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:
AA00010654:00335

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







Morbidity and Mortality



PUBLIC HEALTH SERVICE

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

Prepored by the DI MElrose 4-5131


For release March 10, 1961 Atlanta 22. Georgia Vol. 10, No. 9

Provisional Informati ted Notifiable Diseases in the United States and on

DeatS ec cL\ for Week Ended March 4, 1961


Influenza Repor in %lza within the con- 121 illnesses were investigated and of these, one hundred
tinental United States t nue to b ceab ent. including '3 paralytic and 2' non-paralytic, have been
c 'recorded as 1060 cases. Polio virus type I has been iso-
Hepatitis The 2 cases reported week lasted thus far from 44 of the paralytic and all of the non-
slightly exceed last wee high./ paralytic cases.
1 SThis epidemic was unusually early in starting i'May
21' reached a peak in mid-lulv and fell off earlier than
EPIDEMIOLOGICAL REPORTS the epidemics of the past. The accompanving figure shows
the cases by week of onset. The cases were concentrated
Poliomyelitis Rhode Island in middle lower and lower socioeconomic children residing
During the summer of 1960, Rhode Island suffered primarily in Providence and Pawtucket. Eighty-five per-
its first poliomyelitis epidemic in five years. A total of cent of the paralytic cases were children under 10 years



Table I. Cases of Specified Notifiable Diseases: United States
(Cumulative totals include revised and delayed reports through previous week)

Disease 9th Week Cumulative
(Seventh Revision of International Approxi-
Lists, 1955) First 9 weeks Since seasonal low week mate
Ended Ended seasonal
March March Median Median low
Weekly incidence low or sporadic 4, 5, 1i965-c: 196 196 edian 96- i 1955-56 point
-- Data not available 9I61 1961C 1 6-6 to
Quantity zero i959-6
Anthrax------- -------------- 062 4 4 *
Botulism---------------------049.1 3 *
Brucellosie undulantt fever)----044 13 15 15 80 142 130 *
Diphtheria-----------------------055 9 15 22 164 181 186 744 711 915 July 1
Encephalitis, infectious--------082 28 29 27 198 228 181 198 228 181 Jan. 1
Hepatitis, infectious, and
aerum---------------092,N998.5 pt. 2,091 716 567 15,542 6,598 4,584 30,745 14,-40 9,717 Sept. 1
Malaria-------------------110-117 1 3 7 9 *
Measles -----------------------. 085 14,250 13,484 16,761 92,327 85,685 101,587 128,537 121,772 134,046 Sept. 1
Meningitis, aseptic---------340 pt. 19 31 --- 203 264 --- 203 264 --- Jan. 1
Meningoococal infections---------057 43 54 66 460 502 516 1,114 1,166 1,284 Sept. 1
Poliomyelitis-------------------080 5 16 19 78 169 189 3,144 8,443 8,443 Apr. 1
Paralytic-------------080.0,080.1 1 7 17 43 118 135 2,152 5,619 5,619 Apr. 1
NBoparalytic-----------------080.2 3 6 1 17 29 28 640 2,146 2,146 Apr. 1
UnIpecified-----------------080.3 1 3 1 18 22 26 352 678 678 Apr. 1
Psittacosie----------- -096.2 2 2 10 16 *
Rabies in man------------------09 2 *
Btreptococcal sore throat,
including scarlet fever-----050,051 10,643 10,087 --- 85,196 79,090 --- 182,848 --- --- Aug. 1
Typhold fever------------------040 13 10 13 80 83 130 782 810 1,142 Apr. 1
Typhus fever, endemic-----------101 6 5 *
Babies In animals---------------- 89 79 96 550 712 805 1,126 1,694 1,694 Oct. 1


6-1 %- 4 V V t? u- I, '/j 7






Morbidity and Mortality Weekly Report


POLIOMYELIT




All Cases


POLIO VACCINE DISTRIBUTION AT F


14 21 28l 4 lII I1 2l51 9 1 23 301 13 20 271 3 10
May June July Aug. Se;
WEEK OF ONSET



of age. The following table shows the age distribution of
paralytic cases by vaccination status. More than 56% of
the paralytic cases had either no doses or one dose of
vaccine. On the other hand, 26% had received a full
series of three or more doses. Although this might be
seen as a relatively high number of vaccine failures, it
was found by comparing the number of cases in each group
with the number at risk that a far greater proportion of


