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:
AA00010654:00223

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


yA'. '" ...
asid WAfA'


U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE / PUBLIC HEALTH SERVICE -HEALTH SERVICES AhDJ


DATE OF RELEASE: AUGUST 15,


EPIDEMIOLOGIC NOTES AND REPORTS
HUMAN BABESIOSIS Massachusetts

On July 13, 1969, a 59-year-old widow was admitted
to a New Jersey hospital with a 2-week history of fever,
headache, malaise, and weakness. A peripheral blood smear
contained numerous atypical ring-like structures within
the red blood cells, which resembled Plasmodium falciparum
trophozoites. The patient, however, gave no history of
exposure to malaria, blood transfusions, or drug abuse,
and a medical evaluation uncovered no chronic or debilitat-
ing diseases. A normal splenic shadow was present on a
barium enema examination.
For the past 20 years, the patient's travel had been
limited to the continental United States and Hawaii. On
May 5, she and her 2-year-old dachshund left Southern
California for their summer home on Nantucket Island,


1969 ATLANTA, GEORGIA 30333


Epidemiologic Notes and Reportien i th d
Human Babesiosis '.1 o tI ks .. r. 277
Haterborne Outbreak < r or rd at.p 'e d
F r r.' ] r i e~ r o ni n ; ,, I v., I *? 7





in her on suprasternal notch., ..
,, 1.... ,,,,,,.


r.nd rtlurrn -mrill r,.denlr- hI_, th(. he .0 i- lr.
common on the island, the patient examined the dachshund
daily and removed a number of ticks with tweezers or her
fingers. In mid-May she removed a tick deeply embedded
in her own suprasternal notch.
The patient was treated with chloroquine and gradually
recovered, and the parasitemia disappeared. The pretreat-
ment smears were reviewed at the National Malarial Re-
pository, NCDC, and babesiosis was tentatively diagnosed
(Continued on page 278)


TABLE I. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous weeks)
32nd WEEK ENDED CUMULATIVE, FIRST 32 WEEKS
MEDIAN
DISEASE August 9, August 10. 1964 1968 MEDIAN
1969 1968 1969 1968 1964 1968
Aseptic meningitis ...................... 111 186 81 1.286 1.588 1.185
Brucellosis ............................ 2 2 7 113 127 152
Diphtheria........................... ..... 4 1 1 90 101 101
Encephalitis, primary:
Arthropod-borne & unspecified .......... 22 44 44 642 596 894
Encephalitis, post-infectious ............. 9 7 15 213 335 542
Hepatitis, serum ........................ 158 93 5 3,221 2.591 24
Hepatitis, infectious .................... 917 843 28,576 26.822
Malaria ................................ 44 30 11 1,677 1.298 203
Measles rubeolaa) ......................... 135 189 790 19.677 18.954 186.980
Meningococcal infections, total ........... 33 29 29 2.243 1,869 1,869
Civilian .............................. 31 27 2.041 1.694 "
Military............................... 2 2 202 175 -
Mumps ................................. 578 715 65.888 121.951
Poliomyelitis, total ..................... 2 1 1 8 38 38
Paralytic ............................... 2 1 1 8 38 38
Rubella (German measles) ............... 371 324 47.696 42,505 -
Streptococcal sore throat & scarlet fever.... 4,086 4.499 4,249 285,839 283,609 283,609
Tetanus .............................. 5 4 7 87 89 131
Tularemia .............................. 1 7 88 123 123
Typhoid fever ......................... 11 10 10 172 195 242
Typhus, tick-borne (Rky. Mt. spotted fever) 32 15 14 309 164 164
Rabies in animals ...................... 44 65 69 2,249 2.273 2814

TABLE II. NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax: ........ ........... ....... ................. 3 Rabies in man: ............................... ... 1
Botulism: .......................................... 11 Rubella congenital syndrome: ...................... 6
Leptospirosis: La.-1 ................................. 39 Trichinosis: Conn.-1 ................................. 152
Plague: ......................................... 3 Typhus, marine: Ohio-1 ............................. 32
Psittacosis: ....................................... 23


