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:
AA00010654:00209

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


Vol. 17, No. 50


WEEKLY

'i,-CR T


-k Ending

kmber 14, 1968


.. ,.





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

HEALTH SERVICES AND MENTAL HEALTH ADMINI


TH SERVICE


EPIDEMIOLOGIC NOTES AND REPORTS
INFLUENZA United States


During the past week. influenza activity has been
reported from 11 additional states. It has been manifested
primarily hy an increase in school or industrial absen-
teeisinm, b an increase in febrile respiratory illness, or
by colleges closing early for Christmas actiono.
Documented outbreaks of A2, Hong Kong, 6b influenza
have been reported from Florida, South Carolina, and
Wyoming. In addition to these states, Georgia, Iowa. Kan-
sas. Ohio, and Oregon, which had previous influenza
activity, have now documented A2, Hong Kong '6 influ-
enza outbreaks. Outbreaks of influenza-like disease have
been reported from Idaho, Indiana, Maine, Massachusetts,


( ONT r

Influ,'n/. Unite, t Sta .

i I I Ifk 'n.,a S.urv 'l1,awl! Pc* N it
Mra le,- R-Ihotde,'- I land . .


iil


South Dakota, and Tennessee. Louisiana and North Dakota
have reported documented isolated ca-e of A\ Hong
Kong'68 influenza.
In all the state-, reporting outbreaks, influenza activ-
ity has been focal and sporadic and limited to either in-
stitutions and'or communities. Attack rates in various
(('fotinued on paqy '6'2,


TABLE I. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous weeks)
50th WEEK ENDED CUMULATIVE. FIRST 50 WEEKS
MEDIAN ___ __
DISEASE December 14, December 16, 1963 19 MEDIAN
1968 1967 1968 1967 1963 1967
Aseptic meningitis ................... 55 35 35 4,253 2,936 2,076
Brucellosis ............................ 1 4 4 221 244 244
Diphtheria.............................. 8 2 5 235 199 199
Encephalitis, primary:
Arthropod-borne & unspecified ...... 37 28 1.392 1.541
Encephalitis, post-infectious ......... .. 4 14 450 739 -
Hepatitis, serum ........................ 107 628 4.533 2,264
Hepatitis, infectious .................... 927 737 758 44060 37,260 36,394
Malaria ................................ 56 36 2 2,287 2,023 103
Measles rubeolaa) .................. ..... 261 414 2.876 21,973 61,513 259,326
Meningococcal infections, total ........... 59 45 58 2.464 2.071 2.683
Civilian .............................. 47 40 2,258 1.942 -
Military ............................... 12 5 206 129 -
Mumps .................. ...... ........ 2,385 144,743 -
Poliomyelitis, total ..................... 1 56 45 98
Paralytic ............................. 1 56 32 89
Rubella iGerman measles) .............. 357 412 47,729 43,478
Streptococcal sore throat & scarlet fever.... 11,496 10'505 8.404 415,198 430.282 377.392
T etanus ............................... 2 7 4 156 223 266
Tularemia .............................. 3 6 4 169 165 236
Typhoid fever .................. ........ 12 4 4 394 392 436
Typhus, tick-borne (Rky. Mt. spotted fever) .- 277 297 251
Rabies in animals ....................... 55 49 64 3,228 4,068 4.068

TABLE II. NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax: ........................................... 3 Rabies in man: ............................... .
Botulism: ........................................... 7 Rubella. Congenital Syndrome: .................. 5
Leptospirosis: ..................... ...... ......... 56 Trichinosis: NYC-3 ........ ......... ....... 64
Plague: ..... .......................... .... 3 Typhus, marine: Fla.-1 ....... .... ... .. 33
Psittacosis: ...................................... 42







