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:
AA00010654:00195

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


f NATIONAL COMMUNICABLE DISEASE CENTER


Vol. 17, No. 33


WEEKLY

REPORT


Week Ending


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

HEALTH SERVICES AND MENTAL HEALTH ADMINISTRATION


INTERNATIONAL NOTES
INFLUENZA LABORATORY
FINDINGS HONG KONG ISOLATES


Of five viruses isolated during the recent influenza
outbreak in Hong Kong and sent to the International In-
fluenza Center, NCDC, by Dr. W. K. Chang, National In-
fluenza Center, University of Hong Kong, two have been
examined by reciprocal hemagglutination inhibition tests.
Similarity coefficients for Hong Kong/1/68 and Hong
Kong/8/68 with earlier A2 strains indicate a magnitude
of dissimilarity which has not been previously observed
within this subtype (Table 1). Similarity coefficients for
all virus pairs could not be determined (i) because of the
poor reactivity of many strain specific antisera with the


WPNTENTS % ` //
International Notes c\I /
Influenza Laboratory FindiA Hong Kong Isoat 05
Current Trends
Measles United States. .. S. 307
Morbidity Reporting ... .- 312
Epidemiologic Notes and Reports
Encephalitis New Jersey ........... ........ .. 307
Follow-Up Suspect Botulism California . .. 306
Vaccinia Necrosum Portland. Oregon . .... 312


Hong Kong/1/68 and Hong Kong/8/68 antigens. Never-
theless, these isolates, are still classified as influenza
A2 viruses. All five isolates were readily identified with
the WHO reference A2 polyvalent antisera; antisera pro-
duced against both Hong Kong/1/68 and Hong Kong/8/68
(Continued on page 306)


TABLE I. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous weeks)
33rd WEEK ENDED M N CUMULATIVE, FIRST 33 WEEKS
MEDIAN
DISEASE
August 17, August 19, 1963 1967 MEDIAN
S1968 1967 1968 1967 1963 1967
Aseptic meningitis ...................... 202 107 88 1,789 1,388 1.114
Brucellosis ............................ 5 7 7 132 170 170
Diphtheria............................. 2 3 4 102 65 112
Encephalitis, primary:
Arthropod-borne & unspecified ........... 56 42 653 926 -
Encephalitis, post-infectious .. .......... 8 10 -- 341 595
Hepatitis, serum ............ ......... 103 46 643 2,686 1,345 2 ,
Hepatitis, infectious .................... 932 685 27,756 24,220
Malaria ................................ 49 21 4 1,345 1,234 64
Measles rubeolaa) ....................... 232 231 694 19,256 57,079 238,074
Meningococcal infections, total ........... 26 24 25 1,897 1,595 1.858
Civilian .............................. 26 22 1,722 1,484 -
Military.......... .................... 2 175 111
Mumps ................................. 822 --- 122,772 --
Poliomyelitis, total ..................... 1 2 2 35 23 61
Paralytic ............................. 1 2 2 35 20 54
Rubella (German measles) ............... 321 253 42,821 39.289 -
Streptococcal sore throat & scarlet fever.... 4,349 4,493 3,838 287,940 310,289 279,341
Tetanus ............................... 4 7 7 92 138 153
Tularemia .............................. 3 4 7 126 113 160
Typhoid fever ........................... 9 7 8 205 251 250
Typhus, tick-borne (Rky. Mt. spotted fever) 32 16 14 195 203 168
Rabies in animals ....................... 52 88 81 2,314 2,902 2,902

TABLE II. NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax: ........................................... 3 Rabies in man: ................................ -
Botulism: .................................. ....... 4 Rubella. Congenital Syndrome: ....................... 4
Leptospirosis: Fla.-2, Ohio-1 .......................... 24 Trichinosis: .............. .. ..................... 48
Plague:* ............ ..... ................ ..... 2 Typhus, marine: Tex.-1 -.......... .................. 19
Psittacosis: Mich.-2.................................. 33
*Delayed reports: Plague: Ariz. 1
Typhus, Murine: Puerto Rico delete 1







Morbidity and Mortality Weekly Report


INFLUENZA LABORATORY FINDINGS HONG KONG ISOLATES (Continued from front paye)


strains clearly demonstrated an antigenic relationship with
the earlier A2 \iruses (Table 2). These results confirm
the findings of the World Influenza ('enter in London. The
Hong Kong \irueso represent a major antigenic drift and
identification may not be possible using specific antisera


produced against earlier A2 reference strains.
(Reported by the World Health ,,.,.. .' ." International
Influenza Centerforthe Americas, N(CD', Atlanta, Georgia.)
d>-f>-rcn<>-:
1l11l0 Werkly Fpidernioloaical Record :!(3:):41 ,1 Aua. 16. 1968.


