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:
AA00010654:00192

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


Vol. 17, No. 28


WEEKLY

REPORT


Week Ending
July 13, 1968


ON, AND WELFARE

NTAL HEALTH ADMINISTRATION


EPIDEMIOLOGIC
FOLLOW-UP PLA


The organism isolated from the 67Tho a 6-year-old
female, living in east central Denver (MMWR, Vol. 17,
No. 27), has been confirmed as Pasteurella pestis on the
basis of staining characteristics, colonial morphology,
phage typing, fluorescent antibody (FA) tests, and guinea
pig inoculation studies. A dead squirrel found three-fourths
of a block from the patient's residence has been found
positive for P. pestis by FA tests.
In Denver a major die-off of the eastern fox squirrel
Sciurus niger (the common tree squirrel) has been con-
firmed. From a total of 123 dead animals (including 3
rabbits, 10 ground squirrels, and 110 eastern fox squirrels)


PUBLIC HEALTH SERVICE


CONTENTS
Epidemiologic Notes and Reports
Follow-up Plague Denver, Colorado ............ 261
Follow-up Tularemia Vermont. . . 262
Tularemia Ogdensburg, New York . ... 263
Parathion Poisoning Texas . ..... 263
Current Trends
Measles United States . ..... 268

collected in Denver, 27 eastern fox squirrels were posi-
tive for P. pestis by FA tests. To date, P. pestis has
been isolated from five of these 27 squirrels. Although
dead squirrels from all sectors of the city have been ex-
amined, the majority of plague positive animals were from
the northeastern section of the city. Baited DDT dust
boxes have been placed in trees throughout the Denver
(Continued on page 262)


TABLE I. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous weeks)
28th WEEK ENDED CUMULATIVE, FIRST 28 WEEKS
MEDIAN
DISEASE July 13, July 15, 1963 1967 MEDIAN
1968 1967 1968 1967 1963 1967
Aseptic meningitis ...................... 77 59 49 1,020 989 833
Brucellosis ............................ 2 12 12 101 148 148
Diphtheria.... ... .....'.. ............ 1 1 2 90 57 87
Encephalitis, primary:
Arthropod-borne & unspecified ........... 24 21 481 715
Encephalitis, post-infectious ............. 8 14 297 495 ---
Hepatitis, serum ........................ 67 40 56 2,203 1.117 22,566
Hepatitis, infectious .................... 826 665 23,380 20.986
Malaria ................................ 42 33 4 1.148 1,070 54
Measles rubeolaa) ....................... 325 539 2,180 18,190 55.696 232,261
Meningococcal infections, total ........... 36 38 38 1,729 1.475 1,672
Civilian .............................. 36 37 1,563 1.370 ---
Military ............................... 1 166 105 -
Mumps ................................. 1,270 118,369 -
Poliomyelitis, total ..................... 2 2 2 29 13 31
Paralytic ............................. 2 2 2 29 11 29
Rubella (German measles) ............... 427 394 40,924 37,881 -
Streptococcal sore throat & scarlet fever... 4,907 5,439 4,278 265,609 287,399 259.662
Tetanus ............................... 2 7 6 75 102 124
Tularemia .............................. 11 4 10 113 86 132
Typhoid fever .......................... 9 8 8 156 209 197
Typhus, tick-borne (Rky. Mt. spotted fever) 9 15 14 100 128 101
Rabies in animals ....................... 83 82 82 1.990 2.449 2.449
TABLE II. NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax: ............................................ 2 Rabies in man: ..................................... -
Botulism: ......................................... 3 Rubella, Congenital Syndrome: ......................... 3
Leptospirosis: Hawaii-1 ............................. 14 Trichinosis: NYC-1 ................................... 38
Plague: Colo.-l .................................... 1 Typhus, murine: Fla.-1 ............................... 11
Psittacosis: N.Mex.-1 ............................. 27


atd











area as a control measure for the flea ectoparasite Orchopeas
/,oardi liwhich infests the fox squirrel. Systematic squirrel
collection and close surveillance for other dead rodents
are being conducted.
On July 9. Dr. Roy Cleere. Director of Public Health.
Colorado Department of Health, issued a letter to all
physicians in the Denver metropolitan area and Boulder,
Colorado, that reported the case of plague and included
diagnostic, epidemiologic, and therapeutic information. On
July 15. Dr. Cleere issued a follow-up letter to physicians


JULY 13, 1968


and hospitals in the greater Denver area indicating tnat
other dead squirrels had been found in Denver. It was re-
quested that any suspected cases of plague be reported
immediately to the Epidemiology Section, Colorado De-
partment of Health.
(Reported by R. L ( ',. -- M.., M.P.H., Virector of
Public Health, and Cecil S. Mollohan, MI)., M.P.H., Chief,
Section of Epidemiology, Colorado Department of Health;
the Zoonoses Section, Ecological Investigationx Pro-
gram, NCDC. Ft. Collicts, Colorado; a annan EIS Officer.)