Morbidity and Mortality Weekly Report


INFLUENZA (Continued from front page)


communities have ranged from 10 to 20 percent and attack
rates in various institutions have ranged from 10 to 50
percent. The highest attack rates have been reported from
universities and colleges, while highest absenteeism
rates have occurred in the junior and senior high schools.
Currently, 40 states, the District of Columbia, and
Puerto Rico have reported some form of influenza activity.
The current status of influenza activity is depicted in
Figure 1. As illustrated in Figure 2. the reported pneu-
monia-influenza deaths in 122 U.S. cities have exceeded
the epidemic threshold for the second consecutive week,
and pneumonia-influenza deaths in three divisions, the
East North Central. Mountain, and Middle Atlantic, have
exceeded the epidemic threshold for 2 or more consecutive
weeks.
(Reported by E. Charlton Prather, M.D., M.P.H., Director,
Division of Epidemiology, Florida State Board of Health;


Figure 1
INCIDENCE OF INFLUENZA AND INFLUENZA-LIKE
DISEASE BY STATE AS REPORTED TO NCDC
SEPTEMBER 2 DECEMBER 16, 1968


O3- --- -


U


Figure 2
PNEUMONIA-INFLUENZA DEATHS IN 122 UNITED STATES CITIES


j\


S ..


W N CENTRAL E N CENTRAL NEW ENGLAND
in 0 ES 2! CITIES 14 CITIES








MOUNTAIN E S CENTRAL MIDDLE ATLANTIC
S8 CITIES 8 CmES 20 CInES







PA.9 II969599 22D 9652 26 6 9 S66 2ETA SU ATA NTI 6 5

00 PACIFIC WS CENTRAL SOUTH ATLANTIC
IFI ,,


DECEMBER 14, 1968


ALL CITIES


- i Y1 :' -u ,_-' .....







Morbidity and Mortality Weekly Report


J. iE. V (rolan, Ph.lI). Director, Epidemnioloyic lnres, tiia
tions ranch. Ueoria D)epartment of Public 1e altl; John
. A. 1at er, i. 1. .1 .I'. .. Dire tor, I/irision of lPre entire
Medicine, Idaho Department of Hlealth:. A 1 Iarshall, Jr.,
V.D. Ilirector, Divistion of C'ommunicable id/)oeaxe Control.
Indiana State Hoard of IHealth: Arnold Vl. keee. l.1).,
I.P'./I., Chief, Prerentire viedical Serrice. tIora State De-
partment of /Health: Pon E. Wilcoar, 1.0I., Director. Sec-
tion of Epidemiology, Kanas State Department of /Health;
C('harles T. Caraway, D.i.h., Chief. Section of Epiderni-
ology. Louisiana State Department of flealth; Dean II.
Fisher, .D., Commissioner, Department of Health and
Welfare, aine Oepartment of Health and Wfelfare; Vicholas
J. Fiumara, M.D., lV.P.Hl., Director, Oirision of C'ommuni-
cable Diseases, 4assachusetts Department of Public/


Ilealh: I h'eniiet/h os er, Director, i i/;i o ft I) C'1, :,,i ,
cable i/seaseu i rti i akta SfifI Dlieparmit Ioi/ : '.;
Calrin Spe nceir, M.) i. i, 10itinii C ,iif. ind i,;.i ofi, I
entire t1e'dicione. Ohio l), larm'e nt of llr lt, lolr-,
//olmeoi. ).V.Il.. Publilic Health I 'e, rii arii or, o" /i :a ,
Hoard of llc ulth: Iolert I1 a/l, 1'/.D., director, Se,,'iw, ,f
Epidelii/olo yi, S ith C(araolina State Poar/ of IIf/, /: i ,;. ..
Van /hllc reien, l.I)u.. V.P./I .. A(t ,,/ D)r t r. I, ,,
Special Serriceas. Sout/i )akota State epipart, 'en of ll //e, '
C. R. Tucker, iD.,. il.P.HI., Direc tor and l, puly m 11,
sioner for State Sern ices, Di/'isio, n of Pre ,c table Di,
eases. Tennessee Department of Pub/i lla/it: lHe rma, 5.
Parisih, Acting /Director. Division of Prce entire t edi i/ .
ifyomning State Olcpartnment of Public IHea i Officers.)


