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:
AA00010654:00277

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
Fs.-.^y-r


COMMUNICABLE DISEASE CENTER


c4d


Vol. 15, No. 8




RL

Week Ending
February 26, 1966


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


INFLUENZA UNITED STATES



Eleven States have identified outbreaks of influenza
either by virus isolation or by serology; in seven other
States investigations of influenza-like disease are cur-
rently in progress. Table 1 presents the relevant data
for both categories without attempting to estimate the
amount of illness recognized at the present time or to
give an indication of the relative size and extent of the
outbreaks in any single State. In the areas where inves-
tigations into the etiology of the influenza-like syndrome
are continuing, it is generally true that the outbreaks
identified have been somewhat limited and localized.


Curr ri "I r--r..- I
Influenza i I.-. J -
Influenza .r,, rr. .
Epidemiologic Notes Ean Pil .
Botulism New Yo' .
Meningococcal Infectio United States .
Measles Leslie Count Kentucky .
Reported Cases of Infecti
Quarantine Measures .....


SERVICE






65
65
67
67
72


Pneumonia-influenza mortality reported from 122
United States cities has not shown a significant continued
excursion above the "epidemic threshold" during the
present influenza season; for the week ending Feb-
ruary 26 this is again within the expected variation for the
(Continued on page 62)


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous weeks)
8th WEEK ENDED CUMULATIVE, FIRST 8 WEEKS
MEDIAN
DISEASE FEBRUARY 26, FEBRUARY 27, 1961-1965 MEDIAN
1966 1965 1966 1965 1961-1965
Aseptic meningitis ................... ... ..46 26 22 227 220 184
Brucellosis ............................. 4 2 8 27 28 47
Diphtheria........................... .. 1 6 6 20 28 43
Encephalitis, primary:
Arthropod-borne ....................... 20 25 184 224 -
Encephalitis, post-infectious ............. 17 12 -- 118 98 --
Hepatitis, serum ........... ....... ..... 28 165
Hepatitis, infectious .................... 764 704 1,065 5,673 6,324 8,902
Measles rubeolaa) .... .............. .... 7,914 9,531 11,396 48.305 61,515 72,953
Poliomyelitis, Total (including unspecified) 1 2 2 28
Paralytic ................... .......... 1 1 2 24
Nonparalytic ...................... --
Meningococcal infections. Total .......... 144 88 61 689 584 435
Civilian .............................. 101 75 578 551 -
Military ................. ........... .. 43 13 111 33 -
Rubella (German measles) ................ 1,177 -- 8.257 -- --
Streptococcal sore throat & Scarlet fever .. 12.975 11,297 10,787 84,020 86,089 74,790
Tetanus ................................ 3 6 18 30 -
Tularemia............................ 9 --- 36 38 -
Typhoid fever .......................... 4 7 7 37 53 56
Typhus, tick-borne (Rky. Mt. Spotted fever) 7 6 -
Rabies in Animals ...................... 65 114 75 568 773 520

NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax: .-1 ................................. .. 1 Botulism: ................... ................... ......
Leptospirosis: La.- 1 .................................... 8 Trichinosis: N.Y.C. -1, Ohio- 1....................... 18
Malaria: 111.-1 ................................... 42 Rabies in Man: ................. ................
Psittacosis: 111.-1.................................. 8 Rubella, Congenital Syndrome: ...................... 2
Typhus, murine:....................... ............. 1 ........................................


Is~







Morbidity and Mortality Weekly Report


INFLUENZA UNITED STATES
(Continued from front page)


United States as a whole. During the current week, only
in the Pacific Division is there evidence of mortality
above the threshold. The increased numbers of deaths
accounting for the total in the Pacific Division are
primarily those reported from California and are par-
ticularly from cities in the northern portion of the State
(Figures 1 and 2 on pages 63 and 64).

(Reported by the Influenza-Respiratory Disease Unit,
CDC.)

Table 1
United States Influenza Survey
1965 66 (through February)

First Laboratory confirmation
State
State Recognized Isolation Serology

Confirmed outbreaks
Florida Nov. 1965 B B
Georgia Dec. 1965 B B
Massachusetts Jan. 1966 B B
Connecticut Jan. 1966 .. B
Rhode Island Jan. 1966 .. B
Vermont Jan. 1966 B B
Alabama Jan. 1966 ... B
California Jan. 1966 A2 A
Washington Feb. 1966 B B
Alaska Feb. 1966 B
New Jersey Feb. 1966 B .
Influenza-like illnesses (Localized)
Maine Feb. 1966
New Hampshire Feb. 1966
New York Feb. 1966
Virginia Feb. 1966
North Carolina Feb. 1966
Texas Feb. 1966
Idaho Feb. 1966

.. Laboratory results not yet available.


