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:
AA00010654:00219

Related Items

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


This item is only available as the following downloads:


Full Text



NATIONAL COMMUNICABLE DISEASE CENTER









e tll'




U.S. DEPARTMENT OF HEALTH, EDUCATION AND WELFARE PUBLIC HEALTH SER
DATE OF RELEASE: JULY 11. 1969 ATLANTI


EPIDEMIOLOGIC NOTES AND REPORTS
PLAGUE New Mexico

A second case of bubonic plague was recently re-
ported from New Mexico in a 3-year-old boy, residing in
Jemez Springs. This town is about 50 miles northwest of
Placitas where the first case of plague occurred (MMWR,
Vol. 18, Nos. 25 and 26). The recent case had a history
of playing with a dead chipmunk on June 20, 1969. The
boy became ill on June 23 with malaise and fever and
was hospitalized on June 30. On admission, physical
examination revealed lymphadenopathy in the left inguinal
area. He zubiequornrl developed meningitis and possibly
secondary pneumonitis. He is receiving antibiotic therapy.
Cultures of material from the lesion performed at the
state health department were morphologically compatible
with Pasteurella pestis. Fluorescent unirhod. and phage


Epidemiologic Notes and Reports
Plague New Mexico ................... .... 233
Botulism Seattle, Washington . ..... 234
Trichinosis Ohio . . .. 234
Probable Post-Streptococcal Acute
Glomerulonephritis Taos, New Mexico ..... 235
Staphylococcal Food Poisoning Idaho ........ 235
International Notes
Dengue Puerto Rico . . ....... 234

tests were also positive. Animal inoculation study is in
progress.
Collection of animals in the area is underway.
(Reported by Bruce Storrs, M.D., ..... Division of
Medical Services, Neil Weber, Mammalogist, and Daniel
Johnson, Ph.D., the Public Health Laboratory, New Mexico
Department of Health; and the Ecological Investigations
Program, NCDC, Kansas City, Kansas, and Fort Collins,
Colorado.)


TABLE I. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous weeks)
27th WEEK ENDED CUMULATIVE, FIRST 27 WEEKS
MEDIAN
DISEASE July 5, July 6, 1964 1968 MEDIAN
1969 1968 1969 1968 1964 1968
Aseptic meningitis ...................... 49 60 40 825 943 805
Brucellosis ............................ 8 7 7 85 98 123
Diphtheria.............................. 7 2 3 76 88 84
Encephalitis, primary:
Arthropod-borne & unspecified ........... 10 22 31 500 457 694
Encephalitis, post-infectious ............. 5 14 14 168 290 473
Hepatitis, serum ....................... ..79 89 I 2.699 2,141
Hepatitis, infectious .................... 662 681 552 24289 22,561 21.398
Malaria ................................ 54 53 9 1.370 1.107 158
Measles rubeolaa) ....................... 475 225 2.061 18.405 17,717 180.739
Meningocrccal infections, total ......... 36 31 32 2.057 1,691 1,691
Ciil ian .................... ........... 34 28 1,864 1.525
Military............................... 2 3 193 166
Mumps ................................. 898 1.138 61,954 117.105 -
Poliomyelitis, total ..................... 4 4 3 30 30
Paralytic ............................. 4 4 3 30 28
Rubella (German measles) ............... 667 620 45,259 40,578
Streptococcal sore throat & scarlet fever... 4,812 3,815 4.291 264,190 260,848 260.848
Tetanus .............................. 2 4 4 65 73 95
Tularemia .............................. 1 9 6 80 102 102
Typhoid fever .......................... 7 3 7 143 146 189
Typhus, tick-borne (Rky. Mt. spotted fever) 18 11 11 179 93 93
Rabies in animals ....................... 5550 59 64 1.941 1.961 2 S

TABLE II. NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax: ........................................ 2 Rabies in man: ..................................... .
Botulism: .......................................... 10 Rubella congenital syndrome: ....... ............. 5
Leptospirosis: Hawaii-2 ............................. 31 Trichinosis: N.J.-1 ................................ 146
Plague: ............................................ Typhus, marine: ................................... 5
Psittacosis: Conn.-1l Pa.-1 ...................... 20


Ending






Morbidity and Mortality Weekly Report


INTERNATIONAL NOTES
DENGUE Puerto Rico


An epidemic of dengue is occurring in Puerto Rico
involving persons in approximately 30 towns along the
northern coast. -p.ir.ii. but unconfirmed cases were first
reported in late March and by July 5, a total of -' 1.:0
cases of I. r,,u.-l.," disease were reported. The three
towns r .... rl.n_ the largest number of cases were Manati
(2s5 cases) and Moca (173 cases) in the northwestern part
of the island and Juncos (90 cases) in the east central
section. The disease has been generally mild and symp-
toms hane included fever and rash. All age groups have
been affected. Of 35 paired sera obtained for serologic
testing. 23 had serologic rises by the hemagglutination
inhibition technique compatible with dengue virus infection.


