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:
AA00010654:00262

Related Items

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

Full Text



COMMUNICABLE DISEASE CENTER


15, No. 38


S(i OCT;io=



U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WEL UBLQ


EPIDEMIOLOGIC NOTES AND REPORTS CONTENT,
HUMAN RABIES DEATH-South Dakota


A 10-year-old boy from Bryant, South Dakota, died
of rabies on September 5, 1966. On August 3 the boy had
been sleeping in his parents' backyard in a sleeping bag.
He was awakened when a striped skunk (Mephitis mephitis)
bit him on the right thigh after apparently crawling into
the sleeping bag with the boy. While attempting to get
away from the skunk, the boy received additional bites
on the wrist, the fingers of both hands, and behind the
right ear.
The skunk escaped, but what is believed to be the
same animal was shot several hours later by the boy's
father. This skunk was confirmed as rabid by Seller's


Epidemiologic Notes and Reports
Human Rabies Death South Dakota
Diphtheria South Carolina ...
Current Trends
Aseptic Meningitis ...........
Surveillance Summary
Shigella Second Quarter, 196


stain and direct fluorescent microscopyprocedures at the
South Dakota State Veterinary Diagnostic Laboratory,
Brookings, South Dakota.
A local physician cleansed the child's bite wounds
with phisohex and water and then painted them with tinc-
ture of merthiolate. A booster dose of tetanus toxoid was
given at that time. (Continued on paye 326)


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous weeks)
38th WEEK ENDED CUMULATIVE, FIRST 38 WEEKS
MEDIAN
DISEASE SEPTEMBER 24, SEPTEMBER 25, 1961-1965 MEDIAN
1966 1965 1966 1965 1961-1965
Aseptic meningitis .... .............. .. .. 174 77 94 2,096 1,449 1,431
Brucellosis............................. 5 9 9 167 188 306
Diphtheria.............................. 10 2 9 140 112 184
Encephalitis, primary:
Arthropod-borne & unspecified .......... 72 79 --- 1,541 1.304 -
Encephalitis, post-infectious ......... .. 9 7 -- 600 549 --
Hepatitis, serum ....... ........ 33677 738 1004 24812 31,872
Hepatitis, infectious .................. 588 23.278 2
Measles rubeolaa) ....................... 375 624 627 189.859 240,837 387,689
Poliomyelitis, Total (including unspecified) 2 10 70 46 276
Paralytic .... .................... ... 2 6 66 39 235
Nonparalytic .......................... --- 6 -
Meningococcal infections. Total .......... 28 35 31 2.744 2.352 1.802
Civilian .............................. 26 35 2.468 2.170
Military ............................... 2 --- 276 182 -
Rubella (German measles)................ 216 -- -- 41,901 --
Streptococcal sore throat & Scarlet fever .. 4.756 4,705 4,132 314,932 293,530 255,340
Tetanus................................ 4 4 132 196 -
Tularemia .............................. 6 3 125 190 -
Typhoid fever .......................... 10 5 15 276 302 383
Typhus, tick-borne (Rky. Mt. Spotted fever). 4 3 209 228 -

Rabies in Animals. ...................... 66 85 61 3,124 3,327 2,879

NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax: .................... .. ... .. 4 Botulism : .. 4
Leptospirosis: Iowa-1, Tenn.-l ...... ................ 50 Trichinosis: NYC-1 .. ... ......... 74
Malaria:NYU-1,Pa-3,Md-4,NC-3,Ala-3,Ore-1,lo-2,Ky-2,Cal-2,Ga- 289 Rabies in Man: .. .... ................ .. 1
Psittacosis: ...................... ...... .34 Rubella, Congenital Syndrome: ......... ....... 20
Typhus, murineTex.- ............................... 20 Plague.... .... ...... 4


1966


Ending








Morbidity and Mortality Weekly Report


HUMAN RABIES DEATH South Dakota (Continued)


Eleven nil. of antirabes scrum w as given within
1s hour. of the exposure. Approximately one-half the
volume was infiltrated around the bite wounds and one-
half injected intramuscularly. The child was started on
duck embr o origin rabies vaccinee the same day and
thereafter received a 1 ml. dose I ,, for the following
01 days. During this course of treatment he received
Benadryl, 50 mg q.i.d.

