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:
AA00010654:00346

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


r~ s-r


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


Vol 15, No. 34




R T9


Ending
A 27, 1966


EPIDEMIOLOGIC NOTES AND REPORTS
CONGENITAL MALARIA Illinois

A case of congenital malaria in a .":,-month-old female
infant, born to Philippine parents. \as recently detected
in Chicago. The infant waas born there after a full-term
pregnancy and normal delivery: she was in good health
until the onset of spiking fever at 79-hour interNals at the
age of 7 weeks. Plasmodium mialariae schizontswere found
in blood smears.
The mother had no history of malaria either in the
Philippines or since her arrival in the United States in
1963. However. careful review of thin blood smears ob-
tained from her during a routine prenatal visit and at the
time of delivery revealed one trophozoite and six tropho-
zoites, respectively.


IEpidnmioloLic' Not,s anod Ueporti
Con. eniial Mala. ri, Illinoit .
Fncephaliti -- i .s .
International NoLe t
\ raolaI Minor United Kinldlom
Quar,tntine sure .
Survey illdnic, Sumi unry
Hal ie- 19t .. .


. . . 2 9
. . 290

. I . 290
. . :.300

. . .. ) 1


Neither mother nor child had a history of transfusions.
The diagnosis of P. malaria infection in both cases %as
confirmed by fluorescent antibody studit-. Both patients
were treated with anti-malarial chemotherapy.
The father had a history of malaria during childhood
in World War II in the Philippines. hut has had no attacks
(Continlued on fiaye 290)


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous weeks)
34th WEEK ENDED CUMULATIVE, FIRST 34 WEEKS
MEDIAN
DISEASE AUGUST 27. AUGUST 28, 1961-1965 MEDIAN
1966 1965 1966 i 1965 1961- 1965
Aseptic meningitis .. .......... 145 74 74 1,468 1,147 1,177
Brucellosis ............... .. .. .. 7 9 11 150 160 278
Diphtheria .... ........ 1 2 6 113 97 174
Encephalitis, primary:
Arthropod-borne & unspecified ......... 100 50 1,072 1.077 -
Encephalitis, post-infectious ..... 10 14 -559 521
Hepatitis, serum ........... 35 552 685 910 22,467 ,
Hepatitis, infectious .................. 531 21,216
Measles rubeolaa) ......... 491 598 996 188.156 238.672 384.757
Poliomyelitis. Total (including unspecified) 4 22 59 40 204
Paralytic ... ..... .. ... ..... 2 19 54 33 174
Nonparalytic .. ....... ..... ..... .. 1 6
Meningococcal infections. Total .......... 42 31 28 2,644 2.248 1,688
Civilian ...... .. 39 31 2.373 2,068 -
Military. . ... .. 3 271 180 -
Rubella (German measles) ...... ..... .... 204 -- 41.116 -
Streptococcal sore throat & Scarlet fever 3,797 3.933 3,104 298.120 276.674 241.819
Tetanus .... ...... ......... 5 2 109 176 -
Tularemia .... 5 6 110 166 -
Typhoid fever . 9 15 15 236 265 301
Typhus, tick-borne (Rky Mt. Spotted fever) 13 11 178 200 -

Rabies in Animals ....... .......... 74 74 62 2.838 3,051 2.702

NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum Cum-
Anthrax: ... ............ 4 Botulism 4
Leptospirosis: Tex.-1, Ark.-1 .. .... .47 Trichinosis: Conn.-4. N.Y Ups.-l 68
Malaria: N.Y. Ups.-1, Pa.-3. N.C.-2, Calit.-3, Wash.-3 .. 225 Rabies in Man: 1
Psittacosis: Va.-I. Cal. -1, Tex.- ..... 31 Rubella. Congenital Syndrome 20
Typhus, murine: T. 1 ................ 15 Plague: 4


COMMUNICABLE DISEASE CENTER
COMMUNICABLE DISEASE CENTER















since that time. Repeated blood films have been negative
for malaria organisms.
(Reported by Dr. R.M. McQuay, Parasitologist, Dr. S. Sil-
berman, Pathologist, and Pola Mudrik, all at Mt. Sinai
Hospital, Chicago; Dr. L. Keith. Pediatrician, Presby-
terian-St. Luke's Hospital, .'" ... .: Dr. Norman J. Rose,
State Epidemiologist, Illinois Department of Health,
Springfield; and Dr. Samuel L. Andelman, Chicago Com-
missioner of Health.)
Editorial Comment
Congenital malaria is a rare occurrence even in highly
endemic areas in the world. The incidence estimates vary


AUGUST 27. 1966


from 0.03 to 9.6 percent. Spitz2 observed no malaria
parasites in blood films of 137 newborn infants, although
the maternal side of the placentae in these cases were
heavily infested.
The above case report is of special interest in that
the mother had no clinical history of malaria but apparently
had a persistent low parasitemia.



