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:
AA00010654:00275

Related Items

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

Full Text

Fsa Q, o/q; Vol ;/ Ae i


COMMUNICABLE DISEASE CENTER


Vol. 15, No. 21


Week Ending
May 28, 1966


EDUCATION, AND WELFARE PUBLIC HEALTH SERVICE


EPIDEMIOLOGICAL NOTES AND REPORTS
INTRODUCED MALARIA Fort Knox, Kentucky
1965-1966

On May 2, 1966, the 5-year-old daughter of a non-
commissioned officer stationed at Fort Knox, Kentucky,
began to have chills, fever, nausea, vomiting and poorly
localized abdominal pain. Soon after the onsetof symptoms,
the family consulted a practicing physician who noted
that the' patient had an enlarged spleen. The diagnosis
of vivax malaria, however, was not made until May 9 when
Plasmodium vivax parasites were detected on a routine
blood film prepared at Ireland Army Hospital at Fort Knox.
Thick and thin blood films for malaria were then made on
the mother and her other four children, one of which, a


CONTENTS
Epidemiological Notes and Reports
Introduced Malaria Fort Knox, Kentucky
Current Trends
M easles . .
Poliomyelitis Morbidity Trends .
International Notes
Variola Minor Britain .


. 178
. 179

. 184


.'.-year-old brother of the patient, was also found to have
vivax malaria. In retrospect, this child had a clinical
illness indistinguishable from malaria which began on
March 29, 1966, and which consisted of four episodes of
chills, fever, nausea and vomiting that occurred every other
day. He was asymptomatic during the interval between
(Continued on page 184)


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous weeks)
21st WEEK ENDED CUMULATIVE. FIRST 21 WEEKS
MEDIAN
DISEASE MAY 28. MAY 29, 1961-1965 MEDIAN
1966 1965 1966 1965 1961-1965
Aseptic meningitis ................. .. .. 35 26 24 584 588 529
Brucellosis. ............................ 8 7 10 84 88 158
Diphtheria ............................ 1 4 65 74 114
Encephalitis, primary:
Arthropod-borne & unspecified ........... 26 28 506 641 ---
Encephalitis, post-infectious ......... .. 14 18 -- 351 343 -
Hepatitis, serum ..... ............. ..... ..30 689 750 523 15596 20371
Hepatitis, infectious.................... 744 14.205
Measles rubeolaa) ..................... .. 6,530 7,851 17.864 156.194 199.332 293.070
Poliomyelitis. Total (including unspecified) 1 5 8 10 54
Paralytic ........ ........ ......... 1 3 7 8 48
Nonparalytic ........................... 2 --
Meningococcal infections. Total .......... 87 52 50 2,051 1.725 1.237
Civilian .............................. 78 47 1.812 1,569 -
Military ..................... ......... 9 5 239 156 --
Rubella (German measles) ................ 2.054 -- -- 32,368 -
Streptococcal sore throat & Scarlet fever .. 8,702 6.661 6,460 232,429 216.574 190.101
Tetanus ................................. 7 7 --- 49 86 -
Tularemia .............................. 2 8 52 83 -
Typhoid fever .......................... 6 5 10 119 138 146
Typhus, tick-borne (Rky. Mt. Spotted fever) 5 7 21 23 -

Rabies in Animals. ......................... 88 66 75 1,837 2,093 1,789

NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax: ...... .. .. .. ... 2 Botulism: .. .. 1
Leptospirosis: ................. ......... ....... 17 Trichinosis: Wyo.- ............ .......... .... 43
Malaria: Mich.-l, Ohio-1, Pa.-,, Ky.-2, P.R.-1 .... 114 Rabies in Man: ................. ...
Psittacosis: Tenn.-l ................................ 17 Rubella. Congenital Syndrome: .................. 16
Typhus, marine: T ex.- ............... ... ...... .. .. 7 .......... ..... ............. ... .... .. ..








Morbidity and Mortality Weekly Report



CURRENT TRENDS MEASLES


During the 4-week period ending May 21, 1966, a
total of 31,860 cases of measles was reported. This
constitutes a decrease of 8,195 cases from the total re-
ported during the same 4-week period in 1965 and a de-
crease of 930 cases from the total notified in the pre-
ceding 4-week period in 1966 (Figures 1 and 2).
There were 108 cases of post-measles encephalitis
in a total of 149,664 cases of measles notified during the


first 20 weeks of 1966 in the U.S. The reported incidence
of encephalitis is nearly twice that of the comparable
period in 1965 and approximately the same as that in
1964 (Table 1). Twenty-five of the 108 cases were re-
ported during the 4-week period ending May 21, 1966, and
23 cases for the preceding 4-week period.
(Reported by the Childhood Virus Disease Unit, Epi-
demiology Branch, CDC.)


