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:
AA00010654:00287

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

Fsa.yT/;


COMMUNICABLE DISEASE CENTER


S -- Vol. 15, No. 12




:' I?

Week Ending
March 26, 1966



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


CURRENT TRENDS
MALARIA IN THE UNITED STATES, 1966

This week 5 cases of malaria were reported in the
United States through the National Morbidity Reporting
System, bringing the total number of cases reported in
1966 to 67. The Parasitic Disease Unit of the Com-
municable Disease Center has received additional epi-
demiological information on 47 of the malaria cases
reported through March 26, all of which have had onsets
during 1966. Twenty-two of these cases occurred in
military personnel who were diagnosed in the United States,
18 cases occurred in civilians, and 7 were known malaria
cases transferred to the United States for treatment.
Of the 22 military cases, 19 contracted malaria in
Viet Nam, and one case each was imported from Thailand,
Panama and Korea. In the 19 military cases from Viet Nam,


CONTENTS
Current Trends
Malaria In The United States, 1966 ............ 101
Influenza United States . . .. 102
Epidemiologic Notes and Reports
Heat-Resistant Clostridium perfringens
Outbreak Wisconsin . . .. 103

the species was Plasmodium falciparum in 8 cases,
P. vivax in 10 cases, and P. malaria in one case.
The 18 civilian cases include two merchant seamen
and six Peace Corps workers. Only one of the 18 cases
acquired the disease in Viet Nam. Of the 16 cases in which
the country of origin is known, Africa was the source of
infection in 10 cases.
The seven cases transferred to the United States for
therapy were military personnel who acquired their disease
in Viet Nam. All had falciparum malaria.


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous weeks)
12th WEEK ENDED CUMULATIVE, FIRST 12 WEEKS
MEDIAN
DISEASE MARCH 26, MARCH 27. 1961-1965 MEDIAN
1966 1965 1966 1965 1961-1965
Aseptic meningitis ..... ............ 20 27 16 341 335 268
Brucellosis.............................. 6 2 7 43 45 76
Diphtheria .................. .......... .5 6 34 51 81
Encephalitis, primary:
Arthropod-borne & unspecified ........... 17 28 -- 274 360 -
Encephalitis, post-infectious ........... 17 18 -- 195 170 -
Hepatitis, serum .................. ..... 24 1 770 933 269 ( 9,495 12,960
Hepatitis, infectious .................. 685 8.561
Measles (rubeola)...................... 9,469 11,272 15,519 85.000 105.866 129,117
Poliomyelitis, Total (including unspecified) 1 3 3 3 37
Paralytic ............................ 1 3 2 3 32
Nonparalytic .......................... -- -
Meningococcal infections. Total .......... 125 111 60 1,186 1,012 691
Civilian ............................... 114 105 1,025 941 -
Military ............................ 11 6 --- 161 71 ---
Rubella (German measles) ............... 2,175 -- 15.554 -- ---
Streptococcal sore throat & Scarlet fever 13,611 11,974 11,118 140,291 134,601 120,080
Tetanus................................ 2 4 24 42 -
Tularemia .............................. 2 3 46 52 -
Typhoid fever ........................ 5 2 6 60 78 78
Typhus, tick-borne (Rky. Mt. Spotted fever) 9 6 -
Rabies in Animals................... .... 135 96 96 956 1,176 923

NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax: ................. ................. .. ..... 2 Botulism: .................... 1
Leptospirosis: Texas-1 .......................... .. 9 Trichinosis: N.C.-I, Tenn.-1 ...... .... ... 25
Malaria: D.C.-l, N.Y. Up-State-1. Pa.-2, Calif.-1, P.R.- 67 Rabies in Man: ..... ... .. -
Psittacosis:Wisc.- ... ........ ............... 14 Rubella, Congenital Syndrome: .. ............ .... 9
Typhus, marine: Conn.-1, Texas-1 .... ... .... ..... .. 4 ... ...... ....... .. .


15'/-/ 91








Morbidity and Mortality Weekly Report


MARCH 26. 1966


INFLUENZA UNITED STATES


During the week ending March 26, 1966, reporting of
influenza outbreaks to the CDC has shown a general
decline. Of particular interest is the continued reporting
of influenza virus isolates not associated with generalized
outbreaks. In Idaho where type A2 influenza outbreaks
have been confirmed, there has been a single isolation
of type B influenza virus from a patient not associated
with an outbreak.
Excess mortality due to influenza and pneumonia
deaths as measured in 122 U.S. cities continues above
the epidemic threshold for the 4th consecutive week.