Table 1
Strain Relationships" of Type A2 Influenza Viruses with 1968 Hong Kong Isolates


A2' Japan 305 '57
A2 Japan 170. 62
A2 Taiwan 1 6-1
A2 .Georgia 1 67
A2 Tokyo .3 67
A2. Ann Arbor 7 67
A2 Texas 2 66b
A2,Hong Kong 1, 6
A12 Hong Kongt 8/68


mSinhlarity coefficients (r) according to the formul.i of Archetti and Horsfail, J Exp Med 9S:44 1, 1950.
i- indelerminate


22.6 22.6


SI-


o
o- -


.0 Ct
r..0
L.0 1.0
1.0 4.0 1.0
i i i
i 11.3 64.0


Hemagglutination Inhibition:


Table 2
Type A2 Influenza Viruses


and 1968 Hong Kong Isolates


-r

chickenn Antisera*
A2 Japan 3053 '57
A2 Japan 170. 62
.A2 Tain an '1. 6.1
A\2( eorgia 1 (67
\ 2 Tokyo :3 '67
A2 Ann Arbor 7 67
A2 Texas 2 ti,
.2 lion, Kong 1 (ih
A2 Hong Kong h (W
A2 Polyvalent
* =c por t {i tr 'n
* = 10


Cl






10

80
40



160
80
so

40
4(1
160



40
to
10
32')


0


0
o.






0
0

0
0
0





320
20


0
:4


0
40
-0




10
40
10


10


120
80


EPIDEMIOLOGIC NOTES AND REPORTS
FOLLOW-UP SUSPECT BOTULISM California


An autops- as performed on the I' >'ear-old man who
died o' a syndrome diagnosed clinically as botulism (MM\\R.
Vol. 17. No. 23). There was no gross evidence ofintra-
cranial I' hl't."..l II l..i ,'. sections ofthe brain shoNed
cellular necrosis and occasional pollyorphonuclear cells
and phagoc.rteo. These nonspecific changes were' ascribed
to prolonged anoxia. Botulinsm wa. listed a. t he cause of


death on the death certificate .,ili,.'' lh the clinical diag-
nosis could not he supported hy laboratory findings.
(Reported by John J. Dapolito, W.I).; J.B. Askew, M.D.,
director of Public Health, San Diego County Health De-
partment; Philip K. ('ondil, M.).. Chief, Bureau of Com-
municable Diseases, California State Department of Public
Health; and an IS '"'- .)


:306


AU GlST 17 1968


11.3


Smi. ii(l)l:i; tr1 tl.d.










CURRENT 1
MEASLES Un
During the 4-week period July 14 through August 10,
1968, (weeks 29-32), 932 cases of measles were reported
to NCDC. This is a decrease of 638 cases from the total
for the preceding 4-week period and is 220 cases, 3,438
cases, and 4,216 cases fewer than the cases reported for
the comparable 4-week period in 1967, 1966, and 1965,
respectively (Figure 1).
In this 4-week period, 13 states and the District of
Columbia reported no cases of measles, and 22 states


48,000-

44,000-

40,000-

S36,000-
-
32,000-

S28,000-
-

24,000-

20,000

O 16,000

S12,000

8,000 -

4,000

0


EPIDEMIOLOGIC NOTES AND REPORTS
ENCEPHALITIS New Jersey


reported at least one but fewer than 10 cases. New York
state accounted for 316 of the 932 cases reported. New
York City reported 265 of these 316, and the boroughs of
Bronx and Brooklyn reported 85 percent of the 265 New
York City cases.


(Reported by State Services Section, and Statistics Section,
Epidemiology Program, NCDC.)


The first two confirmed human cases of eastern en-
cephalitis (EE) in 1968 have been reported from New
Jersey. The first patient, an 8-year-old boy who lives in
Atlantic County, developed encephalitic symptoms on
July 17 and is presently recovering from his acute illness.
EE virus was identified as the causative agent by com-
plement fixation, hemagglutination inhibition, and neutral-
ization tests on acute and convalescent sera. The second
patient, a 12-year-old boy, became ill on August 11; his
illness was subsequently confirmed as EE. This patient
had recently been in both Ocean and Cumberland Counties.
The first New Jersey case of EE in horses occurred
on July 22 (MMWR, Vol. 17, No. 30). As of August 20, a


total of 33 confirmed cases of EE in horses have been
reported from eight counties, Atlantic, Burlington, Camden,
Cape May, Cumberland, Gloucester, Monmouth, and Ocean.
In addition there have been 26 suspect equine cases.
An intensive program of field and laboratory surveil-
lance is being continued.



