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:
AA00010654:00217

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



m I









U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE /PUBLIC HEALTH SERV F.
DATE OF RELEASE: MAY 30. 1969 ATLANTa


Vol. 18, No. 21






For

= Week Ending

S ANMNALy,24, 1969


SERVICES AND MENTAL A.Mi<.TTATC'N
1 33 ,- \


EPIDEMIOLOGIC NOTES AND REPORTS
MEASLES Baltimore, Maryland

During April 1969, 11 cases of imeasles were reported
in previously unimmunized children from a geographically
confined, lower socioeconomic area of Baltimore. This is
the largest known outbreak of measles in Baltimore in the
last 2 years. The apparent index case was a 14-vear-old
boy who had onset of measles rash on March 13. His
source of infection was not determined. On March 13,
despite his rash, he had attended a birthday party. Four
other children at the party subsequently developed mea-
sles. The six other cases were in contacts of these five
children.
Of prime concern was the fact that none of the child-
ren had been immunized against measles. Epidemiologic
investigation showed that this was an unrecognized pocket


F' um 'I III I, I //
.i h.ii \ .
TrI iinif aln ,, i -

Surv< illnic. Summary
Leptouspiro is t rnitmd Slt l) ....... 171)



of susceptible children not only to measles but also to
diphtheria, pertussis. tetanus, and polio. This neighbor-
hood had not been included in a measles immunization
program conducted in bordering communities in Januarx
and February 1969 and review of health department rec-
ords indicated that this area had had notahbl poor attend-
ance during the statewide measles campaigns in 1967.
(Continurd on paye i78;


Aseptic meningitis .......
Brucellosis .......
Diphtheria..............
Encephalitis, primary:
Arthropod-borne & unspecif
Encephalitis, post-infectious
Hepatitis, serum .........
Hepatitis, infectious ....
Malaria .............. .
Measles rubeolaa) .........
Meningococcal infections, to
Civilian ........
Military ................
Mumps ...................
Poliomyelitis, total
Paralytic .............
Rubella (German measles)
Streptococcal sore throat & E
Tetanus ..... .
Tularemia .........
Typhoid fever ... ...
Typhus, tick-borne (Rky. Mt.
Rabies in animals .........


TABLE I. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous weeks)

21st WEEK ENDED MEDIAN CUMULATIVE, FIRST 21 WEEKS
May 24, May 25. 1964 1968 MEDIAN
1969 1968 1969 1968 1964 -1968
. ........ .. 22 33 35 575 607 588
...... 5 3 7 51 60 92
............... 6 1 1 62 67 67

fed ........... 19 17 27 408 337 515
s ............. 8 20 18 118 232 354
............... 113 82 2.119 1,621
............ 913 859 751 1 9 117,347
....... 59 22 8 1.063 861 115
S......... 949 724 6,543 14,497 14,521 156,304
tal ....... 57 43 52 1.772 1,441 1.441
..... .. 49 40 1.597 1,298
........ 8 3 175 143
........ 2.395 4,488 51,810 102,619
..... .- 2 1 2 20 10
.......... 2 1 2 20 8
.............. 2,663 2,168 34,946 32,882
scarlet fever.... 7,818 8.206 8.670 228,543 225.104 225,104
.... 5 2 5 46 46 60
...... 13 6 5 51 67 67
..spottd f 5 5 6 110 102 133
spotted fever) 13 9 5 46 33 23
.............. 54 62 92 1,587 7 1606 1.891


TABLE II. NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax: Calif.-1 ................................... 2 Rabies in man: ...........
Botulism: Ill.-1 ................................... Rubella congenital syndrome: ... ..... ... .
Leptospirosis: N.C.-1, Ohio-1, Va.- ................ 21 Trichinosis: Wash.- .............5
Plague: ........ ................................... Typhus, murne: Tex.- ........ ................... 32
Psittacosis: Md.- .............................. .... 613






Morbidity and Mortality Weekly Report


MEASLES (Continued from front page)


On April 25 and May 4, school-based immunization
programs were held in this area. Although approximately
11,000 families live in the area and were contacted, only
369 children from preschool through grade 3 came to the
clinics. To date, no new cases of measles have been re-
ported from this area.


