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:
AA00010654:00290

Related Items

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

Full Text





J



VM W


COMMUNICABLE DISEASE CENTER
A /


SVol. 15, No. 6







Week Ending
February 12, 1966




EDUCATION, AND WELFARE PUBLIC HEALTH SERVICE


SAEASLE ONTONAGON COUNTY, MICHIGAN

During the fall of 1965 there was an outbreak of
measles in Ontonagon County which affected five of the
seven elementary schools. The population of the County
is 10,584 and the total enrollment in the seven schools is
3,027 children; of these 1,060 are in kindergarten through
third grades. The onset of the earliest case of measles
reported was on September 10 and there were peaks of
incidence thereafter in early and late October. One case
of measles encephalitis is known to have occurred. The
epidemic curve of the outbreak of measles in Ontonagon
County is shown in Figure 1.
As two of the elementary schools were still unaffected
by the first week in December, it was decided to try to


CONTEN TS
Measles Ontonagon County . 11
Current Trends
Meningococcal Infection U.S .. . 13
Meningococcal Infection Armed Force, in th I .S. 1:
Influenza U .S. . .. . .. .. i
International Notes Influenza . ..... .... 45


prevent the spread of measles to these schools by immun-
izing the susceptible children.
Before starting the immunization, inquiries were
made through a telephone survey of 31 families known to
have had one or more cases of measles during the previous
3 months. There were 106 children in these families of
whom 77 neither had had measles nor had been vaccinated
(Continued on page 42)


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous weeks)
6th WEEK ENDED CUMULATIVE. FIRST 6 WEEKS
MEDIAN
DISEASE FEBRUARY 12, FEBRUARY 13, 1961-1965 MEDIAN
1966 1965 1966 1965 1961-1965
Aseptic meningitis ............... .. ...28 25 22 156 173 145
Brucellosis ............................ 7 3 9 23 22 31
Diphtheria............... ........ ....... 4 3 6 16 18 35
Encephalitis, primary:
Arthropod-borne & unspecified .......... 24 --- 137 174
Encephalitis, post-infectious ............. 12 '- -- 76 76
Hepatitis, serum ...... ........ ..19 -- 7 ( 121 4791 606
Hepatitis, infectious ................... 710 1285 4,190 4791 606
Measles rubeolaa) ....................... 7,083 8,237 11,214 33,011 42.629 51,041
Poliomyelitis, Total (including unspecified) 1 5 2 1 24
Paralytic ....... ........... ...... I 2 1 1 20
Nonparalytic ..........................- -
Meningococcal infections, Total .......... 87 70 60 437 386 328
Civilian ...................... ......... 66 69 386 371
Military ................................ -21 51 15 -
Rubella (German measles) ................ 1,337 5,505 --- --
Streptococcal sore throat & Scarlet fever .. 11,486 1,3 10,963 58,136 62,769 54,110
Tetanus ................... .... ...... 3 "- 11 20
Tularemia ........ ..... .. ........... 6 23 37 -
Typhoid fever ......................... 4 6 6 29 39 41
Typhus, tick-borne (Rky. Mt. Spotted fever) -- 7 6 -

Rabies in Animals ...................... 92 99 73 436 574 374

NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax: .......... ........ ........ .. ....... Botulism: ............ .... .............. ... 1
Leptospirosis: N.J.-2 ........... .......... ... ... 3 Trichinosis: N.J.-1. .. .. ........... ... ..... 14
Malaria: NYC-1, Md.-l, Pa.-6, Fla.-1 ................... 35 Rabies in Man: ........ ..................
Psittacosis: ........................................ 6 Rubella, Congenital Syndrome: Colo.- ..... .......... 2
Typhus, murine: NYUp-State-1 ......................... 1 ....... ... ............ .............