INFLUENZA SURVEILLANCE Pennsylvania


On December 2. 196B. the Division of Communicable
Diseases, Pennsylvania Department of Health, instituted
a statewide program for influenza surveillance consisting
of 12 surveillance sites throughout the state to monitor
absenteeism in the six state regions (Figure 3). Daily
attendance reports are received from selected elementary
schools, high schools. and industries, and related the
.same day to the Division of Communicable Diseases for
analysis and further investigation if indicated. Approxi-
mately 100,000 people are included in this daily absentee-
ism reporting and comprise approximately 1 percent of the
state's population excluding Philadelphia and Pittsburgh
which have separate surveillance systems. In addition to
the field surveillance, the state laboratory telephones a
daily report identifying the locations of recently confirmed
cases of A2 Hong Kong 68 influenza. This information.
supplemented by pneumonia and influenza mortality statis-
tics from six metropolitan areas, is analyzed. summarized.
and released every 3 days to public health personnel in
the state.
The purpose of this surveillance and reporting system
is to provide current information on the activity of
A2 'Hong Kong 68 influenza in Pennsylvania and to focus

Figure 3
INFLUENZA SURVEILLANCE SITES AND
CONFIRMED CASES
PENNSYLVANIA DECEMBER 11, 1968











'
-... ............. .." .... .

I-31 Stoice Region,
ASue han e Sate Contirmed Case 0 178 Conftrmed Coses
oI0 Confirmed Cos


attention on areas with -.i i increua-d abl-n-
teeism and niortalitv rate-- in an effort to secure earl\
clinical and laboratory\ confirmation of influenza and to
document the effects of a highly communiclable oiru- on
the daily activities of a large population group.
To date. there has been no unexpected increased ah-
senteeism in Penns l\ ania. Although the surceillaiani
system has demonstrated absenteeism of greater than 10
percent between December 9 and 11 in 11 in-titution-.
epidemiologic study of these institutions ha- re etlod
that these rates are either tran-itory ri-e- or normal
values for these institution- (Table 1). A\ of Decem-
ber 13. the state laboratory reported isolation of 22'
A-2 Hong Kong 68-like viruses. Of thee., 17s %aere from
residents of Philadelphia and 25 isolates were from Centre
County, accounting for 91 percent of the confirmed ca es.
In addition, A2 Hong Kong- 6,-like \iruses were obtained
from nine other counties in the state.

Table 1
Institutions by Region with Absenteeism Above 10 Percent
Pennsylvania, December 9-11, 1968

Institutions Population Institutions with
Region under under Absenteeism
Surveillance Sur cillance f10 Percent

I 15 25.614 3
II 15 2bb56 4
III b 91.575 0
IV 7 7.156 1
V 6 100.10
VI 14 9.090 1

TOTAL h5 103,150 11

(Reported by iW. I). Schrack. Jr.. i/.D.. Pircrtoi. I)ioiiom
of Communicable Diseases, Da)is S. Hlail, I In frm:ai,,
Education Advisuor, and Robert E. Lonyyencckcr. Comni nuily
Vaccination Proiect Coordinator. Public Hleath .Adicis~r.
James 41. Prier. D.V.., Ph.D.. Director, 1Diisi) -a of
Laboratories, and 12 Public Hfealth .V r.es, Pernn.ylPaii a
V)epartment of Heolth: and an EIS Officer.)


