Morbidity and mortality

MISSING IMAGE

Material Information

Title:
Morbidity and mortality
Uniform Title:
Morbidity and mortality (Washington, D.C. : 1952)
Running title:
Weekly mortality report
Weekly morbidity report
Morbidity and mortality weekly report
Abbreviated Title:
Morb. mortal.
Physical Description:
25 v. : ; 27 cm.
Language:
English
Creator:
United States -- National Office of Vital Statistics
Communicable Disease Center (U.S.)
National Communicable Disease Center (U.S.)
Center for Disease Control
Publisher:
The Office
Place of Publication:
Washington, D.C
Publication Date:
Frequency:
weekly
regular

Subjects

Subjects / Keywords:
Communicable diseases -- Statistics -- Periodicals -- United States   ( lcsh )
Mortality -- Periodicals -- United States   ( lcsh )
Morbidity -- Periodicals -- United States   ( mesh )
Mortality -- Periodicals -- United States   ( mesh )
Statistics, Medical -- Periodicals -- United States   ( lcsh )
Statistics, Vital -- Periodicals -- United States   ( lcsh )
Genre:
federal government publication   ( marcgt )
statistics   ( marcgt )
periodical   ( marcgt )

Notes

Additional Physical Form:
Also issued online.
Statement of Responsibility:
Federal Security Agency, Public Health Service, National Office of Vital Statistics.
Dates or Sequential Designation:
Vol. 1, no. 1 (Jan. 11, 1952)-v. 25, no. 9 (Mar. 6, 1976).
Issuing Body:
Issued by: U.S. National Office of Vital Statistics, 1952-Jan. 6, 1961; Communicable Disease Center, 1961- ; National Communicable Disease Center, ; Center for Disease Control, -Mar. 6, 1976.
General Note:
Title from caption.

Record Information

Source Institution:
University of Florida
Rights Management:
All applicable rights reserved by the source institution and holding location.
Resource Identifier:
oclc - 02246644
lccn - 74648956
issn - 0091-0031
ocm02246644
Classification:
lcc - RA407.3 .A37
ddc - 312/.3/0973
nlm - W2 A N25M
System ID:
AA00010654:00226

Related Items

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

Full Text


NATIONAL COMMUNICABLE DISEASE CENTER


Vol. 18, No. 39






For

Week Ending

September 27, 1969


U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE / PUBLIC HEALTH SERVICE ". HEALTH SERVICES AND MENTAL HEALTH ADMINISTRATION
DATE OF RELEASE: OCTOBER 3, 1969 ATLANTA, GEORGIA 30333


CURRENT TRENDS
CALIFORNIA ENCEPHALITIS Wsconsin

Encephalitis due to California Encephalitis (CE) virus
has been confirmed in 12 children hospitalized in Wiscon-
sin. There were no deaths. The first patient had onset of
illness on July 4 and the other 11 between July 27 and
September 4. Seven were from southwestern Wisconsin,
three were from southeastern Minnesota, and two were from
northeastern Iowa. Hemagglutination-inhibition (HI) anti-
body titers on acute and convalescent sera showed four-
fold or greater rise to CE virus on all 12. Laboratory con-
firmation is pending on three additional patients.


CONTENTS


oratory on hospitalized
or central nervous system
(Continued on page 338)


TABLE I. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous weeks)
39th WEEK ENDED MEDIAN CUMULATIVE, FIRST 39 WEEKS
MEDIAN
DISEASE September 27, September 28, 1964 1968 MEDIAN
1969 1968 1969 1968 1964 1968
Aseptic meningitis ...................... 157 236 109 2.380 3,107 2.128
Brucellosis ............................ 10 11 3 173 169 193
Diphtheria ............................. 11 7 2 127 145 144
Encephalitis, primary:
Arthropod-borne & unspecified ......... 57 57 75 897 987 1,385
Encephalitis, post-infectious ............. 3 5 9 252 389 605
Hepatitis, serum ....................... 89 124 3,905 3,283
Hepatitis, infectious .................... 940 1,002 34,907 33,308 29
Malaria ........................ ..... 93 35 11 2,168 1,686 308
Measles rubeolaa) ....................... 159 133 478 20,707 19,893 190,345
Meningococcal infections, total ........... 21 23 27 2.414 2,082 2.112
Civilian .................. .............. 21 22 2,208 1,901 "
Military ............................... 1 206 181
Mumps ................................. 524 765 --- 69,224 126,429
Poliomyelitis, total ..................... 1 4 1 13 47 47
Paralytic ..................... ....... 1 4 1 11 47 47
Rubella (German measles) ............... 319 231 -- 49,651 44.362 -
Streptococcal sore throat & scarlet fever.... 5,917 6.141 5,746 317,322 317.125 317,125
Tetanus ............................... 5 8 6 114 124 169
Tularemia ............................. 4 5 4 114 149 149
Typhoid fever ........................... 8 11 11 224 287 315
Typhus, tick-borne (Rky. Mt. spotted fever) 11 9 6 404 256 234
Rabies in animals ....................... 60 63 57 2,641 2,677 3.359

