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:
AA00010654:00203

Related Items

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

Full Text


NATIONAL COMMUNICABLE DISEASE CENTER


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


HEALTH SERVICES AND MENTAL HEALTH ADMINISTRATION


EPIDEMIOLOGIC NOTES AND REPORTS
HUMAN RABIES Elk City, Kansas


Slum.i It t I.k (-1
i I 1-, R 0i 1J


On lOctober 10. 196s. a 13-.,ear-old hoy from Elk C'it. 1 I ... .'
Kan-a-. died after a 6i-da\ illne s that has been diag- I. . .
noi-ed as ralite-. Ilii initial s-\imptonim on Augu t 7 ere
malaie,. anuroxia. nausea, and oimniting. ()\tr the n O 1
da< s he d>\ eloped fi>er. vonfusiomn. hallucination-. n- mH tL O. ,' 1u taniwh a-tnl ]luri an l rrmom nlkr
ness, par.stho ias, and paresis of the right hand and ),,, .,r I'' rouhout hi- iho-p i lizait on. but l 1 4-)-
On \ugu.t 17. (he bov e<|)rienct d increased confu- c 1 -1 ; w% cks. he tppear-d to hai -
and marked respiratory di.,tr, ..-. That ani day mo rint I cr .'. .'rv, "'* r.-piratorr tract -'crotions. HI,
tran-sor to a hospital in HIichita. he -uff.'recil I ar d .. ..." r lai -r-' pirla'ort failur..
respirator., arret, but .a-. resu-scitatid after exporent I no known hitoEr\ if e\po-re t1, ra-
ano\xic s izures. O\r r Ihe next fet' dau\ he s-ufel hliic and thi n .. i a impre on tdunn I- ill ;-
s-\torail ohlier re.i-piratory arrests. Ho I bc aimiCe .oniato-o at t, ,


TABLE I. CASES OF SPECIFIED N $ UNITED STATES
(C l ti t t l i l d i d and de rou h revious )


42nd WEEK ENDED DI (' UMU I.ATI VE. FIRST 42 WEEKS S
MEDIAN
DISEASE October 19, October 21, 1963 1967 MEDIAN
1968 1967 1968 1967 l.)t 1967
Aseptic mnenin tils .................... ..126 108 59 3.559 2,410 1.717
Brucellosis ..... ..................... 3 4 4 185 206 209
Diphth rtia ........................ ..... 14 3 4 181 116 158
Encephalitis, primary:
Arthropod-borne & unspecified ... ...... 36 31 -- 1,115 1.320
Ilnclphalitis, pust-infectious ............. 4 3 405 670
Hepatitis, sruim ......................... 134 54 3.633 1,763 1
Ilepatitis. infectious .................... 1.021 846 718 36.303 31.041 31.07
Malaria ............................... 40 78 4 1,874 1,634 88
Measl' i, rub Inla .................. -. 135 367 784 20.235 59,079 243,982
Meningocioccal infections, total ........... 27 29 39 2.163 1,812 2,251
Civilian ..... ......... ........... 27 29 1.979 1.695
Military ......... ....... ... ......... 184 117
Mumps ............................... 1,169 129.558 -
Poliomyelitis, total ..................... .2 1 2 50 28 77
Paralytic ... ............. ... ....... 2 1 1 50 24 72
Rublla GiGrman mea les) .............. 285 328 45,161 40.987
Streptocuccal sore throat & scarlet fever .... 7,011 7.997 6.149 337,227 360.761 320.599
Tetanus ................. .... ........ 6 3 5 145 183 .14
Tularin ai ................... ....... 3 3 157 147 208
T phoid tIvi r .. ........... .. 9 10 11 312 343 351
Typhus, tick- hoire iRky. Mt. spotted lver) 3 6 2 265 226
Rablits in anir _____