Vol. 18, No. 32






For
Week Ending
August 9, 1969






Morbidity and Mortality Weekly Report


AUGUST 9, 1969


BABESIOSIS (Continued from front page)


on the hasis of the morphology of the parasite and the
absence of malarial pigment or circulating gametoay tes.
The patient's blood \ as inoculated into various labo-
rator\ animals, and infection \a\s established in a hamster.
The appearances of tlch organism in human and hamster red
Ilood cell compatible with a rodent Babesia species,
pos-ihl, H. rodhaini.
tieported by Gordon D I. Rension. M.., AD.ssociate Professor
of itl M.I).. Laihoritory Director, St. I'ter's General Hospital,
\rir Bru riiti'k, \'cir Jersiey; Ronald Altman, i.P.. Direc-
for. hiis0ion of Prercieltable Viseases, Neu' Jersey State
Vlrpariiit of lit/alth: aii ola/ s J. i a.'*. M.D., Direc-
tor. )iiision of (Communicable Diseases, MassachuLsetts
I)' parfmrn( of Plub/ili'c health; and the Malaria Surveillance
[ i., \C ')c .)


Editorial Note:
Babesiosis is a cosmopolitan, tick-transmitted pro-
tozoal infection in many wild and domestic animals. In
some animals it causes a febrile, hemolytic disease. The
three human cases reported in the literature occurred in
splonectomized individuals. 1,2,3 This woman is the first
apparently healthy individual in whom the disease has
been recognized.

References:
ISkrahalo, Z., and DIanovic, Z.: Pirophtlsmosis in man. Report
on a icase. )oc de Mcd Georg et Trop. 9:11, 1957.
I I .,,, I J. E. P., Kennedy, C. C., McGeownr, M. G., et al:
Human (asI of piropla;smosis babesiosiss). Nature, 217:861-2,
1968.
3Srhollton, R. G., raffl, K. HI., lHaly, G. R., ad Gleason, N.:
A cais,, of ba rb'si oi in man in the United States. Am J Trop
Mi d & Hy, 17:'10. 1968.


WATERBORNE OUTBREAK OF GASTROENTERITIS Frederick County, Maryland


In Frederick County. Maryland, 54 of 114 residents
(17 percent) inter\ iewed in 26 occupied dwellings of a new
housing development experienced acute febrile gastro-
entceriti in \Ma and June 1969 (Figure 1), The illnesses
lasted 1 to 9 days and were characterized by diarrhea.
abdominal cramps, fever, and, less frequently, nausea and
vomiting : two persons were hospitalized briefly. The ages
of the patients ranged from 11 months to 50 years. Shigiella
oiin.ci was isolated from 9 of 17 persons in four different
households who submitted stool specimens for culture; no
other bacterial pathogens were recovered.
Except for their common water supply, no factors of
-imiilar exposure could le found to account for this sizable
outbreak. The water for all the houses in the new develop-
ment came from an unchlorinated drill well located about
100 feet from a septic-tank sewerage system. In late May
and early June. residents complained of a foul odor in the
area. possibly due to sewage overflow. In mid-June, water
samnples from the houses and from the well demonstrated
high fecal coliform counts.
Control measures included altering the nearby sewer-
:ace system and installing, on June 19. a chlorinator on
the well supplying water to the housing development. No
cases of febrile gastroenteritis occurred after June 19.
(On June 20 the chlorine content of water from the well
ata-s 0.h parts per million, and no coliforms could be
demonstrated in water from household taps.
ik ported by Charles G. Spicknall, M.D., Deputy State
latif. -- .' and Carl Margrabe, Sanitarian, Environ-
mii, t Healtlh Services, Frederick County; Ioward J.


Figure 1
FEBRILE GASTROENTERITIS BY DATE OF ONSET
FREDERICK COUNTY, MARYLAND MAY 15-JUNE 30, 1969
18

16



12

Sto CHLORINATOR
INSTALLED
s ON WELL


6

4

2


15 1? 19 21 23 25 27 29 31 2 4 6 8 10 12 14 16 18 20 22 24 26 28 30
MAY JUNE
DATE OF ONSET


Garber. M.I)., M.P.lI., Chief, divisionn of Communicable
Diseases, Varyland Department of Health; and an EIS

Editorial Note:
There is a -rr;kin_' similarity between this outbreak
and the recent waterborne outbreak of shigellosis in Prine-
ville. Oregon. (MMWIR. Vol. IS. No. :: i Both point up the
need for chlorination of private water supplies in suburban
housing developments as well as in incorporated cities.