TABLE II. NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax: ......................................... 3 Rabies in man: ......................................
Botulism: .......................................... 11 Rubella congenital syndrome: Mo.-1 .................... 8
Leptospirosis: Ala.-1, Calif.-1 ...................... 59 Trichinosis: Ind.-l, N.Y. Ups.-1 ...................... 162
Plague: ............................................ 3 Typhus, marine: .................................... 35
Psittacosis: ...................................... 32


- 3 eT"t~c/ c- / ~P





338


symptoms are being routinely tested by the HI technique.
Comparative complement fixation tests have been performed
on positives using various strains of CE group viruses.
The highest liters occurred with antigen prepared with the
LaCrosse strain, previously isolated from a fatal case in
Wisconsin (MMHR. Vol. 13, No. 47).
CE virus is endemic in this area with human cases
having been reported each year since 1960. Of 71 cases
studied in previous years, 36 had onset of illness before
September and 35 in September or October.
(Reported by Wayne Thompson, D.I.M., Ph.D., Chief.


SEPTEMBER 27, 1969


Zoonoses Research Laboratory, Department of Preventive
Medicine, and Stanley L. Inhorn, M.D., Director, State
Laboratory of Hygiene, and H. Grant S.4r',*l-r. M.D., Di-
rector, Bureau of Preventable Diseases, Wisconsin State
Division of Health: Arnold H. Reece, M.D., ,"'.t. Pre-
centire Medical Serrice,,ola State i.' :' .r" ", .' of Health;
and Henry Bauer, Ph.D., Director, Division of Medical
Laboratories, and D. S. Fleming, M.D., Director, Divi-
nion of Dinease Prevention and Control, Minnesota De-
partment of Health.)


EPIDEMIOLOGIC NOTES AND REPORTS

TRICHINOSIS Ohio


In July 1969, an outbreak of trichinosis with three
case- was reported from Cleveland. Ohio. The first case
was in a 34-year-old man, who had onset on April 20 of
extreme weakness, facial edema, temperature of 103-104*F..
myalgia of the thighs and calves, and diarrhea. That day.
he went to the emergency room of a local hospital, where
a blood test showed a WBC of 6,300 and eosinophilia of
24 percent. He refused hospitalization. On April 23, he
is-ited his family physician, who also noted severe facial
edema, temperature of 103*F.. myalgia, nuchal rigidity.
sore throat, congested nasal passages, and erythema around
the neck and ears. Tests at that time demonstrated a WBC'
of 10.300. 19 percent *... n-r.i.lhll. and 1+ albuminuria.
H- r- o ered without treatment and returned to work on
\pril 2 Serologic tests performed on blood drawn on
ull\i 1, confirmed the diagnosis of trichinosis. The patient
ga~n\ a history of eating smoked bacon on April 4 and 5.
The other two cases were a father (Case 2) and son
((as-- :). who had sampled uncooked smoked bacon which
r-s eien to them by the first patient. The son had onset
of illne- on April 21 and was hospitalized on \1 5 with
a 2-week history of severe myalgia especially of the
cales. progressively increasing weakness and fatigue,
per orbital edema, and a spiking fever. A blood specimen
take-n on \Mav 6 was positive for trichinosis at the 1:64


