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:
AA00010654:00293

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




COMMUNICABLE DISEASE CENTER


Week Ending
May 21, 1966


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


EPIDEMIOLOGIC NOTES AND REPORTS
EPIZOOTIC OF PLAGUE California

An epizootic of plague in wild rodents has been
observed recently in a number of Counties in California.
Following an initial observation of unusual mortality in
the wood rat population in Tulare County around the begin-
ning of April 1966, field surveys have indicated an exten-
sive plague epizootic among wood rats in Fresno, Tulare
and Kern Counties. Laboratory studies of dead rodents
and their fleas have determined the presence of plague
in ground squirrels, wood rats, field mice and chipmunks
in Madera, Fresno, Tulare, Shasta and Lassen Counties.
Control measures have been initiated on a coopera-
tive basis by the State Department of Agriculture, the


CONTENTS
I pidemiologic Notes and Reports
Epizootic of Plague Callifomnia
Shigellosis Illinois ....
Diphtheria Northern Cheyenne Indian
Reservation, Montana .. ..
International Notes
Quarantine Measures .....


. 169
. 170

. 171

.. 176


California Department of Public Health, local agricultural
commissioners and local health departments. These include
the strengthening of control measures regulating the
capture and commercial sale of trapped rodents, and the
disinfestation of rodent ectoparasites at the point of cap-
ture and again prior to shipment. Particular attention is
(Continued on page 170)


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous weeks)
20th WEEK ENDED CUMULATIVE. FIRST 20 WEEKS
MEDIAN
DISEASE MAY 21. MAY 22. 1961-1965 MEDIAN
1966 1965 1966 1965 1961-1965
Aseptic meningitis .. ....... .27 20 22 549 562 485
Brucellosis... .. 5 8 8 76 81 148
Diphtheria. .......... 11 1 5 64 74 112
Encephalitis, primary:
Arthropod-borne & unspecified .. .... 22 47 479 613 -- -
Encephalitis, post-infectious 20 29 337 325 --
Hepatitis, serum ................... 25 593 769 493 14907 19621
593 769 14.907 19,621
Hepatitis, infectious... 594 i 13.463
Measles rubeolaa) .... ....... .. .. 7.348 9.236 17.165 149.664 191.481 275.206
Poliomyelitis. Total (including unspecified) 2 2 8 9 53
Paralytic ...... ... .. 2 2 7 7 47
Nonparalytic ..... ..... ..... ....... 2 -
Meningococcal infections. Total ...... .. 75 62 51 1.961 1,673 1,187
Civilian .. . ...... 70 58 1.730 1,522 -
Military............... ......... 5 4 231 151 -- -
Rubella (German measles) .......... .. 1,945 --- -- 30.269 --
Streptococcal sore throat & Scarlet fever 7,989 7,884 7,074 223.727 209,913 183,930
Tetanus ..... ...... 7 42 79 -
Tularemia ....... ........ 2 7 50 75 -
Typhoid fever ................ 9 13 13 114 133 136
Typhus, tick-borne (Rky. Mt. Spotted fever) 5 4 16 16 -

Rabies in Animals, ....... .... 68 80 100 1.749 2.027 1,723

NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax: ............ .. ............. 2 Botulism: ........... .. .
Leptospirosis: Iowa-2, Hawaii-2 ........... ... 17 Trichinosis: Ohio-3 .. ....... ............. 42
Malaria: Oreg.-1, Conn.-l. N.Y.City-2, Ind.- ............ 106 Rabies in Man: ........... ......... .. 1
Psittacosis: ........... .. .. ........ ........ 16 Rubella. Congenital Syndrome: ............... 12
Typhus. murine: ........ ..... .... .... .. ........... ............ ........ ..6. ....