PARALYTIC WITH RESIDUAL


Doses of Vaccine


Group 0 1 2 3 4 5 Total
0-4 12 12 4 3 38
5-9 5 7 5 5 1 1 24
10-14 1 3 1 5
15-19 1 1
20-29 2 2 1 5
30+ -


TOTAL 20
PERCENT 27.4


21 13 13 S
28.8 17.8 .7.8 6.8


73
100.0


Percent
52.1
32.9
6.8
1.4
6.8

100.0


18

16

< 14
UJ

o 12

U 10
o 10


children had three or
more doses of vaccine
IS -RHODE ISLAND and the attack rare
among vaccinated per-
1960
1960 sons was actually very
low and among the un-
vaccinated very high.
i by Week of Onset
The estimated effec-
tiveness of vaccine in
KEY Rhode Island was 81%,
which compares with
[ NONPARALYTIC findings in other re-
Scent outbreaks.
PARALYTIC Over 50% of the
cases had a traceable
contact with another
case and 11 families
had multiple cases which
I accounted for 26 cases.
During the epide-
mic 500,000 doses of
:REE CLINICS vaccine were distri-
buted, 300,000 from
free clinics and the re-
(Cumulative Totals) maining by private
practitioners. As in-
dicated in the lower
part of the figure, the
greatest part of this
.7 lI is e ssis i
it. Oct. Nov. "vaccine was distribu-
>t. Oct. Nov.
ted during July direct-
ly prior to the sudden
fall off in the epidemic.
(Reported by Dr. Ray-
mond F. McAteer, Medical Director, Division of Communi-
cable Diseases, Rhode Island Department of Health.)

Undiagnosed Epidemic Exanthem Vermont

An outbreak of illness with exanthem has been oc-
curring in a Vermont college preparatory school for boys
age 14 to 19 years. The first case was noted on January
18, and 34 of the '5 boys have since been ill.
The illness is characterized by some or all of the
following symptoms and signs: a generalized skin rash,
moderately severe sore throat without exudate, mild fever
usually not more than 1020, severe headache, dizziness,
pain in or behind the eyes, weakness, cervical and auri-
cular lymphadenopathy and conjunctival injection. Also
noted frequently are irritability, malaise, and anorexia.
Occasionally there is gastric disturbance, and infrequent-
ly, muscle aching and joint pain. Hepatosplenomegaly
has not been noted.
The exanthem is quite characteristic, although it
does not occur in all cases. It appears at the onset of
(Continued on page 8)


300
g 250
8-200
Du
> u 150
o 100
0 50


Age










Morbidity and Mortality Weekly Report 3

Table 2. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES, EACH DIVISION AND STATE, AND
PUERTO RICO, FOR WEEKS ENDED MARCH 5, 1960 AND MARCH 4, 1961

(By place of occurrence. Numbers under diseases are category numbers of the Seventh Revision of the International Lists, 1955)


Poliomyelitis 080 Brucel-
Menin- loss
Total Paralytic 080.0,080.1 gitis, (undu-
(Includes cases not specified by type) Nonparalytic aseptic lant
Area Cumulative, Cumulative, fever)
9th Week first 9 weeks 9th Week first 9 weeks 080.2 340 pt. 044