dilution using the -~ --, ._,t Kl ir,- (SK) agglutination
test. He was discharged on May 19. This patient's father
became ill on April 2b with symptoms similar to but milder
than those of his son. He saw his family physician, who
noted periorbital edema, temperature of 100-101*F., fatigue,
and mild myalgia. A blood specimen obtained on July 16
was posit\ie for trichinosis at the 1:64 dilution using
the SK agglutination test.
The smoked bacon had been purchased by the first
patient on April 3 from a packing company. He kept 2 lbs.
for himself and gave 4 lbs. to Case 2 and 2 Ibs. to Case 3.
The first patient's wife and three oldest children ate "a
little" of the smoked bacon, but none developed illness.
The wife of Case 3 stated that she never ate raw or under-
cooked pork: she remained well.
(Reported by (Calri~n. Spencer, M.D., Acting ''.., Com-
munircale Disease Dirision, and Jack H. Russell, D.V.M.,
( .' Ptullic Health Ieterinarian, Ohio I', p.-r.'i,,'nr of
IHealth; Jack .i '. .'.V.., Public Health Veterinarian,
Clereland Health Department: and H. G. Curtis, M.D.,
Health Commissioner. Cuyahoga County.)

Edinoril Note:
This is the second outbreak of trichinosis reported
from Cleveland this year i\l'.l I. Vol. 18, No. 27).


Morbidity and Mortality Weekly Report




CALIFORNIA ENCEPHALITIS (Continued from front page)













In June and July 1969, an outbreak of disease due to
Staphylococcus aureus occurred in association with the
private practice of a physician in Dayton, Ohio. Most of
the patients were admitted to a local 500 bed general hos-
pital where phage-typing of the staphylococci was per-
formed.
Eight isolates of phage type 80/81 S. aureus were iden-
tified by the hospital's bacteriology laboratory during the
5-month period from January 1 through May 31; however,
from June 14 through July 9, 13 isolates were obtained.
One of these latter 13 isolates was from the implicated
physician. Of the remaining 12 patients with isolates ob-
tained during this period, one had no evidence of clinical
disease or known contact with this physician; the remain-
ing 11 patients had all been treated by him, and all but
two had undergone a medical or surgical procedure at or
near the site of subsequent infection. These infections
included one case of impetigo after an abrasion, two
of septic arthritis (one after diagnostic aspiration and one
after injection of medication into the joint), five of deep
muscular abscesses after intramuscular injection, and a
postpartum episiotomy infection with septicemia. Of the
two patients who had not had procedures at the site of
subsequent infection, one had presented with a sty and
later developed vaginitis and underwent a vaginal exami-
nation. She subsequently developed buttock abscesses.
The other had a deltoid intramuscular injection and devel-
oped impetigo on her wrist and legs.
Nasal and pharyngeal cultures of physicians and hos-
pital personnel yielded no carriers of type 80/81 S. aureus.
The physician to the 11 symptomatic cases had had good
general health except for chronic dermatitis of the hands.


339


Although he was unaware of prior staphylococcal disease
or carriage, between June 24 and July 3, he became aware
of chin, thigh, and finger lesions. Coagulase positive
S. aureus phage-type 80/ 81 was later cultured from the
chin and finger lesions. Of 313 patients seen between
June 23 and 27, six (1.9 percent) developed disease, where-
as of 252 patients seen between June 10 and 13 and of
318 patients seen between June 16 and 20, two (.8 percent)
and one (.3 pr,..r,-i i. respectively, developed illness. He
stopped seeing patients on July 3 and was admitted to
the hospital on July 5 for treatment.
Appropriate isolation measures prevented spread of
the strain from the hospitalized physician to the other
patients. Post-therapy cultures of the physician and follow-
up cultures of hospital personnel were negative.
(Reported by Calvin Spencer, M.D., Acting Chief, Com-
municable Disease Division, and R. A. Masterson, D.V.M.,
Chief, Epidemiology Section. Ohio Department of Health;
Robert A. Vogel, M.D., Public Health Commissioner, Mont-
gomery County, )..,,: and an EIS Officer.)


Editorial Comment:
Skin lesions of a wide variety of types, even in the
abscence of clinical infection, are recognized to be a
significant source for the dissemination of S. aureus.1 The
physician most probably initially acquired the strain from
an infected patient and then transmitted the strain by con-
tact with subsequent patients under his care.

Reference:
1Selwyn, Sydney, and Chalmers, D.: Dispersal of bacteria from
skin lesions: a hospital hazard. Brit J Derm 77:349-56, July 1965.