FS 1,O/60h `/a/^0







Morbidity and Mortality Weekly Report


EPIDEMIOLOGIC NOTES AND REPORTS
EPIZOOTIC OF PLAGUE California
(Continued from front page)


being given to local areas where field rodents exist adja-
cent to public camping grounds, recreation centers and
resort areas. The State Department of Public Health has
also issued an order designating plague areas and pro-
hibiting the trapping, capturing, holding or possession of
wild rodents either within or from such areas.
There have been four cases of human plague in
California since 1956 with one fatality. This fatal illness
occurred in an adult male in 1956 following a squirrel
hunting trip. Subsequently two cases occurred in 1959. One
patient was presumably infected through contact with wild
rodents on a camping trip in the high Sierra in June; the
other patient was presumably exposed to an infected wild


rodent near his home in the Sierra foothills. The most
recent case was in September 1965 in a 5-year-old male
residing in Shasta County. On September 27 two carcasses
of golden-mantled squirrels were found in close proximity
to the child's house in an area where he habitually played.
Pasteurella pestis was isolated from one of the squirrels
(MMWR, Vol. 14, Nos. 38 and 45).

(Reported by Dr. Philip K. Condit, Chief, Bureau of Com-
municable Diseases, Mr. Richard F. Peters, Chief, Bureau
of Vector Control, and the Microbiology Laboratory,
State of California Department of Public Health; and the
San Francisco Field Station of CDC.)


SHIGELLOSIS Illinois


During the latter part of March 1966, 14 isolations of
Shigella dysenteriae 2 were reported in an institution for
the mentally retarded in Illinois. Investigation revealed
that all 14 isolations were from one cottage, Nursery I,
which contained 139 patients. Nursery I is one of two
cottages housing children under 6 years of age.
On March 12, a 2-1/2-year-old boy became ill with
fever and diarrhea; 3 days later his stool culture was
reported positive for S. dysenteriae 2. Specimens for cul-
ture were then obtained from 50 children in Nursery I, in-
cluding all in the patient's room, in two adjoining rooms,
and from one of the working girls.* This survey yielded
10 more isolations of S. dysenteriae 2; only four of these
patients were symptomatic. During the next 2 weeks, three
additional symptomatic cases were detected, making a
total of 14 isolations of which 8 were from children with
symptoms.
Symptomatology in general was mild, with the excep-
tion of the first patient who had high fever for 3 days and
considerable diarrhea leading to dehydration. Although he
improved during the next 2 days, he died suddenly and
unexpectedly on March 18; no autopsy was performed. Of
the other symptomatic patients, four experienced fever and
diarrhea and three had diarrhea only.
The cottage involved consists of two identical wings,
each with five rooms; there are from 8 to 20 children, with
an average of 14, in each room. Eight of those found to be
positive, including the index case, came from adjoining
rooms at one end of the cottage. The only working girl
who gave a positive culture worked in one of these rooms

*Institutional residents capable of participating in housekeep-
ing activities.


and may have helped occasionally in the other two. The
remaining five isolations came from three scattered rooms
at the other end of the cottage.
The children wander freely in the halls and rooms,
and there is considerable intermingling. The timing of the
cases is consistent with person-to-person spread although
it has not been possible to implicate any one individual.
There was no evidence of a common-source outbreak. The
kitchen serving Nursery I also serves Nursery II, a similar
cottage in which no cases of diarrhea occurred.
All of the patients were isolated and treated with
antibiotics. In addition, children in the cottage and work-
ing girls serving the cottage were given prophylactic medi-
cation. On April 5 and 6, rectal swabs were obtained from
all children and working girls in Nursery I. None of the
swab cultures yielded shigellae.
A review of the records of laboratory isolations from
1954 to the present revealed that, during the 12-year period,
there had been 68 prior isolations of S. dysenteriae 2 from
patients living in several of the cottages. In 1954 there
was a small epidemic in the cottage presently involved in
which nine cases occurred over a period of a few months,
but there had been no further isolations of this organism
from Nursery I until the recent outbreak. There is one
patient in Nursery I who was involved in the 1954 out-
break, but he was not involved in the epidemic now
described.

(Reported by Dr. Norman J. Rose, Chief, Bureau of Epi-
demiology, Dr. W. M. Talbert, Regional Health Officer,
Illinois Department of Public Health; Dr. William Sloan,
Director of Mental Retardation Services, Illinois State
Department of Mental Health; and an EIS Officer.)