Morbidity and Mortality Weekly Report



MEASLES ONTONAGON COUNTY, MICHIGAN
(Continued from front page)


Figure 1
MEASLES EPIDEMIC, ONTONAGON COUNTY, MICHIGAN 1965
Cases by Week of Onset


FEBRUARY 12, 1966


WEEK ENDING 10 17 24 1
SEPTEMBER


15
OCTOBER


against it prior to September 1965. It was found that
children in only 2 of the 31 families had had measles
vaccine. Of the susceptible 77 children, 59 subsequently
contracted measles during the outbreak; 22 of these were
pre-school children.
In the two elementary schools not affected by the
beginning of December, there were 267 children enrolled
in kindergarten through third grades. Live attenuated
measles vaccine was given to 110 of these on December
9; the vaccine was then given on the following day to
145 pre-school children in these two school districts.
During the succeeding week 30 additional susceptible


29 5 12 19
NOVEMBER


10 17
DECEMBER


children in a third district which had been affected earlier
were also immunized.
No severe reactions to the measles vaccine have
been reported. Since this immunization campaign only
four cases of measles have been notified in the two
school districts; they occurred in two families among
unimmunized pre-school children.

(Reported by Dr. George Agate, Director of Epidemiology,
Michigan Department of Health; Mrs. Marion Davison,
Public Health Nurse, Ontonagon County Health Depart-
ment, Michigan; and an EIS Officer.)







FEBRUARY 12, 1966


Morbidity and Mortality Weekly Report


CURRENT TRENDS
MENINGOCOCCAL INFECTION U.S.


A total of 3,039 cases of meningococcal infection
has been reported in the United States during the year
1965. This is an increase of 6 percent over the total for
1964 and 38.3 percent more than the median for 1960-64
(Figure 2).
Through the sixth week of 1966 there has been a
total of 437 cases reported by State Health Departments
to the Communicable Disease Center. The comparable
totals for 1964 and 1965 are given in Table 1. Excluding
the military cases reported in the 1966 column of this

Figure 2
MENINGOCOCCAL INFECTIONS BY WEEK OF REPORT
1965 AND MEDIAN, 1960-64, UNITED STATES


1401


o 0


S40o

20.


1965








1
V,


table it is evident that during this 6-week period the
incidence of cases ofmeningococcal infection in civilians
is not more than would be expected for the time of year.
The incidence in the Armed Forces, however, which is
recorded below, shows a marked increase over that for
the comparable period in 1965.

(Reported by the Investigations Section, Epidemiology
Branch, CDC.)



Table 1
MENINGOCOCCAL INFECTIONS UNITED STATES
Total Cases Reported to CDC
1st Through 6th Week, 1964 to 1966

1964 1965 1966


United States ....
New England .
Middle Atlantic .
East North Central
West North Central
South Atlantic ..
East South Central
West South Central
Mountain ......
Pacific .......


386(15)*
22
53
51
18
85
24
50
8
75


437(51)*
24
71
72
20
74
30
47
20
79


JAN FE8 MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
MONTH


*Cases in Armed Forces, reported through State Health
Departments.


MENINGOCOCCAL INFECTION ARMED FORCES IN THE U.S.A.
January 1 through February 14, 1966


Information received direct from the Armed Forces
concerning meningococcal infections since January 1,
1966, among new recruits indicates that there has not
been any unusual increase in incidence among Navy and
Marine personnel. However, there has been an outbreak of
meningitis at the Lackland Air Force Base, Texas, and,
in the southeastern part of the United States, six Army
bases have reported an increased incidence of cases.
The current incidence among new recruits in the
Navy and Marines is not above the seasonal expectation.
Since January 1 a total of 7 cases with two deaths have
occurred; two separate bases were involved. Meningo-
coccus carrier studies in recruits have revealed carrier
rates on enlistment that are slightly higher than those of
previous years. The range has been from 12 to 27 percent.
Over 50 percent of the strains isolated from these car-
riers have been group B sulfonamide-resistant strains.


Ten cases among recruits with one death have been
reported by the Air Force. Seven of the cases and the
one death were at the Lackland Air Force Base. These
cases all occurred during the week of February 7th; the
other three cases were sporadic, each being reported
from a different base.
In the Army the increase in cases began in December
1965, primarily in six bases in the southeastern part of
the country, and appears to be related to a significant
increase in the number of new recruits. In January there
were 22 cases and one death at these six bases where,
during the first 2 weeks of February, there have been an
additional 38 cases with one death. Two of the latter
cases were in civilian personnel. At all other Army
bases throughout the continental U.S. there have been
25 cases reported in January and 9 cases with one death
reported in February. (Continued on page U4)
















The current trend for the Army can be seen from the
following summary data from all Army bases in the conti-
nental United States:
1964 1965 1966
December 28 65
Through first 6 weeks -- 33 94*
*Including 2 civilian personnel.


