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:
AA00010654:00199

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 it. Eb




SUS











DATE OF RELEASE: SEPTEMBER 26, 1969 -ATLANTA, GEOR
^.. .: .,









U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE / PUBLIC HEALTH SERVICE HEALTH
DATE OF RELEASE; SEPTEMBER 26, 1969 ATLANTA, GEORO


CURRENT TRENDS
ARTHROPODBORNE ENCEPHALITIS-United States 1969

Despite increased rainfall earlier this year, there have
been no outbreaks among humans of arthropodborne enceph-
alitis in the United States; however, there were sporadic
cases among humans and outbreaks among horses.
In the western states, reports of equine encephalitis
in the Columbia River Basin, including portions of Wash-
ington and Oregon, decreased after a peak was reached in
late July and early August. Western Encephalitis virus
(WE) was confirmed as the etiologic agent in 20 cases in
Washington and in 34 cases in Oregon. From Idaho, 50
cases of equine encephalitis were reported, with many
showing titer rise to WE virus. Four cases of equine en-
cephalitis due to WE virus were reported from California,
seven from New Mexico, and one from Texas. One case of


Current Trends
Arthropodborne I .. i- i I .325
Measles Unit I -i .1 30
Epidemiologic Nor -. I
Leptospirosis- .i .r : 26
Fatal Falciparur.. 'I. .. 26
Outbreak of Tub r. 1 ,, ... 327
Follow-up Human Rabies San Diego County,
California .................. ........ 328
Summary of Reported Cases of Infectiou Syphilis ... .328
Surveillance Summary
Salmonellosis April, May, and June 1969 . .29

human encephalitis due to St. Louis Encephalitis virus
(SLE) with onset in early August was reported from Nevada.
In California, SLE virus was isolated from mosquito col-
lections, but no human cases were reported.
In the midwestern states, four cases of human enceph-
alitis due to California Encephalitis virus were confirmed
(Continued on page 326)


TABLE I. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous weeks)
38th WEEK ENDED CUMULATIVE. FIRST 38 WEEKS
MEDIAN
DISEASE September 20, September 21, 1964 1968 MEDIAN
1969 1968 1969 1968 1964- 1968
Aseptic meningitis ...................... 195 295 128 2,224 2,871 2,034
Brucellosis ............................ 3 5 5 163 158 188
Diphtheria............................. 7 4 3 116 138 138
Encephalitis, primary:
Arthropod-borne & unspecified ........... 21 61 72 840 930 1,304
Encephalitis, post-infectious ............. 6 9 9 249 384 598
Hepatitis, serum ........................ 110 116 3,816 3,159
Hepatitis, infectious .................... 1,052 1,056 67 33,956 32,306 28,
Malaria ............... ............ ............ 68 72 23 2,074 1,651 297
Measles rubeolaa) ....................... 160 125 375 20.547 19.760 189.867
Meningococcal infections, total ........... 20 29 29 2.395 2,059 2,078
Civilian .............................. 20 28 2.188 1,879 -
Military ...................... ....... .. 1 207 180 --
Mumps ................................. 498 612 68.689 125,664 -
Poliomyelitis, total ..................... 1 1 12 43 46
Paralytic ............................. 1 1 10 43 43
Rubella(German measles) ............... 308 219 49,331 44.131 ---
Streptococcal sore throat & scarlet fever.... 5,360 5,738 4,757 311,374 310,984 310,984
Tetanus ............................... 6 4 4 109 116 163
Tularemia ..................... ...... 2 2 3 110 144 144
Typhoid fever .......................... 9 15 9 216 276 302
Typhus, tick-borne (Rky. Mt. spotted fever) 10 9 9 392 247 228
Rabies in animals ....................... 57 56 65 2.581 2.614 3.302

TABLE II. NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax: ........................................... 3 Rabies in man: ...................................... 1
Botulism: .......................................... 11 Rubella congenital syndrome: .......................... 7
Leptospirosis: Ala.-l, Calif.-l ................... ... 57 Trichinosis: Calif.-2.............................. .. 160
Plague: .................. ......................... 3 Typhus, marine: Ohio-1 ...... ........................ 35
Psittacosis: Minn.-1, Ohio-1 ......................... 32 Poliomyelitis, non-paralytic: ........................... 1
Poliomyelitis, unspecified: ............................ 1
*Delayed reports: Leptospirosis: Iowa 1






Morbidity and Mortality Weekly Report


SEPTEMBER 20, 1969


ARTHROPODBORNE ENCEPHALITIS (Continued from front page)


in Ohio, six in Wisconsin. and one in Minnesota. Sera from
other cases are undergoing laboratory study The pattern
of cases has been consistent with that of recent years,
with most cases occurring sporadically in young persons
residing in these endemic areas.
In the v.' r, rr, states, two cases of equine encephalitis
due to Eastern Encephalitis virus (EE) were confirmed in
South Carolina, two in North Carolina, and four in New
Jersey. Since the earlier reports of human cases in Florida
ur.1 eqluirn, cases in (.. ori, no new EE virus activity has
been reported from these two states (MMWR, Vol. 18, No. 31).

(I :. io', I by Phillip K. Condit, M.D., Chief, Bureau of
C.. L. ur,: .'.' Diseases, California State Department of
Public Health; E, Charlton Prather, M.D., Director, Divi-
sion of Epidemiology, and Nathan J. Schneider, Ph.D.,
Chief, Bureau of Laboratories, Florida State Board of
Health; John E. Mc('roan, Ph.D., ;. '*. -' Epidemiologic
Investigations Branch, Georgia Department of Public Health;
John A. Mather, M.D., Director, Division of Preventive


Medicine, Idaho Department of Health; D. S. Fleming, M.D.,
Director, Division of Disease Prevention and Control,
Minnesota Department of Health; Walter E. Ward, M.D.,
Chief, Bureau of Preventive Medicine, Nevada State De-
partment of Health, Welfare, and Rehabilitation; M. Gold-
i/..'.. D.V.M., Laboratory Director, New Jersey State De-
partment of Health; Bruce Storrs, M.D., Director, Medical
Services Division, New Mexico Department of Health and
Social Services; John Freeman, D.V.M., Chief, Veterinary
Public Health Section, North Carolina State Board of Health;
Calvin B. Spencer, M.D., Acting Chief, Bureau of Preven-
tive Medicine, Ohio Department of Health; Monroe Holmes,
D.V.M., Public Health Veterinarian, Oregon State Board of
Health; D. H. Robinson, M.D., Bureau of Preventive Health
Services, South Carolina State Board of Health; M. S.
Dickerson, M.D., Chief, Communicable Diseases Services,
Texas State Department of Health; J. Byron Francis, M.D.,
Chief, Division of Epidemiology, Washington State Depart-
ment of Health; and H. Grant 4', i,, M.D., Wisconsin
State Department of Health and Social Services.)


