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:
AA00010654:00291

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



CENTER


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


EPIDEMIOLOGIC NOTES AND REPORTS
ENCEPHALOPATHY Maryland


Between March 1 and March 9, 1966, four children in
Baltimore, Maryland, developed severe encephalopathy
of unknown etiology. The patients lived in widely sep-
arated areas in and around Baltimore and, other than the
dates of onset being within a 9-day period of time, there
appears to have been no common relations ip. As shown
in Table 1, the ages of the patients were 5 y ,ars, 8 years,
9 years, and 11 years respectively; the last was the only
female. Three of the patients died within 3 days of the
onset of the illness; the fourth patient died 13 days after
onset, following 8 days in coma.


CONTENTS

Epidemiologic Notes and Reports
Encephalopathy Maryland ...... ............. 117
Current Trends Influenza ....... ............ 119
International Notes Quarantine Measures. ... .. 124


Characteristically, the patients were previously
healthy children who experienced a mild prodromal illness,
lasting 2 to 5 days, which consisted of fever, headache,
general malaise, nausea and vomiting. Two of the patients
then experienced a distinct period of improvement during
(Continued on page 118)


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous weeks)
14th WEEK ENDED CUMULATIVE. FIRST 14 WEEKS
MEDIAN
DISEASE APRIL 9, APRIL 10, 1961 1965 MEDIAN
1966 1965 1966 1965 1961-1965
Aseptic meningitis .......... ... ...... 23 29 29 389 415 324
Brucellosis ................. ....... .. 4 4 10 50 54 91
Diphtheria ................ ... ... 5 5 6 40 62 91
Encephalitis, primary:
Arthropod-borne & unspecified ........... 28 28 --- 327 417 -
Encephalitis, post-infectious ........... 20 17 229 204 --
Hepatitis, serum ...... ... 39 35 11,036 14,697
Hepatitis, infectious .................... 621 725 892 9,825 i11,036
Measles rubeolaa) ...................... 7,561 11,920 15,907 101,694 128,735 166,302
Poliomyelitis, Total (including unspecified) 2 6 6 40
Paralytic ........................ 2 5 4 35
Nonparalytic ........................ .- --- 2 -
Meningococcal infections. Total .......... 121 78 58 1,423 1,212 844
Civilian ......... ................ 107 70 --- 1,232 1,115 -
Military .............. ............. 14 8 191 97 -
Rubella (German measles) ............ 1,753 --- -- 18.935 -
Streptococcal sore throat & Scarlet fever .. 10,510 11,553 9,790 164,878 157,837 139,570
Tetanus................................ 1 1 25 51 -
Tularemia ................ ..... ... 1 47 55 -
Typhoid fever ..................... 4 5 8 72 94 94
Typhus, tick-borne (Rky. Mt. Spotted fever) 9 6 -
Rabies in Animals.................. .. 95 114 101 1,184 1.432 1.112

NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax: ................ .. ......... ... ...... 2 Botulism: ............ .... ..... ... .........
Leptospirosis: ........ ..... .... .................. 9 Trichinosis: N.Y.C.-I, Pa.-1, Ind.-1, Minn.-1, Iowa- .... 31
Malaria: N.J.-l, N.C.-2, Va.-1, Ky.-1, Calif.-1 ......... 83 Rabies in Man:Colo.-l .. ......... ............ 1
Psittacosis N C.-1 14 Rubella, Congenital Syndrome: Minn.-I ... .... ... 10
Typhus murne: Ark -1. Texas- I. P R I 6 ............... .............. ........ .......