References:
Covell. (;.: Trop. Dis. Bull., 47:1147, 1950.
2Spitz, A.T.: Bull. Wld. Hith. Org. 21:242, 1959.


ENCEPHALITIS Texas


A total of 110 cases of clinical encephalitis have
been reported from Dallas and 58 from Corpus Christi
through August 28, 1966. There have been seven deaths in
Dallas and two in Corpus Christi. In both cities, St. Louis
encephalitis virus is the etiologic agent and Culex quin-
quefasciatus the suspect mosquito vector. Aerospraying
with Malathion was completed on August 27 in Dallas and
on August 30 in Corpus Christi and resulted in a marked
reduction in the numbers of mosquitoes. However, it is
too soon to ascertain the effectiveness of the spraying in
controlling new human cases.


Further information on the onset dates and ages of
Dallas cases of clinical encephalitis is shown in Tables
1 and 2, respectively.
(Reported by Dr. Van C. Tipton, State Epidemiologist,
Texas State Department of Health; Dr. Hal J. Dewlett,
Director. Dallas City Health Department; Dr. William R.
letzger, Director of Public Health and Welfare, Corpus
Christi-Nueces County Health Department; and teams from
CDC.)
Table 2
Age Distribution of Clinical Cases of Encephalitis
Through August 28, 1966 Dallas, Texas


Table 1
Clinical Cases of Encephalitis by Week of Onset
Through August 28, 1966 Dallas, Texas


Age Number
(Years) Cases


Attack
Rate'
Population* 100,000
Population


0-9 10 221,764
10-19 6 14.,183
20-29 11 137.393
30-39 11 147.793
40-49 17 119.964
50-59 17 8.SS79
60-69 19 54,770
70- 19 36,781

Total 110 '. ',7


Population Cens u.


INTERNATIONAL NOTES
VARIOLA MINOR United Kingdom


The United Kingdom was declared smallpox-free on
August 1b. 1966. Prior to this date a total of 73 cases
were recorded. The first recognized case was reported on
May 2. and subsequent epidemiological investigations
identified previous cases which occurred as early as
February 1966. By mid-June a total of 44 cases were known.
confined primarily to the Borough of Staffordshire. West


Midlands (MMWR. Vol. 15, No. 24). In early July. addi-
tional foci accounting for 16 new cases were discovered in
Warwickshire and Lancashire, England, and in Monmouth-
shire. Wales (MMWR. Vol. 15. No. 30). Thirteen new cases
were reported during mid-July and early August from the
same Boroughs.
The geographical distribution of all the cases, as


290


Morbidity and Mortality Weekly Report




CONGENITAL MALARIA Illinois (Continued from front page)


Week Ending

June 11
July 16
July 23
July 30
August 6
August 13
August 20
August 28

Total


Cases

1
1

2
25
35
30
11


Deaths

0
1

0
0
2
3
1
0


Number
Deaths


.5 0
.0 0
0
.4 0
.2 1
.1 1
.7 2
.7 3

.6 7


*1960 DaIll; Count v













shown in Figure 15 (page 300), is listed below.
Lancashire
Salford County Borough ........... 13
Staffordshire
Birmingham County Borough ........ 1
Cheadle Rural District .... 7
Stoke-on-Trent County Borough ..... 19


Stone Rural District .. .......
Hiallall County Borough .
Warley County Borough .. ........
Location not indicated. ....
i ar wickshire
Solihull County Borough . .


ANNUAL SURVEILLANCE SUMMARY
RABIES 1965


In 1905, 4,584 laboratory-confirmed cases of rabies
were reported, a 4.2 percent decrease from the 1964 total
but a 20 percent increase over the previous 5-year average.
Twenty-six States reported an increase in animal rabies,
while 21 States reported a decrease. Rabies virus was
detected in 25 different animal hosts in 47 of the 50 States
reporting rabies. Of 3,210 counties in the United States.
1,227 reported one or more animal rabies cases during the
year (Figure 1). Two human rabies deaths occurred in the
U.S. in 1965, one in a 60-year-old man from West Virginia
and one in a 3-year-old Mexican girl who died in California.
The totals of cases of rabies in wild animals. domestic
animals and man during the years 1953 through 1965 are


shown in Table 3. During this period the reported number
of cases of rabies in wild animals has more than doubled
while there was a consistent decrease in incidence among
domestic animals from over 7,000 cases in 1953 to less
than 1.500 cases in 1961. During the past 5 years the
incidence has remained relatively constant. Rabies in man
has all but disappeared. with one or two cases being re-
ported in each of the past 4 years. These trends are pre-
sented in Figure 2: the effect of the increased incidence
in wild animals and the decreased incidence in domestic
animals is reflected in the trend of the total rabies inci-
dence whii< decreased from 1953-1960 and has since
gradually increa-ed.