(Reported by Robert Farber, M.D., Commissioner of Health,
Baltimore City Health Department; John H. Janney, M.D.,
M.P.H., Director, Division of Communicable Diseases,
and Public Health Advisor Assignees, Maryland State
Department of Health; and an EIS Officer.)


INTERNATIONAL NOTES
SMALLPOX


Through May 13, 1969, a total of 329 cases of small-
pox were reported to the World Health Organization (\HO)
by the 19 countries participating in the West and Central
African Regional Smallpox Eradication and Measles Con-
trol Program. This is a decrease of 87.6 percent from the
2,645 cases recorded during the comparable period in
1968. The long term trend of reported smallpox cases in
the region since January 196S compared with the mean
monthly number of reported cases (luring the period 1960-
1967 is presented in Figure 1.
The weekly reported smallpox cases in the 19 coun-
tries during the first 17 weeks of 1969 compared with total
cases reported during the comparable period in 1968 is
shown in Table 1. Smallpox incidence has continued to


decline this year throughout the 19-country area despite
improved reporting systems :itr.ueh which cases are now
reported that previously might have remained undetected.
In West Africa, smallpox foci are evident in three
separate areas: 1) Sierra Leone, 2) Togo. and 3) Nigeria-
Niger-Cameroon. Outbreaks in these areas are being ac-
S1 contained through effective surveillance systems.
All suspect cases are immediately investigated to trace
the sources of infection and contain further spread of
smallpox.

(Reported by the Smallpox Eradication Program, NCDC.)

Source: World Health Organization Weekly Epidemiological
Record, 44(20):331-337.


Figure 1
REPORTED SMALLPOX CASES BY MONTH, 1960-67 AVERAGE, 1968 AND 1969
"i WEST AND CENTRAL AFRICA


i/
i~ N~; ~


tNCoUPLETE

Table 1
Provisional Number of Smallpox Cases by Week West and Central


5'
,- ,


Africa


Jan. February March April Total T l
eek Ending 1-2 i 15 22 1 8 15 22 29 5 12 19 26 to Date Period1968
Leek Number 1-4 5 6 7 b 9 10 11 12 13 14 15 16 17 1969
Country*
('ameroon 10 1 3 1 15 53
(had 1 10 1 12 1
Dahomey 3 -- 3 245
Ghana 4 "2 6 3
(;uinea 11 1 12 2"78
.iheria -e 5
Mal ------- 42
Niger 2 4 1 13 1 1 1 23 419
Nigeria Ib 3 10 11 10 9 5 45 5 8 124 998
Sierra Leone 20 3 19 11 2 1 56 336
Togo 16 2 2 3 2 1 1 3 34 14 78 248
Upper Volta --- 17
Total h4 12 10 36 24 15 22 47 7 8 13 35 15 1 329 2,645
r .. *,_ r -......i, nr .. n n .. o i ..i .. i i


Nn s a **> reported from Central \f
[kst-s not alaslable,


178


MAY 24, 1969


Congo (B), Gabon. Gambia. Ivory Coast. Senegal, an tania.









Morbidity and Mortality Weekly Report


SURVEILLANCE SUMMARY

LEPTOSPIROSIS United States 1968*


Iin licte niird Stalel during Ikiih. a total of 67 cas -

of human lep(o-piro)si including t\o fatal cases \\,rer

reported to the N('DC. This \\ as the samine number of casev

a" riporltIl iln 1967. ('ase reports \ ore. reoi \ itd oin i of

lheoe fi;7 ct'a-s. The highieit numi er of aes, 13. C\as

rep'or(td from l'oriil. i\n increase in cases over 1!67
Va noted inl 13 talt a (decrease in I11 latts'. andl the