Surveys of Aedes a;i',pi mosquito populations were
conducted in six towns, and adult A. a,'-ypti mosquitoes
were recovered in 50 percent of the homes investigated.
Surveillance centers have been established in three
locations in Puerto Rico to facilitate reporting of cases
and to obtain additional confirmatory evidence of cases.
Ground spraying with larvicidal and adulticidal mosquito
insecticides is currently underway.
(Reported by Dr. Ernesta Colon Yordan, Secretary of Hr alth.
Dr. Raphael Corea-coronas, Auxiliary Secretary of Health
for Preventive Medicine, and Dr. Angel Alberto Colon,
Director, Institute of Laboratories of Hi.a!il. Puerto Rico
Department of Health; and a team from NCDC.)


EPIDEMIOLOGIC NOTES AND REPORTS
BOTULISM Seattle, Washington


During the evening of July 2. 1969. a 67-year-old
woman, a resident of Seattle. Washington, complained of
dizziness and blurred vision while working as a nurse in
a private home. The next morning while driving from Seattle.
she had I "i. I l'. talking and swallowing. Because her
symptoms became worse. she was driven hack to Seattle
by ambulance. She was hospitalized on July 4. and be-
cause she was cyanotic and in respiratory distress, a
tracheostomy was performed. The admitting diagnosis
was cerebral malatasis because she had a prior history
of rectal carcinoma. A diagnosis of botulism was made
after neurologic consultation found acute, progressive,
s)mmetrical, cranial and skeletal nerve flaccid paralysis,
aphoni.a and a clear -ensorium. Antitoxin A and B were
administered beginning 15 hours after admission and con-
tinued exer -t hours for 2 days for a total of 440,000 units
of each in a total volume of 1,320 ml of horse serum with


no apparent ill effect. lrh..ueh there has been some evi-
dence of improvement, the patient remains in critical
condition.
The patient lived and shared meals with her sister
and son, both of whom have remained well. The only foods
which they had not eaten in common on July 1 were home-
canned beets and a preparation containing pickled carrots,
onions, and cauliflower, both canned by the patient.
Serum obtained from the patient prior to antitoxin
treatment caused typical symptoms of botulism in a mouse.
Unfortunately, there was not enough serum to determine
the toxin type.
(Reported by D. R. Peterson, M.D., Epidemiologist, irrn
County Department of Public Health; and A. S. Troupin,
M.D.. Neurologist, and Q. B. DeMarsh, Attending P it-
cian, Seattle; and the Anaerobic Bacteriology Laboratory,
Laboratory Division, NCDC.)


TRICHINOSIS Ohio


Recently in Curahoga ', ..rr. Ohio. six cases of
trichinosis developed among three families of Eastern
European extraction. Four persons in one family had on-
-se of symptom- on \pril 2- and the wife in each of two
other famili-e had on-et on lMa 12, 1969. All had periorbital
edema. malaise. and mu-cle aches and stiffness of the
extremitie-. and three of the -ix had fever. Five persons
had ., -',.,.i.i ranging from 20 to 17 percent. -'.rl. L
was performed on the ill wife in one family and her hus-
hand who hs remained well: only her serum was positive
for tricn hi-nosi-.
The three families- did not know each other and had
no known contact ith each other: however. thoe did have
the -an family ph -icialn and did patronize a large market
in \isk C( l eland. The market con-sit- of approximately
10) individual stalls-. ach specializint in meats, poultry,
fruit, or produce. ll three family group- had purchased


smoked pork sausage from one stall which specializes in
Eastern European style meat products. The owner of the
stall prepares about 300 Ibs. of sausage per week, some
of which is smoked. He also sells raw bulk sausage and
fresh meats. In addition, the ill people ate pork products
purchased at other supermarkets and small stores. The
dates of onset and the one common source of meat sug-
gest that products from the staff were the source of in-
fection for the families.
The persons who became ill preferred eating pork
raw or rare even ihmoujh a sign was fh-plax.\rl in the stall
warning customers to cook pork products. The persons in
the families who remained well usually ate well-cooked
meat products.
The investigation is continuing and an uatempt will
be made to obtain sera from the remaining five patients.
As of July 1 the meat shop was included under the inspec-