Figure 1
COUNTIES REPORTING ANIMAL RABIES 1965


AUGUST 27 1966


Morbidity and Mortality Weekly Report


291


-i
S 13

S 1


(Con/tified on paye 300)


. 3







Morbidity and Mortality Weekly Report


AUGUST 27, 1966


Table 3
Incidence of Rabies in the United States by Type of Animal- 1953-1965*

Wild Animals Domestic Animals

Fxsear B Rac- Other Other Farm Man Total
Foxes Skunks Bats ae Total Dogs Cattle Cats Total
coons Animals Animals

1953 1,033 319 8 40 79 1,476 5,688 1,012 538 106 7,344 14 8,837
1954 1,028 547 4 48 70 1,697 4,083 930 462 102 5,577 8 7,282
1955 1,223 580 14 37 61 1,915 2,657 835 343 89 3,924 5 5,844
1956 1,281 631 41 41 85 2,079 2,592 700 371 94 3,757 10 5,846
1957 1,021 775 31 36 79 1,942 1,758 651 382 63 2,854 6 4,802
1958 845 1,005 68 50 107 2,075 1,643 660 353 77 2,733 6 4,814
1959 920 789 80 43 83 1,915 1,119 699 292 52 2,162 6 4,083
1960 915 725 88 47 61 1,836 697 563 277 82 1,619 2 3,457
1961 614 1,254 186 58 62 2,174 594 435 217 47 1,293 3 3,470
1962 594 1,449 157 62 52 2,314 565 547 232 67 1,411 2 3,727
1963 622 1,462 1 303 162 62 2,611 573 459 217 72 1,321 1 3,933
1964 1,061 1,909 352 173 65 3,560 409 529 220 65 1,223 1 4,784
1965 1,038 1,582 484 99 54 3,257 412 536 289 89 1,326 2** 4,584
*Data prior to 1960 from USDA, ARS. Subsequent data from PHS, CDC.
**One case in a Mexican child who became ill in Mexico but died in California.



Figure 2
CASES OF RABIES IN WILD AND DOMESTIC ANIMALS
8,000-




6,000-


4,000




2,000


\ O ALTOTAL


WILD /



DOMESTIC
DOMESTIC


1953 '54 '55 '56 '57 '58
Source: USDA and USDHEW PHS


'59 '60 '61 '62


63 '64 '65


In 1965 wild animal species accounted for 3,257 or 71
percent of the rabies cases throughout the U.S. Skunks
and foxes were the two most frequently infected species
and accounted for 2,620 or 80 percent of the rabies in
wildlife, and 57 percent of the total rabies cases. Skunks
were second to foxes in incidence from 1953 to 1960 ex-
cept for 1958, but for the past 5 years skunks have been
the species with the highest incidence (Figure 3). In 1965
over one-third of the total rabies cases were recorded in
skunks. The totals of rabies cases in foxes remained
above 1,000 from 1953 to 1957 when a 6-year decline
occurred followed by a rise in 1964 and 1965 to slightly


over 1,000 cases (Figure 4). Bats were the species with
the fourth highest incidence of rabies; more rabid bats
were reported in 1965 than in any year since the first
case was diagnosed in a hat in the U.S. in 1953 (Figure 5).
Although the total reported cases of rabies in bats has
steadily increased during the 13-year period, it is felt that
this trend reflects an increased interest in collecting and
testing bats. The incidence of reported cases of rabid
raccoons ranged from 40 to 62 between 1953 and 1962. then
increased about threefold for 2 years and dropped to 99
cases in 1965 (Figure 6).


292


o








Morbidity and Mortality Weekly Report


Figure 3
CASES OF RABIES IN SKUNKS


Figure 4
CASES OF RABIES IN FOXES


YEAR


'53 '54 '55 '56 '57 '58 '59 '60 '61 '62 '63 '64 65 '66 '67 68 '69 '70
YEAR


Figure 5
CASES OF RABIES IN BATS


Figure 6
CASES OF RABIES IN RACCOONS


'53 '54 '55 '56 '57 '58 '59 '60 '61 '62 '63 '64 '65 '66 '67 '68 '69 '70
YEAR


The distributions of wild animals with rabies reported
in 1965 reveal distinctive geographical patterns peculiar
to each species. The 1,5h2 cases of skunk rabies reported
from 565 counties in 32 States are concentrated in the



Figure 7
COUNTIES REPORTING SKUNK RABIES 1965











t:
'" 1 4.....


central portion of the U.S., with moderate levels in New
York and California (Figure 7). Ohio, Texas and Illinois
notified the highest number of cases in skunks. Rabid
foxes are clearly concentrated in Appalachia from Up-State



Figure 8
COUNTIES REPORTING FOX RABIES 1965


1
;---
~;I---- .A.
'i
r. I
'.-.~-"i v
,r.- pc


~
u

,. i..:~` "

i r`-i


a 0 300
w
m
z 200.


100.


