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:
AA00010654:00230

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


U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE


Vol. 17, No. 44


WE[KIY

REPORT


Week Ending

November 2, 1968




PUBLIC HEALTH SERVICE


HEALTH SERVICES AND MENTAL HEALTH ADMINISTRATION


EPIDEMIOLOGIC NOTES AND REPORTS
BUBONIC PLAGUE DEATH Lemhi County, Idaho


A 32-year-old male, hunting guide was admitted to a
hospital in Salmon, Idaho, on October 22, 1968, with a
temperature of 106'F, hypotension, left axillary adeno-
pathy', and generalized painful extremities. He had been
ill for 3 days prior to admission. He was anuric on admis-
sion and subsequently developed severe gangrenous changes
in hands, feet, glans penis, ear lobes, and the tip of his
nose. The patient was treated with penicillin, chloram-
phenicol. ampicillin, and streptomycin. He expired on Octo-
ber 25.


(ONITENIS
Epidonnologic Notes and Reporti
Bubonic Plague Death Lemhi county Idaho 05
Foodhorne Epidemic of Group G, StreptorcciaI
Pharyngitis Vermont .................. .. 1. 6
Mea.sles Washington, D.C. .................. .407
African Sleeping Sickness Melbourne, Forida ....... 41
Summary of Reported Cases of Infer tious Syphilis ...... .107
International Notes
Quarantine Measures ..................... 412


onOctober31 as Pasteurella pests by colonial morphology
and staining characteristics, fluorescent antibody testing.
and phage typing.
The patient, 3 days prior to the onset of illness, had


A blood culture obtained on admission was positive killed a showshoe rabbit, carried it on horseback, and sub-
for a gram negative rod which subsequently was c..nT r.ir, .. *I continuede d on paye 4016)


TABLE 1. CASES OF SPECI
(Cumulative totals include r


DISEASE


Aseptic meningitis ......................
B rucellosis ...........................
Diphtheria ................. ...........
Encephalitis, primary:
Arthropod-borne & unspecified ...........
Encephalitis. post-infectious .............
Hepatitis, serum ........................
Hepatitis, infectious ....................
M alaria ................................
Measles rubeolaa) .......................
Meningococcal infections, total ...........
C civilian .............................
M military ...............................
Mumps .................................
Poliomyelitis. total .....................
P aralytic .................. ........ .
Rubella (German measles) ...............
Streptococcal sore throat & scarlet fever ....
T etanus ...............................
Tularemia .............................
Typhoid fever .......... ...............
Typhus, tick-borne (Rky. Mt. spotted fever)
Rabies in animals......


28
5
124
1,028
87
137
29
28
1
1.439


294
7,743
1
1
12
3
51


51
748
63
253
30
29
1

3
3
268
7,876
4

8
1
71


:S: UNITED STATES
gh previous weeks)

IAN CUMULATIVE, FIRST 44 WEEKS
MEDIAN
1967 MEDIAN
1968 1967 1963 1967


686
4
1,304
41



3
2

6.540
4
4
8
2
71


3.822
192
191


1,216
418
3.873
38,320
2,010
20,524
2.220
2.034
186
132.255
53
53
45,745
353.757
146
158
337
268
72 93


2.605
214
125

1,408
689
1.861
32.529
1,752
59,632
1,868
1.749
119

32
28
41.540
376,291
190
150
358
293
3 676


1,806
214
169


32,412
92
246,394
2.357



83
78

333,180
228
222
362
234
5 676


TABLE II. NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum,
Anthrax: ........................................... 3 Rabies in man: ......................... ........... 1
Botulism: Calif.-1 ................... ................ 7 Rubella, Congenital Syndrome: ............ ....... .... 5
Leptospirosis: Idaho-1, Tex.-1 ....................... 41 Trichinosis: Ohio-1. Pa.-l .......... ...... ..... 54
Plague: Idaho-1 .................................... 3 Typhus, murine: ..... .... .. 28
P sittacosis: .................. .... ................. 41


Data exclude reports N.H., Ariz.. Wash. State Holiday







406


sequently skinned the animal. Other than the usual ex-
posure to animals in the area, this was the only known
direct exposure during the incubation period for P. pestis.
This year a large rodent population has been noted in
the area. Moreover. observers in the ~icinity of Camus
(reek. Lemhi County, ha\e recently noted a die-off of
animals including tree squirrels and chipmunks. This die-
off is currently under inv estimation. To date, epidemiologic
investigation has revealed no other human cases.