234


JULY 5, 1969





JULY 5. 1969


Morbidity and Mortali


tion of the Ohio Department of Agriculture whose regula-
tions require preparing pork products which appear to be
cooked or :ikel\ to be eaten raw in a manner adequate to
kill trichina larvae.
fRe ported by Calvin B. Spencer, M.D., Acting Chief, Com-
municable Disease Division, Jack H. Russell, D.V.M.,


ty Weekly Report 235


Chief Public Health Veterinarian, and William Lee. Public
Health Representative, Ohio Department of Health; Jack
: 't. D.VM., Public Health Veterinarian, Cleveland Health
Department; and George A. Csanad, M.D., i .
Lakewood, Ohio.)


PROBABLE POST-STREPTOCOCCAL ACUTE GLOMERULONEPHRITIS Taos, New Mexico


From late November 1968 i'hr.-.,,eh March 1969. 10
cases of probable post-streptococcal acute glomerulo-
nephritis occurred in children 2 1/2 to 15 years of age in
greater Taos, New Mexico (estimated population 6,000 to
7,000). Beta hemolytic streptococci, isolated from the
throats of two patients and from several other family mem-
bers of two patients in the same family, were found by
standard typing and grouping methods to be Group A. M
type 12, suggesting that this epidemic was related to type
12 nephritogenic Group A streptococci. Most of the cases
had a history of pharyngitis and one had otitis within a
2-week period prior to the onset of edema, usually facial.
There were no skin lesions reported. Most of the cases
were relatively mild with only mild hypertension and no
serious oligur.i or azotemia. On follow-up examination
most patients were clinically asymptomatic although some
urinary abnormalities persisted.
Eight of the cases came from the vicinity of El Prado
and Arroyo Seco, two small communities north of Taos
with an estimated combined population of about 1,000 to
1,200, -uggo-ring a localized epidemic. Because of this
likelihood, surveys including throat cultures and urinalysis
were conducted on March .-. 1969, on family members of
cases, children riding the school buses coming from these


two areas to Taos schools, and seventh grade students at
the Taos Junior High School where two index cases had
occurred. Results of the throat cultures are presented in
Table 1. Urine samples were studied on 14 of the 16 in-
dividuals with type 12 Group A streptococci in their
throats. Three of these showed a trace of protein and a
few red blood cells. Over 300 urine samples from the re-
maining population were studied for the presence of pro-
tein and red blood cells. Eleven specimens were found
to contain 1+ or more protein by the sulfosalycylic acid
method and four of these contained red cells, granular
casts, and red cell casts, suggesting acute glomerulo-
nephritis. None of these children was among the original
10 cases. Only one of these four children with urinary
findings suggesting acute glomerulonephritis had a throat
culture positive for Group A streptococci and these were
not type 12.
(Reported by William R. Kilgore, M.D., Physician. Taos:
Carol C. Geil, M.D., Instructor in Pediatrics, John Olds,
M.D., Resident in Medicine, and E. A. Mortimer, M.D.,
Professor and Chairman, Department of Pediatrics, Uni-
versity of New Mexico School of Medicine, Albuquerque;
and Bruce H .'.'*'. M.D., Director, Division of Medical
Services, New Mexico Department of Health.)