Alaska

School absenteeism up to 20 percent, attributed to
febrile respiratory illness, has been observed in elementary
and junior high schools in the Anchorage area, beginning
in early February. The characteristic clinical syndrome
has been mild, although fever, headache, and relatively
severe sore throat have been frequently encountered. Six
strains of type B influenza virus have been recovered from
typical cases and recently identified in the Arctic Health
Research Center in Anchorage by hemagglutination-
inhibition procedures employing B/Singapore/3/64 anti-
serum.


Recent evidence of increased amounts of an influenza-
like disease has likewise been reported from the Sitka
area where efforts to identify the etiological agent are
underway.
(Reported by Dr. Thomas McGowan, Director, and Dr.
Ralph Williams, Director of Laboratories, Alaska State
Department of Health, Juneau, and a team from the
Epidemiology Section, Arctic Health Research Center,
Anchorage.)



Idaho
An acute influenza-like illness has been reported in
three Idaho counties. This disease is characterized by
fever, sore throat, cough, myalgia, headache and occa-
sional nausea and vomiting. The duration is usually 3
to 5 days with no response to antibiotic therapy.
The outbreak is believed to date from the arrival in
Blaine County on January 25, 1966, of a vacation group
from southern California. Some members of a skiing party
in this group became ill after arrival. The outbreak became
apparent about February 11 among Wood River High
School students, with absenteeism reaching 30 percent.
Most of these students ski, and some cases occurred
prior to the recognized outbreak. Grade schools in
Bellevue, Hailey, Ketchum and Carey had absenteeism
of up to 25 percent.
Illness began to occur during the week of February
13 in Twin Falls and Lincoln Counties. School absen-
teeism varied between 10 and 30 percent in these counties.
Specimens for virus isolation have been obtained and
are being processed in the State Laboratory.

(Reported by Dr. John A. Mather, Director, Preventive
Medicine l)'..(P i Idaho Department of Health, Boise.)


New Jersey
Outbreaks of mild, febrile respiratory disease have
been reported from several different areas of New Jersey
since mid-February. The illness has occurred primarily
among school children, both in elementary and high
schools, with absenteeism in affected schools generally
ranging from 15 to 20 percent. In one school, a peak
absentee rate of 39 percent was recorded.
Type B influenza virus has recently been recovered
from cases in a school-centered outbreak in Warren County,
New Jersey.

(Reported by Dr. W.J. Dougherty, Director, Division of
Preventable D1 csa.c i. and Dr. Martin Goldfield, Director
of Laboratories, New Jersey State Department of Health.)
(Continued on page 65)


FEBRUARY 26, 1966








FEBRUARY 26, 1966


Morbidity and Mortality Weekly Report


FIGURE 1
PNEUMONIA-INFLUENZA DEATHS IN 122 UNITED


STATES CITIES


38C -IUY

.3-9


WEEK NO 40 44 48 52 4 8 12 16 20 24 28 32 36 40 44 48 53 4 8 12 16 20 24 28 32 36 40 44 48 52 4 8 12 16 20 24 28 32 36
WK ENDED 5 2 30 28 25 22 21 18 16 13 II 8 5 3 31 28 2 30 27 27 24 22 19 17 14 II 9 6 4 I 29 26 26 23 21 18 16 13 10
MONTH 0 N D J F M A M J J A S O NO J F M A M J J A S 0 N 0 J F M A M J J A S
1963 1964 196411965 96511966


125 W N.
CENTRAL 200o
100- 10 CITIES
150-
75-

50- 100'




