Morbidity and mortality

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Material Information

Title:
Morbidity and mortality
Uniform Title:
Morbidity and mortality (Washington, D.C. : 1952)
Running title:
Weekly mortality report
Weekly morbidity report
Morbidity and mortality weekly report
Abbreviated Title:
Morb. mortal.
Physical Description:
25 v. : ; 27 cm.
Language:
English
Creator:
United States -- National Office of Vital Statistics
Communicable Disease Center (U.S.)
National Communicable Disease Center (U.S.)
Center for Disease Control
Publisher:
The Office
Place of Publication:
Washington, D.C
Publication Date:
Frequency:
weekly
regular

Subjects

Subjects / Keywords:
Communicable diseases -- Statistics -- Periodicals -- United States   ( lcsh )
Mortality -- Periodicals -- United States   ( lcsh )
Morbidity -- Periodicals -- United States   ( mesh )
Mortality -- Periodicals -- United States   ( mesh )
Statistics, Medical -- Periodicals -- United States   ( lcsh )
Statistics, Vital -- Periodicals -- United States   ( lcsh )
Genre:
federal government publication   ( marcgt )
statistics   ( marcgt )
periodical   ( marcgt )

Notes

Additional Physical Form:
Also issued online.
Statement of Responsibility:
Federal Security Agency, Public Health Service, National Office of Vital Statistics.
Dates or Sequential Designation:
Vol. 1, no. 1 (Jan. 11, 1952)-v. 25, no. 9 (Mar. 6, 1976).
Issuing Body:
Issued by: U.S. National Office of Vital Statistics, 1952-Jan. 6, 1961; Communicable Disease Center, 1961- ; National Communicable Disease Center, ; Center for Disease Control, -Mar. 6, 1976.
General Note:
Title from caption.

Record Information

Source Institution:
University of Florida
Rights Management:
All applicable rights reserved by the source institution and holding location.
Resource Identifier:
oclc - 02246644
lccn - 74648956
issn - 0091-0031
ocm02246644
Classification:
lcc - RA407.3 .A37
ddc - 312/.3/0973
nlm - W2 A N25M
System ID:
AA00010654:00201

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. 40


WEEKLY

REPORT


.Week Ending
4'Ner 5, 1968


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

HEALTH SERVICES AND MENTAL HEALTH ADMINIS'


SERVICE


CURRENT TRENDS
INFLUENZA
An influenza epidemic in Madras, India, was first ob-
served on September 8, following the arrival of a ship from
Singapore with 16 influenza cases on board.l During the
second and third weeks of September over 45,000 cases of
influenza were reported by dispensaries and government
hospitals in Madras. Of these, approximately 1,000 cases
were admitted as inpatients to the city's hospitals.2 Two
strains of influenza A2 virus have been isolated and sent
to the World Influenza Centre in London for confirmation.
An outbreak of influenza-like illness has also been re-
ported in Bombay.
In the United States, five influenza A2 virus isola-
tions have been made, three in New York City, one in


Current Trends NX ./T--.'
Influenza ...... ......... 369
Epidemiologic Notes and
Arboviral Encephalitis United States .......... 371
Follow-up Outbreak of Typhoid Fever Missouri 371
Organic Phosphate Poisoning Brookshire, Texas 376

Seattle, and one in Anchorage, Alaska. All were from per-
sons returning in the last weeks of September from travel
in the Far East. No new outbreaks of influenza have been
reported in the United States, and there has been no indi-
cation of significant pneumonia-influenza excess mortality
(Figure 1).
There have been numerous, well-documented introduc-
tions of the A2/Hong Kong/68 strains into Japan since the
(Continued on page 370)