1+
Vol. 15, No. 40*






Week Ending
April 9, 1966


W


F1S .60/9:15/11









Morbidity and Mortality Weekly Report


APRIL 9, 1966


EPIDEMIOLOGIC NOTES AND REPORTS
ENCEPHALOPATHY Maryland
(Continued from front page)


one day. All four patients subsequently developed leth-
argy, disorientation, delirium, stupor and convulsions. A
rapid downhill course within 24-36 hours resulted in
respiratory arrest and death in three instances; the patient
who survived for 13 days was in a respirator for 8 days
(Table 1).
The white blood counts among the four patients were
10, 15, 16 and 20 thousand, respectively. None of the
patients were hypoglycemic on hospital admission. Three
of the four patients had atraumatic spinal taps, and less
than 7 white blood cells were seen in each sample of
cerebrospinal fluid. Serum transaminase determinations
were performed on one of the patients, and values ranged
from 200 to 300 Karmen Units. That patient's bilirubin was
normal. None of the four patients had palpable livers or
were clinically jaundiced,
On postmortem examination marked cerebral edema
with fi ii rri;i of the cerebral convolutions was found in
all cases. The brain tissue has since been examined
microscopically in three of the cases hut infiltration of
inflammatory cells was not observed. The liver of one of
the patients on gross examination was pale and swollen,
and on microscopic examination there was extensive fatty
infiltration. This fatty change also appeared in the
proximal tubules of the kidney. The fatty change in both
organs was uniformly distributed in fine droplets. Two
other patients, however, showed only minimal fatty
changes in these organs. To date, only the liver of the
fourth patient has been examined microscopically and it
has shown no fatty infiltration. Histological studies are
continuing.
Virological and toxicological studies are currently in
progress, although there is neither a uniform history of
exposure to other illnesses nor any history of common
exposure to drugs or potential toxic agents.
(Reported by Dr. John II. Janney, State Epidemiologist,
Maryland State Health Iepartment; and an EIS Officer.)

Editorial Note:
These cases bear a striking similarity to a syndrome
that has recently been reported from many parts of the


world''4. This syndrome is characterized by an initial
febrile illness with upper respiratory symptoms, vomiting,
lethargy, convulsions, diffuse nonlocalizing neurological
signs, progressing rapidly into coma with disturbed res-
piratory rhythm and death. Laboratory findings frequently
include hypoglycemia and low CSF glucose. There is
usually an absence of cells in the cerebrospinal fluid. On
postmortem examination there is massive cerebral edema
without the inflammatory changes in the brain tissue
characteristic of viral encephalitis. There is extensive
fatty infiltration of the liver and proximal renal tubules.
In spite of the marked fatty change observed in these
organs, the cellular architecture is usually retained
without the presence of areas of necrosis.
While clinical courses and physical findings of the
four Maryland cases closely resembled this syndrome,
they were not characterized by low blood or CSF glucose.
There was marked cerebral edema without inflammatory
changes in the brain tissue, but only one case showed
the fatty infiltration of the liver and the proximal renal
tubules. The uniform occurrence of a prodromal febrile
illness and a subsequent course compatible with clinical
encephalitis both support the hypothesis of infectious
etiology. However, absence of inflammatory changes in
the brain tissue and the lack of uniform success of viral
isolation attempts does not support this hypothesis.
Likewise no evidence has been elicited of a common
toxic exposure. The etiology of this syndrome remains
obscure.



References
1. Golden, G. S., and Duffell, D.: Encephalopathy and fatty
change in the liver and kidney. Pediatrics 36:67, 1965.
2. Randolph, M.. and others: Encephalopathy, hepatitis and
fatty accumulation in viscern. Amer J Dis Child 110:95,
July 1965.
3. Reye, R i. K. and others: Encephalopathy and fatty de-
generation of the vi-scera: A disease entity in childhood.
Lancet:749, Oct. 12, 1963.
4. Utian, II. I,., and others: "\\hite liver" disease. Lancet:
1042. Nov. 14, 1961.


Table 1


118








APRIL 9, 1966


Morbidity and Mortality Weekly Report


CURRENT TRENDS INFLUENZA


Several additional States have reported laboratory
confirmed influenza outbreaks during the past week.
Oregon and Utah have both reported type A2 virus iso-
lations. The Arizona and Montana outbreaks have been
confirmed serologically as due to type A. In Nebraska a
type B epidemic in a rural area has been confirmed with
several isolates also obtained from sporadic cases in
Omaha. In California where a major A2 outbreak has been
occurring this year, there have been several isolates of
type B virus made simultaneously in the San Francisco
area which are not associated with outbreaks otherwise
confirmed as type B. The influenza-like illness which
occurred in eastern Tennessee has now been confirmed
serologically as type B influenza (MMWR, Vol. 15, No. 11).
Excess mortality due to influenza and pneumonia
deaths as measured in 122 United States cities continues
to decline, although still remaining above the epidemic
threshold. Correlating with this is the decline in mortality
in the Mountain and Pacific Regions.
(Reported by the Influenza-Respiratory DIisease rnit,
CDC.)