WK NO 40 44 48 52 4 8 2I 16 20 24 28 32
1965 11966


E.N. 125-
CENTRAL
21 CITIES 100-


40 44 48 52 4 8
1965 1966


12 16 20 24 28 32


NEW
ENGLAND
14 CITIES






1111 Z1111111P 1111111111


40 44 48 52 4 8
1965 11966


12 16 20 24 28 32 36


MOUNTAIN
8 CITIES


100

75

50-


RP5-

40 44 48 52 4 8 1 16 20 24 28 32
196511966


WK NO 40


E.S
CENTRAL
8 CITIES


MIDDLE
ATLANTIC
20 CITIES










40 44 48 524 8 1216 2024 28 32 36
1965 1966

SOUTH
ATLANTIC
12 CITIES











40 44 48 52 4 8 12 16 20 24 28 32 36
1965 1 1966


11001 ALL
CITIES


400


PACIFIC
16 CITIES


100

-1) 0

4044 48 52 4 8 12 1620 24 28 32
196511966







Morbidity and Mortality Weekly Report



FIGURE 2
MORTALITY IN 122 UNITED STATES CITIES


16,000-


FEBRUARY 26, 1966


WEEK NO 4 8 12 16 20 24 28 32 36 40 44 48 53 4 8 12 16 20 24 28 32 36 40 44 48 52 4 8 12 16 20 24 28 32 36 40 44 48 52
WKENDED 25 22 21 18 6 13 II 8 5 3 31 28 2 30 27 224 22 19 17 14 I1 9 6 4 I 29 2266 232118 16 13 10 5 3 31
MONTH J F M A M J J A S 0 ND J F M A M J J A S O N D J F M A M J JA S O N 0
1964 1965 1966






FEBRUARY 26. 1966


Morbidity and Mortality Weekly Report


INFLUENZA UNITED STATES
(Continued from page 6f)


Vermont
In late January and early February, reports of
influenza-like illnesses were received from towns in the
central and eastern parts of the State. Absenteeism in
schools near Barre was substantially increased and, in
one high school, approached 30 percent.
By mid-February, similar illnesses had been observed
in Windham County to the southwest and in the Burlington
region where school absentee rates increased suddenly
during the week ending February 12. Teachers as well


as students were affected in some of the Burlington area
schools. Franklin County, in the northwest corner of the
State, reported school absenteeism up to 25 percent in
scattered regions, associated with the sudden onset of
high fever, chills, headache, sore throat, and coryza.
Type B influenza virus was recovered from char-
acteristic cases in the Burlington area.
(Reported by Dr. Linus J. Leavens, Director, Com-
municable Diseases, and Mr. R. Pelletier, Virologist,
Vermont Department of Health.)


INFLUENZA INTERNATIONAL NOTES


Outbreaks of influenza types A2 and B, occurring
predominantly in the northern parts of Great Britain, con-
tinue to be associated with increased mortality. Influenza
deaths for England and Wales during the week of February
19 show 333 deaths in contrast to the previous week's
totalof319 and the 16 deaths reported in the corresponding
week of 1965. New National Insurance medical claims
in England, Wales and Scotland have also shown increases
since late January generally in parallel with the occurrence
of the outbreaks.
Preliminary reports of scattered outbreaks of influenza-
like disease in France and Germany are added to the
recent information from Europe. Previously notified out-
breaks of type B influenza in the Netherlands have been
supplemented by the reported isolation of type A2 strains
from some patients in that country.
A small military unit in Stockholm, Sweden, experi-
enced a high incidence of clinically typical influenza with
a cumulative total of 70 cases in a population of some
100 men, beginning in late January. Serological identifi-
cation of the agent as type A influenza has been reported.
No general spread of the infection has been noted.
In the Far East, beginning in late December 1965,
outbreaks of respiratory illnesses in Japan have been
reported in several elementary and middle schools in
Tokyo as well as in 5 other regions to the West and south-


west. A strain of type B influenza virus was isolated in
one of these outbreaks.
Health officials in Hong Kong have reported a mild
outbreak of type A2 influenza in the Colony. Additional
investigation is underway.
(Consolidated by the Influenza-Respiratory Disease Unit,
CDC, from Weekly Epidemiology Report, WHO, Geneva
and information submitted by the WHO International In-
fluenza Center for the Americas, CDC, Atlanta).

Influenza-Like Illness British Columbia, Canada

A fairly extensive outbreak of influenza-like illness
has involved the Vancouver area from mid-February. Chil-
dren predominantly, but adults also, have been affected
with fever, headache, myalgia, and in some cases nausea,
stomach cramps, vomiting and prostration. Two teenage
children, who presumably had this disease, died during
the last week of February. In a few other parts of British
Columbia, school absenteeism to 20 percent has accom-
panied the recognition of similar illnesses. Numerous
clinical specimens have been collected for laboratory
identification although as yet no agents have been isolated.
(Reported by Dr. A. A. Larsen, Director, Division of
Epidemiology, Department of Health Services and Hospital
Insurance, Victoria, B.C.)