EPIDEMIOLOGIC NOTES AND REPORTS
LEPTOSPIROSIS Atlanta, Georgia


On August 29, 1969, a 41-year-old man with a history
of alcoholism became ill with severe headache, muscle
aches and cramps, shaking chills, fever, night sweats,
pharyngitis, and migratory polyarthralgias. On Septem-
ber 2. he was admitted to a hospital, and the initial im-
pression was influenza and early Laennec's cirrhosis.
Subsequent hospital findings of aseptic meningitis, tran-
sient hyperbilirubinemia, and azotemia suggested the diag-
nosis of leptospirosis. On September 4, his serum had a
titer of 1:400 to Leptospira icterohaemorrhagiae, and on
September 12, a second serum specimen had a titer of
greater than 1:6,400. The patient gave no history of recent
exposure to animals. He did state that 18 days prior to on-


set of illness he crossed a leveled housing area where he
first fell, receiving numerous lacerations and abrasions,
and then stepped waist-deep into a pool of stagnant water.
On September 5, the man's family was also serologi-
cally tested; all had no detectable antibody to L. ictero-
haemorrhagiae.
The patient recovered during 2 weeks of hospitaliza-
tion. No antibiotics were given since improvement was
noted prior to the diagnosis of leptospirosis.
(Reported by John E. McCroan, Ph.D., D". .'..r, Epidemi-
ologic Investigations Branch, Georgia Department of Public
Health; and the Bacterial Diseases Branch, Epidemiology
Program, NCDC; and an EIS Officer.)


FATAL FALCIPARUM MALARIA Tennessee


During the 'lieh home from Vietnam on May 28, I'l.'i
a 20-year-old serviceman developed fever and chills fol-
lowed by dry cough, nausea, vomiting, and mild diarrhea.
Four days later, he visited his f.r 11 physician who eli-
cited a history of a dog bite 5 weeks earlier, for which the
patient had already received 14 daily doses of duck embryo
rabies vaccine. Because the present symptoms were con-
sistent with an upper respiratory infection, he was given
penicillin and told to return if he did not improve.
He continued to feel ill, but was not seen by the


physician until June 8, when his family found him semi-
comatose on the bathroom floor and brought him to the
hospital. The admission temperature was 105" F., and there
was meningismus and right upper quadrant tenderness. The
admission peripheral blood smear contained numerous
Plasmodium falciparum ring forms. The hematocrit was
25 percent, white cell count -'..11111 n. i, bilirubin 8.2 mg
percent, BUN 78 mg percent, blood pH 7.10, sodium 134
meq 1, potassium 6.0 meq/1, chloride 95 meq 1, and CO2
18.4 meq 1. The cerebrospinal fluid pressure and protein


326









were elevated. Following consultation with an Army hos-
pital, the patient was started on parenteral chloroquine
and sulfisoxazole, but he steadily deteriorated.
Arrangements were made to air-evacuate the patient
from Chattanooga to Walter Reed Army Hospital on June 10.
Enroute, the flight surgeon controlled an episode of ven-
tricular tachycardia with intravenous CaCl,. On arrival,
the hematocrit was 12.5 percent, white cell count 50,000/
nn ', bilirubin 5.0 mg percent, BUN 236 mg percent, and
the creatinine 4.0 mg percent. The prothrombin time was
40.5 seconds, and further evaluation revealed severe de-
pression of clotting factors II, V, VII, IX, and X. The
parasite count was in excess of 400,000 mm3 of blood.
Carefully monitored intravenous quinine, hemodialysis,
steroids, and fresh frozen plasma were followed by a de-
crease in parasite count to under 1,000'mm3 and correction
of the metabolic disturbances. During the early hours of
June 14, however, acute pulmonary edema developed; there
was no response to therapy, and the patient died.
The autopsy showed bronchopneumonia, intra-alveolar


hemorrhage, hemoglobin pigment and casts, as well as
tubular necrosis in the kidney, and diffuse petechial brain
hemorrhages. \ilh.juehl no parasitized red blood cells
could be identified in the capillaries, malaria pigment was
present throughout the body.
(Reported by John C. Ellis. M.D.. Tri-County Hospital,
Ft. Oglethorpe. Georgia; Cecil B. Tucker, M.D., Director,
Bureau of Preventive Health Services, Tennessee Depart-
ment of Public Health: Edmund C. Tramont, Captain, MC,
Walter Reed Army Hospital; and William E. Long, I.O.,
Chief, Epidemiology '.: .. District of Columbia De-
partment of Public Health.)
Editorial Note:
Chloroquine and sulfisoxazole combination therapy
is undergoing clinical trial in the management of Vietnam
strains of falciparum malaria. In this instance, parenteral
quinine was not immediately available and might have
been extremely hazardous in an oliguric patient when the
facilities for determining serum quinine levels and per-
forming renal dialysis were not available.


OUTBREAK OF TUBERCULOSIS Forgo, North Dakoto


On November 25, 1968, active far-advanced bilateral
cavitary tuberculosis was diagnosed in a 21-,4-r-ol.I office
worker (Case 1, Table 1) of a state health insurance com-
pany in Fargo, North Dakota. She had been ill for some
time, but had continued working.
On December 3, following the diagnosis of this case,
224 of her fellow office workers were tuberculin tested by
the Mantoux method with intermediate strength PPD. Forty-
two had a reaction of 10 mm or more, eight had reactions
of 5 to 9 mm, and 13 were previously known reactors; ex-
cept for these 13 known reactors, none gave a history of
previous tuberculin testing. Between December 5 and 20.
all 63 had a chest roentgenogram taken. One new active
case of moderately advanced tuberculosis (Case 2) was
diagnosed and 39 of the new reactors were placed on isoni-
azid (INH) prophylaxis during February and March.
In March, 185 employees, ton- -lin r of persons who
had ng-pati%- or doubtful reactions when tested in Decem-
ber and new employees, were tuberculin tested; 10 had
reactions of 10 mm or greater and in five the reaction was
5 to 9 mm. Eight of the positive reactors and two individ-
uals whose reactions were in the doubtful range were
placed on INH.
In March and April, a second roentgenogram was taken
on persons who were positive when tuberculin tested in
December; four additional cases of tuberculosis were diag-
nosed (Cases 3,4,5, and 6). Two of these persons had
been receiving INH for approximately 30 days. A review of
the initial chest roentgenograms showed no evidence of
active tuberculosis. On July 25, another case was diag-
nosed in another office worker (Case 7). This woman had