TABLE I. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous weeks)
40th WEEK ENDED CUMULATIVE, FIRST40 WEEKS
MEDIAN
DISEASE October 5. October 7, 1963 1967 MEDIAN
1968 1967 1968 1967 1963 1967
Aseptic meningitis ...................... 166 85 78 3,275 2.213 1,591
Brucellosis ............................ 8 3 4 177 194 199
Diphtheria.............................. 8 14 7 153 111 147
Encephalitis, primary:
Arthropod-borne & unspecified ........... 44 33 1,022 1,251 ---
Encephalitis, post-infectious ............. 8 4 -" 397 665 -
Hepatitis, serum ........................ 103 45 3,381 1,669 29,761
Hepatitis, infectious .................. .. 976 822 34;292 29,526
Malaria .......... ...................... 47 43 4 1,732 1,533 77
Measles rubeolaa) ....................... 108 224 718 20,036 58,445 242,326
Meningococcal infections, total ........... 23 27 27 2,105 1,756 2,149
Civilian .............................. .22 26 -- 1,923 1,640 -
Military .............................. 1 1 182 116
Mumps ....... ............. .... ........ 849 --- -- 127,257 -
Poliomyelitis, total ..................... 1 2 48 27 73
Paralytic ............................. 1 1 48 23 68
Rubella (German measles) ............... 260 194 44,616 40,411
Streptococcal sore throat & scarlet fever.... 6,421 5,986 5,907 323,517 346,218 310.111
Tetanus .............................. .. 6 4 6 131 173 204
Tularemia .............................. 5 2 5 154 140 197
Typhoid fever .......................... 6 8 15 293 324 328
Typhus, tick-borne (Rky. Mt. spotted fever) 5 3 3 261 282 222
Rabies in animals ....................... 51 61 61 2.710 3.420 3.420

TABLE II. NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax: .......................................... 3 Rabies in man: ...................................... -
Botulism: Mich.-1.................................. 5 Rubella, Congenital Syndrome: .................. ...... 5
Leptospirosis: Hawaii-1, Md.-1........................ 33 Trichinosis: ....................................... 50
Plague .......................... ................. 2 Typhus, murine: Fla.-1 ...... .. .................... 24
Psittacosis: ....................................... 35








Morbidity and Mortality Weekly Report


OCTOBER 5. 1968


INFLUENZA (Continued from front page)


onset of the epidemic in Hong Kong in July. The strain
being incorporated into the new monovalent vaccine.
A\ \ichi'2 6h,. was originally isolated in Japan from a
specimen from a crew member of an Israeli \essel which
arrived from Hong Kong. Despite comprehensive sur\cil-
lance efforts in Japan no outbreaks of A2 influenza ha\e
been identified.
Japan had an extensive epidemic of A2 influenza last
winter at about the same time as the epidemics in the
United State- and the United Kingdom. Last spring in-
fluenza B outbreaks were observed in Japan. and in August
196h a small influenza B outbreak was detected in a re-
mote island population.


(Reported by Morris '.-. I -, M.D.. Ph.., Director.
Division of Laboratories, New York City Department of
Health; Donald R. Peterson, M.11.. Director, Epidemiology
and Communicable Disease Control. King County Depart-
ment of Public Health, Seattle, Washington; Donald K.
Freedman, VM.D., Director, Communicable Disease Control,
Alaska Department of health and I welfare; and Hlideo Fukumi,
M.D., Chief. Japanese Influenza Center, Respiratory Virus
Laboratory, National Institute of Health, Tokyo, Japan.)




t1111O tIt kly Epildeniologicul Record, 4.1;(40:512, 0Oct. 1. 1967S.
211 lindustan Times, N'\\ D)rlhi, Sept. 21 1!)6h.