FEBRUARY 12, 1966


(Reported by Captain Jack W. Millar, Director, Preventive
Medicine Division, Bureau of Medicine and Surgery, De-
partment of the Navy; Colonel Franklin L.Bolling, Chief,
Military Public Health and Occupational Medicine, De-
partment of the Air Forces; and Colonel Adam J.
Rapalski, Chief, Preventive Medicine Division, Depart-
ment of the Army.)


CURRENT TRENDS
INFLUENZA United States


Type B influenza, first identified in a number of
areas as school-centered outbreaks, has now been
reported from four States along the Atlantic coast (Georgia,
Massachusetts, Florida, and Rhode Island). An influenza-
like illness with similar epidemiological and clinical
patterns is being investigated in California and Maine.
Pneumonia-influenza deaths which are reported
weekly to the CDC by 122 U.S. cities do not parallel the
evident prevalence of influenza in some parts of the
Country. In the New England and South Atlantic Divisions,
mortality data for the week ending February 12 are
slightly above the "epidemic threshold" for the first
time in recent weeks but this can be intrepreted only as
a trend unless and until it is shown to be sustaineU in
future weeks (See Figures 3 and 4, pp 46 and 47).
(Reported by the Influenza-Respiratory Disease Unit,
CDC.)


Georgia
Type B influenza was reported in Claxton, Georgia,
during December 1965 (MMWR, Vol. 15, No. 3). Since
then, an influenza-like illness has been observed in the
Atlanta metropolitan area. The Atlanta outbreak, first
recognized through increased school absenteeism, appears
to involve primarily school-age children. The commonly
observed illness is mild, with fever, headache and
malaise; it is not infrequently associated with sore
throat, nausea and vomiting.
The attack rate of acute febrile respiratory disease
noted in a survey of one Atlanta school was 21 percent.
Laboratory studies are underway.
(Reported by Dr. John McCroan, Chief Epidemiologist,
Georgia Department of Public Health; and EIS Officers
from the CDC.)


Massachusetts
Outbreaks of type B influenza in the eastern half of
the State (MMWR, Vol. 15, Nos. 3 and 5) are declining.


However, spread to the western half is becoming evident
as measured by school absentee rates in scattered areas
of up to 20 percent. In the Boston metropolitan area
evidence of influenza has decreased, but in Worcester
increasing school absentee rates and absenteeism of
up to 15 percent of employees in certain industries
have been reported.
In many areas visits to emergency wards and to
hospital outpatient departments suggest the likely in-
volvement of adults in the outbreak. Hospital admissions
for pneumonia are likewise reported to have increased
above the average for the time of year.
(Reported by Dr. Nicholas J. Fiumara, Director, Division
of Communicable Disease, Department of Health, Boston,
Massachusetts.)


Florida
An influenza-like illness first noted in Orange and
Hillsborough Counties in Florida during early November
1965 is still continuing to occur in certain parts of the
State. The most heavily involved areas are in Lake and
Orange Co.'unii.-, including the city of Orlando. Not
quite so seriously affected are Hillsborough County and
the city of St. Petersburg. Apart from a low level of
incidence in Dade County, including Miami, the east
coast of Florida has been notably free from the illness.
The illness has affected all age groups with the
exception of the St. Petersburg outbreak which involved
primarily high-school-age children and caused an absentee
rate of 25 percent.
Strains of type B influenza virus have been isolated
from specimens collected from patients in Hillsborough
County. In Dade and Collier Counties type B influenza
has been confirmed through serological studies. Pre-
liminary laboratory studies indicate that the St. Petersburg
school outbreak was also due to type B influenza.

(Reported by Dr. E. Charlton Prather, Epidemiologist,
Florida State Board of Health.)