(Reported by Ronald Altman, M.D., Acting Director, Di-
vision of Preventable Disease, Martin Goldfield, M.D.,
Director, Division of Laboratories, and Oscar Sussman,
D.V.M., M.P.H., Coordinator, Division of Veterinary Public
Health, New Jersey Department of Health.)


AUGUST 17, 1968


Morbidity and Mortality Weekly Report


Figure 1
REPORTED MEASLES BY FOUR-WEEK PERIODS
UNITED STATES EPIDEMIOLOGIC YEAR 1967-1968
COMPARED WITH 1964-65, 1965-66, AND 1966-67


S964-65




/\
1 / 1965-66




/ / \ \
I // /


I \
/ It



/, 1966-67

--.s ..-.

1967-68

4 2 30 27 24 23 20 18 15 13 10 7 5
NOV. DEC. DEC JAN FEB MAR APR MAY JUN. JUL AUG. SEP OCT
FOUR-WEEK PERIOD ENDING







308 Morbidity and Mortality Weekly Report


TABLE III. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

AUGUST 17, 1968 AND AUGUST 19, 1967 (33rd WEEK)

ENCEPHALITIS HEPATITIS
ASEPTIC Primary
MENPTIS BRUCELLOSIS IPHTER1A i Post- MALARIA
AREA MENINGITISI I including Infectious Serum Infectious
unsp. cases
1968 1967 1968 1968 1968 1967 1968 1968 1968 1967 1968
UNITED STATES... 202 107 5 2 56 42 8 103 932 685 49

NEW ENGLAND.......... 3 2 2 6 2 65 12
Maine............... 2 1
New Hampshire...... 2 -
Vermont............ 1
Massachusetts...... 1 6 36 -
Rhode Island....... 3 1 2 15 3
Connecticut........ 2 10 7

MIDDLE ATLANTIC...... 53 9 14 4 33 140 95 3
New York City....... 15 3 2 18 58 35
New York, up-State. 3 5 26 25
New Jersey.. ...... 34 2 11 1 8 23 13 2
Pennsylvania....... 4 1 3 1 2 33 22 1

EAST NORTH CENTRAL... 19 29 21 14 6 140 128 4
Ohio................ 7 11 18 12 1 53 27
Indiana............. 3 1 1 8 9
Illinois............ 7 15 2 1 31 46 2
Michigan........... 1 1 4 36 38 2
Wisconsin.......... 1 1 1 1 12 8 -

WEST NORTH CENTRAL... 5 3 3 2 58 37 3
Minnesota........... 3 2 2 30 2
Iowa............... 1 6 5
Missouri........... 2 2 13 26 2
North Dakota....... 1 3
South Dakota...... 1
Nebraska............. 1 2 1
Kansas............. 5 1

SOUTH ATLANTIC....... 7 11 4 1 2 3 4 5 105 95 4
Delaware........... 3 1 -
Maryland............ 9 1 1 15 20
Dist. of Columbia.. 2 -
Virginia........... 1 3 1 7 15
West Virginia....... 3 6 3
North Carolina..... 2 1 3 4 2
South Carolina..... 1 4 4
Georgia............ 1 27 39
Florida............. 1 2 2 4 4 .40 7 2

EAST SOUTH CENTRAL... 37 12 1 3 56 46 13
Kentucky........... 1 21 19 12
Tennessee.......... 33 8 1 3 19 16
Alabama............ 2 4 1 4
Mississippi........ 1 -- 15 7 1

WEST SOUTH CENTRAL... 20 4 4 3 4 56 73 2
Arkansas.......... 2 1 3 1 -
Louisiana.......... 5 1 2 1 1 16 16 2
Oklahoma............ 1 1 1 8
Texas.............. 14 3 3 36 48

MOUNTAIN........... 2 1 40 23 3
Montana............ 3 2
Idaho.............. 5 1
Wyoming............ -
Colorado............. 2 1 12 2
New Mexico......... 4 5
Arizona............ 20 3 1
Utah.............. 8 -
Nevada.............-