Figure 1
PNEUMONIA INFLUENZA DEATHS IN
MOUNTAIN AND PACIFIC REGIONS U.S.


MOUNTAIN
8 CITIES


WK NO 40 44 48 52 4 8 12 16 20 24 28 32
196511966


200




150




100




50


PACIFIC
16 CITIES


WK NO 40 44 48 52 4 8 12 16 20 24 28 32
1965 11966


The areas contributing to this rise are the Pacific and
Mountain Regions (Figure 1).
(Reported by the Influenza-Respiratory Disease Unit,
CDC.)

Table 1
United States Influenza Summary 1965-66 (Winter)

State First Laboratory Confirmation
Recognized Isolation Serology


Florida
Georgia
Alabama
California
Connecticut
Massachusetts
Rhode Island
Vermont
Alaska
Dist. of Col.
Idaho
Illinois
Maine
Maryland
Michigan
New Jersey
New York
No th Carolina
Ohio
Oregon
Pennsylvania
Texas
Virginia
Washington
Colorado
Oklahoma


Lab. Confirmed Outbreaks
Nov. B
Dec. B
Jan.
Jan. A2
Jan....
Jan. B
Jan.
Jan. B
Feb. B
Feb. B
Feb. A2
Feb. B
Feb. B
Feb. B
Feb. B
Feb. B
Feb. B
Feb.
Feb.
Feb. B
Feb. B
Feb...
Feb. B
Feb. B
Mar. A2
Mar. A2


Influenza Virus Identification
(non-outbreak)
Illinois Jan. A2 .
Iowa Feb. A2 A
Kansas Feb. A2 .
Michigan Feb. A2 .. .
Idaho B .
Influenza-like Illnesses
Arizona Feb.
Nevada Feb.
New Hampshire Feb.
West Vireinia Feb.
Delaware Mar.
Montana Mar.
Nebraska Mar.
New Mexico Mar.
Louisiana Mar.
Tennessee Mar.
Wisconsin Mar.
S. Information not available
(Compiled from reports submitted by State Health Depart-
ments and collaborative laboratories to the /nl/luen.a-
Respiratory Disease Unit, CDC and the WHO International
Influenza-Center for the Americas, CDC.)


102








MARCH 26, 1966


Morbidity and Mortality Weekly Report


EPIDEMIOLOGIC NOTES AND REPORTS
HEAT-RESISTANT CLOSTRIDIUM PERFRINGENS OUTBREAK Wisconsin


On February 24, 1966, over 366 students attending
the Universityof Wisconsin developed mild gastroenteritis.
Investigation indicated that illness was largely confined
to three of the six dining halls serving the students and
incriminated food served at the evening meal on February
23, 1966. These three dining halls served a choice of
roast beef with gravy or fish as the entree, while the
three other dining halls served a choice of hamburger or
fish. All other foods were common to all dining halls. A
total of 2,954 students had eaten that evening, according
to the dietitian. Epidemiological evidence indicated that
contaminated gravy was the source of the outbreak. The
causative agent was Clostridium perfringens.
A food and illness questionnaire was distributed to
students who ate in the three dining halls; 366 ques-
tionnaires were returned from ill students, 344 of which
included time of onset, and 740 questionnaires were
returned from well students. The clinical illness, which
usually had a duration of less than 24 hours, was char-
acterized primarily by diarrhea. About half of the students
also experienced abdominal cramps, while nausea, vom-
iting, and fever were rare. The epidemic curve indicates
a well demarcated incubation period of 14 hours (Figure 2).


Figure 2
OUTBREAK OF CLOSTRIDIUM PERFRINGENS
UNIVERSITY OF WISCONSIN FEBRUARY 24, 1966


MEAN =139 HOURS
MEDIAN= 140 HOURS
RANGE 1-28 HOURS


2 4 8' o' 12 14' 18' '1 2 t 24 '24 26 3
INTERVAL IN HOURS BETWEEN MEAL AND ONSET


The attack rates among students who consumed the
vulnerable foods are shown in Table 2. The 69.9 percent
attack rate among those who ate roast beef and gravy,


the 4.9 percent attack rate among those who did not oat
roast beef and gravy, and the complete absence of illnec=.
in 48 students who ate roast beef Aithout gravy, incrim-
inated the gravy as the source of the outbreak of
epidemiological grounds.