FOLLOW-UP TULAREMIA Vermont
A statewide survey performed in June of persons in Figure 1
Vermont known to ha\e handled muskrats during the spring CASES OF TULAREMIA BY AREA OF TRAPPING
trapping and shooting season has led to the diagnosis of ADDISON COUNTY, VERMONT 1968
six additional tularemia cases in Vermont. Including the / / i,
40 cases reported earlier (MMWR, Vol. 17. Nos. IS and 21), 'j
the total number of cases has reached 4t6 of which 44 have '
been serologically confirmed. Serologic studies are pend-
ing on two patients with clinical histories compatible with ( "
tularemia. l
All 46 persons had handled muskrats taken from three 1\
streams and their tributaries which flow into the eastern
shore of Lake Champlain (Otter Creek. Little Otter Creek,
and Lewis Creek) (Figure 1). The attack rate for persons LTrLE
oTTER
who handled more than 50 animals (71 percent) was signif- r CReEK
icantly higher than the attack rate for persons who handled //
fewer than 50 animals (35 percent) (Table 1). The largest,
group of cases and the highest attack rate were among per-
sons handling animals taken from Dead Creek. a tributary ,!
of Otter Creek(Table 2). Of the seven persons who trapped '1T
Dead Creek and did not become ill, three wore gloves and
four handled fewer than 50 animals.


Table 1
Attack Rates in Trappers by Number of Muskrats Handled
Vermont March 25-April 30, 1968

Number of Number of Number of Attack
Muskrats Persons Persons Total Rate
Handled Ill Well (Percent)
5)0 2h 11 39 71
50 lb 33 51 35
.. -
Total 41 144 90 51

Approximately 10)0 persons who handled muskrals
trapped outside e ddilson County (Figure 1) have been inter-
\it ed and approximately 50 percent ha\e had their sera
tested for e'hience of tularemia. There ha\e been no sug-
ge-sli e clinical histories of l ..1 ,... .' s. rologies in this
group.
Samples of mud and water taken during the first week
of May along DO:ed 'Crook haie been inoculated into guinea
pigs. Following death of the animals, pleen homogenaltes
\tere cultured directly. By this method, PFroaiisrella tu-
I/rensi ha teien recovx erd from ia St Iof mud and water
stjiples laken from a point where i \teni- e trapping had
taken plale. The organism was4 plreion -Isl reeoered from
mu krat4 s olnainod in thii ar a during an animal collection


survey that was in progress when the water and mud sam-
ples were collected I'I'.lIl Vol. 17, No. 21).
(iReported by Donald S. Ricknell, M.D., Vergennes, Ver-
mlon,: l.iitus J. LeaIvens, M.I).. Director, Bureau of Corn-
muititabile Disetase Control, and Oymitry Pomiar, D.V.M.,
Director. lBtrcaui of Laboratories. Vermont. DPepart melnt of
Hllalth; Epiiideiological Ser irces Laboratory Selion, Epi-
demiology Program, atnd ar trial Serology UCit. La bora-
tory Program, 'C/)C'; and a team from Nt CDC.)


