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:
AA00010654:00260

Related Items

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

Full Text



COMMUNICABLE DISEASE CENTER


Vol. 15, No. 37


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


SURVEILLANCE SUMMARY
SALMONELLOSIS June and July 1966


During June and July 1966 there were 2,126 and 1,630
isolations, respectively, of salmonella from human sources.
The cumulative number of such isolations reported during
the first 7 months of 1966 is 10,508, 6.0 percent fewer
than the number of isolations recorded during the same
period in 1965 (11,180). The seasonal pattern continues
to be similar to that observed in 1965 (Figure 1, page 318).
The age-sex distribution remained consistent with past
experience.
The seven most frequently reported human serotypes
for June and July are listed in Table 1, page 318. These
seven accounted for 64.0 and 64.6 percent, respectively,


Surveillance Summars
Sailmon,.llsis Ju:., ;-,i Juti I ti ...
Rabies Isi Q.urter, In( ...
Summar, of i ,pIc rtc d (aII 's of 1 'cfctimc syplhii
Epidemioilo ical N cla d 1 I irt
Hospital Ac quirrid Str iltococn al Inf-'-ti i


of all isolation. The numbers of isolation of two sero-
types abruptly increased in July. Salmonella blockley,
which usually accounts for about 2 percent of all human
isolation of salmonella. represented 6.3 percent in June
due to an outbreak of the werotype in a Massachusetts
hospital S. Ja'a, uhich also accounted for 6.3 percent
i('Ctin ued on page 318)


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous weeks)
37th WEEK ENDED CUMULATIVE, FIRST 37 WEEKS
MEDIAN
DISEASE SEPTEMBER 17, SEPTEMBER 18. 1961- 1965 I MEDIAN
1966 1965 1966 1965 1961-1965
Aseptic meningitis .......... 181 102 102 1.922 1,372 1.354
Brucellosis, ......... .. ............ 5 6 6 162 179 297
Diphtheria. .......... ..... ......... 3 2 9 130 110 181
Encephalitis, primary:
Arthropod-borne & unspecified ...... .. 96 49 1,444 1,225 -
Encephalitis, post-infectious ........ 9 8 5- 91 542 -
Hepatitis, serum 26................ 26 617 738 971 4.135 31134
Hepatitis, infectious .... ........... 535 22,691 2
Measles rubeolaa) ......... 397 623 734 189,484 240,213 387,062
Poliomyelitis. Total (including unspecified) 17 69 44 266
Paralytic- .. ... ..- 16 65 37 229
Nonparalytic ........... .... ..... -- 6
Meningococcal infections, Total ........ 19 26 26 2,716 2,317 1,772
Civilian ......... .. 17 25 2,442 2.135
Military ............................ 2 1 274 182 -
Rubella (German measles) ............. ... 185 --- -- 41.685 -
Streptococcal sore throat & Scarlet fever .. 4.237 4,246 3.593 310,176 288.825 251,336
Tetanus .. ..... .. ........... 8 5 -- 128 192 -
Tularemia .... .. ...... ...... 6 9 119 187 -
Typhoid fever .......................... 14 16 17 266 297 364
Typhus, tick-borne (Rky Mt. Spotted fever) 9 8 205 225 -

Rabies in Animals ................... 82 81 72 3.050 3.242 2.834

NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum Cum.
Anthrax: ........... .. .. 4... .... Botulism: 4
Leptospirosis: .. ................. ........... 48 Trichinosis: 73
Malaria: Pa.-21, Miss.-l, Ark.-1, Ariz.-1, Calif.-1 ...... 267 Rabies in Man: ............1
Psittacosis: Tex.-l. .............................. 34 Rubella. Congenital Syndrome .. .... .... 20
Typhus, marine: P.R.-1 ....... .... .. 19 Plague: .. 4


1966









318


SEPTEMBER 17, 1966


of the human isolations in contrast to its customary one
percent representation, increased as a result of an inter-
state outbreak of salmonellosis in New Jersey, New York
and Pennsylvania caused by contaminated smoked fish
(MMWR, Vol. 15, Nos. 22 and 23).
The seven most commonly reported serotypes from
nonhuman sources for June and July are listed in Table 2.