Table 2
Clostridium perfringens Outbreak
University of A -. ..n r,
Attack Rate in Students February 24, 1966


Food


Fish
Hamburger
Beef with
gravy
Beef without
gravy


Consumed Food


Attack
Rate"


Did Not Consume
Food

ttack
No. Ill Attack
Rate %


1,058 366 34.6


An interview with the chief cook revealed that both
beef bone stock and gravy left over from February 22 had
been added to fresh gravy made for the roast beef. About
27 gallons of the left-over gravy had been placed in three
plastic containers, each containing about 9 gallons,
and placed in the refrigerator overnight. The next day
7 gallons of freshly made gravy were added to the left-
over material taken from the refrigerator: the entire
mixture was brought to a "rolling boil" and served.
Although no left-over food remained from the meal
in question, test samples of each food item which are
routinely collected and refrigerated for every meal were
available for culture. No clostridia or other organisms
were isolated under aerobic or anaerobic conditions. The
gravy failed to produce illness in mice, but it is not
known whether the test sample included the left-over
gravy or was taken only from the fresh gravy prepared on
February 23. Nineteen of 20 stool samples from ill students
yielded abundant numbers of Clostridium perfringens; all
of the isolates readily survived boiling for one hour.
Among 24 stool specimens collected from kitchen per-
sonnel, only one yielded heat-resistant Clostridium
perfringens.
The outbreak was attributed to heat-resistant Clos-
tridium perfringens which had grown in the gravy at some
time during preparation or during inadequate refrigeration
in the three 9-gallon containers.
(Reported by Dr. A.S. Evans, Director, State Laboratory
of Hygiene, Wisconsin; and Dr. Josef Preizler, Deputy
Director, Section of Preventable Disease, Wisconsin
State Board of Health.)
(Editorial Note on page 108)


103


g fe I










Morbidity and Mortality Weekly Report



CASESS OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

MARCH 26, 1966 AND MARCH 27, 1965 (12th WEEK)


AREA



UNITED STATES...

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 ............

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


ASEPTIC
MENINGITIS


1966
20

1



1



2


1
1

1

1















5
3








2








3



3













8
1

7


1965


BRUCELLOSIS


1966


I I I ____________


ENCEPHALITIS


Post-
Infectious


HEPATITIS


DIPHTHERIA Serum Infectious


Both
Types


1966 1966 1965 1966 1966 1965


Primary
including
unsp. cases
1966 1965
17 28

2 1






2 1

3 6
2
2
1 3
S 1

6 6
2 4
2 1
1 1
1


2 1





2 1



1 6

1

2


1

1 2

2



2

1 1
1

1

1
-




















1





1 5
I -S


















1

1 4


24

1




1


13
9

4


2
1

1



1


1
















1


26 36


104


770

47
3
6
1
24
8
5

138
30
42
35
31

136
27
13
31
55
10

45
6
20
8


1
10

95
7
8
3
35
12
5

4
21

72
33
25
5
9

55
10
10
1
34

30
1
1

7
13
6
2


152
15
8
128










lMorlbidily and Mortality Weekly Report


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

MARCH 26, 1966 AND MARCH 27, 1965 (12th WEEK) Continued


MEASLES (Rubeola)
AREA
Cumulative
1966 1966 1965

UNITED STATES... 9,469 85,000 105,866

NEW ENGLAND.......... 101 1,028 22,171
Maine.............. 15 139 1,824
New Hampshire...... 12 300
Vermont............ 2 163 304
Massachusetts...... 49 376 12,415
Rhode Island....... 1 48 2,450
Connecticut........ 34 290 4,878

MIDDLE ATLANTIC...... 958 11,074 4,043
New York City...... 570 5,631 375
New York, Up-State. 82 1,133 1,461
New Jersey......... 93 1,202 695
Pennsylvania....... 213 3,108 1,512

EAST NORTH CENTRAL... 3,113 33,399 18,599
Ohio............... 376 2,355 4,099
Indiana............. 102 2,043 735
Illinois........... 496 7,282 580
Michigan........... 683 5,183 9,754
Wisconsin.......... 1,456 16,536 3,431

WEST NORTH CENTRAL... 483 3,899 8,538
Minnesota.......... 127 1,148 226
Iowa................ 267 1,796 4,850
Missouri........... 55 279 1,126
North Dakota....... 27 631 2,090
South Dakota ....... 1 3 51
Nebraska............ 6 42 195
Kansas. ............ NN NN NN

SOUTH ATLANTIC....... 858 6,527 13,419
Delaware........... 7 91 238
Maryland............. 100 1,100 446
Dist. of Columbia.. 11 282 12
Virginia........... 54 549 1,978
West Virginia...... 459 2,717 8,716
North Carolina..... 12 129 156
South Carolina..... 46 324 341
Georgia............ 24 150 392
Florida............. 145 1,185 1,140

