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:
AA00010654:00215

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 C





35" ," .









U.S. DEPARTMFNT OF HEALTH, EDUCaTiuoN ari, WEL r WL t
DATE OF RELEASE r.IAy 16 1969


EPIDEMIOLOGIC NOTES AND REPORTS
PSITTACOSIS Baltimore, Maryland

Since January 1969, four clinical cases of psittacosis
in humans have occurred in residents of the Baltimore
metropolitan area. All four persons gave a history of close
association with recently purchased psittacine birds that
had been ill with characteristic signs of psittacosis. All
four birds had died approximately 2 weeks prior to onset
of the associated human case.
The first patient, a 55-year-old man, was admitted
to a Baltimore hospital on January 1 because of severe
respiratory distress, jaundice, and obtundation. He was
treated with tetracycline and :r .i.l ii recovered. His


Vol. 18, No. 19






For

Week Ending

May 10, 1969


ATLANTA GEORGIA 3C


Ii': dnl iP-itt.U.o.-i lllin.,r ^

liphthI r -)- I'ln lo \
Monko, -- N- 1 IX
Fllos-up Outbr, u" r
Inur of the, Oreni \1
Su""Ii,r\ of lR'ieportd ('-.


of Inf- l. phi
if[fak e *',[h l


acute and convalescent sera had complement fi\xaton ((F)
tigers against psittaco- is from 1:64 to 1:1..(24. The
second patient. a 5S-year-old woman. was hospitalized
K(' iinAtu sei pln p C It;')


TABLE I. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous weeks)
19th WEEK ENDED CUMULATIVE. FIRST 19 WEEKS
MEDIAN
DISEASE May 10. May I1, 1964- 1968 EDIAN
1964 -1968
1969 1968 1969 1968 1964 1968
Aseptic meningitis .................... 23 25 26 537 544 530
Brucellosis ............................ 3 6 6 40 55 77
Diphtheria.................. .......... 1 1 48 66 66
Encephalitis, primary:
Arthropod-borne & unspecified .......... 19 26 32 373 304 463
Encephalitis, post-infectious ............. 9 14 24 104 201 311
Hepatitis, serum ........................ 97 83 1,919 1,427 1
Hepatitis, infectious .................... 914 929 I 769 17.496 15,967 1513
Malaria ................................ 103 25 3 939 787 102
Measles rubeolaa) ....................... 916 836 8,095 12.452 12.854 142,413
Meningococcal infections, total ........... 60 36 56 1.631 1,350 1.350
Civilian .............................. 58 34 1,484 1,219
Military ............................... 2 2 147 131
Mumps ................................. 2,541 4,093 46,852 93.747
Poliomyelitis, total ......... .......... 1 18 8
Paralytic .................... .... 1 18 7
Rubella (German measles) ............ 3.106 2.283 9.465 28,158
Streptococcal sore throat & scarlet fever.... 8.364 9.016 9 246 211.299 208.024 208,024
Tetanus ............................. 5 3 4 40 39 55
Tularemia .............................. 2 34 5 33 59 59
Typhoid fever .......................... 14 7 7 97 92 117
Typhus, tick-borne (Rky. Mt. spotted fever) 11 5 3 21 16 12
Rabies in animals ..... .............. 77 79 93 1,487 1 464 1 704

TABLE II. NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax: ........................................... 1 Rabies in man: .......... ........ ........ .
Botulism: .................. ......................... 9 Rubella congenital syndrome: .
Leptospirosis: Hawaii-2 ............................. 16 Trichinosis: ....... ..... ........ ............ 30
Plague: ................... ......... .. .. ......... T phus, murine: ......... .. ... 5
Psittacosis: Md.-2 ................... .............. 12
*Delayed reports: Trichinosis: Colo. delete 1.