TABLE II. NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum.
Anthrav\:3 a .... ... ................ ... 3 Hahies in man: Kans.-l ...........
Botulism: .. ...... .... .. ..... ..... .. .... 3 ubella. C(ong9 tal Syndrin : .i .. 5
I. ot, tir l>: Tenn.-l. Tex.- ....... .. ... .. 38 .T m T..- .n .. .. i
P lagu : .. ..... ....... ...... hu ur n :* T x.-
Psittaco is:: Conn.- ..... ........ ..... 39
. i- i r t r, ". \ .1' ; .
Typhus, muinn: Ky. 1


Vol. 17, No. 42







Week Ending
October 19, 1968




PUBLIC HEALTH SEF'. L










encephalitis of unknown etiology. Routine hematologic
and chemical tests were within normal limits; cerebro-
spinal fluid revealed a cell count of 87 white cells with
90 percent lymphocytes and a protein of 74 mg percent.
Stool cultures were negative for polio and other entero-
\iruses. Serologic tests were negative for Western Equine,
California, and St. Louis encephalitis and for mumps,
lymphochorio-meningitis, poliomyelitis, psittacosis, and
Rocky Mountain spotted fever. Rabies neutralizing anti-
body showed a rise in titer from <1:5 on serum drawn
August 17 to 1:50 on serum drawn September 6. These
results were confirmed by indirect fluorescent antibody
and complement-fixation tests. Fluorescent antibody stain-
ing for rabies antigen and mouse inoculation studies of
the patient's brain following autopsy were positive, con-
firming the diagnosis of rabies.
Epidemiologic investigation in Elk City revealed a
unique ecological opportunity for the development of human
rabies. The town of 525 people in a rural area of south-
eastern Kansas has an animal population of at least 150
dogs, 150 cats, and an unknown number of stray animals.
Both the human and animal populations are in close con-
tact with a large skunk population in which rabies has
been found. The level of immunization in the domestic
animals against rabies is less than 10 percent. The pa-


OCTOBER 19, 1968


tient had a paper route which covered the entire town.
He was bitten and nipped by many animals several times
per week since acquiring the paper route in January 1968.
Because of the lack of known exposure to a rabid animal,
the boy received no antirabies therapy.
The following recommendations were made by local
and state authorities in Kansas: (1) Vaccination of all
dogs and cats against rabies; (2) Elimination of all stray
animals; (3) A systematic reduction of the wild skunk
population.
(Reported by Donald i M.D., State Epidemiologist,
Kansas State Department of Health; Rosemary Harvey, M.D.,
Director, Division of Preventive Medicine, Wichita-Sedg-
wick County Department of Health; Edgar H. Beahm, M.D.,
Health Officer, Montgomery County Health Department;
Leonard Sullivan, M.D., Attending Physician, St. Francis
Hospital, Wichita, Kansas; Ralph Summer, M.D., Attending
Physician, St. Margaret's Mercy Hospital, Fredonia, Kan-
sas; and a team from NCDC.)

Editorial Note:
This case of human rabies is the first acquired in the
United States in 2 years. In 1967 the two human cases ac-
quired their infections in Africa (MMWR, Vol. 16, Nos. 30
and 31).


CURRENT TRENDS
VIRAL HEPATITIS United States 1968


During the spring quarter (March 31, 1968, through
June 29, 1968) of epidemiologic year* 1967-68, 12,226
cases of viral hepatitis (infectious and serum) were re-
ported in the United States for a rate of 6.2 cases per
100,000 population (Table 1). This was a 22 percent in-
crease over the rate of 5.1 (9,922 cases) for the spring
quarter of the previous year. In addition, it was the third
time since 1952 that the spring quarter incidence was
higher than the preceding winter quarter incidence. This
occurred for the first time in epidemiologic year 1952-53
and for the second time in 1959-60. Both of these years
immediately preceded a peak year in their respective epi-
demic cycle. The number of reported cases of serum hepa-
titis (1.133) for the spring quarter 1967-68 was more than
twice the 534 cases reported for the spring quarter 1966-67.
Increases in rate, ranging from 2 to 58 percent, were
observed in every division but the West South Central
which decreased by 9 percent in the spring quarter of 1967-68
from the comparable quarter in 1966-67. The Pacific divi-
sion experienced the greatest increase in rate (58 percent)
with a major part of that increase due to the almost three-
fold increase in the number of reported cases of serum
hepatitis (627 compared with 233).
The upward trend of viral hepatitis continued through
the summer quarter (June 30, 196S, through September 28,
1968) of epidemiologic year 1968-69. There were 12,659
cases of viral hepatitis reported for an incidence of 6.3
cases per 100.000 population (Table 2). This was a 31
percent increase over the rate of 4.8 (9,523 cases) in the


