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:
AA00010654:00263

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





















U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE PUBLj f VICE


EPIDEMIOLOGIC NOTES AND REPORTS (ONTENTS
TYPHOID FEVER Nebraska


On September 12, 1966, a case of typhoid fever in a
-.,ir ,oil man was reported from Kearney, Nebraska.
The patient experienced symptoms of fever, chills.
cramping, abdominal pain, and diarrhea on August 27
while vacationing with his wife on a train tour. There was
no nausea or vomiting but the patient was anorectic.
\lihou2h the diarrhea subsided after 2 days, the fever
continued; treatment with penicillin was initiated.
The patient was admitted to hospital on September 2
where blood cultures and stool specimens were found
positive for Salmonella typhi. He was subsequently
treated with chloramphenicol. On September 6 the patient


Epidemiologic Notes and Ilj.prlts
Typhoid Fever Nebraska ..........
Encephalitis ..........


developed acute abdominal pain and at surgery was found
to have a perforated ileum. lie seemed to be recovering
satisfactorily when he suddenly died on September 14.
Autopsy revealed a massive pulmonary embolus.
The patient, a retired farmer, lived in a small farm
town in central Nebraska. The patient's wife, whom he
(Continured on page 334)


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous weeks)
39th WEEK ENDED CUMULATIVE, FIRST 39 WEEKS
MEDIAN
DISEASE OCTOBER 1, OCTOBER 2. 1961-1965 MEDIAN
1966 1965 1966 1965 1961-1965
Aseptic meningitis ................. 169 82 109 2,265 1,531 1.513
Brucellosis. .... ... 22 1 5 189 189 311
Diphtheria........... .......... ......... 1 1 8 142 113 186
Encephalitis, primary:
Arthropod-borne & unspecified ........... 75 81 --- 1,615 1.385 --
Encephalitis, post-infectious ............. 7 9 605 558
Hepatitis, serum ................. 34 1.039 25.548 32.635
Hepatitis, infectious ..... ....... -.... 589 733 23.862
Measles rubeolaa) ................ ....... 478 638 706 190.337 241.475 388.395
Poliomyelitis, Total (including unspecified) 1 27 71 46 303
Paralytic ............................- 23 66 39 258
Nonparalytic .............. .... .. .. 6
Meningococcal infections. Total ......... 41 27 30 2.784 2.379 1.833
Civilian .............. .. ....... 39 27 2.506 2.197 -
Military ............................... 2 278 182 -
Rubella (German measles) ................ ..236 --- 42.137 --
Streptococcal sore throat & Scarlet fever .. 5,744 5,082 4,196 320,697 298.612 259,262
Tetanus ................... ........... 6 4 --- 137 200
Tularemia ........... .......... ......... 4 2 --- 129 192 -
Typhoid fever .......................... 8 13 13 284 315 392
Typhus, tick-borne (Rky. Mt. Spotted fever). 4 6 212 234 -
Rabies in Animals ..................... 57 51 53 3.181 3.378 2,922

NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum Cum.
Anthrax: ................ ....... ................ 4 Botulism: ............ ....... ......... .. 4
Leptospirosis: Hawaii-I ......................... 51 Trichinosis: NJ-I, Pa-1, Mont-1, Calif-1, Tenn-1 ....... 79
Malaria: NYC-I. Pa-4, Ohio-1. Calif-2, Ark-1, Ga-2 ..... 300 Rabies in Man: SD-1 ... ............ .. ........ 2
Psittacosis: Wash-1 .................. ............... 35 Rubella. Congenital Syndrome: ................ ... 20
Typhus murine 21 Plaeun 4 ............ ..-... 4