Twenty-four days after the exposure the boy deiel-
oped a se% ere headache. There were no prior symptoms
except for "a funny feeling" in the e.i_- of the right
hand before onset of headache. He was hospitalized at
DeSmet, South Dakota, the following day when he devel-
oped a fever of 104 F. About 48 hours after the onset of
headache he became irrational. There was a short period
of hyperexcitability, laryngeal spasm and increased sal-
ivation, followed by coma.

The boy was transferred to Sioux Valley Hospital.
Sioux Falls, South Dakota. on September 1, 1966. At this
time he responded only to deep pain. Deep tendon reflexes
were diminished, more so in the upper than lower extrem-
ities. He remained comatose until death on September .5,
1966.
Therapy included ACTH, instituted early in the
course of illness becauseof the possibility that symptoms
might be a vaccine reaction. Subsequent treatment in-


SEPTEMBER 24. 1966


eluded tracheotomy. steroids for hypotension and urea
to reduce cerebral edema.
Tissues were submitted to the State Health and
CDC Laboratories for microscopic examination and virus
isolation. Impression smears from the brain, lungs, and
salivary glands were negative on direct fluorescent micro-
scopic examination. A positive virus isolation was made
in mice and the brains from the first mouse passage were
positive by direct fluorescent microscopy for rabies. Pre-
liminarN immunologic tests on blood serum drawn termi-
nally. using the indirect fluorescent antibody technique,
were positive.
(Reported by Ben Diamond, Director of L.aboratories,
South Dakota State Department of Health; and the CDC
Rabies Ini'estiyations Laboratory.)

Editorial Note:
This clinical failure illustrates the limitation of
present rabies prophylactic procedures. In spite of nearly
ideal management including thorough cleansing of the
wounds, infiltration with antirabies serum and a full
course of vaccine, the patient developed rabies in less
than 30 days from time of the bites. Skunks are known to
excrete higher titers of virus in their saliva than other
rabid animals. Bites involving the ....'si- and face, ana-
tomical areas heavily supplied with nerve endings, are
known to carry a greater hazard of disease.


DIPHTHERIA- South Carolina


On June 18, 1966. a 10-year-old Negro boy died in
Columbia. South Carolina, after an 8-day illness charac-
terized by fever, sore throat and respiratory distress.
Nasopharyngeal and throat cultures grew out a toxigenic
strain of C. diphtheriae. After the death of this boy, 21
additional cases and 21 carriers were discovered. The epi-
demic reached its peak during the week ending August 6.
when seven new cases were diagnosed. All cases oc-
curred among the nonwhite, lower socioeconomic populace.
Twenty of these were below the age of 15 years; 8 oc-
curred in the 1-4 year age group. The index case and a
lig-year-old male infant died. No new cases have been
reported since September 6.
Both patients who died and 15 other clinically ill
persons I. i...... i. had not. been immunized against diph-
theria. In three other cases immunization was inadequate;
in one other case it had lapsed. The status was unknown
in the remaining case. Only two carriers had received a
full course of diphtheria toxoid previously. All cases,
except for the two fatal ones, were I'.,. l11 mild and
without complications. Of the 43 C. diphtheria strains
isolated, 41 were toxigenic. One non-toxigenic strain
was recovered from a carrier and another from a patient
with a traumatic ocular infection.
The 22 cases were confined to the city of Columbia
which has a population of 97.433 including 29,644 non-
whites (19610 census). In contrast to tie absence of re-
ported diphtheria cases since 1957, the recent attack