100-


293


A'GUST 27 1966












New York to Tennessee with sprinklings in the New Eng-
land States and Texas and small foci in Louisiana, Alabama
and Georgia. The 1.038 cases of fox rabies were reported
from 240 counties in 28 States, Tennessee and Virginia
reporting the highest incidence (Figure 8). Bat rabies was
the most widely distributed type of animal rabies as it



Figure 9
COUNTIES REPORTING BAT RABIES 1965


most frequently infected species with rabies, and among
domestic animals ranked second. In both Table 3 and
Figure 12 it is evident that the rabies incidence in dogs
has shown the most dramatic decline of any animal species.
From 1953 to 1965 there was more than a 90 percent de-
crease in cases of rabid dogs, and from 1962-1965 a 27



Figure 10
COUNTIES REPORTING RACCOON RABIES 1965


~ .
.
5 k1
*1o


was reported from 249 counties in 43 States, with evident
concentrations in California, Maryland, Mississippi and
New Jersey (Figure 9). Although reported from 13 States,
most of the 99 cases of rabid raccoons were reported from
Florida and Georgia where the problem is localized (Fig-
ure 10).
In 1965 domestic animal species accounted for 1,326
or 29 percent of the rabies cases throughout the U.S.
Cattle were the most frequently infected species and ranked
third among the total rabies cases. There has been about,
a 50 percent decrease in incidence of rabies in cattle dur-
ing the 13-year period (Figure 11). Dogs were the fifth




Figure 11
CASES OF RABIES IN CATTLE


2000

1600

a 1200-

z 800

400


HF nnn nn


percent decline. Improved public education in regard to
vaccination of pets and better "stray dog" control have
influenced this decline. Although the incidence of rabies
in cats has also declined during the same period, it has
been less than a 50 percent reduction. The reason for the
unparallel decline may be that rabies incidence in cats is
more closel related to that of the local wildlife whereas
rabies incidence in dogs tends to be dependent on other
dogs. The incidence of rabies among "other farm animals."
which include horses, mules, sheep, goats and swine, has
remained relatively constant since 1955,





Figure 12
CASES OF RABIES IN DOGS


6000

5000

4000

3000

2000




'53 54 '55 '56 '57 '58 '59 '60 61 '62 63 '64 65 '66 '67 '68 '69'70
YEAR


294


Morbidity and Mortality Weekly Report


AUGUST 27, 1966


'53 54 '55 56 '57 '58 '59 '60 '61 '62 '63 '64 '65 '66 67 '68 69 '70
YEAR


' ~ ~ '


"'







Morbidity and Mortali


Figure 13
COUNTIES REPORTING CATTLE RABIES 1965





S ... :.. .. ,, "



















related to certain wildlife species. The distribution of
'1: 3
-i-












The distribution of domestic animals with ratites in
1965 demonstrates geographical patterns that are closely
related to certain wildlife species. The distribution of
rabies among cattle and other farm animals is related to
the geographical pattern of rabid foxes and skunks in
particular (Figure 13). The distribution of rabid dogs,
however, is an exception in that it is related to the effec-
tiveness of local rabies control programs Although cases
were scattered in 233 counties in 34 States, 33 percent of
the 412 rabid dogs were reported from the four States on
the U.S.-Mexican border and 27 percent from the four con-
tigous States of Kentucky. Tennessee. Missouri and
Illinois (Figure 14),

Human deaths due to rabies have declined from 14 in
1953 to one or two in each of the past 4 years. A line list-
ing of the four human rabies deaths in the past 3 years is
in Table 4. One of the two deaths in 1965 occurred in a
man from Wnest Virginia who had been bitten by a rabid
dog 23 months earlier and had received 14 daily doses of


AUGUST 27 1966


Table 4
Human Rabies Deaths, 1963-1965


Locality


Alabama

Minnesota

West Virginia

Mexico


Date and
Place of Death

9 4 63
Alabama
9/1/64
Minnesota
5 21 65
W. Virginia
12 "b 65
California


*Trapped and k.nn i a fox 6 months prior to death. No history of bite from this animal and no treatment for this possible exposure.


ity Weekly Report 295




Figure 14
COUNTIES REPORTING DOG RABIES 1965







4 1-





....... L


i .__..'._; -^ ..






duck embryoorigin anti-raliie. \ vaccine iniediatel\ follow-
ing that exposure(MMIRi, \ol. 14. No. 23). This man aas
also known to have trapped and skinned a fox 6 months
before his death, but it i- not kno\M n whether that fox or
others he trapped about this time were rabid. The second
human case was in a 35-month-old Mexican girl \\ho died
at the Children's Hospital in San i c,.. California (1MMWR,
Vol. 14, No. 52). She had boon bitten by a presumed rabid
dog near her home in Fnsenada, Baja California. Treat-
ment with an unspecified rabies vaccine was begun in Baja
California the day after she aas bitten, but was discon-
tinued the following 2 days and then resumed for the next
9 days. There was no history of hyperimmune serum being
given after the child had been bitten. After the death of
the child on December 8 an autopsy was performed and
specimens of the brain were positive for rabies by fluores-
cent ,ri ,...i., technique.

