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:
AA00010654:00289

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




IICABLE DISEASE CENTER


Vol. 15, No. 41


WEEKLY

1I PCRf

Week Ending
October 15, 1966


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


EPIDEMIOLOGIC NOTES AND REPORTS
BOTULISM California

On October 10 and 11, 1966, three patients with
botulism were hospitalized at Sutter Memorial Hospital in
Sacramento, California, following ingestion of home-
processed dried venison jerky. A 28-year-old patrolman
who prepared the meat and his 24-year-old sister both
developed severe diploplia, dysphagia, ptosis and
dysponia on October 9. These symptoms appeared within
3 days of the time the venison was first sampled and
24 hours after moderately large amounts were eaten. The
third patient, the patrolman's 2-year-old daughter, devel-
oped unsteady gait progressing to severe weakness,
ptosis and palatal paralysis on October 11, 2 to 3 days


after exposure. Of 17 ( I i... I, I- i l:f
the venison, 2 develop i ld transien :~-*r,'.I. r ,l
and 15 remained asympto a
Filtrates prepared fr ...: -..r i. '. irl,
killed mice. Antisera for *'.. lI e r l' .,
to protect, but sera for types e' o own some
protection. Further characterization of the type of botulism
involved must await bacteriological identification.
(Continued on page 356)


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous weeks)
41st WEEK ENDED CUMULATIVE, FIRST 41 WEEKS
MEDIAN
DISEASE OCTOBER 15, OCTOBER 16, 1961-1965 MEDIAN
1966 1965 1966 1965 1961-1965
Aseptic meningitis ..................... 80 68 68 2,394 1,677 1.659
Brucellosis............................ 6 1 8 198 194 324
Diphtheria.......... ................. .. 6 2 9 151 118 203
Encephalitis, primary:
Arthropod-borne & unspecified ........... 38 47 --- 1.721 1.472 --
Encephalitis, post-infectious ..... ... 5 5 -- 621 572 -
Hepatitis, serum ........................ 22 1,091
H2i feios 53 644 797 26,767I 34,317
Hepatitis, infectious ................... 573 25,029
Measles rubeolaa) ............. ... 681 872 872 191.490 243,198 390.194
Poliomyelitis, Total (including unspecified) 1 24 74 48 347
Paralytic ................ ............ 1 19 68 39 296
Nonparalytic ......................... --- 6 -
Meningococcal infections, Total .......... 34 37 37 2,851 2,462 1,900
Civilian ................... ....... .... 32 37 2.570 2,280 -
Military .......... ........... ..... 2 -. -- 281 182 ---
Rubella (German measles) ................ ..202 --- 42,572 -- -
Streptococcal sore throat & Scarlet fever .. 5.906 6.272 4,610 332.657 310,791 268.524
Tetanus......................... ....... 5 4 151 210 -
Tularemia ................ .. ... ....... 2 8 136 205
Typhoid fever ......................... 11 5 17 307 338 431
Typhus, tick-borne (Rky. Mt. Spotted fever). 4 2 223 243 -
Rabies in Animals .................... 57 65 65 3,287 3.496 3.037

NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax: ...... ................. ....... 4 Botulism : Calif.-3 ............. ...... ........ 8
Leptospirosis: ....................... .............. 53 Trichinosis: Conn.-l, Mich.-l, N.J.-1 ................. 84
Malaria: Calif.-10, Ky.-2, Mass.-l. Mich.-3, NY City-1, S.C.-l 334 Rabies in Man: ..................... ........... 2
Psittacosis: ...... ... .. .................... .. 40 Rubella, Congenital Syndrome: ..................... 20
Typhus murin. Tpx -I 3 i Pi;u;


-5 Z. 609







Morbidity and Mortality Weekly Report


PUBLIC HEALTH SERVICE RECOMMENDATIONS ON THE USE OF BCG VACCINATION
IN THE UNITED STATES

The following recommendations represent the position of the Public Health Service
on the use of BCGI vaccination in the United States. The statement was drafted by a
panel of public health and tuberculosis specialists* who met at the Communicable
Disease Center in Atlanta on July 21 and 22, 1966. The recommendations have
been approved by the Surgeon General.