NOVEMBER 2, 1968


Although plague has been recognized as enzootic in
Idaho. the only previous case in Idaho occurred in 1940.




(Reported by John A. Mather. M.D., M.P.H., Director, Divi-
sion of Prerentive Medicine, Idaho Department of Health;
the Zoonoses Section, Ecological Investigations Program,
NC(', Fort Collins, Colorado; and two EIS Officers.)


FOODBORNE EPIDEMIC OF GROUP G, STREPTOCOCCAL PHARYNGITIS Vermont


\n epidemic of streptococcal pharyngitis occurred
among students at a college in Vermont from October 16-22.
196h(Figure 1). Of the 502 students enrolled in the school,
172 were seen in the college dispensary and 27of these re-
quired hospitalization. Symptoms for the majority of the out-
patients and 80 percent of the hospitalized patients included
abrupt onset of sore throat, headache. chills, and fee r (Ta-
ble 1), and the prominent clinical findings during the acute
phase of the illness were a red beefy pharynx. exudate, and
tender anterior cervical lymphadenopathy. During the epi-
demic, pharyngeal cultures were taken on 126 ill patients:
theo yielded 75 Group G streptococci (59 percent), three
Group B isolates. and no Group A streptococci. On Octo-
ber 20, a random culture survey of 87 well students showed
a Group G prevalence of 23 percent. On October 21. 39
students who had been positil\ for Group G and who had

Figure 1
CASES OF PHARYNGITIS, BY DATE OF VISIT
TO OUTPATIENT CLINIC
VERMONT, OCTOBER 7-23, 1968


] HOSPITALIZED


HfTh-r


n t iIII ,1 9 ..


7 8 9 10 11 12 13 14 15 16
DAY


17 18 19 20 21 22 23


Table 1
Clinical Data from Students with Positive Group G
Streptococcal Cultures

20 Hospitalized O
Symptoms or Students 22 Outpatien
Signs No. with No. with
Percent Percent
Symptom Symptom
Sore Throat 20 100 21 96
Headache 18 90 15 68
Chills and Fever 18 90 16 73
Nausea and
Vomiting 11 55 8 36
Diarrhea 5 25 2 9
Red Throat 19 95 21 96
Exudate 14 70 6 27
Cervical
Lymphadenopathy 1S 90 15 68


been on oral penicillin for from 1-4 days were recultured.
Only three Group G isolates were made.
The suddenness with which the majority of cases ap-
peared suggested a common source of infection. Food
history questionnaires distributed on October 19 demon-
strated a significant association between the presence of
illness and the consumption of the noon meal served in
the college cafeteria on October 15. Furthermore, ques-
tionnaires incriminated egg salad served at that meal as
the vehicle of infection (Table 2). An epidemiologic in-

Table 2
Summary of Food History Data
Obtained from Students
October 19, 1968

Persons Who Ate Persons Who Did Not
Food Specified Food Eat Specified Food
or Attack Attack
Beverage Ill Not Total Rate Ill Not Total Rate
Ill Percent Ill Percent
Lunch -
October 15 82 72 154 53 8 30 38 21
Egg Salad 73 51 124 59 9 21 30 30
Raisin
Pudding 45 33 78 58 37 39 76 49
Soup 36 31 67 54 46 41 87 53
Milk 54 46 100 54 2h 26 54 52


Morbidity and Mortality Weekly Report


BUBONIC PLAGUE DEATH (Continued from front page)


~C













\jeftli talhon i\- cont inuirt to idlentilf' the -ourc -" tfhe h

i n Coct I lIII.

(H/i' .Cr ',ed hI y I .h-< /.I. /.C ,'-1- M1.l).. /1/r f'ctr. l Cu-cau C /

(',CmmuniC a bi' I)is s' I,('o C nfitr l. i ld ) ijnftry I 'f maiir. 1).1 .l1..

/ CrC tor. Ur liCC' of IL bhCCorC 'Ctort m / i //l i'C HlC /$ C,.


I', / lif lC I if / A.hl ei ori I r Iit 1,p i ll, C

strep1orf f 'I 'I l I) i 1i,> 1 1 .l /" a V'ir l 1 I 'I. !

l iC CCiC/C l C rc /ii tioCCnCC P'roC /raiC \<0'l 1 'r / 1,,rt

C'I,/rard : anS/ an KI'S ffirc r. C


MEASLES Woshington, D.C.