FIGURE 1
MEASLES REPORTED BY FOUR-WEEK PERIODS UNITED STATES
EPIDEMIOLOGIC YEARS, 1964-65 AND 1965-66
COMPARED WITH 10-YEAR PERIOD, 1954-1963


170,000-


70,000

50,000-

30,000-

10,000


.............. 1964-65 Epidemiologic Year
1965-66 Epidemiologic Year


44 48 52 4 8 12 16 20 24 28 32 36 40
WEEK NUMBER

Table 1
REPORTED CASES OF POST-MEASLES ENCEPHALITIS AND MEASLES
First 20 Weeks, 1964-66

Area 1966 1965 1964
AreaEncephalitis Measles Encephalitis Measles Encephalitis Measles
Encephalitis Measles Encephalitis Measles Encephalitis Measles


UNITED STATES ...
New England ......
Middle Atlantic ....
East North Central .
West North Central .
South Atlantic .....
East South Central .
West South Central .
Mountain ..........
Pacific ...........


149,664
1,724
15,921
54,667
6,986
11,482
16,398
18,604
8,902
14,980


191,481
33,199
9,204
38,730
14,474
20,330
11,601
26,646
15,166
22,131


337,914
11,133
39,899
74,456
18,808
30,110
48,443
58,466
12,825
48,774


178


May 28, 1966


F_








Morbidity and Mortality Weekly Report




FIGURE 2
REPORTED MEASLES BY FOUR-WEEK PERIODS
UNITED STATES, 1956-1966


1956 1957 1958 1959 1960 1961
YEAR


1962 1963 1964 1965 1966


CURRENT TRENDS
POLIOMYELITIS MORBIDITY TRENDS


Six cases of paralytic poliomyelitis with onset in
1966 have been reported to the Poliomyelitis Surveillance
Unit through May 14, 1966 (Table 2). This total compares
with 5 cases with onset in the same period in 1965. Two
cases occurred within 30 days of vaccination with tri-


valent oral vaccine. Four of the 6 cases occurred in
children under 4 years of age. It is expected that polio-
myelitis in 1966 will continue at its low level of incidence.
(Reported by the CNS Disease Unit, Epidemiology Branch,
CDC).


Table 2
PARALYTIC POLIOMYELITIS WITH ONSET IN 1966
(through May 7, 1966)

Virus Clinical
State Age Sex Race Onset Date IPV OPV
Isolation Status*

Washington .. 11 M W 1/2 /66 3 2** II 1
Mississippi.. 2 M W 1/21/66 0 1*** Not reported Not reported
Texas....... 3 F W 1/22/66 0 0 Negative 3
Texas....... 11 mo. F W 1/25/66 0 0 I 4
Minnesota.... 30 M W 2/26/66 0 0 II Not reported
Georgia...... 2 M W 3/19/66 0 1 I Not reported

*1 = complete recovery, no residual paralysis
3 = significant disability
4 = severe disability (bed, wheelchair, etc.)
**Trivalent vaccine given on November 17, 1965, and on December 28, 1965.
***Trivalent vaccine given on January 12, 1966.


179


May 28, 1966


180,000-


160,000-


140,000-


120,000-


100,000-


80,000-


60,000-


40,000-


20,000-


V


w









180 Morbidity and Mortality Weekly Report



CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

MAY 28, 1966 AND MAY 29, 1965 (21st 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... 35 26 8 26 28 14 1 30 744 689

NEW ENGLAND .......... 2 2 14 36
Maine.............. 2 3
New Hampshire...... 1 1 4
Vermont ........... -
Massachusetts...... 1 5 18
Rhode Island....... 1 1 3 4
Connecticut........ 1 3 7

MIDDLE ATLANTIC...... 5 2 1 7 8 1 18 122 148
New York City...... 1 2 2 13 22 44
New York, Up-State. 1 1 2 42 36
New Jersey......... 2 1 5 4 2 26 49
Pennsylvania....... 2 1 2 1 32 19

EAST NORTH CENTRAL... 4 4 1 4 2 2 116 160
Ohio............... 1 1 2 1 36 28
Indiana............. 2 12 4
Illinois............ 3 1 1 15 28
Michigan........... 2 2 49 79
Wisconsin.......... 1 4 21