Table 1
The Seven Most Frequently Reported Serotypes
from Human Sources June and July, 1966


June July
Serotype
Rank Number Percent Rank Number Per ent
S typhi-murium 1 575 27.0 1 164 28.5
S. typhi-murium
var tnpenhagen
S eidelberg 2 173 8.1 2 163 10.0
S 81bokley 3 135 6.3
S jlva 4 135 6.3
S. infantis 5 131 6.2 9 90 5.5
S en-eritidis 6 114 5,4 3 111 6.8
S. n,, port 7 98 4.6 4 96 5.9
S. aint-pmul 6 70 4.3
S. thompson 7 59 3.6
Tolal 1,361 64.0 1.053 64.6
Tota nl all types 2.126 1,630


The most prominent nonhuman sources for both months
were turkeys, chickens, powdered milk, and livestock feed.
(Reported by the Salmonella Unit, Epidemiology Branch,
CDC.)


Table 2
The Seven Most Commonly Reported Serotypes
from Nonhuman Sources June and July, 1966


June July
Serotype
Rank Number Percent Rank Number Percent
S. typhk-mnsrum 1 98 15.7 1 77 15.1
S, typhi-murim
aut. copenho}en
S. hreielberg 2 61 9.R 2 40 7.8
S. uewuruauitk 3 42 6.7
S uchus aernyrund 4 30 4.8 4 32 6.3
S. so:ra-paul 5 29 4.7 7 22 4.3
S. aatum 6 26 4,2 3 33 6.4
S. monltp ideo 7 26 4.2 6 24 4.7
S. ,tnnessee 5 26 5.1
Total 312 50.1 254 49.7
Total l serotypos 623 511
Most Common Sources of Nonhuman Isolatrons

Turkey 1 186 29.9 1 126 24.7
Chicken 2 150 24.1 2 89 17.4
Powdered Milk 3 65 10.4 4 33 6.4
Livestock Food 4 31 5.0 3 43 8.4


RABIES 1st Quarter, 1966


During the first quarter of 1966, 1,056 laboratory con-
firmed cases of rabies were reported, a decrease of almost
300 cases from the total reported during the same quarter
in 1965. Thirty-three States reported at least one case of
animal rabies; 22 States reported 10 or more cases. Twenty-
four States reported fewer cases during the first quarter
of 1966 than during the comparable period in 1965, while
11 States reported an increase in the number of cases.
Texas had the highest incidence with its total of 138
cases. No human deaths occurred during the quarter. A


total of 273,840 doses of rabies vaccine for human treat-
ments were distributed from January through March of 1966,
compared to:. VC:.. .d -irihItiI- for the entire year of 1965.
This was due to large shipments to the armed forces for
use in pre-exposure immunization of military personnel.
The incidence of 1,056 rabies cases during the first
quarter of 1966 is approximately the same as the average
of 1,011 cases for the first quarter of the preceding 6
years. Wildlife accounted for 707 cases of rabies (67
percent), while domestic animals were r.--l[,n-l.le for


Morbidity and Mortality Weekly Report





SALMONELLOSIS (Continued from front page)


Figure 1
REPORTED HUMAN ISOLATIONS OF SALMONELLA
IN THE UNITED STATES










Morbidity and Mortali


349 cases (33 percent). In order of most frequently infected

species, skunks and foxes were followed lb cattle and

dogs (Table 3).

Of the 349 skunk rabies cases reported. four mid-

western States (Minnesota, Ohio, Iowa, and Illinois) ac-

counted for 14S (42 percent), while Texas and California

were responsible for an additional 91 cases (26 percent).

More States reported rabies in skunks than any other waild-

life species, a total of 24 States having recorded at least

one case.

Cases of fox rabies declined from 475 during the first

quarter of 1965 to 311 during the first quarter of 1966.

New York State and Missouri recorded 52 and 32 cases of

fox rabies, representing increases of four and five times,

respectively, oer the amount reported during the first

quarter of 1965.

Ten species of wild animals were reported as rabid.


