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:
AA00010654:00347

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


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


) Vol. 15, No. 49


WEEKLY

REPORT

Week Ending
December 10,1966




PUBLIC HEALTH SERVICE


MEASLES VACCINE DISTRIBUTION
A total of more than 20 million doses of live atten-
uated measles virus vaccine were distributed by manu-
facturers from licensure in March 1963 through October
1966 (Figure 1). This total represents 19,279,941 doses
officially reported through September 1966 and an esti-
mated 948,000 for October 1966.
For the last 12 months for which data are available
(November 1965 through October 1966), 8,069,148 doses
were distributed. This represents more than twice the
amount of vaccine which would be required to immunize
the nearly four million children born in the United States
during the same 12-month period. During the comparable


('ON1'I'NI 'I S


(Currf nt fIrenl
S . . . (;
Fpi d-m logic Noto and Rl pu.rt
(, troeit ril i Or,-,on .... ..... .



months in 1964 and 1965, a total of 5.790.575 doses was
distributed.

(Reported by the Childhood Viral Diseases Unit and the
Statistics Section, Epidemiology Branch, CDC.)


Figure 1
LIVE MEASLES VIRUS VACCINE DISTRIBUTED IN UNITED STATES
1963-1966


MONTHLY
CUMULATIVE
--- ESTIMATED*


VACCINE LICENSED


- .....- ---., W- I I


F M V J J S 0 N
1964


F M a M J j S9
965


JF M M J J S 0 N
1963


9 M J
U9663







Morbidity and Mortality Weekly Report


CURRENT TRENDS
MEASLES 1966


A total of 1,338 cases was reported for the week end-
ing December 10, 1966, a decrease of 134 cases from the
previous week. Seven states notified more than 50 cases
each and together accounted for 54.9 percent of the total
reported: Texas, Washington, Oregon, Mississippi, North
Dakota. California, and Oklahoma. Through the 49th week
the total number of cases for the 1966 calendar year is
199,168, which is 57,282 less than the 256,450 cases


reported for the comparable period in 1965.
The counties reporting "outbreaks" of measles through
the 48th week (ending December 3) are shown in Table 1.
Sixteen counties in eight states notified almost 30 percent
of the United States total for that week.

(Reported by the Childhood Viral Diseases Unit, Epidemi-
ology Branch, COC.)


Table 1
Counties Reporting "Outbreaks" of Measles*

Pop. October November December
State and County Pop. (1,000's) 15 er November December9 5 1 19 6 3
115 2 9 5 1 9 2


Michigan
Wayne .......................... ...
Nebraska
Richardson ............................
North Dakota
McHenry ............... .............
Oregon
W ashington ...........................
Tennessee
M aury ................................
Texas
Brown ..............................
G alveston ............................
Hutchinson ...........................
Parker................ ..............
P ecos ............................
Red River ................... ....
T ravis ...............................
Vermont
Rutland ..............................
Washington
K ing .... .. ... .. ... .. ... ..... ... ....
Snohomish .............. ............
Spokane ..............................


2,666

14

11

92

42

25
140
34
23
12
16
212

47

935
172
278


20 21 26T 10 71 16 30 35

8 41 18 7

3 21 14 10 6 1

10 12 69 56 65? 83


11 9 4


25 14 24


1 3 17
24 59 16 9 12
50 2
2 11 18 27
12 6 7
2 2 14 11
3 4 7 3 1 5


25 12 14 5t 4 13 1 6


6 41
95 60


6 48 38 38
3 89 25t 44


23 42 24 60 14


*Criteria for "outbreaks:"
Pop. at least 1,000,000: 25 cases/week for 2 consecutive weeks.
Pop. 500,000-999,999: 20 cases/week for 2 consecutive weeks.
Pop. 100,000-499,999: 15 cases/week for 2 consecutive weeks.
Pop. less than 100,000: 10 cases/week for 2 consecutive weeks.
tOrganized control measures undertaken according to reports received by MMWR.


EPIDEMIOLOGIC NOTES AND RE

An outbreak of acute gastroenteritis occurred among
77 persons following a luncheon attended by 147 people
on October 18, 1966, in Bend, Oregon. The illness was
mild in severity, with only one person hospitalized be-
cause of dehydration. Chicken salad was suspected of
being responsible for the outbreak; Clostridium perfringens
was identified on culture.
Investigational interviews were obtained from 112 of
the participants. Of these, 70 percent became ill. The
symptoms among 73 patients are shown in Table 2; diar-
rhea and cramps predominated while inimiring was infre-
quent. The duration of illness ranged from one to 36 hours
with a median of 10 hours. The epidemic curve revealed a
range of incubation period from 6 to 24 hours with a median
of 15 hours.