Figure 1
PNEUMONIA-INFLUENZA DEATHS IN 122 UNITED STATES CITIES


ALL CITIES


8 89DEO B i 8 15 Z Z i 1 t 30 2 81 3 ) 9 i 9
19661 '6' 1964 116 10' 69 62 961


W N CENTRAL E N CENTRAL NEW ENGLAND
75 i0 CITIES 21 CITIES 14 CITIES
200 10
ooo


255



1M 40 44 40 52 4 8 28 06 t Z4 28 S 41 48 52 4 12 16 428 32 40 44 4 $852 4 8 12 816 M N Z 16
360939 38 3 839 196 33969


MOUNTAIN
8 CITIES


8 CITIES
231


430 4 a 4 4 82 1 2024232 1Z 444 48 2 4 8 22 N02424
-6189 3 3 1969


3M MIDDLE ATLANTIC
so0 20 CITIES


4 3i 44 118 a 3 I 18 i 3 O 1 f 1
1968 1969


PACIFIC W S CENTRAL SOUTH ATLANTIC
16 CITIES 13 CITIES 12 CITIES









wtif0 o1o0 4 3 2 4 8 3 ,& s a 4 o 2 40 44 48 23 4 a i 0 44 48 4 a 1 20 4 M 2 6
B 8 169 '6a| 1369 1368|,9


370


U
"
) ~(*W ERMYICI*OLS*OLD-----
u i ClffCT~D NUYB(~1
-"












To date in 1968, a total of 11 confirmed cases of human
disease caused by Eastern encephalitis virus have been
reported to NCDC. Four states, New Jersey, Pennsylvania,
Delaware, and Maryland, reported this virus in human,
equine, or avian populations (MMWR; Vol. 17, No. 30).
In nine New Jersey residents with clinical encepha-
litis and in one with aseptic meningitis, Eastern encepha-
litis etiology was confirmed by serologic testing. Dates of
onset were between mid-July and mid-September. Of the
encephalitis cases, four were less than 15 years old and
four were over 60 years old. Five deaths occurred, includ-
ing the four elderly patients. In addition to the human cases,
115 equine cases were. confirmed in a total of 134 suspect
cases in 12 New Jersey counties between July 22 and
September 22.
A Pennsylvania resident developed a laboratory con-
firmed case of Eastern encephalitis 1 week after camping
in New Jersey. Nine other campers from his group have
remained well. In Pennsylvania 19 of 472 sera from wild
birds were positive for arboviruses by serologic testing.
In Delaware, approximately 1,500 pheasant deaths
occurred in four separate flocks in Newcastle and Sussex
Counties from July through mid-September. Laboratory con-
firmation of Eastern encephalitis virus was obtained in
two of these flocks and also in five of 20 suspect equine
cases.
Eastern encephalitis virus activity was confirmed in
five wild bird flocks, one horse, and five ponies in Wicomico
and Worcester Counties, Maryland.
California encephalitis virus activity has been re-
ported from six states this year (MMWR, Vol. 17, No. 38).
Arkansas and Iowa each reported one confirmed case, while


Kentucky reported two, Wisconsin and Minnesota three
each, and Ohio four cases; 24 additional cases, eight from
Wisconsin and 16 from Ohio, were suspect on clinical
grounds and single serum specimen titers. Of the 10 patients
in Trigg and Calloway Counties, Kentucky, previously re-
ported as suspect cases of California encephalitis viral
disease, only two confirmations were made; paired sera
on the other eight patients were negative.
Since the beginning of this summer four confirmed human
cases of Western encephalitis have been reported from
three states. Two of these were from Texas, which also re-
ported two suspect cases. Colorado and Wisconsin each
recorded one confirmed case.
To date, the only confirmed cases of human disease
caused by St. Louis encephalitis virus have occurred in
southeastern Illinois (MMWR, Vol. 17, No. 37). In addition
to the 16 clinical cases of encephalitis or aseptic meningitis
previously reported from Saline County and vicinity, 23
suspect cases have now been investigated. Further labora-
tory studies on paired sera are in progress.
(Reported by the following health departments and collabo-
rating agencies: Arkansas State Board of Health; Colorado
State Department of Public Health; Delaware State Board of
Health and Delaware State Board of Agriculture; Iowa State
Department of Health; Kentucky State Department of Health;
Maryland State Department of Health and the University of
Maryland Livestock Sanitary Service; Minnesota Department
of Health; New Jersey State Department of Health; Ohio
Department of Health; Pennsylvania Department of Health
and the City of Philadelphia Health Department; Texas
State Department of Health; Wisconsin Division of Health
and the Zoonoses Research Laboratory of the U-d i :.
of Wisconsin; and many EIS Officers.)