Nebraska
An outbreak of influenza-like illness occurred in the
school district of Polk, approximately 60 miles west of
Lincoln, Nebraska, during the last week of February and
the first 2 weeks of March. Common symptoms were
malaise, aching of the muscles of the neck. arms and
legs, with fever, chills and headache; rhinorrhea, ocular
pain and conjunctivitis occurred later in some instances.
Some of the children affected had headache. fever and
mild sore throat for one day, felt well enough to return
to school the next day and then had a relapse. Generally
the illness lasted for 4 days to one week and there was
some residual fatigue thereafter.
The most striking feature of the outbreak was the
excessive rate of absenteeism from the high school.
From March 7 through March 10, 55 of 105 high school
students were absent with a peak of 39 absences on
March 10. There was much less absenteeism in the ele-
mentary school where an additional factor was an outbreak
of chickenpox in the primary grades.
On March 12 and 13 a telephone survey of 73 fam-
ilies was made to determine the extent of the epidemic.
Table 2 shows the attack rate by age of the 233 indi-
viduals covered by the survey. The overall attack rate
was 23 percent; the highest rate, 57 percent, occurred
in the 15 to 19 year age group.
Type B influenza virus has been isolated from this
outbreak.


(Reported by Dr. E.A. Rogers, Director of Health, he-
braska D- pi.'., .' of Health; and EIS Officers from the
CDC Kan .. F :...' Station.)


Table 2
Attack Rates By Age From A Telephone Survey
of 73 Families
Polk. Nebraska, 1966


Age Group Number Ill Number Persons

0-4 2 14
5-9 9 22
10-14 9 24
15-19 17 30
20-39 3 39
40-59 8 59!
60+ 5 45
Total 53 233


Percent Ill
14

37
57

14
11
23


Maine
A small outbreak of type B influenza occurred at the
U.S. Naval Air Station in Cumberland County, Maine, in
February 1966. The outbreak was first suspected during
the week of February 6 when increased numbers of febrile
respiratory illness were seen in the Station's medical
clinics serving both military personnel and their depend-
ents. Although the total number of clinic visits by military
personnel increased only slightly, the proportion of indi-
viduals with illnesses suggestive of influenza accounted
for approximately one-third of these visits. During the
following week, the prevalence of the influenza-like
disease persisted at the increased level and thereafter
declined.
Epidemiological investigations, which included a
review of medical records, of 492 of 720 (68.3 percent)
military personnel who reported to sick call between
February 1 and 28. showed that 195 (20.5 percent) had
an oral temperature of 100F. or more at the time of the
first visit to the clinic. Approximately two-thirds of the
total 492 individuals had received influenza vaccine.
The same proportion of vaccination was observed both
among persons reporting influenza-like illnesses and
those reporting non-respiratory diseases.
Specimens for virus isolation and serological testing
were collected from 23 suspect influenza cases during
the acute phase of illness. Type B influenza virus has
been identified from one of the specimens and serolo-
gical evidence of type B infection demonstrated in 9 of
16 patients from whom acute-convalescent serum spec-
imens were obtained.


(Reported by Captain R.J. Martin, M.C., Senior Medical
-.'.*., Naval Air Station Hospital, Brunswick, Maine;
Captain Jack Millar, Director, Preventive Medicine
Division, Department of the Navy, Washington, D.C.,
and an epidemiological team from CDC.)