Tuberculosis has been and still is the costliest of
the communicable diseases in the United States both in
terms of human lives and dollars. It has always been
the desire of public health workers in this country to
use all the necessary tools to control this disease.
Therefore, in 1946 when European countries were adopting
mass BCG vaccination as an element of their tuberculosis
control programs, the Public Health Service first convened
an advisory group to consider the use of BCG in this
country. That group recommended against its use since
its effectiveness had not been determined. Instead of
mass usage, large-scale controlled trials were urged.
Subsequent advisory committees have recommended that
BCG vaccination be limited to special groups, but em-
phasized in 1957: "The Committee expressed the opinion
that vaccination may lead to a false sense of security
which could result in failure to observe precautions that
otherwise would be taken," and in 1962: "The Committee
wishes to emphasize that BCG vaccination should not be
considered a substitute for other control measures, but
should be an addition to these, used in special sit-
uations." Today, in 1966, this panel recommends an even
more limited use of BCG vaccination in the United States.
Vast changes have been seen in tuberculosis control
in the past 20 years. In 1946 specific chemotherapy had
only recently been discovered and was still in limited
use; today excellent drugs are available which can not
only reverse the course of the disease, but will also
rapidly eliminate infectiousness. Then, too, in 1946 rates
of new infections were thought to be high and most of
the disease seen then was thought by many to follow
recent infection. Today in this country, accumulated data
show that infection rates are very low, and it is recognized
that 75-80% of new cases of tuberculosis comes from the
reservoir of persons infected in the more distant past.
Today it is possible and practicable to prevent many of
these infected persons from developing disease namely,
with chemoprophylaxis. ,F in r ., and most important,
today the resources to combat tuberculosis in the United
States are vastly increased and should remain at a high
level for the next several years if the 1963 recommen-
dations of the Surgeon General's Task Force are followed.
The panel has reviewed epidemiologic information
relating to the status of tuberculosis in this country and
is thoroughly familiar with the results of field trials of
BCG not only in the United States, but also in Great
Britian and other countries. The panel is fully cognizant
of the past positions of the Public Health Service as well


as the current views in other countries and of the World
Health Organization. It is important to recognize that the
present epidemiologic situation in the United States is
much more favorable than that in developing countries. It
is also much more favorable than the situation that
existed in many developed countries at the end of World
War II when BCG vaccination was widely adopted.
BCG vaccine has been demonstrated to have some
effectiveness, particularly where rates of new infections
are high. Its impact as a public health measure does,
however, diminish progressively as the opportunity to
become infected continues to decrease. Because of the
favorable epidemiologic. medical, and socioeconomic
conditions prevailing in the United States, and in light
of the changes described above, the following recom-
mendations are made for the use of BCG in this country
today. The panel recognizes that for regions with different
conditions, the recommendations concerning the use of
BCG might be quite different.

Recommended Usage
For the individual. Since modern methods for detec-
tion, isolation, treatment, and chemoprophylaxis, when
adequately applied, are highly successful in controlling
tuberculosis, BCG should be reserved for situations in
which these methods cannot be applied. BCG should be
used for the uninfected individual or small groups of
uninfected individuals living in unavoidable contact with
one or more uncontrolled infectious persons who cannot
or will not obtain or accept supervised treatment.
For groups. Based on available data, there is no
epidemiologic indication for the use of BCG on a group
or community basis in the United States. In particular,
BCG is not recommended for medical and paramedical
personnel and students, or for employees and inmates of
penal and mental institutions, because the knowledge of
tuberculin conversion, if it occurs, is essential so that
chemoprophylaxis may be instituted and the infectious
source identified and treated. Moreover, adequate tuber-
culosis control programs can be developed in such groups
with reasonable assurance of cooperation.
A so-called "micro-epidemic" of infection is another
situation in which BCG is not recommended. Today, with
low rates of transmission and expanded tuberculin testing,
such outbreaks will be more easily recognized than in
the past. Their management requires the prompt identi-
fication and removal of the source of infection and the
identification and treatment of the tuberculin converters.