Morbidity and Mortality Weekly Report


FOLLOW-UP PLAGUE (Continued from front page)







JULY 13, 1968


Morbidity and Mortality Weekly Report


Table 2
Attack Rates in Trappers by Streams from Which Muskrats Were Token
Vermont March 25-April 30, 1968

Positive Serology* and/or No Symptoms and Attack Rate
Stream Total
Typical Symptoms** Negative Serology (Percent)

Dead Creek 31 7 38 81
Otter Creek 7 09 36 19
Little Otter and Lewis Creeks 8 8 16 50
Total 46 44 90
*Titer of 1:160 or higher
**Fever, prostration, lymphadenopathy, and hand ulcer(s)


TULAREMIA Ogdensburg, New York


During the last week of March and the first week of
April 1968, four muskrat trappers in Ogdensburg, New York,
developed fever and regional .Il.-r.i ii. i A lymph node
biopsy on April 24 from one of these trappers revealed
granulomatous lymphadenitis. All four trappers had agglu-
tination titers against Francisella tularensis of 1:160 or
higher in sera drawn from 1 to 3 months after onset of
symptoms. The two sons of one ill trapper, both of whom
assisted in the preparation of animals and one of whom
was clinically ill, had serologies of 1:160 or greater against
F. tularensis. In two trappers high titers to Brucella abortus
were noted. No history of raw milk ingestion or other ex-
posure to B. abortus was obtained; agglutination absorp-
tion studies confirmed F. tularensis infection.
Ogdensburg is located on the bank of the St. Lawrepce
River in northwestern New York, approximately 120 miles
from Crown Point, New York, where three other cases of
tularemia in muskrat trappers were recently reported (MMWR,
Vol. 17, No. 20). All of the Ogdensburg trappers took their


animals from the Oswegatchie River. According to trappers.
this area harbored unusually large numbers of live musk-
rats this year and dead muskrats were apparent. Bacterio-
logic studies are underway on frozen specimens of musk-
rats trapped by these individuals. No cases of tularemia in
muskrat trappers have been reported in the region between
Crown Point and Ogdensburg this year.

(Reported by Hugh F. Frame. M.D., Health Officer, Odgens-
burg, New York; Robert Lonngren, M.D., Ogdensburg. New'
York; John T. Prior, M.D., Professor of Pathology. Upstate
Medical Center, Syracuse, New York; Robert Bacorn, M.D.,
Regional Health Officer, Syracuse Regional Office, Syra-
cuse, New York;Melvin Abelseth, D.V.M., Assistant Direc-
tor, Laboratory for Veterinary Science, Mrs. Orpha Clemons,
Bacteriologist, James O. Culver, M.D., Public Health Phy-
sician, Bureau of Epidemiology, and Julia L. Freitag, M.D..
Director, Bureau of Epidemiology, New York State Health
Department; and an EIS Officer.)


PARATHION POISONING Texas


On June 13, 1968, 23 cotton workers near Santa Rosa,
Texas, were poisoned with the chemical parathion*. Their
initial symptoms were nausea, vomiting, sweating, and
extreme weakness, and two patients subsequently devel-
oped acute pulmonary edema. In all cases, onset of symp-
toms was approximately 2 1/2 hours after the workers
entered a field that had been sprayed with a combination
of methyl and ethyl parathion the night before, June 12.
Of the 23 patients, 13 required hospitalization and 10 were
treated as out-patients.
The patients were initially treated with 2 mgm atro-
pine, intravenously, and 2 PAM**. In addition to treatment,
immediate steps were taken to decontaminate the patients
by removing their clothing and washing their skin to pre-
vent further absorption of the parathion. Serum cholinester-
ase activity (which is depressed in organic phosphate
poisonings) was determined on all patients by the Caraway
method. The normal range for serum cholinesterase activ-
ity by this method is 65-100 units per ml. The values ob-
tained for the hospitalized patients ranged from 2-8 units
per ml and for the out-patients from 30-60 units per ml.
Within 3 days, all patients had completely recovered
and were discharged from the hospital. Follow-up treat-


ment for all 23 patients included atropine tablets in suffi-
cient quantities to maintain a dry mouth and daily obser-
vation by the local physician.
On June 12 the cotton field had been sprayed with
parathion. Because of a heavy dew that evening, consider-
able moisture was present on the cotton plants the follow-
ing day. Because of this moisture and the height of the
cotton plants (approximately 3 1/2 feet), the workers'
clothing was thoroughly soaked soon after work started in
the field. These factors contributed to increased exposure
to the parathion. All 23 workers were local residents. and
most of them had worked for the cotton field owner for
several years and had worked with parathion in the past
without any adverse effects.
(Reported by J. S. Wiserman, Ph.D., Project Director,
Community Pesticides Study, Texas State Department of
Health, San Benito, Texas.)