SEPTEMBER 17, 1966


Table 3
Incidence of Rabies in Wild and Domestic Species of Animals
First Quarters of 1965 and 1966


WILD SPECIES DOMESTIC SPECIES
January- Horse TOTAL

March Skunk Fox Raccoon Bat Other Total Cattle Dog Cat Other Total
& Mule

1965 365 475 25 16 15 896 199 140 61 28 9 437 1,333

1966 349 311 32 8 7 707 145 123 53 19 9 349 1,056


SUMMARY OF REPORTED CASES OF INFECTIOUS SYPHILIS

AUGUST 1966 AND AUGUST 1965



CASES OF PRIMARY AD SECONDAY SYPHILIS: RL rtlg Areas Augusr 19h and August 1965 Provtln~ l Data


Reporting Area

NW ENGIAND. ............
Na ne h.... .............
New Hampshire...........
Veon2.t...............
C0nneCCtPIcut ...........

IDLE ATCTIIC..........
Upstate Neu York.. .....
New York City...........
PaC (Excl. Phla.)......
Fhiladelph a............
New Jersey ........
EAST NORTH CENTRAL.......
ohio.................
IWn tiRa.... ..E ...
Dc state Illinois-......
Chicag:. .... .... ..
Hichicgan................
12sc3t22 ............

6. 0R CE L.....
onnesota...............

North Dakota-............
South Dakota.............

rbT kA TIrI.... ............
D6 a e..............

DOstr2lt if C2lumhiaL ...
V 0rgina ............
Wet Vlrgla...........
M77.00 .
v1t27 7 302


9Cu iat ive
August Jan -: ug
1966 ic I" a ri


Reporting Area


August Jan 4Au


49 -. r ..I
S 5 1 entucky ................ 18 10 94 93
7 23 T esse ........... -. 3 38 210 38
2 2 Alabaa.................. 137 12i 87 1020
)3 33 224 185 Mississippi....... ... 43 73 385 407
2 i 20 14
10 14 63 88 WES: SOUTH CENTRAL...... 63 20 1.763 3.39
Arknss................. 2 23 97 i63
366 460 2.714 3.784 Loulslana ........... 70 75 4J31 67
38 63 250 362 Oklahi ........... 10 9 94 85
210 248 1.674 1.68 Texas.................. 171 103 1147 884
27 17 114 10B
25 33 176 187 O6 TA1NI2 ................. 9 44 383 378
66 99 480 659 -onmta .................. i i 23
Idaho.................... 2 3 5
302 266 2,118 2.003 Wy g... ...........
64 48 409 417 Colirdo,.............. 3
13 3 67 36 New theto...... 12 I1 65 75
16 26 127 154 Ariona.................. 28 138 208
97 105 685 813 Utah.................... I 0
107 70 758 527 Nevada .................. 2 16 4
5 5 72 56
PACIFIC .................... 142 157 99 1,380
38 52 284 345 asilngln...... ..... 3 26 5
3 3 22 62 Oregn .................. 5 36 26
9 6 ;7 20 Cllfornl. .............. 134 4 1,104 1,290
8 17 108 155 Alaska ................... i 6
S 5 I Haau .......... .. 3 7 15
i 6 25 32
8 I2 Oj 61 I. TOTAL ............... 1 956 2.056 12 410 I. 626
9 4 47 144
I ERITRIES............... 9 89 i41 55O
515 51 4.167 46 517 iert Rio ............... a2 88 136 538
9 10 34 4 4 Vlrgio Isia ..... .. 2 I 12
52 42 374 294


C'iulative Totals include revised and delaydl reports
through previous iiths.


ity Weekly Report 319






The remaining eight speicis include 32 raccoons reported

mostly from Georgia and FIlorida, S hats reported from 7

States, 2 hocliats, one squirrel, one- rat. orne i house and

one badger.

Among domestic animals. the 145. rabid cattle reported

were concentrated in tho central and eastern portions of

the I1.S. Of the 123 dog rabies cases reported. 12 percent

were from the four States along I he I:.S.-M\i'can Border

and 28 percent were from four continguou- States in the

Mississippi-Ohio Valley (Tennessoe. Kentuck Missouri.

Illinois). Fourteen additional Stales reported the remain-

ing 36 cases of dog rabies. Other domestic animals re-

ported as having rabies were .53 eats. 19 horses andmules.

5 swine. 3 sheep. and one goat.