(Reported by the Veterinary Section, Epidecmiu/ol;y ranch,
C'C.)


1963

1964

1965

1965


Biting
Animal

Probably
Dog
Skunk

Dog

Dog


Nature of
Exposure

Unknown

Wrist and
Fingers
Bite on
right hand
Bite on
right ear


Incubation
Period

Unknown

20 days

23 months*

10 days


Duration
Of Illness

7 days


6 days

8 days

11 days


I I 1 I I 1 1


I I (


I 1 I ) I









296 Morbidity and Mortality Weekly Report


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

AUGUST 27, 1966 AND AUGUST 28, 1965 (34th WEEK)


ENCEPHALITIS HEPATITIS
ASEPTIC Primary Post- Both
AREA MENINGITIS BRUCELLOSIS including Infectious DIPHTHERIA Serum Infectious Types
unsp. cases


1966 1 1965 1966


1966 1965


1966 1966 1965 1966 1966 1965


UNITED STATES... 145 74 7 100 50 10 1 2 35 531 552

NEW ENGLAND.......... 23 1 1 4 24 25
Maine.............. 1 1 3 4
New Hampshire...... 2 6
Vermont............. 1 1
Massachusetts...... 22 1 4 9 8
Rhode Island....... 3
Connecticut........ 9 3

MIDDLE ATLANTIC...... 12 4 3 10 2 17 72 115
New York City...... 5 1 12 17 11
New York, Up-State. 1 1 1 2 14 57
New Jersey.......... 4 3 1 8 2 15 17
Pennsylvania....... 2 1 2 1 1 26 30

EAST NORTH CENTRAL... 6 22 21 6 4 1 1 98 105
Ohio............... 2 2 16 5 16 24
Indiana............. 4 3 10
Illinois........... 1 14 3 1 3 21 26
Michigan........... 3 1 2 I 1 52 39
Wisconsin.......... 1 1 6 6

WEST NORTH CENTRAL... 8 5 8 15 31 33
Minnesota........... 6 1 1 3 6
Iowa............... 2 1 8 21
Missouri............ 1 12 1
North Dakota....... 5 12 -
South Dakota....... 1 1 1
Nebraska............ 1 2
Kansas............. 4 1 6 3

SOUTH ATLANTIC........ 17 2 2 3 2 1 3 45 58
Delaware........... 1 1 1
Maryland............ 1 1 9 12
Dist. of Columbia.. 1 2
Virginia........... 5 1 5 16
West Virginia...... 5 2 5
North Carolina..... 1 1 7 9
South Carolina..... 1 1 3 4
Georgia............ 2 6 2
Florida............. 3 2 I 1 2 11 8

EAST SOUTH CENTRAL... 22 4 4 1 1 45 39
Kentucky............ 2 2 13 11
Tennessee.......... 1 2 1 1 12 16
Alabama............ 5 6
Mississippi........ 19 3 1 15 6

WEST SOUTH CENTRAL... 29 4 1 52 2 1 1 53 47
Arkansas........... 5 9
Louisiana.......... 3 1 1 1 1 11 4
Oklahoma ........... 4 1 5 -1
Tpxas.............. 22 3 47 1 37 33

MOUNTAIN ............. 5 2 10 16 21
Montana........... 3 4 2
Idaho ............. 1 2
Wyoming.............. 2 1 1
Colorado........... 1 5 3 6
New Mexico......... 3 1
Arizona............ I 1 4 6
Utah................ 2 2 3
Nevada............. -

PACIFIC.............. 36 24 4 3 2 12 147 109
Washington.......... 5 1 15 11
Oregon............. 1 -- 19 10
California......... 31 23 3 2 2 11 110 85
Alaska............. I 3 1
Hawaii............. 1 -- 2


Puerto Rico .......... -


- I


2 1 36 40








Morbidity and Mortality Weekly Report 297


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED
AUGUST 27, 1966 AND AUGUST 28. 1965 (34th WEEK) CONTINUED


MENINGOCOCCAL INFECTIONS, POLIOMYELITIS
MEASLES (Rubeola) TOTAL Total Pa c RUBELLA
STotal Paralytic
AREA
Cumulative Cumulative Cumulative
1966 1965 1966 1965 1966 1965 1966 1966 1966
1966 1965 1966 1965 1966


UNITED STATES... 491 188,156 238,672 42 2,644 2,248 4 54 204

NEW ENGLAND........... 3 2,233 36,743 4 117 113 1 40
Maine.............. 1 195 2,789 9 16 13
New Hampshire...... 1 80 381 9 7 -
Vermont............ 225 1,255 4 6 -
Massachusetts...... 1 774 19,273 4 48 37 1 5
Rhode Island....... 72 3,899 12 14 8
Connecticut........ 887 9,146 35 33 14