MELIOIDOSIS Maryland


Melioidosis was recently diagnosed in a male rhesus
m'onke l (liiiraca mulatta) being used in psychological re-
search at the National Institutes of Health ij\llI The
monke, was received at NIH on Oct. 1, 1968, in a ship-


ment of 50 from India. His only overt illness occurred on
October 7, when he had soft stools for which he received
tetracycline, nitrofurazone, and a commercially-made oral
feeding mixture. On December 2 he was issued to a psy-


278







Morbidity and Mortali


chology laboratory, where on December 18 he underwent a
craniotomy with excision of parts of the cortical sensory
areas. Sensory testing was started on Jan. 15, 1969, but
the monkey proved difficult to test and train.
In late April round scabs were noted at the surgical
scar; by mid-May they appeared raised and were thought
to be underlain by abscesses. On May 19 the lesions
were distinctly suppurative, and at this time similar pro-
cesses were noticed on the skin of the chest and leg.
The superficial head and chest lesions were cultured. The
former site yielded a mixed flora of Staphylococcus aureus,
Enterobacteriaceae, and Proteus sp. with a few colonies
that were later shown to be Pseudomonas pseudomallei,
and the chest culture yielded predominantly P. pseu-
domallei.
The animal was sacrificed on May 28. Blood values
at that time were hematocrit 32 percent, hemoglobin 9.1
g/ 100 ml, RBC 4,490,000, and WBC 24,850 with 84.5
percent neutrophils, 15 percent lymphocytes, and 0.5 per-
cent monocytes. At necropsy a 2 cm raised, fluctuant,
subcutaneous abscess was observed on the left dorsal
aspect of the head, directly over the site of the previous
frontopariental craniotomy. The abscess contained thick
pale yellow pus. A similar subcutaneous abscess was
located on the left chest, approximately 1 cm lateral to
the nipple, and was connected by a fistulous tract to a
larger 3 by 4 cm abscess in the left axilla, apparently in-
volving the axillary lymph nodes. Internally, multiple 0.5
to 1 cm abscesses were observed in the liver, spleen,
pancreaticosplenic lymph nodes, and in the superior gas-


AUGUST 9, 1969


SUMMARY OF REPORTED CASES OF INFECTIOUS SYPHILIS

CASES OF PRIMARY AND SECONDARY SYPHILIS: By Reporting Areas July, 1968 and July, 1969 Provisional Data
Cumulative Cumulative
Reporting Area July Jan.-July Reporting Area July Jan.-July
196 19681969 1 968 1069 1968 1969 1968 1969 1968
NEW ENGLAND .............. 42 23 210 188 EAST SOUTH CENTRAL........ 51 124 566 865
Maine................... 2 2 5 4 Kentucky................. 6 6 103 64
New Hampshire........... 4 7 Tennessee............. 8 27 165 211
Vermont................. 1 1Alabama................. 26 72 148 382
Massachusetts........... 22 16 123 115 Mississippi.............. 11 19 150 208
Rhode Island............. 2 2 18 23
Connecticut............. 11 3 56 46 WEST SOUTH CENTRAL........ 293 344 2,081 2,049
Arkansas................. 23 13 113 80
MIDDLE ATLANTIC.......... 332 278 2,160 1.860 Touisiana............... 67 100 396 519
Upstate New York........ 17 32 158 134 Oklahoma................ 5 7 48 50
New York City........... 235 175 1,483 1,176 Texas.................... 198 224 1,524 1,400
Pa. (Excl. Phila.)...... 12 18 88 146
Philadelphia............. 14 21 125 142 MOUNTAIN ................. 75 33 363 297
New Jersey............... 54 32 306 262 Montana........... .... 2 5 6
Idaho ............ .... 1 5 3
EAST NORTH CENTRAL....... 225 216 1.480 1,672 Wyoming................ 4 1
Ohio.................. 31 42 209 275 Colorado................ 6 31 9
Indiana................. 33 20 206 196 New Mexico............... 37 13 164 88
Downstate Illinois...... 32 18 162 103 Arizona................. 19 11 111 153
Chicago................ 69 86 519 599 Utah.................... 3 1 9 8
Michigan................ 54 50 370 487 Nevada................... 9 6 34 29
Wisconsin............... 6 14 12
PACIFIC.................. 166 156 1,116 1,000
WEST NORTH CENTRAL........ 31 41 193 223 Washington............... 5 7 32 32
Minnesota................ 11 9 27 27 Oregon.................. 3 4 25 23
Iowa.................... 2 20 21 California .............. 157 143 1.054 940
Missouri................. 11 25 94 112 Alaska........ ...... 1 1 1
North Dakota............ 5 6 Hawaii.................. 1 1 4 4
South Dakota............. 2 7 25 1,587 1,598 10,981 11,168
Nebraska................. 3 2 18 19 S. TOTAL...........
Kansas................... 6 1 22 13 TERRITORIES.. ...54 81 69 664
TERRITORIES .............. 54 81 690 664
SOUTH ATLANTIC............ 372 383 2,812 3,014 Puerto Rico............. 54 81 682 633
Delaware................ 6 3 27 21 Virgin Islands........... 8 31
Maryland................ 25 59 249 281
District of Columbia..... 48 39 325 363
Virginia................ 36 25 160 168
West Virginia............ 3 3 12 22
North Carolina........... 36 34 306 377 Note: Cumulative Totals include revised and delayed reports
South Carolina........... 56 41 350 304 through previous months.
Georgia................. 91 74 580 474
Florida.................. 71 105 803 1,004