FOLLOW-UP OUTBREAK OF TYPHOID FEVER Missouri


Further investigation has revealed that of 189 persons
attending the Church of God summer camp in Audrain County,
Missouri, in early August (MMWR, Vol. 17, No. 36), 38
became ill within 3 weeks of departure from the camp.
Symptoms included fever, malaise, diarrhea, constipation,
abdominal pain, and headache. To date, isolations of
Salmonella typhi have been made from stool and/or blood
specimens from 18 of these patients. Serologic evidence
of infection (typhoid 0 titer equal to or greater than 1:320)
has been obtained on three additional patients. Phage
type C1 has been documented on the 14 isolations tested
to date.
In an attempt to discover a chronic carrier, stool
specimens for culture were obtained from all persons known
to have attended the camp. To date, three isolations from
asymptomatic persons have been made; all were from young
siblings of documented cases. No previously documented
typhoid carrier is known to have been associated with the
camp in any way.
Epidemiologic evidence implicates the camp drinking
water as the vehicle of infection. All water was obtained
from a well located on the camp grounds. However, cul-


tures of the well water, first performed 2 weeks following
the close of the camp meeting, failed to reveal bacterial
contamination. In addition fluorescin dye placed in the
camp latrines at that time has not yet appeared in the well
water.
Efforts to discover a chronic carrier among the camp
participants are continuing.
(Reported by E. A. Belden, M.D., M.P.H., State Epidemi-
ologist, and Elmer R. Spurrier, Dr.P.H., Director, Central
Laboratory, Missouri Department of Health and Welfare;
Mr. William Johnson, Sanitarian, Audrain County Health
Department; Norman J. Rose, M.D., M.P.H., State Epi-
demiologist, and Mary Louise Brown, M.S., Division of
Laboratories, Illinois Department of Public Health; D. L.
Carpenter, M.D., M.P.H., State Epidemiologist, Oklahoma
State Department of Health; D. E. Wilcox, M.D., State
Epidemiologist, Kansas State Department of Health; M. H.
Goodwin, Ph.D., State Epidemiologist, Arizona State
Department of Health; D. L. Blakey, M.D., M.P.H., State
Epidemiologist, Mississippi State Board of Health; Epi-
demiological Services Laboratory Section, Epidemiology
Program, NCDC; and a team of EIS Officers.)


OCTOBER 5, 1968


Morbidity and Mortality Weekly Report


EPIDEMIOLOGIC NOTES AND REPORTS
ARBOVIRAL ENCEPHALITIS United States







372 Morbidity and Mortality Weekly Report


TABLE II. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED
OCTOBER 5, 1968 AND OCTOBER 7, 1967 (40th WEEK)


ENCEPHALITIS HEPATITIS
ASEPTIC Primary
AREA EPTICS ilt'(1ELlOSH IIPHTHERI including Post- MALARIA
AREA MENINGITIS includingg Infectious Serum Infectious
unsp. cases
1968 1967 1968 1968 1968 1967 1968 1968 1968 1967 1968
UNITED STATES... 166 85 8 8 44 33 8 103 976 822 47

NEW ENGLAND........... 6 2 1 1 9 56 44 1
Maine.*............. 2 7 -
New Hampshire ...... 1 -
Vermont............. 2 4 1 -
Massachusetts...... 5 1 30 20 1
Rhode Island....... 1 2 9 8 -
Connecticut........ 1 1 5 10 8 -

MIDDLE ATLANTIC...... 51 3 7 1 2 27 145 128 13
New York City...... 19 1 20 92 40
New York, up-State. 5 3 2 6 23 33 1
New Jersey......... 14 27 1
Pennsylvania....... 13 2 4 1 1 30 28 11

EAST NORTH CENTRAL... 16 4 17 12 2 7 128 109 2
Ohio.*............. 5 1 13 9 1 19 22 -
Indiana............. 5 21 -
Illinois............ 2 1 3 1 2 40 25 1
Michigan ............ 11 1 3 5 53 36 1
Wisconsin .......... 11 5