Morbidity and Mortality Weekly Report


PSITTACOSIS (Continued from front page)


on April 10 because of fever to 104F and severe pneu-
monia. She was treated with penicillin and slowly re-
covered. A single convalescent blood had a CF titer of
greater than 1:256 against psittacosis. The third patient
was admitted to a hospital on April 3 with fever, pneu-
monia, and toxemia. She also was placed on tetracycline
and made a gradual recovery. She had acute and convales-
cent titer values of 1:64 to greater than 1:256. The fourth
patient, an R1-year-old girl, was hospitalized on April 1.
She had been started on penicillin and tetracycline at
home 5 days before hospitalization. Sera drawn 2 weeks
apart had titers of 1:8 to 1:16. Another serum will be
processed. The first and third patients had had associa-
tion with conures (psittacine birds) and the second and


fourth patients with parakeets. The second patient had
also had contact with another bird that had been in the
household for 8 months and had remained well.
Epidemiologic investigation revealed that although
all the birds were purchased from different retail dealers
in Baltimore, birds associated with three of the four
human cases came from the same large wholesaler and
were imported through New York City. The remaining
bird came from a distributor in Miami.
(Reported by Kenneth L. Crawford, D.V.M., M.P.H., Chief,
Division of Veterinary Medicine, John HI. Janney, M.D.,
M.P.H., Director, Division of Communicable Diseases,
and J. M. Joseph, Ph.D., Chief. Virology Laboratory,
Maryland State Department of Health; and an EIS Officer.)


DIPHTHERIA Phoenix (Maricopa County), Arizona


Between Nov. 1, 1968, and May 1, 1969, 12 cases of
diphtheria including three deaths were reported from
Phoenix (Maricopa County), Arizona. No cases had been
reported from Arizona in the previous 5 years and only
five had been reported between 1959 and 1964. The cur-
rent outbreak began in November 1968 when three cases
were reported; one case occurred in December, two in
February 1969. five in March, and one in April. Eleven of
of the 12 cases including the three fatal cases were in
children. 10 of whom were Mexican-Americans. One case
occurred in a 60-year-old Mexican-American farm laborer.
Toxigenic, gravis strain Corynebacterium diphtheria was
isolated from the 11 children and a mitis strain from the
man. The fatal cases were unimmunized and the other
nine cases were either unimmunized or had not completed
a primary immunization series.
Epidemiologic investigation showed that of the 11
children, seven had direct or indirect association with a
previous diphtheria case while four had no apparent asso-
ciation with another case. The first reported case was in
an 8-year-old boy who became ill on Nov. 11, 1968. The
source of his infection was not determined. The second
patient, a 7-year-old Negro boy who became ill on No-
vember 17, attended second grade at the same school as
the first patient. These two boys were hospitalized at a
local hospital where a long term patient, a 13-year-old boy
with muscular dystrophy, became ill on November 26. The
fourth patient, a 6-year-old boy who died on December 23
after a 10-day illness, was a classmate of a household
contact of the first patient. Although this household con-
tact had not consulted a physician, she gave a history of


exudative pharyngitis in early December. The fifth and
sixth cases, reported on March 14 and 17, were in 4 and
6-year-old girls whose older siblings attended elementary
school with the fourth patient. These older siblings were
found to be carriers of the causative organism. A seventh
case occurred on February 21 in a 9-year-old girl and an
eighth case on February 28 in a 9-year-old boy. The
sources of their infections were undetermined. On March 12
a ninth case occurred in a 12-year-old schoolmate of the
eighth case and on March 25 a tenth case child became
ill, an 8-year-old classmate of the seventh case. One
other case was reported in April in a 6-year-old girl who
died and whose sister was found to be a carrier of the
causative organism. Both attended a nearby school from
which no cases had been reported. A diphtheria immuni-
zation program conducted after the onset of the outbreak
in areas where cases had occurred had not included
this school.
To date, 15,000 doses of Td and DPT have been
administered to school contacts, preschool siblings, and
neighborhood contacts of these cases by the local and
state health departments. In addition, the stimulus of
local news coverage prompted several thousand citizens
to obtain diphtheria and tetanus immunization in public
health clinics and from private physicians.

(Reported by Philip M. Hotchkiss, D.V.M., M.P.H., Acting
Assistant Commissioner of Epidemiology Program Design,
Arizona State Department of Health; S. F. Farnsworth,
M.D., Director. Varicopa County Health Department; and
an EIS Officer.)