DECEMBER 14. 19(H









464 Morbidity and Mortality Weekly Report


TABLE 111. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

DECEMBER 14, 1968 AND DECEMBER 16, 1967 (50th WEEK)

ENCEPHALITIS HEPATITIS
ASEPTIC DIPHTHERIA Primary
AREA EINGITIS including infectious Serum Infectious MALARIA
unsp. cases


UNITED STATES... 55 35 1 8 37 28 4 107 927 737 56

NEW ENGLAND........... 3 3 1 1 8 64 38 2
Maine. ............. 3 2 1
Nev Hampshire.*.... 4 1
Ver-ont............ 3 -
Massachusetts ...... 2 3 1 1 32 7
Rhode Island ....... 1 8 7
Connecticut........ 8 14 22

MIDDLE ATLANTIC...... 12 2 3 4 35 187 133 10
New York City...... 6 1 1 20 69 48 2
New York, up-State. 3 5 28 46
Nev Jersey.* ....... 7 42 2 1
Pennsylvania....... 2 2 1 3 48 27 7

EAST NORTH CENTRAL... 12 2 13 7 1 4 155 132 11
Ohio ............... 7 9 2 1 33 35
Indiana ............ 1 14 8
Illinois.......... 4 1 2 2 34 59 9
ichian .......... 3 3 2 53 21 2
Wiconsn.......... 21 9

WEST NORTH CENTRAL.. 1 44 41 1
Minneta.......... 1 11 14
Ioa................ -- 9 7
Mi s uri............ 8 9
North Dakota.......- 1 7
Soith Dakota........ 3 -
Nebraska............ 2 1
Kanss ............ 10 3 1

SOUTH ATLANTIC ....... 1 4 4 4 2 4 99 50 12
Delaware........... 3 6
Maryland............ 1 1 1 18 10
Dist. of Columbia.. 1
Virginia ........... 3 1 2 14 10
West Virginia ...... I 11 8
North Carolina..... 1 16 1 11
South Carolina..... 1 1 8 1 1
Georgia............ 19 9 -
Florida............ 1 4 1 9 5

EAST SOUTH CENTRAL... 3 2 2 2 2 9 62 75 3
Kentucky ........... 1 28 40 2
Tennessee.......... I 9 10 17
Alabama............. 1 13 4 1
Mississippi........ 2 1 2 2 11 14

WEST SOUTH CENTRAL... 4 2 1 2 2 4 2 61 74
Arkansas.......... 1 6 2
Louisiana.......... 1 1 2 2 10 19
Oklahoma............ 1 17 7
Texas.*............ 4 1 2 1 1 28 46

MOUNTAIN............. 12 40 6
Montana............... 1 4
Idaho................ 1 1
Wyoming ............ 1 1
Colorado............. 16 6
New Mexico ......... 10 -
Arizona.............- 1 8
Utah ............... -
Nevada............... -

PACIFIC.............. 20 20 11 8 3 45 243 154 11
Washington .........8 28 13 1
Oregon.............. 2 19 12
California.......... 20 10 11 7 3 42 191 129 10
Alaska............. 2 -
Hawaii............ 2 1 3 -

F2erto, RiL .I........ 8 28


*Delayed reports: Diphtheria: Tex. 4
Hepatitis, serum: N.J. delete 5
Hepatitis, infectious: Me. 8, N.H.


1, N.J. delete 13








lMorbidi t and Mortality W1eekly Report 165


TABLE III CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

DECEMBER 14, 1968 AND DECEMBER 16. 1967 (Soth WEEK) CONTINUED



MEASLES (Rubola) MENINGOCOCCAL INFECTIONS, MUIPS POLIOMYELITIS R H'EL
TOTAL
AREA 3Tl .1i
AREA Cumulative Cumulative T


UNITED STATES.. 261 21,973 61,513 59 2,464 2,071 2,385 56 i7

NEW ENGLAND.......... 43 1,303 930 139 82 376 42
Maine. ............ 38 262 6 3 55 -
New Hampshire...... 8 150 78 8 4 9 -
Vermont ............ 3 34 1 1 56
Massachusetts...... 2 386 395 74 37 146 17
Rhode Island....... 16 55 62 9 6 23 -
Connecticut........ 17 671 99 41 31 87 3