rate among the nonwhite 1-15 year age group was 18.2 per
10,000. Contact among all but two of the cases and car-
riers has been established in three distinct geographic
foci.
Two weeks after the onset of the initial case, the
county health officer decided to culture all members and
close contacts of the clinically affected persons. Four
hundred cultures were taken by mid-August. Each house-
hold contact was treated with 1.000 unitsof antitoxin and
2.4 million units of procaine penicillin each day until
three consecutive throat cultures were negative. The
clinically ill patients were treated with 20,000-S0.000
units of antitoxin and 2.4 million units procaine penicillin
per day.
On July 2S, a mass vaccination program was under-
taken at a clinic in each of the three epidemic areas.
Over 25,000 doses of DT or DTP vaccine have been ad-
ministered. Eighty to 90 percent of the doses have been
given to the nonwhites, the majority to persons less Ihan
20 years of age. A large proportion of this population
was known to have been susceptible due to a survey con-
ducted in this area in 1964 to determine the immunization
status of the residents; results indicated that at that time
only 62 percent of the nonwhite population in the 1-14
year age group had received adequate DTP immunization.
(Reported by Or. G. E. McDaniel, Director, Di/ision of
Disease Control, State Board of Health of South Carolina;
anu an EIS Officer.)










SEI'PTI: MER 24, 6lfil


Morbidity and Mortality Weekly Report


CURRENT TRENDS
ASEPTIC MENINGITIS


During the first 3h weeks of 1966, .2096 cases of
aseptic meningitis oero reported to the (Commnuniable
Disease Center through the National Morbidity Reporting
System. During the comparable period in 1965. 1.449
cases were recorded. Through the first 2(S weeks of both
years the numhbrs of report d ctas. s were nearly the same:
765 in 1966 and 712 in 1965.


The increased number- of cases during recent
weeks haxe been reported primarily from several states
along the eastern seaboard (Florida. Massachusetts, New
Jersey, New York (ity., Rhode Island and West Virginia)
in addition to (alifornia, Louisiana, Mississippi and
Texas. Table 1 compares the reported incidence of asep-
tie meningitis from these 10 states at the end of the 26th
and 3thh weeks of 1965r and 19)fi,


Tobl 1
SIoate Reporlng Signt(lont Increase" n Incidence of Aseptic Meningitos


(tlhfi,


0,10 0 ii ,k Ib t.i Oil



.0,0 00 0


xIi\ 1-
No.0l to-i o,
\,.0l 't-ott 00l
tthoI- I0,


No single etiologic agent has oben identified to
account for the majority of the cases.


SURVEILLANCE SUMMARY
SHIGELLA Second Quarter, 1966


During the second quarter of 1966, 1 ,56 shigella
isolation from human sources \w re reported from 53 cen-
ters. This represents an 11.6 percent decrease from the
2,099 reco\eries reported during the first quarter. The
number of isolations notified Ihe first quarter showed a
13.6 percent decrease from the total of 2.,29 reported
during the fourth quarter of 1965. The seasonal pattern
demonstrated in the first two quarters of 1966 has de\i-
ated slightly from that of the 1964 and 1965 (Figure 1).

Figure 1
REPORTED ISOLATIONS OF SHIGELLA


r 1.











Nineteen serotypes were recorded for the second
quarter, three less than for the -"r ..,. quarter. The six
most frequently reported are ted eare d in Table 2. In this
quarter as well as in previous ones. these subgroups have
been the most common, accounting for over 85 percent of
all isolation. Shigella sonnei has consistently held the
first rank and S. flecneri 2, the second.


Toble 2
The Six Most Frequently Reported Shigella Serotypes
from Human Sources


Second Quarter 1966 Previous Quarter

Rank Serotype Number Percent Rank Percent

1 S. sonnei 640 34.5 1 36.h
2 S. fle.reri 2 464 25.0 2 31.2
3 S. flexneri 3 277 14.9 3 10.0
4 S. flecxnri 6 12S 6 9 5 4.0
5 S. flexneri 4 10S 5., 4 7.7
6 S. fle.xnori 1 4b 2. 6 6 3.6


A regional difference has been recognized among shi-
gella isolation, as a significantly higher percentage of
S. flex'ncri isolation has been noted in the South as com-
pared to the North.. flerneri violations accounted for
about 73 percent of all shigella isolations in the south-
eastern quarter of the 1.S.. and around 81 percent in the
southwestern quarter. In contrast. S. sonnci recoveries
dominated the isolations from the northeastern and north-
western quarters. here 53 and 7:T percent. respectively,
were reported.