(Reported by Veterinary Section. Epidemioloyy Hranch.

c(c.)










320 Morbidity and Mortality Weekly Report



CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

SEPTEMBER 17, 1966 AND SEPTEMBER 18, 1965 (37th WEEK)


ENCEPHALITIS HEPATITIS
ASEPTIC Primary Post- I Both
AREA MENINGITIS BRUCELLOSIS including Infectious DIPHTHERIA Serum Infectious Types
unsp. cases
1966 1965 1966 1966 1965 1966 1966 1965 1966 1966 1965
UNITED STATES... 181 102 5 96 49 9 3 2 26 535 617

NEW ENGLAND.......... 22 1 5 1 1 -17 52
Maine.............. 1 6 5
New Hampshire ...... 5
Vermont............. 2
Massachusetts...... 8 1 2 1 6 20
Rhode Island....... 13 1 2- 7
Connecticut........ 2 1 3 13

MIDDLE ATLANTIC...... 42 2 13 15 1 18 71 86
New York City...... 14 7 5 13 19 32
New York, Up-State. 1 2 1 3 16 13
New Jersey.......... 26 1 7 1 11 16
Pennsylvania....... 1 2 3 2 1 1 25 25

EAST NORTH CENTRAL... 30 33 30 12 4 87 128
Ohio............... 3 3 22 6 11 34
Indiana............. 2 2 1 10 12
Illinois............ 3 5 5 4 1 21 21
Michigan........... 22 20 2 3 41 59
Wisconsin.......... 3 1 1 4 2

WEST NORTH CENTRAL... 9 14 3 8 8 1 24 30
Minnesota.......... 5 10 1 12 2
Iowa ............... 3 3 2 -- 5 6
Missouri........... 2 1 6 4 5
North Dakota....... 2 1 4
South Dakota....... -
Nebraska............ 1 1 3
Kansas............. 2 4 2 10

SOUTH ATLANTIC....... 6 6 1 2 3 51 74
Delaware........... 1 1
Maryland............ 17 4
Dist. of Columbia.. 1 2
Virginia............ 1 1 1 1 14 16
West Virginia...... 1 2 12
North Carolina..... 4 1 1 4 6
South Carolina..... 1 9
Georgia............ 5 2
Florida............ 1 2 1 2 7 22

EAST SOUTH CENTRAL... 11 5 6 2 3 35 51
Kentucky ........... 10 21
Tennessee.......... 2 1 3 2 10 16
Alabama............ 5 4 5 7
Mississippi........ 4 3 3 10 7

WEST SOUTH CENTRAL... 10 7 1 21 1 1 39 51
Arkansas ........... 1 3 7
Louisiana.......... 6 2 3 2
Oklahoma........... 1
Texas.............. 4 5 1 20 1 1 32 42

MOUNTAIN............. 7 5 1 2 43 36
Montana ............ 1 1
Idaho............... 1 4
Wyoming............ 1 1 2 -
Colorado........... 1 1 11 16
New Mexico.......... 5 3 7 8
Arizona............ 1 16 5
Utah............... 1 6 1
Nevada ............. 1

PACIFIC.............. 44 29 10 5 3 8 168 109
Washington ........ 4 1 1 11 14
Oregon............... 40 9
California.......... 39 26 9 4 3 8 112 85
Alaska ............. 3
Hawaii............... 1 2 2 1

Puerto Rico.......... 19 36









Morbidity and Mortality Weeklyv I 'eporl


( ASES OF SPEC(IFIEI) NOTIFIABLE DISEASES. I(NIlI) STATES

FOR W I: KS I NI).I)

SEPTEMBER 17. 1966 AND SEPTEMBER IN, 1965 (37th WEIlK) (ONTIINUII)


AREA



UNITED STATES.,

NEW ENGLAND ..........
Maine .............
Ne, Hampshire......
Vermont............
Massachusetts......
Rhode Island.......
Connecticut ........

MIDDLE ATLANTIC......
New York City......
New York, Up-State.
New Jersey.........
Pennsylvania ......

EAST NORTH CENTRAL...
Ohio. ..............
Indiana ............
Illinois...........
Michigan...........
Wisconsin..........