PACIFIC............... 56 36 1 10 9 2 53 272 176 17
Washington.......... 4 3 1 3 25 24
Oregon.............. 18 10 -
California.......... 50 28 1 9 6 2 53 226 142 14
Alaska............. -
Hawaii............. 2 5 3 3

Puerto Rico.......... 33 17 4

Delayed reports: Hepatitis, serum: N.J. delete 1
Hepatitis, infectious: Me. 5, N.J. delete 5







Morbidity and Mortality Weekly Report 309


TABLE III. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

AUGUST 17, 1968 AND AUGUST 19, 1967 (33rd 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... 232 19,256 57,079 26 1,897 1,595 822 1 1 35 321

NEW ENGLAND.......... 7 1,140 830 7 101 67 73 1 44
Maine.. ........... 35 234 6 3 4 5
New Hampshire....... 141 74 7 2
Vermont............ 2 34 1 1 8 -
Massachusetts..*.... 1 357 337 6 48 32 27 1 8
Rhode Island....... 5 62 1 8 4 13 11
Connecticut........ 6 600 89 31 25 21 20

MIDDLE ATLANTIC...... 104 3,960 2,225 3 341 261 66 49
New York City...... 94 1,994 445 1 69 46 62 32
New York, Up-State. 4 1,210 .568 1 59 65 NN 17
New Jersey ........ 6 620 481 122 92 4
Pennsylvania..*.... 136 731 1 91 58 NN

EAST NORTH CENTRAL... 31 3,707 5,277 1 228 215 221 1 75
Ohio................ 1 289 1,136 62 74 37 9
Indiana............. 10 653 587 29 22 25 16
Illinois........... 9 1,356 934 51 52 18 1 16
Michigan........... 5 261 906 1 66 51 49 13
Wisconsin.......... 6 1,148 1,714 20 16 92 21

WEST NORTH CENTRAL... 2 379 2,834 1 101 68 8 1 16
Minnesota.......... 1 16 131 1 24 16 3
Iowa................ 1 97 745 6 13 6
Missouri.......... 81 332 32 14 1 4
North Dakota........ 131 857 3 1 5 2
South Dakota........ 4 52 t 5 6 NN
Nebraska........... 40 624 6 12 4
Kansas............. 10 93 25 6 -

SOUTH ATLANTIC....... 12 1,480 6,807 4 385 304 64 1 58
Delaware........... 15 43 8 6 1 -
Maryland............ 94 149 28 38 5 1
Dist. of Columbia.. 6 22 14 10 -
Virginia............ 1 297 2,171 1 31 37 16 11
West Virginia.*.... 3 280 1,368 1 10 21 23 28
North Carolina..... 281 847. 76 66 NN 1
South Carolina..... 12 507 56 29 3 3
Georgia............. 4 32 73 44 -
Florida............. 8 491 1,668 2 89 53 16 15

EAST SOUTH CENTRAL... 5 487 5,126 2 162 125 47 1 1 2 26
Kentucky...*....... 99 1,318 1 65 34 7 1 9
Tennessee.......... 3 61 1,825 1 52 52 35 17
Alabama............ 93 1,321 24 26 3 1 1 1 -
Mississippi........ 2 234 662 21 13 2

WEST SOUTH CENTRAL... 45 4,679 17,178 4 301 215 77 19 21
Arkansas........... 3 1,404 20 28 -
Louisiana.......... 2 151 2 86 85 -
Oklahoma... ...... 111 3,348 49 16 2 4
Texas.............. 45 4,563 12,275 2 146 86 77 17 17

MOUNTAIN ............. 13 984 4,594 29 27 109 10
Montana............ 67 281 3 5 1
Idaho............... 20 377 11 1 2 -
Wyoming............ 51 180 1 -
Colorado............ 9 503 1,543 10 12 16 -
New Mexico......... 4 96 576 3 5 -
Arizona............ 221 1,008 1 4 49 8
Utah............... 21 360 1 4 32 1
Nevada............. 5 269 3 2 -

PACIFIC.............. 13 2,440 12,208 4 249 313 157 10 22
Washington......... 515 5,417 37 28 5 1 2
Oregon.............. 8 496 1,566 19 25 5 3
California......... 5 1,392 4,930 4 180 247 139 9 17
Alaska............. 2 133 2 9 5 -
Hawaii............. 1 35 162 11 4 3

Puerto Rico.......... 5 388 2,099 19 12 9 -

Delayed reports: Measles: Mass. delete 8, N.J. 6, Pa. delete 5, W. Va. delete 2, N.C. delete 1, Ky. delete 4
Meningococcal infections: N.C. 1
Mumps: Me. 1
Poliomyelitis, paralytic: Okla. 1
Rubella: W. Va. 2, Ky. 4