WEST NORTH CENTRAL... 1 3 1 1 131 26
Minnesota.......... 1 3 4
Iowa ............... 17 3
Missouri............ 1 1 107 10
North Dakota....... -
South Dakota....... I -
Nebraska ........... 1 2
Kansas............. 3 2 6

SOUTH ATLANTIC....... 4 2 2 2 3 3 2 92 57
Delaware........... 2 1
Maryland............ 1 1 1 33 6
Dist. of Columbia.. 1 1
Virginia........... 2 8 10
West Virginia...... 3 11
North Carolina..... 2 1 1 2 11 5
South Carolina..... 7
Georgia............ 15 2
Florida............. 2 1 1 1 21 14

EAST SOUTH CENTRAL... 5 1 1 1 1 62 51
Kentucky........... 4 1 27 17
Tennessee......... 1.. 1 1 1 14 11
Alabama ............ 5 10
Mississippi........ 16 13

WEST SOUTH CENTRAL... 6 5 3 3 1 1 1 40 33
Arkansas........... 5 3 1 6 7
Louisiana.......... 1 10 5
Oklahoma............ 1 3 -
Texas............... 6 2 1 21 21

MOUNTAIN............. 1 2 5 2 1 19 39
Montana............. 4 1
Idaho.............. 1 6
Wyoming............ 1 1 -
Colorado ........... 1 4 1 8 12
New Mexico......... 5 13
Arizona............. 2 1 6
Utah............. 1 1
Nevada............. -

PACIFIC.............. 10 8 8 4 5 4 148 139
Washington......... 1 2 7 10
Oregon............. 13 13
California.......... 7 6 7 4 5 4 124 115
Alaska............. I 4 -
Hawaii.............. 2 1

Puerto Rico.......... 21 33










Morbidity and Mortality Weekly Report


CASIS OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

MAY 28, 1966 AND MAY 29, 1965 (21st WEEK) CONTINUED


MEASLES
AREA

1966



NEW ENGLAND........... 103
Maine............... 9
New Hampshire...... 3
Vermont............ 3
Massachusetts...... 14
Rhode Island.......
Connecticut........ 74

MIDDLE ATLANTIC...... 394 11
New York City...... 108
New York, Up-State. 102
New Jersey.......... 36
Pennsylvania....... 148

EAST NORTH CENTRAL... 2,307 51
Ohio ............... 240
Indiana............ 337
Illinois ........... 178 1
Michigan........... 545
Wisconsin........... 1,007 2!

WEST NORTH CENTRAL... 359
Minnesota.......... 32
Iowa............... 290
Missouri............ 22
North Dakota....... 12
South Dakota...... 2
Nebraska .......... I
Kansas....... .... .. NN

SOUTH ATLANTIC........ 432 11
Delaware............ 17
Maryland............ 99
Dist. of Columbia.. 9
Virginia............ 85
West Virginia...... 148
North Carolina..... 20
South Carolina..... 25
Georgia ........... -
Florida............ 29

EAST SOUTH CENTRAL... 586 1
Kentucky............ 88
Tennessee........... 403 1
Alabama............. 74
Mississippi........ 21

WEST SOUTH CENTRAL... 829 1
Arkansas............ 14
Louisiana........... 2
Oklahoma............ 18
Texas.............. 795 1

MOUNTAIN ............ 545
Montana............ 92
Idaho.............. 194
Wyoming.............
Colorado........... 49
New Mexico......... 40
Arizona............ 136
Utah............... 34
Nevada..............

PACIFIC.............. 975 15
Washington.......... 230
Oregon.............. 59
California.......... 661 11
Alaska.............. 22
Hawaii.............. 3
Puerto Rico.......... 77


(Rubeola)

Cumulative
1966 1965



1,827 33,906
179 2,413
42 356
212 833
658 18,285
68 3,647
668 8,372

6,315 10,079
7,851 1,169
1,856 2,843
1,733 1,707
4,875 4,360

6,974 41,529
5,455 7,617
4,411 1,330
0,415 1,835
9,936 21,384
6,757 9,363

7,345 14,771
1,551 528
4,410 8,124
411 2,332
897 3,293
6 76
70 418
NN NN

1,914 21,071
206 444
1,789 881
360 51
1,414 3,394
4,218 11,793
245 255
528 899
218 583
2,936 2,771

