4
Georgia............ 16 24 4
Florida............ 4 3 3 10 24 9 -

EAST SOUTH CENTRAL... 5 4 5 1 1 29 21
Kentucky........... 1 9 5
Tennessee.......... 4 5 1 14 7
Alabama. .......... 4 1 3 4
Mississippi ........ 3 5

WEST SOUTH CENTRAL... 16 8 1 10 1 2 39 51
Arkansas........... 3
Louisiana.......... 8 8 2 8
Oklahoma.. *....... 2 5 5
Texas.............. 8 8- 1 26 43

MOUNTAIN............. 17 24 1
Montana ..........- 1 6 1
Idaho ............
Wyoming............ 1 -
Colorado............- -- 2
New Mexico........ --- --- --- --- --- --- --- 6 6
Arizona............ 9 6
Utah............... 2 4
Nevada............. 4

PACIFIC.............. 20 18 4 7 2 35 214 138 21
Washington......... 3 1 21 13 2
Oregon............. 1 6 18
California......... 17 16 -- 3 7 2 34 187 106 7
Alaska.............. -I
Hawaii................ 1 12

Puerto Rico. ........ 25 9


*Delayed reports: Encephalitis, primary: Okla. 1
Hepatitis, serum: N.J. delete 1, P.R. 1
Hepatitis, infectious: N.J. delete 6, Ala. 1, P.R. 4







Morbidity and Mortality Weekly Report 257


TABLE III.CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

JULY 6, 1968 AND JULY 8, 1967 (27th WEEK) CONTINUED


MEASLES (Rubeola) MENINGOCOCCAL INFECTIONS, MUMPS POLIOMYELITIS RUBELLA
TOTAL
AREA Cumulative Cumulative Total Paralytic
Cum.
1968 1968 1967 1968 1968 1967 1968 1968 1968 1968 1968
UNITED STATES... 234 17,881 55,157 32 1,691 1,437 1,132 4 4 26 608

NEW ENGLAND.......... 22 1,081 779 87 58 187 1 1 1 181
Maine............... 35 229 6 3 12 2
New Hampshire..*... 141 72 7 2 2 -16
Vermont............ 1 29 3 -
Massachusetts..*... 17 344 304 37 29 105 1 1 1 93
Rhode Island....... 1 60 7 4 40 32
Connecticut........ 5 559 85 29 20 25 38

MIDDLE ATLANTIC...... 73 3,365 2,054 13 299 227 66 114
New York City...... 46 1,530 394 1 62 38 59 41
New York, Up-State. 18 1,135 464 1 47 54 NN 69
New Jersey... ..... 6 546 472 9 111 83 7 2
Pennsylvania....... 3 154 724 2 79 52 NN 2

EAST NORTH CENTRAL... 29 3,512 4,987 4 202 184 306 1 88
Ohio................ 276 1,114 2 54 64 18 12
Indiana............ 6 614 570 28 21 6
Illinois........... 14 1,309 864 1 44 44 24 1 2
Michigan............ 3 236 866 1 59 41 49 24
Wisconsin.......... 6 1,077 1,573 17 14 215 44

WEST NORTH CENTRAL... 1 354 2,740 86 63 21 10
Minnesota............ 15 127 19 15 2 -
Iowa................ 89 736 6 12 19 8
Missouri........... 80 326 31 12 1
North Dakota....... 1 123 796 3 1 1
South Dakota....... 4 51 4 6 NN -
Nebraska.......... 35 611 6 11
Kansas............ 8 93 17 6 -

SOUTH ATLANTIC......... 31 1,352 6,531 2 344 276 83 1 1 1 65
Delaware............ 1 14 42 6 5 4 1
Maryland........... 1 80 140 2 26 33 15 6
Dist. of Columbia.. 6 21 13 10 1
Virginia........... 5 288 2,037 27 32 17 6
West Virginia...... 5 .239 1,319 8 20 19 16
North Carolina..... 2 281 836 68 58 NN 1 1 1
South Carolina..... 12 489 55 24 2 2
Georgia............ 4 30 60 43 -
Florida............ 17 428 1,617 81 51 26 33

EAST SOUTH CENTRAL... 2 523 4,966 1 145 119 99 53
Kentucky............ 167 1,287 1 57 34 42 29
Tennessee.......... 1 55 1,726 48 48 53 24
Alabama............ 1 75 1,302 20 24 4 -
Mississippi......... 226 651 20 13 -