summer quarter of the previous year. Cases reported as
serum hepatitis ( 1,231) in the 1968-69 summer quarter were
more than twice the number reported for the corresponding
quarter of 1967-68.
The 31 percent increase in rate for the United States
as a whole reflected rate increases in all divisions except
the West South Central which had a decrease in rate of 24
percent. Rate increases among the remaining divisions
ranged from 17 to 69 percent with the New England divi-
sion experiencing the highest increase. The increased
numbers of cases reported as serum hepatitis accounted
for a large part of the total viral hepatitis rate increases
in the Middle Atlantic and Pacific divisions.
The pattern of viral hepatitis during the spring quarter
of 1967-68 and the summer quarter of 1968-69 can be seen
in relation to previous years in Figure 1. Two peaks in
the curve are apparent; the 1953-54 peak was followed by
a progressive 5-year decline in incidence until 1958-59
when a reversal in this downward trend occurred. This
was followed by a second peak year, 1960-61, 2 years
later. The progressive decline in incidence, following
the 1960-61 peak, reversed itself during epidemiologic
year 1966-67, 6 years after the previous peak year. This
reversal has continued through the summer quarter 1968-69.
The rates in the first 3 quarters of 1968 were higher than
rates for the comparable quarters of 1967. In contrast,
preceding the peak (1960-61) of the last epidemic cycle,
the rates for the first 3 quarters of 1960 were markedly
(Continued on page 396)


Morbidity and Mortality Weekly Report

HUMAN RABIES (Continued from front page)







Morbidity and Mortality Weekly Report


Table 1
Reported Cases and Incidence of Viral Hepatitis, by Geographic Division
Spring Quarters 1967-68 and 1966-67


I.'
1,1 u*i'. I.,) Iii.


I)in i-ion




1 united f'Slaw-
No% England
M iddle \ilanlit
E i North (Contral
\\eot North Contral
South \tlantic
Ea tl Souilh C iiltral
l -l Soutiih C('i nral
Mouintuain
Parific


Ilifil tl
I I



1

17

11;
0 i
'::::


.8)1
Infectilou
ilpat it I.





1;IL79
1012

1.,9 f





-127
S1 17


I "s3
1,. I





lio:)s
1.1) 1


197
:'.150


.1 I Ii ,


teru llln
iHlpalr 1

1 3 1 :',
61.17.

.19


fi


I:
17!


InfiectioI



SI
1.7 1




!):*, 7
717

ill i


:.98 7


1 lI;
I I;
I' i




-'hi
1 i. ll
971
:i00
'-'. ^ I ^


I -, 1






ii)i





91 i


'1 I ii ui I
** ( >*t p> 100. ,00 -n pul IU ..n 1- ,d o U n I ( .. 1 Ni l ". .tr ihnm .- ,)ul 1 1 90 ; .>nsl ...l. I 1lt67

Toble 2
Reported Cases and Incidence of Viral Hepatitis, by Geographic Division
Summer Quarters 1968-69 and 1967-68
(fhani froti m 'uriinri r
Sunimmer Qua:rlr SunLier Quarter (Quarter EY' 196T7-fi
,lul\ 2, 19fT-Sept. 3 ,). 1967 june 30. 19iTh -S 2p. 1 istI J u urirrnr Quarl-r
(Georalphic E __ 19is-
D i ision i ... i ,
,,,,I um [III I I Uil .TF Ta .