ICIt\\t't'n Janitiar,\ I and No\C Iheb r 2. C It I.:' 11 i pcI 'le I

mew -l,- a t 'a-,+ \A r" re orl to lot O Di trl'( of t 'olumblh a

Dep:,rtnwint of PuI lic Hllealith h i ,ool p>rili pml-- teach

or-. aind nur-tC and hCiC ph\ -wII C \cCliCiwC and ho-,[ I I l-

(Tahl :C)C () I Iif C' 11 -C-po cl Ce -,C 27 C,',' iCnlC' i 1;1

Ctd l>i a llph i\ -cill of thi hl C:lth Ideparit entCi ;ii d four \ere

llot Ihotl hd be lun Ih+, chtldrl i cmuhl ntl"I b hlo

ca[ld I for conflir Ta tion. l l (I'Cn oC ICtC four cC I aC rto

porled tI o (' I) in Ci'ao-l heu'C iil- it h;id ifle n1 r'liortedi

to thi, health dipartmonC t [ i a I phy- C iC n. ()f rI- T27 in\(-

tlialt d ca -.e, 2; \\ pro foullnd not Io he loinc a wh-. ]The

dita no-i,- for Ihe :1i2 ciat(- included rubnella (I0 i -abu-).

allergy \\itlh rth (5 ca-(-). ntrcaria (3 <-a (1). Im lie(ig

(2 ca-eo-). chlt kenpo\ (2 ca-e -). and i inf'luen/a (1 ;is- ).

iOf iho 27 ih n t'steie taltd ca-i-. four \ereP c(onifirmEd a-

rmi'alh<: T\\wo \\ere in un\iaccin tfd children (in kinder

garton andll ir-t C rlad,) \\hu hmid 'C I ,n C '\li-po-'d In i ifCr i ia .

Thiie ourcfe ofit infection i (Ih- lCIi r tl \\1o on(firl'nld caiC-C

could not ho do Iternincd. Tlhw'- four 'onfirnioml cCase'C \\ere'

reportC d to N(CDC a- (ItC / loC .


Table 3
Investigation of Cases
Washington, D.C.
January 1 November 2, 1968



'Courc of C i i C MC Ca-I I




School- :3 ( I
l'h -\ ician
or l .-p- ital T

Tot;a Il 1 2:7 2: 1



In aIddl l IIot l t1o Ith- e fliC rIlc I rt* t d p C :I ci 'froi I t :C1

u lC)C-oc cai ia -i\th 'cat in vhli'h a mtro'riln t ;- hi to or

rT'l d ;iagjo-.i- could not bth obtain{l o\*,- r |>porldl a;

i.'.i ll to ('DC .

( lepor ',i 1/ h .lfin le. Pai r, 11.1 .. l.I'.ll C /irf, c,,rr Ca

of ('CoC ooi/nica Ch' .is''Iasf' Con/t/ro Pi) si// t oIf i'(,C u i

l)i T m1 ri, t 0 ,f Puhblic / lliHi : and 11/ El,'/ Offi[ r.


SUMMARY OF REPORTED CASES OF INFECTIOUS SYPHILIS


CASES OF PRIMARY I) Sr CI AY YPHIC I I: B Rep orTC


icpter ber 1C-i innd Seplrmbr 1967 Provil i nal data


Rp trncC Ar-,.


NEWI EN LAND... .... .. .

Nc- Ha-pshr- ...........
V -r..ntC ..... .....
M.ss ichuset ts...........
Rh i, <- Island............
Cont. ct iut..............

MIDDEi ATLACNTIC.........
Upstate N-w Yrk ........
Nep York Ci v. ..........
Pa. (Excl. Phila.) ......
Phi ladelphta............
Neo jersey ..............

EAST NORTH CENTRAL.......
Ind ana ........ ........
Do nstat Ilhli is......
Chicag .. .. ..... ...
MHihian- ...............
Wisc nsin ... ........

WEST NORTH CENTRAL.. .....

N.i n Eh jk'td .......... .
I ria. .. .............
misu ................


tIT ATLANTIC. ... ......
h Dlawa. ..... .........
Sa d I ................ .


D sr t f u b .
tIrlH ATLANTIC............

iryth Can d. .. .....C .. .



NFoth Car .lna......
cuth Caroiina........

Fl rIda .... .......... .


s 1Cu Cr 1 1o 7
h tit "hri, L tan C, Ft
1909 1irh7 11)t8 I 67


Report -n Ar'


?'~~~ ~ CC ..' .^. C.