-iame itiumbehr a in 19G7 in one state. ('ases weNtr r reported

in 196I h from o'\tn lstals that had no caii-'s in the pre-

Table 2
Human Leptospirosis 1968

Comparison
Five vear of numbers
of cases
Mean 1968 reported in
State (1963 1967) Cases 1968 with 1967

Alabama 10 0 -2
Alaska 00 0 0
Arizona 0 2 0 0
Arkansas 2 2 0 -2
California 50 4 -5
Colorado 02 0 0
Connecticut 00 0 0
Delaware 00 0 0
Florida 56 13 +5
Georgia 1 0 3 +3
Hawaii 156 11 3
Idaho 20 1 +1
Illinois 1 6 1 +1
Indiana 1 0 0 0
Iowa 86 8 +1
Kansas 08 1 +1
Kentucky 02 0 0
Louisiana 60 3 -11
Maine 08 0 1
Maryland 1 6 2 0
Massachusetts 4 0 0
Michigan 1 2 0 -2
Minnesota 06 0 0
Mississippi 1 0 0 -1
Missouri 0 2 0 0
Montana 04 0 -1
Nebraska 0 2 0 0
Nevada 00 0 0
New Hampshire 00 0 0
New Jersey 1 4 1 -1
New Mexico 02 0 O
New York 20 2 +1
North Carolina 1 0 0 0
North Dakota 00 0 0
Ohio 2.0 2 +2
Oklahoma 00 2 +2
Oregon 12 0 0
Pennsylvania 08 0 0
Rhode Island 00 0 0
South Carolina 02 0 0
South Dakota 00 0 0
Tennessee 4 8 5' +3
Texas 58 7 +4
Utah 02 O -1
Vermont 00 0 0
Virginia 06 0 0
Washington 126 0 -1
West Virginia 04 1' +1
Wisconsin 00 0 0
Wyoming 00 0 0

TOTALS 1.8 67 0

S1 Fatal Case


tiour year and eight Mlat*- reporting caor- in i)tl7 re-

ported no cat- in 1t96S (Tahule 2). Mo-l uai -pe occurred
in titi sumImwir nionth Sex antl g e (it-lr ihuttlio data fromn

the It case report- l-howed Ihat 70 percent of iti- ca,,e-

occurried in lale o- and that i\(; I irc it i;ire in per- hIo-

twetien 10 and (30 \ars of age (Tabhl 3). Mo>t hii lori(-
ere indefinite as to sin hle p oure of' infection, but the

mot probable souriii werx dot n and cat iwiater, andi

roixhnts (Table 1). In :331 i cae reports, where initial im-

pres ions tere noted. mlnin ili-i usually\ ai>eptii miinin-

gitis. was tihe predominant tentati e diagnosiso The mo1t1

frequent s symptoms roflctited central nervous system, renal.

and hepatic disturbances.

Table 3
Human Leptospirosis by Age and Sex 1968


AGE
(YEARS)


0 9

10- 19

20 29

30 39

40 49

50 59

60+

TOTAL


SEX

FEMALE

0

3

5





20

2

13


PERCENT
OF TOTAL


7

30


Table 4
Most Probable Source of Human Leptospirosis 1968


MOST PROBABLE
SOURCE




Rodenti
Dog o, Cat
Carrle or Swine
Water Conxact
Sewage
Wild Animals
Viel Nam
Unknown

TOTAL

Percent of Total


PRESUMPTIVE INFECTING SEROTYPE





0 0

0 .c








1 2 5
2 1 9 21


3 3

I 2



16 2 2 1 1 44 100

13 36 5 5 2 39 10


(Reported by the Veterinary PuIlic Health Sictio Epi-

ldemniolosiiy Program, .Y(I)(r

'Provisinal di&a,

A opy of tli *riini,il ro-irl from whik h tbi- dLiiti \e\r,
dci-ritdI is iva il[.J. on r,'qu'.-t from:
N',tion-lS ( Commrnut1 1 hh' )1 ,'-d>c ( 'onter
Attn: CLh I', V\etrin ari Public l Halth Sction
F.pi ti midlo luLx Pr,-oram
Xtlantal Georia 1303313


MAY 24,. 1969








180 Morbidity and Mortality Weekly Report


TABLE III. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

MAY 24,1969 AND MAY 25,1968 (21st WEEK)


v*E'l ENCEPHALITIS HEPATITIS
"IN- II- HItit Primary including I'P MALARIA
REA1S unsp. cases 1- Serum Infectious
Cum.