F5266/9: rr/"j9








Morbidity and Mortality Weekly Report


OCTOBER 3, 1966


TYPHOID FEVER Nebraska
(Continued from front page)


had married 7 months previously, had had typhoid fever
in 1947 when a small outbreak of eight cases occurred
following a church supper in the town. She never received
antimicrobial treatment, but her stool specimens were
reportedly negative for typhoid organisms when examined
in 1948. She denies any illness in the last 15 years and
has not worked as a food handler.
The couple had had no recent contact with any of the
other persons who had had typhoid fever in 1947. They
had not eaten in any local restaurants nor had they been
to any picnics or family gatherings during the month prior
to the patient's illness. Their home is served by the city
water supply and city sewage disposal.
On August 17 the couple went to Kansas City,


Missouri, to join a group of 121 people from all parts of
the midwestern and western United States on a railway
tour of western U.S. and Canada. Meals on the tour were
prepared by eating establishments along the way. While
traveling the patient had the onset of his symptoms; he
took a train directly home from Seattle, Washington, on
August 27.
Three stool cultures obtained from the patient's
wife on September 14 have subsequently grown out
S. typhi. Cultures from the husband and wife were
found to be of the same phage type, FI, at the Bacter-
iology Section of the Laboratory Branch of CDC
(Reported by Dr. E.A. Rogers, Director, Nebraska State
Department of Health; and a team from CDC.)


ENCEPHALITIS


St. Louis Encephalitis in Dallas, Texas
A total of 134 confirmed or presumptive cases of St.
Louis encephalitis (SLE) with clinical encephalitis has
been reported from Dallas City and County through Octo-
ber 1, 1966. An additional 45 cases with clinical illnesses
other than encephalitis have shown similar laboratory evi-
dence of infection. These include 17 cases with aseptic
meningitis. 15 with febrile headache, and 13 with other
clinical findings. Thus, a total of 179 confirmed or pre-
sumptive infections have been reported in all clinical
categories. Confirmed SLE infection is 1. ii..l for this
report, as a fourfold increase in CF antibody titer: presump-
tive evidence is the presence of any serologic evidence of
Group B arbovirus infection.
The weeks of onset of the 179 confirmed or presump-
tive cases are presented in Figure 1. Two patients became


Figure 1
ST. LOUIS ENCEPHALITIS BY WEEK OF ONSET
DALLAS COUNTY, TEXAS 1966


40
38
36




3,:

I 1









2 9 16
JULI


-AERIAL SPRAYING


*TWO OF THE i79


,3 20 Z2

~A ONSET
HADO ONSE S iN


3 s I? 24
SEPTEMBER

JUNE, '966


ill in June 1966 with several additional cases occurring
during the last 3 weeks of July. An abrupt increase in
incidence was seen during August, followed by a sharp
decline in September.
The distribution of the 179 cases and attack rates
per 100,000 population are shown by age and race in Table 1.
Al,:,,,-l, cases appeared in all age groups, the attack
rates increase with advancing age. The attack rates are
higher in the non-white population in all age groups.
Thus far, 19 deaths attributable to SLE infection have
occurred. The attack rates and mortality rates are shown
by age group in Figure 2. Both rates show a progressive
increase with advancing age.


Figure 2
ST. LOUIS ENCEPHALITIS
AGE SPECIFIC ATTACK RATE*
DALLAS COUNTY, TEXAS 1966


70-

60-

50-
0
0
0
o
0
' 30-
[L


ATTACK RATE,


/
/
/

,/ MORTALITY RATE


0-9 10-19 20-29 30-39 40-49 50-59 60-69 70+
AGE


*BASED ON POPULATION DATA, U S CENSUS, 1960


Intensive local control measures were begun on Au-
gust 15. Between August 19 and August 27, the entire area
of the City of Dallas and Dallas County was sprayed with


334


I I







OCTOBER 3. 1966


Morbidity and Mortality Weekly Report


Malathion by aircraft :I nr,. at low altitudes. The inci-
dence of cases declined markedly within 2 to 3 weeks after
completion of the aerial spraying. Further epidemiologic
and laboratory study will be necessary to evaluate with
accuracy the effect of this spraying on the course of the
epidemic.