*Parathion is O,O-dimethyl O-(p-nitrophenyl) phosphorothioate
**2-PAM is 2-Pyridine aldoxime methochloride (or pralidoxime
chloride)
Reference:
'Caraway, Wendell, T.: Photometric Determination of Serum
Cholinesterase Activity, Am J Clin Pathol 26:945-955, 1956.


263








261 Morbidity and Mortality Weekly Report


TABLE III. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

JULY 13, 1968 AND JULY 15, 1967 (28th WEEK)

ENCEPHALITIS HEPATITIS
ASEPTIC Primary
AREA MENINITIS including In ious Serum Infectious MALARIA
unsp. cases
1968 1967 1968 1968 1968 1967 1968 1968 1968 1967 1968
UNITED STATES... 77 59 2 1 24 21 8 67 826 665 42

NEW ENGLAND.......... 1 1 1 34 24 1
Maine.............. 1 3 3
New Hampshire ...... 3 -
Vermont ........... -
Massachusetts...... 14 12 1
Rhode Island ....... 10 1
Connecticut........ 1 7 5

MIDDLE ATLANTIC...... 3 4 1 3 3 21 150 109 4
New York City...... 1 2 1 2 8 53 37 1
New York, Up-State. 1 4 25 27 1
New Jersey.......... 1 1 8 35 21 2
Pennsylvania....... 1 1 1 2 1 37 24

EAST NORTH CENTRAL... 14 10 7 9 156 113 3
Ohio............... 7 2 3 8 39 25
Indiana............. 2 1 13 3
Illinois........... 2 1 2 49 45
Michigan............. 3 7 1 1 44 32 3
Wisconsin......... 11 8 -

WEST NORTH CENTRAL... 3 1 3 2 2 47 45 2
Minnesota.......... 1 2 2 11 7
Iowa................ -- 1 7 5
Missouri............ 1 17 30
North Dakota....... -
South Dakota....... 1
Nebraska............ 1 1
Kansas............. 3 1 10 2 2

SOUTH ATLANTIC......... 3 5 2 1 2 2 2 65 65 12
Delaware ........... 1 3 1 -
Maryland........... 1 I 1 20 15 3
Dist. of Columbia.. 1 2 2
Virginia........... 1 2 1 3 17
West Virginia...... 1 10
North Carolina..... 1 1 6 3 8
South Carolina ..... 2 3
Georgia............ 5 2
Florida............ 1 3 1 1 23 12 1

EAST SOUTH CENTRAL... 3 8 1 1 48 29 1
Kentucky........... 12 7
Tennessee.......... 1 8 1 1 29 11
Alabama............ 2 3 1 -
Mississippi........ 4 10 1

WEST SOUTH CENTRAL... 32 11 3 2 3 48 59
Arkansas.. ........ 2 -
Louisiana.......... 17 2 1 12 6
Oklahoma.. ........ 1 1 1 5 5
Texas.............. 14 11 1 2 31 46

MOUNTAIN ............ 2 1 36 40 7
Montana............ 1 12 10 -
Idaho............... 2 3
Wyoming ............ -
Colorado............. 1 6 7
New Mexico. ....... I 5 4
Arizona........... 12 13
Utah............... 4 4
Nevada............. -

PACIFIC.............. 18 20 6 2 2 38 242 181 12
Washington......... 1 1 11 19 1
Oregon............. 1 1 12 12
California.......... 14 12 4 1 2 37 214 150 2
Alaska............. 2 3 -
Hawaii............. 2 7 1 2 9

Puerto Rico.......... 11 25

Delayed reports: Aseptic meningitis: Okla. 1
Hepatitis, infectious: Ohio delete 1, Ark. delete 1, N. Mex. 4









Morbidity and Mortality Weekly Report 265


TABLE III. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

JULY 13, 1968 AND JULY 15, 1967 (28th 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... 325 18,190 55,696 36 1,729 1,475 1,270 2 2 29 427

NEW ENGLAND.......... 20 1,100 792 1 88 58 153 1 69
Maine...*.......... 35 233 6 3 5 11
New Hampshire..*... 141 72 7 2 2 -
Vermont............. 1 34 1 1
Massachusetts. .... 9 352 308 1 38 29 88 1 18
Rhode Island....... 1 60 7 4 29 21
Connecticut........ 11 570 85 29 20 29 18