EPIDEMIOLOGIC NOTES AND REPORTS
BOTULISM New York City


On Friday, January 14, 1966, a 68-year-old woman
with suspected botulism was admitted to a New York
Hospital. The patient had been ill since the previous
Tuesday morning when she felt weak, dizzy and had
some difficulty in swallowing. Tne symptoms persisted
throughout the day. On Wednesday she had difficulty in
opening her eyes; the difficulty in swallowing increased


and she also began to have some dysphonia. She was
worse on Thursday and was admitted to the Booth Memorial
Hospital in Queens with a provisional diagnosis of
myasthenia gravis. However, further investigation revealed
that she had eaten home-canned mushrooms on Sunday,
January 9, which suggested a clinical diagnosis of
(Continued on page 66)





Morbidity and Mortality Weekly Report


BOTULISM New York City
(Continued from page 65)


botulism. Accordingly she was moved to a New York
Hospital where facilities were better for the management
of respiratory muscle failure.
On admission to the New York Hospital she was
noted to have complete bilateral ptosis. There was severe
involvement of the extraocular muscles but the pupils
were normal in size and reacted to light and accom-
modation. The tendon reflexes were normal although
there was a general weakness of the voluntary muscles,
most marked in the neck and facial muscles. The patient
was mentally clear and fairly cooperative. There was
dryness of the mouth and throat; examination of the chest
revealed minimal rales at both lung bases. Lumbar
puncture, ECG and other routine laboratory tests were
negative.
She was given 10,000 units of botulism antitoxin
(Type A and B) on the afternoon of January 14, and, in
view of the history of eating home-canned mushrooms,
polyvalent antiserum of types A,B and E was given in
a dose of 40 ml at 11 p.m. that night. A further dose of the
polyvalent antiserum was given the following morning.
A response to botulinum antitoxin was not apparent;
there was no objective improvement for 3 to 4 days. On
Monday, January 17, the patient developed pneumonia
which responded well to antibiotic treatment. On Tuesday,
January 18, there was improvement in muscular function
with less ptosis and some clarity of speech. Tracheostomy
was notrequired and the patient has made a good recovery.
Investigation revealed that the patient, who is a
widow and lives alone, had purchased some mushrooms
in a local store in October 1964. These had been washed,
cut into small pieces and put into 12 glass jars with a


small amount of water and salt. The jars were then
loosely capped and cooked in a double pressure cooker
for 45 minutes, after which the jar tops were secured.
The jars of canned mushrooms were then stored in a
dark basement at room temperature. The first jar was
opened on Sunday, January 9, 1966.
The patient gave a history of tasting a piece of
mushroom when she first opened the jar which she said
tasted "funny." The mushrooms were then washed, pan
fried and added to a stew. She was the only one to eat
this meal and no other home-canned items were eaten
during the 3 days before she became ill.
The jar of mushrooms used for the meal and its
remaining contents had been discarded. However, the
11 other jars of the batch of home-canned mushrooms
were examined. The contents of two of the jars were
foul-smelling and cultures of the juice from these jars
gave isolates identified as Clostridium botulinum, type B.
Fluid from each of the 11 jars was injected into mice;
that from one jar proved fatal to three out of three mice
injected. Thereafter mice protected with botulinum anti-
toxin type B survived intraperitoneal injection of this
juice while unprotected mice in a control group died
after a similar injection. The patient's serum, obtained
before the administration of antisera, was not toxic to
mice.
(Reported by Dr. Julia Freitag, A. '-,.. Director, Epi-
demiology Division, State Department of Health, New
York; Dr. Tibor Fodor, Bureau of Preventable i.'.j c ,,
New York City Health Department; Shigella Surveillance
Unit and Investigations Section, Epidemiology Branch,
CDC.)


MENINGOCOCCAL INFECTION U.S.


During the week ending February 26, 1966, 144
cases of meningococcal infection were reported through
State and local health departments to the Communicable
Disease Center. Forty-three of these cases occurred in
military personnel, which is the highest weekly total so
far this year. In the United States as a whole, 16 percent
of the reported cases of meningococcal infection have
been in military personnel; 90 percent of these have
been reported from eight States (Table 2). In six of the
eight States listed, meningococcal infection in military
personnel has accounted for 40 to 60 percent of the total
cases reported. In California, however, only 7.2 percent
of the cases reported in 1966 have been among the military.


Table 2
Military-Associated Meningococcal Infections
U. S., First Eight Weeks, 1966
Percent
Total Military Milita
Military
U. S. . ... 689 111 16.1
New Jersey ... 28 13 46.4
Missouri . ... 15 8 53.3
South Carolina ....... 24 11 45.8
Georgia . ... 15 6 40.0
Kentucky . ... 39 24 61.5
Louisiana ... 33 15 45.5
Texas . ... 56 17 30.4
California .... 83 6 7.2
Total of military cases from 8 States = 100 (90%).