PORTS GASTROENTERITIS-Oregon

Attack rates according to history of foods eaten failed
to incriminate any single food (Table 3). The chicken
salad was eaten by all but two of those interviewed. These
two who did not eat the salad did not become ill, which

Table 2
Outbreak of Gastroenteritis Oregon
Symptoms of Patients

Symptom Number Percent

Diarrhea 66 90
Abdominal Cramps 62 85
Nausea 23 32
Vomiting 9 12
Headache 6 8
Dizziness 2 3


DECEMBER 10, 1966







DECEMBER 10, 1966


Morbidity and Mortality Weekly Report


Food or beverage


Chicken Salad .............
Lemon Dessert ................ ..........
Chocolate Dessert ..... ..............
M ilk ................... ....... .. ....
Butter ....... ..
C offee ......... ..................
Tea ................. .................
Breadsticks .............................
Lettuce ..........................


Table 3
Outbreak of Gastroenteritis Oregon
Food Histories

Persons who ate specified fiood

Not Attack
II1 N Total rate
(percent)


Persons lho did not eat specified food
I Attack


Total


rate
(percent)


suggests that the salad may have been the vehicle of in-
fection. No illness was reported among other family mem-
bers of the group questioned.
The chicken salad was prepared from canned chicken
which was cooked, diced, and freeze-dried prior to canning.
The product is not refrigerated until after it is rehydrated.
At 2:00 p.m. on October 17, two-thirds of a cup of powdered
chicken broth mix was added to 24 quarts of hot water
which was stirred and then cooled for 10 minutes. Twenty-
four cans of chicken were opened and rehydrated when
added to the broth. The mixture was allowed to stand for
15 minutes for further cooling before the broth was drained.


At 5:50 p.m., the chicken was divided into two large
batches and put into two bowls that were placed in a walk-
in refrigerator whichh has a temperature between 35' and
40*F. Hard-boiled eggs were prepared and refrigerated that
same day.
On October 18 at approximately 11:00 a.m., sweet
pickles, fresh diced celery and cucumbers, diced hard-
boiled eggs, mayonnaise, and lemon juice were mixed in
with the rehydrated chicken in a large stainless steel bowl.
Individual portions of the chicken salad were then placed
on lettuce leaves using an ice cream scoop. The salad
(Continued on page 432)


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous weeks)
49th WEEK ENDED CUMULATIVE, FIRST 49 WEEKS
MEDIAN
DISEASE DECEMBER 10. DECEMBER 11. 1961- 1965 MEDIAN
1966 1965 1966 1965 1961-1965
Aseptic meningitis ... ............ 52 34 38 2.833 2,033 2.041
Brucellosis .......................... 3 8 8 227 232 376
Diphtheria .. .................. 2 11 182 149 275
Encephalitis, primary:
Arthropod-borne & unspecified .......... 30 25 2,035 1.800 --
Encephalitis, post-infectious ........ 9 7 686 625 -
Hepatitis, serum ..... .......... ..... 38 1382 789 40.528
Hepatitis, infectious ..... 732 614 30.533 3140.528
Measles rubeolaa) .. ............... 1,338 3.071 3.646 199,168 256,450 409.236
Poliomyelitis, Total (including unspecified) 1 2 6 94 58 423
Paralytic ................... ..... 1 2 4 89 44 362
Nonparalytic ............ .. .- 9
Meningococcal infections. Total .... ... 53 47 51 3.230 2.848 2.208
Civilian ................. ........ 45 46 -- 2,917 2,646
Military ................ .. 8 1 313 202 -
Rubella (German measles) .... ........ 407 --- 44,902 -
Streptococcal sore throat & Scarlet fever 9.718 8.758 7,648 395,402 367.383 317.263
Tetanus ................. ........ 2 7 --- 186 266 -
Tularemia ...... ........ .. 4 3 169 233 -
Typhoid fever ......... .. ..... ..... 11 10 10 363 432 515
Typhus, tick-borne (Rky. Mt. Spotted fever) 6 248 260 -

Rabies in Animals ....... ..............64 72 72 3,798 4,051 3.557

NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax: . 7 Botulism: ..... ........ 10
Leptospirosis: P.R.-l .......... ... ... .... ... 63 Trichinosis: .. ........ .. ................ 94
Malaria: Calif.-3, Ind.-1, Iowa-1. Ky.-3. NYUpS-3. Pa.-3 470 Rabies in Man: ....... .. 1
Psittacosis: Calif.-l, Qhio-1 ..... .......... .... 46 Rubella, Congenital Syndrome: ................. 23
Typhus, murine: Tex.-t ... ....... 28 Plague: 5................