MIDDLE ATLANTIC...... 43 4,617 2,556 12 437 346 51 -
New York City...... 22 2,384 520 3 89 67 23 12
New York, Up-State. 7 1,347 642 72 84 NN 1 5
New Jersey.*....... 5 702 610 9 156 111 28 -
Pennsylvania....... 9 184 784 120 84 NN

EAST NORTH CENTRAL... 49 4,173 6,218 8 309 286 707 10 100
Ohio................ 4 329 1,202 2 84 94 80 2 5
Indiana.*........... 11 730 669 1 44 31 84 3 9
Illinois........... 11 1,430 1,239 3 70 66 57 2 15
Michigan........... 6 328 1,026 1 89 74 200 3 46
Wisconsin......... 17 1,356 2,082 1 22 21 286 25

WEST NORTH CENTRAL... 6 453 2,996 10 138 100 174 3 30
Minnesota. ........ 19 139 29 22 1 I
Iowa............... 2 146 815 3 14 22 167 1 14
Missouri........... 81 340 7 48 21 5 2 7
North Dakota....... 138 890 4 3 8
South Dakota....... 4 58 5 7 NN -
Nebraska........... 4 55 660 9 15 1
Kansas ............. 10 94 29 10 -

SOUTH ATLANTIC....... 46 1,715 7,347 10 492 406 155 3 24
Delaware............ 1 19 51 12 8 4 7
Maryland............ 103 180 3 44 56 6 2
Dist. of Columbia.. 6 25 17 15 1
Virginia............ 17 348 2,326 1 48 45 9
West Virginia...... 11 326 1,477 1 14 38 115 1 6
North Carolina..... 1 321 935 2 98 86 NN 1
South Carolina..... 3 26 514 2 63 33 12 6
Georgia............. 4 42 93 60 -
Florida............. 13 562 1,797 1 103 65 9 3

EAST SOUTH CENTRAL... 3 506 5,509 4 219 166 108 1 17
Kentucky............ 3 106 1,432 3 98 47 69 1 9
Tennessee.......... 64 2,043 68 73 36 --- 8
Alabama............ 95 1,357 1 28 29 2 -
Mississippi........ 241 677 25 17 1

WEST SOUTH CENTRAL... 45 5,268 18,126 7 355 260 236 24 24
Arkansas........... 2 1,404 21 41 1 I -
Louisiana.......... 25 156 3 100 102 -
Oklahoma............ 1 130 3,359 1 56 19 7 2 4
Texas............... 44 5,111 13,207 3 178 98 228 21 20

MOUNTAIN............. 13 1,086 4,893 45 40 114 1 17
Montana............ 58 334 6 5 19 -
Idaho............... 21 405 12 3 5 1
Wyoming............ 55 204 3 1 -
Colorado........... 2 524 1,632 14 13 30 10
New Mexico......... 10 164 607 1 5 21 -
Arizona............. 1 235 1,059 5 6 17 1 4
Utah................ 21 383 1 4 22 2
Nevada............. 8 269 3 3

PACIFIC............... 13 2,852 12,938 8 330 385 464 12 83
Washington.......... 5 601 5,674 51 38 153 1 30
Oregon............. 3 588 1,706 25 30 24 17
California.......... 5 1,617 5,235 8 236 302 261 11 32
Alaska ............ 11 141 4 11 11 2
Hawaii............. 35 182 14 4 15 2

Puerto Rico.......... 10 499 2,242 20 15 25
*Delayed reports: Measles: N.J. delete 1, Minn. 1
Meningococcal infections: Alaska 1
Mumps: Me. 11
Poliomyelitis, paralytic: Ind.1
Rubella: Me. 5








466 Morbidity and Mortality Weekly Report


TABLE III. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

DECEMBER 14, 1968 AND DECEMBER 16, 1967 (50th WEEK) CONTINUED


STREPTOCOCCAL TYPHUS FEVER
SORE THROAT & TETANUS TULAREMIA TYPHOID TICK-BORNE RABIES IN
AREA SCARLET FEVER (Rky. Mt. Spotted) ANIMALS
Cum. Cum. Cum. Cum, Cum.
1968 1968 1968 1968 1968 1968 1968 1968 1968 1968 1968
UNITED STATES... 11,496 2 156 3 169 12 394 277 55 3,228