MIDDLE ATLANTIC...... 28 17,953 14,600 8 315 297 12
New York City...... 13 8,260 2,317 1 44 51 10
New York, Up-State. 8 2,516 4,103 2 89 84 2
New Jersey.......... 1 1,845 2,524 4 95 78
Pennsylvania....... 6 5,332 5,656 1 87 84 -

EAST NORTH CENTRAL... 145 68,306 55,208 8 409 315 I 73
Ohio................ 5 6,331 8,848 4 112 84 6
Indiana............. 19 5,665 1,807 1 72 41 4
Illinois........... 9 11,326 2,625 76 86 1 -- 2
Michigan........... 64 14,247 26,282 2 107 67 7
Wisconsin.......... 48 30,737 15,646 1 42 37 54

WEST NORTH CENTRAL... 5 8,666 16,418 1 141 113 1 4
Minnesota........... 1,639 631 1 34 23 1
Iowa............... 5,303 8,976 22 7 2
Missouri............ 1 530 2,584 54 51 -
North Dakota ..... 3 1,078 3,666 9 8 2
South Dakota....... 40 112 4 3 -
Nebraska........... 1 76 449 8 10 -
Kansas............. NN NN NN 10 11 -

SOUTH ATIANTIC....... 68 15,069 24,665 3 446 433 1 31
Delaware............ 256 502 4 7 2
Maryland............ 1 2,096 1,149 46 42 6
Dist. of Columbia.. 1 382 74 11 8 2
Virginia............ 18 2,118 4,040 49 50 -
West Virginia...... 23 5,181 13,539 24 24 -- 7
North Carolina..... 14 476 382 3 113 86 -
South Carolina..... 654 1,010 47 58 -
Georgia............ 1 234 614 63 53 1
Florida............. 10 3,672 3,355 89 105 14

EAST SOUTH CENTRAL... 27 19,585 13,637 6 230 178 1 3 17
Kentucky........... 1 4,694 2,425 2 84 71 4
Tennessee.......... 14 12,208 7,802 1 74 55 1 8
Alabama............ 4 1,676 2,301 1 50 32 1 5
Mississippi........ 8 1,007 1,109 2 22 20 2 -

WEST SOUTH CENTRAL... 109 24,193 30,613 1 366 301 47
Arkansas........... 4 970 1,084 33 14 -
Louisiana.......... 1 99 104 137 168 1
Oklahoma............ 474 203 18 18 1
Texas............... 104 22,650 29,222 1 178 101 45

MOUNTAIN............. 46 11,856 19,583 3 84 70 1 6
Montana............ 1 1,803 3,702 4 2
Idaho............... 5 1,547 2,770 5 8 1
Wyoming............. 12 157 841 6 5 -
Colorado............ 1 1,277 5,604 3 45 14 1 1
New Mexico......... 12 1,130 674 10 10 -
Arizona............. 13 5,277 1,283 10 16 4
Utah................ 2 622 4,506 13
Nevada............. 43 203 4 2

PACIFIC.............. 60 20,295 27,205 8 536 428 2 21
Washington ......... 9 3,487 7,217 37 33 2 5
Oregon.............. 21 1,722 3,186 33 32 5
California......... 28 14,487 12,866 8 447 340 6
Alaska.............. 467 170 15 16 1
Hawaii 2...... 132 3 7h6 4 7 &


... ............ ... I I
Puerto Rico .......... 33 2,632 2,322 10 6 1 2


I









298 Morbidity and Mortality Weekly Report


CASES OF SPECIFIED NOTIFIABLE DISEASES- UNITED STATES

FOR WEEKS ENDED

AUGUST 27, 1966 AND AUGUST 28, 1965 (34th 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. 196 1 966 Cm. 1966 Cum. 1966 Cum.
1966 1966 1966 1966 1966
UNITED STATES... 3,797 5 109 5 110 9 236 13 178 74 2,838

NEW ENGLAND .......... 386 2 1 2 6 2 65
Maine.............. 24 23
New Hampshire...... 7 22
Vermont............ 20 -- 18
Massachusetts...... 40 2 1 2 3 1 2
Rhode Island....... 37 -
Connecticut........ 258 3 1 -

MIDDLE ATLANTIC..... 149 11 1 41 3 38 3 178
New York City...... 4 4 1 17 -
New York, Up-State. 144 2 10 1 13 3 167
New Jersey......... NN 1 7 10
Pennsylvania....... 1 4 7 2 15 11

EAST NORTH CENTRAL... 273 2 10 12 1 31 1 16 4 375
Ohio................ 6 3 3 1 16 1 9 180
Indiana............. 75 1 2 3 2 1 81
Illinois........... 77 2 5 3 7 2 46
Michigan........... 84 1 3 4 30
Wisconsin.......... 31 1 6 1 38