Table 1
Throat Cultures from Close Contacts of Patients with Glomerulonephritis

SNumber Number Group A Number Percent of Total Percent of Group A
Population Cultured (Lancefield M.-lhodj \ T. p- 1-: Cultures Group A M Type 12
Family Members 32 5 3 10.0 60
School Bus 97 13 4 4.1 30
Seventh Grade 211 28 9 4.3 32
Total 340 46- 16 4.7 33


STAPHYLOCOCCAL FOOD POISONING Idaho


On April 26 and 27, 1969, two separate outbreaks of
food poisoning occurred on the Fort Hall Indian Reserva-
tion. Pocatello, Idaho. On April 26 about 150 of approxi-
mately 200 persons attending a luncheon at the annual
Bannock-Shoshone tribal meeting developed nausea, ab-
dominal pain, vomiting and diarrhea within 1 to 6 hours
after eating, 35 persons were hospitalized. Roast beef
served at the luncheon was found to be heavily contami-
nated with coagulase-positive Staphylococcus aureus.
The second outbreak occurred on April 27 following a


church dinner on the reservation. About 36 of 58 persons
became ill within hours after the dinner with the same
symptoms as persons in the first outbreak; three persons
were hospitalized. Roast turkey from this meal was also
heavily contaminated with coagulase-positive staphylo-
cocci. This organism was also isolated from vomitus and
stools of persons in both outbreaks.
The beef and turkey for both meals were furnished by
the same local catering service. The food handler who
(Continued on page 240)







236 Morbidity and Mortality Weekly Report


TABLE 1II. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED
JULY 5, 1969 AND JULY 6, 1968 (27th WEEK)


ASEPTI( ENCEPHALITIS HEPATITIS
I- BICEL- IHTHERIA Primary including Post- MALARIA
AREA CITIS LI S unsp. cases Infectious Seru Infectious
Cum.

'.iTE I -I: TE'.. .2 S lu 22 5 DI 662 81 54 I,370

NEW ENGLAND........... 1 3 43 29 1 44
Maine............. 1 1 2
New Hampshire....... 5 1 2
Vermont............ 1 1 1 -
Massachusetts...... 1 23 20 33
Rhode Island....... 1 5 2 2
Connecticut........ 8 4 1 5

MIDDLE ATLANTIC...... 9 1 1 2 2 16 100 114 152
New York City ..... 3 2 10 16 21 13
New York, up-State. 1 16 30 23
New Jersey.......... 6 1 1 4 22 37 54
Pennsylvania....... 2 1 46 26 62

EAST NORTH CENTRAL... 5 1 3 3 1 13 103 105 3 133
Ohio............... 2 1 1 2 3 21 18 14
Indiana............ 3 21 10
Illinois........... 2 1 2 21 23 3 73
Michigan........... 1 1 1 8 51 31 35
Wisconsin.......... 1 7 12 1

WEST NORTH CENTRAL... 1 4 1 35 42 2 88
Minnesota.......... 1 1 9 11 7
Iowa ............... 3 6 9 7
Missouri........... 17 7 23
North Dakota........ I 1 3 2
South Dakota........ -- .
Nebraska........... 1 1 3
Kansas............. 1 1 11 2 46

SOUTH ATLANTIC....... 14 1 4 5 68 84 20 425
Delaware........... .- 4 2
Maryland ........... 3 1 7 9 5 16
Dist. of Columbia.. 2 1
Virginia............ 1 6 10 1 16
West Virginia...... 4 7
North Carolina .... 12 11 12 197
South Carolina..... 8 2 3 39
Georgia............ 5 16 132
Florida............. 3 1 3 4 30 24 2 22

EAST SOUTH CENTRAL... 1 1 1 1 32 29 1 52
Kentucky............ .- 7 9 1 42
Tennessee.......... 1 1 16 14 -
Alabama .......... 2 3 8
Mississippi........ 1 1 7 3 2

WEST SOUTH CENTRAL... 6 6 9 2 45 43 3 38
Arkansas........... 2 1 6
Louisianat......... 3 7 1 7 8 1 28
Oklahoma........... .1 .. 2 2 9 1 4
Texas.............. 2 6 1 34 26 -

MOUNTAIN............. 1 26 21 15 107
Montana ............. 1 -
Idaho.............. 3
Wyoming............. 1 1 --
Colorado........... 5 13 92
New Mexico......... 1 4 4 2 6
Arizona............. 11 9 1
Utah............... 5 2 I
Nevada............. 4 4

PACIFIC............... 13 1 3 4 2 38 210 214 9 331
Washington......... 6 21 5
Oregon ............. 11 6 6
California.......... 12 1 3 3 2 38 190 187 6 254
Alaska............ 1 1 2- 2
Hawaii.............. 1 2 3 64

S28 I

*nelaved Reports: Asc-tic Meningitis: N.C. Delete 1, La. 1
Hepatitis, Infectious: Me. 3, Ala. 2, P.R. 8