119










120 Morbidity and Mortality Weekly Report



CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

APRIL 9, 1966 AND APRIL 10, 1965 (14th 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... 23 29 4 28 28 20 5 5 39 621 725

NEW ENGLAND.......... 1 2 4 1 28 25
Maine .............1 5
New Hampshire...... 1 4 3
Vermont ............
Massachusetts...... 3 12
Rhode Island....... -
2 1 I 4 3
Connecticut........ -

MIDDLE ATLANTIC...... 4 3 8 11 3 20 86 134
New York City...... 1 1 1 5 11 20 24
New York, Up-State. 1 1 2 1 25 52
New Jersey.......... 6 3 -- 15 34
Pennsylvania....... 3 1 1 2 4 26 24

EAST NORTH CENTRAL. 2 1 3 3 1 2 137 155
Ohio...... ...... 33 63
Indiana ............ 8 10
Illinois ........... 1 1 1 26 30
Michigan.......... 1 3 1 2 62 45
Wisconsin.......... 8 7

WEST NORTH CENTRAL... 2 3 1 3 2 67 41
Minnesota.......... 2 1 2 7 6
Iowa............ 1 19 18
Missour 29 11
Missouri........... 29 11
North Dakota....... 1 31
South Dakota....... 2
Nebraska............. 3 2
Kansas.......... .. 1 -6 3

SOUTH ATLANTIC....... 5 3 1 7 1 1 3 1 68 47
Delaware............ 2 1 3 1
Maryland............. 18 7
Dist. of Columbia.. 1 3 -
Virginia........... 1 1 5 1 7 18
West Virginia...... 2 7
North Carolina..... 1 5 2
South Carolina..... -- 1 5
Georgia............ -- 13 -
Florida............ 2 1 1 1 2 1 16 7

EAST SOUTH CENTRAL... 4 1 3 1 43 55
Kentucky........... 4 17 23
Tennessee.......... 3 16 15
Alabama............ 1 1 6 11
Mississippi........ 4 6

WEST SOUTH CENTRAL... 1 3 3 1 4 2 1 39 62
Arkansas........... 1 I 1 3
Louisiana........... 1 1 3 13
Oklahoma........... 6 1
Texas.............. 1 2 2 3 2 1 29 45

MOUNTAIN............. 1 2 1 1 2 38 58
Montana............. 1 1
Idaho............... 1 20
Wyoming ............ 3 1
Colorado............ 1 1 11 8
New Mexico.......... 8 12
Arizona.............. 1 8 6
Utah................ 1 2 7 10
Nevada............... -

PACIFIC.............. 10 12 3 3 6 14 115 148
Washington.......... 1 1 5 18
Oregon.............. 1 9 5
California.......... 10 12 3 6 13 101 121
Alaska.............. 4
Hawaiico..........- 1 1 34-

Puerto Rico...........1 1 18 1 34










Morbidity and Mortality Weekly Report 121


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

APRIL 9, 1966 AND APRIL 10, 1965 (14th WEEK) CONTINUED



MENINGOCOCCAL INFECTIONS, POLIOMYELITIS
MEASLES (Rubeola) TOTAL Total Paralytic RUBELLA
TOTA Total Paralytic
AREA --
Cumulative Cumulative Cumulative
1966 1966 1966 1965 1966 1966
1966 966 1965966 1965 1966 1965 1966 1966 1966

UNITED STATES... 7,561 101,694 128,735 121 1,423 1,212 5 1,753

NEW ENGLAND........... 107 1,245 25,746 7 71 63 195
Maine............... 3 146 1,936 1 7 8 18
New Hampshire...... 8 20 325 7 4 2
Vermont............. 32 198 377 1 3 1 3
Massachusetts...... 40 472 14,360 3 29 21 75
Rhode Island....... 3 56 2,855 5 11 44
Connecticut........ 21 353 5,893 2 20 18 53

MIDDLE ATLANTIC...... 666 12,482 5,056 17 149 159 128
New York City...... 372 6,388 480 23 25 32
New York, Up-State. 79 1,283 1,691 4 36 37 94
New Jersey.......... 56 1,351 873 5 46 54 -
Pennsylvania....... 159 3,460 2,012 8 44 43 2

EAST NORTH CENTRAL... 2,640 39,087 24,122 21 209 145 675
Ohio................ 275 2,975 5,038 7 58 41 40
Indiana............. 113 2,380 989 1 30 19 82
Illinois........... 425 8,075 935 2 40 37 110
Michigan........... 509 6,363 12,849 6 60 25 104
Wisconsin.......... 1,318 19,294 4,311 5 21 23 339