Morbidity and Mortality Weekly Report



MENINGOCOCCAL INFECTION ARMED FORCES IN THE U.S.A.
January 1 through February 14, 1966
(Continued from page 43)











Rhode Island
A febrile illness subsequently confirmed by lab-
oratory studies as being due to type B influenza virus,
was first noted in Rhode Island during late January of
this year. During the first 2 weeks of February the
reported incidence of influenza-like illness has already
reached the level reported for the whole of February 1965.
The southwestern portion of the State is reported to be
more h-ea~ili affected, particularly the towns of South
Kingston, Richmond, Charleston and Hopkinton. In
Providence and Pawtucket, starting- in the last week of
January, there was an absentee rate in junior high and
high schools of greater than 25 percent. In other areas
of the State, the unusual numbers of children absent from
schools indicate a more generalized epidemic. So far,
observations indicate that school-age children are
predominantly affected.
Paired sera obtained from three adult patients with
this influenza-like illmnss, who were admitted to hospital
in Providence, have shown significant rises in complement
fixation titers for type B influenza.
(Reported by Dr. James E. Bowes, State Epidemiologist,
Rhode Island Department of Health.)


California
Outbreaks of an influenza-like illness are under in-
vestigation in many parts of the State. Predominantly
school-centered and first reported in the town of Indio
southeast of Los Angeles, outbreaks have since been
recognized in areas of Santa Cruz, Santa Clara, Ventura,
Los Angeles, Sacramento, San Mateo and Alameda
Counties.
Clinically the illness is characterized by an acute
onset with high fever, headache, pharyngitis, malaise,
myalgia and non-productive cough. Gastrointestinal com-


plaints have not been common features. Both the elemen-
tary and secondary schools have experienced elevated
absentee rates. There has been little evidence of rising
absenteeism in industry.
Increased numbers of visits to emergency wards and
outpatient clinics have been reported, although general
hospital admissions have not been influenced noticeably.
Reported influenza and pneumonia mortality in the larger
cities of the State are not above the seasonal expectation.
Virus isolation procedures and serological studies
are underway.
(Reported by Dr. Henry Renteln, California State Depart-
ment of Public Health; and an EIS Officer.)


Maine
Beginning early in February, increasing absenteeism
in widely scattered schools has been related to an in-
fluenza-like illness. The schools in Washington County
along the northern Maine coast, particularly in the
Machias area, have been affected; some schools have
been closed temporarily because of the numbers of
children absent.
In Waterville, north of Augusta, the current i;hi
school absentee rate is reported to be around 20 percent.
Students at the University of Maine in Orono are also
affected by similar influenza-like illness. As judged by
the level of absences from industry in the areas involved,
the adult population has not been noticeably affected
by the illness.
Laboratory studies of specimens from typical cases
are in progress but an etiologic agent has not yet been
identified.
(Reported by Dr. Dean Fisher, Commissioner and Acting
Director of Health and State Epidemiologist, Maine
Department of Health and Welfare.)


INTERNATIONAL NOTES
INFLUENZA


Since October 1965 laboratory confirmed influenza
outbreaks have been reported from six countries in addi-
tion to the United States: Czechoslovakia, Hungary,
Romania, Great Britain, the Netherlands, and Thailand.
Based on reports published in the WHO Weekly Epidemio-
logical Record, the first four of these six countries have
experienced type B influenza, Great Britain, both type
A2 and B, and Thailand, type A2 alone. The outbreaks in
Czechoslovakia, Hungary, and Romania, all identified by
repeated isolations of type B influenza virus and sero-
logical tests, may represent regional spread of the illness.

Czechoslovakia
Beginning in the second half of September, localized
cases of influenza were reported from several areas of
Czechoslovakia, particularly Eastern Slovakia. During the


succeeding 2 months, the outbreak gradually moved
westward to involve Moravia and Bohemia. Type B virus
was isolated in numerous areas and serological confir-
mations of infection were likewise obtained in various
outbreaks. The disease was mild, was noted to affect
children predominantly, and occurred in circumscribed
epidemics.