During April, MaY and June. 70.n percent of the
-.' 11 isolations \were reported from children under 10
years of age. approximately the same percent as in the
preceding quarter. Again no sex predilection for shigella
was apparent in the second quarter, although a predomi-
nance of males among the less than 5-year age group
was observed. Of the total second quarter isolations. 348
or 18.8 percent were from families with other members of
the same family positive for shigella. This was slightly
lower than the percentages reported during the previous
two quarters (25.2 and 27.4 percent, respectiovel).


til,
iii!










328 Morbidity and Mortality Weekly Report



CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

SEPTEMBER 24, 1966 AND SEPTEMBER 25, 1965 (38th WEEK)


ENCEPHALITIS HEPATITIS
ASEPTIC Primary Post- 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... 174 77 5 72 79 9 10 2 33 588 677

NEW ENGLAND.......... 11 2 1 1 3 37 40
Maine.............. 12 3
New Hampshire...... 1 6
Vermont............ 1 -4
Massachusetts...... 2 2 1 15 18
Rhode Island....... 9 2 3
Connecticut ........ 3 7 6

MIDDLE ATLANTIC ..... 32 4 11 16 1 20 102 131
New York City...... 7 2 4 6 13 27 27
New York, Up-State. 4 1 1 1 22 33
New Jersey.......... 18 4 4 4 19 37
Pennsylvania....... 3 1 2 6 1 2 34 34

EAST NORTH CENTRAL... 21 15 23 19 2 86 148
Ohio................ 7 5 22 13 25 41
Indiana............. 2 -- 11 6
Illinois........... 5 6 1 5 1 19 23
Michigan........... 3 3 -1 27 50
Wisconsin......... 4 1 1 4 28

WEST NORTH CENTRAL... 3 10 2 8 13 1 47 22
Minnesota.......... 8 1 1 4 3
Iowa................ 1 1 32 4
Missouri........... 1 7 2 4 3
North Dakota....... 2 2 9 -
South Dakota....... 1
Nebraska........... 3 3
Kansas............. 1 1 -- 3 8

SOUTH ATLANTIC....... 58 5 2 2 2 53 57
Delaware.......... 1 2 4
Maryland........... 3 1 17 10
Dist. of Columbia.. -
Virginia............ 6 -- 4 21
West Virginia...... 41 1 2 2
North Carolina..... 1 1 10 2
South Carolina..... 1 1 5
Georgia............ -- 2 2
Florida............. 6 3 1 15 13

EAST SOUTH CENTRAL... 11 7 2 1 1 38 66
Kentucky............ 1 3 1 19 35
Tennessee........... 9 1 2 1 14 15
Alabama............. 1 2 3 12
Mississippi........ 1 2 4

WEST SOUTH CENTRAL... 9 7 2 13 6 3 8 1 1 40 72
Arkansas........... 1 4 1 5 4
Louisiana.......... 1 3 2 8 1 7 5
Oklahoma............ 1 3 -
Texas.............. 8 6 6 5 1 1 25 63

MOUNTAIN ............. 3 3 14 28 42
Montana ............ 1 2
Idaho.............. 1 -- 4 1
Wyoming .......... -
Colorado........... 2 12 3 6
New Mexico......... 1 4 20
Arizona............ 2 12 12
Utah............... 1 2
Nevada ............. 3 -

PACIFIC.............. 29 24 1 9 9 1 1 7 157 99
Washington......... 1 3 1 1 9 2
Oregon............ 3 3 18 7
California.......... 27 21 1 6 6 7 128 87
Alaska............. 1 2
Hawaii............. I I

Puerto Rico.......... 27 52










Morbidity and Mortality Weekly Heport


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

SEPTEMBER 24, 1966 AND SEPTEMBER 25, 1965 (38th WEEK) CONTINUE


AREA
Cumulative
1966 1966 1965

UNITED STATES... 375 189,859 240,837

NEW ENGLAND........... 6 2,264 36,817
Maine............... 201 2,796
New Hampshire...... 80 381
Vermont............. 5 238 1,257
Massachusetts...... 1 781 19,295
Rhode Island....... 72 3,938
Connecticut..... 892 9,150