Table I
Data on Eight Cases of Tuberculosis
Fargo, North Dakota

Tuberculin Diagnosis
Case Age Sex Status Date

1 24 F 11-68 Positive 11-25-68 Far Advanced
2 18 F 12-3-68 15mm 12-5-68 Mod. Adv.
3 21 F Known Reactor 3-13-69 Minimal
4 25 M 12-3-68 50mm 3-11-69 Minimal
5 17 F 14-5-68 25mm 4-10-69 Primary
6 29 F 12-3-68 50mm 4-10-69 Minimal
7 20 F 12-5-68 40mm 7-25-69 Mod. Adv.
8 35 F 4-2-69 Positive 4-10-69 Minimal


been started on INH in February but had received the drug
for only a short period at her physician's recommendation.
As a result of this case, employees were again tuberculin
tested on July 29. No new cases were detected.
There was one other c-.s (Case 8) associated with
this outbreak in a woman who did not work with the index
case but who had contact with her at a kitchen ware party.
This woman sought attention from her private physician
after hearing about the index case.
The household contacts of all eight cases were also
examined; no additional cases were found.
(Reported by James R. Amos, M.D., State Health Officer,
and Kenneth Mosser, Director, Division of Communicable
Disease, North Dakota State Department of Health; and
D. H. Lawrence, M.D., Health Officer, Fargo City Health
Department; and the Tuberculosis Branch, State and Com-
munity Services Division, NCDC.)


SEPTEMBER 20, 1969


Morbidity and Mortality Weekly Report






Morbidity and Mortality Weekly Report



FOLLOW-UP HUMAN RABIES San Diego County, California


The 3-year-old boy from Lakeside, San Diego County,
California. who aas bitten by a rabid bobcat on April 1,
1969, and who had onset of symptoms on April 18 followed
on April 27 hi coma, died on August 29 (\1011' Vol. 18.
Nos. 16 and 23). Nervous tissue obtained on May 9 was
positive for rabies by fluorescent antibody staining. Re-
sults of a postmortem examination and cultures of materials
obtained at that time are pending.
(Heported by J. B. Askew, M.D., Health Director, and Don-
ald Ramras, ..D)., Assistant Health Director, San 1,.:;,
County Health Department; Richard Emmons, M.D., Public


SEPTEMBER 20, 1969


Health Medical *,if ,, and James Chin, Head, Epidemi-
ology, Bureau of Communicable Diseases, California State
Department of Public Health; Samuel Giammona, M.D., Pro-
fessor of Pediatrics, and William Nyhan, M.D., Professor
and Chief of the Department of Pediatrics, University Hos-
pital of San i' .'.' County.)


Editorial Note:
The death of this child 133 days after the onset of
symptoms makes him the longest known American survivor
of rabies.


SUMMARY OF REPORTED CASES OF INFECTIOUS SYPHILIS


CASES OF PRIMARY AND SECONDARY SYPHILIS: By Reporting Areas August 1968 and August 1969 Provisional Data

August C aive August Cumulative
Auust Jan.-Aug.gu
Reporting Area Reporting Area an.-Aug.
_1969 1968 1969 1968 1969 1968 1969 1968
NEW ENGLAND............. 40 35 250 223 EAST SOUTH CENTRAL ........ 83 102 649 967
Maine................... 1 5 5 Kentucky................. 12 14 115 78
New Hampshire............ 7 Tennessee................ 32 13 197 224
Vermont................. 1 Alabama.................. 23 38 171 420
Massachusetts........... 27 21 150 136 Mississippi.............. 16 37 166 245
Rhode Island............. 8 26 23
Connecticut............. 5 13 61 59 WEST SOUTH CENTRAL......... 315 287 2,396 2.336
Arkansas................. 24 7 137 87
MIDDLE ATLANTIC...........405 327 2,565 2,187 Louisiana................ 74 67 470 586
Upstate New York......... 26 42 184 176 Oklahoma............ .... 3 6 51 56
New York City............ 304 117 1,787 1 ,373 Texas.................... 214 207 1 ,738 1,607
Pa. (Excl. Phila.)...... 13 97 159
Philadelphia............. 20 27 145 169 MOUNTAIN.................. 49 37 412 334
New Jersey............. 46 48 352 310 Montana.................... 1 1 6 7
Idaho.................... 1 6 3
EAST NORTH CENTRAL....... 212 217 1 692 1 .889 Wyoming .................. 1 5 1
Ohio..................... 41 24 250 299 Colorado................. 3 3 34 12
Indiana................. 27 35 233 231 New Mexico............... 15 15 179 103
Downstate Illinois...... 9 19 171 122 Arizona.................. 17 15 128 168
Chicago................. 84 75 603 674 Utah...................... 3 12 8
Michigan................. 49 59 410 546 Nevada................... 8 3 42 32
Wisconsin................ 2 5 16 17
PACIFIC.................... 185 176 1,301 1,176
WEST NORTH CENTRAL........ 46 38 239 261 Washington................ 7 3 39 35
Minnesota................ 5 7 32 34 Oregon................... 3 1 28 24
Iowa.................... 6 5 26 26 California............... 172 171 1,226 1,111
Missouri................. 20 22 114 134 Alaska................... 3 4 1
North Dak,ta............. 3 8 6 Hawaii................... 1 4 5
South Dak ta.............. 2 1 9 26
Nebraska................. 4 1 22 20 U. S. TOTAL............... 1,791 1,715 12,772 12,883
K(ansas.................... 6 2 28 15
S TERRITORIES............... 103 117 793 781
SOUTH ATLANTIC............ 456 406 1,268 3,51) Puerto Rico.............. 102 106 784 739
Delaware................. 3 2 30 23 Virgin Islands........... 1 11 9 42
Maryland................. 13 41 282 J22
District of C lumbia..... h5 55 381 418
Virginia................. 30 43 100 211
West Virginia............. 1 6 13 28
North Carolina........... 18 47 344 434 Note: Cumulative Totals include revised and delayed reports
South Carolina............ 3 3 38 349 through previous months.
Clorgia.................. 1. 5 I 1 7", 589
Florida.................. 731 Ik 0 34 1 ,143