6,984 11,997
4,324 2,158
0,365 6,852
1,446 2,016
849 971

9,433 27,299
744 1,047
78 70
420 156
8,191 26,026

9,447 15,771
1,477 3,170
1,091 2,114
103 784
933 4,345
959 525
4,500 846
351 3,811
33 176

i,955 22,909
2,817 6,577
1,103 2,805
1,823 10,718
123 122
89 2.687

1,960 1,597


MENINGOCOCCAL INFECTIONS,
TOTAL Tt

Cumulative
1966 1966 1965 1966



5 92 87
8 9
8 5
3 2
35 29
3 10 13
2 28 29

17 230 233
1 34 38
4 63 60
7 65 68
5 68 67

16 319 213
3 86 59
3 56 29
2 60 57
6 84 41
2 33 27

4 112 92
S 26 19
S 16 5
3 46 44
5 4
1 4 2
8 9
7 9

14 328 340
1 4 4
S 31 32
S 7 4
S 43 37 -
10 23
7 84 63
S 41 50
1 45 45 -
5 63 82

7 180 131
3 73 58
4 57 40
S 38 22
12 11

13 301 256
6 23 13
4 115 144
1 17 17
2 146 82

S 70 58
4 1
5 7
3 3
38 13
9 10
8 16
6
3 2

11 419 315
1 32 24
1 28 23
9 341 252
S 15 9
3 7 -
1 5 4 -


POLIOMYEI



1965


.ITIS
RUBELLA
Paralytic
Cumulative
1966 1966 1966



263
6
2
3
150
S 3
99

S 106
S27
69

10

S769
67
S170
102
238
S192

-1 75

S66
S 4
5




S 1 181
4
26

58
48

7-
1
38

S 1 331
S195
134
2
1


__ I __ _









182 Morbidity and Mortality Weekly Report


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

MAY 28, 1966 AND MAY 29, 1965(21st 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... 8,702 7 49 2 52 6 119 5 21 88 1,837

NEW ENGLAND.......... 1,322 2 1 3 4 32
Maine............... 43 2 8
New Hampshire...... 27 2 11
Vermont............. 13 13
Massachusetts...... 322 2 -
Rhode Island....... 64 -
Connecticut........ 853 3 3

MIDDLE ATLANTIC...... 438 7 25 2 2 123
New York City...... 34 3 13 -
New York, Up-State. 344 3 2 117
New Jersey ........ NN 1 6 1 -
Pennsylvania....... 60 3 3 1 6

EAST NORTH CENTRAL... 1,151 1 4 12 2 22 2 2 10 258
Ohio................ 240 3 9 2 2 4 136
Indiana ............ 172 1 3 1 1 56
Illinois........... 206 1 5 1 3 4 22
Michigan........... 317 1 2 3 23
Wisconsin.......... 216 1 1 6 1 21

WEST NORTH CENTRAL... 259 3 3 1 13 1 27 402
Minnesota.......... 3 8 92
Iowa................ 109 4 7 88
Missouri........... 36 3 1 5 6 141
North Dakota....... 31 1 1 6
South Dakota....... 19 5 41
Nebraska........... 8 1 7
Kansas............. 53 2 2 1 1 27

SOUTH ATLANTIC....... 968 3 12 7 24 2 9 11 244
Delaware........... 47 -
Maryland........... 183 6 -1 -
Dist. of Columbia.. 12 -
Virginia............ 354 2 8 2 4 5 149
West Virginia...... 223 1 1 1 33
North Carolina..... 8 1 2 2 3 1
South Carolina..... 34 1 1 4 -
Georgia............. 4 1 4 1 1 1 3 38
Florida............. 103 2 6 2 2 23

EAST SOUTH CENTRAL... 1,132 2 13 2 10 1 3 9 250
Kentucky............ 95 2 1 2 2 39
Tennessee.......... 910 7 1 5 1 3 6 200
Alabama............ 81 2 4 2 9
Mississippi........ 46 I 1 2

WEST SOUTH CENTRAL... 747 3 12 1 13 1 8 3 20 386
Arkansas........... 2 1 11 1 1 3 44
Louisiana.......... 63 3 1 2 20
Oklahoma............ 55 1 1 1 2 5 109
Texas............... 629 2 6 1 1 4 12 213

MOUNTAIN............. 1,605 1 1 2 6 1 1 36
Montana........... 27 7
Idaho .............. 100 -
Wyoming ............ 17 -
Colorado........... 1,008 1 2 1 2
New Mexico......... 217 1 1 1 6
Arizona............. 61 1 20
Utah................ 175 1 3 -
Nevada............... 1