Table 1
St. Louis Encephalitis Dallas, Texas
Age Specific Attack Rate*


White

No. of R
Cases pec

9
10
7
15 1
13 1:
.2 2!
17 3.
16 41
109 1:


ate
r 105

4.9
7.9
6.2
1.7
2.4
8.4
5.4
9.0
3.4


Non-White

No. of Rate
Cases per 105

9 22.8
4 1b.1
7 33.2
6 29.8
8 52.6
10 87.4
16 235.4
10 240.9
70 49.9


Total

No. of Rate
Cases per 105

18 8.1
14 9.4
14 10.5
21 14.2
21 17.5
32 36.0
33 60.3
26 70.7
179 18.8


*Confirmed and presumptive cases per 100.000 population
(1960 Census).

Thus far, the SLE virus has been isolated from post-
mortem specimens obtained from three cases, and a tenta-
tive identification has been made from an isolate from the
blood of a house sparrow. Prior to the aerial spraying,
SLE virus was isolated from several pools of mosquitoes.
It is estimated that one out of every 150 mosquitoes was
infected. Immediately after the spraying, mosquito counts
were markedly reduced for a period of 7 to 14 days. Subse-
quently there have been no confirmed viral isolations at
this time.
(Reported by Dr. Van C. Tipton, State Epidemiologist,
Teras State Department of Health; Dr. Hal J. Dewlett.
Director, Dallas ( Health Department; and a team from
CDC.)


St. Louis Encephalitis in Corpus Christi, Texas
Through the week ending September 30, 1966, 219
cases of central nervous system infection have been
reported to the Corpus Christi-Nueces County Health
Department. Of these, 98 have been classified on the
basis of laboratory data as confirmed orpresumptive cases
of SLE virus infection. The first recognized case had
onset of symptoms in mid-July. The peak of the epidemic
occurred during the third week in August when 24 patients
developed illness (Figure 3).
Age specific attack rates for the 98 confirmed and
presumptive cases demonstrate that all age groups were
involved. However, the attack rates rise with increasing
age (Table 2). Three deaths, all in individuals over 50
years of age. have been attributed to SLE infection.
Entomologic studies revealed that Culex quinque-
fasciatus was the only species present in sufficient
quantity to be implicated as the responsible vector. Four
isolates of SLE virus have been made from pools of these
mosquitoes collected on August 27 and 28. A relatively


high mosquito infection rate (approximately 1:200) was
noted.
Figure 3
ST. LOUIS ENCEPHALITIS BY WEEK OF ONSET
NUECES COUNTY, TEXAS 1966


WEUGUS
WEEK OF ONSETI


Table 2
St. Louis Encephalitis Corpus Christi, Texas
Age Specific Attack Rate*

White Non-White Total


Age No. of
Cases
0-9 10
10-19 18
20-29 15
30-39 13
40-49 9
50-59 9
60-69 11
70+ 11
Total 96


Rate No. of Rate No. of
per 105 Cases per 105 Cases
17.3 0 0.0 10
44.0 0 0.0 18
54.8 1 82.2 16
42.9 0 0.0 13
38.6 0 0.0 9
53.1 1 100.3* 10
122.8 0 0.0 11
188.4 0 0.0 11
45.4 2 19.2 98


Rate
per 105
16.5
42.2
56.0
40.7
36.5
55.7
116.5
180.7
44.2


*Confirmed and presumptive cases per 100,000 population
(1960 Nueces Co.)
**Based on one case in a population of 997.