WEST SOUTH CENTRAL... 42 4,440 16,795 7 281 204 121 2 2 15 42
Arkansas........... 2 1,401 4 19 25 1
Louisiana.......... 2 148 2 79 82 2
Oklahoma............ 1 109 3,313 48 14 1 1 1
Texas.............. 41 4,327 11,933 1 135 83 121 1 1 14 39

MOUNTAIN ............. 16 926 4,410 1 26 25 89 17
Montana............ 66 275 1 3 3 1
Idaho............... 3 20 365 11 1 14
Wyoming............ 1 50 178 1 2 -
Colorado............ 6 475 1,470 7 10 12 3
New Mexico.......... --- 82 565 --- 3 -- -- -- --
Arizona............. 6 207 955 1 4 48 10
Utah................ 21 333 1 4 10 3
Nevada............. 5 269 3 2 -

PACIFIC.............. 18 2,328 11,895 4 221 281 160 8 38
Washington..... .... 513 5,380 36 24 12 1
Oregon.............. 8 452 1,507 17 24 20 5
California.......... 10 1,327 4,744 3 155 221 116 8 30
Alaska.............. 2 126 1 2 9 9 1
Hawaii............. 34 138 11 3 3 1

Puerto Rico.......... 5 339 1,969 18 10 14 3

*Delayed reports: Measles: N.H. 28, Mass. delete 6, N.J. 4






258 Morbidity and Mortality Weekly Report


TABLE II CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

JULY 6, 1968 AND JULY 8, 1967 (27th 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.
1968 1968 1968 1968 1968 1968 1968 1968 1968 1968 1968
UNITED STATES... 3,772 4 73 9 102 4 147 11 91 56 1,906

NEW ENGLAND........... 576 1 40 4 62
Maine...*............ 10 50
New Hampshire...... 2
Vermont ............ 17 40 8
Massachusetts...... 96 2 1
Rhode Island....... 55 -
Connecticut.. ...... 398 1 2 -- I

MIDDLE ATLANTIC...... 13 10 4 7 12 1 7 17
New York City...... 8 5 7 -
New York, Up-State. 4 4 7 2 1 11
New Jersey ........ NN -
Pennsylvania....... 5 1 3 1 5 6

EAST NORTH CENTRAL... 326 8 7 23 3 5 168
Ohio............... 35 1 11 2 4 69
Indiana ............ 95 1 1 3 59
Illinois........... 78 5 4 8 1 1 18
Michigan ........... 76 2 1 9
Wisconsin .......... 42 1 13

WEST NORTH CENTRAL... 125 1 3 7 8 1 3 23 438
Minnesota.......... 18 1 1 9 125
Iowa....... ....... 12 1 4 82
Missouri........... 4 2 5 3 1 1 75
North Dakota....... 32 7 75
South Dakota....... 4 1 -1 1 34
Nebraska........... 37 3 1 1 22
Kansas............. 18 I 2 25

SOUTH ATLANTIC....... 494 2 14 2 7 2 39 5 52 2 211
Delaware........... 4 -
Maryland........... 84 1 7 5 3
Dist. of Columbia.. 1 1 2 -
Virginia........... 107 2 1 1 8 21 2 87
West Virginia...... 105 1 27
North Carolina..... 34 2 2 2 2 16 8
South Carolina..... 3 1 1 2 -
Georgia............ 7 1 2 9 2 6 31
Florida............ 150 2 6 1 2 11 2 55

EAST SOUTH CENTRAL... 659 9 6 1 17 1 10 8 457
Kentucky............ 113 1 1 3 1 5 219
Tennessee.......... 483 2 4 1 11 1 7 2 217
Alabama............ 43 3 1 1 20
Mississippi........ 20 3 1 3 1 1

WEST SOUTH CENTRAL... 453 1 15 3 22 11 3 13 8 353
Arkansas........... 7 4 2 1 1 1 1 41
Louisiana.......... 5 5 1 4 2 31
Oklahoma...*........ 6 2 6 3 2 6 2 106
Texas......*....... 435 1 6 10 5 6 5 175

MOUNTAIN............. 522 5 9 2 4 46
Montana............ 18 -
Idaho.............. 62 -
Wyoming............ 12 1 1 2
Colorado............ 351 2 2 -2 2 3
New Mexico......... --- --- --- --- 6 -- 19
Arizona............ 47 2 22
Utah.............. 32 2 -
Nevada. .. ........ -