NEW ENGLAND........... 1,446 4 47 13 2 74
Maine. *............ 47 2 55
New Hampshire...... 32 1 1 -- 2
Vermont ............ 29 47 11
Massachusetts...... 178 1 7 2- 5
Rhode Island ....... 55 -
Connecticut ........ 1,105 2 3 -- 1

MIDDLE ATLANTIC...... 315 19 10 35 22 2 55
New York City...... 9 11 18 -
New York, Up-State. 240 4 7 8 5 2 45
New Jersey......... NN 1 4 7
Pennsylvania....... 66 3 3 .5 '10 10

EAST NORTH CENTRAL... 760 1 17 11 1 49 9 2 284
Ohio... ............ 102 2 1 20- .7 1 93
Indiana............ 181 2 1 7 -. 90
Illinois........... 104 8 8 1 20 2 39
Michigan ........... 210 3 1 17
Wisconsin........... 163 1 2 2 1 45

WEST NORTH CENTRAL... 459 15 1 17 5 45. .9 7 801
Minnesota.......... 32 2 2 2 260
Iowa.............. .. 130 4 2 121
Missouri........... 20 5 1 8 4 30 3 1 117
North Dakota ....... 105 1 1 3 131
South Da.kot: ....... 35 1 3 2 4 97
Nebraska........... 74 3 1 4 1 27
Kansas............. 63 5 4 1 48

SOUTH ATLANTIC....... 1,026 32 12 64 142 11 400
Delaware ........... 9 1
Maryland........... 154 3 18 6
Dist. of Columbia.. 2 1 -- 2
Virginia........... 378 4 3 10 44 5 138
West Virginia...... 165 2 2 1 51
North Carolina..... 14 2 3 4 39 12
South Carolina..... 184 4 .4 9.-
Georgia............ 2 3 4 15 27 4 83
Florida............ 120 12 2 21 3 1 107

EAST SOUTH CENTRAL... 1,657 1 17 2 11 2 48 57 12 695
Kentucky........... 211 1 2 2 12 10 9 374
Tennessee.......... 1,255 1 7 2 7 21 39 2 287
Alabama ............ 65 6 2 1 27
Mississippi........ 126 3 2 13 3 7

WEST SOUTH CENTRAL... 854 31 48 3 54 -30 7 493
Arkansas........... 21 5 15 2 20 6. 62
Louisiana .......... 16 10 7 6 1 2 48
Oklahoma........... 70 9 15 14 1 124
Texas............. 747 16 17 1 13 9 4 259

MOUNTAIN.............. 2,850 1 9 21 5 1 90
Montana............ 212
Idaho.............. 87 -
Wyoming ............ 842 1 1 1 4
Colorado........... 1,104 3 5 4 4
New Mexico.......... 243 8 39
Arizona............ 110 1 6 -- 39
Utah............... 252 5 1
Nevada.............- 1 3

PACIFIC.............. 2,129 20 4 1 65 1 13 336
Washington......... 985 1 2 2
Oregon............. 99 1 I 5 6
California......... 931 18 3 1 57 1 13 328
Alaska ............ 13 -- 1- -
Hawaii............. 101

Puerto Rico.......... 2 12 5 20
*Delayed reports: SST: Me. 9








Morbidity and Mortality Weekly Report


Week No. TABLE IV. DEATHS IN 122 UNITED STATES CITIES FOR WEEK ENDED DECEMBER 14, 1968
50
(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 anfd year
oe Influenza All Influenza All
Ages and over Ages Causes Ages and over All Ages Causes
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.--------