At the time of recognition of the first case on
August 18, the Health Department's routine fogging of the
area with benzine hexachloride dust utilizing a Buffalo
turbine was intensified. Aerial spraying with Malathion
was begun on August 28. and was completed in the pop-
ulous areas of Nueces County within 3 days. Counts of
C. quinquefasciatus mosquitoes fell dramatically on the
day after the aerial spraying to 2 percent of the previously
recorded numbers. Within 5to 7 days. counts of C. quinque-
fasciatus returned to the level noted before spraying:
however, no viral isolates have been recovered from these
mosquitoes collected.
(Reported by Dr. Van C. Tipton. State Epidemiologist,
Texas State Department of Health: Dr. R.1I'. letzger,
Director of Public Health and Welfare. Dr. George Fischer,
Epidemiologist, Corpus Christi-uteces County Health
Department: and a team from CDC.)


St. Louis Encephalitis in St. Louis, Missouri
From June through September 1966. 12 patients with
encephalitis and 36 patients with either aseptic menin-
(Continued on page 340)


335


Age


0-9
10-19
20-29
30-39
40-49
50-59
60-69
70+
Total








336 MIorbidity and Mortality Weekly Report



CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

OCTOBER 1, 1966 AND OCTOBER 2, 1965 (39th WEEK)


ENCEPHALITIS HEPATITIS
ASEPTIC Primary Post- Both
AREA MENINGITIS BRUCELLOSIS including Infectious DIPHTHERIA Serum Infectious Types
unsp. cases
1966 I 1965 1966 1966 1965 1966 1966 1965 1966 1966 1965
UNITED STATES... 169 82 22 75 81 7 2 1 34 589 736

NEW ENGLAND........... 5 3 2 1 20 25
Maine.............. 3 2
New Hampshire...... 4
Vermont ........... 1
Massachusetts...... 3 3 8
Rhode Island....... 2 2 1 4
Connecticut........ 1 9 10

MIDDLE ATLANTIC...... 20 7 11 13 1 17 105 145
New York City...... 8 6 4 14 25 15
New York, Up-State. 3 5 1 2 1 1 25 92
New Jersey.......... 9 1 2 4 2 26 13
Pennsylvania....... 1 2 3 29 25

EAST NORTH CENTRAL... 26 28 1 20 13 1 1 94 154
Ohio.............. 4 5 1 19 7 26 46
Indiana............ 2 4 11
Illinois........... 3 9 1 3 26 32
Michigan........... 17 11 1 1 1 35 55
Wisconsin.......... 2 3 3 10

WEST NORTH CENTRAL... 23 4 5 9 17 2 31 23
Minnesota.......... 16 3 2 4 1 6 7
Iowa............... 1 1 1 1 2 1 3 5
Missouri........... 1 1 2 22 1
North Dakota....... 1 -
South Dakota....... 1 2
Nebraska ........... 2 1 1 I
Kansas............. 3 1 1 12 7

SOUTH ATLANTIC....... 16 2 9 2 1 1 1 60 82
Delaware........... 1 3
Maryland............ 2 14 18
Dist. of Columbia.. 1
Virginia........... 2 8 1 17 19
West Virginia...... 1 7 1
North Carolina..... 3 1 1 1 4 11
South Carolina..... 4 1 4 3
Georgia.............. 1 4
Florida............. 3 1 7 30

EAST SOUTH CENTRAL... 7 4 1 1 4 1 3 32 36
Kentucky........... 1 2 2 11 15
Tennessee.......... 3 2 3 8 13
Alabama............ 1 1 1 1 8 6
Mississippi........ 2 1 1 5 2

WEST SOUTH CENTRAL... 16 6 5 11 19 1 1 47 62
Arkansas........... 8 6
Louisiana.......... 2 2 1 1 4 13
Oklahoma........... 1
Texas............... 16 6 3 9 19 35 42

MOUNTAIN ............. 3 4 10 26 35
Montana............ 3 2 4
Idaho............... 10 5
Wyoming.............. 1
Colorado........... 2 4 4
New Mexico......... 1 2 2 8
Arizona............ 3 1 1 6 8
Utah............... 4 2 4
Nevada ............. 1