FEBRUARY 26, 1966






FEBRUARY 26, 1966


Morbidity and Mortality Weekly Report


MEASLES Leslie County, Kentucky


During the first 9 months of 1965, there were 34 cases
of measles reported from Leslie County, which has a
population of 18,000 and is situated in mountainous
southeastern Kentucky. Due to two subsequent outbreaks
in the last quarter of the year, the provisional total for
the whole of 1965 is now 89.
A measles immunization campaign was begun on
November 8, 1965, organized jointly by the Leslie County
Health Department, the Frontier Nursing Service and
U.S. Peace Corps Trainees. A total of 695 doses of
vaccine was given to children aged 1 year to 8 years
who had no history of either measles or vaccination
against it. This covered an estimated 80 percent of the
children susceptible to measles in the County.
This immunization campaign was preceded by a
3-weeks intensive house-to-house visiting in certain


school districts of the County. During this house visiting
an outbreak of measles was uncovered in one rural school
district, and investigation showed that there had been
36 cases of measles between October 15 and November 8.
The probable source of this outbreak was the exposure
of two school-aged children, who later developed measles,
in a neighboring county. After the outbreak in October
and November, no further cases were reported in Leslie
County until December 25, when a further 18 cases were
notified from a distant area not covered by the house-to-
house campaign and where no mass immunization was
done. In the campaign area, however, only one case was
reported during December.
No more vaccine is being given at this time in an
effort to determine how far the transmission of measles
(Continued on page 72)


SUMMARY OF REPORTED CASES OF INFECTIOUS SYPHILIS

JANUARY 1966 AND JANUARY 1965


CASES OF PRIMARY AND SECONDARY SYPHILIS: By Reporting Areas January 1966 and January 1965 Provisional Data

Cumulative Cumulative
Reporting Area January January Reporting Area January January
1966 1965 1966 1965 1966 1965 1966 1965
NEW ENGLAND............... 48 39 48 39 EAST SOUTH CENTRAL ........ 185 223 185 223
Maine................... Kentucky ................. 11 8 11 8
New Hampshire........... 1 1 Tennessee ................ 31 57 31 57
Vermont.................. Alabama .................. 99 114 99 114
Massachusetts............ 32 21 32 21 Mississippi.............. 44 44 44 44
Rhode Island.............. 3 2 3 2
Connecticut.............. 13 15 13 15 WEST SOUTH CENTRAL........ 240 191 240 191
Arkansas................. 18 12 18 12
MIDDLE ATLANTIC............. 343 394 343 394 Louisiana................ 55 63 55 63
Upstate New York......... 35 31 35 31 Oklahoma................. 19 14 19 14
New York City............ 205 252 205 252 Texas.................... 148 102 148 102
Pa. (Excl. Phila.)....... 27 16 27 16
Philadelphia............. 20 12 20 12 MOUNTAIN.................. 39 44 39 44
New Jersey............... 56 83 56 83 Montana.................... 3 1 3 1
Idaho.................... 1 1
EAST NORTH CENTRAL........ 241 227 241 227 Wyoming................... -
Ohio..................... 48 39 48 39 Colorado ................. 7 2 7 2
Indiana .................. 6 3 6 3 New Mexico............... 7 9 7 9
Downstate Illinois....... 21 20 21 20 Arizona ................... 21 20 21 20
Chicago.................. 76 87 76 87 Utah..................... 1 6 1 6
Michigan................. 77 74 77 74 Nevada................... 5 5
Wisconsin................ 13 4 13 4
PACIFIC................... 188 172 188 172
WEST NORTH CENTRAL ........ 53 40 53 40 Washington............... 7 9 7 9
Minnesota................ 2 7 2 7 Oregon...................... 2 4 2 4
Iowa..................... 6 4 6 4 California............... 177 157 177 157
Missouri ................. 31 18 31 18 Alaska................... 1 1 1 1
North Dakota.............. I Hawaii................... 1 1 1 1
South Dakota.............. 2 4 2 4
Nebraska................. 6 5 6 5 U. S. TOTAL............... 1,853 1,897 1,853 1,897
Kansas.................... 5 2 5 2
TERRITORIES............... 84 63 84 63
SOUTH ATLANTIC........... 516 567 516 567 Puerto Rico............... 82 62 82 62
Delaware ................ 3 5 3 5 Virgin Islands............ 2 1 2 1
Maryland ................... 35 37 35 37
District of Columbia..... 46 44 46 44
Virginia ................ 18 37 18 37
West Virginia............. 9 4 9 4
North Carolina............ 79 65 79 65 Note: Cumulative Totals include revised and delayed reports
South Carolina........... 87 77 87 77 through previous months.
Georgia.................. 82 95 82 95
Florida.................. 157 203 157 203