350


OCTOBER 15. 1966














The recommendations of this panel limiting the use
of BCG should not be construed to mean that tuberculosis
is no longer a problem. On the contrary, vigorous efforts
must be sustained to capitalize on the gains of the past.
In addition to the current programs of tuberculosis control,
an expanded study of the level of infection, as measured
by standardized tuberculin testing, is needed. As the risk
of new infections continues to diminish, the need for
surveillance will increase to assure that deviations from
the norm can be rapidly detected and corrective action
instituted.
If, in spite of the above recommendations, an indi-
vidual health official in the United States believes that
the local situation calls for further use of BCG, he should
first assure himself that the situation is, in fact, pre-
carious. He should have epidemiologic information on the
transmission rate as measured by conversions obtained
in repeated tuberculin testing of representative samples
of the population; he should identify as precisely as
possible the persons who might benefit from BCG vac-
cination; and he should re-examine his resources to
determine ifthere are not better ways to meet the problem.
Under no circumstance should BCG vaccination be an
alternative for an adequate tuberculosis control program,
nor should other measures be relaxed when BCG is used.

The health official should be aware that the use
of BCG does not absolve him or his health jurisdiction
from attempting adequate supervision of individuals with


351


tuberculous infection or disease. In addition. hI(e should
recognize (hai the use of G('( will complicate future lu-
berculosis control programs hy adding to Ihe population
a group of reactors who cannot be distinguished from those
naturally infected.
As the 1957 Report on 13('G stated:
"The procedure (BCG vaccination) makes it impossible
to use the tuberculin test
(1) as evidence of recent infection in lthe individual;
(2) as an index of infection in population groups:
(3) for the location of sources of contagion:
(4) as a preliminary screening device prior to chest
roentgenographic examination in the diagnosis of
tuberculosis:
(5) for differential diagnosis in diseases with some
similarity to tuberculosis."
Since there will be some continued indication for
the use of BCG, according to the recommendations of the
panel, the Public Health Service should continue to assure
that a safe and potent vaccine is licensed for use in the
United States.

*Special Panel of Public Health and Tubier ulosis Sptecialist

Dr. Robert J. Andorson Dr. tHerman I:. Ilillihn,
Dr. Georges Canetti Dr. Fdith M. Lincoln
Dr. John S. Chapman Dr. Johannes, MNtijp3 r
Dr. Francis J. Curry Capt. Jack Millar, USN
Dr. Winthrop N. Davey D)r. D)vidi J. S-r'er
Dr. Robert L. IYeager


SUMMARY OF REPORTED CASES OF INFECTIOUS SYPHILIS

SEPTEMBER 1966 AND SEPTEMBER 1965
CASES OF PRIMARY AND SECONDARY SYPHILIS: By Rep rting Ar-a September 1965 and prember .0b3 Prvii ni D .
Cumulative I Csulati
Reporting Area ptmber an pt Reportng Area Sptber J
9 66 1965 196 196 1 169 1965 1966 1i65
NEW ENGLAND.............. 32 41 353 353 EAST SOUTH CENTRAL........ 14 232 1,759 2.106
Maine.... ... .. 5 I Kentucky ................ 10 16 1 04 '
New Hampshire ........... 8 2 Tennessee........... 31 9
Ve r ont ................. 3 2 Alabama .......... ....... 10 116 q86 1,! 7
Massachusetts........... 21 24 245 209 Mis issippi ............ 5 69 4i 457
Rhode Island............ I 4 21 18
Connecticut .....'........ 13 72 1l0 WEST SOUTH CENTRAL ........ 27 197 2.041 1,788
Arkansas................. 19 10 I16 173
MIDDLE ATLANTIC....... .. 2 294 407 3,008 3.632 Louisiana............... 51 59 .'8 523
Upstate New York....... 13 46 263 415 Oklahoma................. 4 105 8q
New York City ........... 189 220 1.863 .,I19 Texas................. 191 1.4 ,8 1 ,i,
Pa. (Excl. Phila.)...... 10 36 144 144
Philadelphia............ 26 37 202 224 MOUNTAIN.................. 35 53 318 427
New Jersey .............. 56 68 536 730 Motana............ 2 2 25 ii
Idaho ................... 2 2 5 7
EAST NORTH CENTRAL ....... 293 253 .l 2.249 Wy.aing... .... .
Ohio................... 67 $i 476 471 Colorado.. ............ .. 2 13 35
Indana................ 74 41 New Mexic ......... .... 8 I 7 6
Downstate Illnois ....... 8 6 15 Arizona.................
Chicago .. ..... ........ 96 103 781 917 Utah..................... 1 3
Michigan................ 98 70 856 597 Nevada................ .. 18
Wisconsin.............. 7 5 79 63
PACIFIC .... 10 163 1319 i >9
WEST NORTH CENTRAL........ 3i 51 314 393 Washingto............. 6 2 32 ,
Minnesota........ ...... 2 7 24 9 Oregn. ................. 2 38
Iowa ....... ........... 8 8 55 28 California.... .... 118 15 I22 ,434
M ssour. .. -.. .-.......... 6 19 114 17, Alaska.............. 1 0
North Dakota............ 5 2 awaii.. ................. 9 2,
South Dakota............. 2 27 34
Nebraa. ............. 9 39 67 S. TOTAL .. ......... ... I 1,914 12
Kana................. 3 5 50 3 _
TERRITORIES .............. 06 86 750 0os
SOUTH ATLANTIC............ 583 517 4,750 .3 Puert, Ri o............ 84 728 62I
Delaware .......... .... b 40 5 Virgn Islands.......... 2 22 .
Maryland ... .......... 42 37 416 334
District of C,umbia..... 51 3 363 366
Virgonia.............. 4 28 2AI 255
West Virginia.......... 9 54
North Carolin. ........... .s 79 729 78 Nrote Cumulative Toals include revsed d and dilayd rep.irts
South Caroel6e ........ .. b 64 b,8 631 through previous months.
Georgia.................. 9I o 772 827
Florida .............. 134 o, 454 i.7 l