MIDDLE ATLANTIC...... 165 3,520 2,135 5 304 235 126 61
New York City...... 105 1,635 '411 3 65 38 101 50
New York, Up-State. 14 1,149 523 1 48 59 NN 5
New Jersey......... 44 590 477 111 85 25 5
Pennsylvania. ..... 2 146 724 1 80 53 NN 1

EAST NORTH CENTRAL... 27 3,539 5,041 7 209 191 340 1 98
Ohio................ 3 279 1,116 2 56 66 31 11
Indiana............. 2 616 579 28 21 18 5
Illinois............ 10 1,319 876 3 47 45 24 1 27
Michigan........... 2 238 871 2 61 44 49 29
Wisconsin.......... 10 1,087 1,599 17 15 218 26

WEST NORTH CENTRAL... 7 361 2,772 86 63 42 1 1 1 11
Minnesota........... 15 128 19 15 1
Iowa................ 4 93 738 6 12 39 7
Missouri........... 80 329 31 12 1 1 1 1
North Dakota....... 123 814 3 1 3
South Dakota....... 4 52 4 6 NN -
Nebraska........... 1 36 618 6 6 11
Kansas............. 2 10 93 17 6 2 -

SOUTH ATLANTIC....... 19 1,371 6,612 5 351 286 86 1 44
Delaware............ 14 43 6 5 4
Maryland ........... 2 82 142 26 34 27 4
Dist. of Columbia.. 6 22 13 10 9 1
Virginia........... 1 289 2,066 1 28 35 4 6
West Virginia ...... 10 249 1,334' 1 9 20 25 8
North Carolina..... 281 838 1 69 60 NN 1
South Carolina..... 1 13 492 55 27 1 1
Georgia............. 4 32 1 61 43 -
Florida... ........ 5 433 1,643 1 84 52 16 24

EAST SOUTH CENTRAL... 15 538 5,000 3 148 120 77 1 30
Kentucky.. ....... 2 169 1,289 57 34 2 1 2
Tennessee.......... 55 1,756 1 49 49 67 27
Alabama............ 10 85 1,303 2 22 24 8 1
Mississippi........ 3 229 652 20 13 -

WEST SOUTH CENTRAL... 39 4,479 16,878 6 287 206 126 1 1 16 33
Arkansas........... 2 1,401 1 20 25 -
Louisiana.......... 2 149 2 81 82
Oklahoma...*....... 1 110 3,314 1 49 15 1
Texas............... 38 4,365 12,014 2 137 84 126 1 1 15 33

MOUNTAIN............. 12 938 4,469 1 27 26 149 26
Montana............ 66 275 3 5 1
Idaho............... 20 368 11 1 21 -
Wyoming............ 50 178 -
Colorado............ 4 479 1,492 1 8 11 36 4
New Mexico..*....... 3 85 571 3 3 1
Arizona............. 5 212 973 1 4 47 20
Utah................ 21 343 1 4 37 -
Nevada............. 5 269 3 2 -

PACIFIC.............. 21 2,344 11,997 8 229 290 171 8 55
Washington......... 1 514 5,384 1 37 25 5 -
Oregon..*.......... 7 454 1,515 17 24 15 2
California.......... 13 1,340 4,823 7 162 228 121 8 42
Alaska.............. 2 128 2 9 4 2
Hawaii.............. 34 147 11 4 26 9

Puerto Rico.......... 8 347 2,015 1 19 10 34

Delayed reports: Measles: Mass. delete 1, Pa. delete 10, Ore. delete 5
Meningococcal infections: Fla. 2
Mumps: N.H. 4, Okla. 2
Poliomyelitis, paralytic: Ky. 1
Rubella: Me. 3. N.H_ 1 N_ Mov. 4. Oro S








2 66 Morbidity and Mortality Weekly Report


TABLE IIl CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

JULY 1., 1968 AND JULY 15, 1967 (2Rth 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 I I 1 ." f I ",, 1 ( r- I J.t I .rI ] J'
UNITED STATES... 4,907 2 75 11 113 9 156 9 100 83 1,990

NEW ENGLAND.......... 722 1 6 46 1 5 3 65
Maine...? .......... 3 50
New Hampshir. ..... 14 1 1 I I 2
Vermont............ 58 6 46 2 10
Massachusetts........ 108 2 1 2
Rhode Island....... 59 -
Connecticut........ 480 1 2 -- 1