170


MAY 21, 1966









Morbidity and Mortality Weekly Report


Editorial Note:
Shigella dysenteriae 2, or Schmitz's bacillus, is
rarely reported in the U.S. Until the present outbreak, only
29 isolations had been reported since the .,htii 11, Sur-
veillance Program was established in the fall of 196!3.
This epidemic adds 14 more isolation to the record.
Seventeen of the previous 29 isolations have been from
two counties in Illinois; institutions for the retarded are
situated in each of these counties. Recent inquiries in the
area currently involved revealed no isolations of S. dysen-
teriae 2 from the general community. There has been only
one other S. dysenteriae 2 isolation in the U.S. so far
this year which was from California in March.


S. dysenteriae 2 is known to be of varying virulence,
with some strains producing severe disease, and others
producing relatively mild illness. The clinical picture at
this institution falls into the latter pattern. The index
case died one week after onset of symptoms, but this
occurred after a period of marked clinical improvement.
Since an autopsy was not performed, the specific cause
of death remains unknown.
Prophylactic chemotherapy was used as a control
measure in this outbreak ilri.. ,i, its efficacy has not
been established.


DIPHTHERIA-Northern Cheyenne Indian Reservation, Montana


Following the identification, between November 22,
1965, and February 7, 1966, of two cases and two carriers
of diphtheria among Indians living on the Northern Chey-
enne Indian Reservation in Montana, an investigation
uncovered an additional six carriers. Nine of the 10 in-
dividuals affected were children, all of whom had re-
ceived at least two diphtheria immunizations in the past.
The strains involved were Corynebacterium diphtheria
intermedius and mitis. Of the 10 strains seven were toxi-
genic, five of these being from carriers.
The first case on November 22, 1965, was in a 5-
year-old Indian.boy who complained of a sore throat and
was noted to have a non-fibrinous membrane on both
tonsils. A throat culture taken at that time yielded a toxi-
genic C. diphtheriae, intermedius. The child had a mild
illness which responded quickly to penicillin therapy and
two subsequent cultures, from material obtained on De-
cember 2 and December 10, were negative. Two of 14
immediate contacts of this case were found to be har-
boring non-toxigenic C. diphtheria mitis. Both carriers
were treated with procaine penicillin and following treat-
ment cultures were negative.
On February 7, 1966, swabs from a 7-year-old Indian
girl complaining of a sore throat yielded a culture of
toxigenic C. diphtheriae intermedius. She was treated
with CR Bicillin, after which cultures were negative for
C. diphtheriae.
Epidemiological investigation failed to establish
any connection between this girl and the earlier case.
However, investigation of the girl's immediate contacts
identified five other individuals who were harboring toxi-
genic C. diphtheria intermedius. All were treated with
CR Bicillin and all gave negative results from subsequent
cultures. One other person was found to have a non-
toxigenic strain of C. diphtheriae mitis and this individu-
al refused treatment.
Symptoms varied among those classified as carriers;
two of seven individuals harboring toxigenic organisms
were mildly ill, while five were asymptomatic. One person


from whom a non-toxigenic organism was recovered com-
plained of a sore throat at the time the swab was obtained
for culture.
In order to determine the prevalence of C.diphtheriae
in the communities on the Reservation, 200 throat cul-
tures were obtained from children attending one elemen-
tary school, prior to their receiving immunizations during
a program planned for March 10-14, 1966. There were
positive isolates of C. diphtheriae from 14 of the 200
children; of these, 7 strains were intermedius type and
toxigenic while 7 strains were mitis type and non-
toxigenic.
The mass immunization program was conducted in
the four major communities situated in the Northern Chey-
enne Indian Reservation. Individuals who were unable to
come to one of the clinics were either transported to the
clinic or immunized in their homes. In this way more
than 2,200 of the 2,800 residents of the Reservation re-
ceived booster immunizations against diphtheria, tetanus
and, if indicated, pertussis.
After this program, a general survey was conducted
to ascertain the immunization levels of the residents of
the Reservation. Results indicated that the level was not
sufficiently high and a second campaign was conducted
in an effort to reach those not adequately immunized. A
later follow-up survey revealed that the current immuni-
zation levels of the residents of the Northern Cheyenne
Reservation are sufficiently high to prevent outbreaks of
clinical diphtheria for some time to come.
(Reported by Dr. Mary E. Soules, Director, Division of
Disease Control, Montana State Board of Health; Dr.
Thomas Ivy, Medical Officer in Charge of the PHS Indian
Health Center, Lame Deer, Montana; Dr. Emery A. John-
son, Indian Health Area Director, Dr. Ralph A. Seltzer,
Acting Chief of Program Services, and Mrs. Judith
Blackfeather, Public Health Nurse, all with the PHS
Area Office, Division of Indian Health, Billings, Mon-
tana; the Kansas City Field Station and an EIS Officer,
CDC.)