FOLLOW-UP GASTROENTERITIS IN A TOUR GROUP
RETURNING FROM THE ORIENT United States


Bacteriologic studies have been completed on the
rectal swabs obtained from 117 persons in the second of
two tour groups returning from the Orient who developed
gastroenteritis in August (MMWR, Vol. 18, No. 35). Five
were positive for Vibrio parahemolyticus (serotypes: two
K-6 and one each of K-l, K-8, and non-typable), eight for
non-cholera vibrios (serotypes: six NCV-1-', one NCV-317,
and one NCV-non-typable), one for Aeromonas shigelloides,
one for Shigella flexneri, and six for Salmonellae (two S.
derby, two S. stanley, and one each of S. anatum and S.


kottbus). A second rectal swab obtained 1 week later from
all persons with positive isolates showed that two persons
still harbored Salmonellae and one carried V. parahemoly-
ticus; there were no non-cholera vibrio organisms on repeat
rectal swab culture.
(Reported by H.L. Smith,Ph.D., Director, Vibrio Reference
Laboratory, Department of Microbiology, Jefferson Medical
College, Philadelphia; Epidemiological Services Labora-
tory Section, Epidemiology Program, NCDC; and an EIS
Officer.)


SEPTEMBER 27, 1960


Morbidity and Mortality Weekly Report



OUTBREAK OF STAPHYLOCOCCAL DISEASE Dayton, Ohio






340 Morbidity and Mortality Weekly Report


TABLE III. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

SEPTEMBER 27, 1969 AND SEPTEMBER 28, 1968 (39th WEEK)


AEPTIC ENCEPHALITIS HEPATITIS
?;IN- BRIC vl- DiiintHtI Primary including I t.- MALARIA
AREA LSIS unsp. cases i Serum Infectious

Cum.

'ilTE' T:TE I1 1 ,1 1 ,IU2 93 .,168

NEW ENGLAND.......... 4 4 2 1 4 103 54 5 75
Maine*............. 1 2 6
New Hampshire...... 1 2 2
Vermont............ 5 2
Massachusetts ...... 3 1 2 56 23 2 47
Rhode Island....... 1 1 2 23 17 2 7
Connecticut........ 2 1 1 18 8 1 13

MIDDLE ATLANTIC...... 38 6 4 42 169 172 6 244
New York City...... 7 1 23 55 63 1 21
New York, up-State. 7 2 1 1 27 27 2 39
New Jersey*........ 14 3 12 46 21 3 100
Pennsylvania ...... 10 3 6 41 61 84

EAST NORTH CENTRAL... 34 1 31 25 1 6 167 133 7 238
Ohio.............. 23 20 22 1 2 38 41 1 21
Indiana............. 1 1 10 15 19
Illinois............ I 2 2 64 35 2 146
Michigan........... 8 8 1 4 50 38 4 51
Wisconsin.......... 2 5 4 1

WEST NORTH CENTRAL... 20 4 2 5 32 50 6 153
Minnesota.......... 14 2 1 1 11 13 8
lova ............. 3 1 2 4 10 16
Missouri........... 2 1 6 9 40
North Dakota....... 2 I 1 1 3
South Dakota.......- -
Nebraska............ 1 3 3
Kansas............. 10 14 6 83

SOTH ATLANTIC....... 18 2 2 1 4 5 127 128 14 545
Deaare........... 3 1 3
Maryland........... 6 1 1 19 14 1 29
Dist. of Columbia.. 1 4 3 1 2
Virginia........... 1 1 27 20 5 25
West Virginia...... 2 1 1 30 10 -
North Carolina..... 4 3 236
South Carolina..... 8 1 1 8 7 1 49
Georgia ............ 1 1 3 21 169
Florida............ 2 1 2 29 49 6 32

EAST SOUTH CENTRAL... 20 5 1 1 58 80 16 109
Kentucky........... 8 16 36 16 85
Tennessee.......... 9 1 1 1 29 24 -
Alabama............ 1 6 12 21
Mississippi........ 2 4 7 8 3

WEST SOUTH CENTRAL... 6 1 7 3 3 1 1 54 61 12 153
Arkansas........... 2 3 13
Louisiana.......... 3 3 3 12 18 1 43
Oklahoma........... -a 8 8 53
Texas............... 4 1 4 1 1 34 35 8 44

MOUNTAIN............. 2 2 1 6 2 39 40 124
Montana...... ..... 6 10 3
Idaho............... 1 1 3
Wyoming............ 6 -
Colorado........... 2 5 12 105
New Mexico......... 3 7 7
Arizona............ 2 15 8 1
Utah............... 2 9 3 1
Nevada............. 4