During April, May, and June 1969, the total numbers of
salmonella isolations from humans were 1,604, 1,455, and
1,721, respectively, and the weekly averages for the 3
months were 321, 364. and 430, respectively (Figure 1).
For the same months 837, 699, and 620 nonhuman isola-
tions were reported (Table 2).
Since the beginning of the Salmonella Surveillance
Program at NCDC, a number of gradual changes in the fre-
quencies of isolation of individual serotypes from humans
have occurred. Although the 1968 total number of isolations
of salmonellae increased by 5.8 percent from the 1963
total, the frequencies of isolation of S. enteritidis, S. thomp-
son, and S. saint-paul doubled (Figure 2). In general, these



Figure 1
REPORTED HUMAN ISOLATIONS OF SALMONELLA
UNITED STATES 1965-1969


329


increases have been reported from all areas of the United
States. No explanation for this phenomenon is apparent.
(Reported by the Salmonellosis Unit, Enteric Diseases Sec-
tion, Bacterial Diseases Branch, Epidemiology Program,
NCDC.)



Copies of the original reports from which these data were
derived are available on request from
National Communicable Disease Center
Attn: Chief, Salmonellosis Unit, Enteric Diseases Section,
Bacterial Diseases Branch, Epidemiology Program
Atlanta, Georgia 30333


Figure 2
ISOLATIONS OF S. ENTERITIDIS, S. SAINT-PAUL,
AND S. THOMPSON BY YEAR


5 ENTERITIOIS
--- S SAINT-PAUL
. .----- 5 THOMPSON




-------------
--------------
--


1963 1964 1965 1966


1967 1968 1969


Table 2
Ten Most Frequently Reported Salmonella Serotypes from Humans and Nonhumans
April, May, and June 1969

Human Nonhuman
Serotype Number Percent Serotype Number Percent
typhimurium* 1,323 27.7 typhimurium* 397 18.4
enteritidis 493 10.3 heidelberg 231 10.7
thompson 334 7.0 cholerae-suis K 190 8.8
infants 315 6.6 anatum 96 4.5
newport 305 6.4 infants 83 3.8
heidelberg 293 6.1 saint-paul 82 3.8
saint-paul 183 3.8 kentucky 71 3.3
typhi 130 2.7 thompson 52 2.4
blockley 99 2.1 montevideo 49 2.3
derby 72 1.5 .. ; L- ,:. 44 2.0

Subtotal 3,547 74.2 Subtotal 1,295 60.1
Total all serotypes 4,780 Total all serotypes 2,156

*Includes var. copenhagen 64 1.3 'Includes var. copenhagen 92 4.3


SEPTEMBER 20, 1969


Morbidity and Mortality Weekly Report


SURVEILLANCE SUMMARY
SALMONELLOSIS April, May, and June 1969


2.000-


1,500-


[Poo


500-


0
500

0oo






330


For the first 48 weeks of the Measles Epidemiologic
Year 1965-69*, 22,875 cases of measles were reported to
the NCDC. This is a 4.2 percent decrease in reported cases
from the total for the comparable period during the epidemi-
ologic year 1967-68 (Figure 3).
During the first 36 weeks of 1969, there were 20.258
cases of measles reported (Table 3). This represents a 4
percent increase oxer the total for the same period last
year. Although several areas showed sporadic increases
over individual 4-week periods. the overall increase was
due to excess cases in three of the nine geographic dixi-
sions of the United States. The Middle Atlantic states
showed a 115 percent increase in reported cases; approxi-
mately 0b percent of this was from New York City. The
West North Central states had an excess of 181 cases or


SEPTEMBER 20, 1969


37 percent over the preceding period, mostly from the state
of Iowa. The South Atlantic states reported an excess of
992 cases or a 70 percent increase. This was Itr.. .rrir,.lri I'.
due to marked increases in Delaware and Virginia. Puerto
Rico showed a threefold increase in the same time period.
\1I1l".L 'l some of this increase may represent more
efficient surveillance, it appears that the trend towards
measles control, which began in 1963 with the advent of
live vaccine, has been temporarily lessened and that, at
least in some areas, a resurgence of measles may be at hand.

(Reported by the Field Services Branch, and Statistical
Services Activity, Epidemiology Program, NCDC.)

*The Measles Epidemiologic Year begins with calendar week 41
and ends with week 40 of the following year.


Figure 3
REPORTED MEASLES BY 4-WEEK PERIOD, USA, EPIDEMIOLOGIC
YEAR 1968.69, COMPARED WITH 1964-65 THROUGH 1967-68


48,000-


1964-65 REPORTED
USA, EPID



/
/I 1965-66

// --




i/
k '

It





1966-67





' -^'"" __ \ '*


CASES OF MEASLES BY 4-WEEK PERIOD
EMIOLOGIC YEAR 1968-69 COMPARED
WITH 1966-67 AND 1967-68


Morbidity and Mortality Weekly Report


CURRENT TRENDS
MEASLES United States and Puerto Rico


44,000-


40.000-

o 36.000-
P

S32.000-
w

28,000.