WEST NORTH CENTRAL... 7 7 2 4 5 70 58 3
Minnesota.......... 5 2 1 1 28 8 1
Iowa. .............. 1 2 5 6
Missouri........... 15 42 1
North Dakota....... 1 2 -
Soith Da'ota .. ... 1 7
Nebraska ........... 2 2 1
Kansas............. 1 5 1 2 11 -

SOUTH ATLANTIC....... 17 24 4 4 1 3 1 7 106 98 16
Delaware............ 1 3 12 1
Maryland .......... 5 18 17 12 1
Dist. of Columbia.. 1 1 -
Virginia.......... 3 4 3 1 5 5
West Virginia...... 7 1 1 23 4
North Carolina..... 7 8 8
South Carolina..... 1 7 7
Georgia............ 4 16 16 5
Florida............ 2 2 1 6 27 33 1

EAST SOUTH CENTRAL... 6 1 1 1 68 61 -
Kentucky ........... 14 12 -
Tennessee.......... 6 1 1 28 18 -
Alabama............ 1 20 11 -
Mississippi........ 6 20 -

WEST SOUTH CENTRAL... 6 5 3 1 4 2 72 90 -
Arkansas........... 4 6 -
Louisiana.. ....... 2 3 2 3 12 14 -
Oklahoma............ 1 2 1 2 11 -
Texas............... 3 1 1 2 54 59 -

MOUNTAIN............. 4 2 1 4 2 57 30 4
Montana............ 1 2 11 -
Idaho.............. -
Wyoming............ -
Colorado .......... 3 2 4 2 35 3
New Mexico......... 5 11 -
Arizona............ 8 6 1
Utah............... 4 2 -
Nevada............. 3 -

PACIFIC............. 53 37 9 6 2 51 274 204 8
Washington......... 1 4 2 1 1 22 16 1
Oregon............. 8 6 13 5
California......... 43 25 7 5 2 50 235 182 7
Alaska............. 1 i1 1
Hawaii............. 2 3

P.rt. R ........ ~- I -- 22 11


*Delayed reports: Aseptic meningitis: La. 1
Diphtheria: La. delete 2
Encepha.litis, primary: La. delete 2
Encephalitis, post-infectious: Iowa 1, La. 2
Hepatitis, infectious: Me. 7, N.J. delete 8,


Ohio delete 1, La. delete 1, P.R. 3








Morbidity and Mortality Weekly Report 373


TABLE III. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

OCTOBER 5, 1968 AND OCTOBER 7, 1967 (40th WEEK) CONTINUED


MEASLES (Rubeola) MENINGOCOCCAL INFECTIONS, MUMPS POLIOMYELITIS RUBELLA
TOTAL
AREA Total Paralytic
AREA Cumulative Cumulative Total Paralytic
Cum.
1968 1968 1967 1968 1968 1967 1968 1968 1968 1968 1968
UNITED STATES... 108 20,036, 58,445 23 2,105 1,756 849 1 1 48 260

NEW ENGLAND.......... 3 1,168 860 3 124 71 80 1 34
Maine ............. 38 242 6 3 2 4
New Hampshire...... 141 74 7 2 3 -
Vermont ............ 2 34 1 1 7 1
Massachusetts...... 2 367 357 1 64 33 36 1 14
Rhode Island ....... 6 62 9 4 7 3
Connecticut........ 1 614 91 2 37 28 25 12

MIDDLE ATLANTIC...... 27 4,156 2,302 4 380 288 43 12
New York City...... 14 2,163 472 1 76 51 25 5
New York, Up-State. 4 1,227 594 1 68 70 NN 7
New Jersey.......... 6 646 490 131 94 18 -
Pennsylvania....... 3 120 746 2 105 73 NN -