WEST NORTH CENTRAL... 134 6 1 11 20 2 15 643
Minnesota.......... 10 1 4 149
Iowa............... 20 1 5 1 131
Missouri........... 3 4 5 8 1 10 202
North Dakota....... 76 1 26
South Dakota....... 4 2 67
Nebraska........... 1 2 1 18
Kansas............. 21 2 5 1 50

SOUTH ATLANTIC....... 484 1 28 9 3 43 6 80 18 373
Delaware........... 9 1 1 -
Maryland ........... 49 2 1 1 8 23 2
Dist. of Columbia.. 5 2 -
Virginia........... 115 4 2 8 5 26 4 199
West Virginia...... 150 1 1 1 44
North Carolina..... 10 4 2 1 4 1 18 3
South Carolina..... 30 1 1 1 8 5 -
Georgia............ 1 1 7 2 2 7 5 75
Florida............. 115 10 9 8 50

EAST SOUTH CENTRAL... 626 1 13 20 25 3 30 11 370
Kentucky........... 16 1 3 3 1 7 3 75
Tennessee.......... 443 2 10 11 2 18 4 268
Alabama............ 71 6 4 6 5 1 13
Mississippi........ 96 1 4 3 5 3 14

WEST SOUTH CENTRAL... 456 22 4 48 1 25 6 17 584
Arkansas........... 1 2 4 39 1 2 2 61
Louisiana.......... 10 5 3 7 5 35
Oklahoma .......... 12 1 4 1 9 4 5 150
Texas............... 433 14 2 8 5 338

MOUNTAIN................ 717 2 6 12 3 1 63
Montana............ 20 2 7
Idaho.............. 44 -
Wyoming............. 35 -
Colorado........... 335 2 3 2 8
New Mexico......... 187 1 2 1 11
Arizona............. 29 1 3 1 32
Utah............... 67 2 3 1
Nevada............ 4

PACIFIC.............. 572 1 15 3 1 33 1 5 187
Washington......... 54 11 2 10
Oregon............. 7 1 1 2
California......... 448 1 14 3 1 19 1 3 175
Alaska............. 34 -
Hawaii ....... 9 -
Puerto Rico.......... 1 2 33 7 1 11









Morbidity and Mortality Weekl Report






DEATHS IN 122 UNITED STATES CITIES FOR WEEK ENDED AUGUST 27, 1966


299


34 (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 year Area All 65 years Iand l year
Ages and over Iluenza Ca Ages and over Influ n Cas
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.-------


686
232
39
20
24
46
23
11
25
67
67
10
50
22
52

3,126
52
36
139
48
36
37
63
85
1,559
35
464
189
55
98
27
44
67
42
23
27

2,278
55
31
702
163
153
111
65
316
33
49
36
26
38
120
28
107
37
30
42
90
46

738
59
20
34
121
32
91
56
228
56
41


408
133
22
14
17
25
13
7
19
34
39
2
31
15
37

1,792
26
22
77
25
21
22
38
44
886
18
263
106
32
62
16
27
47
22
19
19

1,270
32
18
381
83
91
61
36
183
15
27
23
11
23
61
13
64
22
16
25
55
30

441
39
10
18
76
22
58
33
131
31
23


SOUTH ATLANTIC: 1,089 553 37 65
Atlanta, Ga.----------- 136 49 3 10
Baltimore, Md.--------- 191 82 2 17
Charlotte, N. C.------- 38 22 1 4
Jacksonville, Fla.----- 66 32 1 1
Miami, Fla.------------ 99 56 3 1
Norfolk, Va.----------- 63 28 2 5
Richmond, Va.----------- 90 45 2 12
Savannah, Ga.----------- 34 20 3 2
St. Petersburg, Fla.--- 83 62 8 1
Tampa, Fla.------------ 61 37 4 1
Washington, D. C.------ 179 96 5 6
Wilmington, Del.------- 49 24 3 5

EAST SOUTH CENTRAL: 638 333 33 34
Birmingham, Ala.------- 98 52 7
Chattanooga, Tenn.----- 55 35 4 1
Knoxville, Tenn.------- 39 23 2 -
Louisville, Ky.-------- 132 74 18 5
Memphis, Tenn.--------- 147 73 1 12
Mobile, Ala.----------- 39 18 -
Montgomery, Ala.------- 37 18 2 2
Nashville, Tenn.------- 91 40 6 5