; 24.000

20,000


S16,000


S12.0001

4000

4.000


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


^L


,~? 2' 1~ n ~O I ii ii 9
D(E II Ttl UI I ~r U UI1 LL ~I( OL1
(-rll L"LO






SEPTEMBER 20, 1969 Morbidity and Mortality Weekly Report 331



Table 3
Reported Cases of Measles, by Geographic Divisions, United States
First 36 Weeks 1969 and Comparable Periods, 1967 and 1968


Total
Number Cases per Four-Week Period Ended* 36 Weeks 969 C96o
1969 Dec. 31 Comparable Decrease Decrease
Division 1968
through from from
Jan. 25 Feb. 22 Mar. 22 Apr. 19 May 17 June 14 July 12 Aug. 9 Sept. 6 Sept. 6,
1969 1968 1967 1968 1967
United States 1,173 2,036 2,692 3.794 3,831 3,109 2,085 949 589 20,258 19,520 57,620 (738) 38,100
New England 34 107 106 230 196 150 164 81 34 1,102 1,148 840 46 (308)
Maine 2 2 1 3 8 37 238 29 201
New Hampshire 1 28 31 100 48 18 10 2 238 141 74 (97) (67)
Vermont I I 1 3 2 34 (1) 32
Massachusetts 4 16 13 25 42 43 30 29 12 214 359 343 145 (16)
Rhode Island 4 3 10 1 4 1 23 5 62 (18) 57
Connecticut 23 60 61 94 104 87 120 46 21 616 604 89 (12) (515)
Middle Atlantic 387 574 852 1,508 1,507 1,314 911 289 143 7,485 4,006 2,255 (3,479) (1.751)
New York City 213 366 568 1,078 1,139 823 485 172 61 4,905 2,080 453 (2,825) (1,627)
New York, Upstate 36 57 80 164 90 80 59 20 10 596 1,217 583 621 (634)
New Jersey 89 73 149 122 100 178 124 26 35 896 599 486 (297) (113)
Pennsylvania 49 78 55 144 178 233 243 71 37 1,088 110 733 (978) 623
East North Central 107 230 353 332 333 336 221 147 121 2,180 3,762 5.387 1,582 1.625
Ohio 12 27 36 41 101 67 60 17 14 375 293 1,139 (82) 846
Indiana 26 46 121 108 98 50 4 12 1 466 671 593 205 (78)
Illinois 9 52 75 44 44 113 68 58 32 495 1,360 952 865 (408)
Michigan 13 30 35 26 22 35 46 23 43 273 264 921 (9) 657
Wisconsin 47 75 86 113 68 71 43 37 31 571 1,174 1.782 603 608
West North Centrol 34 44 113 104 102 74 18 22 13 524 383 2.848 (141) 2,465
Minnesota I 1 1 2 2 7 16 132 9 116
Iowa 14 27 64 71 81 58 9 4 1 329 98 748 (331) 650
Missouri 1 10 3 1 1 6 4 26 81 333 55 252
North Dakota 2 3 1 1 2 2 3 14 133 862 119 729
South Dakota 1 2 3 4 52 1 48
Nebraska 20 13 36 29 15 12 3 7 3 138 41 628 (97) 587
Kansas 4 3 7 10 93 3 83
South Atlantic 233 374 401 470 437 243 199 74 59 2.490 1,498 6,870 (992) 5,372
Delaware 1 2 19 I11 94 98 44 4 373 16 46 (357) 30
Maryland 1 4 6 2 17 3 30 2 10 75 96 157 21 61
District of Columbia -- 6 22 6 16
Virginia 62 116 212 205 210 19 30 28 1 883 295 2,188 (588) 1,893
West Virginia 21 22 58 30 19 9 5 15 14 193 288 1,383 95 1,095
North Carolina 5 31 49 44 25 83 62 9 7 315 282 848 (33) 566
South Carolina 13 27 8 24 21 9 6 2 6 116 12 511 (104) 499
Georgia 1 1 2 4 34 2 30
Florida 130 172 48 54 51 22 22 14 20 533 499 1,681 (34) 1,182
East South Central 19 9 16 5 20 18 13 6 1 107 492 5,177 385 4,685
Kentucky 6 2 10 3 15 14 9 3 1 63 100 1,325 37 1,225
Tennessee 3 3 5 2 2 2 17 62 1,864 45 1,802
Alabama 1 2 1 4 94 1,325 90 1,231
Mississippi 10 4 1 2 4 2 23 236 663 213 427
West South Central 265 571 633 798 843 693 338 216 139 4,496 4,779 17,336 283 12.557
Arkansas 2 1 13 16 2 1,404 (14) 1,402
Louisiana 1 7 63 3 44 2 120 23 155 (97) 132
Oklahoma 1 100 3 1 6 14 10 1 136 117 3,351 (19) 3,234
Texas 264 468 623 733 821 635 326 215 139 4,224 4,637 12,426 413 7,789
Mountain 31 25 78 103 213 135 146 70 51 852 977 4,632 125 3,655
Montana 2 1 1 4 2 5 1 1 17 58 282 41 224
Idaho 29 7 6 12 34 1 89 20 380 (69) 360
Wyoming 51 181 51 130
Colorado 5 1 9 5 79 13 3 21 4 140 501 1,555 361 1,054
New Mexico 9 13 26 59 54 24 32 24 4 245 102 581 (143) 479
Arizona 16 9 12 31 68 84 69 21 41 351 219 1,015 (132) 796
Utah 1 2 3 2 1 9 21 369 12 348
Nevada 1 I 5 269 4 264
Pacific 63 102 140 244 180 146 75 44 28 1,022 2,475 12,275 1.453 9.800
Washington 2 8 17 12 10 5 3 1 1 59 515 5,422 456 4,907
Oregon 20 10 7 84 32 25 13 7 198 511 1,593 313 1,082
California 40 80 116 144 131 104 52 28 24 719 1,412 4,954 693 3,542
Alaska 1 3 4 8 2 138 (6) 136
Hawaii 1 4 7 8 7 8 3 38 35 168 (3) 133
Puerto Rico 30 58 48 117 347 262 302 197 87 1,448 403 2,108 (1,045) 1,705
*Includes revisions through September 6, 1969.






332 Morbidity and Mortality Weekly Report


TABLE III CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

SEPTEMBER 20, 1969 AND SEPTEMBER 21, 1968 (38th WEEK)


IFpr ENCEPHALITIS HEPATITIS
Xiti- BRICL- i'iTHLII Primary including Post- MALARIA
AREA SIS unsp. cases I ,s Serum Infectious
Cum.