310 Morbidity and Mortality Weekly Report


TABLE 111. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
FOR WEEKS ENDED

AUGUST 17. 1968 AND AUGUST 19, 1968 (33rd 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... 4,349 4 92 3 126 9 205 32 195 52 2,314

NEW ENGLAND.......... 540 2 46 7 1 69
Maine... ............ 13 53
New Hampshire...... 3 1 -- 2
Vermont ............ 4 46 10
Massachusetts...... 53 1 3 1 3
Rhode Island....... 43 -
Connecticut........ 424 1 3 1

MIDDLE ATLANTIC ..... 100 12 7 19 14 1 32
New York City...... 2 6 9 -
New York, Up-State. 96 4 7 3 2 1 25
New Jersey.. ....... NN 4 6
Pennsylvania........ 2 2 3 6 7

EAST NORTH CENTRAL... 362 1 9 8 1 27 6 6 216
Ohio.............. 49 1 12 4 84
Indiana............ 155 1 1 3 4 74
Illinois............ 50 5 5 1 11 2 2 27
Michigan ........... 69 1 3 1 10
Wisconsin.......... 39 1 21

WEST NORTH CENTRAL... 90 4 9 1 9 3 7 13 572
Minnesota .......... 9 1 5 169
Iowa............... 30 1 1 1 3 94
Missouri........... 4 2 7 3 1 1 82
North Dakota....... 31 3 91
South Dakota....... 11 1 1 3 4 79
Nebraska........... 5 3 1 25
Kansas............. 1 1 1 1 32

SOUTH ATLANTIC....... 490 2 21 8 1 44 22 110 9 252
Delaware............. 1- -
Maryland........... 28 2 9 2 12 5
Dist. of Columbia.. 2 2 1
Virginia........... 153 4 1 8 4 35 3 95
West Virginia...... 156 1 31
North Carolina..... 3 2 2 2 1 28 9
South Carolina..... 21 2 6 -
Georgia............ 3 3 1 12 15 26 38
Florida.. ......... 125 2 8 2 11 3 6 73

EAST SOUTH CENTRAL... 1,085 10 1 7 24 6 35 8 514
Kentucky............ 114 1 1 5 2 8 6 254
Tennessee........... 772 3 1 5 13 3 22 2 238
Alabama............ 114 3 3 21
Mississippi........ 85 3 1 6 1 2 1

WEST SOUTH CENTRAL... 490 1 19 1 33 3 29 1 17 5 393
Arkansas........... 16 4 6 4 1 2 1 46
Louisiana........... 6 1 8 6 3 35
Oklahoma .......... 38 8 3 12 8 2 116
Texas.............. 430 7 1 13 10 7 2 196

MOUNTAIN............. 673 6 13 5 3 62
Montana............. 11 -
Idaho............... 53 -
Wyoming............ 11 1 1 3
Colorado............ 244 3 2 -4 3
New Mexico......... 140 6 2 25
Arizona............. 95 3 1 31
Utah............... 119 2 -
Nevada... ......... I

PACIFIC............. 519 15 1 2 3 33 1 6 204
Washington......... 27 1 2 1 2
Oregon.............. 52 I 1I 4 5
California......... 333 13 1 1 3 27 1 5 197
Alaska............... 16
Hawaii.............. 91 -

Puerto Rico.......... 3 2 8 1 2 17
Delayed reports: SST: Me. 1
Typhoid: N.J. delete 1, Nev. 1
Typhus fever, tick-borne: Fla. 1







Morbidity and Mortality Weekly Report


TABLE IV. DEATHS IN 122 UNITED STATES CITIES FOR WEEK ENDED AUGUST 17, 1968

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


All Causes Pneumonia Under All Causes Pneumonia Under
AreaAll 65 years and year Area All 65 years and
Influenza All Influenza All
Ages and over Influenza All Ages and over Influenza Au
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.--------