OCTOBER 15, 1966


Morbidity and Mortality Weekly Report








352 Morbidity and Mortality Weekly Report



CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

OCTOBER 15, 1966 AND OCTOBER 16, 1965 (41st 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... 80 68 6 38 47 5 6 2 22 573 644

NEW ENGLAND........... 8 6 4 1 23 29
Maine............... 5 6
New Hampshire...... 1 1
Vermont............ 3
Massachusetts...... 5 6 4 1 10 8
Rhode Island....... 2 3
Connecticut........ 1 4 11

MIDDLE ATLANTIC...... 7 3 4 12 1 11 88 102
New York City...... 2 2 1 6 7 16 39
New York, Up-State. 2 1 26 13
New Jersey.......... 2 1 4 -- 4 15 16
Pennsylvania....... 1 1 1 2 1 31 34

EAST NORTH CENTRAL... 5 12 10 8 1 111 154
Ohio................ 4 10 4 26 46
Indiana............ 1 1 6 4
Illinois........... 1 4 2 19 30
Michigan........... 1 4 52 67
Wisconsin .......... 3 1 8 7

WEST NORTH CENTRAL... 1 9 3 4 1 41 30
Minnesota.......... 1 3 1 1 11 9
Iowa................ 6 1 9 4
Missouri........... 1 -- 12 5
North Dakota....... 4 2
South Dakota....... 2
Nebraska............. 6
Kansas............. 2 3 4

SOUTH ATLANTIC....... 6 1 2 7 8 1 2 44 72
Delaware........... 1 -
Maryland........... 1 1 9 10
Dist. of Columbia.. -
Virginia............ 2 1 1 5 6 20
West Virginia...... 3 10
North Carolina..... 1 5 4
South Carolina..... 4
Georgia............. 11 5
Florida............ 2 7 2 1 1 10 18

EAST SOUTH CENTRAL... 5 13 I 1 42 57
Kentucky............ 12 13 21
Tennessee........... 1 20 19
Alabama............. 5 7 4
Mississippi........ 2 13

WEST SOUTH CENTRAL... 15 8 5 7 5 1 50 45
Arkansas........... 1 8 4
Louisiana.......... 1 3 1 2 1 4 14
Oklahoma........... -
Texas.............. 15 7 2 6 1 38 27

MOUNTAIN............. 2 2 1 35 24
Montana............ 1 2 4
Idaho.............. 1 1
Wyoming ...........
Colorado........... 3 2
New Mexico......... 1 21 7
Arizona............. 5 8
Utah............... 3 1
Nevada ............. 1