Morbidity and Mortality Weekly Report 237


TABLE III. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

JULY 5, 1969 AND JULY 6, 1968 (27th WEEK) CONTINUED


MEASLES (Rubeola) MENINGOCOCCAL INFECTIONS, MUMPS POLIOMYELITIS RUBELLA
TOTAL
AREA Cumulative Cumulative Total Paralytic
Cum.
1969 1969 1968 1969 1969 1968 1969 1969 1969 1969 1969
UNITED STATES... 475 18,405 17,717 36 2,057 1,691 898 3 667

NEW ENGLAND.......... 34 946 1,065 70 87 183 1 76
Maine. ............. 5 35 6 6 3 3
New Hampshire...... 2 228 141 2 7 1 1
Vermont............ 2 1 1 1 -
Massachusetts...... 2 170 328 31 37 84 18
Rhode Island....... 4 22 1 6 7 13 4
Connecticut........ 26 519 559 25 29 81 1 50

MIDDLE ATLANTIC....... 213 6,948 3,304 2 331 299 111 71
New York City...... 105 4,625 1,530 67 62 101 32
New York, Up-State. 11 551 1,141 51 47 NN 35
New Jersey......... 20 818 529 1 141 111 10 -- 2
Pennsylvania....... 77 954 104 1 72 79 NN 2

EAST NORTH CENTRAL... 93 1,880 3,512 7 277 201 225 162
Ohio................ 38 337 276 3 98 54 77 7
Indiana............. 2 453 614 1 35 26 9 6
Illinois........... 36 399 1,309 39 44 32
Michigan........... 7 197 236 3 88 60 32 53
Wisconsin.......... 10 494 1,077 17 17 107 64

WEST NORTH CENTRAL... 3 481 354 2 108 86 9 12
Minnesota.......... 1 5 15 1 23 19 -
Iowa................ 1 320 89 1 15 6 7 2
Missouri.*......... 16 80 46 31 -
North Dakota....... 7 123 3 2 10
South Dakota....... 1 3 4 1 4 NN -
Nebraska........... 126 35 9 6
Kansas............ 4 8 14 17 -

SOUTH ATLANTIC....... 22 2,335 1,352 9 363 346 60 116
Delaware............ 2 362 14 4 6 1 4
Maryland.*......... 1 63 80 33 26 8 4
Dist. of Columbia.. 6 9 13 1
Virginia........... 9 853 288 2 46 27 13 30
West Virginia...... 162 239 1 17 8 21 41
North Carolina..... 6 291 281 3 62 68 NN -
South Carolina..... 109 12 1 52 55 4 2
Georgia............ 1 4 1 61 60 -
Florida............. 4 494 428 1 79 83 13 34

EAST SOUTH CENTRAL... 2 100 449 3 130 145 35 25
Kentucky........... 1 59 93 46 57 3 1
Tennessee.......... 1 17 55 3 49 48 29 22
Alabama............ 3 75 20 20 1
Mississippi........ 21 226 15 20 3 1

WEST SOUTH CENTRAL... 60 4,079 4,441 3 280 280 97 2 43
Arkansas........... 16 2 28 18 -
Louisiana.*........ 120 3 1 74 79 --
Oklahoma............ 130 109 1 28 48 1 -
Texas.............. 60 3,813 4,327 1 150 135 96 2 43

MOUNTAIN............. 29 698 917 36 26 55 28
Montana............ 10 57 5 3 5 -
Idaho............... 84 20 6 11 3 1
Wyoming............. 50 -
Colorado............ 115 475 6 7 7 7
New Mexico......... 20 212 82 6 12 4
Arizona............. 9 270 207 9 1 26 15
Utah................ 6 21 2 1 2 1
Nevada............. 1 5 2 3 -

PACIFIC.............. 19 938 2,323 10 462 221 123 134
Washington.......... 57 513 50 36 7 4
Oregon............... 2 190 447 11 17 6 9
California.......... 17 660 1,327 10 380 155 100 84
Alaska.............. 8 2 11 2 4 8
Hawaii.............. 23 34 10 11 6 29

Puerto Rico.......... 50 1,106 339 15 18 31 35

*Delayed Reports: Measles: Mass. Delete 3, Md. 1
Meningococcal Infections: La. Delete 1
Mumps: Me. 6
Rubella: Me. 3, Mo. 139, Md. Delete 1