MAY 10, 1969








Morbidity and Mortality Weekly Report



SUMMARY OF REPORTED CASES OF INFECTIOUS SYPHILIS

CASES OF PRIMARY AND SECONDARY SYPHILIS: By Reporting Arrl- April 1169 and April 1968 Provlis.ila D.lt


Reporting Area

NEW ENGIAND............
Haine .................
New Hampshire............
Vermont...............
Massachusetts...........
Rhode Island..........
Connectlcut ............

MIDDLE ATLANTIC..........
Upstate New York........
New York City...........
Pa. (Excl. Phila.) .....
Philadelphia..........
New Jersey ............

EAST NORTH CENTRAL.......
Ohio.......... ........
Indiana ......... .......
Downstate Illinois......
Chicago ................
Michigan................
Wisconsn ..............

WEST NORTH CENTRAL........
Minnesota .............
o a. ... ....... ........ .
MHssouri.................
North Dakota............
South Dakota... ......
Nebraska. ..............
Kansas ..................

SOUTH ATLANTIC..........
Delaware .................
Maryland..............
District of Columbia....
Virginia ..............
West Virginia ...........
North Carolina. ...........
South Carolina...........
Georg a ..............
Florida ..........


April
1969 1968


Cumulative
Jan.*Apr.
1969 I 1968


Reporting Area

EAST SOUTH CENTRAL........
Kentucky.................
Tennessee ..............
Alabama.................
Mississippi..............

WEST SOUTH CENTRAL........
Arkansas..... ........
Louisiana................
Oklahoma ..............
Texas.................

MOUNTAIN................
Montana...............
Idaho ..................
Wyoming..................
Colorado ..............
New Mexico...............
Arizona.......... .......
Utah. ... .
Nevada..................

PACdFIC ...............
Washington ..............
Oregon.................
California.............
Alaska ...... ... .. ..
Hawai. ...........

U. S. TOTAL ..............


Cumulative
April Jan.-Apr.
1969 1968 1969 1968


1 .549


TERRITORIES.............. 120 93 427 355
Puerto Rico.............. 120 91 424 329
Virgin Islands........... 2 3 26


Note: Cumulative Totals include
through previous months.


revised and delayed reports


EPIDEMIOLOGIC NOTES AND REPORTS

SPONTANEOUS MELIOIDOSIS IN AN IMPORTED MONKEY New Mexico


Melioidosis \\as recently diagnosed in an imported
stump-tailed Ilacaque monkey (Vlac'iir i spc'io i). The

animal a\as one of 19 obtained on July 11. 19SH. hly an

aeromedical research laboratory in New Me\xico from a

dealer in California. The actual date of importation from

Thailand was unknown. On July L'5, the animal developed

an abscess on the left arm and axilla and podernma with

lymphadenitis of the left arm. He w\as treated with kana-
iimycin but his response was not recorded. On October 17,
he t\as included in a group of four monkeys sent to a

hospital in New Mexico for renal clearance studies. He
was first taken from his cage on November 1) and was

noted to be slightly anieic. A serum sample in Decembler
had an abnormal light green color. In January an indurated

lesion 0 -as noted in the left axilla with a 1 cmn hard sub-

cutaneous mass. The surface was ulcerated and draining

a serious exudate. Cultures at that lime \\ere negative.

It was not kno\\n if this was the same lesion as noted in

the previous July. The lesion showed substantial improle-

mnent by February 14 without therapy. On February 24 the

animal w\as noted to be anorectic and disinterested in

his surroundings. On March 3 a 5 cmi1 mass was seen o\er

the left clavicle which \ias apparently unrelated to the

axillar, lesion. \t this point the animal 9\as killed. At
necropsy, the mass w\as found to he a subcutaneous ab-

scess. Another abscess \\as found in the retroperitoneum

from t1he femoral triangle to the thorax. A nilky w\ white


material \was present in both absceses- anld IP's dyioil as

preudiomallci was isolated.
Because of the potential sex erit of this di e-as- in
7mahn, an opidelmologic in\ -1tigat1ion \as- initial ited.

