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:
AA00010654:00274

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


F5 sl.o/;


COMMUNICABLE DISEASE CENTER

















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


EPIDEMIOLOGIC NOTES AND REPORTS
ENCEPHALITIS Texas
Corpus Christi, Nueces County
During the first 3 weeks of August a total of 47
cases of encephalitis and other illnesses clinically diag-
nosed as compatible with St. Louis encephalitis Iirus
infection has been reported by the Corpus Christi-Nueces
County Health Department. Initial sera from four patients
with encephalitis had hemagglutination-inhibition tigers
ranging from 1:40 to 1:640 for St. Louis encephalitis virus.
Clinical, epidemiologic and viral studies are in progress.
Mosquito control measures which were instituted in
the beginningof the summer have been greatly intensified.
(Reported by Dr. Van C. Tipton. State Epidemiolojist.
Texas State Department of Health: aond Dr. William R.
Vetzger, Director of Public Health and Welfare. Corpus
Christi-'ucces County Health Department.)


t'A\ TEA TS


Ii,',hllnt)L,, i- I lic
lm onl a lt i- x ........ ..


R epo rt-,d ( ,- s Im irn u lzatiin m |n ct ,|ili s h .......
Malaria 196. .....
InternationI \,'t,--
Quasr.ainin, fl ,.,ur


Dallas
\ total of 93 cai-es of clinical encephalitis have
occurred in Dallas. Texa-. from the middle of Jul\ through
August 23, 1916I. Six deaths hale been associated with
the outbreak. In addition there have been 52 cases of
aseptic meningitis.
(C'otinuted on page 282)


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous weeks)
33rd. WEEK ENDED j CUMULATIVE. FIRST 33 WEEKS
MEDIAN
DISEASE i., i.. i :, ,i' .: -T 1961-1965 MEDIAN
1966 1965 1966 1965 1961- 1965

Br.j,- II Ji 14 i
Diphtheria. . .. 4 6 5 112 95 165
Encephalitis, primary:
Arthropod-borne & unspecified ......... 110 45 972 1,027
Encephalitis, post-infectious ......... 8 8 -548 507
Hepatitis, serum .. .......... 33 605 746 875 21 915 28,354
Hepatitis, infectious .............. 610 20.688
Measles rubeolaa) ................. ..... 693 665 1.183 187,665 238.074 383,740
Poliomyelitis, Total (including unspecified) 2 1 23 59 36 182
Paralytic ......... 2 1 22 54 31 155
Nonparalytic . .- 5
Meningococcal infections. Total ......... 33 25 26 2.602 2.217 1.665
Civilian . .. 29 24 2.334 2.037
Military ..... .... .......... ... 4 1 268 180
Rubella (German measles) .. .. .......... 228 -- --- 40.912 -
Streptococcal sore throat & Scarlet fever .. 3.838 3,193 3,003 294.323 272,741 238.988
Tetanus. ....... ... .. 5 10 104 174
Tularemia ........ ... 8 5 105 160
Typhoid fever .... ................. 11 8 20 227 250 288
Typhus, tick-borne (Rky. Mt. Spotted fever) 5 13 165 189 -

Rabies in Animals....................... 92 60 60 2.764 2.977 2.653

NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum Cum.
Anthrax: ..... ...... 4 Botulism: .. .... 4
Leptospirosis: Hawaii-i, Tex-2 ..... .............. 45 Trichinosis: Ore- Ohio- ..... 63
Malaria: NYC-, Mich-3, Md-4, NC-I,NYUpS-, La-1, Fla-1, Calif-3 213 Rabies in Man: ............ .......
Psittacosis: Minn-1, Tex-1 ................. ........... 28 Rubella, Congenital Syndrome: Minn-2 ....... 20
Typhus murine' 14 Pl.iu,


1/. ** _







282


Studies at the Texas State Department of Health lab-
oratories revealed a fourfold increase in CF antibody
titers for St. Louis encephalitis virus for 4 patients and
initial titers of 1:10 or greater for 53 others. Presumptive
virus isolates have been found in autopsy specimens from
two patients and from pools of Culex quinquefasciatus
mosquitoes.