MIDDLE ATLANTIC...... 13 18,013 14,796
New York City...... 4 8,286 2,399
New York, Up-State. 3 2,535 4,135
New Jersey......... 1.846 2,574
Pennsylvania....... 6 5,346 5,688

EAST NORTH CENTRAL... 86 68,748 55,802
Ohio............... 11 6,351 8,883
Indiana............ 5,698 1,838
Illinois........... 5 11,363 2,742
Michigan. .......... 40 14,472 26,473
Wisconsin.......... 30 30,864 15,866

WEST NORTH CENTRAL... 10 8,687 16,527
Minnesota.......... 3 1,643 674
Iowa................ 3 5,308 8,997
Missouri............ 531 2,588
North Dakota...... 4 1.088 3,702
South Dakota...... 40 115
Nebraska........... 77 451
Kansas............. NN NN NN

SOUTH ATLANTIC....... 42 15,269 24,940
Delaware............. 257 503
Maryland........... 1 2,106 1,161
Dist. of Columbia.. 1 383 77
Virginia ........... 3 2,174 4,073
West Virginia...... 26 5,286 13,715
North Carolina..... 3 487 391
South Carolina..... 1 657 1,017
Georgia ........... 234 617
Florida............ 7 3,685 3,386

EAST SOUTH CENTRAL... 26 19,716 13,911
Kentucky............ 3 4,711 2,574
Tennessee........... 18 12,301 7,896
Alabama............ 1 1,686 2,325
Mississippi....... 4 1,018 1,116

WEST SOUTH CENTRAL... 78 24,570 30,886
Arkansas............ 971 1,084
Louisiana.......... 99 106
Oklahoma............ 3 487 203
Texas............... 75 23,013 29,493

MOUNTAIN ............. 30 11,978 19,717
Montana............ 4 1,817 3,724
Idaho.............. 7 1,570 2,787
Wyoming............ 2 161 845
Colorado............ 2 1,314 5,634
New Mexico.......... 1 1,133 677
Arizona............. 9 5,300 1,315
Utah............... 5 640 4,531
Nevada............. 43 204

PACIFIC............... 84 20,614 27,441
Washington.......... 28 3,565 7,238
Oregon.............. 17 1,801 3,236
California.......... 23 14,587 1? -
Alaska.............. 15 523 I1
Hawaii............... 1 138 3,812
Puerto Rico........... 42 2,770 2,407


MENINGOCOCCAL INFECTIONS,
TOTAL

Cumulative
1966 -
1966 1965

28 2,744 2,352


121
9
- 9
- 4
49
13
37

9 333
2 47
2 93
1 98
4 95

4 430
1 116
1 77
79
1 115
1 43

3 147
34
22
2 57

- 4
8
1 11

4 459
4
- | 46
S 11
1 52
28
3 118
48
63
89

3 242
85
2 81
1 54
22

2 375
- 35
- 138
1 19
1 183

85
4
- 5
- 6
- 46
10
10

- 4

3 552
37
34
3 462
15
- 4


120
16
7
7
40
14
36

306
53
87
80
86

334
89
42
94
72
37

122
26
9
52
11
3
10
11

451
7
44
9
53
24
91
59
57
107

185
73
60
32
20

307
15
170
19
103

73
2
8
5
14
11
16
14
3

454
33
33
363
18
7

6


POLIOMYELITIS
Total Paralytii

1966 1965 1966

2-



-2


I -


1


S 9


3 12
4
8
4




55



53

4
- 53





4
- .- 4


-3 45
2 23
14
1 8


329


56 216

I 29
10


5

13

16
5
9

2

3 76
4
1 4
2 18
17
33

1 9
1 -
7










330 Morbidity and Mortality Weekly Report


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

SEPTEMBER 24, 1966 AND SEPTEMBER 25, 1965 (38th 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