serologic survey \ as conducted of all other monkeoy- at

the hospital, monkeys at the aeoromedical research labora-

tory, and all personnel \\ho had 1 contat \with theI e mon-
keys. Fixe animals had tilCtr, that In nman \would h1 l in-

dicati\e of infection (liter of 1:,(l hy h'enlaiglutinaiion

technique or I:h hLy completIo nt fixation technique). Of
tlese fi\e monkeyi only one0 had ,lien ill. H, \\-as from

the same shipment as the indel\ caie. In NoS emhIlri 196;

he was used in a study in which a permanent sulhcu-

taneous catheter w\as implanted. In February 196l9 a >erit<
of absce-,ses hald de\eloped along the sbicutlaneous route

of the catheter. The.(e \\ re opened, drained. and cultured.

St5phyloo/c1' ls aureus. 1, and organsll tS identified a- hi-

longing to the klebielhla-aerolacter group were rero\etred.
The ah,7t c sesI w 'ere refractor, to treatimntq E\udat e from,

lesion, feces. a pharyngoal -\ahb. aind hair clippine- w<1re

obtained on May 2 and P. psu r lnomnaih; \/ as identified b\

prlesumptilve plate cultureI and or fluore scent anihodis
technique in the culliure prepared frim their feces. the

phary ngel s0 1ab, a1nd the found d o lidate. Thi- an imal i-

currently in strict quarantine. The other four aninal- (tl\o

front an earlier -hipment ,of the -7ame con pa n\ als the

( Co'! :iu cd h. lmp / lt;6S)


IMA1 10, 1969








164 Morbidity and Mortality Weekly Report


TABLE III. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

MAY 10, 1969 AND MAY 11, 1968 (19th WEEK)


;AFPT] ENCEPHALITIS HEPATITIS
TRE;IN- iBREL- i p" fill Primary including I'- MALARIA
AREA ( i1 LOSI unsp. cases rSl erum Infectious
Cum.

UNITED ST1-F -. I.' -. I '

NEW ENGLAND .......... 1 3 5 82 32 34
Maine ............. 3 2 2
New Hampshire...... 6 1 2
Ver ont............ 1
Massachusetts...... 2 25 14 26
Rhode Island....... 2 33 11
Connecticut ........ 1 1 3 14 4 4

MIDDLE ATLANTIC...... 5 4 4 3 38 171 140 15 lu6
New York City...... 2 2 24 65 54 8
New York, up-State. 2 22 22 2 19
New Jersey ........ 3 3 11 47 33 4 36
Pennsylvania....... 2 1 3 1 37 31 9 43

EAST NORTH CENTRAL... 2 1 4 13 116 179 3 78
Ohio ............... 2 1 28 42 10
Indiana ............ 1 1U 16 7
Illinois .......... 2 1 17 71 2 34
Michigan........... 1 2 10 56 41 1 26
Wisconsin .......... 5 7 1

WEST NORTH CENTRAL... 2 1 1 22 4 2 o2
Minnesota .......... 1 9 11 7
Iowa............... 1 3 9 5
Missouri........... 1 J 15 15
North Dakota ....... 1 1 2
South Dakota ....... 1 1
Nebraska .......... 1 -2 1 3
Kansas ............ 1 1 2 30

SOUTH ATLANTIC....... 5 6 1 2 69 2 54 311
Delaware ........... 2 -
Maryland........... 1 11 1
Dist. of Columbia.. 2 1
Virginia........... 2 4 I 12
West Virginia......l 2 -
North Carolina..... 1 9 j b 137
South Carolina ..... 2 6 3 2 26
Georgia............ 31 33 45 luy
Florida.............. 2 1 1b 25 l

EAST SOUTH CENTRAL... 1 1 2 64 57 25
Kentucky........... 1 -- 2 21 20
Tennessee .......... 1 1 2 5 25
Alabama............ 4 4 -
Mississippi ........ 9 7 -