427









428 Morbidity and Mortality Weekly Report



CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

DECEMBER 10, 1966 AND DECEMBER 11, 1965 (49th WEEK)


ENCEPHALITIS HEPATITIS
ASEPTIC Primary Post- Both
AREA MENINGITIS BRUCELLOSIS including Infectious DIPHTHERIA Serum Infectious Types
unsp. cases
1966 I 1965 1966 1966 1965 1966 1966 1965 1966 1966 1965
UNITED STATES... 52 34 3 30 25 9 2 38 732 614

NEW ENGLAND.......... 3 3 2 2 2 48 28
Maine .............. --- 10 8
New Hampshire...... 1
Vermont............ 1 1
Massachusetts...... 2 2 25 10
Rhode Island....... 2 3 1 3
Connecticut........ I 11 6

MIDDLE ATLANTIC...... 2 3 1 9 9 22 102 124
New York City...... 1 1 6 3 15 27 39
New York, Up-State. 1 1 2 3 4 32 43
New Jersey......... 1 3 3 24 19
Pennsylvania....... 1 1 19 23

EAST NORTH CENTRAL... 2 8 3 3 129 124
Ohio............... 6 1 31 30
Indiana............ 1 1 2 5
Illinois........... 1 2 24 23
Michigan........... 1 1 1 1 39 53
Wisconsin.......... 33 13

WEST NORTH CENTRAL... 6 1 1 1 51 35
Minnesota.......... 5 1 9 17
Iowa................ 1 7
Missouri........... 1 1 1 30 2
North Dakota....... 8 -
South Dakota........ -
Nebraska........... 1
Kansas............. 2 9

SOUTH ATLANTIC........ 8 1 1 I 1 85 62
Delaware........... 1 1 4 8
Maryland........... 1 16 18
Dist. of Columbia.. 2 1
Virginia........... 14 12
West Virginia...... 5 4
North Carolina..... 1 1 1 5 1
South Carolina..... 3 3
Georgia............ 26 4
Florida............ 5 1 10 11

EAST SOUTH CENTRAL... 2 1 1 2 47 38
Kentucky............. 1 1 13 12
Tennessee.......... 1 1 26 12
Alabama............ 2 4 9
Mississippi........ 4 5

WEST SOUTH CENTRAL... 12 6 1 3 2 2 66 45
Arkansas........... 1 1 3 5
Louisiana.......... 1 1 2 14 6
Oklahoma........... 5
Texas............... 11 6 1 1 1 44 34

MOUNTAIN ............. 2 50 25
Montana............ 4 5
Idaho............. 2 1
Wyoming............ 1
Colorado............. 5 8
New Mexico......... -- 19 3
Arizona............. 1 10 6
Utah............... 1 10 1
Nevada............- -

PACIFIC............... 25 13 1 5 7 3 10 154 133
Washington.......... 1 1 2 17 10
Oregon.............. 2 1 1 1 21 16
California.......... 21 11 1 4 6 1 10 115 103
Alaska............. 1 2


Puerto Rico .......... 1 28 15









Morbidity and Mortality Weekly Report


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

DECEMBER 10, AND DECEMBER 11, 1965 (49th 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................
Nevada ............

PACIFIC ..............
Washington.........
Oregon ............
California .........
Alaska..............
Hawaii .............


Puerto Rico..........


INFECTIONS,
L

ilative
S1965


MENINGOCOCCAL II
MEASLES (Rubeola) TOTAI

Cumulative Cumi
1966 1966
1966 1966 1965 1966 66

1,338 199,168 256,450 53 3,230

42 2,560 37,231 2 149
9 294 2,919 12
80 383 9
21 344 1,407 4
6 831 19,374 62
73 3,957 2 19
6 938 9,191 43

67 18,480 17,361 16 428
5 8,365 3,261 1 65
27 2,648 4,412 1 112
18 1,986 3,425 10 129
17 5,481 6,263 4 122

153 70,133 61,066 8 510
8 6,452 9,130 2 148
17 5,804 2,313 88
34 11,520 3,631 2 91
49 15,036 27,613 2 130
45 31,321 18,379 2 53

103 9,231 17,303 1 166
7 1,681 808 1 36
5 5,413 9,261 22
538 2,661 64
63 1,374 3,995 11
40 116 6
28 185 462 11
NN NN NN 16

121 16,004 26,514 12 548
4 267 516 2 7
2,123 1,240 49
390 127 1 15
12 2,251 4,194 1 64
29 5,523 14,659 2 47
49 670 412 5 139
1 664 1,167 54
S 241 628 77
26 3,875 3,571 1 96

171 20,568 15,521 2 277
25 4,834 3,473 1 96
36 12,643 8,547 1 93
26 1,788 2,353 59
84 1,303 1,148 29

327 26,433 31,933 6 431
12 994 1,188 1 37
1 100 121 2 163
52 630 233 1 23
262 24,709 30,391 2 208