WEST SOUTH CENTRAL: 1,155 568 35 99
Austin, Tex.----------- 43 22 5 4
Baton Rouge, La.------- 25 15 1
Corpus Christi, Tex.--- 22 13 3
Dallas, Tex.----------- 152 80 4 9
El Paso, Tex.----------- 41 18 5 4
Fort Worth, Tex.------- 54 31 3
Houston, Tex.----------- 228 93 4 28
Little Rock, Ark.------ 74 32 3 15
New Orleans, La.------- 200 94 2 7
Oklahoma City, Okla.--- 81 43 1 6
San Antonio, Tex.------ 122 59 5 13
Shreveport, La.-------- 50 28 3 3
Tulsa, Okla.----------- 63 40 3 3

MOUNTAIN: 391 244 14 30
Albuquerque, N. Mex.--- 49 29 2 3
Colorado Springs, Colo. 20 9 3 2
Denver, Colo.----------- 119 75 6 10
Ogden, Utah----------- 17 11 1 1
Phoenix, Ariz.--------- 84 47 8
Pueblo, Colo ---------- 18 11 1 2
Salt Lake City, Utah--- 55 40 3
Tucson, Ariz.----------- 29 22 1 1

PACIFIC: 1,655 970 31 90
Berkeley, Calif.------- 25 17 1 1
Fresno, Calif.--------- 47 22 2 2
Glendale, Calif.------- 38 27 2 5
Honolulu, Hawaii------- 47 28 1 8
Long Beach, Calif.----- 66 43 1 5
Los Angeles, Calif.---- 591 363 9 30
Oakland, Calif.-------- 50 28 1 4
Pasadena, Calif.------- 36 24 3
Portland, Oreg.-------- 123 73 2 7
Sacramento, Calif.----- 71 35 2
San Diego, Calif.------ 85 39 2 9
San Francisco, Calif.- 191 104 4 4
San Jose, Calif.------- 34 22 3 -
Seattle, Wash.---------- 157 80 1 5
Spokane, Wash.--------- 53 37 2 4
Tacoma, Wash.----------- 41 28 1

Total 11,758 6,579 367 716

Cumulative Totals
including reported corrections for previous weeks

All Causes, All Ages ------------------------- 433,401
All Causes, Age 65 and over------------------- 249,331
Pneumonia and Influenza, All Ages------------- 18,745
All Causes, Under 1 Year of Age--------------- 22,842


Week No.


*Estimate based on average percent of divisional total.









300 Morbidity and Mor





VARIOLA MINOR United Kingdom
Cot/inued fi rom page 291)

Monmoulhshire
Pontypool Urban, Rural Districts ... 1.

73:

The last infected area was Salford County. Borough.
Lancashire.
The source of the outbreak remains unidentified.
(Compiled from reports from the World Health Organization.)



Figure 15

DISTRIBUTION OF VARIOLA MINOR*

UNITED KINGDOM, FEBRUARY-AUGUST, 1966


0 20 40 60

0 LOCATION OF ONE CASE UNKNOWN MILES





QUARANTINE MEASURE


CHOLERA Iraq
Jordan, Syria and Lebanon prohibit disembarkation
travelers from Iraq except residents reentering these three
countries. provided 1I, submit to 5 days isolation.


tality Weekly Report


AUGUST 27 l966


THE MORBIDITY AND MORTALITY WEEKLY REPORT. WITH A CIRCULA.
TION OF 13.000 15 PUBLISHED BY THE COMMUNICABLE DISEASE
CENTER. ATLANTA. GEORGIA 30333.
CHIEF. COMMUNICABLE DISEASE CENTER JAMES L. GODDARD, M.D.
CHIEF, EPIDEMIOLOGY BRANCH A. D. LANGMUIR, M.D
CHIEF, STATISTICS SECTION R. E. SERFLING. PH.D.
ASST. CHIEF, STATISTICS SECTION IDA L. SHERMAN,M.S.
CHIEF. SURVEILLANCE SECTION D. A, HENDERSON, M.D.
ASSISTANT EDITOR. MMWR PAUL D. STOLLEY. M.D.
IN ADDITION TO THE ESTABLISHED PROCEDURES FOR REPORTING
MORBIDITY AND MORTALITY. THE COMMUNICABLE DISEASE CENTER
WELCOMES ACCOUNTS OF INTERESTING OUTBREAKS OR CASES. SUCH
ACCOUNTS SHOULD BE ADDRESSED TO
THE EDITOR
MORBIDITY AND MORTALITY WEEKLY REPORT
COMMUNICABLE DISEASE CENTER
ATLANTA. GEORGIA 30333
NOTE: THESE PROVISIONAL DATA ARE BASED ON WEEKLY TELE-
GRAMS TO THE CDC BY THE INDIVIDUAL STATE HEALTH DEPART-
MENTS, THE REPORTING WEEK CONCLUDES ON SATURDAY; COMPILED
DATA ON A NATIONAL BASIS ARE RELEASED ON THE SUCCEEDING
FRIDAY-
SYMBOLS:---DATA NOT AVAILABLE
QUANTITY ZERO
THE CONSTRUCTION OF THE MORTALITY CURVES IS DESCRIBED IN
VOL. 14. NO. 1,


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