PACIFIC.............. 15 2 4 7 28 191 284 27 527
Washington......... 2 5 25 5
Oregon.............. 1 14 14 3 13
California......... 11 2 3 7 27 164 241 22 417
Alaska............. 1 1 1 3
Hawaii............. 2 1 7 3 1 89

_I -
*Delayed reports: Aseptic meningitis: Pa. delete I
Hepatitis, infectious: Me. 2, N.J. 10, Ohio delete 1
Malaria: Iowa 1






Morbidity and Mortality Weekly Report 341


TABLE III. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

SEPTEMBER 27, 1969 AND SEPTEMBER 28, 1968 (39th WEEK) CONTINUED


MEASLES (Rubeola) MENINGOCOCCAL INFECTIONS, MUMPS POLIOMYELITIS RUBELLA
TOTAL
AREA Total Paralytic
AREA Cumulative Cumulative Total Paralytic
Cum.
1969 1969 1968 1969 1969 1968 1969 1969 1969 1969 1969
UNITED STATES... 159 20,707 19,893 21 2,414 2,082 524 1 1 11 319

NEW ENGLAND.......... 4 1,115 1,162 1 94 121 79 1 29
Maine ............. 8 38 6 6 8 2
New Hampshire ... 238 141 3 7 1 2
Vermont............ 3 2 1 3 -
Massachusetts...... 2 219 362 37 63 24 12
Rhode Island....... 27 6 12 9 7 5
Connecticut........ 2 620 613 1 36 35 36 1 8

MIDDLE ATLANTIC...... 12 7,524 4,102 3 396 375 39 1 1 2 18
New York City.... 4 4,921 2,149 1 76 75 34 2
New York, Up-State. 2 601 1,223 1 77 67 NN 1 1 1 8
New Jersey.. 2 905 618 1 158 130 5 -- 5
Pennsylvania..... 4 1,097 112 85 103 NN 1 3

EAST NORTH CENTRAL... 31 2,283 3,836 1 331 255 117 60
Ohio............... 7 386 296 124 70 3 8
Indiana............ 1 467 678 39 35 6 5
Illinois ........... 11 550 1,374 49 56 18 4
Michigan.......... 7 294 275 95 74 30 21
Wisconsin.......... 5 586 1,213 1 24 20 60 22

WEST NORTH CENTRAL... 17 564 385 1 122 113 17 1 18
1l.rn ......... 1 8 16 26 27 2 1
.. ..... 1 332 99 18 7 9 13
Missouri........... 1 28 81 51 37 2 -
North Dakota....... 15 134 1 3 2
South Dakota....... 3 4 1 5 NN -
Nebraska........... 14 171 41 9 7 4 2
Kansas............. 7 10 1 16 27 1 -

SOUTH ATLANTIC....... 17 2,556 1.519 2 415 416 44 1 33
Delaware............ 3 384 16 10 8 -
Maryland.......... 1 77 102 1 39 34 3 3
Dist. of Columbia.. 11 35 6 9 14 1 1
Virginia........... 1 884 299 53 38 7 6
West Virginia...... 201 290 18 12 25 10
North Carolina... 316 282 69 78 NN -1
South Carolina..... 120 12 57 56 3 3
Georgia ............. 2 4 70 85 -
Florida............ 1 537 508 1 90 91 5 1 9

EAST SOUTH CENTRAL... 2 113 496 3 148 188 26 1 27
Kentucky........... 1 66 100 51 86 4 5
Tennessee.......... 17 62 2 56 54 16 19
Alabama............ 6 94 24 26 6 1 1
Mississippi........ 1 24 240 1 17 22 2

WEST SOUTH CENTRAL... 39 4,600 4,846 3 324 309 54 4 59
Arkansas........... 16 2 1 31 20 -
Louisiana........... 120 23 1 86 88 -
Oklahoma........... 2 142 123 30 50 32 10
Texas............... 37 4,322 4,698 1 177 151 22 4 49

MOUNTAIN.............. 20 891 999 1 46 35 41 25
Montana............ 18 58 8 6 1 4
Idaho.............. 89 21 1 9 11 1 -
Wyoming.............. 52 1
Colorado........... 141 508 8 10 9 7
New Mexico......... 11 263 112 6 8 3
Arizona ............. 8 369 222 10 2 16 7
Utah ................ 1 10 21 3 1 6 3
Nevada............. 1 5 2 3 -