1961 1960 1961 1960 1961 1960 1961 1960 1961 1960 1961 1961

UNITED STATES--------- 5 16 78 169 1 7 43 118 3 6 19 13

NEW ENGIAND------------------ 1 2 6 1 2 6 -
Maine ---------- 1 2 1 2 -- -
New Hampshire------------ -
Vermont------------------ -
Massachusetts-------------- 1 4 1 4 -
Rhode Island----------------- -
Connecticut---------------- 1 -- -
MIDDLE ATLANTIC--------- -- 1 7 28 6 19 1 1
New York------------------- 1 2 26 1 17 1 -
New Jersey----------------- 1 2 1 2 1
Pennsylvania-------------- 4 4 -
EAST NORTH CENTRAL--------- 7 12 22 7 4 4 5 -
Ohio--------------------- 2 7 13 3 2 -
Indiana-------------------- 1
Illinois------------------- 2 3 2 2 1 -
Michigan------------------ 44 1 4 I 4 3 -
Wisconsin-------------- -- 1 2 2 1 -
WEST NORTH CENTRAL------- 1 8 1 5 1 9
Minnesota----------------- 1 4 1 4 -
Iowa ---------------------- 2 1 7
Missouri------------------ 1 1
North Dakota--------------- -
South Dakota--------------- 1 1 -
Nebraska------------------ -
Kansas-------------------- 1
SOUTH ATLANTIC--------------- 1 1 7 33 1 5 27 1 2 -
Delaware------------------ 1 1 2
Maryland----------------- -
District of Columbia------ .
Virginia------------------ -
West Virginia------------- 1 1 2 2 1 -
North Carolina------------- 1 2 12 1 2 12 -
South Carolina------------ 2 2 -
Georgia-------------------- 1 1 -
Florida---------------- 2 16 1 10 -
EAST SO1TH CENTRAL------- 1 10 4 3 1 2
Kentucky---------------- 1 10 3 2 1 1
Tennessee----------------- -
Alabama------------------- -
Mississippi--------------- 1 1
WEST SOUTH CENTRAL---------- 1 I 9 9 4 7 1 1 2
Arkansas----------------- 1 -
Louisiana--------------- 3 4 2 3 2
Oklahoma ------------- 1 -
Texas--------------------- 1 5 4 2 3 1 1
MOUNTAIN-------------------- 1 13 10 7 6 2 1
Montana------------------ 1 4 1 3 -
Idaho-------------------- 2 4 1 -
Wyoming------------------- -
Colorado------------------ 3 3 -
New Mexico----------------- 1 2 -
Arizona------------------- 2 2 1 2 -
Utah--------------------- 4 2 1
Nevada--------------------- .
PACIFIC---------------------- 1 6 17 49 1 5 11 41 1 6
Washington--------------- 1 4 1 4 -
Oregon------------------- -- 2 7 1 3 -
California----------------- 1 5 15 37 1 4 10 33 1 6
Alaska--------------------- -
Hawaii--------------------- 1 1 -

Puerto Rico------------------ 1 12 1 12 -










4 Morbidity and Mortality Weekly Report

Table 2. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES, EACH DIVISION AND STATE, AND
PUERTO RICO, FOR WEEKS ENDED MARCH 5, 1960 AND MARCH 4, 1961 Continued

(By place of occurrence. Numbers under diseases are category numbers of the Seventh Revision of the International Lists, 1955)


Diphtheria 055 Hepatitis, infectious, and
Encephalitis, serum 092,N998.5 pt.
infectious eae
Area Cumulative, Cumulative,
9th Week first 9 weeks 082 9th Week first 9 weeks 085