WEST SOUTH CENTRAL... 2 3 1 3 68 61 1 26
Arkansas .......... 1 4 5
Louisiana, ........ 1 2 1 13 lu 1 19
Oklahoma ........... 5 2 2
Texas.............. 1 -1 2 50 45 -

MOUNTAIN............. 1 1 3 1 3 58 4b 4 69
Montana............ 1 2 5-
Idaho.............. 3 b I
Wyoming............ 2
Colorado ........... 1 3 17 15 4 o3
New Mexico......... 1 7 5 3
Arizona ............ 1 11 9 1
Utah............... 2 4 4 1
Nevada .............. 14

PACIFIC.............. 12 3 2 4 32 244 274 24 228
Washington.......... 3 35 17 5
Oregon............. 11 17 5
California......... 9 3 1 4 31 195 231 13 184
Alaska............. -7 7
Hawaii............. 1 1 3 2 11 34

F-ert R -.......... I 33 19 1
Delayed reports: Encealitis primary: La.
Fncephalitis. post-infectious: La. delete 1
Hepatitis, serum: N.J. delete 1
Hepatitis, infectious: N.Y. Ups. 7(196S), 8(1969), N.J. delete 11, La. delete 1
malaria : "e. 2








Morbidity and Mortality Weekly Report 165


TABLE 111. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

MAY 10, 1969 AND MAY 1968 (19th WEEK) -CONTINUED


MEASLES (Rubeola) MENINGOCOCCAL INFECTIONS, MUMPS POLIOMYELITIS RUBELLA
TOTAL
AREA Total Paralytic
AREA Cumulative Cumulative Total Paralyti

1!9,q 1969 1968 1969 196 168 1969 191 9 19 I'I 1 '
UNITED STATES... 916 12,452 12,854 60 1,631 1,350 2,541 1 3,106

NEW ENGLAND............ 67 661 543 3 49 71 410 117
Mainel ............. 2 13 4 5 36 4
New Hampshire...... 34 200 71 1 1 7 1 -- 1
Vermont............ 2 1 1 16 2
Massachusettst..... 15 122 178 1 22 31 133 43
Rhode Island....... 9 1 4 6 52 9
Connecticut ........ 18 326 279 1 18 21 172 -- 58

MIDDLE ATLANTIC...... 347 4,361 1,985 10 245 225 193 447
New York City...... 228 3,095 686 3 44 44 111 58
New York, Up-State. 18 397 892 2 41 37 NN 43
New Jersey......... 27 401 337 2 104 80 82 55
Pennsylvania....... 74 468 70 3 56 64 NN 291

EAST NORTH CENTRAL... 76 1,272 2,765 9 210 145 692 870
Ohio............... 35 207 233 2 73 39 71 230
Indianat........... 8 365 436 1 28 19 155 167
Illinois........... 8 210 1,107 35 35 62 79
Michigan.t ......... 11 124 179 5 60 40 241 267
Wisconsin.......... 14 366 810 1 14 12 163 127

WEST NORTH CENTRAL... 12 378 282 1 77 64 227 115
Minnesota ......... 1 10 16 16 21 7
Iowa............... 12 241 64 10 4 170 74
Missouri........... 14 65 1 28 18 2 13
North Dakota....... 6 103 2 29 6
South Dakota....... 4 4 NN -
Nebraska........... 113 28 9 6 5 15
Kansas............. 3 8 14 14 -

SOUTH ATLANTIC....... 79 1,751 1,024 17 296 298 202 30u
Delaware........... 28 198 8 4 4 3 7
Maryland............ 2 30 62 2 29 18 26 40
Dist. of Columbia.. 3 6 8 11 11 20
Virginia........... 10 692 206 3 35 21 18 52
West Virginia...... 3 144 169 1 13 7 119 112
North Carolina..... 7 148 256 45 58 NN -
South Carolina.*... 8 91 10 1 43 51 8 15
Georgia............. 1 3 9 51 57 -
Florida............ 21 444 304 1 68 71 17 62