AUGUST 20, 1966


Principle control measures have been directed toward
eliminating the mosquito reservoirs in the area. Mobile
equipment, including aircraft, have been used to spray
the entire city with malathion.
(Reported by Dr. Van C. Tipton, State Epidemiologist,
Texas State Department of Health; and Dr. Hal J. Dewlett.
Director, Dallas City Health Department.)


SALMONELLOSIS Massachusetts


An outbreak of Salmonella cubana in aMassachusetts
hospital has been found associated with a carmine dye
used for the investigation of gastrointestinal disease in
several patients.

Investigation of the outbreak was initiated by the
hospital when it was noted that S. cubana accounted for
a disproportionate number of salmonella isolation from
clinical specimens in the hospital bacteriology labora-
tory. In 1965. this serotype represented 10.3 percent of
salmonella isolations at the hospital as compared to 0.7
percent of the national total (Table 1). From January
through July 1966, S. cubana accounted for 48.5 percent
of the hospital isolates of salmonellae. Several of the
patients with S. cubana infection developed symptoms of
salmonellosis after admission to the hospital. Many of
this group had been admitted because of chronic gastroin-
testinal disease or feeding problems and had been given
carmine powder for timing collection of fecal specimens,
measurement of bowel transit time and demonstration of
fistulae.

Carmine powder from capsules prepared for ingestion
and from opened and unopened pharmacy stocks was cul-
tured and found to be heavily contaminated with Salmo-
nella cabana. A preliminary quantitative culture revealed
105 salmonellae per gram. Samples of carmine powder
from four other hospitals have been collected and ex-
amined by the Massachusetts Departmentof Public Health;
samples from two of these hospitals have been found
positive for S. cubana. The powder in each instance was
prepared from dried female insects of the species coccus
cacti. Further investigation of the sources and use of
this type of powder is underway.


Year


1963
1964
1965
1966"*


National*


Total S. Per-
Serotypes cubana cent

lb,649 40 0.2
21,113 63 0.3
20,b65 145 0.7
10,507 95 0.9


'Data taken from Salmonella
1964, 1965.
**January through July, 1966.


Hospital

Total S. Per-
Serotypes cubana cent


Survpillance, Annual Sunnmmarie


Discussion:
From the facts accumulated thus far, it would seem
that carmine dye, particularly that prepared from the in-
sect coccus cacti. should be carefully checked bacterio-
logically to insure the absence of ip.iir.. micro-
organisms before being administered to patients. This
applies particularly to materials given to patients with
impaired intestinal physiology who may be at greater risk
of enteric infection. It should be pointed out that S. cu-
bana has Group G salmonella antigens and may not be
recognized as a salmonella in laboratories using only
diagnostic antisera A through E.
(Reported by David J. Lang, M.D., and Lawrence J. Kunz,
Ph.D., Boston, Massachusetts; by A. Daniel Rubenstein,
M.D., Director, Division of Hospital Facilities, Massa-
chusetts Department of Public Health.)


SALMONELLOSIS- Spokane, Washington


During the last 2 weeks of July. 1966, an outbreak
of salmonellosis associated with the consumption of
barbecued chicken involved 24 different family groups in
Spokane. Washington. Reports indicated that a total of 65
individuals became ill. 241 of whom were hospitalized:
two deaths \ere associated with the outbreak.
While all family groups purchased the barbecued
chickens from supermarkets. 21 of 24 groups bought
chickens from a single stand in a modern Spokane super-
market. The dates of purchase ranged from July 11 to
July 27; 22 of the groups bought their chickens between
July 19 and Julyo 21.
Investigation of the food handling operations and
practices at the involved store revealed a number of


deficiencies. The barbecuing oven was found to give
internal (body cavity) bird temperatures of 150: the tem-
perature of the meat itself was substantially less. The
duration of barbecuing was variable, and some individuals
complained that the meat was inadequately cooked. The
holding oven (warmer) for cooked birds gave internal
(body cavity) bird temperatures of 100-110", thus allowing
bacterial growth to occur in the cooler meat after barbe-
cuing. In addition, the barbecued birds were placed on the
same surfaces as uncooked birds, and unpurchased birds
were refrigerated and warmed again for sale the next day.
Salmonella typhi-murium has been isolated from over
30 individuals associated with this outbreak, from three
packaged, barbecued birds from the incriminated store.