EAST SOUTH CENTRAL... 1,041 9,791 6,009
Kentucky............ 315 3,190 772
Tennessee........... 589 5,446 3,605
Alabama............. 54 734 1,215
Mississippi........ 83 421 417

WEST SOUTH CENTRAL... 1,532 8,412 14,248
Arkansas........... 201 322 780
Louisiana .......... I 53 30
Oklahoma............ 34 165 88
Texas.............. 1,296 7,872 13,350

MOUNTAIN............. 478 4,354 8,411
Montana............. 73 688 2,316
Idaho............... 25 510 1,267
Wyoming............. 5 70 380
Colorado............ 116 492 1,419
New Mexico.......... 37 184 294
Arizona ............ 216 2,283 287
Utah................ 6 120 2,377
Nevada.............. 7 71

PACIFIC.............. 905 6,516 10,428
Washington.......... 122 1,495 3,233
Oregon............. 68 531 1,571
California......... 706 4,422 4,555
Alaska.............. 4 24 88
Hawaii............... 5 44 1 981
Puerto Rico.......... 122 956 631


MENINGOCOCCAL INFECTIONS,
TOTAL

Cumulative
1966 1966 1 ~1965


1,186

58
6
7
2
24
4
15

127
23
30
39
35

172
47
24
35
51
15

63
13
11
25
3
2
3
6

195
1
19
3
23
8
41
27
32
41

101
51
27
17
6

187
11
69
7
100

37
3
1
1
21
5
5

1

246
13
9
209
12
3


1,012

49
7
2

19
7
14

142
21
33
47
41

120
30
16
30
23
21

57
13
1
32
3
2
2
4

204
3
19
3
22
13
33
25
31
55

57
25
18
10
4

164
9
83
15
57

40

5
2
9
6
11
5
2

179
13
14
147
3
2


POLIOMYELITIS -1
------- M-RUBELLA
Total Paralyl i

u d I a ti tIV
1966 1965 1966 1966 1966

12 2,175

S155
3
4
4
57

87

155
S 48
101

6

-- 629
65
S 89
107
S 124
244

1 73

68
2
3


- I


--t+ +--t


328
S 2
36

98
34

S 42

116

129
48
77
4


1 18



- 18

335
151
- 11

35

135
3


1 353
1 105
S 38
203
2
5
2


I 3


I


,


/ ,










106 Morbidity and Mortality Weekly Report


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

MARCH 26, 1966 AND MARCH 27, 1965 (12th 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... 13,611 2 24 2 46 5 60 9 135 956

NEW ENGLAND........... 1,967 2 1 2 1 8
Maine.............. 233 -
New Hampshire...... 30 1 3
Vermont............. 11 5
Massachusetts...... 506 2 1
Rhode Island....... 131 -
Connecticut........ 1,056 2 -

MIDDLE ATLANTIC..... 464 4 2 14 1 10 73
New York City...... 27 3 1 6
New York, Up-State. 306 3 10 70
New Jersey......... NN 3
Pennsylvania....... 131 1 1 2 1 3

EAST NORTH CENTRAL... 2,173 11 9 20 131
Ohio............... 300 3 5 13 75
Indiana............. 363 2 1 2 23
Illinois........... 461 5 3 12
Michigan........... 480 I- 1 1 11
Wisconsin.......... 569 1 2 1 10

WEST NORTH CENTRAL... 609 1 3 2 7 1 19 210
Minnesota.......... 5 4 40
Iowa............... 312 2 5 50
Missouri .......... 15 1 1 2 4 7 85
North Dakota....... 134 3
South Dakota....... 12 2 21
Nebraska........... 12 1 6
Kansas............. 119 2 1 I 5

SOUTH ATLANTIC....... 1,410 6 6 10 6 20 135
Delaware ........... 58 -
Maryland ........... 232 2
Dist. of Columbia..
Virginia........... 336 2 5 2 11 95
West Virginia...... 464 1 1 4 15
North Carolina..... 23 2 1 3
South Carolina..... 78 -
Georgia............. 13 2 1 2 15
Florida............ 206 3 1 3 10

EAST SOUTH CENTRAL... 2,042 1 1 12 5 17 146
Kentucky............ 131 2 1 2 19
Tennessee.......... 1,688 6 3 15 124
Alabama............ 123 1 1 4 1 3
Mississippi...... 100 -

WEST SOUTH CENTRAL... 1,079 1 7 2 11 1 3 1 40 191
Arkansas.......... 1 2 9 1 3 24
Louisiana .......... 4 1 1 1 3 12
Oklahoma........... 29 14 30
Texas............... 1,049 1 3 1 1 20 125

MOUNTAIN............. 2,161 1 6 2 12
Montana............. 84 1
Idaho .............. 196 -
Wyoming............. 50
Colorado........... 1,301 2 1
New Mexico........ 231 3
Arizona............ 113 1 2 7
Utah ............... 186 3 -
Nevada............