705
219
51
22
26
55
31
16
22
56
60
12
50
32
53

3,143
50
37
132
42
28
40
52
80
1,548
34
508
191
53
96
31
44
73
44
30
30

2,536
70
30
736
130
234
135
90
352
34
49
49
40
41
135
27
103
41
33
46
104
57

773
52
18
45
119
25
98
73
225
60
58


425
121
36
17
19
30
17
14
15
25
35
10
27
21
38

1,787
29
21
68
20
11
25
29
36
900
21
278
101
33
58
21
29
47
23
20
17

1,380
40
19
388
78
118
71
50
183
21
22
29
20
24
69
7
59
20
23
28
72
39

459
34
13
26
75
19
59
42
126
35
30


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


Total 11,872 6,667 391 600

Cumulative Totals
including reported corrections for previous weeks

All Causes, All Ages ------------------------- 424,765
All Causes, Age 65 and over------------------- 245,687
Pneumonia and Influenza, All Ages------------- 17,669
All Causes, Under 1 Year of Age--------------- 19,807


Week No.
33


1,086
132
237
47
68
81
55
89
29
75
72
161
40

617
88
38
30
116
148
58
39
100

1,106
24
34
33
162
31
70
220
40
179
78
116
54
65

410
52
24
116
22
88
13
51
44

1,496
22
37
30
37
94
419
90
25
115
74
84
191
35
151
48
44






Morbidity and Mortality Weekly Report


EPIDEMIOLOGIC NOTES AND REPORTS
VACCINIA NECROSUM Portland, Oregon

In Portland. Oregon. on May 30. a 6f2-year-old woman
with chronic lymphocytic leukemia died from vaccinia
necrosurn (vaccinia gangrenosa). complicated by general-
ized seepticemia. The patient had been receiving antime-
tabolite therapy for the 6i years since the leukemia had
been diagnosed. Since June 1967 she had had recurrent
herpes simplex, involving the entire left side of her face.
On February 2s. 196,8 she was vaccinated with smallpox
Vaccine by her physician to abate the spread of herpes
virus, and on March 24 she was admitted to the hospital
with severe necrotic ulceration at the site of vaccination.
The lesion spread locally to involve the entire deltoid
region, and multiple satellite lesions occurred over the
trunk and face. .\l, i"i, _l, she was treated with Vaccinia
Immune Globulin, local steroid ointment, whole blood
transfusions, and finally dehridement, she failed to recover.
(Reported by Portland :, Health Department; Gordon
Edwards, 4.I)., Acting State Epidemiologist, Oregon State
Board of Health; and the Smallpox Eradication Program,
\ CDC.)


Editorial Note
Vaccinia necrosum, a disease invariably fatal prior to
the availability of vaccinia hyperimmune gamma-globulin
and thiosemicarbazone 1 occurs in an estimated five to 10
patients per year in the United States and generally in
patients with disorders of the immunological system such
as agammaglobulinemia or leukemia. In the United States
since 1960. at least seven cases occurred in patients who
had been vaccinatedto relieve chronic or recurrent herpes.

Reference:
Kempe, C. lenry: Studies on smallpox and complications of
smallpox vaccination. Pediatrics 26: 176-89, 1960.


CURRENT TRENDS
MORBIDITY REPORTING

The "Manual of Procedures for National Morbidity
Reporting and Surveillance of Communicable Diseases"
has recently been revised and is available on request
from:
National Communicable Disease Center
Atlanta. Georgia 30333
Attn: Acting Chief, Statistics Section,
I.l.id- ;,|l,,c Program
The manual describes procedures by which data are col-
lected for the "Morbidity and Mortality it .-,I.lI' Report"
and the "Annual Supplement" to the \IM (R includes
instructions for submitting surveillance forms on individual
cases of diseases under national surveillance, and exhibits
current surveillance forms used by various programs of the
NCDC.


Amm
AUGUST 17, 1968

o I


THE MORBIDITY AND MORTALITY WEEKLY REPORT. WITH A CIRCULA-
TION OF 17,000. iS PUBLISHED AT THE NATIONAL COMMUNICABLE
DISEASE CENTER. ATLANTA, GEORGIA.
DIRECTOR, NATIONAL COMMUNICABLE DISEASE CENTER
DAVID_ N FF MO.
CHIEF, EPIDEMIOLOGY PROGRAM A.O. L -..:u-. 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
MORBIDI TY AND MORTALITY, THE NATIONAL COMMUNI .e .- iL E E *SE
CENTER WELCOMES ACCOUNTS OF INTERESTING OUTB '-- ', : -: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 ::., *.*,. L E.F DISEASE CENTER
ATLANTA Fr ,- I ',
ATTN: ir C.- .
: .. .. i. T 1 ri. 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 *'iir.' THE REPORTING WEEK CONCLUDES
ON SATURDAY :,4 ,''1. ,' D* T ON A NATIONAL BASIS ARE RELEASED
ON THE SUCCEEDING FRIDAY


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