Morbidity and Mortality Weekly Report


ENCEPHALITIS Texas (Continued from front page)


Table 1
Incidence of Salmonella cubana
among Salmonella serotypes


I I










and from left-oxer barbecued chicken and nrappinigs. An
investigation of the poultry plant in western W'ashington
which processes the chickens used in the barbecuing oper-
ation rme\aled a modern, efficient plant. Of 27 en iron-
mental swabs, including from the water o\orflo\I from the
final chilling unit. 6 were positive for various ltpes of
salmonella.
As a result of the investigation, the barbecuing
operations at supermarkets throughout Spokane haae been
temporarily suspended by the Spokane(ity Health Depart-
ment. Meetings are being scheduled with the manufac-


283


turers and dis-tributors of the barbecuing machines and an
educational program will be drawn up for Ihose using
these machines.
\plpromxiately 25 case (, of gastroent(eritil have been
identified in northern Idaho, all in person- who ingested
barbecued chicken obtained from the same supermarkett in
Spokane, \tashington. These cases are still under inxes-
Sigation.
(Reported b/y Dr. Ernest A. Ayer, ('Chit, Division of Epi-
driiolog!i I iia.hington Stote Drpiertmiient of iHealth; and
an kES Officrr.)


CURRENT TRENDS

REPORTED CASES OF POST-INFECTIOUS AND POST-IMMUNIZATION ENCEPHALITIS
SECOND QUARTER ENDING JULY 1, 1966 (WEEKS 14-26)

State Mumps Measles Chickenpox Other Specified

Alaska ... ................. 1
Arkansas ................ 3 3
California .... ...... ...... ... 31 29 11 Influenza-1
Connecticut ................... ......... 1 1
Florida ............ ............. 17 2 4
Illinois .... ... ........ 7 3 1 Rubella-1
Louisiana ..... .... .................. 1
Maryland ............. 1.....
M assachusetts ........................ i 7
Michigan .... ... .. ...... 13 5 4
Minnesota .............................. 5 3 1 Influenza-1. Herpes Simplex-2
New Hampshire .............. ... .. Influenza-1
New York, Upstate .................. 11 3 4
Pennsylvania ................ .. 13 9 3 Rubella-1
Tennessee .. ........ ..... 5 4 .Influenza-2. Herpes Simplex-1
T exas ........ .... ..... .. ....... 8 3
Utah ......... ............ .. ... 1 Herpes-1
\ ir. .. ... ... .. ... 4 1
Washington ....... ... ........... 8

Second Quarter Total
1966 ...... ............ 135 66 33
1965 .................................. 150 39 25
Cumulative Total (weeks 1-26)
1966 ...... ....... .... 241 128 61
1965 ............ .... 264 70 58

...= Data not available. (States not reporting a case not listed)



MALARIA 1966


Through July 1966, a total of 151 case reports of
malaria with onset in the first 6 months of 1966 were
received by the Malaria Surveillance Unit in the Parasitic
Diseases Section of CDC. Imported malaria was respon-
sible for 149 of the cases, 100 of which were in military
personnel and 49 in civilians. Eight of the civilians were
foreign visitors to the United States. South Vietnam was
the country of origin of 91 of the military cases; for civil-
ians, 29 cases originated in Africa and 11 in Asia. The
remaining two malaria cases of the total 151 reported were


probably introduced. The cases were in two children of
one family in Kentucky with onsets on the same day;
investigations to clarify the mode of transmission are
continuing.
The parasite species is known in 132 of the 151
cases. The distribution by species is shown in Table 2.
Plasmodium vivar accounted for 57.6 percent of all cases.
and P. falciparum for 33.3 percent. Of the military cases
38 percent were attributable to P. falciparum as compared
to 24 percent of the civilian cases.
(Continued on page 288)


AUGUST 20, 1966


Morbidity and Mortality Weekly Report








284 Morbidity and Mortality Weekly Report


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

AUGUST 20, 1966 AND AUGUST 21, 1965 (33rd WEEK)


ENCEPHALITIS HEPATITIS
ASEPTIC Primary Post- Both
AREA MENINGITIS BRUCELLOSIS including Infectious DIPHTHERIA Serum Infectious Types