UNITED STA7t :. I 1 I I .. .i.j

NEW ENGLAND............ 1 2 2 75 23 39
Maine...t.......... 2 2 2
New Hampshire..... 2
Vermont.. .......... 1 7 ..
Massachusetts...... 1 2 1 25 11 30
Rhode Island ....... 28 2 1
Connecticut............. 13 8 4

MIDDLE ATLANTIC...... 2 1 1 61 177 131 9 117
New Yrk City...... 1 42 66 53 1 9
New York, up-State. 8 28 24 1 22
New Jersey......... 1 1 8 22 19 6 42
Pennsylvania...... 1 3 61 35 1 44

EAST NORTH CENTRAL... 7 4 2 9 135 144 12 92
Ohio............... 4 2 1 37 62 10
Indiana ............ 1 19 7 7
Illinois ........... 2 2 1 3 41 27 10 46
Michigan........... 1 1 4 32 38 2 28
Wisconsin .......... 6 10 1

WEST NORTH CENTRAL... 3 1 66 77 4 73
Minnesota .......... 1 8 21 7
Iowa............... 3 13 14 5
Missouri...?....... 37 35 2 23
North Dakota........ 2 2
South Dakota. ...... 2 -
Nebraska ........... 2 3
Kansas ............. 2 7 2 33

SOUTH ATLANTIC....... 4 4 4 2 6 64 74 14 346
Delaware........... 2 2
Maryland........... 1 2 7 13 10
Dist. of Columbia.. 2 2 1 1
Virginia........... 8 2 1 14
West Virginia...... 6 9 -
North Carolina..... 1 2 1 9 5 1U 155
South Carolina..... 1 17 3 1 27
Georgia............ 11 119
Florida.............. 3 1 3 1 2 15 28 2 18

EAST SOUTH CENTRAL... I 1 1 1 46 29 32
Kentucky........... 15 5 26
Tennessee.......... 1 1 1 1 15 9 -
Alabama............ 4 2 6
Mississippi........ 12 13 -

WEST SOUTH CENTRAL... 4 1 2 2 70 68 30
Arkansas........... 3 2 5
Louisiana.. ....... 2 1 1 2 15 12 22
Oklahoma............ 1 11 3 3
Texas.............. 1 1 41 51 -

MOUNTAIN.............. 1 I 37 26 72
Montana............. 2 4 -
Idaho.............. 1 3 6 2
Wyoming...*........ 1 -
Colorado........... 14 3 64
New Mexico......... 6 6 4
Arizona ............ 6 4 1
Utah................ 6 2 1
Nevada............. -

PACIFIC............... 11 5 3 2 3 35 243 287 20 262
Washington......... 3 32 31 5
Oregon............. 1 2 1 16 27 6
California......... 6 3 3 2 3 34 188 229 13 207
Alaska.............. 1 5 1 1
Hawaii............. 2 6 43

Puerto Rio........... 19 26 1

*Delayed reports: Encephalitis, primary: Pa. delete 1
Hepatitis, serum: La. 1(1968)
Hepatitis, infectious: Me. 3, N.I. 6, Mo. 13, Wyo. 1, P.R. 1








Morbidity and Mortality Weekly Report 181


TABLE Ill. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

MAY 24, 1969 AND MAY 25, 198 (21st WEEK) CONTINUED


MEASLES (Rubeola) MENINGOCOCCAL INFECTIONS, MUMPS POLIOMYELITIS RUBELLA
TOTAL
AREA Cumulative Cumulative Ttal Para ytic
Cum.