PACIFIC.............. 56 28 1 14 3 2 10 174 174
Washington.......... 2 4 1 1 7 11
Oregon............. 1 1 1 36 19
California.......... 55 25 10 1 2 9 131 139
Alaska............. 5
Hawaii............ -

Puerto Rico........... 2 19 27









Morbidity and Mortality Weekly Report


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

OCTOBER 1, 1966 AND OCTOBER 2, 1965 (39th WEEK) CONTINUED


AREA


1966


UNITED STATES... 478

NEW ENGLAND.......... 15
Maine............... 10
New Hampshire......
Vermont ............ -
Massachusetts...... 2
Rhode Island.......
Connecticut........ 3

MIDDLE ATLANTIC...... 23
New York City...... 7
New York, Up-State. 1
New Jersey.......... 2
Pennsylvania....... 13

EAST NORTH CENTRAL... 95
Ohio................ 4
Indiana............ 4
Illinois .......... 2
Michigan............ 45
Wisconsin........... 40

WEST NORTH CENTRAL... 11
Minnesota...........
Iowa............... 1
Missouri............
North Dakota ..... 10
South Dakota ......
Nebraska ........... -
Kansas............. NN

SOUTH ATLANTIC....... 38
Delaware ...........
Maryland ...........
Dist. of Columbia..
Virginia............ 2
West Virginia...... 25
North Carolina..... 6
South Carolina.....
Georgia.............
Florida............ 5

EAST SOUTH CENTRAL... 55
Kentucky............ 20
Tennessee.......... 26
Alabama............ 3
Mississippi........ 6

WEST SOUTH CENTRAL... 80
Arkansas.......... ..
Louisiana.......... -
Oklahoma............
Texas.............. 80

MOUNTAIN ............. 26
Montana............ 3
Idaho............... 15
Wyoming............ 5
Colorado........... 1
New Mexico...........
Arizona.............
Utah.............. 1
Nevada............. 1

PACIFIC.............. 135
Washington........... 68
Oregon.............. 28
California......... 36
Alaska............ 1
Hawaii ............. 2
Puerto Rico........... 22


II


MEAS


MENINGOCOCCAL INFECTIONS,
TOTAL

Cumulative
1966 1966 1965


SLES (Rubeola)

Cumulative
1966 1965
190,337 241,475

2,279 36,839
211 2,802
80 381
238 1,268
783 19,298
72 3,938
895 9,152

18,036 14,843
8,293 2,416
2,536 4,143
1,848 2,577
5,359 5,707

68,843 55,891
6,355 8,895
5,702 1,847
11,365 2,764
14,517 26,473
30,904 15,912

8,698 16,578
1,643 688
5,309 9,001
531 2,591
1,098 3,731
40 115
77 452
NN NN

15,307 25,092
257 505
2,106 1,163
383 77
2,176 4,080
5,311 13,839
493 391
657 1,018
234 617
3,690 3,402

19,771 13,948
4,731 2,586
12,327 7,910
1,689 2,335
1,024 1,117

24,650 30,958
971 1,084
99 107
487 203
23,093 29,564

12,004 19,817
1,820 3,731
1,585 2,794
166 848
1,315 5,678
1,133 677
5,300 1,332
641 4,553
44 204

20,749 27,509
3,633 7,245
1,829 3,261
14,623 13,003
524 186
140 3,814
2,792 2,435


1 11


41

2



1
1


7
1
2
3
1

9
2
3
1
3


1




1




9



3
3
3


POLIOMYELITIS
RUBELLA
Total Paralytic
Cumulative
1966 1965 1966 1966 1966

1 66 236


2,379

120
16
7
7
40
14
36

311
54
90
80
87

344
92
43
97
74
38

123
27
9
52
11
3
10
11

455
7
44
9
53
24
93
59
57
109

185
73
60
32
20

311
15
171
20
105

74
2
8
5
15
11
16
14
3

456
34
33
364
18
7
8


3
1
2










11

1










10
18
2


S 1


337


3

1
2



1
1








1








1









338 Morbidity and Mortality Weekly Report


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

OCTOBER 1, 1966 AND OCTOBER 2, 1965 (39th 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... 5,744 6 137 4 129 8 284 4 212 57 3,181