144
2h


125
75



1,628
175
240


.,175

117





244
37
j31
78
27
31
41

4,770
50)
481
576

234
!hl

"27
174S
S1,44


CAST OUCTH i IFNT i .......
KLInr k. ...............
Snlam s ............

H sis. sippi ..............

WEST -OUTHT CENTRAL .......
Arkansas................
uOklah.a.................

MOUNTAhm ................
Stxas. ...................
OIdaho. .... ...............

Wyi'm- 1g, .................
> 1,-rado .................
lin. m ..................



A( IFI1C .................
W.Nh ngtn. ........... .
Oregon. .. ......... .......
Alaska ..... ..............

Ha. a ...................

N. TOTAL.................
PAcFICg ..................


C.Cll frnCa.........



l, $. TOTAL...............


TERRITORIEF............. 7 1 74 89 684
iPerto Rico............ 7I 70 810 654
Virgin Islands......... 4 39 30




Note. Cumulative Totals include revised and delayed reports
through previous months.


NOVEMBE III 19i68


Morbidity and Mortality Weekly Report


Sept :ea c
1968 1ih7


Cumulativi
Jan Spt
1968 1 67


59

261
2,605


59
1,80:





36
5






33


35
30




14.,75


,bt


" '


1./1







408 Morbidity and Mortality Weekly Report


TABLE III. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

NOVEMBER 2, 1968 AND NOVEMBER 4, 1967 (44th WEEK)


ENCEPHALITIS HEPATITIS
ASEPTIC F j I Primary Post-
PIiincluding Post- MALARIA
AREA MENINGITIS n g Infectious Serum Infectious MALARIA
unsp. cases
1968 1967 1968 1968 1968 1967 1968 1968 1968 1967 1968
UNITED STATES... 111 105 3 8 28 41 5 124 1,028 748 87

NEW ENGLAND............ 3 2 2 4 1 4 44 25
MaineA............ 2 6
New Hampshire...... --- --- --- --- --- I---
Vermont............ 3
Massachusetts...... 3 2 1 22 9
Rhode Island....... 2 1 9 2
Connecticut........ 2 2 3 8 7

MIDDLE ATLANTIC...... 18 8 2 3 51 187 156 15
New York City...... 6 1 26 75 50 1
New York, up-State. 2 2 1 1 8 31 52
New Jersey* ....... 4 6 1 15 29 20 6
Pennsylvania....... 6 1 2 52 34 8

EAST NORTH CENTRAL... 12 15 1 12 5 2 2 166 119 4
Ohio............... 6 1 6 2 41 25 2
Indiana............ 3 2 2 18 9
Illinois........... 2 1 1 52 39
Michigan........... 4 10 5 2 45 37 2
Wisconsin.......... 1 1 10 9

WEST NORTH CENTRAL... 6 6 1 2 65 42 5
Minnesota.......... 6 3 1 2 22 10 2
Iowa............... 3 21 7
Missouri........... 9 19 2
North Dakota...... -
South Dakota ....... 1
Nebraska............ 1 2
Kansas............. 12 3 1

SOUTH ATLANTIC....... 10 41 3 1 2 6 127 108 26
Delaware ........... 2 1 1 8 -
Maryland........... 4 6 11 9
Dist. of Columbia.h 1 2 1
Virginia........... 1 34 1 2 9 13 4
West Virginia...... 1 1 1 3 10 -
North Carolina..... --- -- 1 13 8 15
South Carolina..... 4 1 -
Georgia............ 3 30 50 7
Florida............. 1 3 54 8

EAST SOUTH CENTRAL... 4 1 2 2 1 1 32 36 10
Kentucky........... --- 9 11 10
Tennessee........... 2 1 1 1 13 14
Alabama............ 1 5 2
Mississippi........ 2 1 2 5 9

WEST SOUTH CENTRAL... 10 2 2 5 3 6 86 47 1
Arkansas........... 1 4 7
Louisiana.......... 4 1 2 2 1 5 19 10
Oklahoma.*......... 2 3 2 12 1 1
Texas.............. 3 1 1 51 29

MOUNTAIN............ 1 2 3 3 40 26 11
Montana*........... 5
Idaho............... 4 1
Wyoming............ 2
Colorado........... 2 3 3 33 1 11
New Mexico......... 1 2 6
Arizona............ --- --- --- --- --- --- 11 ---
Utah............... 1
Nevada ............ -

PACIFIC.............. 48 36 4 14 1 49 281 189 15
Washington......... --- 5 --- --- --- 2 --- --- --- 8 ---
Oregon............. 18 9
California.......... 47 30 4 12 1 48 257 168 7
Alaska.............. 3 -
Hawaii............ 1 1 1 3 4 8