PACIFIC ............. 17 1,061 2,548 6 538 270 107 1 50
Washington......... 1 60 535 1 56 39 24 12
Oregon.............. 198 529 2 18 21 9 5
California.......... 14 754 1,440 3 443 196 52 1 21
Alaska .............. 1 9 9 11 2 16 7
Hawaii............. 1 40 35 10 12 6 5

Puerto Rico.......... 35 1,544 418 19 20 46 -
*Delayed reports: Measles: Iowa 1
Meningococcal infections: N.J. delete 1, Md. delete 1
Mumps: Me. 11
Rubella: Me. 1






342 Morbidity and Mortality Weekly Report


TABLE I1. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

SEPTEMBER 27, 1969 AND SEPTEMBER 28, 1968 (39th WEEK) CONTINUED


STREPTOCOCCAL TYPHOID TYPHUS FEVER RABIES IN
SORE THROAT & TETANUS TULAREMIA D TICK-BORNE R S
AREA SCARLET FEVER FEVER (Rky. Mt. Spotted) ANIMALS
Cum. Cum. Cum. Cum. Cum.
1969 1969 1969 1969 1969 1969 1969 1969 1969 1969 1969
UNITED STATES... 5,917 5 114 4 114 8 224 11 404 60 2,641

NEW ENGLAND.......... 576 1 14 2 12 2 25
Maine. ............ 3 1 6
New Hampshire... 3 4
Vermont ............ 14 1 5
Massachusetts...... 86 1 7 2
Rhode Island....... 31 1 -
Connecticut........ 453 2 3 1 8

MIDDLE ATLANTIC...... 114 15 5 1 24 42 16 169
New York City...... 19 7 1 1 11 -
New York, Up-State. 89 3 4 5 6 14 159
New Jersey......... NN 3 3 14 -
Pennsylvania....... 6 2 5 22 2 10

EAST NORTH CENTRAL... 412 1 14 1 13 22 3 1 186
Ohio............... 43 1 8 63
Indiana.......... 97 2 1 46
Illinois........... 68 1 8 1 4 10 3 30
Michigan ........... 146 5 4 7
Wisconsin......... 58 7 40

WEST NORTH CENTRAL... 292 10 13 9 8 12 489
Minnesota.......... 3 3 3 4 130
Iowa ............... 85 1 7 3 71
Missouri........... 15 3 9 3 3 125
North Dakota....... 86 1 63
South Dakota....... 26 1 24
Nebraska............ 51 1 1 1 13
Kansas.............. 26 4 3 1 63

SOUTH ATLANTIC....... 792 1 21 1 21 4 36 9 226 8 653
Delaware........... 1 2 3 -
Maryland........... 60 1 4 2 47 3
Dist. of Columbia.. 2 1 -
Virginia ......... 268 4 1 1 2 76 3 330
West Virginia...... 189 1 2 1 5 94
North Carolina..... NN 2 5 6 4 52 5
South Carolina .... 123 1 2 1 1 30 -
Georgia............ 11 4 1 4 9 13 2 70
Florida............. 140 1 10 4 3 11 3 151

EAST SOUTH CENTRAL... 1,117 2 18 1 12 33 2 61 4 359
Kentucky........... 98 1 7 6 1 13 3 185
Tennessee.......... 678 4 1 11 19 1 40 1 122
Alabama............ 210 5 4 5 46
Mississippi........ 131 1 2 1 4 3 6

WEST SOUTH CENTRAL... 688 1 21 18 22 43 7 381
Arkansas........... 17 1 1 10 7 1 29
Louisiana.......... 21 7 4 3 29
Oklahoma........... 70 1 7 28 2 57
Texas ............. 580 1 12 6 9 8 4 266

MOUNTAIN............. 1,209 5 14 24 16 115
Montana............ 65 1 2 -
Idaho.............. 125 3 5 -
Wyoming*........... 123 2 5 52
Colorado........... 512 2 3 9 3
New Mexico........ 194 1 5 17
Arizona.......... ..... 84 2 5 22
Utah .............. 106 11 2 5
Nevada............... 1 16