Hepatiti- Htep tatiti l putitit 1fpal t1 Hopn R

UIniied State- 102 .921 9.18), 4.. 1.2; 1 1 1.1 12.1 2. i.: 1 1
Neiv England 15 11: 3 .ti :0 tli)9 19 (. I '.. 119
\idfdle \tlantii _' 1 .;9) 1 il(; 4.1 11 1 .731; 2. 1(9 3.9 .i -:
East North Central 2:3 1 mi l. '91 :.: 41 1 1.9! 1.t i .1 ::I 13 '-
i\\e t North Central 7 :>:0 :)17 .1 17 i(f; 1 1.1 -i 1 12 l .
South Allantic 30 1.0(17 1 ,037 3.5 () 11 1.242 4. 1 -: -17
Ean t South Contral 579 1 5 4 ..i 10 62 (692 3.5 107 "1'
\\V-t- south e( ntrrnl 2'2 1..();0 () ,.4 3.3 7il 79; 1.1 2; 1 '2
Mountain 1 :81il 36i 1.7 .3 ..~ :)l; 7.1 19 1
Pa'ifi c 271) 2.:S0l 2 .l) 111.3 ti17 2. 7 2 1 4, 199 16. 1 >I10 ,

'li.it p".rr 1lt.00 O p01 l p ui, l ic 0l -.i- l Linm.tl.- J 1, 1 7, id J Il i ili1


Figure 1
VIRAL HEPATITIS INCIDENCE
BY FOUR-WEEK PERIOD
USA
SINCE JULY 1952


30" i i


-- ........... o ----
Wee Nube I27 I 27
Yoer 952 953


217 27 27 27 2 27 27 27 7 27 27 7
1958 1959 1960 '961 1962 1963 1964 1965 1966 1967 968


OCTOBElU 19. 1N68


TI


'l :r


27 I 27 I 27 I 27
1954 1955 1956 1957







392 Morbidity and Mortality Weekly Report


TABLE III. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

OCTOBER 19, 1968 AND OCTOBER 21 1967 (42nd WEEK)

ENCEPHALITIS HEPATITIS
ASEPTIC Primary
[1111 1 I I I. SII I tll'I F I I \Po st-
AREA MENINGITIS including ous Serum Infectious MALARIA
Infectious Serum Infectious
unsp. cases
1968 1967 1968 1968 1968 1967 1968 1968 1968 1967 1968


UNITED STATES... 126 108 3 14 36 31 4 134 1,021 846 40

NEW ENGLAND.......... 6 1 2 10 56 43
Maine .* ............ 1 2
New Hampshire ...... -- 2 2
Vermont ............ 5 -
Massachusetts...... 2 2 24 19 -
Rhode Island....... 4 1 -- -- 6 5
Connecticut.......... 10 18 15

MIDDLE ATLANTIC...... 31 11 6 2 1 47 186 157 8
New York City...... 2 0 7 26 57 64
New York, up-State* 1 31 25 1
New Jersey......... 10 2 2 19 51 34 1
Pennsylvania....... 1 2 3 2 1 2 47 34 6

EAST NORTH CENTRAL... 18 8 11 10 2 13 165 134 2
Ohio ............... 11 4 10 8 1 3 35 27
Indiana.*.......... 16 14
Illinois............ 1 3 -- 1 4 55 62 1
Michigan............ 6 1 -1 1 6 52 29 1
Wisconsin. .... .. 1 7 2 -

WEST NORTH CENTRAL... 1 1 1 4 3 38 45 6
Minnesota .......... -1 3 3 8 8 3
Iowa............... 8 7 -
Missouri........... 15 24 1
North Dakota....... -
South Dakota ..... -
Nebraska.......... 1 2
Kansas.. ........... 1 1 6 4 2