MAY 21. 1966









172 MIorbhidit and Mortality Weekly Report



CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

MAY 21, 1966 AND MAY 22, 1965 (20th WEEK)



ENCEPHALITIS HEPATITIS
ASEPTIC Primary Pst- 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... 27 20 5 22 47 20 11 1 25 594 593

NEW ENGLAND........... 3 1 1 20 33
Maine.............. 2 3
New Hampshire...... 9
Vermont ............ -
Massachusetts...... 1 3 1 16 14
Rhode Island....... 3
Connecticut........ -1 -- 2 4

MIDDLE ATLANTIC...... 5 2 16 7 5 14 106 93
New York City...... 2 2 3 10 18
New York, Up-State. 2 1 2 1 27 42
New Jers-y ......... 2 13 1 1 27 28
Pennsylvania....... 1 4 3 34 23

EAST NORTH CENTRAL... 5 3 2 6 3 1 108 116
Ohio... ............. 2 2 3 -47 35
Indiana............. 2 1 11 16
Illinois........... 1 2 7 14
Michigan............. 3 1 1 39 42
Wisconsin.......... 2 4 9

WEST NORTH CENTRAL... 1 2 3 5 44 32
Minnesota.......... 3 5 6 5
Iowa............... 13 8
Missouri........... 1 2 19 7
North akota ....... 1
South Dakota....... 1 1
Nebraska............ 3 3
Kansas............. 2 7

SOUTH ATLANTIC....... 3 1 1 2 19 1 77 69
Delaware ...........
Maryland............ 29 10
Dist. of Columbia.. 2
Virginia............ 1 1 9 12
Wist Virginia.... 5 13
North Carolina..... 2 1 7 6
South Carolina..... 1 1
rgia............ 5 3
Florida........ .. 3 1 17 1 19 24

EAST SOUTH CENTRAL... 2 1 38 30
Kentucky........... 9 6
Tennessee........... 16 14
Alabama.............. 2 1 11 10
Mississippi........ 2

WEST SOUTH CENTRAL... 2 1 1 3 2 1 2 47 44
Arkansas........... 1 1 5 4
Louisiana.......... 1 1 6 11
Oklahoma............ 1 1
Texas.............. 2 1 1 2 1 35 29

MOUNTAIN. ............ 1 3 7 17 36
Montana............. 1 7 4 5
Idaho.............. 1
Wyoming ............ 1
Colorado........... 7 13
New Mexico......... 1 9
Arizona............. 1 2 4 3
Utah............... 5
Nevada... ......- -

PACIFIC............... 9 11 1 2 2 6 8 137 140
Washington........... 2 10 10
Oregon............. 1 19 11
California.......... 8 9 1 2 6 8 106 111
Alaska ............. 7


Puerto Rico.......... I 1 22 28


1 I I


"I -










Morbidity and Mortality Weekly Report


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

MAY 21, 1966 AND MAY 22, 1965 (20th WEEK) CONTINUED


AREA



UNITED STATES...

NEW ENGLAND...........
Maine...............
New Hampshire......
Vermont.............
Massachusetts......
Rhode Island.......
Connecticut........

MIDDLE ATLANTIC......
New York City......
New York, Up-State.
New Jersey.........
Pennsylvania.......

EAST NORTH CENTRAL...
Ohio...............
Indiana............
Illinois...........
Michigan...........
Wisconsin..........

WEST NORTH CENTRAL...
Minnesota ..........
Iowa...............
Missouri...........
North Dakota.......
South Dakota.......
Nebraska...........
Kansas.............

SOUTH ATLANTIC.......
Delaware ..........
Maryland...........
Dist. of Columbia..
Virginia...........
West Virginia......
North Carolina....
South Carolina....
Georgia...........
Florida............