NEW ENGLAND .......... 773 3 I 7 3 1 74
Maine.............. 28 25
New Hampshire...... 8 25
Vermont............ 50 1 21
Massachusetts...... 117 2 1 3 1 3
Rhode Island....... 64 -
Connecticut........ 506 1 4 2

MIDDLE ATLANTIC...... 137 1 13 2 49 40 3 195
New York City...... 3 5 2 21 1
New York, Up-State. 116 2 11 13 3 182
New Jersey.......... NN 1 2 7 12
Pennsylvania........ 18 4 10 15 12

EAST NORTH CENTRAL... 377 16 1 15 37 17 9 415
Ohio............... 20 4 3 18 9 3 190
Indiana ............ 76 3 5 3 3 90
Illinois........... 105 3 1 6 4 8 2 56
Michigan........... 131 4 6 1 34
Wisconsin.......... 45 2 1 6 45

WEST NORTH CENTRAL... 181 2 9 1 16 26 4 8 708
Minnesota.......... 7 1 2 2 159
Iowa............... 55 1 5 142
Missouri........... 2 1 6 1 10 13 3 3 218
North Dakota....... 51 1 1 33
South Dakota....... 9 2 2 78
Nebraska........... 3 2 2 21
Kansas............. 54 5 1 57

SOUTH ATLANTIC....... 712 30 10 3 53 3 100 6 413
Delaware........... 14 1 2 -
Maryland........... 92 3 1 9 25 1 3
Dist. of Columbia.. 2 2
Virginia........... 187 4 2 11 1 31 3 214
West Virginia....... 195 1 47
North Carolina..... 11 4 3 6 2 22 4
South Carolina..... 92 2 1 2 11 5
Georgia............ 4 7 2 1 3 15 90
Florida............. 117 10 9 2 55

EAST SOUTH CENTRAL... 1,174 1 16 19 3 35 1 37 6 411
Kentucky........... 77 2 2 2 5 1 9 87
Tennessee.......... 859 2 10 1 19 22 3 286
Alabama............ 116 1 7 4 6 6 2 18
Mississippi......... 122 5 3 5 1 20

WEST SOUTH CENTRAL... 606 2 31 2 59 28 7 16 652
Arkansas........... 5 4 1 45 2 2 1 73
Louisiana.......... 7 3 8 1 41
Oklahoma .......... 25 2 7 9 4 1 164
Texas.............. 576 2 18 1 4 9 1 13 374

MOUNTAIN............. 825 2 6 13 3 1 83
Montana............ 45 2 7
Idaho ............ 92
Wyoming............ 31
Colorado............ 320 2 3 2 17
New Mexico.......... 157 1 -2 I 13
Arizona............. 83 1 4 36
Utah................ 95 2 3 1 3
Nevada ............ 2 1 7

PACIFIC .............. 959 17 3 36 1 7 230
Washington......... 269 11 13
Oregon............. 20 1 4
California.......... 606 16 3 22 1 7 213
Alaska .... ........ 5
Hawaii ............. 59 -
Puerto Rico.......... 3 1 42 2 11 3 15









Morbidity and Mortality Weekly Report


DEATHS IN 122 UNITED STATES CITIES FOR WEEK ENDED OCTOBER 1, 1966

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


339


All Causes Pneumonia Under All Causes Pneumonia Under
Area All 65 years and year Area All 65 years and yar
Ages and over Influenza All Ages and over Influenza All
All Ages Causes All Ages Causes