Puerto Ri .......... 23 18


Encephalitis, primary: Okla. 1
Hepatitis, infectious: Me. 5, Okla. 2, Mont. delete 1







Morbidity and Mortality Weekly Report 109



TABLE III. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

NOVEMBER 2, 1968 AND NOVEMBER 4, 1967 (44th WEEK) CONTINI ;I)


MEASLES (Rubiola) MENINGOCOCCAL INFECTIONS, MMll' POLIOMYELITIS RUIIEILA
TOTAL
AREA ~..iri, yl l i
AREA Cumulative Cumulative Tta ara yt


UNITED STATES... 137 20,524 59,632 29 2,220 1,868 1,439 3 294

NEW ENGLAND............ 8 1,188 886 1 130 74 184 27
Maine* ............. 38 248 6 3 24 2
New Hampshir ..... --- 141 77 --- 7 2 --- --- ---
Vermont ............ 2 14 1 1 38
Massachusetts. ..... 4 373 373 1 67 35 70 1 16
Rhode Iland....... 6 62 9 4 18 -
Connecticut........ 4 628 92 40 29 34 9

MIDDLE ATlANTIC ...... 33 4,248 2,367 3 398 308 102 I 33
New York City...... 26 2,252 481 80 54 31 6
New York, Up-State. 5 1,254 607 1 72 77 NN 1 13
New Jersey......... 2 624 524 138 101 71 8
Pennsylvania....... 118 755 2 108 76 NN 6

EAST NORTH CENTRAl... 17 3,956 5,777 6 272 258 362 7 90
Ohio. ............. 2 310 1,166 3 76 90 36 8
Indiana ............. 694 621 2 38 28 22 1 8
Illinois........... 2 1,386 1,051 60 59 29 -2 3
Michigan ........... 2 296 971 1 78 63 95 2 38
Wisconsin.......... 10 1,270 1,968 20 18 180 33

WEST NORTH CENTRAL... 2 397 2,912 2 120 88 287 -- 3 26
Minnesota.......... 1 17 134 2 29 21 58
Iowa.*............. 104 763 8 18 174 24
Missouri........... 81 339 39 17 19 2
North Dakota....... 1 138 875 3 3 34 2
South Dakota....... 4 58 5 7 NN -
Nebraska........... 43 649 9 13 2
Kansas............. 10 94 27 9 -

SOUTH ATLANTIC....... 11 1,551 7,089 7 442 363 59 3 17
Delaware........... 16 50 8 7 2 2
Maryland........... 103 169 2 38 50 7 -
Dist. of Columbia.. 6 23 16 14 1 1
Virginia .......... 5 305 2,222 1 42 42 5 4
West Virginia...... 2 299 1,437 13 35 33 1 5
North Carolina..... 284 916 2 85 71 NN -
South Carolina..... 12 511 58 30 4 2
Georgia............ 4 36 1 88 56 1 -
Florida............ 4 522 1,725 1 94 58 7 -2

EAST SOUTH CENTRAL... 501 5,370 2 200 144 59 1 11
Kentucky........... 103 1,404 2 92 42 36 1 5
Tennessee.......... 62 1,958 58 62 23 5
Alabama ........... 95 1,336 27 26 -
Mississippi........ 241 672 23 14 -

WEST SOUTH CENTRAL... 47 4,989 17,800 4 324 236 95 24 39
Arkansas........... 2 1,404 20 33 2 I
Louisiana.......... 24 156 92 94 2 -
Oklahoma............ 125 3,358 1 51 18 1 2 5
Texas.............. 47 4,838 12,882 3 161 91 90 21 34

MOUNTAIN............. 1,023 4,778 39 37 72 1 20
Montana............ 58 319 6 4 3 I
Idaho............... .. 21 393 11 3 4 2
Wyoming............ 54 185 3 1 -
Colorado............. 518 1,603 11 13 39 15
New Mexico......... 122 591 4 13 -
Arizona ............ --- 224 1,035 --- 4 5 --- --- --- 1 ---
Utah............... 21 383 1 4 13 2
Nevada............. 5 269 3 3 -

PACIFIC.............. 19 2,671 12,653 4 295 360 219 12 31
Washington.......... --- 557 5,565 --- 45 35 --- -- 1
Oregon.............. 5 547 1,670 1 23 27 16 9
California.......... 14 1,522 5,098 3 211 283 189 11 19
Alaska.............. 10 140 3 11 11 -
Hawaii.............. 35 180 13 4 3 2