ty Weekly Report 279


tric nodes. One of the liver abscesses was contiguous
with the wall of the gallbladder. Two 1 cm subpleural
abscesses occurred in the dorsal aspect of the right
apical lung lobe and lesions were found also in several
mediastinal lymph nodes. The pus in the internal lesions
was thin, dull white, and in some lesions appeared tinted
pale green. Cultures taken from the head, chest, liver,
and spleen yielded pure growth of P. pseudomallei, while
culture of heart blood was negative. Identification of the
organism was confirmed at the Walter Reed Army Institute
of Research and at NCDC.

(Reported by Thomas D. Moore, Ph.D., and Anton M.
Allen, D.V.M., Ph.D., Chief, Comparative Pathology Sec-
tion, and Amos E. Palmer, D.V.M., Chief, Animal Con-
ditioning Section, Laboratory Aids Branch, Division of
Research Services, National Institutes of Health.)

Editorial Comment:
This report represents the fourth culture positive
case of melioidosis in imported nonhuman primates re-
ported this year. Melioidosis was previously diagnosed in
two stump-tailed macaques (MMWR, Vol. 18, No. 19) and
a chimpanzee. The first reported case had a history of a
chronically discharging lesion present at the time of
importation. The next two cases first showed signs of
disease at the site of implanted foreign objects. The
current case first showed signs of disease at the site of
an old surgical wound. A serological survey currently in
progress indicates that a significant number of monkeys
from Southeast Asia have titers to P. pseudomallei.







280 Morbidity and Mortalily Weekly Report


TABLE II. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

AUGUST 9, 1969 AND AUGUST 10, 1968 (32nd WEEK)

AEPTIP ENCEPHALITIS HEPATITIS
'I- 1BR 11iiEL- fIT Primary including pI t- MALARIA
AREA TIS L unsp. cases Idctous Serum Infectious
Cum.

Jrf.i EL _1AIE .... 22 .. 9 15 1 -] -.. 31,0 7

NEW ENGLAND............ 1 4 67 37 2 61
Maine .............. 5 1 4
New Hampshire...... 5 1 2
Vermont............. 3 4 -
Massachusetts...... 1 3 40 16 1 41
Rhode Island........ 10 4 3
Connecticut........ 1 4 11 1 11

MIDDLE ATLANTIC...... 35 5 6 2 69 203 150 7 191
New York City...... 1 2 62 100 48 16
New York, up-State. 4 2 1 2 1 21 39 1 29
New Jersey.*........ 11 1 2 5 38 40 4 76
Pennsylvania........ 19 3 1 44 23 2 70

EAST NORTH CENTRAL... 8 5 13 1 22 105 129 1 167
Ohio............... 5 4 10 5 29 46 1 17
Indiana............. 6 13 14
Illinois............ 3 3 1 21 26 98
Michigan............ I 1 16 46 39 37
Wisconsin.......... 3 5 1

WEST NORTH CENTRAL... 17 8 35 50 3 111
Minnesota........... 17 6 11 20 7
Iowa............... 3 4 9
Missouri........... 7 9 1 29
North Dakota...... 2 3
South Dakota....... 1 4 --
Nebraska........... 10 4 3
Kansas............. 2 3 7 2 60