NEW ENGLAND:
Boston, Mass.---------
Bridgeport, Conn.-----
Cambridge, Mass.------
Fall River, Mass. ----
Hartford, Conn.-------
Lowell, Mass.---------
Lynn, Mass.-----------
New Bedford, Mass.----
New Haven, Conn.------
Providence, R. I.-----
Somerville, Mass.-----
Springfield, Mass.----
Waterbury, Conn.------
Worcester, Mass.------

MIDDLE ATLANTIC:
Albany, N. Y.---------
Allentown, Pa.--------
Buffalo, N. Y.--------
Camden, N. J.-------
Elizabeth, N. J.------
Erie, Pa.-------------
Jersey City, N. J.----
Newark, N. J.---------
New York City, N. Y.--
Paterson, N. J.-------
Philadelphia, Pa.-----
Pittsburgh, Pa.-------
Reading, Pa.----------
Rochester, N. Y.------
Schenectady, N. Y.----
Scranton, Pa.---------
Syracuse, N. Y.-------
Trenton, N. J.--------
Utica, N. Y.----------
Yonkers, N. Y.--------

EAST NORTH CENTRAL:
Akron, Ohio-----------
Canton, Ohio----------
Chicago, Ill.---------
Cincinnati, Ohio------
Cleveland, Ohio-------
Columbus, Ohio--------
Dayton, Ohio----------
Detroit, Mich.--------
Evansville, Ind.------
Flint, Mich.----------
Fort Wayne, Ind.------
Gary, Ind.------------
Grand Rapids, Mich.---
Indianapolis, Ind.----
Madison, Wis.---------
Milwaukee, Wis.-------
Peoria, Ill.----------
Rockford, Ill.--------
South Bend, Ind.------
Toledo, Ohio----------
Youngstown, Ohio------

WEST NORTH CENTRAL:
Des Moines, Iowa------
Duluth, Minn.---------
Kansas City, Kans.----
Kansas City, Mo.------
Lincoln, Nebr.--------
Minneapolis, Minn.----
Omaha, Nebr.----------
St. Louis, Mo.--------
St. Paul, Minn.-------
Wichita, Kans.--------


721
221
38
36
29
62
33
20
27
59
56
9
50
28
53

3,004
43
38
141
40
32
41
63
84
1,548
32
427
163
46
102
18
46
44
38
24
34

2,429
62
29
718
162
206
120
63
335
42
57
37
10
36
145
28
132
43
32
42
79
51

714
48
14
33
132
32
92
58
193
57
55


442
133
23
30
20
26
25
13
17
38
35
7
27
15
33

1,747
31
26
87
25
19
29
31
45
871
16
244
82
32
73
12
27
29
27
18
23

1,336
35
18
398
97
105
64
28
190
25
20
27
5
24
69
16
77
24
22
15
47
30

417
31
10
14
86
22
56
27
98
36
37


*Estimate based on average percent


SOUTH ATLANTIC:
Atlanta, Ga.----------
Baltimore, Md.---------
Charlotte, N. C.-------
Jacksonville, Fla.-----
Miami, Fla.------------
Norfolk, Va.-----------
Richmond, Va.-----------
Savannah, Ga.-----------
St. Petersburg, Fla.---
Tampa, Fla.------------
Washington, D. C.------
Wilmington, Del.-------

EAST SOUTH CENTRAL:
Birmingham, Ala.-------
Chattanooga, Tenn.-----
Knoxville, Tenn.-------
Louisville, Ky.--------
Memphis, Tenn.---------
Mobile, Ala.-----------
Montgomery, Ala.-------
Nashville, Tenn.-------

WEST SOUTH CENTRAL:
Austin, Tex.-----------
Baton Rouge, La.-------
Corpus Christi, Tex.---
Dallas, Tex.-----------
El Paso, Tex.----------
Fort Worth, Tex.-------
Houston, Tex.----------
Little Rock, Ark.------
New Orleans, La.-------
Oklahoma City, Okla.---
San Antonio, Tex.------
Shreveport, La.--------
Tulsa, Okla.-----------