1966 I 1965 1966 1


1966 1965


S 1966 1966 1965 1966 1966 1965


UNITED STATES... 142 54 11 110 45 8 4 6 33 610 605

NEW ENGLAND ......... 9 3 3 3 22 29
Maine.............. 3 5
New Hampshire...... 2
Vermont ... ......- 2
Massachusetts...... 8 3 2 2 2 13
Rhode Island....... 1 3 1
Connecticut ....... 1 1 14 6

MIDDLE ATLANTIC...... 6 6 9 15 1 16 66 122
New York City...... 4 3 2 8 13 16 33
New York, Up-State. 1 1 4 18 34
New Jersey.......... 1 5 2 2 9 32
Pennsylvania....... 2 1 1 1 1 1 23 23

EAST NORTH CENTRAL... 8 10 15 10 2 3 152 100
Ohio................ 1 3 10 8 1 27 30
Indiana............ 1 7 5
Illinois............ 5 4 1 1 1 1 50 16
Michigan........... 1 3 3 1 1 1 66 42
Wisconsin.......... 1 2 7

WEST NORTH CENTRAL... 1 5 5 2 4 2 28 18
Minnesota........... 1 3 -- 5 5
Iowa............... 2 4 2 11 6
Missouri............ 11 2
North Dakota....... -2 2 2
South Dakota........ 1- -
Nebraska............. 1 1
Kansas............. 2 4

SOUTH ATLANTIC....... 24 4 4 6 1 1 2 6 2 54 58
Delaware .......... 1 -
Maryland........... 1 14 7
Dist. of Columbia.. 1 2
Virginia........... 2 2 2 3 1 7 14
West Virginia...... 15 5 9
North Carolina..... I 8 5
South Carolina..... 2 1 1 4
Georgia.............. 1 3 7 -
Florida............ 6 1 3 1 3 11 17

EAST SOUTH CENTRAL... 12 10 2 4 3 1 38 59
Kentucky ........... 1 6 9 18
Tennessee.......... 2 1 1 1 3 1 17 19
Alabama............ 5 3 5 7
Mississippi........ 4 1 3 7 15

WEST SOUTH CENTRAL... 39 4 62 2 2 61 53
Arkansas........... 4 10
Louisiana........... 4 3 2 18 8
Oklahoma............ 1 2
Texas............... 35 4 59 -- 2 38 33

MOUNTAIN............ 1 4 5 25 29
Montana ........... 2 1
Idaho.............. 3 1 5
Wyoming............. 1
Colorado............ 1 4 2 14
New Mexico......... 1 .- 8 2
Arizona............. 8 4
Utah............... 1 3 3
Nevada ............ -

PACIFIC.............. 43 11 5 4 1 10 164 137
Washington.......... 1 1 1 17 6
Oregon.............. 2 24 7
California.......... 42 9 3 3 1 10 119 123
Alaska.............. 3 -
Hawaii............. I 1 1


Puerto Rico..........


I -


- I


- 21 25


- 1 2








Morbiditv and Mortality Weekly Report


CASESS OF SPECIFIED NOTIFIABLE DISEASES: IGNITED STATES

FOR WIIKS ENI)ED)

AUGUST 20, 1966 AND AUGUST 21, 1965 (33rd WEEK) CONTINUED


MEASLES (Rubeola)


AREA


NEW ENGLAND..........
Maine..............
New 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.............
Hawaii .............