EAST SOUTH CENTRAL... 2 62 342 3 88 113 68 103
Kentucky........... 1 29 77 25 42 11 19
Tennessee.......... 15 48 3 39 38 54 82
Alabama............ 1 1 56 14 16 2 1
Mississippi........ 17 161 10 17 1 -- 1

WFST SOUTH CENTRAL... 196 2,876 3,424 6 237 244 287 1 439
Arkansas........... 3 1 2 25 15 1 -
Louisiana.......... 1 74 2 2 67 64 -
Oklahoma.......... 1 109 101 23 45 16 153
Texas............... 194 2,690 3,320 2 122 120 270 1 286

MOUNTAIN............. 94 389 643 1 33 19 162 172
Montana............ 4 55 4 2 32 1
Idaho .............. 38 11 1 6 6 10 bi
Wyoming............. 8 8 44 -
Colorado............ 34 70 311 6 7 25 103
New Mexico......... 28 152 53 6 17 20
Arizona............. 24 114 145 8 1 77 30
Utah............... 2 19 1 1 2
Nevada ............. 1 5 2 3

PACIFIC.............. 43 702 1,846 10 396 171 300 535
Washington......... 1 46 450 1 50 27 63 57
Orego................ 7 147 367 9 16 5 26
California.......... 35 493 996 9 319 118 214 416
Alaska. ........... 10 -- 10
Hawaii............. 6 33 8 10 18 3b

Puerto Rico.......... 90 463 269 3 12 16 18 4


*Delayed reports: Measles: Mass. delete 9, Mich. delete 1, Alaska delete 3
Meningococcal infections: Ind. delete 1, S.C. delete 1
Mumps: Me. 3
Rubella: Me. 6, Alanka 3








166 Morbidity and Mortality Weekly Report


TABLE IlI. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

MAY 10, 1969 AND MAY 11, 1968 (19th WEEK) CONTINUED


STREPTOCOCCAL TYPHUS FEVLR
SORE THROAT & TETANUS TULAREMIA POD TICK-BORNE RABIES IN
AREA SCARLET FEVER FER (Rky. Mt. Spotted) ANIMALS
Cum. Cum. Cum. Cum. Cum.
j 1h 1969 l'j69 1 69 19)b) 1 9 1969 I1' l6 19 19469 11)6,4
UNITED STATES... 8,364 5 40 2 33 14 97 11 21 77 1,487

NEW ENGLAND........... 1,250 1 5
Maine* ............. 14 4
New Hampshire...... 40
Vermont............ 10 -
Massachusetts...... 176 1 -
Rhode Island....... 92 -
Connecticut........ 918

MIDDLE ATLANTIC...... 331 1 6 1 2 10 5 43
New York City...... 22 1 4 1 6 -
New York, Up-State. 203 2 1 1 2 5 41
New Jersey........ N
Pennsylvania....... 106 2 2

EAST NORTH CENTRAL... 897 3 2 10 5 85
Ohio............... 196 6 26
Indiana. .......... 223 2- 1 1 20
Illinois........... 137 -1 -1 1 3 16
Michigan........... 249 2 3 1 2
Wisconsin .......... 92 21

WEST NORTH CENTRAL... 318 1 4 1 1 17 279
Minnesota.......... 17 5 67
Iowa............... 95 2 36
Missouri........... 12 3 5 86
North Dakota....... 91 1 34
South Dakota....... 32 13
Nebraska ........... 58 1 1 8- 8
Kansas ............. 13 1 1 4 35

SOUTH ATLANTIC....... 717 9 13 2 14 5 6 11 425
Delaware........... 13
Maryland............ 13( 2
Dist. of Columbia.. 11 2
Virginia. 1......... 211 -- 1 7 236
West Virginia...... 115 1 2 1 1 1 1 2 67
North Carolina..... 21 1 5 3 4 4 4
South Carolina..... 63 1 1 1 -
Georgia............ 7 1 1 5 1 34
Florida............ 151 4 4 -2 1 84