UNI ii ''1 1 l1' I '52 I .,, I ,"

NEW ENGLAND.......... 8 1 2 1 1 127 74 2 70
Ma ine.............. 4 7 6
New Hampshire ...... 3 2
Vermont........... .. 5 13 -
Massachusetts...... 5 1 1 1 67 23 1 45
Rhode Island....... 1 34 11 1 5
Connecticut ....... 1 14 20 12

MIDDLE ATLANTIC...... 50 1 6 3 44 216 166 1 238
New York City...... 29 79 67 20
New York, -State. 9 4 5 62 36 1 37
New Jersey ... 9 1 9 24 45 97
Pennsylvania....... 23 1 1 3 1 51 18 84

EAST NORTH CENTRAL... 30 7 27 1 12 160 139 27 231
Ohio............... 6 1 18 4 48 28 20
Indiana............. 16 9 19
Illinois........... 7 4 1 4 33 35 23 144
Michigan........... 12 6 5 4 58 67 4 47
Wisconsin.......... 1 5 I

WEST NORTH CENTRAL... 29 5 1 27 58 1 146
Minnesota .......... 26 1 9 16 8
Iowa ................ 1 3 9 11 15
Missouri........... 1 1 3 21 40
North Dakota....... 1 1 3
South Dakota ....... 1
Nebraska........... 1 4 3
Kansas............. 1 5 4 1 77

SOUTH ATLANTIC....... 34 1 4 2 2 1 5 125 97 2 531
Delaware........... 1 7 4 3
Maryland ........... 21 1 1 17 12 28
Dist. of Columbia.. 1 1 1
Virginia........... 1 1 1 11 11 20
West Virginia...... 7 1 10 8 -
North Carolina..... 7 19 1 236
South Carolina..... 4 3 1 48
Georgia............ 3 32 17 169
Florida............ 4 1 1 1 2 36 23 26

EAST SOUTH CENTRAL... 2 2 1 4 1 57 55 5 93
Kentucky........... 32 21 1 69
Tennessee.......... 1 2 1 14 18
Alabama............. 1 5 7 3 21
Mississippi ........ 1 1 2 6 9 1 3

WEST SOUTH CENTRAL... A 1 1 1 1 2 67 78 11 141
Arkansas........... 7 10
Louisiana.......... 1 1 2 16 16 2 42
Oklahoma........... 7 9 8 53
Texas.............. 2 1 1 1 44 46 1 36

MOUNTAIN............. 1 3 1 -2 36 59 2 124
Montana............ -1 2 8 3
Idaho.............. 1 2 3 3
Wyaming............ 4 -
Clorado............ 2 1 1 9 33 2 105
New Mexico......... 4 4 7
Arizona............ 1 13 7 1
Utah............... 4 1
Nevada............. -- 2 4

PACIFIC............... 4 14 1 42 237 330 17 500
Washington.......... 3 26 30 5
Oregon............. 1 1 25 16 10
California......... 20 4 13 1 41 180 280 17 395
Alaska............. 4 3 -
Hawaii............. 3 -- 2 1 88


I r t il' t -

T'Fcmrellitis, pri-arv: "Ini 1
Sepatitss, serum: :... delete 1
e-'ctitis infection<: "e. 6, !:.J. delete 2
"alaria: Ion'a 1






Morbidity and Mortality Weekly Report 333


TABLE Il1. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

SEPTEMBER 20, 1969 AND SEPTEMBER 21, 1968 (38th WEEK) CONTINUED


MEASLES (Rubeola) MENINGOCOCCAL INFECTIONS, MUMPS POLIOMYELITIS RUBELLA
TOTAL
AREA Cumulative Cumulative Total Paralytic
Cum.
1969 1969 1968 1969 1969 1968 1969 1969 1969 1969 1969
UNITED STATES... 160 20,547 19,760 20 2,395 2,059 498 10 308

NEW ENGLAND.......... 4 1,111 1,159 2 93 121 71 1 19
Maine*............. 8 38 6 6 2 -
New Hampshire...... 238 141 3 7 1 1
Vermont............. 3 2 1 3 1
Massachusetts*..... 3 217 362 37 63 24 6
Rhode Island....... 27 5 1 12 9 3 5
Connecticut........ 1 618 611 1 35 35 38 1 6

MIDDLE ATLANTIC...... 16 7,512 4,065 4 394 371 53 1 31
New York City...... 6 4,917 2,130 75 75 49 9
New York, Up-State. 3 599 1,218 4 76 67 NN 14
New Jersey......... 5 903 607 158 128 4 4
Pennsylvania....... 2 1,093 110 85 101 NN 1 4

EAST NORTH CENTRAL... 25 2,252 3,811 5 330 250 140 73
Ohio............... 3 379 296 1 124 67 2 4
Indiana........... 466 676 1 39 34 36 7
Illinois........... 14 539 1,369 3 49 56 27 5
Michigan............ 7 287 272 95 73 17 24
Wisconsin.......... 1 581 1,198 -23 20 58 33

WEST NORTH CENTRAL... 16 546 385 121 111 22 1 23
Minnesota.......... 7 16 26 26 1
Iowa*.............. 330 99 18 7 18 9
Missouri........... 1 27 81 51 37 1 -
North Dakota....... 1 15 134 1 3 6
South Dakota....... 3 4 1 5 NN -
Nebraska........... 14 157 41 9 6 3 6
Kansas............. 7 10 15 27 1 1

SOUTH ATLANTIC....... 39 2,539 1,510 4 414 412 46 1 27
Delaware........... 7 381 16 2 10 8 5 2
Maryland............ 1 76 100 39 34 7 3
Dist. of Columbia.. 24 24 6 -9 14 3
Virginia........... 883 297 2 53 36 9 2
West Virginia...... 4 201 289 18 11 12 11
North Carolina..... 16 282 69 77 NN -
South Carolina..... 3 120 12 57 56 3 1
Georgia............ 2 4 70 85 -
Florida............ 536 504 89 91 10 1 5

EAST SOUTH CENTRAL... 2 111 496 1 145 187 27 1 19
Kentucky........... 65 100 1 51 85 8 5
Tennessee.......... 17 62 54 54 17 14
Alabama ............ 2 6 94 24 26 2 I -
Mississippi......... 23 240 16 22 -

WEST SOUTH CENTRAL... 34 4,561 4,827 321 307 34 4 35
Arkansas........... 16 2 30 20 -
Louisiana.......... 120 23 85 88 -
Oklahoma* ........... 4 140 123 30 50 5
Texas............... 30 4,285 4,679 176 149 34 4 30

MOUNTAIN............. 13 871 992 45 33 24 14
Montana............ 1 18 58 8 5 2 1
Idaho.............. 89 21 8 11 -
Wyoming............. 51 1 -
Colorado............ I 141 504 8 10 3 7
New Mexico......... 5 252 112 6 6 I
Arizona ............. 6 361 220 10 2 9 4
Utah............... 9 21 3 1 4 1
Nevada .............. 1 5 2 3 .