68 Morbidity and Mortality Weekly Report



CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

FEBRUARY 26, 1966 AND FEBRUARY 27, 1965 (8th 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... 46 26 4 20 25 17 1 6 28 764 704

NEW ENGLAND.......... 1 1 1 2 1 6 24 42
Maine............... 8 13
New Hampshire...... 1 7
Vermont............. 1 1
Massachusetts...... 1 1 1 6 18
Rhode Island....... 1 6 -
Connecticut........ 1 9 2

MIDDLE ATLANTIC...... 4 3 4 6 1 12 99 102
New York City...... I 2 2 6 11 5
New York, Up-State. 1 1 2 28 58
New Jersey.......... 1 1 2 6 6 13
Pennsylvania....... 1 1 2 1 54 26

EAST NORTH CENTRAL... 5 3 4 2 4 1 144 158
Ohio................ 1 1 43 64
Indiana............ 2 1 10 11
Illinois............ 2 1 2 2 3 17 27
Michigan.......... 1 1 1 64 48
Wisconsin.......... 1 10 8

WEST NORTH CENTRAL... 2 5 1 3 92 44
Minnesota........... 1 1 3 15 2
Iowa............... 1 6 14
Missouri........... 1 66 11
North Dakota....... 1
South Dakota....... -
Nebraska........... 3 4
Kansas............. 1 4 12

SOUTH ATLANTIC ...... 7 2 1 7 5 1 2 1 64 76
Delaware............ 2 1 1 7
Maryland............. 1 2 1 9 15
Dist. of Columbia.. -
Virginia........... 1 1 16 18
West Virginia...... 1 6 7
North Carolina...'.. 2 8 2
South Carolina..... 2 5
Georgia.............. 1 I 5 2
Florida............. 1 2 1 4 1 19 20

EAST SOUTH CENTRAL... 2 1 1 1 1 3 119 95
Kentucky............ 1 81 47
Tennessee.......... 1 1 1 19 31
Alabama............ 3 16 10
Mississippi........ 1 3 7

WEST SOUTH CENTRAL ... 12 2 1 5 1 1 50 50
Arkansas........... 1 2 1 7 10
Louisiana.......... 6 6 11
Oklahoma........... 1 -
Texas.............. 5 2 3 1 36 29

MOUNTAIN............. 2 1 4 46 26
Montana............ -- 4
Idaho.............. 3 3
Wyoming............ -
Colorado............ I 3 11
New Mexico.......... 2 1 15 6
Arizona............. 12 4
Utah............... 5 8
Nevada ............. -1

PACIFIC............... 13 13 3 4 4 126 111
Washington.......... I 1 11 14
Oregon............... I 14 5
California.......... 12 12 1 4 3 101 84
Alaska............. 7
Hawaii............... 1 1 1

Puerto Rico.......... 21 12









Morbidity and Mortality Weekly Report 69


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

FEBRUARY 26,1966 AND FEBRUARY 27, 1965 (8th WEEK) Continued



MENINGOCOCCAL INFECTIONS, POLIOMYELITIS
MEASLES (Rubeola) TOTAL RUBELLA
Total Paralytic
AREA ------
Cumulative Cumulative Cumulative
1966 1966 1966 1965 1966 1966
1966 1965 1966 1965 1966 1965 1966
UNITED STATES... 7,914 48,305 61,515 144 689 584 1 1,177

NEW ENGLAND........... 52 567 14,173 4 40 34 65
Maine............... 6 60 1,469 3 6 9
New Hampshire...... 8 225 7 1 -
Vermont............. 7 144 119 1 2
Massachusetts...... 6 199 8,239 2 16 14 -- 13
Rhode Island....... 1 34 1,777 2 4 1
Connecticut........ 32 122 2,344 2 11 9 40

MIDDLE ATLANTIC ..... 924 7,023 2,254 8 87 85 57
New York City...... 482 3,494 246 16 13 36
New York, Up-State. 59 720 793 2 17 20 21
New Jersey.......... 113 686 379 2 28 33
Pennsylvania....... 270 2,123 836 4 26 19

EAST NORTH CENTRAL... 3,131 19,814 10,903 20 108 72 -- 435
Ohio................ 159 1,030 2,280 5 32 21 37
Indiana............. 223 1,089 451 1 11 8 54
Illinois........... 747 4,604 320 5 23 17 87
Michigan............ 439 2,960 5,749 7 31 16 64
Wisconsin.......... 1,563 10,131 2,103 2 11 10 193