PACIFIC.............. 717 9 1 4 1 42 5 10 264
Washington ........ 460 1 2 2 3 4
Oregon........... ..... 65 1 6 1 4
California......... 8 1 1 1 32 2 9 256
Alaska ............. 87 -
Hawaii............. 105 2 -


*Delayed reports: SST: Me. 4, S.C. 7, Wyo. 20
RMSF: Va. 2, S.C. delete 1


Puerto Rico.......... 9 2 8 6 -I 20





Morbidity and Mortality Weekly Report






TABLE IV. DEATHS IN 122 UNITED STATES CITIES FOR WEEK ENDED SEPTEMBER 27, 1969


343


(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 1 year Area All 65 years and 1 year
Ages and over Influenza All Ages and over InAluenza 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----------
DEtrolt, HM .- -------
var.nevLlle. InJ.- ...
Flint, Mich.------.----
F-ort wayne, Ind.-- -
Gary, Ind ---- -
Grand Papid., Mich.---
Indiansp.-l :, Ind ---
Madion, WaU.---------
MHilIalC, 11 .-------
Ptoria, Ill -----------
Rockford. ill.--------
'iuth Bend, ind.-----
ilid.-,, Obh o-.----------
Younpsto.n, Ohio-.-

WEST NORTH (ElNRAT--
Des Meone Iowa -----
Duluth, Minn.---------
Kansas Ciry, Kans.----
Kansas City, Mo.------
Lincoln, Nebr.--------
Minneapolis, Minn.----
Omaha, Nebr.-----------
St. Louis, Mo.--------
St. Paul, Minn.-------
Wichita, Kans.--------


682
190
49
35
29
62
34
18
22
50
52
16
50
30
45

3,203
50
42
134
48
33
50
66
80
1 ,564
25
512
201
51
108
25
25
84
42
33
30

2,495
69
36
692
155
189
124
83
328
-l1
55
.0
39
38

36
138
3Q
35
3-
107
57

786
54
26
33
13.
18
95
91
228
52
55


405
99
26
24
21
28
20
13
19
30
31
12
28
21
33

1,822
27
25
67
26
17
33
32
21
903
14
272
125
34
73
12
17
54
25
24
21

1,371
40
22
367
88
99
70
41
184
.6
23
25
13
2-
81
18
82
26
20
22

31


'69
32
1 7
23
88
9
60
*9
126
34
31


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. Hex.---
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 ,259
117
231
54
92
122
63
93
39
86
65
241
56

634
70
55
32
135
142
51
45
104

1,168
43
36
14
175
46
82
238
66
160
101
105
59
43

409
40
33
106
15
106
11
52
46

1,628
14
48
42
30
89
531
91
36
145
59
102
173
44
140
46
38


1
7
48
2

39
4
5
1
4
15
6
1
3

111
4
1

16
8
9
25
3
17
10
10
5
3

15
4
1
4

4
I
1

63


3


Total 12,264 6,802 388 678

Expected Number 11,842 6.780 352 513


Cumulative Total
includess reported corrections
for orevsous weeks)


507,470 290,242


23,543 23,918


Week No.
39


*Mortality data are being collected from Las Vegas. Nev., for possible inclusion in this
La Vega I e ... table, however, for statistical reasons, these data will be listed only and not included in
the total, expected number, or cumulative total, until 5 years of data are collected.






344


INTERNATIONAL NOTES
IMPORTED SMALLPOX Uruguoy*
An imported case of smallpox in a 7-month-old child
has been reported from Uruguay. The child resides in
Jaguarao, State of Rio Grande do Sul, Brazil, which is
directly across the river from the I rII'I.,i..Im locality Rio
Branco. where the child was hospitalized. Contacts and
other persons related to the case have been vaccinated.

'Sourc,: i'orltd Health Organization Weekly Epidemiological
Record. 4(39):562, September 26, 1969.


SEPTEMBER 27, 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.
DIRECTOR, EPIDEMIOLOGY PROGRAM A. D. LANGMUIR, M.D.
EDITOR MICHAEL B. GREGG, M.D.
EDITOR pro tern ALAN R. HINMAN, 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 C ASE
INVESTIGATIONS WHICH ARE OF CURRENT INTEREST TO HE AL T
OFFICIALS AND WHICH ARE DIRECTLY RELATED TO THE CONTROL
OF COMMUNICABLE DISEASES. SUCH COMMUNICATIONS i,.uLD 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 ND'IIDDUAL
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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