Puerto Rico.......... 5 446 2,217 20 14 19


*Delayed reports: Measles: Mass. delete 1, Ohio delete 1, Iowa 1, Va. delete 1
Meningococcal infections: Ala. I
Mumps: Me. 8
Poliomyelitis, paralytic: Ala. delete 1
Rubella: Me. 7







410 Morbidity and Mortality Weekly Report


TABLE I1. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

NOVEMBER 2, 1968 AND NOVEMBER 4, 1967 (44th WEEK) CONTINUED


STREFTCOCCCAL TYPHUS FEVER
SORE THROAT & TETANUS TULAREMIA TYPHOID TICK-BORNE RABIES IN
AREA SCARLET FEVER (Rky. Mt. Spotted) ANIMALS
Cum. Cum. Cumr. Cum. Cum.
____19h8 168 1968 1968 1968 1968 1968 1968 1968 1968 1 1968
UNITED STATES... 7,743 1 146 1 158 12 337 3 268 51 2,920

NEW ENCLIAND.......... 909 4 47 1 12 1 72
Maine. ............ 1 2 53
New Harpshire ...... --1 -- 1 --- 2
Vern,,t ........... 24 47 11
'Mas chusetts...... 27 1 -- 1 6 1 5
Rh d,. I land ....... 116 -
Connecticut....... 627 2 3 1

MIDDLE ATLANTIC...... 41 18 7 1 32 1 22 1 49
New Y r'rk City...... 7 11 15
New York, Up-tat. 26 4 7 1 8 5 1 40
N, Jersey.. ... .N 4 7
Pennsvlvania....... 8 3 5 1 10 9

EAST NORTH CENTRAL... 627 14 11 4 47 9 5 268
Ohio ............... 108 2 1 19 7 2 90
61 2 1 4 7 86
rd i na ............. 61 2 1 4 7 86
I1 no s ........... 138 6 8 19 2 37
an........... 180 3 14
S nsin.. ......... 140 1 -- 3 41

WESc NORTH CENTRA ... 245 14 15 1 35 9 10 724
S .......... 18 2 1 1 227
1, .. .122 4 2 1 4 116
rr su .... 5 7 25 3 1 103
N,.rth Dakota ....... 48 1 112
ou h D' t ....... 23 3 1 2 4 97
Ncbr s ka ...........2 3 3 I 25
Kan scs............ 22 5 2 3 44

S'017T ATLANTIC....... 702 32 1 1 1 56 1 141 7 345
Delaware........... 14 1
Maryland ........... 78 3 9 18 5
Dist. of Columbia.. 2 1 1
Virginia ........... 224 4 3 10 1 44 120
West Virginia...... 141 2 2 2 47
North Carolina..... 13 2 1 3 2 39 12
South Carolina..... 5 4 1 2 9
Ceoria............ 9 3 4 14 26 4 66
Florida............ 169 12 2 18 3 1 93

EAST OIUTH CENTRAL... 1,367 15 8 1 39 1 52 14 625
Kentucky ............ 105 1 1 9 10 9 321
T nnessee....... 1,004 6 5 16 1 36 5 273
Alabama............ 146 5 2 4 24
Mis is ipp ........ 112 3 2 1 12 2 7

WEST SOI'TII CENTRAL... 7q3 1 28 46 2 48 28 5 450
Arkansas........... 12 4 15 2 17 6 1 58
Lou iiana .......... 4 10 7 6 1 1 42
Oklahoma .......... 43 8 14 13 118
Texas ............... 734 1 14 16 11 8 3 232

MOUNTAIN............. 2,243 1 8 16 5 2 82
Mon t na .... .... 21
Idah .............. 169 1
Wvoming* ........... 289 1 1 3
Colo.rado ........... 1,538 3 2 4 4
Nrw Mexico......... 168 8 2 35
Ariz ona..... .. -- -- 4 --- 36
'Utah 1............ -. -. 4 1
Nevad............ ..- 3

PACIFIC.......... .... 816 20 4 1 52 1 7 305
Washington ......--- -1 -- --- 2 --- 2
Oregon .............. 1 5 6
Cali fornia ......... 542 18 3 1 45 1 7 297
Alaska ...... ...... -
w ii ............. 84 -