WEST NORTH CENTRAL... 372 2,007 4,954 11 38 25 68
Minnesota........... 103 721 123 2 8 4 -5
Iowa ............... 149 693 2,789 4 52
Missouri............ 32 136 585 5 15 14 3
North Dakota....... 86 438 1,316 2 2 3 8
South Dakota....... 2 25 1- -
Nebraska............ 2 17 116 1 2 -
Kansas............. NN NN NN 1 6 3 -

SOUTH ATLANTIC....... 524 3,901 8,589 27 121 120 101
Delaware............ 5 48 122 2 1
Maryland............ 68 699 277 1 15 6 1
Dist. of Columbia.. 18 197 10 3 -
Virginia............ 47 322 1,150 2 13 17 33
West Virginia...... 137 1,710 6,058 1 5 10 37
North Carolina..... 4 45 118 5 22 22
South Carolina..... 28 160 154 8 24 15 4
Georgia........... 57 91 199 8 15 21
Florida............. 160 629 501 2 27 24 -25

EAST SOUTH CENTRAL... 1,016 5,866 3,209 24 63 28 137
Kentucky........... 409 2,276 267 18 39 8 95
Tennessee.......... 370 3,166 2,050 4 14 12 39
Alabama............ 202 293 654 2 7 7 3
Mississippi........ 35 131 238 3 1 -

WEST SOUTH CENTRAL... 785 3,581 7,145 30 97 78 1
Arkansas........... 37 620 5 6 -
Louisiana.......... 9 38 17 19 33 30
Oklahoma............ 14 47 46 1 3 9 I
Texas............... 762 3,459 6,462 10 56 33 -

MOUNTAIN.............. 449 2,140 4,945 7 29 27 119
Montana............ 93 379 1,584 2 4
Idaho............... 28 306 764 4 8
Wyoming............ 21 126 I 1
Colorado............ 35 223 698 4 17 7 22
New Mexico......... 27 42 99 2 4 3 -
Arizona............. 245 1,077 136 1 4 6 83
Utah................ 21 88 1,513 4 2
Nevada............. 4 25 1 2- -

PACIFIC.............. 661 3,406 5,343 13 106 115 195
Washington......... 115 949 1,693 2 8 7 93
Oregon.............. 42 286 913 1 5 8 34
California.......... 504 2,134 2,142 10 83 99 67
Alaska.............. 8 56 8 1 1
Hawaii.............. 29 539 2 2- -
Puerto Rico........... 66 498 242 -









70 Morbidity and Mortality Weekly Report


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

FEBRUARY 26, 1966 AND FEBRUARY 27, 1965 (8th 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... 12,975 3 18 9 36 4 37 7 65 568

NEW ENGLAND........... 1,769 2 1 2 1 5
Maine.............. 279 -
New Hampshire...... 20 1 1
Vermont ........... 47 4
Massachusetts...... 363 2 -
Rhode Island....... 88
Connecticut........ 972 2

MIDDLE ATIANTIC...... 327 3 9 1 4 51
New York City...... 30 3 5
New York, Up-State. 235 2 4 49
New Jersey......... NN 2 -
Pennsylvania....... 62 1 2

EAST NORTH CENTRAL... 1,432 3 11 6 6 61
Ohio...... I ...... 150 3 3 31
Indiana............ 395 1 2 1 9
Illinois........... 216 2 5 1 4
Michigan........... 394 1 2 8
Wisconsin.......... 277 1 1 3 9

WEST NORTH CENTRAL... 626 1 2 2 1 16 153
Minnesota.......... 12 3 29
Iowa ............... 271 4 30
Missouri ........... 15 1 8 67
North Dakota....... 244 3
South Dakota....... 15 1 17
Nebraska........... 4 -- 2
Kansas............. 65 2 1 1 5

SOUTH ATLANTIC....... 1,341 1 4 5 8 5 9 75
Delaware ........... 42 -
Maryland ........... 215 -
Dist. of Columbia.. 5 -
Virginia........... 327 2 5 1 6 59
West Virginia...... 348 1 1 6
North Carolina.... 42 2 I 3 -
South Carolina..... 103 1 -
Georgia..... .... .. 12 2 1 1 7
Florida............ 247 1 1 1 1 3

EAST SOUTH CENTRAL... 1,691 2 10 1 3 17 92
Kentucky........... 255 2 2 13
Tennessee.......... 1,134 2 6 1 3 15 77
Alabama............... 285 2 2
Mississippi........ 17 -

WEST SOUTH CENTRAL... 1,537 2 5 3 5 1 8 98
Arkansas........... 2 3 4 8
Louisiana......... 1 2 4 1 7
Oklahoma .......... 49 7
Texas ............. 1,485 1 7 76