238 Morbidity and MortaliIt Weekly Report


TABLE III. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

JULY 5. 1969 AND JULY 6, 1968 (27th WEEK) CONTINUED


STREPTOCOCCAL TYPHUS FEVER
SORE THROAT & TETANUS TULAREMIA TYPTICK-BORNE RABIES IN
AREA SCARLET FEVER FEVER (Rky. Mt. Spotted) ANIMALS
Cum. Cu m. Cum. Li. I u,.
1969 I969 1969 1969 1969 1969 1969 19969 169 1969 1969
UNITED STATES... 4,812 2 65 1 80 7 143 18 179 50 1,941

NEW ENGLAND............ 816 14 5 2 9
Maine.............. 6 1 1 5
New Hampshire...... 1
Vermont............ 22 14 1
Massachusetts...... 144 3 -
Rhode Island....... 37 1 -
Connecticut........ 607 -

MIDDLE ATLANTIC...... 365 10 3 1 14 3 20 6 72
New York City...... 26 5 1 6 --
New York, Up-State. 291 2 2 1 5 5 4 67
New Jersey......... NN 1 3 -
Pennsylvania....... 48 2 3 2 12 2 5

EAST NORTH CENTRAL... 318 1 9 7 13 3 127
Ohio............... 59 7 35
Indiana. .......... 44 1 2 39
Illinois........... 70 1 6 2 2 1 23
Michigan........... 102 3 4 3
Wisconsin.......... 43 4 27

WEST NORTH CENTRAL... 160 4 7 4 2 16 363
Minnesota.......... 8 1 5 89
Iowa............... 36 1 5 54
Missouri........... 1 4 2 1 102
North Dakota....... 98 -- 4 49
South Dakota....... 6 1 13
Nebraska ........... 2 1 10
Kansas............. 10 3 3 1 46

SOUTH ATLANTIC....... 513 13 1 19 2 26 14 100 5 527
Delaware.......... 1 2 -
Maryland .......... 85 4 2 26 -
Dist. of Columbia.. 2 1 -
Virginia............ 118 1 3 9 33 4 271
West Virginia...... 99 I 2 1 4 1 83
North Carolina..... NN 2 5 4 1 28 4
South Carolina..... 87 1 2 1 2 5 -
Georgia............ 2 3 7 2 48
Florida............ 122 7 4 2 7 121

EAST SOUTH CENTRAL... 642 1 9 9 1 15 27 3 305
Kentucky............ 73 3 2 5 1 162
Tennessee.......... 458 4 8 1 11 21 2 110
Alabama............ 57 1 -- 1 33
Mississippi........ 54 1 1 1 2 -

WEST SOUTH CENTRAL... 261 13 12 2 19 17 7 260
Arkansas........... 4 1 2 10 4 2 20
Louisiana......... 1 5 2 16
Oklahoma. .......... 1 1 5 10 1 40
Texas.............. 255 7 4 9 3 4 184

MOL'TAIN............. 1,636 1 9 20 8 3 91
Montana........... 9 1 -
Idah............... 72 3 -
Wyoming............. 4 2 5 1 47
Coorado........... 1,323 1 2 7 3
Nw Mexico.......... 141 1 5 1 9
Arizona............. 47 4 22
tah............... 40 5 2
Nvada ............. -- 1 1 8

PA IFIC .............. 101 6 1 27 1 5 5 187
Washington........9 1 1 3 1
regon.............. 46 6 1 1
Calirnia......... -- 5 1 20 1 2 4 185
Alska. ............ 8 -
3Hawa i........ .... 38

Puert Rico......... 3 3 3 1 18

*Delayed Reports: SST: Me, 6
Rabies in animals: Ind. Delete 1






239


Morbidity and Mortality Weekly Report






TABLE IV. DEATHS IN 122 UNITED STATES CITIES FOR WEEK ENDED JULY 5, 1969


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

All Causes Pneumonia Under All Causes Pneumonia Under
Area All 5 years and 1 year Area All 65 years and 1 year
Influenza All y Influenza All
Ages Iand over All 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, 111.---------
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.--------