SOUTH ATLANTIC....... 8 33 1 3 4 124 78 9
Delaware.......... -- 6 -
Maryland........... 1 24 14 13
Dist. of Columbia 1 1
Virginia........... 1 1 23 13
West Virginia...... 1 3 1 4 10 -
North Carolina..... 1 3 1 3 3 7 9
South Carolina..... 1I 10 3
Georgia.......... 1 17 18
Florida ............ 4 2 -- 52 7

EAST SOUTH CENTRAL... 3 5 2 1 1 1 84 64
Kentucky........... 2 1 42 24
Tennessee.......... 1 4 1 1 18 26
Alabama ............ 7 4 -
M ssissippi........ 1 17 10

WE I SOUTH CENTRAL... 8 5 12 2 2 75 82 2
Arkansas ......... 2 11 13 1
Louisiana..*...... 3 2 10 1 1 14 13 1
Okl ahoma........... 3 1 3 15
Texas *............. 2 2 1 1 47 41

MOUNTAIN............. 4 1 41 24 1
Montana.*...... ... 4 3 1
Idah ..............- 9 1
Wyoming.............
Colorado........... 3 1 12 4
New Mexico ......... 7 6
Arizona............ 4 5
Utah............... 5 5
Nevada. ............

PACIFIC.............. 47 44 1 12 7 1 59 252 219 12
Washington ........ 2 25 20 1
Oregon............. 4 3 3 16 13
California......... 33 1 12 6 1 56 205 185 11
Alaska ............ 1 1
Hawaiil............. 1 8 5


Aseptic meningitis: Tex. delete 1
Diphtheria: N.Y. Upstate 1, Tex. 9
Encephalitis, primary: Tex. delete 1
Hepatitis, serum: Ind. delete 1, D.C. 6
Hepatitis, infectious: Me. 6, La. delete 1,


Tex. delete 3, Mont. delete 2


S. s ..... .... i 21 31







Morbidili andl Mortality Weekly Report ::



TABLE Ill. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

(XTOBFR 19 1968 AND (X:ITBER 21, 1967 ((42i WEEK) CONTAIN ED


M1EASIES (Rubeola) MENING(OCOCCAL INFECTIONS, M' POLIOMYELITIS RI-ILA
TOlAL
AREA T" I a I lv IV t
ARA Cumulati e Cumu lativ I rvt


UNITED STATE ... 135 20,235 59,079 27 2,163 1,812 1,169 .2

NEW ENGLAND.......... 7 1,172 881 125 73 108 -
M.ine. ............ 38 248 6 14 -
New Hampshi r ..... 141 77 7 2 9
V r month ............ 2 34 1 1 14
Missa, huset t ..... 1 365 369 64 14 61 1
Rhode Islnd ....... 6 62 9 4 10
Connecticut........ 6 620 91 38 29 -

MIDDLE ATLANTIC...... 30 4,162 2,327 4 390 297 34 -
New York City...... 22 2,196 476 2 80 52 26 12
New York, Up-Statt* 7 1,239 598 69 73 NN -
New Jersy....... 1 612 502 2 136 97 8 -
Pennsylvania....... 115 751 105 75 NN

EAST NORTH CENTRAL... 27 3,913 5,686 3 261 246 275 1 4 75
Ohio................. 2 299 1,159 2 72 87 26 1 2
Indiana............ 8 693 617 36 26 17 1 15
Illinois........... 2 1,381 1,023 58 57 42 5
Michigan........... 7 291 956 1 75 59 51 1 1 1 29
Wisconsin..... .... 8 1,249 1,931 20 17 139 24

WEST NORTH CENTRAL... 1 394 2,898 114 81 136 3 1
Minnesota.......... 16 134 27 20 7 3
Io a .............. 103 755 7 16 95 I 8
Missouri ......... 81 338 37 16 18 2
North Dakota....... 137 874 3 2 11 -
South Dakta ....... 4 55 5 6 NN
Nebraska ........... 1 43 648 8 13 5
Kansas............. 10 94 27 8 -