MIDDLE ATLANTIC...... 204 10 7 1 13 7 3 20
Nw York City...... 8 5 7 -
SNw York, Up-State. 195 4 7 1 3 1 3 14
Nw J rsey......... NN 1
Pennsylvania....... 1 1 3 5 6

EAST NORTH CENTRAL... 404 8 7 1 24 3 16 184
Ohio................. 119 1 11 2 3 72
Indiana............ 55 1 1 3 1 60
Illinois........... 60 5 4 1 9 1 5 23
Michigan............ 104 2 1 9
Wisconsin.......... 66 1 7 20

WEST NORTH CENTRAL... 173 3 1 8 8 3 22 460
Minnesota........... 37 1 11 136
Iowa............... 34 1 4 86
Missouri........... 2 1 6 3 1 1 76
North Dakota....... 63 5 80
South Dakota....... 15 1 1 1 34
Nebraska........... 20 3 1 1 23
Kansas............ 4 -1 25

SOUTH ATLANTIC....... 391 14 7 39 2 54 9 220
Delaware............ 3 -
Maryland.......... 115 1 7 1 6 3
Dist. of Columbia.. 45 I 2 -
Virginia........... 72 2 1 8 1 22 87
West Virginia...... 123 1 2 29
North Carolina..... 2 2 2 16 1 9
South Carolina..... 8 2
Georgia............ 6 2 9 6 2 33
Florida............. 19 6 2 11 2 4 59

EAST SOUTH CENTRAL... 1,039 9 6 2 19 7 17 11 468
Kentucky............ 11 1 1 2 5 2 3 8 227
Tennessee.......... 859 2 4 11 5 12 2 219
Alabama............ 115 3 1 1 21
Mississippi........ 54 3 1 3 1 1

WEST SOUTH CENTRAL... 557 1 16 4 26 3 14 13 8 361
Arkansas........... 8 4 3 5 2 3 1 1 42
Louisiana.......... 1 5 1 5 2 2 33
Oklahoma ........... 50 6 1 4 6 1 107
Texas.............. 498 1 7 10 5 6 4 179

MOUNTAIN............. 812 5 9 2 4 51
Montana ............ 21 -
Idaho ............. 47 -
Wyoming............ 12 1 1 2
Colorado ........... 420 -- 2 2 3
New Mexico.. ...... 132 6 20
Arizona............. 56 4 26
Utah .............. 124 2
Nevada...............- -

PACIFIC........... .. 605 1 14 1 1 25 1 7 161
Washington......... 22 -
Oregon............. 43 1 1 3 -- 3
California......... 383 1 12 1 22 1 7 158
Alaska............. 37 -
Hawaii............. 120 -

Puerto Rico.......... 1 5 1 16

Delayed reports: SST: Me. 1, N. Mex. 41
Rabies in animals: N. Mex. I








Morbidity and Mortality Weekly Report






TABLE IV. DEATHS IN 122 UNITED STATES CITIES FOR WEEK ENDED JULY 13, 1968

(By place of occurrence and week of filing certificate. Excludes fetal deaths)


267


All Causes Pneumonia Under All Causes Pneumonia Under
Adeand year
Area All 65 years and 1 year Area All 65 years aInfld u enz a All
Influenza All Influenza All
Ages and over Ill esa Ages and over
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.---------


766
231
59
21
33
63
30
27
24
58
61
11
47
40
61

3,582
50
31
153
56
49
36
62
83
1,721
60
519
238
65
127
31
41
-117
61
38
44

2,739
78
53
792
137
237
130
83
334
42
41
57
36
69
172
49
136
58
34
45
100
56

859
82
24
36
127
24
116
79
249
87
35


473
129
40
12
24
33
18
19
15
34
35
10
28
27
49

2,059
31
19
80
23
32
19
34
38
1,000
37
281
119
47
87
18
28
75
36
23
32

1,517.
48
29
421
89
129
77
42
184
25
19
31
10
46
83
20
87
34
22
31
60
30

458
48
16
12
66
14
71
41
123
47
20


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


1,245
121
292
65
83
105
49
110
49
80
71
179
41

671
122
43
51
144
132
55
42
82

1,293
33
36
26
168
55
90
265
52
180
113
154
67
54

454
45
25
130
27
91
23
63
50

1,697
23
43
37
50
114
498
114
38
127
73
99
201
28
151
59
42


Total 13,306 17376 452 692

Cumulative Totals
including reported corrections for previous weeks

All Causes, All Ages ------------------------ 364,250
All Causes, Age 65 and over------------------- 211,596
Pneumonia and Influenza, All Ages------------- 15,630
All Causes, Under 1 Year of Age--------------- 16,787