PACIFIC.............. 604 13 1 1 24 1 6 154
Washington......... 52 -
Oregon............. 51 1 1 3 3
California......... 468 11 1 21 1 6 151
Alaska............. 24 -
Hawaii.............. 9 -

Puerto Rico.......... 6 5 16

*Delayed reports: SST: Me. 19
Tularemia: Okla. 1
Typhoid: Tex. delete 1







Morbidity and Mortality Weekly Report


TABLE IV. DEATHS IN 122 UNITED STATES CITIES FOR WEEK ENDED JULY 6, 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 1 year Area All 65 years and year
Ages and over Influenza All Ages and over Influenza All
All Ages Causes All Ages Causes


NEW ENGLAND:
Boston, Mass.-------
Bridgeport, Conn.---
Cambridge, Mass.------
Fall River, Mass.-----
Hartford, Conn.-------
Lowell, Mass.----------
Lynn, Mass.-----------
New Bedford, Mass.----
New Haven, Conn.------
Providence, R. I.-----
Somerville, Mass.----
Springfield, Mass.----
Waterbury, Conn.-----
Worcester, Mass.------

MIDDLE ATLANTIC:
Albany, N. Y.----------
Allentown, Pa.--------
Buffalo, N. Y.--------
Camden, N. J.----------
Elizabeth, N. J.------
Erie, Pa.-------------
Jersey City, N. J.----
Newark, N. J.----------
New York City, N. Y.--
Paterson, N. J.-------
Philadelphia, Pa.-----
Pittsburgh, Pa.-------
Reading, Pa.----------
Rochester, N. Y.------
Schenectady, N. Y.----
Scranton, Pa.----------
Syracuse, N. Y.-------
Trenton, N. J.--------
Utica, N. Y.----------
Yonkers, N. Y.--------

EAST NORTH CENTRAL:
Akron, Ohio-----------
Canton, Ohio----------
Chicago, Ill.----------
Cincinnati, Ohio-----
Cleveland, Ohio-------
Columbus, Ohio--------
Dayton, Ohio----------
Detroit, Mich.--------
Evansville, Ind.------
Flint, Mich.----------
Fort Wayne, Ind.------
Gary, Ind.------------
Grand Rapids, Mich.---
Indianapolis, Ind.----
Madison, Wis.---------
Milwaukee, Wis.-----
Peoria, Ill.-----------
Rockford, Ill.--------
South Bend, Ind.-------
Toledo, Ohio----------
Youngstown, Ohio------

WEST NORTH CENTRAL:
Des Moines, Iowa------
Duluth, Minn.----------
Kansas City, Kans.----
Kansas City, Mo.-------
Lincoln, Nebr.--------
Minneapolis, Minn.----
Omaha, Nebr.----------
St. Louis, Mo.--------
St. Paul, Minn.-------
Wichita, Kans.--------


711
242
43
18
25
58
34
27
28
49
72
13
34
19
49

3,055
56
33
132
38
21
55
88
89
1,711
28
314
136
41
111
33
39
44
34
18
34

2,259.
63
36
656
121
160
131
59
343
36
45
43
21
38
127
33
111
21
24
34
95
62

692
45
29
36
112
17
97
67
179
65
45


435
146
27
13
16
32
25
19
19
27
43
10
16
9
331

1,801
35
22
73
23
14
31
52
37
1,019
18
178
73
31
68
21
26
24
18-
12
26

1,232
35
21
370
58
68
59
30
184
23
25
27
13
25
69
14
69
5
19
21
54
43

411
30
16
22
71
13
53
45
96
40
25


42
13
4

2
3
2

2
2
4
2
3

5

124

2
3
1

3
5
1
81

7
1
3
8
3
.2
1

1
2

54

2
18
1
5
1
2
8

1
1

2

2


4
1
5
1

21
1

3
3

6

2
1
5


*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.----------


1,000
115
231
41
65
75
43
70
26
60
57
167
50

492
66
34
16
97
106
46
36
91

833
21
31
21
131
19
57
171
36
157
47
61
36
45

396
39
27
119
16
97
23
47
28

1,319
16
34
18
47
94
377
65
23
81
58
95
164
33
133
43
38


Total 10,757 6,060 375 514

Cumulative Totals
including reported corrections for previous weeks

All Causes, All Ages ------------------------- 350,958
All Causes, Age 65 and over------------------- 204,231
Pneumonia and Influenza, All Ages------------ 15,179
All Causes, Under 1 Year of Age--------------- 16,091