1961 1960 1961 1960 1961 1960 1961 1960 1961 1960 1961 1960


UiED STArBS ------ 9 15 164 181 28 29 2,091 716 15,542 6,598 14,250 13,484

EW EHNGIAND-------------- -- 2 5 2 5 66 10 492 221 1,052 796
Maine-------------------. I1 4 24 14 11 69
New Hampshire------------- 7 1 31 1 6 14
Vermont------------------ 3 82 5 39 2
Massachusetts------------- 2 3 1 3 22 8 152 114 582 485
Rhode Island-- --------- -- 1 1 9 1 68 42 304 24
Connecticut---------------- 1 1 21 135 45 110 202
MIDDIE AT TIC-------------- 1 3 6 3 6 387 87 2,262 609 2,398 2,039
New York-------------- 2 1 2 4 171 59 951 306 1,239 1,670
New Jersey------------ 1 97 5 446 42 342 274
Pennsylvania------------- 1 1 5 2 119 23 865 261 817 95
EAST NOTH CNTRAL-------- 2 1 4 15 3 467 166 3,035 1,235 4,043 3.364
hio----------------------- 1 9 203 57 1,270 337 1,060 508
Indiana---------------- 3 79 22 436 172 268 318
Illinois------------------ 2 3 1 82 41 507 279 474 887
Michigan-------------- 1 2 3 94 41 739 346 823 963
Wisconsin----------------- 9 5 83 101 1,418 688
WEST NORT CENTRAL------- 1 9 11 1 201 30 1,540 588 730 215
Mfnnesota------------------ 1 5 2 48 6 375 55 13 97
Iowa---------------------- 1 2 60 4 349 105 222 60
Missouri---------------- 1 54 16 364 192 342 10
North Dakota-------------- 1 4 1 37 58 106 48
South Dakota-------------- 3 4 7 87 86 1 -
Nebraska---------------- 1 17 1 143 51 46
Kansas----------- 1 11 2 185 41 MN N
SOUTH ATANTIC------------- 3 3 29 41 7 3 220 66 1,730 754 1,738 694
Delaware----------------- 4 7 43 39 52 4
Maryland------------------ 2 41 2 166 67 142 142
District of Columbia------ 3 1 16 7 5 82
Virginia----------------- 6 7 1 38 14 217 168 368 239
West Virginia------------- 1 1 38 20 397 169 293 42
North Carolina------------ 3 1 1 60 2 370 34 425 19
South Carolina---- --- 12 1 10 3 145 20 138 11
Georgia------------- ----- 3 3 1 5 11 181 76 4
Florida--------------- 3 3 16 17 4 21 6 195 174 315 151
EAST SOUTH CENTRAL----- 1 1 4 18 1 316 89 2,732 1,130 1,722 1,050
Kentucky------------ 2 94 30 879 515 877 219
Tennessee------------- 1 2 2 142 26 1,165 326 555 541
Alabama------.------------ 10 43 24 432 228 228 149
Mississippi-------------- 1 6 1 37 9 256 61 62 141
WEST SOUTH CBTRAL------- 2 7 110 61 3 1 156 57 1,016 471 579 2,574
Arkansas------------------ 1 1 36 1 219 25 233 13
Louisiana------------ 2 11 11 12 42 21 7
Oklahoma------------------ 2 5 4 6 90 73 1 49
Texas------------ 2 5 97 44 3 104 50 665 352 345 2,505
MOUNAIN----------------- 2 3 23 1 1 80 64 1,063 636 681 665
Montana----------------- 2 9 2 129 26 83 62
Idaho-------------------- 11 4 6 61 104 47 104
Wyoming----------------- 5 2 14 4 3
Colorado-------------..--- 1 2 20 23 349 172 118 151
New Mexico------------- 2 2 1 11 14 196 113 NN -
Arizona----------------- 9 12 89 146 325 103
Utah------------------ -...- 3 1 22 6 194 60 74 238
Nevada-------------------- 3 1 31 11 31 7
PACIFIC------------------- 1 10 10 198 147 1,672 954 1,307 2,087
Washington--------------- 1 26 21 209 120 315 782
Oregon-------------------- 21 34 298 202 146 262
California---------------- 9 10 146 85 1,097 584 836 615
Alaska--------------- 1 1 2 51 21 2 22
Hawaii ------------ --- 4 5 17 27 8 406

Puerto Rico---------------- 2 7 43 7 23 64 176 26 47

NN-NOt NObitiable









Morbidity and Mortality Weekly Report 5


Table 2. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES, EACH DIVISION AND STATE, AND
PUERTO RICO, FOR WEEKS ENDED MARCH 5, 1960 AND MARCH 4, 1961 Continued

(By place of occurrence. Numbers under diseases are category numbers of the Seventh Revision of the International Lists, 1955)

Strepto-
coccal Typhoid fever 040 Typhus
Meningoccocal Psitta- fever
Malaria infections cosis thsote fee Rabies in
throat, endemic animals
Area etc. Cumulative,
110-117 057 096.2 050,051 9th Week first 9 weeks 101