SOUTH ATLANTIC....... 16 1 4 3 5 2 10 101 46 10 480
Delaware........... 4 2
Maryland........... 10 1 1 14 1 23
Dist. of Columbia.. 1 1
Virginia........... 1 3 1 12 6 18
West Virginia...... 1 3 1 -
North Carolina..... 11 14 3 223
South Carolina..... 2 7 1 1 42
Georgia............. 3 31 9 4 146
Florida............. 4 1 1 1 1 2 7 23 10 2 25

EAST SOUTH CENTRAL... 6 4 1 42 42 4 67
Kentucky........... 1 16 15 1 54
Tennessee.......... 1 3 1 20 17 -
Alabama............ 4 6 3 3 11
Mississippi........ 1 7 2

WEST SOUTH CENTRAL... 9 1 5 1 80 84 9 86
Arkansas ........... 4 6 8
Louisiana.......... 3 5 10 12 2 34
Oklahoma........... 1 1 8 8 30
Texas............... 5 1 58 58 7 14

MOUNTAIN............. 1 3 1 2 51 34 1 119
Montana............ 1 1 3 7 3
Idaho............... 4 1 3
Wyoming............ -
Colorado............. 3 8 13 100
New Mexico............ 6 4 1 7
Arizona............. 5 4 -
Utah................ 2 4 4 1
Nevada............. 21 4

PACIFIC.............. 19 1 3 11 3 42 233 271 7 395
Washington.......... 1 25 29 5
Oregon............. 2 23 10 8
California......... 17 1 3 10 3 41 182 229 6 298
Alaska.............. 1 3 1 2
Hawaii............. 2 1 82

Puerto Rico.......... 13 16 1 2

*Delayed reports: Aseptic meningitis: N.J. 19
Hepatitis, serum: N.J. delete 2
Hepatitis, infectious: Me. 5, N.J. delete 2







Morbidity and Mortality Weekly Report 281


TABLE III. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

AUGUST 9, 1969 AND AUGUST 10, 1968 (32nd WEEK) CONTINUED


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

L'r. I TL T E .. 134 Iq,677 1 ,' 5.- 33 2,2.. 1,864 5,d 2 8 371

NEW ENGLAND.......... 12 1,074 1,132 5 79 94 81 1 29
Maine ........... 7 37 6 6 1 1
New Hampshire...... 1 238 141 2 7 -
Vermont............ 3 2 1 4 3
Massachusetts*..... 8 209 353 2 33 42 35 9
Rhode Island....... 22 5 8 7 15 4
Connecticut........ 3 595 594 3 30 31 26 1 12

MIDDLE ATLANTIC...... 45 7,342 3,796 7 360 338 87 39
New York City...... 23 4,844 1,900 2 73 68 83 27
New York, Up-State. 4 586 1,206 1 61 58 NN 6
New Jersey.*....... 11 861 580 4 149 122 4 -- 2
Pennsylvania....... 7 1,051 110 77 90 NN 4

EAST NORTH CENTRAL... 27 2,059 3,675 6 307 226 162 70
Ohio................ 2 361 288 1 116 62 5 17
Indiana............ 465 643 34 27 12 1
Illinois........... 11 463 1,347 41 51 36 3
Michigan............ 9 230 255 2 94 66 40 24
Wisconsin.......... 5 540 1,142 3 22 20 69 25

WEST NORTH CENTRAL... 4 511 377 116 100 8 1 13
Minnesota.......... 5 15 25 23 -
Iowa................ 3 328 96 15 6 6 1
Missouri............ 22 81 51 32 4
North Dakota....... 1 11 131 3 3
South Dakota....... 3 4 1 5 NN -
Nebraska........... 135 40 9 6 2 5
Kansas............. 7 10 15 25 1

SOUTH ATLANTIC....... 7 2,433 1,465 2 395 381 55 1 76
Delaware........... 373 15 8 8 3 -
Maryland............ 65 94 1 36 28 4 11
Dist. of Columbia.. 6 9 14 -
Virginia........... 1 882 293 49 30 9 17
West Virginia...... 2 179 277 18 9 31 27
North Carolina..... I 308 281 66 76 NN -
South Carolina..... 2 112 12 55 56 -
Georgia............. 1 4 69 73 -
Florida............. 1 513 483 1 85 87 8 1 21