Week No.
27










PRESUMPTIVE BUBONIC PLAGUE
i nthi til from fron pI / I )

rods: culture rtesu l ar; pending. Following therapy with
tetrac rclintc and streptomycin, the patient had an uneDent-
ful ho-p ital course and w\as discharged on July 8.
Epidemniologic in\ estigation revealed that the child
had not (ra\eled boryond tlh(, cits limits of Denver within
the last 2 years. There was no history of flea hites or con-
tact with rodents. A die-off of squirrels in the area of the
child's home is presently under investigation.
Although plague has been recognized as enzootic in
Colorado, this is the first case acquired in a metropolitan
area in the state.
(Reported by (ecil S. Mollohan, M.D., M.P.H., Chief, See-
tion of Epidemiology, Colorado Department of Health;
Zoonoses Section, Ecological Investigations Program,
\CDC. Kansas City, Kansas, and Bacterial Reference
Unit, Bacteriology Section, Laboratory Program, NCDC;
and two EIS Officers.)



TRICHINOSIS Hawaii


On April 19, 1968, two young men in the South Kona
district on the Island of Hawaii ate inadequately cooked
meatof a wild pig and subsequentlydeveloped trichinosis.
The first case, a 22-year-old male, had his onset of ill-
ness on May 4. His symptoms included fever, periorbital
edema. urticara. and myalgia. The second case, a 24-year-
old male, became ill on May 10, and his symptoms were
low grade fever, malaise, myalgia, and diarrhea. An ele-
vated cosinophile count was observed for both patients on
laboratory examination.
An acute serum was obtained from the first patient
but was negative in the bentonite flocculation test for
trichinosis. Both patients were treated with thiabendazole
and recovered completely.
Examination of the meat of the wild pig showed it to
be infected with many live, encysted Trichinella spiralis
larvae.
(Reported by J. M. Gooch, D.V.M., M.P.H., Public Health
Veterinarian, anid R. Peninyton, M.D., Chief, Epidemiology
Branch, Hawarii Health Department; J. E. Alicata, Ph.D.,
College of Tropical Agriculture, University of Hawaii;
and an EIS Officer.)
Editorial Note:
Most of the cases of trichinosis that have been re-
ported to the Hawaii Department of Health were in persons
who had eaten improperly cooked meat or meat products
of wild swine.1 Surveys of the animal populations on the
islands of Hawaii and Maui have shown a high prevalence
of trichinosis in feral swine and mongooses, whereas
domestic swine have a low prevalence of trichinosis.
Reference:
1Alicala, J. K I.: Parasitic Infections of Marn and Animals in
Hawaii, l vawaii Agricultural Elxperimwnt Station, college of
Tropical Agriculture, University of lHawaii. Tec(hnical Bulle-
tin No. 61, November 1964.


JULY 6, 1968
o0
'L--iV


THE MORBIDITY AND MORTALITY WEEKLY REPORT. WITH A CIRCULA-
TION OF 17.000. IS F "L ": *'r HE NATIONAL COMMUNICABLE
DISEASE CENTER, AT .r .,"
DIRECTOR. NATIONAL COMMUNICABLE DISEASE CENTER
DAVID J. SENCER, M.D.
CHIEF, EPIDEMIOLOGY PROGRAM A.D. LANGMUIR, M.D.
ACTING CHIEF. STATISTICS SECTION IDA L. SHERMAN, M.S.
EDITOR MICHAEL B GREGG. M.O
IN ADDITION TO THE ESTABLISHED PROCEDURES FOR REPORTING
MORBIDITi .reC r ri :.A T 'HENA rr.L ..T :.M .E. E 5E
CENTER A '.' E.. *C : :. *N r OF N't.i E i .' :u, T i j O :
INVESTIGATIONS WHICH ARE OF CURRENT INTEREST TO m LyTL
OFFICIALS AND WHICH ARE DIRECTLY RELATED TO THE ':CN*T..L
OF COMMUNICABLE DISEASES. SUCH COMMUNICATIONS SHOULD BE
ADDRESSED TO:
NATIONAL C* "*.*r,. : I.E-L DISEASE CENTER
ATLANTA, : OR. ". )':'..
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 B' TME INisi. DuAL
STATE HEALT- CO ETMIEn'S. STHE REPORTING *L-P COr. r ,Lu
ON SATURDAY *.:. '' : ..TA ON A NATIONAL BASIS ARE L IE
ON THE SUCCEEDING FRIDAY


Morbidity and Mortality Weekly Report


I-


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