Hungary
In the last week of October, an increased incidence
of mild influenza-like disease was noted in the towns of
Kaposvar and Csongrad in southern Hungary. Several
strains of type B influenza virus were recovered in the
former town and serological identification of influenza
type B was made elsewhere. Spread to the north and east
(Continued on page 52)


FEBRUARY 12, 1966


Morbidity and Mortality Weekly Report








Morbidity and Mortality Weekly Report


Figure 3
PNEUMONIA-INFLUENZA DEATHS IN 122 UNITED STATES CITIES





PNEUMONIA-INFLUENZA DEATHS IN 122 UNITED STATES CITIES


ALL
CITIES


700-



500 -

400-

300-

WEEK NO 40 44 48 52 4 8 12 16 20 24 28 32 36 40 44 4 53 4 8 12 16 20 24 28 32 36 40 44 48 52 4 8 12 16 20 24 28 32 36
WK ENDEO 5 2 30 28 25 22 21 18 16 13 II 8 5 3 31 28 2 30 27 2 24 22 19 17 14 II 9 6 4 1 29 26 26 23 21 16 13 10
MONTH 0 N D J F M A M J J AS 0 N D J F M A M J J A S ON D J F M AM J J A S
196311964 196411965 196511966


WN.
CENTRAL 20(
10 CITIES
15(

10(




4. 4 I.. l I.1, .1 .* la I
40 44 48 52 4 8 12 16 20 24 28 32
1965 11966


40 44 48 52 4 8 12 16 20 2428 32 40 44 48 52 4 8 12 16 20 24 28 32 36
1965 1966 1965 11966


MOUNTAIN
8 CITIES


E.S
CENTRAL
8 CITIES


150


50-



40 44 48 52 4 B 12 16 20 24 28 32 40 4448 52 4 12 16 20 24 28 32
1965)1966 196511966


PACIFIC
16 CITIES


W.S.
CENTRAL
13 CITIES


00 100 100


--50
50-0 50



WK NO 40 44 4 52 4 8 12 16 20 2428 32 40 44 46 52 4 8 12 16 20 24 28 32
196511966 1965 1966


MIDDLE
ATLANTIC
20 CITIES











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

SOUTH
ATLANTIC
12 CITIES











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


FEBRUARY 12, 1966







FEBRUARY 12, 1966


16,000-


Morbidity and Mortality Weekly Report




Figure 4
MORTALITY IN 122 UNITED STATES CITIES





MORTALITY IN 122 UNITED STATES CITIES


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
WKIENOED 25 22 21 18 13 II 8 5 3 31 28 2 30 27 27 24 22 19 17 14 1I 9 6 4 1 29 26266 221 18 16 13 10 8 5 3 31
MONTH J F MA M J J A S 0 NO J F M A M J J A S 0 N 0 J F M A M J J A S 0 N D
1964 1965 1966









48 Morbidity and Mortality Weekly Report



CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

FEBRUARY 12, 1966 AND FEBRUARY 13, 1965 (6th WEEK)


ENCEPHALITIS HEPATITIS
ASEPTIC Primary Post- Both
AREA MENINGITIS BRUCELLOSIS including Infectious DIPHTHERIA Serum Infectious Types
unsp. cases
1966 T 1965 1966 1966 1965 1966 1966 1965 1966 1966 1965
UNITED STATES... 28 25 7 24 22 12 4 3 19 710 770

NEW ENGLAND.......... 2 3 2 1 1 30 42
Maine.............. 10 8
New Hampshire...... 3 5
Vermont.............. 1
Massachusetts...... 2 1 1 1 8 18
Rhode Island....... 2 1 8 6
Connecticut........ 1 4

MIDDLE ATLANTIC...... 2 5 7 2 2 1 10 104 99
New York City...... 1 3 2 5 19 23
New York, Up-State. 1 1 27 46
New Jersey.......... 1 2 5 14 9
Pennsylvania....... 1 3 1 1 1 44 21

EAST NORTH CENTRAL... 1 2 4 4 2 1 1. 121 187
Ohio................ 2 30 58
Indiana............ 14 13
Illinois........... 1 2 2 1 24 25
Michigad........... 2 3 1 46 90
Wisconsin.......... -- 7 1

WEST NORTH CENTRAL... 1 1 4 1 5 29 35
Minnesota.......... 1 2 9 4
Iowa................. 4 14
Missouri........... i 1 1 6 8
North Dakota.... -
South Dakota.... 1
Nebraska............ 2 -- 1
Kansas............. 1 3 9 7