PACIFIC.............. 31 16 1 9 3 2 1 7 139 131
Washington ......... 1 1 4 5
Oregon.............. 2 1 20 5
California......... 28 15 1 7 2 2 7 112 119
Alaska.............. 3 1
Hawaii ............. 2 -

Puerto Rico.......... 31 37









333:


lMorbiditv and Mortality Weekly Report


CASES OF SPECIFIED NOTIFIABLE DISEASES: IUNITEI) STATES

FOR WEEKS FNDI)l)

O(CTOBR 15, 1966 AND OC(IOBER 16, 1965 (lst WIFK) CONTINI ID)


MEASLES (Rubeola)


AREA


i I .' II ,

NEW ENGIAND.......... 3
Maine.............. 10
New Hampshire......
Vermont............ 27
Massachusetts......
Rhode Island ....... -
Connecticut ........

MIDDLE ATLANTIC...... 13
New York City...... 7
New York, Up-State. 11
New Jersey......... 7
Pennsylvania....... 8

EAST NORTH CENTRAL... 109
Ohio ............... 5
Indiana ............ 18
Illinois........... 8
Michigan............ 43
Wisconsin.......... 35

WEST NORTH CENTRAL... 20
Minnesota ..........
Iowa............... 11
Missouri........... 1
North Dakota....... 8
South Dakota.......
Nebraska ..........
Kansas ............. NN

SOUTH ATLANTIC......... 40
Delaware ..........
Maryland ..........
Dist. of Columbia.. 1
Virginia.......... 8
West Virginia..... 12
North Carolina..... 5
South Carolina.....
Georgia............ -
Florida............ 13

EAST SOUTH CENTRAL... 63
Kentucky............ 4
Tennessee .......... 51
Alabama............. 4
Mississippi........ 4

WEST SOUTH CENTRAL... 99
Arkansas............
Louisiana ..........
Oklahoma........... 2
Texas.............. 97

MOUNTAIN............ 63
Montana............. 6
Idaho.............. 38
Wyoming............. 2
Colorado............ 3
New Mexico......... 4
Arizona............. 10
Utah...............
Nevada..............

PACIFIC.............. 215
Washington.......... 105
Oregon.............. 6
California.......... 99
Alaska............. 5
Hawaii............. -
Puerto Rico........... 61


Cumulat ive
1966 19



2,329 36
225 2
80
266 1
788 19
72 3
898 9

18,097 15
8,302 2
2,549 4
1,862 2
5,384 5

69,053 56
6,365 8
5,734 1
11,384 2
14,600 26
30,970 16

8,744 16
1,643
5,327 9
533 2
1,124 3
40
77
NN

15,398 25
257
2,111 1
384
2,188 4
5,340 13
500
658 1
234
3,726 3

19,847 14
4,736 2
12,384 7
1,698 2
1,029 1

24,841 31
971 1
99
494
23,277 29

12,087 19
1,838 3
1,625 2
168
1,321 5
1,137
5,312 1
641 4
45

21,094 27
3,816 7
1,849 3
14,747 13
540
142 3

2,915 2


MENINGOCOCCAL INFECTIONS,
TOTAL

Cu mul at ive
1966 1966 T 1965


,907
,821
381
,301
,305
,940
,159

,035
,469
,164
,657
,745

,367
,911
,960
,804
,643
,049

,677
698
,052
,595
,765
115
452
NN

,340
506
,170
78
,108
,960
395
,058
617
,448

,136
,690
,991
,335
,120

,105
,085
109
210
,701

,898
,746
,804
851
,696
677
,350
,568
206

,733
,283
,303
,080
187
,880

,504


Total


POLIOMYELITIS
RUBELLA
Paralytic
Cumulat ive
1965 1966 1966 1966

202

32
9


6
-- 6

13

14
7


55


3 14 10 1 1









354 Morbidity and Mortality Weekly Report


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

OCTOBER 15, 1966 AND OCTOBER 16, 1965 (41st WEEK) CONTINUED


STREPTOCOCCAL TYPHUS FEVER RABIES IN
SORE THROAT & TETANUS TULAREMIA TYPHOID TICK-BORNE ANIMALS
AREA SCARLET FEVER (Rky. Mt. Spotted)
1966 1966 Cum. 1966 Cum. 1966 Cum. 1966 Cum. 1966 Cum.
1966 1966 1966 1966 1966
UNITED STATES... 5,906 5 151 2 136 11 307 4 223 57 3,287