MOUNTAIN ............. 2,551 1 1 1 3 5
Montana........... 75 1
Idaho.............. 120 -
Wyoming........... 12 -
Colorado........... 1,546 1 1
New Mexico......... 405 -
Arizona ............ 165 1 4
Utah............... 226 1 1 I -
Nevada............. 2

PACIFIC.............. 1,701 3 1 2 3 4 28
Washington ......... 588 -
Oregon............. 53 -
California......... 959 3 1 2 3 4 28
Alaska........... 55 -
Hawaii ............. 46 -


Puerto Rico........... 1 1 1 i 1 -








Morbidity and Mortality Weekly Report


Week No. Table 4. DEATHS IN 122 UNITED STATES CITIES FOR WEEK ENDED FEBRUARY 26, 1966
8
(By place of occurrence and week of filing certificate. Excludes fetal deaths)

All Causes Pneumonia Under All Causes Pneumonia Under

Area All years and year Area All 65 years year
All 65 years Influenza All Influenza All
Ages and over Influl n a Aue Ages and over Inluenza -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.--------


773
261
43
37
37
47
31
21
39
54
71
10
46
33
43

3,381
33
31
152
51
41
45
90
69
1,670
42
591
188
58
98
22
33
50
57
29
31

2,677
59
27
829
183
195
135
87
379
40
49
51
49
36
145
29
131
45
32
41
82
53

762
49
20
32
121
21
100
69
232
72
46


468
142
26
24
26
25
24
15
33
32
40
7
24
19
31

2,032
26
23
92
30
24
27
53
32
1,008
18
351
115
35
59
14
21
35
30
21
18

1,514
35
20
453
117
107
77
55
208
27
27
30
19
21
77
16
77
25
18
25
46
34

436
22
10
18
72
16
67
38
118
49
26


*Estimate based on average percent of divisional total.


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

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

WEST SOUTH CENTRAL:
Austin, Tex.-----------
Baton Rouge, La.-- ----
Corpus Christi, 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.-----------


1,188
135
232
60
86
72
50
119
24
93
75
206
36

564
86
52
23
119
110
47
42
85

1,000
34
26
27
148
27
66
185
43
157
54
112
69
52

478
50
20
118
20
130
28
49
63

1,525
30
56
22
39
87
283
102
52
116
90
114
236
57
145
55
41


Total 12,348 7,214 630 624

Cumulative Totals
including reported corrections for previous weeks

All Causes, All Ages ------------------------- 106,244
All Causes, Age 65 and over------------------- 61,523
Pneumonia and Influenza, All Ages------------- 5,064
All Causes, Under 1 Year of Age--------------- 5,515


'













MEASLES Leslie County, Kentucky
(Continued from page 67)

can be interrupted without immunizing every u- .--pIpi b
child in a given geographical area. Arrangements for
surveillance to this end have been made.
(Reported by Dr. Joseph W.' Skaggs, D.V.M., Acting
Director, Division of Epidemiology, Kentucky State
Department of Health; Mrs. Martha Cornett and Mrs.
Elizabeth Newton, Public Health Nurses, Leslie County
Health Department, Kentucky; and an EIS Officer.)


QUARANTINE MEASURES


Immunization Information for International Travel
1965-66 edition Public Health Service Publication No. 384


The following change should be made in the list of Yellow
Fever Vaccination Centers in Section 6:

Page 76
Delete

City Urbana, Illinois
Center University of Illinois, Health Center
1109 South Lincoln
Telephone 333-2715
Clinic Hours Wednesday, 11 a.m.
Fee Yes


Add

City Urbana, Illinois
Center University of Illinois, Health Center
1109 South Lincoln
Telephone 333-2717
Clinic Hours Wednesday, 11 a.m.
By appointment
Fee Yes

Page 77
Delete

City Kalamazoo, Michigan
Center Kalamazoo County Health Dept. at
Upjohn Co. Industrial Health Dept.
241 West South
Telephone FI 5-3571
Clinic Hours By appointment
Fee No

Add

City Kalamazoo, Michigan
Center Kalamazoo County Health Dept. at
Upjohn Co. Industrial Health Dept.
7171 Portage Road
Telephone FI 5-3571
Clinic Hours By appointment
Fee No


FEBRUARY 26, 1966


THE MORBIDITY AND MORTALITY WEEKLY REPORT. WITH A CIRCULAR.
TION OF 15.300. 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
COMMUNICABLE 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 NATIONALBASIS ARE RELEASED
ON THE SUCCEEDING FRIDAY.


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