PACIFIC............... 1,080 6 1 8 4 106
Washington......... 316 -
Oregon.............. 22 1- -
California......... 650 6 1 5 4 106
Alaska............. 69 -
Hawaii ............. -
Puerto Rico.......... 4 2 22 4 5










lMorbidity and Mortality Weekl Rleport






DEATHS IN 122 UNITED STATES CITIES FOR WEEK ENDED MAY 28, 1966

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


All Causes Pneumonia Under All Causes Pneumonia Under
Area All 65 ars and 1 year Area All 65 years and 1 year
Age 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, III.---------
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.-------


735
244
41
28
40
44
33
24
27
41
75
13
51
25
49

3,438
51
36
139
44
31
48
71
117
1,626
40
605
207
59
107
31
47
53
50
37
39

2,665
75
39
752
152
229
133
90
358
37
60
55
20
67
146
48
109
40
29
55
108
63

801
47
21
40
136
25
111
91
217
60
53


429
130
24
21
28
26
19
18
19
27
35
8
28
15
31

2,041
29
22
91
30
15
32
51
60
962
24
353
104
43
64
22
26
35
31
25
22

1,476
39
27
417
77
117
59
51
216
26
28
25
12
41
77
22
66
20
20
37
63
36

478
29
15
20
77
19
69
51
129
35
34


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.----------


1,170
137
268
46
56
92
55
80
40
65
72
196
63

669
87
44
28
188
131
50
39
102

1,174
35
40
30
149
25
74
200
64
208
104
121
65
59

404
39
27
114
14
99
13
50
48

1,446
22
50
21
47
67
396
89
37
108
64
79
189
28
145
50
54


Total 12,502 1 7,090 486 673

Cumulative Totals
including reported corrections for previous weeks

All Causes, All Ages ------------------------- 275,789
All Causes, Age 65 and over------------------- 159,965
Pneumonia and Influenza, All Ages------------- 13,149
All Causes, Under 1 Year of Age--------------. 14,143


Week No.


*Eatimate based on average percent


of divisional total.










184


Morbidity and Mortality Weekly Report


EPIDEMIOLOGICAL NOTES AND REPORTS
INTRODUCED MALARIA Fort Knox, Kentucky
(Continued from front page)

episodes. The blood smears from these two patients have
been confirmed at the Communicable Disease Center as
positive for P. vivax. Both of the children were treated
with chloroquine andprimaquine and have been well since.
The family had lived in Panama from 1957-1961 at
which time they moved to the Fort Knox area. Both chil-
dren were born at Ireland Army Hospital; neither child has
ever travelled outside Kentucky and neither has had an
illness necessitating transfusions.
From May 1 to September 30, 1965, the children were
almost constantly around their area of residence at Fort
Knox. Light trap mosquito catches during that period were
positive for both Anopheles quadrimaculatus and Ano-
pheles punctipennis in low density. Epidemiological in-
vestigations failed to find a related index case although
numerous servicemen who had served in Southeast Asia
would be presumed to have been in close proximity to the
residence of this family at Fort Knox. These two cases
are believed to be delayed primary cases of vivax malaria
and that the actual transmission occurred during the sum-
mer of 1965.*
*They are accordingly considered to represent an introduction
of malaria into the United States.
(Reported by Dr. Calixto Hernandez, Medical Director,
Division of Epidemiology, and Dr. Joseph Skaggs, Ken-
tucky State Department of Health; Lt. Col. Robert Quinn,
Chief of Preventive Medicine at Fort Knox; and an EIS
Officer.)
Editorial Note:
The previous introduction of malaria occurred at Fort
Benning, Georgia, in 1964-1965 when two army wives who
had never travelled outside of the country developed vivax
malaria. Epidemiological investigations at that time
established that the probable index case was a service-
man who had just had a tour of duty in South Korea (MMWR,
Vol. 14, No. 33).


INTERNATIONAL NOTES
VARIOLA MINOR Britain


Latest information available from an official source
records a total of 14 new cases of variola minor in Staf-
fordshire, England, during the period May 11-19. This
brings the total of reported cases to 23. Of the new cases
10 were observed in Stoke-on-Trent County Borough, 2 in
Walsall County Borough, 1 in Warley District and 1 in
Cheadle Rural District. These four areas have been noti-
fied to the World Health Organization as smallpox in-
fected local areas and listed accordingly.
On May 26 no further cases had been notified from
Britain to WHO.
(World Health Organization Weekly Epidemiological Rec-
ord No. 21 of May 27, 1966).


May 28, 1966



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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.
EDITOR: MMWR D.J.M. MACKENZIE, M B..
F. R. C.P E.
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



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