EAST SOUTH CENTRAL...
Kentucky............
Tennessee .........
Alabama ...........
Mississippi........

WEST SOUTH CENTRAL...
Arkansas...........
Louisiana...........
Oklahoma...........
Texas..............

MOUNTAIN. .............
Montana............
Idaho ..............
Wyoming.............
Colorado...........
New Mexico.........
Arizona ...........
Utah................
Neiada..............

PACIFIC..............
Washington.........
Oregon ............
California.........
Alaska. ............
Hawaii .............
Puerto Rico...........


MEASLES (Rubeola)


1966

7,348

114

5

36
2
71

545
158
95
67
225

2,508
234
435
381
511
947

290
44
205
6
35


NN

562
32
61
5
147
127
21
5
5
159

747
60
566
77
44

1,022

1
9
1,012

516
124
53
3
52
82
190
12


1,044
189
76
756
22
1


_______________ I ______


Cumulative
1966 1965
149,664 191,481

1,724 33,199
170 2,348
39 356
209 778
644 18,009
68 3,585
594 8,123

15,921 9,204
7,743 1,037
1,754 2,730
1,697 1,546
4,727 3,891

54,667 38,730
5,215 7,262
4,074 1,308
10,237 1,718
9,391 19,947
25,750 8,495

6,986 14,474
1,519 515
4,120 8,050
389 2,262
885 3,196
4 75
69 376
NN NN

11,482 20,330
189 435
1,690 845
351 45
1,329 3,292
4,070 11,428
225 247
503 863
218 559
2,907 2,616

16,398 11,601
4,236 2,102
9,962 6',597
1,372 1,986
828 916

18,604 26,646
730 1,044
76 68
402 155
17,396 25,379

8,902 15,166
1,385 3,095
897 2,058
103 720
884 4,061
919 524
4,364 762
317 3,770
33 176

14,980 22,131
2,587 6,363
1,044 2,697
11,162 10,315
101 120
86 2,636

1,883 1,460


Nh1i' 4UUL.L,, L l;: L IT A,
TOTAL


1966

75


~

~


Cumulative
1966 1965
1,961 1,673

87 83
8 9
8 5
3 2
35 28
7 12
26 27

213 229
33 36
59 59
58 68
63 66

303 204
83 57
53 29
58 53
78 39
31 26

108 89
26 19
16 5
43 41
5 4
3 2
8 9
7 9

315 328
3 4
31 32
7 4
44 36
10 23
77 58
41 50
44 44
58 77

168 123
70 54
53 36
33 22
12 11

289 251
17 12
112 141
16 17
144 81

70 55
4 1
5 7
3 2
38 13
9 8
8 16
6
3 2

408 311
31 24
27 23
332 248
15 9
3 7

4 4


Total 1
Total I


1966


Paralytic
Cumulat
66 196


19


1965

2


RUBELLA

ive
1966
6
7 1,945

229
16
7
6
101
14
85

101
30
69

2

577
30
117
135
129
166

1 137
1 8
116
4
9




1 170

18

39
42

5
1
66

1 208
19
183
S 6
i


3


- _










174 Morbidity and Mortality Weekly Report


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

MAY 21, 1966 AND MAY 22, 1965 (20th 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... 7,989 42 2 50 9 114 5 16 68 1,749

NEW ENGLAND............ 1,364 2 1 3 3 28
Maine............... 47 3 6
New Hampshire...... 56 -
Vermont............ 35 13
Massachusetts....... 300 2 1
Rhode Island....... 81 -
Connecticut......... 845 3 -

MIDDLE ATLANTIC...... 315 7 1 25 1 2 5 121
New York City...... 27 3 1 13 -
New York, Up-State. 207 3 5 115
New Jersey......... NN 1 6 1 1 -
Pennsylvania........ 81 3 3 1 6

EAST NORTH CENTRAL... 1,212 3 12 4 20 7 248
Ohio................ 116 3 1 9 3 132
Indiana............ 291 1 3 1 55
Illinois........... 324 1 5 2 18
Michigan............ 304 1 1 3 3 23
Wisconsin.......... 177 1 2 5 1 20