2,230
194
79
225
773
72
887

17,925
8,247
2,508
1,844
5,326

68,161
6,326
5,646
11,317
14,183
30,689

8,661
1,639
5,303
529
1,075
40
75
NN

15,001
256
2,095
381
2,100
5,158
462
654
233
3,662

19,558
4,693
12,194
1,672
999

24,084
966
98
474
22,546

11,810
1,802
1,542
145
1,276
1,118
5,264
620
43

20,235
3,478
1,701
14,459
467
130


Puerto Rico.......... 42 2,599


36,722
2,786
381
1,246
19,269
3,897
9,143

14,532
2,282
4,084
2,512
5,654

55,046
8,843
1,801
2,602
26,240
15,560

16,391
625
8,971
2,580
3,654
112
449
NN

24,602
502
1,146
73
4,028
13,511
378
1,009
613
3,342

13,597
2,410
7,785
2,294
1,108

30,529
1,081
104
202
29,142

19,548
3,696
2,761
841
5,600
674
1,277
4,496
203

27,107
7,213
3,176
12,820
170
3,728

2,298


MENINGOCOCCAL INFECTIONS,
TOTAL

Cumulative
1966 1966 1965



113 112
S 9 16
9 7


Total

1966


- 1







- 1I


- 10 5 -


POLIOMYELITIS
Py- RUBELLA
Paralytic
Cumulat ive
1965 1966 1966 1966



S23
-



3
S 15

16

-8

-1


1



-I





1








-1


3


-1
2

2 47

I
-1

1
-











2 45













2
2






1


2








286 Morbidity and Mortality Weekly Report

CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

AUGUST 20, 1966 AND AUGUST 21, 1965 (33rd 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 C 1966 umu. 1966 um.
1966 1966 1966 1966 1966
UNITED STATES... 3,838 5 104 8 105 11 227 5 165 92 2,764

NEW ENGLAND.......... 430 2 1 4 2 3 65
Maine.............. 35 1 23
New Hampshire...... 3 1 22
Vermont ............ 1 18
Massachusetts...... 52 2 1 1 1 2
Rhode Island....... 46 -
Connecticut......... 294 3 1 -

MIDDLE ATLANTIC..... 97 11 2 40 35 175
New York City...... 2 4 16 -
New York, Up-State. 91 2 2 10 12 164
New Jersey.......... NN 1 7 10
Pennsylvania....... 4 4 7 13 11

EAST NORTH CENTRAL... 355 8 12 1 30 1 15 6 371
Ohio................ 8 3 3 1 15 8 180
Indiana............ 65 1 3 2 80
Illinois ........... 135 2 5 3 1 7 6 44
Michigan............ 86 2 4 30
Wisconsin.......... 61 1 6 37

WEST NORTH CENTRAL... 144 6 10 4 20 2 24 628
Minnesota......... 1 6 145
Iowa............... 19 1 1 5 5 130
Missouri........... 1 4 5 8 1 4 192
North Dakota....... 86 1 3 26
South Dakota....... 7 2 4 67
Nebraska........... 4 1 1 1 18
Kansas ............. 27 2 3 5 1 1 50

SOUTH ATLANTIC....... 397 2 27 9 40 2 74 7 355
Delaware ........... 1 -- I -
Maryland........... 53 2 1 7 1 23 1 2
Dist. of Columbia.. 4 -- 2 -
Virginia........... 66 4 2 8 21 195
West Virginia...... 124 1 I 1 43
North Carolina..... 6 1 4 2 3 1 17 3
South Carolina..... 41 1 1 7 5
Georgia............ 3 6 2 2 7 4 70
Florida............. 99 1 10 9 1 42

EAST SOUTH CENTRAL... 831 1 12 2 20 25 2 27 15 359
Kentucky........... 9 1 1 3 3 1 6 5 72
Tennessee.......... 741 1 2 10 11 1 16 7 264
Alabama............. 69 6 4 6 5 12
Mississippi........ 32 3 1 3 5 3 11

WEST SOUTH CENTRAL... 481 1 22 5 44 24 6 22 567
Arkansas........... 2 4 35 I 2 2 59
Louisiana.......... 5 3 7 3 30
Oklahoma........... 16 I 4 8 4 5 145
Texas............... 465 1 14 1 2 8 12 333

MOUNTAIN ............. 580 1 2 1 6 12 3 7 62
Montana............ 33 2 7
Idaho .............. 51 --
Wyoming............ 15 -
Colorado ........... 184 1 2 3 2 8
New Mexico......... 130 1 2 1 11
Arizona............ 51 1 3 5 31
Utah ............... 116 1 2 3 1 1
Nevada.............- 1 1 4

PACIFIC .............. 503 14 3 4 32 1 8 182
Washington......... 5 11 8
Oregon............. 13 1 I 1 2
California......... 405 13 3 4 18 1 8 172
Alaska.............. 58- -
Hawaii............. 22 2
Puerto Rico.......... 4 1 6 10