853
272
63
28
36
73
26
19
36
65
68
23
57
30
57

3,960
49
28
168
47
34
50
84
88
2,117
48
549
208
68
119
39
40
85
74
27
38

2,990
67
27
884
196
252
131
91
429
39
45
59
38
59
163
37
177
45
42
54
95
60

898
51
24
53
146
33
128
79
264
89
31


541
158
46
19
23
45
19
15
25
43
37
18
35
19
38

2,309
29
21
112
24
20
28
49
44
1,221
28
301
113
48
83
23
26
52
43
18
26

1,677
48
18
457
126
145
70
54
207
27
27
37
16
36
79
20
118
21
31
41
61
38

535
34
18
27
90
25
72
44
140
67
18


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.----------


1,270
146
242
40
87
135
55
103
40
95
61
214
52

649
106
49
35
89
143
50
60
117

1,362
31
36
42
187
72
86
278
77
168
109
140
73
63

489
45
28
150
18
109
23
51
65

1,684
27
54
18
41
97
513
76
39
160
53
92
203
61
145
72
33


667
64
125
22
48
69
23
59
24
80
28
97
28

374
69
30
20
55
84
27
28
61

715
17
18
23
101
33
52
121
54
78
61
77
46
34

281
22
17
89
8
56
19
26
44

1,018
20
33
13
26
64
315
43
24
93
34
42
132
37
80
45
17


Total 14,155 8,117 703 637

Cumulative Totals
including reported corrections for previous weeks

All Causes, All Ages ------------------------ 636,726
All Causes, Age 65 and over------------------- 365,722
Pneumonia and Influenza, All Ages------------- 25,340
All Causes, Under 1 Year of Age--------------- 30,069








468 Morbidity and M



EPIDEMIOLOGIC NOTES AND REPORTS
MEASLES Rhode Island


From mid-September through mid-December 196b, an

outbreak of 49 cac'e of measles occurred in Providence,

Rhode I-land. Except for see ral small self-limited family

outbreaks. this is the first reported outbreak from Rhode

Island since a s ttate lde a iccination campaign was con-

ductid in Januar\ 1966. \l ost ca-es since the immuniza-

tion campaign. ha\e occurred sproadicall usually second-

ary to infections imported from out of state. In 1968. prior
to this outbreak, onl\ six cases were reported. All were
traced to out of state contacts.

The present outbreak occurred in Portuguese persons,
manl of whomi arrived in the U'nited States after the Jan-

uary 1966 immunization campaign in Rhode Island. The
first case. a 3-year-old boy, developed measles on Septem-

her 15 while \isiling in Portugal. The family returned to

the IUnited States on September 30 and that same day. the

bo 's 6-vear-old sister had onset of illness and exposed
her 6-year-old cousin. All the remaining cases have been

traced to school contacts of the sister of the first case.

Special immunization clinics have been conducted in this

area of the city and plans have been made to immunize

persons from Portugal as they arrive in Rhode Island.
(Reportcd by Joseph E. Cannon, M.D., I.P.H., Director of

llealth. I/hode Islani Department of Health: and an EIS
Officer.)


.2 3r~ I tIlTe i


ERRATUM, Vol. 17, No. 45, p. 424

In the article "Quarantine Measures" under New York

City. Pan Medical Associates, the "No" after fee should
he changed to "Yes."


)rtality Weekly Report


DECEMBER 14, 1968


THE MORBIDITY AND MORTALITY WEEKLY REPORT, WITH A CIRCULA-
TION OF 17,000 IS PUBLISHED AT THE NATIONAL COMMUNICABLE
DISEASE CENTER, ATLANTA, GEORGIA.
DIRECTOR, NATIONAL COMMUNICABLE DISEASE CENTER
DAVID J, SENCER, M.
CHIEF, EPIDEMIOLOGY PROGRAM A- 0. LANGMUIR. M.D0
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
AT CLOSE OF BUSINESS ON FRIDAY; COMPILED DATA ON A NATIONAL
BASIS ARE RELEASED ON THE SUCCEEDING FRIDAY.


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