UNITED STATES... 949 14,497 14,521 57 1,772 1,441 2,395 2 2,663

NEW ENGLAND.......... 27 716 701 1 57 73 315 209
Maine. ..*. ......... 4 30 5 6 31 25
New Hampshire...... 2 210 113 1 7 3 9
Vermont............ 2 1 1 25 4
Massachusetts..A. 14 138 203 26 32 156 54
Rhode Island ...... 9 1 4 6 22 15
Connecticut....... 11 353 353 1 21 21 78 102

MIDDLE ATLANTIC...... 370 5,196 2,334 14 271 241 208 144
New York City....... 240 3,604 915 3 49 47 133 39
New York, Up-State. 21 448 946 45 38 NN 43
New Jersey..A ..... 47 578 394 11 119 90 75 24
Pennsylvania....... 62 566 79 58 66 NN 38

EAST NORTH CENTRAL... 118 1,473 3,047 12 231 159 529 725
Ohio............... 15 232 243 4 80 43 41 30
Indiana............. 32 431 539 28 19 84 124
Illinois ........... 40 264 1,188 2 39 38 91 300
Michigan... A .... 10 136 197 4 68 46 151 111
Wisconsin .......... 21 410 880 2 16 13 162 160

WEST NORTH CENTRAL... 5 402 313 1 93 70 186 160
Minnesota.......... 2 13 16 16 4 1
Iowa............... 257 77 10 5 150 131
Missouri... *...... 3 18 72 43 21 10 3
North Dakota....... 6 107 3 6 6
South Dakota ....... 1 1 4 1 1 4 NN -
Nebraska........... 1 114 32 9 6 16 19
Kansas ............. 4 8 14 15 -

SOUTH ATLANTIC....... 106 2,023 1,114 12 316 309 194 327
Delaware........... 22 249 8 4 4 3 3
Maryland........... 30 69 1 30 19 12 30
Dist. of Columbia.A 2 6 1 9 11 2
Virginia ........... 49 854 219 1 36 22 44 83
West Virginia...... 6 156 177 1 14 7 79 145
North Carolina..... 25 179 260 2 51 62 NN -
South Carolina..... 4 97 12 2 46 54 12 17
Georgia ............ 1 3 4 56 57 -
Florida............. 455 360 70 73 44 47

EAST SOUTH CENTRAL... 4 73 380 2 104 126 78 73
Kentucky........... 3 39 86 2 38 47 8 8
Tennessee.......... 15 51 39 43 64 65
Alabama............ 1 61 17 18 3 -
Mississippi........ 1 18 182 10 18 3 -

WEST SOUTH CENTRAL... 240 3,350 3,897 6 250 254 259 2 261
Arkansas..* ........ 16 2 27 15 -
Louisiana.......... 26 100 2 2 71 66 -
Oklahoma............ 5 116 105 1 24 48 31 127
Texas .............. 209 3,118 3,788 3 128 125 228 2 134

MOUNTAIN............. 35 485 731 34 22 145 109
Montana............. 8 57 4 2 17 1
Idaho............... 5 47 12 6 9 3 6
Wyoming.A......... 48 -
Colorado............ 1 100 353 6 7 26 57
New Mexico.......... 13 174 73 6 5 11
Arizona............. 16 152 164 8 1 72 31
Utah............... 3 19 2 22 3
Nevada ............. 1 5 2 3

PACIFIC.............. 44 779 2,004 9 416 187 481 655
Washington......... 4 53 470 50 31 140 102
Oregon............... 14 167 387 1 10 16 10 41
California.......... 18 529 1,113 8 337 130 219 349
Alaska.............. 1 11 1 11 100 91
Hawaii.............. 7 19 33 0 8 10 12 72

Puerto Rico.......... 54 654 293 1 13 17 12 8


*Delayed reports: Measles: Mass. delete 10, N.J. 114, Mich. delete 2, D.C. delete 1, Ark. 13, Wyo. delete 8
Meningococcal infections: Mo. 12
Mumps: Me. 7
Rubella: Me. 1, Wyo. 8