MOUNTAIN:
Albuquerque, N. Mex.---
Colorado Springs, Colo.
Denver, Colo.-----------
Ogden, Utah------------
Phoenix, Ariz.---------
Pueblo, Colo.-----------
Salt Lake City, Utah---
Tucson, Ariz.----------

PACIFIC:
Berkeley, Calif.-------
Fresno, Calif .---------
Glendale, Calif.-------
Honolulu, Hawaii------
Long Beach, Calif.-----
Los Angeles, Calif.----
Oakland, Calif.--------
Pasadena, Calif.-------
Portland, Oreg.--------
Sacramento, Calif.-----
San Diego, Calif.------
San Francisco, Calif.--
San Jose, Calif .*-------
Seattle, Wash.---------
Spokane, Wash.---------
Tacoma, Wash.---------


1,083
122
201
52
89
88
62
85
39
78
57
178
32

587
94
40
49
120
122
57
25
80

1,044
45
49
25
130
33
72
191
17
179
80
102
54
67

406
49
17
118
23
86
27
48
38

1,522
17
44
41
46
59
515
106
32
108
60
96
175
34
114
40
35


Total 11,510 6,432 381 567

Cumulative Totals
including reported corrections for previous weeks

All Causes, All Ages ------------------------- 490,661
All Causes, Age 65 and over------------------- 281,170
Pneumonia and Influenza, All Ages------------- 20,581
All Causes, Under 1 Year of Age--------------- 26,079


Week No.
39


of divisional total.









340 Morbidity and Mc




ENCEPHALITIS (Continued from page 335)


gitis or undifferentiated. febrile illnesses were investi-
gated in the metropolitan St. Louis area. Five of the
patients with encephalitis and one patient with aseptic
meningitis have laboratory evidence of SLE virus infection.
There was a small cluster of suspect SLE cases in
a western suburb of St. Louis during the third and fourth
weeks of August.
Specimens from the 48 patients are being studied for
evidence of enterovirus and arbovirus infections.
(Heported by the iissouri Department of Public Health
and lielfare, the St. Louis City Health Department, the
St. Louis City Division of Health. and the Kansas City
Field Station.)


St. Louis Encephalitis in Louisiana
Since June 1966, a total of 88 suspected cases of
clinical encephalitis and 30 cases of suspected aseptic
meningitis have been reported and subsequently inves-
tigated by the Louisiana State Board of Health. Of these,
there are 4 confirmed and 19 presumptive cases of SLE
infection. Although cases have been scattered throughout
the State, a cluster was noted in the heavily populated
Orleans and Jefferson Parishes.
There have been no deaths among those cases with
laboratory evidence of infection with SLE virus, although
eight deaths have occurred in patients with clinical
encephalitis of unknown cause.
Numerous mosquito pools and bird bloods have all
been negative for evidence of SLE virus.
(Reported by Dr. John A. Trautman, Chief of Epidemiology
Section, Louisiana State Board of Health; and an EIS
Officer.)

California Encephalitis in Ohio
Through the week ending September 30, 1966, 22
cases of California encephalitis virus infection have been
reported from Ohio. Nine patients reside in Trumbull and
Summit Counties in the northeastern corner of the State:
the remaining cases are scattered irtIui.,ulir rural areas
of central and northern Ohio in nine other counties.
The first clinically recognized case had onset of
symptoms in early June. 9 cases had onset in July and 10
cases in August. Two recently reported cases had onsets
in mid-September.
In 1965, 28 cases of California virus infection were
recorded from 16 Ohio counties.
(Reported by Or. Calvin B. Spencer, Acting Chief, Bureau
of Preventive Medicine, Ohio Department of Health.)


irtality 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 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


U NIl OF FL L B
DOCUMENTS CEP"_






I U.S. DEPOSITORY


OCTOBER 3, 1966


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