WEST NORTH CENTRAL...
Minnesota. .........
Iowa ...............
Missouri...........
North Dakota.......
South Dakota.......
Nebraska. ..........
Kansas.............

SOUTH ATLANTIC ......
Delaware ...........
Maryland...........
Dist. of Columbia..
Virginia ..........
West Virginia......
North Carolina.....
South Carolina.....
Georgia ...........
Florida............

EAST SOUTH CENTRAL...
Kentucky ..........
Tennessee..........
Alabama ...........
Mississippi........

WEST SOUTH CENTRAL...
Arkansas ..........
Louisiana .........
Oklahoma ..........
Texas .............

MOUNTAIN.............
Montana............
Idaho..............
Wyoming ............
Colorado...........
New Mexico.........
Arizona ...........
Utah...............
Nevada.............

PACIFIC.............
Washington .........
Oregon ............
California.........
Alaska.............
u I~i


MEASLES (Rubdla)

SCumnillat iv
,6 a96 1 19 5
2 196( 19v5

)7 189,484 2'0, 213

8 2, '8 36,798
3 ?01 :,792
80 381
1 ?33 1,257
2 780 19,281
7- 2 3,938
2 89P' 9,149

14 18,000 14,747
4 8,282 2,378
4 2,532 4,125
1,846 2,565
6 5,340 5,679

19 b8.662 55,655
5 6,340 8,867
12 5,698 1,828
20 11.358 2,701
60 14,432 26,441
32 30,834 15.818

7 8,677 16,457
1 1,640 63
5,305 8,983
531 2,588
5 1,084 3,685
40 115
1 77 450
NI NN NN


15,227
257
2,105
382
2,171
5,260
484
656
234
3,678

19,690
4,708
12,283
1,685
1,014

24,492
971
99
484
22,938

11,948
1,813
1,563
159
1,312
1,132
5,291
635
43

20,530
3,537
1,784
14,564
508
13 T


24,902
303
1,160
77
4,059
13,698
390
1,016
617
3,382

13,771
2,481
7,853
2,322
1,115

30,818
1,084
105
203
29,426

19,688
3,714
2,783
845
5,627
677
1,309
4,529
204

27,377
7,222
3,231
12,942
182
3 8


MEN INGOtO AL INiFCTIoNs,
1OTAL

Cu.iulalive
1966 66 196

19 2, 716 ,317

1 121 117
9 16
9 7
6
I 49 39
13 14
2 37 35

2 324 303
45 51
91 87
97 79
2 91 86

6 426 329
115 88
76 42
2 79 92
4 114 70
42 37

144 119
34 24
22 8
55 52
11 11
4 3
8 10
10 11


l.qtal

*9 I t
11-h


OIMEI I i RUBELLA
Parael ytic RI I A


1965 1966 9 1' 66

6-' 185

I


17
9







i 9
2 5
30
37

1 2

2


- -1




- -

3


- 5


54

1

-2
- 52


Puerto Rico.......... 59 2,728 2,388 110 6 1 4











322 Morbidity and Mortality Weekly Report


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

SEPTEMBER 17, 1966 AND SEPTEMBER 18, 1965 (37th WEEK) CONTINUED


STREPTOCOCCAL TYPHUS FEVER RABIES IN
SORE THROAT & TETANUS TULAREMIA TYPHOID TICK-BORNE ANIMALS
AREA SCARLET FEVER (Rky. Mt. Spotted)
1966 1966 Cum. 1966 Cum. 1966 Cum. 1966 Cum. 1966 Cum.
1966 1966 1966 1966 1966
UNITED STATES... 4,237 8 128 6 119 14 266 9 205 82 3,050

NEW ENGLAND ......... 373 3 1 6 2 70
Maine............. 36 24
New Hampshire...... 24
Vermont............ 20
Massachusetts...... 60 2 -1 3 1 2
Rhode Island....... 43
Connecticut........ 234 1 3 -

MIDDLE ATLANTIC...... 82 11 3 47 2 40 3 188
New York City...... 8 4 2 19 1 1
New York, Up-State. 72 2 11 13 2 175
New Jersey......... NN 1 7 2 12 -
Pennsylvania....... 2 4 1 10 15 12