EAST NORTH CENTRAL... 23 3,859 5,575 2 257 236 239 3 78
Ohio................ 1 297 1,152 70 81 20 1 7
Indiana............. 7 685 602 35 25 32 1 21
Illinois........... 4 1,378 998 2 58 56 9 1 6
Michigan........... 2 277 943 74 57 33 21
Wisconsin.......... 9 1,222 1,880 20 17 145 23

WEST NORTH CENTRAL... 5 390 2,884 1 114 78 78 4 7
Minnesota.......... 16 134 27 19 5 -
Iowa............. 3 102 750 7 16 70 2 4
Missouri........... 81 337 37 16 2
North Dakota....... 1 135 872 3 2 2
South Dakota....... 4 55 5 6 NN -
Nebraska........... 1 42 642 1 8 13 2 -
Kansas.............. 10 94 27 6 1 -

SOUTH ATLANTIC....... 3 1,528 6,935 5 421 342 56 3 24
Delaware............ 16 49 8 7 3 -
Maryland........... 102 162 34 44 8 1
Dist. of Columbia.. 6 23 14 10 8 1 -
Virginia........... 305 2,197 1 39 40 4 2
West Virginia...... 2 292 1,398 12 32 14 1 13
North Carolina..... 282 861 2 80 71 NN 1
South Carolina...... 12 511 1 57 29 -
Georgia............. 4 36 85 51 -
Florida............. 1 509 1,697 1 92 58 19 8

EAST SOUTH CENTRAL... 496 5,230 2 190 139 24 2 6
Kentucky........... 100 1,340 86 40 2 1 1
Tennessee.......... 62 1,893 1 55 59 18 3
Alabama............ 94 1,329 26 26 2 1 2
Mississippi........ 240 668 1 23 14 2

WEST SOUTH CENTRAL... 18 4,864 17,538 1 310 224 53 23 17
Arkansas........... 2 1,404 20 32 -
Louisiana*......... 1 24 155 88 88 1 -
Oklahoma........... 123 3,351 50 17 2 -
Texas............... 17 4,715 12,628 1 152 87 52 21 17

MOUNTAIN............. 8 1,013 4,705 34 33 60 16
Montana*........... 58 296 6 2 2 -- -
Idaho............... 21 389 11 3 2 2
Wyoming............. 52 181 1 1 -
Colorado............ 7 515 1,577 10 13 32 1
New Mexico......... i 113 591 3 7 -
Arizona.............. 228 1,020 2 4 9 12
Utah................ 21 382 1 4 8 -- 1
Nevada............. 5 269 3 3 -

PACIFIC.............. 21 2,562 12,416 5 275 345 216 1 1 12 66
Washington......... 5 540 5,478 1 40 31 47 1 28
Oregon.............. 1 530 1,630 21 27 10 5
California.......... 15 1,455 4,995 3 199 273 140 1 1 11 31
Alaska.............. 2 140 1 3 10 8 -
Hawaii.............. 35 173 12 4 11 2

Puerto Rico.......... 6 424 2,133 20 13 21
*Delayed reports: Measles: Me. 1, Mont. delete 1
Meningococcal infections: Ind. delete 1, La. delete 1
Mumps: Me. 3
Rubella: Me. 3, La. delete 1







374 Morbidit, and Mortality Weekly Report


TABLE Ill. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

OCTOBER 5, ,168 AND OCTOBER 7. 1967 ( 40th WEEK) CONTINUED


STREITOCOCCAL TYPHUS FEVER
SORE THROAT & TETANUS TULAREMIA TYPHOID TICK-BORNE RABIES IN
AREA SCARLET FEVER (Rky. Mt. Spotted) ANIMALS
Cum. Cum. Cum. Cum. Cum.
I'r I ,r i ,rI i l t, 1 .I .,


NEW ENGLAND.......... 702 3 1 47 8 1 1 71
M in ....... 17 53
Nw Haphire ...... 1 2
Ver ............ 49 1 47 11
ass i hu tt ...... 77 1 4 1 1 4
Rhode I l nd........ 39 -
('Conn t ut ........ 520 2 3 1