WEST NORTH CENTRAL... 457 4,744 9,746 7 74 65 135
Minnesota.......... 40 1,233 313 4 19 14 6
Iowa................ 385 2,440 5,283 1 12 1 121
Missouri........... 11 314 1,442 2 29 34 4
North Dakota....... 21 712 2,426 3 3 1
South Dakota ..... 3 55 2 2 -
Nebraska........... 42 227 3 4 3
Kansas............. NN NN NN 6 7 -

SOUTH ATLANTIC....... 388 7,844 15,474 19 233 243 1 93
Delaware............ 5 104 286 1 3 3 -
Maryland............ 63 1,251 552 2 23 26 15
Dist. of Columbia.. 295 20 6 4 2
Virginia........... 54 751 2,362 2 31 27 15
West Virginia...... 119 3,106 9,549 8 16 23
North Carolina..... 3 138 170 5 46 36 -
South Carolina..... 51 384 607 3 33 35 14
Georgia............. 15 167 430 5 39 33 1
Florida............. 78 1,648 1,498 1 44 63 24

EAST SOUTH CENTRAL... 621 11,265 7,546 5 116 76 94
Kentucky........... 167 3,558 953 53 29 24
Tennessee.......... 425 6,450 4,537 2 35 23 65
Alabama............ 17 766 1,492 2 21 18 5
Misssisippi........ 12 491 564 1 7 6

WEST SOUTH CENTRAL... 1,283 11,211 17,605 16 221 204 3 8
Arkansas........... 53 375 825 12 10 1
Louisiana .......... 59 43 4 88 114 -
Oklahoma............ 52 231 111 2 9 16 1
Texas............... 1,178 10,546 16,626 10 112 64 2 7

MOUNTAIN............. 586 5,431 10,130 1 42 44 146
Montana............ 89 818 2,615 3 1 14
Idaho............... 50 587 1,511 1 7 -
Wyoming............. 72 539 1 2 -
Colorado............ 50 600 1,849 22 10 13
New Mexico.......... 66 302 335 6 6 -
Arizona............. 309 2,867 389 7 11 118
Utah................ 5 161 2,808 5 1
Nevada.............. 17 24 84 1 2 2 -

PACIFIC.............. 813 8,385 13,310 28 308 213 1 279
Washington.......... 83 1,710 3,943 1 17 15 1 77
Oregon.............. 52 661 1,921 1 13 17 48
California.......... 654 5,911 5,906 25 262 174 148
Alaska.............. 24 50 97 1 13 4 6
Hawaii............. --- 53 1.443 --- 3 3 --- ---
Puerto Rico........... 167 1,268 830 2 3 1









122 Morbidity and Mortality Weekly Report


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

APRIL 9, 1966 AND APRIL 10, 1965 (14th 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 1. 19 Cum. 1966 Cum. 1966 Cum.
1966 1966 1966 1966 1966
UNITED STATES... 10,510 1 25 47 4 72 9 95 1,184

NEW ENGLAND........... 1,665 2 1 3 12
Maine.............. 113 -
New Hampshire...... 66 5
Vermont............ 37 7
Massachusetts...... 326 2 -
Rhode Island....... 197 -
Connecticut........ 926 3

MIDDLE ATLANTIC...... 483 4 1 17 1 4 86
New York City ..... 35 3 1 8
New York, Up-State. 310 3 4 81
New Jersey......... NN 3 -
Pennsylvania....... 138 1 3 1 5

EAST NORTH CENTRAL... 1,686 12 1 12 11 164
Ohio................ 117 3 1 6 8 95
Indiana ............ 233 3 2 1 29
Illinois........... 406 5 1 1 13
Michigan........... 558 1 12
Wisconsin .......... 372 1 2 1 15

WEST NORTH CENTRAL... 389 1 3 7 1 24 265
Minnesota.......... 15 4 48
Iowa................ 205 2 5 66
Missouri ........... 10 1 1 4 7 102
North Dakota....... 108 4
South Dakota....... 9 3 26
Nebraska............ 9 6
Kansas............. 33 2 I 1 5 13