EAST NORTH CENTRAL... 324 3 16 1 14 1 33 17 14 401
Ohio................ 26 4 3 16 9 3 187
Indiana............. 61 1 3 1 5 3 1 4 87
Illinois........... 77 3 5 3 7 2 51
Michigan........... 117 4 1 5 1 32
Wisconsin.......... 43 2 2 1 6 4 44

WEST NORTH CENTRAL... 140 7 2 14 1 23 1 3 18 682
Minnesota.......... 2 1 2 156
Iowa............... 38 1 5 1 137
Missouri........... 5 2 8 10 1 2 4 209
North Dakota....... 65 1 3 30
South Dakota....... 9 2 6 74
Nebraska........... 1 2 1 2 2 21
Kansas............. 25 2 5 1 55

SOUTH ATLANTIC....... 642 2 30 10 3 49 5 96 7 397
Delaware........... 16 1 2 -
Maryland........... 55 1 3 1 1 9 25 2
Dist. of Columbia.. 7 2 -
Virginia........... 140 4 2 2 10 2 30 206
West Virginia...... 185 1 I 1 47
North Carolina..... 7 4 3 6 1 19 4
South Carolina..... 70 1 2 1 9 5
Georgia............ 8 7 2 2 2 15 4 85
Florida............ 154 10 9 2 53

EAST SOUTH CENTRAL... 925 1 15 19 4 32 1 36 11 401
Kentucky........... 64 2 2 3 8 2 87
Tennessee.......... 744 2 10 4 18 1 22 3 279
Alabama .............. 88 6 4 6 6 2 16
Mississippi........ 29 1 5 3 5 4 19

WEST SOUTH CENTRAL... 462 2 28 3 52 2 28 7 14 622
Arkansas........... 3 1 4 2 42 1 2 2 4 68
Louisiana.......... 2 6 3 8 37
Oklahoma........... 16 2 4 9 4 4 160
Texas............... 441 1 16 1 3 1 9 1 6 357

MOUNTAIN ............. 768 2 6 13 3 4 72
Montana............ 21 2 7
Idaho.............. 35
Wyoming ........... -
Colorado........... 373 2 3 2 8
New Mexico......... 152 2 1 1 13
Arizona............ 67 1 4 36
Utah ............... 120 2 3 1
Nevada.............- I 3 7

PACIFIC.............. 521 16 3 35 1 11 217
Washington......... 56 11 2 13
Oregon............. 11 1 1 1 4
California......... 419 15 3 21 1 8 200
Alaska.............. 17 -
Hawaii ............. -
Puerto Rico.......... 12 4 38 1 9 12









Morbidity and Mortality Weekly Ieporl






DEATHS IN 122 UNITED STATES CITIES FOR WEEK ENDED SEPTEMBER 17, 1966


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

All Causes Pneumonia Under All Causes Pnumonia Under

Area All 65 years and year Area All 65 yea d year
All years All
over Influenza All and over Influenza All
Ages and All Ages Causes ges and r 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.--------


674
213
36
23
27
56
20
28
31
47
55
13
36
31
58

2,865
45
33
127
37
37
42
48
78
1,468
47
399
174
43
90
22
37
61
32
17
28

2,544
74
38
715
178
229
133
72
357
43
44
41
20
50
129
24
137
24
33
41
99
63

764
52
26
28
131
18
127
68
216
52
46


402
127
21
16
19
28
11
18
18
33
25
8
19
20
39

1,589
24
15
72
22
17
24
24
31
810
22
219
102
26
67
13
24
30
23
13
11

1,396
45
23
386
104
105
64
37
197
33
22
19
11
36
69
13
84
14
22
20
59
33

450
36
19
14
86
8
63
45
125
31
23


*Estimate based on average percent of divisional total.