WEST NORTH CENTRAL... 280 3 3 12 1 12 375
Minnesota.......... 10 7 84
Iowa............... 119 4 2 81
Missouri........... 3 3 1 5 1 135
North Dakota........ 106 6
South Dakota....... 7 2 36
Nebraska............ 13 1 7
Kansas............. 22 2 2 1 26

SOUTH ATLANTIC....... 797 9 1 7 2 25 7 10 233
Delaware ........... 5 -
Maryland............ 162 6 1
Dist. of Columbia.. 2 -
Virginia............ 261 2 9 2 4 144
West Virginia...... 193 1 I 2 32
North Carolina..... 26 1 2 2 3 1
South Carolina..... 13 1 1 2 4 -
Georgia............. 15 3 1 1 1 1 1 35
Florida............. 120 4 2 3 21

EAST SOUTH CENTRAL... 1,068 2 13 8 2 2 9 241
Kentucky............ 26 2 1 2 37
Tennessee.......... 891 7 4 2 2 6 194
Alabama............. 69 2 4 2 9
Mississippi........ 82 I 1 1

WEST SOUTH CENTRAL... 863 9 1 12 1 7 2 3 18 366
Arkansas........... 2 1 10 I 1 1 41
Louisiana ........- 3 1 2 20
Oklahoma........... 49 1 2 2 5 104
Texas............... 814 4 1 1 3 12 201

MOUNTAIN............ 1,079 1 1 6 1 35
Montana............. 49 7
Idaho............. 63 -
Wyoming ............ 35 -
Colorado........... 510 1 2 1 2
New Mexico.......... 208 5
Arizona.............. 98 1 20
Utah................ 116 1 3 -
Nevada.............. -- 1

PACIFIC............... 1,011 6 1 1 8 4 102
Washington ......... 343 -
Oregon.............. 17 -
California:........ 576 6 1 1 5 4 102
Alaska.............. 67 -
Hawaii.............. 8 -
Puerto Rico.......... 6 1 20 4 5









Morbidity and Mortality Weekl Rleport






DEATHS IN 122 UNITED STATES CITIES FOR WEEK ENDED MAY 21, 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 I lyear Area All 65 years and l year
Ages and over Influenza All s nd over Influenza All
Ages and over Ages and overauses
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.--------


716
206
32
36
32
54
27
31
27
42
76
12
47
33
61

3,306
50
28
152
44
27
44
60
97
1,672
40
499
184
38
123
24
33
74
53
26
38

2,738
40
33
821
151
238
141
73
353
42
54
57
37
59
171
28
140
45
30
45
106
74

809
50
20
40
112
43
134
83
218
66
43


441
109
20
25
21
26
21
22
20
24
51
10
33
20
39

1,866
33
15
89
22
17
33
32
45
925
20
278
94
22
85
17
20
49
30
17
23

1,564
20
21
463
100
153
72
39
175
25
28
40
22
34
89
15
89
22
20
22
69
46

476
34
15
15
66
32
83
42
121
40
28


SOUTH ATLANTIC:
Atlanta, Ca.-----------
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.----------


1,102
132
224
27
62
88
57
85
31
71
87
190
48

593
102
59
34
91
137
48
38
84

1,118
30
29
42
163
40
70
190
74
166
104
99
53
58

386
55
13
118
21
82
19
31
47

1,621
22
50
32
51
78
445
89
49
150
70
90
182
36
180
50
47


Total 12,389 6,997 472 690

Cumulative Totals
including reported corrections for previous weeks

All Causes, All Ages ------------------------- 263,287
All Causes, Age 65 and over------------------- 152,875
Pneumonia and Influenza, All Ages------------- 12,663
All Causes, Under 1 Year of Age--------------- 13,470


Week No.
















INTERNATIONAL NOTES QUARANTINE MEASURES


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


The following information should be added to the list of
Yellow Fever Vaccination Centers in Section 6:


Page 84


City: Huntington, West Virginia


Cabell-Huntington Health Department
1336 16th Street
Telephone: 523-6483


Tuesday, Friday
1:30 p.m. to 2:30 p.m. by appt.


MAY 21, 1966


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



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