1961 1961 1960 1961 1961 1961 1960 1961 1960 1961 1961 1960

UID STAIES--------- 1 43 54 2 10,643 13 10 80 83 89 79

NBW ENGLAND-----------..... 4 1 683 1 2 1 -
Maine--------------------- 1 12 1 1 -
New Hampshire------------- I 1 1 0 -
Vermont-------------------- 28 -
Massachusetts-------------- 2 259 1 1 -
Rhode Island ---------- -6 64 -
Connecticut---------------- 310 -
IDI ATLANTIC------------- 1 5 8 1 1,205 1 1 8 5 1 9
New York------------------ -- 1 3 676 1 1 2 3 1 9
New Jersey---------------- 1 3 252 1 -
ennsylvania-------------- 1 3 2 1 277 5 2 -
EAST NORI CNTRAL----------- 9 14 1,453 2 7 7 6 8
Ohio----------------------- 1 1 420 4 1 1 -
Indiana-------------------- 2 1 291 1 1 2 4
Illinois------------------ 4 217 1 1
Michigan------------- 6 6 293 2 1 4 2 3
Wisconsin------------------ 2 232 1 1 -
WEST NORTH CENTRAL---------- 1 3 285 7 7 6 9
Minnesota---------------- 1 14 3 1 1
Iowa --------------------- 1 57 1 3 3
Missouri----------------- 2 21 3 7 3
North Dakota--------------- 101 1 2
South Dakota-------------- 1
Nebraska------------------- -
Kansas------------------ 91 -
SOUTH AANTIC-------------- 4 8 1 727 3 2 12 17 26 13
Delaare-------------- 1 3 -
Maryland------------------ 72 -
District of Columbia------. 2 1 1 -
Virginia----------.------- 2 161 3 15 5
West Virginia-------------- 322 1 5 4
North Carolina------------- 2 44 1 2 7 -
South Carolina------------ 35 1 5 -
Seorgia-------------------- 2 3 7 5 4
Florida-------------------- 2 2 89 1 1 1 -
EAST SOUH CENTRAL.-------- 4 5 1,883 3 2 15 25 10 17
Kentucky--------------- -- 1 1 339 1 2 3 9 1 7
Tennessee----------------- 1 1 1,323 2 10 14 4 8
Alabama----------------- 1 2 13 2 2 5 2
Mississippi-------------- 1 1 208 -
WEST SOUTH CENTRAL---------- 5 6 1,176 4 1 12 11 30 21
Arkansas------------------ 17 2 7 12
Louisiana---------------- 1 5 8 2 4 6 1
Oklahoma--------------- 2 9 2 1
Texas---------------------- 2 1 1,142 4 1 8 4 17 8
MOUNTAIN------------------- 2 1,832 2 8 7 3 1
Montana------------------- 61 1 4 -
Idaho---------------------- 1 174- -
Wyoming----------------- 1 61 -
Colorado------------------- 1 740 4 -
New Mexico----------------- 299 2 1 3 2
Arizona-------------------- 164 1 1 1
Utah---------------------- 284 -
Nevada-------------------- 49 -
PACIFIC---------------------- 9 9 1,399 1 9 3 7 1
Washington---------------- 1 813 1 -
Oregon--------------------- 1 1 147 -
California-------------- 8 7 425 1 8 3 7 1
Alaska--- --------- -
iHiat i----------------- 3 3

Puerto Rico------------ 13 3 12 1






Morbidity and Mortality Weekly Report


15,000


15,000 NUMBER OF DEATHS IN SELECTED CITIES


14,000 CURRENT WEEK
---- 5-WEEK MOVING AVERAGE
ADJUSTED AVERAGE

13,000 A


12,000!


1,0001-


10,000 --


I
Ti ii


JUL AUG SEP OCT NOV DEC JAN FEB MAR APR MAY JUN
1960 1961


T II T i T


iili T i lT


S iT i i T T T TII ITI IIi -


The chart shows the number of deaths reported for
117 major cities of the United States by week for the cur-
rent year, a 5-week moving average of these figures
plotted at the central week, and an adjusted average for
comparison. For each region the adjusted average was
computed as follows: From the total deaths reported each
week for the years 1956-1960, 3 central figures were
selected by eliminating the highest and lowest figure
reported for that week. A 5-week moving average of the
arithmetic mean of the 3 central figures was then com-
puted with adjustment to allow for population growth in
each region. The average value of the regional increases
was 2 percent which was incorporated in the adjusted
average shown in the chart.
Table 4 shows the number of death certificates re-


ceived during the week indicated for deaths that occurred
in selected cities. Figures compiled in this way, by week
of receipt, usually approximate closely the number of
deaths occurring during the week. However, differences
are to be expected because of variations in the interval
between death and receipt of the certificate and because
of incomplete reporting due to holidays or vacations. If a
report is not received from a city in time to be included
in the total for the current week, an estimate is used.
The number of deaths in cities of the same size may
also differ because of variations in the age, race, and sex
composition of the populations and because some cities
are hospital centers serving the surrounding areas. Changes
from year to year in the number of deaths may be due in
part to population increases or decreases.