NEW ENGLAND.......... 945 4 1 10 3 1 76
Maine .............. 17 25
New Hampshire...... 12 1 26
Vermont........... 59 -- 22
Massachusetts...... 196 2 1 6 1 3
Rhode Island....... 72
Connecticut....... 589 2 4 2

MIDDLE ATLANTIC...... 96 13 1 52 41 2 200
New York City...... 10 5 22 1
New York, Up-State. 84 2 11 13 2 187
New Jersey......... NN 2 7 12
Pennsylvania....... 2 4 1 12 16 12

EAST NORTH CENTRAL... 401 17 18 2 39 17 11 431
Ohio..... ......... 47 4 3 2 19 9 192
Indiana............ 48 4 8 4 2 93
Illinois........... 115 3 6 4 8 4 61
Michigan........... 131 4 6 3 37
Wisconsin.......... 60 2 1 6 2 48

WEST NORTH CENTRAL... 291 1 11 16 1 28 4 15 737
Minnesota.......... 4 2 4 168
Iowa............... 142 1 2 5 -- 2 145
Missouri........... 1 6 10 13 3 6 227
North Dakota....... 74 1 1 37
South Dakota....... 2 2 1 80
Nebraska........... 2 2 1 22
Kansas............. 68 1 2 1 7 1 58

SOUTH ATLANTIC....... 511 1 32 1 11 56 2 107 4 422
Delaware........... 12 I 2
Maryland........... 21 3 1 9 26 3
Dist. of Columbia.. 4 2 -
Virginia........... 201 1 6 2 13 31 3 219
West Virginia...... 190 1 1 49
North Carolina..... 17 4 -3 6 1 27 4
South Carolina..... 22 2 -1 11 5
Georgia............ 2 7 1 3 4 1 16 91
Florida............. 42 10 9 1 56

EAST SOUTH CENTRAL... 1,217 18 1 21 4 40 2 39 7 421
Kentucky............ 134 2 2 4 10 9 2 89
Tennessee.......... 897 3 1 12 19 2 24 4 291
Alabama............ 114 7 4 6 6 20
Mississippi........ 72 6 3 5 1 21

WEST SOUTH CENTRAL... 590 3 37 60 2 31 8 10 671
Arkansas........... 6 4 46 2 2 3 76
Louisiana.......... 1 9 3 2 10 42
Oklahoma........... 40 2 7 9 5 1 169
Texas............. 544 2 22 -4 10 1 6 384

MOUNTAIN ............. 910 2 6 13 3 4 87
Montana............. 50 2 7
Idaho ... ... ...... 99 -
Wyoming ............ 40 -
Colorado............ 292 2 3 2 1 18
New Mexico......... 281 1 2 1 -13
Arizona............. 63 1 4 2 38
Utah............... 85 2 3 3
Nevada............. 1 1 8

PACIFIC............... 945 17 3 1 38 1 3 242
Washington......... 366 11 13
Oregon............. 26 1 1 4
California......... 466 16 3 1 24 1 3 225
Alaska.............. 12 -
Hawaii.............. 75 2
Puerto Rico.......... 8 44 3 14 16









353


Morbidity and Mortalily I ekklN Report






DEATHS IN 122 UNITED STATES CITIES FOR WEEK ENDED OCTOBiER 15. 196(


(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 and 1 year
Ages and over Influenza All Ages and over Influenza All
All Ages Causes All Ages Causes