SOUTH ATLANTIC....... 6 1,533 7,024 3 432 355 77 3 14
Delaware............ 16 50 8 7 -
Maryland........... 1 103 168 1 36 48 1 -
Dist. of Columbia.. 6 23 15 12 1 1
Virginia.*......... 1 301 2,214 40 42 12
West Virginia...... 1 294 1,413 13 34 40 1 5
North Carolina...... 1 284 894 1 83 71 NN 1
South Carolina..... 12 511 58 30 11 1
eor a............ 4 36 86 53
Florida ............ 2 513 1,715 1 93 58 12 5

EAST SOUTH CENTRAL... 3 500 5,334 2 196 142 44 12
Kentuc ky........... 3 103 1,396 1 90 42 18 1 6
Tennessee ........ 62 1,932 1 57 60 21 6
Alabama............ 95 1,335 26 26 3 -
Mississippi........ 240 671 23 14 2 -

WEST SOUTH CENTRAL... 29 4,918 17,665 7 320 232 89 1 22
Arkansas........... 2 1,404 20 33 1 1 1
Louisiana.......... 24 156 4 92 93 6
Ok I ahma........... 125 3,354 50 17 9 2
Texas.............. 29 4,767 12,751 3 158 89 74 21 2

MOUNTAIN............. 8 1,016 4,737 1 38 35 51 1
Montana............ 58 306 6 3 4 1
Idaho.............. 1 393 11 3 6
Wyoming..... .. 53 181 2 1 -
Colorado........... 1 516 1,590 11 1 7 7
Ner Mexico......... 4 117 I 591 3 12 6
Arizona............ 2 225 1,025 1 4 5 12 3
Utah............... 21 I 382 1 4 10 -- -
Nevada........... 5 269 3 3

PACIFIC .............. 24 2,627 12,527 7 287 351 355 -2
Wahinat. n ......... 5 551 5,514 1 52 5 1 1
Oregon.............. 6 540 1,655 22 7 16b
California......... 13 1,492 5,040 6 205 1 278 279 -
Alaska............. 9 1 0 3 11 3
Hawa ii ............. 35 178 4 12 4 5 2

Puerto Ric ......... 2 436 .2 2 5 1 3 35 2

*Delayt, r po rt : M ,1, e -. delete 4, N.J. del te 3, V delIt, 6
heninoai ,1 infection: yo. 1
Mump': Me. 5
Poliomyeliti-, paralyti.: X.Y. rp-t it 1, Io, a 1, I, t 1
Rubella: Me. 2, Va. 5







394 Morbidity and Mortality Weekly Report


TABLE III. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

OCTOBER 19, 1968 AND OCTOBER 21 1967 (42nd WEEK) CONTINUED


STREPTOCOCCAL TYPHUS FEVER
SORE THROAT & TETANUS TULAREMIA TYPHOID TICK-BORNE RABIES IN
AREA SCARLET FEVER (Rky. Mt. Spotted) ANIMALS
C. um. Cum. um. Cum. Cum.

UNITED STATES... 7,011 6 145 157 9 312 3 265 44 2,826

.EW ENGLAND.......... 744 3 47 9 1 72
Maine.*............. 15 53
New Hampshire...... 1 1 2
Ver-o t ............ 1 47 11
Masiachusetts...... 136 1 5 1 5
Rhode Island....... 49 -
Connecticut........ 542 2 3 1

MIDDLE ATLANTIC...... 101 18 7 1 27 2 21 1 45
New York Cityv..... 1 11 1 15
N-w York, Up-State. 88 4 7 5 1 5 1 38
New Jersey ........ NN 4 1 7
Pennsylvania....... 12 3 3 9 7

EAST NORTH CENTRAL... 534 2 15 11 40 9 3 258
Ohio......... ...... 37 1 2 1 17 7 86
Indiina ........... 82 3 1 3 83
Illinois .......... 171 1 6 8 19 2 1 37
Michigan .......... 147 3 1 14
Wis onsin.......... 97 1 1 2 38