NEW ENGLAND ......... 596 3 1 1 7 1 3 2 73
Maine.............. 30 1 25
New Hampshire...... 20 1 25
Vermont ........... 26 20
Massachusetts...... 65 2 1 3 1 3
Rhode Island ...... 44
Connecticut........ 411 1 1 4 1 2

MIDDLE ATLANTIC...... 97 1 12 47 40 4 192
New York City...... 2 1 5 19 1
New York, Up-State. 87 2 11 13 4 179
New Jersey......... NN 1 7 12
Pennsylvania ....... 8 4 10 15 12

EAST NORTH CENTRAL... 203 16 14 4 37 1 18 5 406
Ohio............... 14 4 3 2 18 9 187
Indiana............. 40 3 5 3 1 87
Illinois........... 81 -3 5 1 4 1 8 3 54
Michigan ........... 4 1 6 1 33
Wisconsin.......... 68 2 1 6 1 45

WEST NORTH CENTRAL... 214 7 1 15 3 26 1 4 18 700
Minnesota.......... 1 1 1 157
Iowa................ 75 1 5 5 142
Missouri........... 2 5 1 9 3 13 1 3 6 215
North Dakota....... 129 1 2 32
South Dakota ....... 4 2 2 76
Nebh ska........... 2 2 21
Kan-s............. 3 2 5 1 2 57

SOUTH ATLANTIC....... 561 30 10 1 50 1 97 10 407
Delaware........... 16 1 2 -
Maryland............ 105 3 1 -9 25 2
Dist. of Columbia.. 2 -
Virginia........... 97 4 2 1 11 30 5 211
West Virginia...... 179 1 47
North Carolina..... 23 4 3 6 1 20 4
South Carolina..... 22 2 1 9 5
Georgia............ 4 7 2 2 15 5 90
Florida............ 115 10 9 53

EAST SOUTH CENTRAL... 1,041 15 19 32 36 4 405
Kentucky........... 58 2 2 3 8 87
Tennessee.......... 810 2 10 18 22 4 283
Alabama............ 94 6 4 6 6 16
Mississippi........ 79 5 3 5 19

WEST SOUTH CENTRAL... 483 2 30 5 57 28 7 14 636
Arkansas........... 1 1 5 2 44 2 2 4 72
Louisiana.......... 1 7 3 8 3 40
Oklahoma........... 26 2 3 7 9 4 3 163
Texas............... 456 16 3 9 1 4 361

MOUNTAIN ............ 863 2 6 13 3 3 82
Montana............ 16 2 7
Idaho. ............. 127
Wyoming............. 20
Colorado............ 341 2 3 2 2 17
New Mexico......... 195 1 2 1 13
Arizona............. 52 1 4 36
Utah............. 112 2 3 1 2
Nevada............. 1 7

PACIFIC.............. 698 1 17 3 1 36 1 6 223
Washington......... 155 11 13
Oregon............. 19 I 1 4
California......... 454 1 16 3 1 22 1 6 206
Alaska............ .. 26
Hawaii............. 44 2
Puerto Rico.......... 4 2 41 9 12


I I I I I


1 I I I I










Morbidity and Mortality Weekly Report






DEATHS IN 122 UNITED STATES CITIES FOR WEEK ENDED SEPTEMBER 24, 1966


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

All Causes Pneumonia Under All Causes Pneumonia Under

Area es I6 n year Area All 65 a nd a
Area All 65 years and I ear Area All 6 years Influenza All
Ages and over fl All Ages and over A
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.--------


*Estimate based on average percent of divisional total.


SOUTH ATLANTIC: 1,093 530 56 62
Atlanta, Ga.----------- 128 47 6 10
Baltimore, Md.---------- 260 126 10 20
Charlotte, N. C.------- 29 11 2 1
Jacksonville, Fla.----- 58 22 2 6
Miami, Fla.------------ 106 49 2 6
Norfolk, Va.----------- 41 20 3 3
Richmond, Va.----------- 54 36 1 -
Savannah, Ca.----------- 35 18 3 1
St. Petersburg, Fla.--- 71 56 2 2
Tampa, Fla.------------ 68 34 11 1
Washington, D. C.------ 193 81 7 11
Wilmington, Del.------- 50 30 7 1