Puerto Rico......... 6 12 4 18








Morbidity and lMortality r ceklh Report


Week No. TABLE IV I DEATHS IN 122 I'NITIIl) ST'IATI S (ITIIS FOR WITlK ENI)II) NOVEMBER 2, 1968

44
(By place of occurrence and week of filing certificate. Excludes fetal deaths)

All Pn a U r A Causes Pnumnineumonia Under l Caseneumni nd

Area All 65 years andArea 1year Are Aiy
Area All 65 yearsInfluenzad Area All 65 years Influenza All
Ages and over Ages ;,nd ovr
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, I11.---------
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.--------


27
66
53
5
45
J33
52

4, 109


136
11
i2


74
1 ,600
41)
404
193


31
4)


31








73

763
180
185
131
79
385
43
52
44
28
57
158
38
131
35
35
47
104
73

805
45
29
26
142
24
1 2 i
75
216
85
38


4 6

II

19

14
20
19

13


II



I 3
25
18

1 ,78.
18
34
76
16

19
129
14

30


27
71
18
23

14
22
16
19

1 ,5q
41
19

398
1II4
104
74
40
215
28
30
25
17
39
82
17
90
16
23
27
69
47

488
28

1 1
87
18
75
41
124
53
17


SOUTH ATLANTIC: i,,'/
Atlanta, Ca.----------- I 60 i .'
Baltimore, Md.--------- .'11 I 7
Charlotte, N. C(.------- 1 I
Jacksonville, Fla.- ---- 32 7
Miami, Fla.------------ -
Norfolk, Va.----------- '- -7
Richmond, Va.---------- 4 41 2
Savannah, Ca.---------- 3I
St. Petersburg, Fla.--- 106 85
Tampa, Fla.------------ 57 2
Washington, D. C.- ---- 233 7
Wilmington, Del.- ------ 26 4

EAST SOUTH CENTRAL: 1 44 9 2
Birmingham, Ala.------- I 2 1 6) 4
Chattanooga, Tenn.---- 2 10 4
Knoxville, Tenn.------- I9 27
Louisville, Ky.-------- 8 51 17
Memphis, Tenn.--------- 114 6-5
Mobile, Ala.-----------7 2
Montgomery, Ala.------- 1 2
Nashville, Tenn.------- i 92 3

WEST SOUTH CENTRAL: 1,089 51 32 77
Austin, Tex.----------- 0 14
Baton Rouge, La.------- 23 9 -
Corpus Christi, Tex.--- 23 1 1 3
Dallas, Tex.----------- 176 79 13
El Paso, Tex.---------- 42 21 ) 3
Fort Worth, Tex.------- 86 i9
Houston, Tex.---------- 19' I 4 h
Little Rock, Ark.------ I 4 2
New Orleans, La.------- 144 73 3 i
Oklahoma City, Okla.--- 80 7
San Antonio, Tex.------ 122 72 7
Shreveport, La.-------- 67 36 5 7
Tulsa, Okla.----------- 48 23 I 3

MOUNTAIN: .36 I 38 15 I
Albuquerque, N. Mex.--- 37 19
Colorado Springs, Colo. 2 2
Denver, Colo.---------- 133 72 4 6
Ogden, Utah------------ 8 12 2
Phoenix, Ariz.--------- 100 56 1 7
Pueblo, Colo.---------- 22 2 1
Salt Lake City, Utah--- 55 I 1 7
Tucson, Ariz.---------- 40 5 4 3

PACIFIC: 1,582 978 36 61
Berkeley, Calif.------- 19 14
Fresno, Calif.--------- 22 1 1
Glendale, Calif.------- 24 18 1 i
Honolulu, Hawaii------- 58 31 1 4
Long Beach, Calif.----- 90 47 1 3
Los Angeles, Calif.---- 451 .'68 14 0
Oakland, Calif.-------- 75 45 2 4
Pasadena, Calif.------ 45 2 1
Portland, Oreg.-------- 141 100 1 9
Sacramento, Calif.----- 67 i) I 4
San Diego, Calif.------ 95 56 2 4
San Francisco, Calif.-- 191 11 4 3
San Jose, Calif.------- 41 iO -
Seattle, Wash.--------- 142 80 4 6
Spokane, Wash.--------- 54 45 1 1
Tacoma, Wash.----------- 47 30 1

Total 1 2,223 1h. 2 44 55

Cumulative Totals
including reported corrections for previous weeks

All Causes, All Ages -------------------------
All Causes, Age 65 and over------------------- 3,7
Pneumonia and Influenza, All Ages-------------- 2
All Causes, Under 1 Year of Age---------------