WEST NORTH CENTRAL... 348 1 14 15 34 9 6 700
Minnps.ta .......... 12 2 1 4 218
Iowa ............... 113 4 2 1 1 111
SMis, 'ur ........... 3 1 5 7 25 3 101
North Dakota....... 84 1 109
Souri a D t' ..... 22 3 1 4 97
Nebraska........... 90 3 3 1 25
Kansas.... ......... 24 5 2 39

SOUTH ATLANTIC....... 797 32 11 1 54 1 140 6 333
Delaware ........... 6 1
Maryland........... 85 3 9 18 5
Dist. of Columbia.. 2 2 1 1
Virginia........... 233 4 3 9 1 43 1 117
West Virginia...... 187 2 2 1 43
North Carolina.t... 23 2 2 2 39 12
South Carolina.*... 78 4 1 9
Georgia............ 11 3 4 14 26 1 62
Florida............ 172 12 2 1 18 3 3 92

EAST SOUTH CENTRAL... 1,263 15 8 3 38 51 11 601
Kentucky........... 192 1 1 1 9 10 6 307
Tennessee.......... 809 6 5 16 35 3 264
Alabama............ 69 5 2 4 1 23
Mississippi....... 193 3 2 2 11 2 1 7

WEST SOUTH CENTRAL... 767 2 27 46 3 45 28 3 442
Arkansas........... 19 4 15 3 14 6 2 56
Louisiana.......... 52 1 10 7 6 1 41
Oklahoma.*........ 77 8 14 13 117
Texas.............. 619 1 13 16 11 8 1 228

MOUNTAIN ............. 1,356 1 8 15 5 1 80
Montana........... 19 -
Idaho.............. 159 1- -
Wyoming..... ...... 286 1 3
Colorado............ 456 3 2 4 4
New Mexico........ 271 8 33
Arizona............ 74 1 3 36
Utah............... 91 4 1 1
Nevada. ............ 1 3

PACIFIC.............. 1,101 1 20 4 1 50 1 13 295
Washington ......... 339 1 2 2
Oregon............ 90 1 1 5 6
California......... 527 1 18 3 1 43 1 13 287
Alaska.............. 33 -
Hawaii........... ... 112 -

Puerto Rico.......... 10 1 11 1 4 18

*Delayed reports: SST. Me. 7
Tetanus: N.Y.C. 1
Tularemia: Tex. 1
Typhoid: S.C. delete 3, Okla. 2
Rabies in animals: N.C. delete 1






Morbidity and MInrlality Weekly Report


TABLE IV. DEATHS IN 122 UNITED STATES CITIESS FOR WI K ENI)EI) (XTOBER 19, 1I96X


(By place of occurrence and week


of filing certificate. Excludes fetal deaths)


Area


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, 111.--------
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.--------


Al I a I -

All 65 years
Ages and over


759
275
49
31
37
63
26
30
24
45
49
18
31
27
54

3,322
50
31
162
43
46
39
89
101
1,710
33
395
198
55
132
22
30
82
51
28
25

2,700
87
26
788
172
171
131
83
381
56
49
45
31
79
158
39
123
41
43
30
105
62

874
68
36
41
136
42
94
72
265
55
65


463
152
32
23
20
42
19
24
17
22
21
11
24
19
37

1,906
27
17
100
25
26
25
51
36
1,019
21
210
93
36
87
8
18
49
33
12
13

1,545
52
14
415
89
89
83
47
227
28
24
27
15
47
82
23
89
29
27
25
69
44

536
38
22
20
88
27
67
41
163
32
38


and
Influenza
All Ages


1 year
All
Causes


Area


SOUTH ATLANTIC:
Atlanta, Ca.-----------
Bal t ignore, Md .--------......
Charlotte, N. C.-------
Jacksonville, Fla.-----
Miami, Fla.------------
Norfolk, Va.-----------
Richmond, Va.-----------
Savannah, Ga.-----------
St. Pet-rs urig, Fla.---
Tampa, Fia.-----------
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.----------