EAST SOUTH CENTRAL... 1 106 482 139 160 34 1 55
Kentucky............ 1 62 99 49 64 7 2
Tennessee.......... 17 58 52 51 26 49
Alabama............ 4 93 23 24 1 1 4
Mississippi........ 23 232 1i 21 -

WEST SOUTH CENTRAL... 20 4,357 4,642 3 300 296 43 2 2 4 30
Arkansas........... 16 2 29 20 2 -
Louisiana.......... 120 11 79 83 -
Oklahoma............ 136 111 29 49 2 -
Texas............... 20 4,085 4,518 3 163 144 39 2 2 4 30

MOUNTAIN............ 11 801 958 3 44 29 23 23
Montana............ 16 58 1 9 3 1 -
Idaho............... 1 89 20 2 8 11 1
Wyoming.............. 51 1
Colorado............ 136 492 7 10 2 3
New Mexico......... 5 241 92 6 9 4
Arizona............. 4 310 219 10 1 7 11
Utah............... 1 8 21 2 1 4 3
Nevada............. 1 5 2 3 -

PACIFIC............... 8 994 2,427 7 503 245 85 36
Washington........... 58 515 2 53 37 6 2
Oregon............. 1 198 488 2 14 19 12 4
California.......... 7 695 1,387 3 415 176 59 22
Alaska............... 8 2 11 2 4 5
Hawaii.............. 35 35 10 11 4 3

Puerto Rico.......... 38 1,361 383 17 19 7 -

*Delayed reports: Measles: Me. 2, Mass. delete 1, N.J. 1
Rubella: Me. 9







282 Morbidity and Mortality Weekly Report


TABLE III. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

AUGUST 9, 1969 AND AUGUST 10, 1968 (32nd WEEK) CONTINUED


STREPTOCOCCAL TYPHUS FEVER
SORE THROAT & TETANUS TULAREMIA TYPED TICK-BORNE RABIES IN
AREA SCARLET FEVER FEVER (Rky. Mt. Spotted)
Cum. Cum. Cum. Cum. Cum.
1969 1969 1969 1969 1969 1969 1969 1969 1969 1969 1969
UNITED STATES... 4,086 5 87 1 88 11 172 32 309 44 2,249

NEW ENGLAND.......... 623 14 6 3 17
Maine. ............ 1 I 5
New Hampshire...... 33 1 4
Vermont ............ 1 14 2
Massachusetts...... 118 4 1
Rhode Island....... 37 1 -
Connecticut........ 433 2 5

MIDDLE ATLANTIC...... 318 13 4 17 3 30 3 102
New York City...... 12 6 1 8 -
New York, Up-State. 289 3 3 5 5 3 95
New Jersey......... NN 2 6 -
Pennsylvania....... 17 2 4 3 19 7

EAST NORTH CENTRAL... 295 11 7 6 20 1 151
Ohio.............. 16 1 7 44
Indiana............. 96 1 1 42
Illinois........... 59 7 2 6 9 26
Michigan........... 83 3 4 5
Wisconsin.......... 41 4 34

WEST NORTH CENTRAL... 174 1 6 1 11 2 8 8 11 425
Minnesota.......... 4 1 2 1 3 5 109
Iowa............... 33 7 1 62
Missouri........... 1 1 7 1 3 2 110
North Dakota....... 90 2 55
South Dakota....... 7 1 24
Nebraska.......... 39 1 1 1 10
Kansas............. 3 3 1 1 55

SOUTH ATLANTIC....... 415 1 18 20 1 30 23 182 3 575
Delaware........... 1 2 3 -
Maryland........... 53 1 4 4 40 1 1
Dist. of Columbia.. 2 1 -
Virginia............ 83 4 2 54 297
West Virginia...... 132 1 2 1 5 87
North Carolina..... NN 2 5 6 3 45 4
South Carolina..... 18 1 2 1 2 12 23 -
Georgia............. 4 2 3 7 2 12 1 54
Florida............ 124 1 9 4 7 1 132

EAST SOUTH CENTRAL... 1,009 2 15 9 17 2 37 4 335
Kentucky........... 126 6 2 5 3 176
Tennessee......... 652 4 8 12 2 31 114
Alabama............ 132 2 4 1 1 1 42
Mississippi....... 99 1 1 2 3