182 Morbidity and Mortality Weekly Report


TABLE III. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

MAY 24,1969 AND MAY 25,1968 (21st WEEK) CONTINUED


STREPTOCOCCAL TYPHUS FEVER
SORE THROAT & TETANUS TULAREMIA TYPHOID TICK-BORNE RABIES IN
AREA SCARLET FEVER FEVER (Rky. Mt. Spotted) ANIMALS
Cum. Cum. Cum. Cum. Cum.
1961 1969 1969 1969 1969 1969 1969 1969 1969 1969 1969
UNITED STATES... 7818 5 46 13 51 5 110 13 46 54 1587

NEW ENGLAND.......... 1387 3 4 2 5
Maine.... ......... 14 1 4
New Hampshire...... 36 -
Vermont............. 27 3 4 1
Massachusetts...... 213 1 -
Rhode Island....... 116 -
Connecticut........ 981 -

MIDDLE ATLANTIC...... 484 6 2 2 12 3 3 47
New York City...... 65 4 1 6 -
New York, Up-State. 337 2 1 2 4 44
New Jersey.......... NN -
Pennsylvania....... 82 2 3 3 3

EAST NORTH CENTRAL... 750 3 7 1 3 10 5 97
Ohio....... ........ 188 6 28
Indiana............. 166 1 4 27
Illinois........... 122 3 5 1 1 17
Michigan........... 189 2 3 2
Wisconsin.......... 85 1 1 1 23

WEST NORTH CENTRAL... 279 1 2 2 6 4 1 1 3 278
Minnesota.......... 11 1 1 72
Iowa................ 112 39
Missouri.... ....... 11 3 2 1 90
North Dakota....... 69 1 35
South Dakota....... 17 1 1 13
Nebraska........... 52 1 8
Kansas.... ........ 7 1 2 2 3 21

SOUTH ATLANTIC....... 789 1 10 2 15 2 16 6 17 23 462
Delaware........... 6 1 -
Maryland........... 139 2 4 4 -
Dist. of Columbia.. 2 1 1
Virginia ........... 175 1 2 10 248
West Virginia...... 217 1 2 1 3 3 70
North Carolina..... 10 1 5 3 1 8 4
South Carolina..... 111 1 1 2 -
Georgia........... 11 1 2 5 1 38
Florida ............ 120 1 5 4 2 9 102

EAST SOUTH CENTRAL... 1118 4 1 8 11 2 14 7 266
Kentucky........... 103 2 2 1 1 148
Tennessee.......... 832 2 1 7 8 2 12 3 89
Alabama............ 116 1 3 29
Mississippi........ 67 1 1 -

WEST SOUTH CENTRAL... 584 12 2 6 1 16 1 6 8 213
Arkansas........... 1 1 7 2 1 17
Louisiana .......... 14 5 13
Oklahoma........... 30 1 1 4 2 1 35
Texas.............. 540 6 1 1 9 1 2 6 148

MOUNTAIN ............. 1472 2 7 14 4 5 67
Montana............. 26 -
Idaho.............. 109 -
Wyoming ............ 151 1 2 5 3 40
Colorado ........... 837 2 4 2
New Mexico......... 112 1 5 7
Arizona............ 129 1 2 14
Utah............... 107 1 4 1
Nevada ............. 1 1 3

PACIFIC.............. 955 5 25 1 3 152
Washington......... 673 1 1 -
Oregon............. 123 6 -
California......... 4 18 1 3 152
Alaska.............. 103 -
Hawaii.............. 56 -

Puerto Rico.......... 2 2 3 1 12
*Delayed reports: SST: Me. 6, Ohio delete 1, lo. 6
Rabies in animals: Kans. delete 14








Morbidity and Mortality Weekly Report






TABLE IV. DEATHS IN 122 UNITED STATES CITIES FOR WEEK ENDED MAY 24, 1969


(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 and n year
Ages and over Influenza All Ages and over Influenza All
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.--------