676
204
47
30
21
62
26
23
14
35
64
9
53
36
52

3,018
47
33
133
30
26.
35
67
74
1 ,549
35
447
165
46
99
30
27
78
40
34
23

2,572
59
30
857
148
159
97
66
391
28
46
33
30
55
148
35
111
36
28
34
119
62

695
36
14
35
112
22
96
51
182
91
56


396
102
27
18
15
37
18
16
11
25
35
5
35
19
33

1 ,769
33
21
74
19
16
22
30
30
909
24
253
98
30
64
23
16
51
13
27
16

1,432
31
23
454
83
88
53
37
207
18
22
20
18
34
92
18
60
18
13
23
75
45

404
24
8
19
64
14
58
28
95
59
35


SOUTH ATLANTIC:
Atlanta, Ga.-----------
Baltimore, Md.---------
Charlotte, N. C.-------
Jacksonville, Fla.-----
Miami, Fla.------------
Norfolk, Va.-----------
Richmond, Va.-----------
Savannah, Ga.----------
St. Petersburg, Fla.---
Tampa, Fla.------------
Washington, D. C.------
Wilmington, Del.-------

EAST SOUTH CENTRAL:
Birmingham, Ala.-------
Chattanooga, Tenn.-----
Knoxville, Tenn.-------
Louisville, Ky.--------
Memphis, Tenn.---------
Mobile, Ala.-----------
Montgomery, Ala.-------
Nashville, Tenn.-------

WEST SOUTH CENTRAL:
Austin, Tex.-----------
Baton Rouge, La.-------
Corpus Christi, Tex.---
Dallas, Tex.-----------
El Paso, Tex.-----------
Fort Worth, Tex.-------
Houston, Tex.-----------
Little Rock, Ark.------
New Orleans, La.-------
Oklahoma City, Okla.---
San Antonio, Tex.------
Shreveport, La.--------
Tulsa, Okla.-----------

MOUNTAIN:
Albuquerque, N. Mex.---
Colorado Springs, Colo.
Denver, Colo.----------
Ogden, Utah------------
Phoenix, Ariz.---------
Pueblo, Colo.----------
Salt Lake City, Utah---
Tucson, Ariz.----------

PACIFIC:
Berkeley, Calif.-------
Fresno, Calif.----------
Glendale, Calif.-------
Honolulu, Hawaii-------
Long Beach, Calif.-----
Los Angeles, Calif.----
Oakland, Calif.--------
Pasadena, Calif.-------
Portland, Oreg.--------
Sacramento, Calif.-----
San Diego, Calif.------
San Francisco, Calif.--
San Jose, Calif.-------
Seattle, Wash.----------
Spokane, Wash.----------
Tacoma, Wash.----------


Total


1,147
156
295
40
36
74
57
90
28
68
70
202
31

506
101
39
36
109
88
38
29
66

994
27
23
12
135
31
72
192
57
169
64
103
56
53

376
41
26
114
21
73
27
40
34

1,178
12
21
15
48
104
254
55
39
135
44
86
144
52
98
45
26


I


11.162


Cumulative Totals
including reported corrections for


6.246 1 386 1 555


previous weeks


All Causes, All Ages ------------------------- 361,508
All Causes, Age 65 and over------------------- 208,240
Pneumonia and Influenza, All Ages------------- 18,507
All Causes, Under 1 Year of Age--------------- 16,497


Week No.


*Estimate based on average percent of divisional total.


i t









Morbidity and Mortality Weekly Report


STAPHYLOCOCCAL FOOD POISONING
(Continued from page 235)


prepared the beef had a lesion on his finger from which
coagulase-positive S. aureus were isolated. Environmental
cultures of the meat Ir 1pa ii l;n area and utensils were
also positive for this organism. Both meats were prepared
24 hours prior to serving, were sliced while warm, were
placed in 80 to 100-lb. masses in aluminum-lined and
covered fiber cartons which did not permit rapid cooling,
and stored in a walk-in cooler.
All coagulase-positive staphylococci isolated from
epidemic and environmental specimens were phage-type
6'47,53 ,54,75 '3A +. Studies performed by the Food
and Drug Administration demonstrated type A and D
staphylococcal enterotoxin in samples of both beef and
turkey.
(Reported by Robert 1. Adler, M.D., Medical Director, Fort
Hall Indian Health Center; Ivan Frazier, Administrator,
Soulthastern District Health Department; John A. Mather,
i.D., Director, Preventive Medicine Division, Idaho De-
partment of Health; Division of Microbiology, Food and
Drug Administration; and an EIS Officer.)


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
ATLAN I A, 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.


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JULY 5, 1969




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