Week No.
28







2168


CURRENT TRENDS
MEASLES United Stotes


For tihe 'eek ondtling ,ill\ 1;. 9(i.'S, 32 (5 a: es of
mi easle- were reported to NCD( This is the third con-
- lecuttl e wc\'lk in lhichl the reported riase- i hai\', totaled
1'ife\ r iithn (1) rS;11eI per w\ik. The rep(ortedI cass, since
the o ek ending Janu:lIay ;t\ h len 4S3 ca Ises were reported,
hai\ rantged from l il l to !199.
From June 16 through July 13. 196S. weekss 25-2h),
1..ih) ca- .e of mliaslet s reported. Thiis is 1,125 fewer
iasI than the 2,705 rleporid for the preceding 4-week
pri)od and is 60 percent of the 2.653 cases reported for
ilhe c( rr.i -1.... i.. weeks in 1967(Figure 2).The cumula-
tii'c total for the first 40 weeks of the current measles
opidemiiologic lear* is 32.5 percent of the 67,8h9 eases
reported during the comparable 40-week period in epi-
demiologic \ear 1966-6(7.

Figure 2
REPORTED CASES OF MEASLES BY 4-WEEK PERIODS
UNITED STATES
EPIDEMIOLOGIC YEAR 1967-68, COMPARED WITH 1966-67


*"o las O(C ;:. r8 Ilo :aL 2.l uH" AL* l vj S lrP oCr


(Reported by State Serricel' Section, and Statistics Sec-
tion, Epidemioloyi P'roiram, ('l)('.)

'Th<-, eplcmilo zic \ ur % I'r me:i r l-h,-, hf( ins \\ith we.t k 41 of
th," c-.d ndl .ir y ;ar .mid ,,i- with week 10 ol tih -ucceeding
'aITr.





ERRATUM, Vol. 17, No. 27, p. 254
In thIe article "Shigella July-Decomber 1967,"
paragraph two is incorrect. Please suhstilute the followiing
corrected paragraph:
"Of t th total of (i.i.ii isolations, 5.113 were classi-
fied by seroyi'pe. Ther .).113 'hig I lla violations rvpre-
.-'nled *ii 2. -ror\ ly. Thi" -ix most frequently reported sero-
lypies luring thlr(i-month period are |presented in Tablel."
In thr iami, article in Taile 2. the word "Total"
should 1be suhlstituted for the word "Subtotal" and the
lines- "Specimrns not typed 1.6:3s" and "Total 6,556"
-hould he deleted.


JIILY 13, 1968


THE MORBIDITY AND MORTALITY WEEKLY REPORT. WITH A CIRCULAR*
TION OF 17,000 IS PUBLISHED AT THE NATIONAL COMMUNICABLE
DISEASE CENTER. ATLANTA, GEORGIA
DIRECTOR. NATIONAL COMMUNICABLE DISEASE CENTER
S- u J. SENCER. M.D.
CHIEF, EPIDEMIOLOGY PROGRAM LANGMUER, M.D.
ACTING CHIEF, STATISTICS SECTION IDA L. SHERMAN, M.S.
EDITOR MICHAEL B GREGG M.D.

IN ADDITION TO THE ESTABLISHED PROCEDURES FOR REPORTING
MORBIDITY AND MORTALITY, THE i'- .'NA-L -OMMUN" ABLE DIT ATE
CENTER WELCOMES ACCOUNTSOF '.T' : r,i_ OUTBAr- :, C'. :E
INVESTIGATIONS WHICH ARE OF CURRENT INTEREST TO HEALTH
OFFICIALS AND WHICH ARE DIRECTLY RELATED TO THE CONTROL
OF COMMUNICABLE DISEASES. SUCH COMMUNICATIONS SHOULD BE
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 THE NCDC BY THE INDIVIDUAL
STATE HEALTH DEPARTMENTS. THE REPORTING WEEK C'N. ~"L
ON SATURDAY; COMPILED DATA ON A NATIONAL BASIS ARE .EL L it
ON THE SUCCEEDING FRIDAY.


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