SOUTH ATLANTIC ...... 4 9 1 3 8 1 3 2 59 79
Delaware ........... 1 5
Maryland........... 1 16 14
Dist. of Columbia.. 1 -
Virginia........... 1 I 1 9 8
West Virginia...... 1 6 15
North Carolina..... 3 13 6
South Carolina..... 1 1 1 7
Georgia............. 1 -
Florida............ 2 8 7 2 1 12 24

EAST SOUTH CENTRAL... 7 1 1 2 1 66 68
Kentucky.......... 4 1 2 26 19
Tennessee.......... 27 34
Alabama............ 3 1 4 9
Mississippi....... -- 1 9 6

WEST SOUTH CENTRAL... 5 1 1 1 64 75
Arkansas........,... 1 8 23
Louisiana........... 1 6 15
Oklahoma............ 1 4 1
Texas............... 4 1 46 36

MOUNTAIN............. 1 2 1 46 59
Montana............ 1 3 4
Idaho............... 7
Wyoming............ 2 4
Colorado......... .. 1 1 15 11
New Mexico......... 13 9
Arizona............ I 9 20
Utah............... 4 4
Nevada............. -

PACIFIC.............. 8 4 1 3 3 5 191 126
Washington......... 18 8
Oregon ............ 29 10
California.......... 8 3 1 3 3 5 143 93
Alaska............. 1 15
Hawaii............. -

Puerto Rico.......... 9 32
-i -I -1 9 32








Morbidity and Mortality Weekly Report 49


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

FEBRUARY 12, 1966 AND FEBRUARY 13, 1965 (6th WEEK) Continued


MENINGOCOCCAL INFECTIONS, POLIOMYELITIS
MEASLES (Rubeola) TOTAL Total c RUBELLA
Total Paralytic
AREA
Cumulative Cumulative Cumulative
1966 1966 1966 1965 1966 1966 1966
1966 1965 1966 1965 1966
UNITED STATES... 7,083 33,011 42,629 87 437 386 1 1 1 1 1,337

NEW ENGLAND.......... 87 459 10,876 4 24 22 160
Maine............... 9 48 1,222 5 2
New Hampshire...... 5 184 7 1 5
Vermont............ 19 136 105 1 -
Massachusetts...... 48 159 6,430 2 8 10 93
Rhode Island....... 3 32 1,277 2 2 9
Connecticut......... 8 79 1,658 2 6 4 44

MIDDLE ATLANTIC...... 1,137 5,056 1,483 9 71 53 76
New York City...... 595 2,559 174 14 11 41
New York, Up-State. 170 599 521 3 15 10 35
New Jersey.......... 118 447 238 4 23 23
Pennsylvania....... 254 1,451 550 2 19 9

EAST NORTH CENTRAL... 2,694 13,087 7,564 15 72 51 342
Ohio................ 107 711 1,378 4 24 16 29
Indiana............. 68 471 328 2 7 7 31
Illinois........... 466 2,617 230 7 13 13 24
Michigan........... 475 2,130 4,156 1 19 8 117
Wisconsin.......... 1,578 7,158 1,472 1 9 7 141

WEST NORTH CENTRAL... 328 1,311 3,381 3 20 18 72
Minnesota.......... 111 519 55 2 5 3 8
Iowa............... 165 439 1,882 4 56
Missouri ........... 16 81 347 6 9
North Dakota ..... 30 255 983 3 8
South Dakota........ 2 23 1 1
Nebraska........... 6 15 91 1 1 -
Kansas............. NN NN NN 3 2

SOUTH ATLANTIC....... 458 2,889 5,993 9 74 85 41
Delaware........... 6 41 79 2 3
Maryland........... 131 521 116 8 5 6
Dist. of Columbia.. 30 129 9 3 -
Virginia............ 34 220 829 2 7 13 3
West Virginia...... 220 1,411 4,377 3 6 17
North Carolina..... 2 37 101 4 17 13
South Carolina..... 17 132 55 1 14 8 1
Georgia............. 34 161 5 15
Florida............. 18 364 266 2 20 20 11