EAST SOUTH CENTRAL: 589 315 35 37
Birmingham, Ala.------- 88 49 4 3
Chattanooga, Tenn.----- 50 24 6 8
Knoxville, Tenn.------- 43 26 2 2
Louisville, Ky.-------- 122 78 11 4
Memphis, Tenn.---------- 113 50 4 10
Mobile, Ala.----------- 38 16 3
Montgomery, Ala.------- 41 22 7 5
Nashville, Tenn.------- 94 50 1 2

WEST SOUTH CENTRAL: 1,105 587 27 71
Austin, Tex.----------- 37 23 1 3
Baton Rouge, La.------- 23 14 2
Corpus Christi, Tex.--- 24 14 -
Dallas, Tex.----------- 162 80 6 6
El Paso, Tex.----------- 37 21 1 2
Fort Worth, Tex.------- 79 49 2 4
Houston, Tex.----------- 238 108 2 19
Little Rock, Ark.------ 55 32 1 3
New Orleans, La.------- 174 82 4 13
Oklahoma City, Okla.--- 63 39 2
San Antonio, Tex.------ 106 64 2 7
Shreveport, La.-------- 47 22 4 8
Tulsa, Okla.----------- 60 39 2 3

MOUNTAIN: 384 211 15 21
Albuquerque, N. Mex.--- 38 16 6 4
Colorado Springs, Colo. 20 14 1 -
Denver, Colo.---------- 117 61 2 8
Ogden, Utah------------ 18 10 2 2
Phoenix, Ariz.--------- 66 28 2 4
Pueblo, Colo.----------- 17 14
Salt Lake City, Utah--- 57 37 3
Tucson, Ariz.---------- 51 31 2

PACIFIC: 1,674 1,018 26 70
Berkeley, Calif.------ 18 12
Fresno, Calif.---------- 43 22 5
Glendale, Calif.------- 39 25
Honolulu, Hawaii------- 38 14 3
Long Beach, Calif.----- 68 50 2 2
Los Angeles, Calif.---- 601 383 7 26
Oakland, Calif.-------- 72 36 2 4
Pasadena, Calif.------ 39 28 -
Portland, Oreg.-------- 118 70 5
Sacramento, Calif.----- 65 34 2 5
San Diego, Calif.------ 90 57 2 4
San Francisco, Calif.-- 187 102 5 4
San Jose, Calif.------- 46 30 2 2
Seattle, Wash.---------- 152 91 4 8
Spokane, Wash.--------- 42 30 1
Tacoma, Wash.---------- 56 34

Total 11,921 6,736 377 648

Cumulative Totals
including reported corrections for previous weeks


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


479,125
274,722
20,202
25,512


Week No.









332 Morbidity and Mo





SURVEILLANCE SUMMARY
SHIGELLA Second Quarter, 1966
(Continued from page 327)


Nonhuman
A total of 17 isolation of shigella was reported
during the second quarter of 1966, as summarized in
Table 3.


Table 3
Reported Shigella Serotypes from Nonhuman Sources


No. of Reporting
Serotpe Iolaton enter
Isolation Center


Mich.
" isc.
Ga.
Texas
Md. (3)
Wise. (1)
Fla. (3)
Texas
Wise.
Pa.


Source


Monkey
Monkeys
Research sample
Lab stock culture
Monkeys
Monkey
Monkeys
Lab stock culture
Monkey
Monkeys


SEPTEMBER 24, 1966


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 CDC BY THE INDIVIDUAL
STATE HEALTH DEPARTMENTS. THE REPORTING WEEK CONCLUDES
ON SATURDAY; COMPILED DATA ON A NATIONAL BASIS ARE RELEASED
ON THE SUCCEEDING FRIDAY.


n


33

o
- a
> >



"an
m

a


m

ma

Om
.o
0 n
In I
-r
ff Q
On


reality Weekly Report


> o



--C


S. boydii I
S. flexneri 1
S. flexneri 2
S. fle.neri 2b
S. flexneri 3



S. flerneri 4a
Unknown
S. flexneri
(not typed)

Total