EPIDEMIOLOGIC NOTES AND REPORTS
AFRICAN SLEEPING SICKNESS Melbourne, Florida

.i- 7-year-oll dentist returned to Florida on October 29.
196s. from safari in Rhodesia and Botswana (formerly
Bechuanaland) with an acute illness characterized by
c(hi ll., feer, lethargy, malaise, axillary lymphadenopathy.
and a skin le ion on the right forearm. whilee on safari, he
ha, heen biltn ibya numerous t(sese flies and had de\el-
oped s ymiptom' shortly before returning to Florida, where
he was hospitalized on November 1. Blood smears re-
sealed numerous trypanosomes. No malaria parasites were
seen. A lumbar puncture revealed one lymphocyte and a
protein of 22 img percent. Suramin,* the drug of choicel
for early hemolyphatic Rhodesian sleeping sickness. was
begun on Notember 3: this drug therapy will be continued
for 3 weeks. the recommended period of administration.
(Reported by E. Charlton Prather. M.D., M.P.H., Director,
Division of Epidemiology. Florida State Board of Health;
Richard Camberg, M.D., Daniel Donoran, M.D., N. Frank
Fain, Ge e Stra M.D., corg trud Melbourne, Florida; and
an EIS Officer.)
*Availablh from the P1ara, itic l)is.as Drug Service, NCDC,
Atl.anta.
lifert ce:
1i\\trd Hlealh Organi nation: Expert Commlttlo on Trypanosom l
.si. \\t1 T < chnical R Iport No. 247, GCneva,, 1962.

INTERNATIONAL NOTES
QUARANTINE MEASURES

Additional Imm unization Information for International
Travel 1967-68 edition Public Health Service
Publication No. 384

The following new Yellow Fever Vaccination Center
should be included in Section 6:


City and

Center:




Clinic Ho


State: Bakersfield. California

Kern County Health Department
1700 Flower Street, 93302
Telephone 325-5051

urs: Wednesday. 8:30-11:00 a.m.


Fee:

City and State:

Center:




Clinic Hours:

Fee:


No

Eloise, Michigan

Wayne County Department of Health
Wayne County Health Center, 48132
Telephone 274-2800. Ext. 313

Wednesday. 9:00-11:00 a.m.

No


City and State: St. Paul, Minnesota

Center: Airport Medical Center
311 Terminal Building,
St. Paul-Minneapolis International
Airport. 55111
Telephone 721-6551

Clinic Hours: Monday, 2:00-5:00 p.m.

Fee: No


THE MORBIDITY AND MORTALITY WEEKLY REPORT WITH A CIRCULA-
TION OF 17 000. 5I PUBLISHED AT THE NATIONAL COMMUN CABLE
DISEASE CENTER, ATLANTA, GEORGIA
DIRECTOR. NATIONAL COMMUNICABLE DISEASE CENTER
DAVID J SENCER. M-D.
CHIEF, EPIDEMIOLOGY PROGRAM A.D, LANGMUIR. M.D.
CHIEF, STATISTICS SECTION IDA L. SHERMAN. M.S.
EDITOR MICHAEL B GREGG, MD

IN ADDITION TO THE ESTABLISHED PROCEDURES FOR REPORTING
MORBIDITY AND MORTALITY, THE NATIONAL COMMUNICABLE DISEASE
CENTER WELCOMES ACCOUNTS OF INTERESTING OUTBREAKS OR CASE
INVESTIGATIONS WHICH ARE OF CURRENT INTEREST TO HEALTH
OFFICIALS AND WHICH ARE DIRECTLY RELATED TO THE CONTROL
OF COMMUNICABLE DISEASES. SUCH COMMUNICATIONS SHOULD BE
ADDRESSED TO:
NATIONAL COMMUNICABLE DISEASE CENTER
ATLANTA, GEORGI A 30333
ATTN: THE EDITOR
MORBIDITY AND MORTALITY WEEKLY REPORT

NOTE: THE DATA IN THIS REPORT ARE PROVISIONAL AND ARE
BASED ON WEEKLY TELEGRAMS TO THE NCDC BY THE INDIVIDUAL
STATE HEALTH DEPARTMENTS THE REPORTING WEEK CONCLUDES
ON SATURDAY; COMPILED DATA ON A NATIONAL BASIS ARE RELEASED
ON THE SUCCEEDING FRIDAY


'I I 1. IE





i U.S. DEPOSITORY


| U.S DEPOSITORY


412


Morbidity and Mortality Weekly Report


NOVEMBER 2, 1968


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