EAST SOUTH CENTRAL... 990 4,320 2,109 15 30 24 190
Kentucky ........... 436 1,772 156 11 16 7 142
Tennessee.......... 503 2,395 1,388 2 10 10 47
Alabama............. 40 81 407 1 3 7 1
Mississippi........ 11 72 158 1 1 -

WEST SOUTH CENTRAL... 585 2,233 4,157 14 47 50 1 1 1 1 1
Arkansas........... 1 24 142 1 5 4 1
Louisiana........... 7 25 8 1 9 20 -
Oklahoma........... 11 21 38 2 6 1 1 1
Texas............... 566 2,163 3,969 12 31 20 -

MOUNTAIN............. 357 1,474 3,569 6 20 8 201
Montana............ 22 255 1,252 2 3
Idaho.............. 224 540 56
Wyoming............. 2 21 95 1 1- -
Colorado............. 40 149 489 3 13 3 13
New Mexico......... 4 86 1 1 -
Arizona.............. 276 764 95 2 2 2 127
Utah................ 17 53 1,006 1 2
Nevada............. 4 6 1 -

PACIFIC.............. 447 2,182 3,497 12 79 75 254
Washington.......... 102 636 942 5 108
Oregon.............. 40 220 651 3 6 28
California......... 295 1,294 1,467 12 61 68 104
Alaska.............. 5 7 38 8 1 5
Hawaii ............ 5 25 399 2 -
Puerto Rico.......... 101 379 186 2 -









50 Morbidity and Mortality Weekly Report


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

FEBRUARY 12, 1966 AND FEBRUARY 13. 1965 (6th 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... 11,486 3 11 6 23 4 29 7 92 436

NEW ENGLAND........... 1,542 1 1 3
Maine.............. 130 -
New Hampshire...... 128 -
Vermont............. 92 3
Massachusetts...... 328 -
Rhode Island....... 81
Connecticut........ 783 -

MIDDLE ATLANTIC...... 435 2 3 8 1 11 39
New York City ..... 29 2 3 4-
New York, Up-State. 328 2 11 37
New Jersey......... 2
Pennsylvania....... 78 1 2

EAST NORTH CENTRAL... 820 3 6 6 10 49
Ohio................ 103 1 3 3 5 30
Indiana............. 384 I 1 3 7
Illinois........... 136 2 2 2
Michigan.......... 1 1 5
Wisconsin.......... 197 1 1 5

WEST NORTH CENTRAL... 512 2 1 1 1 22 120
Minnesota.......... 17 3 21
Iowa................ 198 5 23
Missouri .......... 28 9 55
North Dakota....... 194 3
South Dakota....... 11 2 13
Nebraska........... 2 2
Kansas.............. 62 2 1 1 1 3 3

SOUTH ATLANTIC....... 931 3 5 2 8 5 14 57
Delaware........... 22 -
Maryland............ 120
Dist. of Columbia.. -
Virginia............ 288 2 2 5 1 13 45
West Virginia...... 331 1 I 5
North Carolina..... 20 2 1 3
South Carolina..... 24 -
Georgia............ 5 2 1 1 5
Florida............ 121 1 2

EAST SOUTH CENTRAL... 1,548 3 8 1 11 63
Kentucky.......... 289 2 2 10
Tennessee.......... 997 1 4 1 9 51
Alabama............ 147 2 2 2
Mississippi........ 115 -

WEST SOUTH CENTRAL... 1,099 1 2 1 1 16 80
Arkansas........... 4 1 7
Louisiana.......... 3 1 2 1 6
Oklahoma .......... 64 1 2 6
Texas............... 1,028 1 12 61

MOUNTAIN.............. 2,479 2 1 5
Montana............ 47 -
Idaho............... 144
Wyoming.......... 4 -
Colorado............ 1,317 -
New Mexico.......... 282 -
Arizona............ 322 1 1 4
Utah............... 351 -
Nevada............. 12

PACIFIC.............. 2,120 2 1 1 1 7 20
Washington ......... 635 -
Oregon............. 64 -
California......... 1,287 2 11 1 7 20
Alaska.............. 57
Hawaii .......... .. 77
Puerto Rico ..........6