PACIFIC .............. 11 1,044 2,515 4 532 267 81 1 67
Washington......... 59 533 1 55 39 15 24
Oregon............. 198 525 16 21 13 10
California......... 11 740 1,420 3 440 193 42 1 23
Alaska .............. 8 2 11 2 7 4
Hawaii ............. 39 35 10 12 4 6

Puerto Rico.......... 29 1,509 412 19 20 30 1

*Delayed reports: Measles: Mass. delete 1 Iowa 1
Mumps: Me. 1
Poliomyelitis, paralytic: Okla. delete 1 (1968)
Ruhella: Me. 2







334 Morbidity and Mortality Weekly Report


TABLE III. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

SEPTEMBER 20, 1969 AND SEPTEMBER 21, 1968 (38th WEEK) CONTINUED


STREPTOCOCCAL TYPHUS FEVER
SORE THROAT & TETANUS TULAREMIA THIDTICK-BORNEABES I
AREA SCARLET FEVER FEVER (Rky. Mt. Spotted) AMINALS
i -, C l I wul I uI 7. t" u i.

L IIL' :-.I.... :' .." i" i -l 1 71 1,, 2 7 2 ,561

NEW ENGIAND........... 479 1 1 14 1 10 3 23
Maine.............. 2 1 6
New Hampshire...... 4
Vermont............. 1 14 2 4
Massachusetts...... 03 1 1 1 7 1 2
Rhode Island....... 8 1
Connecticut........ 345 1 7

MIDDLE ATLANTIC...... 188 1 15 5 2 23 42 6 153
New York City...... 17 7 1 10 -
New York, Up-State. 130 3 4 5 6 6 145
New Jersey......... %*"* 1 3 1 3 14 -
Pennsylvania.*...... 41 2 1 5 22 8

EAST NORTH CENTRAL... 301 1 13 2 12 22 3 2 185
Ohio............... 31 1 -- 8 1 63
Indiana............. 71 1 2 45
Illinois........... 52 7 3 10 3 1 30
Michigan........... 91 1 5 4 -- 7
Wisconsin.......... 56 1 7 40

WEST NORTH CENTRAL... 315 10 13 9 8 9 477
Minnesota.......... 8 3 3 3 126
Iowa .*............. 74 1 7 1 68
Missouri........... 6 3 9 3 2 122
North Dakota ....... 83 2 62
South Dakota....... 2 -- -- 1 24
Nebraska.......... 91 1 1 12
Kansas............. 24 4 3 1 1 63

SOUTH ATLANTIC....... 566 1 20 20 32 4 216 12 645
Delaware........... 13 2 3 -
Maryland............ 35 1 4 3 45 3
Dist. of Columbia.. 2 1
Virginia........... 14 72 7 327
West Virginia...... 20 1 2 1 5 1 94
North Carolina..... N 2 5 6 48 1 5
South Carolina..... 40 1 2 1 30 -
Georgia............ 6 1 4 3 9 1 13 2 68
Florida............. 130 1 4 8 1 148

EAST SOUTH CENTRAL... 994 16 11 1 33 4 59 1 355
Kentucky........... 146 6 -- 6 3 12 182
Tennessee.......... 626 4 10 19 39 1 121
Alabama............ 130 5 4 1 5 46
Mississippi........ 92 1 1 1 4 3 6

WEST SOUTH CENTRAL... 581 2 20 18 22 43 16 374
Arkansas........... 2 1 1 10 7 2 28
Louisiana.......... 1 7 4 3 1 29
Oklahoma............ 27 1 7 28 2 55
Texas............... 551 2 11 6 9 8 11 262

MOUNTAIN ............. 1,297 5 14 1 24 2 16 4 115
Montana............ 28 1 1 2 -
Idaho.............. 99 3 1 5 -
Wyoming............ 6 2 5 52
Colorado........... 22 2 3 1 9 3
New Mexico......... 210 1 5 2 17
Arizona............ 73 2 5 22
Utah............... 59 1 2 5
Nevada............. 2 16

PACIFIC.............. 639 9 3 4 41 5 4 254
Washington......... 408 1 2 2 3 4
Oregon............. 62 1 6 3
California......... "" 8 4 31 2 4 247
Alaska............. 62 -
Hawaiit.............. 107 2

Puerto Rico.......... 2 6 20
* *.I r r e cr,-r 'T 'r. r TI .
Typhoid fever: Iowa 1, Hawaii 1
R"SF: Va. 15






Morbidity and Mortality Weekly Report


335


TABLE IV' DEATHS IN 122 L UNITED STATES CITIES FOR WEEK ENDED SEPTEMBER 20, 1969

(By place of o;currence and week of filing certificate. Excludes fetal deaths)


All Causei Pneumonia Under All Causes Pneumonia Under

Area All 65 year l and 1 year Area All 65 years and 1 year
Aes ar E AgInfluenza AA ll Influenza A
All Ages Causes Ages and ver All Ages Causes


NEW ENCLANT:
B.stLon. Mass ---------
Bridgeport, C.;nn.-- ---
Cambridge, as ..------
Fall Piver, MaK s.-- -
Harfrord. Cinn -------
Lowell, Mas -.---------
Lynn, Man -----------
Ner Bedford, Masi ----
New Haven, (.:nrn.------
Providence. R. I -- -
SomervillE, Mia s.-----
Springfic id, Mas.----
Waterbury, (ona.- --- -
WYrcester, Mass -----

MIDDLE ATLAINTIC:
Albany, N. Y.--------
Allentorwn, Pa -------
Buflt lo., N. Y.---------
Camdren, Nr. J.---------
Elizabeth, fI. J.------.
Erie. Pa.------- -- ----
J Ersey CitV, N. J.----
N1Ewark, N J. ---------
New :.r. Citv. N. Y.--
Paterson, N. J.-------
PhiiadElphia, Pa.-----
Pittsburgh, Pa -------
Readng,, Pa.-----------
RochE'ter, N. '.------
Schr-.ect dy, N. .--- -
Scrant:r Pa.- --------
SyracJ: -, N. .-------
Trent:.n, 11. 1 --------
LU li.a, N. Y ----------
Yonkers, I. Y --------

EAST NOiRTH CEnTRAL:
Akron, Oh1 :.------------
Cantnr., i'hi o----------
Chicago. Ill .--------
Cincinnati, Ohi'c.------
Cleveland, Ohi.:.-------
Columbus, Oh- -
Daytn., Ohio-----------
DEtroit, Mich.--------
Evan'ville, Ind.----- .
Flint, Mich.----------
Fort Wayne, Ind.------
Gary, Ind.------------
Grand Rapids, Mach.---
Indir napclis, Ind.----
Madion, Wk;.----------
Mlliaulkc Wii.-------
Ptoria, Ill.----------
Rocktor ,. Ill.--------
South 8ind, Ind.------
Toledo, Oihio----------
YouneiCtowr, Ohio.------

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


no






2 :

.I
,-,


52

3 ,
28








-5








-j





11
17



52
, h

















5
33
51

3 ,'
-5

























113

32
-2











12

251
S7














2.7
i.'
25






'2



113
26















L.
132
32

84
65








47
l-5















47


-Ij
I '2




35
1 3








2 8
I.