EAST SOUTH CENTRAL... 1,189 4 1 7 1 11 3 9 9 251
Kentuc ky .......... 119 2 -- 2 1 1 5 142
Tennessee.......... 920 2 1 6 1 8 2 8 2 84
Alabama............ 104 2 25
Mississippi ........ 46 1 1 -

WEST SOUTH CENTRAL... 520 4 12 2 1 12 1 2 11 197
Arkansas........... 3 6 1 10
Liuisiana.......... 1 5 13
Ok ahoma........... 30 1 2 1 2 31
Texas.............. 486 4 6 1 6 10 137

MOUNTAIN............. ,658 3 2 14 2 3 5 56
Montana............ 15
Idaho.............. 87
Wyoming............ 198 5 -- 4 35
Colorado........... 974 2 2 3 2
New Mexico.......... 158 1 2 5 --- 7
Arizona............ 112 1 0
Utah ............... 113 2 1 1
Nevada............. I 1 3

PACIFIC.............. 1,484 5 7 24 1 14 14b
Washington ......... 753 1 1 -
Oreg .o ............ 94 6 6 6 -
California ........ 552 4 1 17 1 14 146
Alaska............. 23 -
Hawa i ............. 62

Puerto Rico ........ .. 3 11
*~ivorprs i:o. 4 u eee101


SST: .ie. 14, Ind. delete 1,000
Rabies in animals: Ind. delete


1, Va. delete 1, Kv. delete 1


D'el aved reports:







Morbidity and Mortalilt Weeklh Report


TABLE IV. DEATHS IN 122 UNITED STATES CITIES FOR WI-EK ENDED MAY 10, 1969

(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, 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.--------


- t_ -t sIIr t


All Causes

All 65 years
Ages and over


Pneumonia
and
Influenza
All Ages


Under
1 year
All
Causes


Area


All Causes Pneumonia


65 years
and over


+ + 4-I I I


766
258
48
29
29
68
31
17
34
47
63
9
53
27
53

3,373
68
39
161
43
33
39
59
80
1,668
42
501
186
64
121
30
29
81
54
38
37

2,618
53
38
754
192
167
116
79
369
49
64
43
29
63
160
36
133
36
34
43
98
62

786
64
14
31
136
19
122
87
195
63
55


457
130
29
24
26
37
21
12
21
28
35
5
37
13
39

1,933
41
24
83
23
23
23
33
32
956
24
266
111
45
71
25
21
47
31
30
24

1 ,510
29
25
412
120
93
65
52
198
30
26
23
19
34
99
21
82
25
27
27
62
41

454
37
8
15
80
14
74
47
106
44
29


SOUTH ATLANTIC:
Atlanta, Ca.----------
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.-------
Louisvill Ky.--------
Memphis, Tenn.----------
Mobile, Ala.-----------
Montgomery, Ala.- -----
Nashville, Tenn.-------

WEST SOUTH CENTRAL:
Austin, Tex.-----------
Baton Ruge, La.-------
Corpus Christi, Tex.---
Dallas, -----------
El Paso, Tex.----------
Fort Worth, Tcx.-------
Houston, Te.-----------
Little Rck, Ark.------
New Orleans, La.-------
Oklahoma City, Okla.---
Sin Antonio, Tex.------
Shrevepoirt, Li.--------
lulsa, Okla.-----------

MO'NTAIN:
Albuquerque, N. Mex.---
Colorado Springs, Colo.
Denver, Coi.---------
Ogden, ital------------
Phoenix, Ariz.--------
Pueblo, CnIo.----------
Salt Lake City, Utah---
Tu son, 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 ,18B
106
274
47
71
103
63
74
35
90
67
213
45

667
97
42
55
122
163
45
35
108

1 ,146
38
48
18
150
4b
75
217
76
153
85
121
63
54

396
32
30
103
17
89
16
58
51

1 ,611
11
64
27
44
91
499
69
39
150
60
99
189
35
129
63
42


and
Influenza
All Ages


43
1
9

3



4
2
4
4
7
1

29
3
2
2
13
5

2
2

47
3


4
b
4
5
8
4


7
6

12
3
4


1

1


Total 12,551 7,198 47') 52


Cumulative Totals
including reported corrections for


previous weeks


All Causes, All Ages -------------------------- 2b3,46
All Causes, Age 65 and over------------------- 152,556
Pneumonia and Influenza, All Ages------------- 15,163
All Causes, Under 1 Year of Age--------------- 11,827