PACIFIC.............. 1,706 3 1 4 6 50
Washington......... 672 -
Oregon............. 19 -
California......... 923 3 1 3 6 50
Alaska............. 18 -
Hawaii............ 74 -
Puerto Rico.......... 11 6 9 3 1









Morbidity and Mortality Weekly Report






DEATHS IN 122 UNITED STATES CITIES FOR WEEK ENDED MARCH 26, 1966


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

All Causes Pneumonia Under All Causes Pneumonia Under

Area All 65 years and 1 year Area All 65 years an year
Ages and over Influenza Ages and over Influenza All
All Ages Causes All Ages Causes


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

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

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

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


738
230
56
33
23
57
29
28
24
53
72
7
45
26
55

3,635
47
38
162
50
38
37
68
86
1,799
42
686
216
44
97
23
49
51
46
24
32

2,623
64
46
794
138
229
111
80
364
33
43
46
42
45
167
39
121
32
31
32
94
72

852
46
28
40
142
45
98
60
283
61
49


433
129
33
19
10
29
14
19
18
19
45
6
34
16
42

2,154
29
22
103
26
22
28
46
40
1,059
25
397
121
30
66
13
25
36
26
18
22

1,479
45
32
437
80
127
57
57
186
28
25
33
18
27
93
20
65
13
12
20
60
44

543
28
21
21
85
32
58
41
184
41
32


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.----------


Total


1,181
159
234
47
62
89
56
96
28
81
73
204
52

646
107
46
56
114
164
45
27
87

1,134
43
32
25
158
37
74
219
48
204
86
97
55
56

568
43
32
143
35
181
27
45
62

2,056
20
47
56
52
71
781
115
47
107
74
121
214
45
206
58
42


9 1- t 1


13,433


Cumulative Totals
including reported corrections for previous weeks

All Causes, All Ages ------------------------ 160,422
All Causes, Age 65 and over------------------- 93,313
Pneumonia and Influenza, All Ages------------- 7,971
All Causes, Under 1 Year of Age--------------- 8,215


Week No.


*Estimate based on average percent


"


of divisional total.









108 Morbidity and Mor




HEAT-RESISTANT CLOSTRIDIUM PERFRINGENS
OUTBREAK Wisconsin
(Continued from page 103)


Editorial Note:
The clinical and epidemiological pattern of Clos-
tridium perfringens food poisoning is so characteristic as
to be almost diagnostic. After an incubation period of 8
to 24 hours (usually 10 to 14 hours), the patient develops
abdominal pain with nausea and diarrhea. Vomiting and
fever are seldom present. The illness is of short duration
and the patient is usually well within 24 hours.
Illness follows the ingestion of a food heavily con-
taminated with the causative organism. The food item is
usually a meat dish or gravy which has been prepared on
one day and served the following day after a short
warming period. Creamed chicken, "turkey-a-la-king", and
boiled or braised meats have been incriminated in out-
breaks. The contaminated foods appear edible, rarely
showing evidence of spoilage. Occasionally when milk
sauces of vegetables are involved, "stormy fermentation"
has been observed.
The causal organism is Cl. perfringens, type k.
Food poisoning strains are heat-resistant by virtue of
spore formation, a property that allows the organism to
survive cooking. The spores are ubiquitous on meats,
and when conditions are favorable they germinate and
prolific growth results within a few hours.
In outbreaks, the same serologic type of Cl. per-
fringens may often be isolated from the incriminated
food and from a high proportion of stool specimens.
Isolation of the organism is best accomplished after
boiling the specimen for one hour. This procedure should
not be used, however, in examining suspect foods, since
only vegetative cells may be present. 2
Prevention of clostridial food poisoning requires that
meat dishes be eaten soon after thorough cooking. Where
this is impractical, as for example in large institutions,
cooked foods must be refrigerated promptly and reheated
adequately immediately before serving.
References:

'Hobbs, B.C., Smith, M.E., Oakley, ('.L., \arrack. G.H., and
Cruickshank, J.F.: Clostrdium it lchii food poisoning. J Hyg
51:75, 1953.

2Hobbs. BF.C.: Clostridium elchii ais a food poisoning organism.
J Appl Bact 28(1):74-S2, 1965.


tality Weekly Report


MARCH 26, 1966


THE MORBIDITY AND MORTALITY WEEKLY REPORT. WITH A CIRCULAR.
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
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 COC 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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