1 / I I


I I I I I I









Morbidity and Mlirlality W'ekl Report






DEATHS IN 122 UNITED STATES CITIES FOR WEEK ENDED AUGUST 20, 1966

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


287


All Causes Pneumonia Under All Causes Pneumonia Under
Area All 65 years and 1 Yea Area All 65 years and 1 year
Ages and over Influenza All Age. 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.--------


678
256
39
22
22
54
18
20
26
43
60
8
42
24
44

2,972
46
43
140
40
28
37
42
93
1,458
34
412
212
54
102
18
42
60
46
26
39

2,388
61
40
650
201
189
126
71
307
46
43
36
42
41
141
32
122
33
21
47
92
47

780
41
20
38
147
27
98
75
224
72
38


396
147
19
16
14
28
10
15
17
22
31
4
31
14
28

1,685
26
27
69
21
20
23
22
45
817
24
234
111
38
63
13
24
37
26
19
26

1,303
35
20
345
116
99
73
38
150
28
23
23
23
22
79
14
72
22
11
27
56
27

473
27
13
16
87
21
63
43
130
53
20


*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.----------


1,113
134
229
38
59
85
46
86
34
72
88
187
55

552
79
44
34
80
123
47
39
106

1,084
31
30
23
169
40
82
172
52
179
58
119
70
59

406
47
24
115
18
87
22
49
44

1,470
16
41
34
53
87
434
90
33
108
57
81
217
27
113
41
38


Total j 11,443 6,304 363 677

Cumulative Totals
including reported corrections for previous weeks

All Causes, All Ages ------------------------- 421,655
All Causes, Age 65 and over------------------- 242,765
Pneumonia and Influenza, All Ages------------- 18,378
All Causes, Under 1 Year of Age--------------- 22,127


Week No.


of divisional total.








288


Morbidity and Mortality Weekly Report


MALARIA 1966 continued d front pau/e 283)


Table 2

Cases of Malaria by Parasite Species
United States- January-June, 1966*



Species Total Percent



P. .i'ra ...... .. 76 57.6
P. filcipar .... ...... 44 33.3
P. m/ial riac ... ... 1 0.
'. orale / .. ... ....... 4 3.0
Mixed infections .... ... 7 5.3


132 100.0

*Prhliminar i .I ta


During the past decade the incidence of imported
malaria has increased considerably. For example in the
full year 1959 there were 60 cases, and in 1964 and 1965,
168 and 15-1 cases, respectively. Already in the first 6
months of 1966 there have been 149 imported cases.

No concomitant rise. however. has been seen in the
number of ca es acquired in the United States. At most,
four such cases occurred in any one year since 1959 and
all but two of these could he defined as sporadic. The
number of induced cases* likewise has shown no increase
in recent years, not more than one or two cases having
been reported in any one year between 1959 and 1964, and
no cases since 1964.

*Malaria infection acquir.-d through artificial mean., i.e., blood
transfusions, common si. ringle etc.







INTERNATIONAL NOTES
QUARANTINE MEASURES

Cholera Iraq
An outbreak of cholera has been reported by Iraq.
\ valid certificate of vaccination against cholera is
required for entrance into the country. The certificate
\\ill be required also by countries visitedd or transited
within 5 days (of departure from Iraq. This includes the
United States.





ERRATUM, Vol. 15, No. 31, p. 262:
In the article entitled "Current Trends Plague." the
second sentence in the third paragraph should read: "The
family did raise domestic rabbits, some of which died
shortly after the patient became ill."


AUGUST 20, 1966 _==<

u-----(D
0__0



i----0


THE MORBIDITY AND MORTALITY WEEKLY REPORT, WITH A CIRCULA-
TION OF 15,600. IS PUBLISHED AT THE COMMUNICABLE DISEASE
CENTER. ATLANTA. GEORGIA.
CHIEF, :r' .'., ,_'- DISEASE CENTER DAVID J. SENCER, M.D.
CHIEF, F i1"'i .L : BRANCH A.D. LANGMUIR, M.D.
ACTING CHIEF, STATISTICS SECTION IDA L. SHERMAN, M S.

IN ADDITION TO THE ESTABLISHED PROCEDURES .ri
MORBIDITY AND MORTALITY, THE COMMUNICABLE ':: i f'
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.


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