MIDDLE ATLANTIC...... 118 2 17 7 1 24 19 1 43
New York City ...... 3 2 10 1 12
Nw York, Up-'tatr 89 4 7 5 4 1 36
New Jersey......... NN 4 6
Pennsylvania....... 26 3 3 9 7

EAST NORTH CENTRAL... 345 11 10 2 39 8 3 253
Ohio............... 17 1 1 2 16 6 86
I nd i n ............ 94 2 1 3 2 82
Illinois........... 44 5 7 19 2 35
Michigan........... 99 2 1 1 14
Wi ns in .......... 91 1 1 36

WEST NORTH CENTRAL... 334 2 13 2 15 2 34 9 11 658
Minn-ctt.......... 20 2 1 1 6 208
Iwa .............. 117 4 2 1 1 109
Mi ,souri........... 3 1 4 7 1 25 3 2 95
North Dakota ...... 53 105
..urh Di..t ... 17 3 1 4 79
Nebraska........... 88 1 3 3 1 25
Kansas............. 36 2 5 2 2 37

SOUTH ATLANTIC....... 706 1 28 11 55 2 139 8 318
Delaware........... 16 -- 1
Maryland............ 119 3 9 18 5
Dist. of Columbia.. 21 2 1 1
Virginia........... 133 4 3 9 42 1 112
West Virginia...... 216 2 2 3 41
North Carolina.... 11 2 2 2 2 39 12
South Carolina..... 30 3 4 9 -
Georgia............ 8 4 14 26 3 59
Florida............ 152 1 12 2 16 3 1 87

EAST SOUTH CENTRAL... 1,120 15 8 31 3 51 10 582
Kentucky........... 224 1 1 6 10 8 296
Tennessee.......... 677 6 5 16 2 35 2 258
Alabama............. 107 5 2 1 4 22
Mississippi........ 112 3 2 7 2 6

WEST SOUTH CENTRAL... 502 1 26 44 40 28 6 434
Arkansas........... 5 4 15 11 6 54
Louisiana....... 4 1 10 6 6 1 1 41
Oklahoma........... 16 8 12 13 117
Texas.............. 477 12 15 11 8 5 222

MOUNTAIN............. 1,418 8 15 5 78
M ntana. ........... 10 -
Idaho............... 79 1 -
Wyoming ........... 208 1 1 3
Colorado........... 925 3 2 4 4
New Mexico......... 104 8 33
Arizona............ 45 3 36
Utah............... 39 4 -
Nevada............. 8 1 2

PACIFIC.............. 1,176 18 2 4 1 47 1 11 273
Wash ington......... 489 1 2 2
Oregon............. 75 1 1 5 6
Calif rnia......... 454 16 2 3 1 40 1 11 265
Alaska ............. 36 -
awa i i ............. 122 -

Puerto Rico.......... 3 1 10 3 17
*Delayed reports: SST: Me. 11, La. delete 1







Morbidity and Mortality Weekly Report






TABLE IV. DEATHS IN 122 UNITED STATES CITIES FOR WEEK ENDED OCTOBER 5, 1968


375


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

All Causes Pneumonia Under All Causes Pneumonia Under
Area All 65 years and year Area All 65 years ad year
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.--------


697
227
39
24
24
48
43
22
22
48
58
12
50
32
48

3,041
47
35
156
35
35
31
62
46
1,521
22
460
179
70
109
27
27
73
38
28
40

2,525
51
32
736
156
200
129
87
325
31
57
47
38
44
135
33
118
33
37
47
113
76

738
51
19
38
108
22
71
88
203
75
63


409
113
25
15
20
21
32
11
17
23
32
9
37
23
31

1,755
20
26
86
20
19
22
39
20
881
12
255
86
47
65
15
18
51
26
21
26

1,439
25
20
414
92
106
69
49
189
23
29
28
14
32
72
18
78
12
24
32
63
50

461
32
14
24
70
16
45
50
113
55
42


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


1,174
122
250
40
70
102
47
77
59
88
66
195
58

584
97
43
45
111
130
42
27
89

1,173
30
58
24
171
42
91
245
51
122
101
133
44
61

418
44
32
118
20
76
13
51
64

1,470
13
51
19
36
102
470
90
23
115
77
99
145
40
107
54
29

11,820


1 6,595


572


Cumulative Totals
including reported corrections for previous weeks

All Causes, All Ages ------------------------ 508,696
All Causes, Age 65 and over------------------- 292,781
Pneumonia and Influenza, All Ages---------- 20,466
All Causes, Under 1 Year of Age--------------- 24,097