WEST SOUTH CENTRAL... 416 1 16 15 1 22 2 33 11 312
Arkansas........... 2 1 1 1 10 6 1 24
Louisiana.......... 2 6 4 2 1 23
Oklahoma............ 8 1 6 1 1 2 23 1 46
Texas.............. 404 8 4 9 4 8 219

MOUNTAIN ............ 705 2 8 1 22 2 14 2 99
Montana............ 15 1 -
Idaho .............. 73 3 1 4 -
Wyoming ........... 3 2 5 50
Colorado............ 382 1 3 1 8 3
New Mexico.......... 106 1 5 2 11
Arizona........... 58 1 5 22
Utah................ 68 5 2 3
Nevada............. 1 10

PACIFIC ............. 131 6 30 5 6 233
Washington......... 16 1 1 3 1 3
Oregon............. 61 6 2
California......... --- 5 23 2 5 228
Alaska............... 8 -
Hawaii............. 46 -

Puerto Rico.......... 4 5 18

*Delayed reports: SST: Me. 3
Rabies in animals: Wyo. 2







Morbidity and Mortality Weekly Report


TABLE IV. DEATHS IN 122 UNITED STATES CITIES FOR WEEK ENDED AUGUST 9, 1969

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


283


All Causes Pneumonia Under All Causes Pneumonia Under

Area All 65 years and 1 year Area All 65 years Infand 1 year
Ages and over Influenza Ages and over IAll esz 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.--------


746
268
56
25
30
53
21
20
28
57
65
11
39
25
48

3,112
49
39
181
47
40
41
61
68
1,595
43
403
158
39
105
28
32
78
44
25
36

2,315
49
33
621
164
151
143
66
315
30
60
44
26
44
160
40
111
29
42
21
93
73

806
57
25
41
129
26
118
65
231
70


451
143
41
19
19
34
17
12
17
29
40
9
21
19
31

1,752
23
30
108
29
24
23
37
30
899
24
219
77
25
64
18
23
43
17
17
22

1,301
25
21
334
97
85
93
34
158
19
29
23
12
29
89
22
65
14
29
12
64
47

497
41
17
12
85
18
78
39
134
48
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 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.----------


1,088
123
200
43
68
104
50
84
32
83
59
195
47

622
85
49
17
116
134
57
36
128

1,242
39
29
30
157
42
84
284
67
168
89
117
63
73

448
36
26
126
15
115
23
54
53

1,598
15
60
34
46
92
502
73
36
128
73
101
153
47
157
47
34


Total 11,977 6,743 1 389 581


Cumulative Totals
including reported corrections for


previous weeks


All Causes, All Ages ------------------------ 423,593
All Causes, Age 65 and over------------------- 243,441
Pneumonia and Influenza, All Ages------------- 20,706
All Causes, Under 1 Year of Age--------------- 19,604


Week No.
32


17 1
20 1 4
61 3 2
315 13 21
45 1 5
28 1 2
77 4 2
43 2
66 2 8
83 3 5
33 5 2
82 2 6
30 1 1
19 1







284


Morbidity and Mortality Weekly Report


ERRATA

Vol. 18, No. 30, p. 263
In lh i ariritw "'Pla UPI' l!)(t;h, in Tablhe 1 undtor
19(7 for Ne'pal ci'`a' and death-. delct(l the nlumi'rs 1;3
andi 12. No plaluo Casi ,s or h~iathI' 'ore reported in Nepal
during 1 !) .


Vol. 18, No. 31, p. 270
In thi article "l ipatitis Cook County. Illinois,"
in the -oc rion "Hlli porrdii iy ..." include ".. A1. Holm v s.
1.1) ., Alssoi''i I'tro/ isr r 0/ tif 1edicih/e. I /nifersity of
l//iiiiis, rlti l)ircrto of h'is-drCr iln Scftioln of tHepatology,
I'rcs hbytcriian St. Luk, xs Hfospimli, ('hijago,"


Vol. 18, No. 31, p. 271

In ith artir('l "Smanlltpox-\orldwidte." the last sen-
te1ncc in the first paragraph should hie changed to "Based
on current trendr, an estimated 45,000 cases will be re-
corded in 1969 (Figure 2)."


AUGUST 9, 1969


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.

F


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