758
224
60
21
33
53
37
22
22
63
63
11
59
29
61

3,166
55
51
143
45
42
34
60
57
1 ,645
31
401
195
48
109
23
43
77
44
36
27

2,733
77
53
771
196
216
130
83
383
48
51
39
37
33
139
46
107
33
34
55
127
75

799
57
36
37
115
34
90
73
238
83
36


478
139
46
14
21
28
24
14
16
40
32
9
36
18
41

1,925
26
33
93
25
25
20
34
25
1 ,022
21
213
108
33
77
16
29
44
32
29
20

1,538
42
37
433
127
108
51
43
212
28
29
20
20
21
81
23
62
18
19
33
80
51

486
37
25
19
69
24
59
41
136
51
25


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 Wnrth, 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.----------


1,152
104
237
48
81
104
60
77
44
81
74
192
50

667
82
51
39
116
166
51
66
96

1,144
36
52
37
163
47
85
199
54
158
81
104
61
67

452
42
32
118
26
108
15
50
61

1,673
23
53
25
59
86
488
101
51
160
67
100
182
43
133
55
47


605
49
128
20
44
60
37
40
16
63
42
84
22

359
51
27
25
58
93
24
34
47

587
19
20
22
91
28
44
86
31
74
43
57
37
35

264
23
21
61
20
61
11
31
36

1 ,030
20
27
21
28
50
309
57
35
109
40
50
109
28
79
36
32


6
2
3
10
4

37
7
2

6
10
6
3
3

82
2
6
2
11
7
8
14

16
1
7
6
2

26
1
2
10
1
7
1
1
3

65

2

2
1
16
6

8
1


Total 12,544 7,272 448 599


Cumulative Totals
including reported corrections for


previous weeks


All Causes, All Ages ------------------------ 288,478
All Causes, Age 65 and over------------------- 167,015
Pneumonia and Influenza, All Ages------------- 16,049
All Causes, Under 1 Year of Age--------------- 13,024


Week No.
21


1








Morbidity and Mortality Weekly Report


EPIDEMIOLOGIC NOTES AND REPORTS

TRICHINOSIS New York City


Between Oct. 17 andl No\. 2, 196i, fIive women
from five different families living in one neighborhood in
No.\ ork ('it. \\ reo diagnosed hy three physicians as
hating trichinosi-. Each person experienced a mild ill-
nes- characterized lIZ f'evr. peirorbiltal eolema, and myalgia,
uad each had eooinophilia ranging from 10 to 61 percent.
\l1 became ill several days after eating raw or very rare
hamburger. Sera were obtained from four of the five pa-
tients. Three were positive for trichinosis by the floccula-
tion lest and the complement fixation test and the other
was positi oe only hI\ the flocculation test. Two patients
were treated with cortico steroids, one with a piperazine

compound, one with corli(osteroids and piperazine, and
one received no treatment. All recovered quickly and
une\ entfullll.
Epidemiologic in\esligation found that four of the
familie- purchased all their raw meal at a single neighbor-
hood market and Ihe other family bought mainly ground
meat at this market. The five patients were the only mem-
bers of their respective families who preferred to eat meat
raw or Fery rare. Ins 'etigation at the market revealed that
all meat was ground in the same grinder in a cold room out
of \iew of the customer. Although a second grinder was
present. it was used only in emergencies. Thus the same
grinder could have been used to grind beef and pork.
Since 2 to 11 oz. of meat may remain in a grinder after
each use. it i- possible that beef could have become con-
laminated with infected pork.
Control recommendations made to the market manager
included the following: all meat grinding should be done
outside the walk-in refrigerator in full view of the custo-
mer: the grinding head should be carefully washed and
sterilized after grinding pork.

(Reported hy Leo HI. Buckner, M.D.. Epidemiologist, and
Tibor Fodor, M.D., 'Chief, Division of Epidemiology and
DiaWnosi.s, Vinceiot Guinee, M~.D., Director, Bureau of
Pre'rentable Diseases, and Daniel Widelock. Ph.D., Deputy
Director, Bureau of Laboratories, New York City Depart-
ment of Health.)


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

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


MAY 24, 1969


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