21
',*
il


AI









3:
22



'8









ii
-.5
















,7
3-







2i'
112

..

21







It
1 ,



12
333











1 .
-
1-











I-
2'
27

3"
.3

82

25
I?
.'5



31

2-
67
I7

i"
123
31
28


Total 11,920 6,615 394 615

Expected Number 11,796 6,742 347 515


Cumulative Total
(includes reported corrections
for previous weeks)


495,206


283,440


23,155


23,240


Week No.
38


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.----------


1,027 545 49 46
131 57 1 7
213 111 7 13
41 25 2 1
57 21 3 2
91 46 4
63 36 6 2
75 37 3 1
33 20 4 2
86 72 7 1
63 42 9 4
131 55 5 5
43 23 2 4

651 325 24 45
85 42 8
55 24 5 -
46 32 5 1
116 71 9 9
174 72 4 16
66 30 7
29 10 3
80 44 1 1

1,219 589 38 64
49 25 6 2
35 20 1 1
44 28 2 2
141 64 3 10
40 20 2 3
91 56 4 4
245 97 2 6
66 33 5 6
164 81 3 10
120 51 4
112 52 3 8
53 33 3 4
59 29 4 4

431 223 13 37
47 23 3 4
27 16 1 3
109 59 4 10
17 10 1 1
92 40 1 5
19 16 1 1
51 25 2 7
69 34 6

1,510 881 27 74
14 10 1
52 25 2 4
25 20
48 24 4
80 50 3 1
382 223 7 14
88 52 2 7
32 26 1 1
171 103 4 11
43 27 2
114 66 1 8
221 109 3 5
34 24 1
124 63 2 12
48 36 1
34 23 1 3


Mortality data are being collected from Las Vegas, Nev., for possible inclusion in this
Laa V.ga NEv. 21 a 2 1 table, however, for statistical reasons, these data will be listed only and not included in
the total, expected number, or cumulative total, until S years of data are collected.







336


ERRATUM, Vol. 18, No. 36, p. 316

In the artlicl, "Sur veillance Summaiiry, Tetanus-United
Slat-e and Puerto Rico, l19i7," in the footnote containing
part lo (thit "R i ,commenedatiotl of1 thle PHS A\dvisory Com-
nittel' on Immunization Practices Diphtheria. Tetanus.

and Portussis vaccinee (MMi\R. Vol. 15. No. 4s)." under
"Tliereaifter and for all other indillsu:l.-," and in the foot-
note. TI'd a1- init'pedl as TD. It should he corrected to
read "Td*" and "'Td s considered the agent of choice
for immunization .."


SEPTEMBER 20. 1969


THE MORBIDITY AND MORTALITY WEEKLY REPORT, WITH A CIRCULA-
TION OF 18,500 IS PUBLISHED AT THE NATIONAL COMMUNICABLE
DISEASE CENTER, ATLANTA. GEORGIA.
DIRECTOR, NATIONAL COMMUNICABLE DISEASE CENTER
DAVID J. SENCER, M.D.
DIRECTOR, EPIDEMIOLOGY PROGRAM A. D. LANGMUIR. M.D.
EDITOR MICHAEL B. GREGG, M.D.
MANAGING EDITOR PRISCILLA B. HOLMAN
IN ADDITION TO THE ESTABLISHED PROCEDURES FOR REPORTING
MORBIDITY AND MORTALITY. THE NATIONAL COMMUNICABLE DISEASE
CENTER WELCOMES ACCOUNTS OF INTERESTING OUTBREAKS OR CASE
INVESTIGATIONS WHICH ARE OF CURRENT INTEREST TO HEALTH
OFFICIALS AND WHICH ARE DIRECTLY RELATED TO THE CONTROL
OF COMMUNICABLE DISEASES. SUCH COMMUNICATIONS -*:"JLD BE
ADDRESSED TO:
NATIONAL COMMUNICABLE DISEASE CENTER
ATTN: THE EDITOR
MORBIDITY AND MORTALITY WEEKLY REPORT
ATLANTA, GEORGIA 30333

NOTE: THE DATA IN THIS REPORT ARE PROVISIONAL AND ARE
BASED ON WEEKLY TELEGRAMS TO THE NCDC BY THE INDIVIDUAL
STATE HEALTH DEPARTMENTS. THE REPORTING WEEK CONCLUDES
AT CLOSE OF BUSINESS ON FRIDAY; COMPILED DATA ON A NATIONAL
BASIS ARE OFFICIALLY RELEASED TO THE PUBLIC ON THE SUCCEED-
ING FRIDAY.


Z
m
3-
r

-4
m

I, nC
II
rI m C-

0r nC~
r m 1


Mn -4 z
m m z

a -" m(
> t w
m r
z 3- m m
mZ+m


l m


tj I)fEpoLi R'


z II
"m.

1 I I


Morbidity and Mortality Weekly Report


--

o-
Os



0

O
>*ga
W
jS
=




Full Text
xml version 1.0 encoding UTF-8
REPORT xmlns http:www.fcla.edudlsmddaitss xmlns:xsi http:www.w3.org2001XMLSchema-instance xsi:schemaLocation http:www.fcla.edudlsmddaitssdaitssReport.xsd
INGEST IEID EGPGW0BMK_VV8PE4 INGEST_TIME 2012-07-16T17:07:05Z PACKAGE AA00010654_00199
AGREEMENT_INFO ACCOUNT UF PROJECT UFDC
FILES