Week No.
40







376


Morbidity and Mortality Weekly Report


EPIDEMIOLOGIC NOTES AND REPORTS
ORGANIC PHOSPHATE POISONING Brookshire, Texas


On August 19 and 20, 196h, a total of six members of
a family in Brookshire, Texas, were hospitalized with
symptoms of nausea, abdominal cramps, vomiting, diarrhea,
fever, leg cramps. miosis, sweating, and salivation. Several
persons had respiratory distress, and five were semi-
comatose on admission. Symptomatic treatment for food
poisoning was initiated; five patients received atropine,
supportive intravenous infusions, and antibiotics; the sixth
patient was treated with atropine and 2-pyridine aldoxime
methochloride(2-PAM chloride) intravenously when organo-
phosphate ester intoxication was suspected approximately
24 hours after admission. Prior to this treatment, this
patient had suffered a respiratory arrest followed by severe
convulsions. Serum cholinesterase levels were below nor-
mal in several patients.
Onset of symptoms occurred 1-7 hours after the pa-
tients ate one of two meals which consisted of tortillas
prepared from flour, baking powder, salt, and lard and a
custard which contained a few tablespoons of flour. Amounts
of all ingredients except the flour had been used in foods
prepared for previous meals. The flour had been bought in
a 100-pound unlabeled brown paper sack from a railroad
salvage store 2 days before the incriminated meal on
August 19.
The dough used in making the tortillas was discarded
and fed to the family's chickens on August 21; eight
chickens died and several of them were thrown out of the
fenced-in chicken yard. Subsequently, two dogs and one
catdied. \h..iO,Ii the dogs and cat could not enter the
chicken yard, they had access to the discarded dead
chickens.
Flour samples from the family's flour bin contained
carbophenothion* (trithion) in concentrations of 3,220 ppm.
Blood samples from the six patients and from two dead
animals are being tested for the presence of carbopheno-
thion. Epidemiologic investigation is continuing to deter-
mine the source of the contaminated flour.


(Reported by Robert Hatcher, M.D., Pesticide Program,
San Benito, M. S. Dickerson, Director, Communicable Dis-
ease Division, and J. E. Peavy, M.D., Commissioner of
Health, Texas State Department of Health; the Pesticides
Program, Food and Drug Administration, Atlanta, Georgia;
and an EIS Officer.)

*(:arbophenothion is O,O-dicthyl S-p-chlorophenylthiomethyl
phosphorodithi tc.


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 C-SEaE *ruTER
D ..0 J. SENCER. M.D.
CHIEF. EPIDEMIOLOGY PROGRAM A.D. LANGMUIR, M.D.
CHIEF, STATISTICS SECTION IDA L. SHERMAN, M.S.
EDITOR MICHAEL B. GREGG, MD.

IN ADDITION TO THE ESTABLISHED PROCEDURES FOR REPORTING
MORBIDITY ANDMORT LI r T- NATIONAL COMMtU.NI. ABLE DIsE ASE
CENTER WELCOMES AC :Cu1 TrS OF INTERESTING OuT, aaTE A OR C A'E
INVESTIGATIONS WHICH ARE OF CURRENT I -TEREtT TO MEALT-
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 T-E .ND. OiODAL
STATE HEALTH DEPARTMENTS. THE REPORTING WEEr COrNCLUDES
ON SATURDAY$ COMPILED DATA ON NATIONAL BASIS ARE RELEASED
ON THE SUCCEEDING FRIDAY.


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