SOUTH ATLANTIC....... 998 1 8 6 1 14 6 8 156
Delaware........... 124 -
Maryland........... 116 4
Dist. of Columbia.. 24 -
Virginia........... 367 2 6 2 3 105
West Virginia...... 305 1 1 19
North Carolina..... 13 2 1 2 3 -
South Carolina..... 26 1 1 -
Georgia............. 16 3 1 4 19
Florida............ 7 1 4 1 1 13

EAST SOUTH CENTRAL... 1,388 1 12 1 6 12 171
Kentucky........... 70 2 1 4 25
Tennessee .......... 1,147 6 1 4 7 142
Alabama............ 90 1 4 I 1 4
Mississippi........ 81 -

WEST SOUTH CENTRAL... 768 6 11 3 1 26 250
Arkansas........... 2 9 1 7 36
Louisiana.......... 4 3 1 1 2 16
Oklahoma........... 80 1 9 50
Texas............... 682 3 1 1 8 148

MOUNTAIN.............. 1,735 1 6 1 15
Montana............ 76 1 2
Idaho............... 217 -
Wyoming........... 31 -
Colorado............ 994 2 1
New Mexico.......... 157 3
Arizona ........... 109 1 9
Utah................ 146 3 -
Nevada ............. 5

PACIFIC.............. 1,398 3 1 4 -- 9 65
Washington......... 404 -
Oregon............. 27 -- I -
California.......... 883 3 1 3 9 65
Alaska.............. 84-
Hawaii........... .. --- -. .
Puerto Rico.......... i n










Morbidity and Mortality Weekly Report


DEATHS IN 122 UNITED STATES CITIES FOR WEEK ENDED APRIL 9, 1966


(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 l year Area All 65 years and 1 year
Influenza All Influenza All
Ages and over Ages Causes Ages and over All Ages Causes
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.--------


759
244
33
19
31
57
30
24
27
49
77
16
64
27
61

3,393
29
34
145
44
30
43
62
98
1,832
28
490
174
38
110
26
36
82
38
21
33

2,491
63
34
666
145
191
109
71
384
38
59
45
29
75
169
40
120
44
31
24
98
56

861
49
28
31
141
30
121
69
264
78
5O'


451
130
18
12
17
34
22
16
19
29
46
11
39
16
42

2,011
17
25
88
26
18
28
33
54
1,063
19
287
107
25
73
15
26
42
22
15
28

1,442
40
21
376
79
108
63
42
214
26
34
28
15
52
105
22
71
23
16
12
65
30

533
33
20
16
96
16
77
35
161
52
27


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.----------


625
63
138
32
28
50
23
46
14
72
43
95
21

298
46
21
19
46
67
14
33
52

600
14
23
16
79
23
39
86
37
101
48
65
32
37

272
24
19
87
4
69
11
31
27

1,036
12
38
19
23
52
284
48
34
109
31
66
96
26
122
49
27


2
6 Total 12,514 7,268 605 599
5
9 Cumulative Totals
4 including reported corrections for previous weeks
2
All Causes, All Ages ------------------------ 186,349
All Causes, Age 65 and over------------------- 108,473
Pneumonia and Influenza, All Ages------------- 9,242
All Causes, Under 1 Year of Age--------------- 9,498


Week No.


*Estimate based on average percent of divisional total.










Morbidity and Mortality Weekly Report


INTERNATIONAL NOTES-QUARANTINE MEASURES

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


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


Page 82


Delete
City:


Center:







Clinic Hours:


Fee:


Add


City:


Center:







Clinic Hours:


Fee:


Corpus Christi, Texas


Corpus Christi-Nueces County
Health Department
1811 Shoreline Blvd.
Telephone: TU 2-6577


Friday, 2 p.m.


Yes





Corpus Christi, Texas


Corpus Christi-Nueces County
Health Department
1811 Shoreline Blvd.
Telephone: TU 2-6577


Friday, 10:30 11:30 a.m.


Yes


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 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.


o




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UNIV. OF FL Lid.
DOCUMENTS DEPT.







U.S. DEPOSITORY


124


APRIL 9, 1966


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