Week No.
19


inder
I year
All
Causes


55
2
14
b

3
4



2
3
10


39
9
3

2
10
11
i







168 Morbidity and M(



MELIOIDOSIS (Continued from paoe 163)

indexc ca-,. and one from a third shipment) ha\e shown
no o\ert sigi n of illnes- .
In\esatgations of humans who had contact with these
animals are continuing.
(Reported h/ Richard J1. ('ronin,. ,1.). IVcteran.t Admlini-
,tration Hlospi/tal, A;lbqtucirue ," Lt. Col. Jack D Oouglas,
AeroRmedica Re earc Base. New' e/1ric(' : A. [). Alcriinder, Ph.1)., W alter Reed
lArmy Institutel of R .,earchl, Wallter Reed Army Mledical
('Iener. It'ashingon., D).C.: 11nd the l pidemiology Program,
Ind Laboratory 1iirsion, CI)C.)


FOLLOW-UP OUTBREAK OF GASTROENTERITIS
DURING A TOUR OF THE ORIENT Alaska

Additional information concerning the outbreak of
gastroenteritis among members of a tour group returning
to Seattle from a tour of the Orient on an international
flight from Bangkok (MMWVR, Vol. IS. No. 18) shows that
of 42 tourists. 23 det eloped illness (attack rate 55 per-
cent). In S3 percent of the cases, the initial symptoms
were lower gastrointestinal and included diarrhea (91 per-
cent). abdominal cramps (79 percent), nausea (65 percent),
and vomitingg (39 percent): there were no reports of fever.
One person died and two were hospitalized: 50 percent of
the ill travelers recovered within 12 hours.
Epidemiologic investigation incriminated a dinner
served aboard the flight between Bangkok and Hong Kong
on the evening of May 3:. The mean incubation period was
approximately 15 hours (Figure 1). No information is
available concerning the health of non-lour members of
the Bangkok to Hong Kong flight. No flight crew members
reported illness: lhowe\er, none ate dinner aboard the
plane. Food histories while not conclusive suggest
that a shrimp cral salad and or cocktail sauce served
at that meal was the vehicle of infection. No leftover
food was available for analysis. Laboratory evaluation
of specimens from patients is in progress.

Figure 1
CASES OF ACUTE GASTROENTERITIS
DURING A TOUR OF THE ORIENT
BY HOURS AFTER SUSPECT MEAL MAY 1969


MEAL

2


0 5 10 15 20 25 30 80
HOURS

(Heporltd by the Eiteric Disrasxes Section, Bacterial
Dijs(ci.se BrTnc/h. Epidcmiolo/y Program, N CD(', and a
tem of EI S Officers.)


realityy Weekly Report


THE MORBIDITY AND MORTALITY WEEKLY REPORT.
TION OF 17.000 IS PUBLISHED AT THE NATIONAL
DISEASE CENTER. ATLANTA, GEORGIA.
DIRECTOR, NATIONAL COMMUNICABLE DISEASE CENTI
DAVID
CHIEF, EPIDEMIOLOGY PROGRAM A. D
CHIEF, STATISTICS SECTION IDA


EDITOR
MANAGING EDITOR


MICHAE
PRIS


MAY 10. 1969

0 0
o s-i
WITH A CIRCULA-
COMMUNICABLE .
o
ECR >_)
J. SENCER, M.D. --
SLANGMUIR, M.D. ()SI
L. SHERMAN. M.S. W

L B. GREGG, M.D.
CILLA B. HOLMAN -- O


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 OFFICIALLY RELEASED TO THE PUBLIC ON THE SUCCEED-
ING FRIDAY.


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UNIV OF FL IB
DOCUMENTS DEPT.







U.S. DEPOSITORY




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