All
Ages


1,049
117
205
46
70
94
52
73
28
65
66
182
51

605
79
60
41
124
126
51
37
87

1,113
37
36
22
143
20
72
259
47
164
79
116
61
57

440
52
20
109
21
94
29
65
50

1,657
31
62
25
63
85
464
85
44
144
58
87
200
44
164
55
46


and
Influenza
Al 1 Ages


1 yar
All



35
2
6


Total 12,519 7,089 405 560

Cumulative Totals
including reported corrections for previous weeks

All Causes, All Ages ------------------------- 533,383
All Causes, Age 65 and over------------------- 306,750
Pneumonia and Influenza, All Ages------------- 21,247
All Causes, Under 1 Year of Age--------------- 25,263


Week No.


395


1 r












VIRAL HEPATITIS (Continued frtom page 390)


higher than for the C comparable period in 1959. Thus the
e\tent of (hi pre- ent re'\ eral is not as groat as that oh-
-erted in 1959-60).

fl't por/tid b!/ lf'plil///is I' it., V iral DIist easc/ Sectiiol, /an
Ntat/istic, Sc<'/iloyi Prograrn).

'\lr!>hditii (lt,i .ir' ;um anriztd in terms if ;i .pidtmiohb i' c
', r" hih i/ kr th p.it II be ins: with itlh 27th oeck of thi/
/t,'], tr t.-T- .


INFLUENZA


An outbreak of influenza from which A2, Hong Kong

variantt strains ha\se been isolated has occurred in a school
in Surrey, England. The disease has not spread rapidly
and has been confined almost exclusively to children. In
addition, the influenza epidemic which began in Teheran
during the second Neek of September (MM\IR. Vol. 17,
No. 39) is ,-preading rapidly throughout Iran.-

Isolated cases of A2 influenza continue to be reported
in the I'nited States. Recently, an A2 influenza virus
similar to the Hong Kong strains was isolated in Illinois
from a soldier returning from Vietnam. There have still
been no reported outbreaks of influenza in the civilian

population of the UInited States.


(Reported by KRobrt Muldoon, M.l)., Department of ledi-
ciIne, University of Illinoi.s: and Richard Morris.ey, M.P.II.,
(Chief, Divisin of Laboraorries, Illinoi. Department of
Public Health.)



1III/1O leckly Epidnmiological Record, 4I.(t2):53:7.
211/10 Ieekly Epirien iloyicat l Record, 4/(41):522.


THE MORBIDITY AND MORTALITY WEEKLY REPORT. WITH A CIRCULA-
TION OF 17,000 IS PUBLISHED AT THE NATIONAL COMMUNICABLE
DISEASE CENTER. ATLANTA, GEORG A.
DIRECTOR. NATIONAL COMMUNICABLE DISEASE CENTER
: SENCER. M.D.
CHIEF. EPIDEMIOLOGY PROGRAM I 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 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 SHOULD BE
ADDRESSED TO:
NATIONAL COMMUNICABLE DISEASE CENTER
ATLANTA, GEORGIA 30333
ATTN: THE EDITOR
MORBIDITY AND MORTALITY WEEKLY REPORT


NOTE: THE DATA IN THIS REPORT ARE PROVISIONAL AND ARE
BASED ON WEEKLY TELEGRAMS TO THE NCDC BY THE INDIVIDUAL
STATE HEALTH DEPARTMENTS THE REPORTING WEEK CONCLUDES
ON SATURDAY; COMPILED DATA ON A NATIONAL BASIS ARE RELEASED
ON THE SUCCEEDING FRIDAY









I
m



n a
-I



oc m C

0 .Z >,m ,t,
S Z z

o xr r^ n
a > z Om;
0 a zm > >
Sa a>r- ;




w 0 z
m x 0
,z 0m
-4 r
m -n
>
-

-4





















C
-'n 3



0 m


om
Om



mo


Morbidity and Mortality Weekly Report


OCTOBER 19, 1968

i
Ot g


O
C--*
,L a





C'
Y 1


C'