Table 3. DEATHS IN SELECTED CITIES BY CGOGRAPHIC DIVIONS
(Ny place of occurrence and veekof filing certificate. Excludes fetal deaths. Data exclude figures shown in parenthesae in table 4)

9th th Percentave t 9 eek
v9th 8th Adjusted b cinen l t
ended ded average, adjusted
Area 9th avera
March Feb. v O 11 1960 Pect
4, 25, 1956-60 current change
1961 1961 e

TOAL, 117 M WM CTIE ---------------- 12,052 11,591 12,177 -1.0 110,612 119,111 -7.1

S e Egland-------------------------------(14 cities) 713 711 744 -4.2 6,820 7,655 -10.9
Middle Atlantic--------------------------(20 cities) 3,439* 3,220 3,355 +2.5 31,385 31,763 -1.2
Eat North Central-------------------------(21 eitie) 2,477* 2,428 2,574 -3.8 23,168 25,933 -10.7
West North Central--------------------------(9 cities) 864 821 892 -3.1 7,529 8,379 -10.1
South Atlantic---------------------------( cities) 958 1,013 1,047 -8.5 9,716 10,522 -7.7
ast South Central-------------------------(8 cities) 540* 596 555 -2.7 5,184 5,431 -4.5
Vest Bouth Central--------------------------(13 cities) 1,044 992 1,096 -4.7 9,682 10,821 -10.5
Mountain---------------------------------- (8 cities) 454 371 364 +24.7 3,470 3,622 -4.2
Pacific---------------------------------.(13 cities) 1,563 1,439 1,550 +0.8 13,658 14,985 -8.9

*Includes estimate for misslag reports.


9,000L
r i












Mobidity md Mortality Weekly Report 7


Table 4 DEATHS IN SELECTED CITIES


,i a.a f en t fi f e. --e--L


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UNIVERSITY OF FLORIDA

SIIIIl I Ill II 11110296llll 1
3 1262 08864 0296


Morbidity and Mortality Weekly Report


illness or within the first four days, and may reappear
after an absence of several days. It is a bright, pinkish,
diffuse, finally maculopapular eruption occurring on the
face, trunk and extremities. The tin', macules measure
from 1 to 3 mm. in diameter. The majority of the patients
have experienced mild to moderate pruritis and one noted
a fine brawny desquamation as the rash cleared. White
blood counts are usually low, but with some variation.
The first case occurred January 18 in a boy who had
spent Christmas vacation at his home in Massachusetts
and had also visited Connecticut and New York before
returning to school on January 4. The next case occurred
February 3 in a boy who sat at the same table with the
first case. Two cases occurred February 7, and thereafter
increasing numbers were affected so that by February 27,
about 40% of the boys in the school had become ill. New
cases continue to occur daily.
During the outbreak it was wisely decided not to
close the school or send the boys home. The school of-
ficials made every effort to contain the outbreak by re-
stricting social contacts of the students. No cases have
been reported outside the private school. Throat washings,
fecal and blood specimens from,15 cases were collected
on February 24 for laboratory study.
(Submitted by Dr. Linus J. Leavens, Director, Communi-
cable Disease Control Services, Vermont Department of
!Iea!th.)


Recent Smallpox Vaccination Recommended for Persons
Traveling to Spain
The Public Health Service recommends that persons
traveling to Spain should have had a successful smallpox
vaccination performed within one year of the date of de-
parture as a precautionary measure. It should be empha-
sized that this is a recommendation and not a quarantine
requirement. The three-year period of validity for the
smallpox vaccination certificate for entering the United
States remains the same.


FOR SOURCE AND NATURE OF MORBIDITY DATA SEE
LAST WEEK'S MORBIDITY AND MORTALITY WEEKLY
REPORT


NIV 0 F
U.S. DCEPOSITOR




U.S. DEPOSITORY


INTERNATIONAL NOTES


Influenza England and Wales


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The British Ministry of Health, London, reports that
the epidemic of A2 influenza is subsiding in all parts of
England and Wales. Deaths due to influenza, pneumonia,
and bronchitis reported for the week ending February 25
have declined markedly from the levels reported during
preceding weeks.


Smallpox Madrid, Spain
The Division of Foreign Quarantine has informed us
that recently smallpox was imported to Madrid, Spain by
a child who flew from Bomba\ to Rome on TWA flight
#809, January 26 and from Rome to Madrid on Alitalia
#346, January 27. Diagnosis was made on February 6
and death occurred on February 14.
A secondary case in Madrid was confirmed on Febru-
ary 23 and 13 additional cases were reported for the week
ending March 4. We have been advised that a smallpox
vaccination campaign is in progress.


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