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

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

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

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


775
259
45
27
29
53
41
18
28
46
68
12
60
28
61

3,231
42
30
154
33
39
39
50
88
1,732
47
392
163
53
111
39
38
53
58
35
35

2,546
52
38
730
180
219
127
70
374
34
53
57
36
63
122
25
130
30
28
30
100
48

814
59
31
40
116
17
112
85
226
77
51


472
157
27
20
18
24
32
11
20
30
36
8
35
19
35

1,910
18
18
92
20
20
25
25
42
1,033
27
205
94
39
80
30
26
36
32
27
21

1,447
29
23
409
95
139
76
43
200
20
26
32
10
40
75
18
78
14
13
16
59
32

505
43
18
18
71
12
76
54
134
49
30


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


1,139
137
210
43
81
97
46
78
24
75
82
222
44

652
110
44
39
141
124
53
49
92

1,079
35
19
32
153
41
68
214
55
148
87
117
43
67

380
46
14
104
19
78
21
47
51

1,298
24
62
12
38
85
273
90
22
105
66
100
184
31
109
54
43


Total 11,914 6,819 434 614

Cumulative Totals
including reported corrections for previous weeks

All Causes, All Ages ------------------------ 514,532
All Causes, Age 65 and over------------------- 294,841
Pneumonia and Influenza, All Ages------------- 21,461
All Causes, Under 1 Year of Age--------------- 27,368


Week No.








356


Morbidity and Mortality Weekly Report


EPIDEMIOLOGIC NOTES AND REPORTS
BOTULISM California
(Con/inued from front page)


The two adult patients, both of whom required tra-
cheostomies, initially received antitoxin A and B. Later
all three patients were given antitoxin E, but the adults
were allergic to horse serum and had to be desensitized.
The child responded to antitoxin E and was subsequently
discharged from the hospital; the two adults have shown
improvement. Of the 17 others at risk, 7 were given
prophylactic antitoxin; all have remained well.
The deer had been shot and killed by the patrolman
on September 29 near Riverton, California. Meat taken
from the animal that afternoon was sliced into thin strips
and refrigerated. The following day, the strips were
smeared with four commercial ingredients used to prepare
cured smoked meat, and then placed in 8 to 9 inch layers
in a plastic dishpan before being refrigerated for 24 hours.
For the next 2 days, slices of the cured meat were
smoked in an electrically heated chamber using wood
chips for smoke. On October 3 the venison was placed in
cloth bags which remained at room temperature for 4 days.
There was no history of ingestion of home-canned
foods or of any seafood products during the week pre-
ceding the outbreak.
Samples of the venison are currently being cultured
at the California State Department of Public Health
Laboratory and at Laboratory Branch at the Communicable
Disease Center.
(Reported by Dr. Philip K. Condit, Chief, and Dr. Henry
A. Renteln, California State Department of Public Health;
and an EIS Officer.)


THE MORBIDITY AND MORTALITY WEEKLY REPORT, WITH A CIRCULA-
TION OF 15.600, IS PUBLISHED. AT THE COMMUNICABLE DISEASE
CENTER, ATLANTA. GEORGIA
CHIEF. COMMUNICABLE DISEASE CENTER DAVID J. SENCER, M.D.
CHIEF, EPIDEMIOLOGY BRANCH A.D. LANGMUIR. M.D.
ACTING CHIEF. STATISTICS SECTION IDA L. SHERMAN. M.S.
IN ADDITION TO THE ESTABLISHED PROCEDURES FOR REPORTING
MORBIDITY AND MORTALITY, THE COMMUNICABLE DISEASE CENTER
WELCOMES ACCOUNTS OF INTERESTING OUTBREAKS OR CASE INVES-
TIGATIONS WHICH ARE OF CURRENT INTEREST TO HEALTH OFFICIALS
AND WHICH ARE DIRECTLY RELATED TO THE CONTROL OF COM-
MUNICABLE DISEASES. SUCH COMMUNICATIONS SHOULD BE ADDRESSED
TO:
THE EDITOR
MORBIDITY AND MORTALITY WEEKLY REPORT
COMMUNICABLE DISEASE CENTER
ATLANTA, GEORGIA 30333
NOTE: THE DATA IN THIS REPORT ARE PROVISIONAL AND ARE
BASED ON WEEKLY TELEGRAMS TO THE CDC BY THE INDIVIDUAL
STATE HEALTH DEPARTMENTS. THE REPORTING WEEK CONCLUDES
ON SATURDAY; COMPILED DATA ON A NATIONAL BASIS ARE RELEASED
ON THE SUCCEEDING FRIDAY.


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DEPOSITORY


OCTOBER 15, 1966


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