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, lex.---
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.----------


1,155
137
252
46
59
90
53
68
32
82
69
209
58

608
82
50
25
134
141
32
38
106

1,112
47
40
43
159
43
75
198
69
141
81
98
60
58

415
29
22
122
17
88
20
57
60

1,435
18
37
20
53
70
349
119
26
137
74
95
182
40
130
53
32


Total 11,572 6,290 338 757

Cumulative Totals
including reported corrections for previous weeks

All Causes, All Ages ------------------------- 467,171
All Causes, Age 65 and over------------------- 267,963
Pneumonia and Influenza, All Ages------------- 19,819
All Causes, Under 1 Year of Age--------------- 24,866


Week No









324 Morbidity and Mo





EPIDEMIOLOGICAL NOTES AND REPORTS
HOSPITAL ACQUIRED STREPTOCOCCAL INFECTION
Seattle, Washington


Eight cases of streptococcal puerperal endometritis
and three cases of streptococcal postoperative wound
infection occurred among patients in a Seattle hospital
over a period of 77 da\s> last year. There was one death.
Subcultures from eight patients were confirmed as Lance-
field group streptococci and further characterized as
M-noniypabh., T9.
One, the outbreak was recognized. an intensive search
for sources of the infection was undertaken. Cultures of
the throats and other anatomic sites of all attendants were
negiaive for streptococci as well as were cultures from
various fomites in the environment. Epidemiologic inves-
tigation implicated a medical attendant as the probable
source of the infection in this outbreak although the ex-
act mode of spread remained obscure. Further intensive
bacteriologic studyhowever, revealed that the anal orifice
of this attendant was heavily colonized with beta hemo-
lytic streptococci (Group A, M-nontypable. T9). The ca-
pacity of this attendant to disseminate organisms into the
immediate environment was demonstrated experimentally
when, attired in hospital working garments, he performed
simulated occupational tasks requiring progressively in-
creasing amounts of physical activity in a streptococcus-
free room. Streptococci were detected in air samples when
the medical attendant entered the room. and as his activity
increased, airborne streptococci were detected in increas-
ing numbers in sequential samples.
Following intensive treatment with penicillin and
vancomycin, cultures from the asymptomatic carrier were
negative for streptococci. Two members of the medical
attendant's family, who were also found to be infected
with the homotypic strain, responded favorably to treat-
ment.


(Reported by Dr. Donald R. Peterson, Director. Division
of Epidemiology and Communicable Disease Control,
Jean G. Spearman, Public Health Nurse Epidemiologist,
aid Mr. Paul Bonin, Director, Division of Laboratories,
Seattle-King County Department of Public Health; and
the Staphylococcus and Streptococcus Unit, Bacteriology
Section, 'CDC.)


rtality Weekly Report


THE MORBIDITY AND MORTALITY WEEKLY REPORT, WITH A CIRCULA-
TION OF 15.600, IS PUBLISHED AT THE COMMUNICABLE DISEASE
CENTER, ATLANTA. GEORGIA.
CHIEF. COMMUNICABLE DISEASE CENTER DAVID J. SENCER, M.D.
CHIEF, EPIDEMIOLOGY BRANCH A.D. LANGMUIR. M.D.
ACTING CHIEF. STATISTICS SECTION IDA L. SHERMAN, M.S.

IN ADDITION TO THE ESTABLISHED PROCEDURES FOR REPORTING
MORBIDITY AND MORTALITY. THE COMMUNICABLE DISEASE CENTER
WELCOMES ACCOUNTS OF INTERESTING OUTBREAKS OR CASE INVES-
TIGATIONS WHICH ARE OF CURRENT INTEREST TO HEALTH OFFICIALS
AND WHICH ARE DIRECTLY RELATED TO THE CONTROL OF COM-
MUNICABLE DISEASES. SUCH COMMUNICATIONS SHOULD BE ADDRESSED
TO:

THE EDITOR
MORBIDITY AND MORTALITY WEEKLY REPORT
COMMUNICABLE DISEASE CENTER
ATLANTA. GEORGIA 30333
NOTE: THE DATA iN THIS REPORT ARE PROVISIONAL AND ARE
BASED ON WEEKLY TELEGRAMS TO THE COC BY THE INDIVIDUAL
STATE HEALTH DEPARTMENTS. THE REPORTING WEEK CONCLUDES
ON SATURDAY; COMPILED DATA ON A NATIONAL BASIS ARE RELEASED
ON THE SUCCEEDING FRIDAY.


UJNIV. OF FL LIB
DOCUMENTS DE PT


r-* .



U.S. DEPOSITORY


SEPTEMBER 17, 1966


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