Morbidity and Mortality Weekly Report






DEATHS IN 122 UNITED STATES CITIES FOR WEEK ENDED FEBRUARY 12, 1966


b (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 Ca s 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.--------


871
289
46
29
38
37
51
27
31
73
77
26
47
40
60

3,513
46
43
168
50
34
41
81
97
1,742
28
492
219
78
118
29
41
80
48
33
45

2,893
64
39
895
227
212
113
87
383
56
49
41
38
54
185
31
149
49
35
20
114
52

842
58
10
40
126
25
116
78
242
94
53


543
177
19
17
26
20
37
21
24
33
56
22
32
23
36

2,072
26
30
100
29
23
21
44
49
1,027
13
287
130
51
70
15
29
49
25
23
31

1,675
42
29
492
144
130
61
60
194
33
25
29
23
37
106
16
88
27
20
16
71
32

528
34
5
25
80
15
65
51
158
61
34


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


1,394
142
346
50
77
105
57
96
41
97
92
244
47

641
118
47
24
119
128
56
34
115

1,221
46
36
35
166
39
92
209
69
208
82
127
56
56

419
42
26
117
14
104
17
44
55

1,613
21
45
32
52
78
535
116
23
65
86
118
209
26
117
54
36


Total 13,407 7,759 640 735

Cumulative Totals
including reported corrections for previous weeks

All Causes, All Ages ----------------------- 80,280
All Causes, Age 65 and over------------------- 46,409
Pneumonia and Influenza, All Ages------------- 3,713
All Causes, Under 1 Year of Age--------------- 4,196


Week No.







S52
<^='
o 9--

0 ---- fo
U-

CIA
o Q0

z -D
_-_ (55


C"
Z
z^_0

IB ^--


FEBRUARY 12, 1966


INTERNATIONAL NOTES
INFLUENZA
(Continued from page 45)


was observed with only sporadic cases reported in Buda-
pest but with a particular prevalence in Balassagyarmat
where some 10 percent of the total population was report-
edly affected in a single week (November 18-25). By mid-
dle to late December, the outbreaks had begun to decline.



Great Britain
Influenza in Great Britain (MMWR, Vol. 15, No. 4) is
still reported to predominate in the northern half of the
country where school-centered outbreaks continue to be
particularly characteristic of the initial involvement of a
community. Such is the case in the western parts of Scot-
land, especially Glasgow and its environs, where laboratory
confirmation of type B influenza has been repeatedly re-
ported. Additional evidence supportsthe early observation
that type A2 influenza infection in adults may parallel
the type B illnesses seen in school children. It is not yet
possible, however, to determine the uniformity of this
phenomenon.
Influenza mortality reported from England and Wales
continues to show a marked increase in recent weeks.
During the first 5 weeks of 1966, 515 deaths have been
recorded in contrast to 92 registered in the comparable
period of 1965. During the week ended February 5 alone,
264 influenza deaths were reported while 111 had been
listed in the previous week of 1966. Both figures aremany
times higher than the 19 and 17 influenza deaths recorded
for comparable weeks in 1965. Greater London has not
contributed to these mortality increases, the levels there
being within the seasonal average. Slightly more than 50
percent of the influenza deaths reported in England and
Wales are occurring in individuals aged 75 years or more
and 94 percent in those aged 45 and over.


Romania
Romania reported a focus of influenza-like disease
in the town of Timisoara less than 100 miles southeast of
Csongrad, Hungary, during December. Five strains of type
B influenza virus were isolated from patients there and
serological evidence of influenza B infection obtained.
No additional information has yet been reported on the
progress of the epidemic in Romania.


Netherlands
Localized outbreaks of influenza, classified clinically
as mild and recognized early in January 1966, have been
reported from certain areas of the Netherlands. A few
strains of type B influenza virus have been isolated from
military and civilian patients.

(Reported by the Influenza-Respiratory Disease 1i'.',
CDC.)


ui -E -- -






LIT E b POS TORT


,o
*0


m a

m4o

Om


mo
:<


THE MORBIDITY AND MORTALITY WEEKLY REPORT. WITH A CIRCULA-
TION OF 1. 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 INVEST.
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.


Morbidity and Mortality Weekly Report


x
m
rn


P Cw
s >
re >





* m a





m