74 12,571 20,709 94
7 1,910 3,894 5
14 1,690 2,985 5
1 234 873 6
22 1,429 5,957 49
10 1,220 688 10
8 5,359 1,451 13
2 664 4,636 1
10 65 225 5

280 23,188 28,812 6 627
120 4,854 7,494 2 54
97 2,435 3,447 1 41
57 15,116 13,614 3 510
4 619 205 18
2 164 4,052 4

56 3.512 2,826 1 18


11


2,848

147
18
9
8
55
18
39

381
63
109
101
108

432
118
48
118
100
48

137
32
12
54
13
3
10
13

537
11
53
11
71
29
112
65
61
124

219
86
68
38
27

359
18
194
21
126

102
2
13
6
28
11
20
17
5

534
47
37
424
18
8


129


POLIOMYELITIS
Total Paralytic
Cumulative
1966 1965 1966 1966
1966

1 2 1 89





-


1


7
2
-


-

-1
-
1




1

2
1
3




I









3

















1 71
2





1


1
"1


4





1
3

1 1 1 71



1 1 1 68












3-
2

1- 1



1


RUBELLA


1966

407

36
8


6
2
20

14
8
6



71
12
13
10
10
26

27
2
19
1
5




35



3
1
-


8

22

56
44
12



2



2

12
7
1



4



154
98
14
40
1
I


,









130 Morbidity and Mortality Weekly Report


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

DECEMBER 10, 1966 AND DECEMBER 11, 1965 (49th 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... 9,718 2 186 4 169 11 363 6 248 64 3,798

NEW ENGLAND.......... 1,355 4 1 13 3 86
Maine.............. 84 -- 26
New Hampshire...... 14 30
Vermont............. 106 25
Massachusetts...... 176 2 1 9 1 4
Rhode Island....... 127 -
Connecticut........ 848 2 4 2 -

MIDDLE ATLANIC ...... 290 15 3 60 2 49 4 225
New York City...... 12 5 25 1
New York, Up-State. 229 2 2 14 13 4 208
New Jersey......... NN 3 8 1 16 -
Pennsylvania....... 49 5 1 13 1 20 16

EAST NORTH CENTRAL... 979 21 2 22 2 46 20 4 483
Ohio............... 128 5 3 1 21 9 1 201
Indiana............. 104 4 1 11 5 111
Illinois........... 245 4 1 7 1 7 11 2 74
Michigan........... 278 6 7 42
Wisconsin.......... 224 2 1 6 1 55

WEST NORTH CENTRAL... 431 15 19 34 4 24 876
Minnesota.......... 12 3 1 1 5 208
Iowa............... 162 2 5 4 161
Missouri........... 3 8 10 18 3 3 248
North Dakota....... 161 1 3 56
South Dakota....... 11 4 9 114
Nebraska........... 3 1 2 2 28
Kansas.............. 79 1 2 7 1 61

SOUTH ATLANTIC....... 920 1 36 1 14 3 70 4 114 12 491
Delaware........... 13 1 2 -
Maryland............ 115 3 1 4 12 1 27 3
Dist. of Columbia.. 2 -
Virginia........... 232 6 2 16 31 6 248
West Virginia...... 255 1 1 1 59
North Carolina..... 25 4 3 6 27 4
South Carolina..... 94 2 1 2 15 5 -
Georgia............ 6 8 3 4 3 22 4 106
Florida............. 180 1 13 1 13 1 71

EAST SOUTH CENTRAL... 1,459 26 24 2 46 43 13 492
Kentucky........... 200 2 2 10 9 1 117
Tennessee.......... 1,073 7 14 2 24 25 12 333
Alabama............ 169 8 4 6 7 20
Mississippi........ 17 9 4 6 2 22

WEST SOUTH CENTRAL... 870 45 1 74 1 35 10 6 742
Arkansas........... 6 4 56 4 2 82
Louisiana.......... 3 12 4 10 1 53
Oklahoma........... 60 3 7 1 10 7 182
Texas.............. 801 26 1 7 11 1 5 425

MOUNTAIN ............ 1,763 2 12 16 4 96
Montana............. 63 2 7
Idaho.............. 188
Wyoming............. 93 6 1
Colorado........... 824 2 3 2 18
New Mexico......... 249 1 2 1 17
Arizona............. 194 1 5 42
Utah............... 145 2 5 3
Nevada............. 7 1 9

PACIFIC.............. 1,651 1 22 3 43 1 1 307
Washington......... 379 13 15
Oregon.............. 67 1 1 4
California......... 1,129 1 21 3 27 1 1 288
Alaska............ 27
Hawaii 4.... -..... -


... .. .. .. .. I
Puerto Rico .......... 1 3 1 4 -- 18 1 I I 1 19









Morbidity and Mortality W'eekly Report






DEATHS IN 122 UNITED STATES CITIES FOR WEEK ENDED DECEMBER 10, 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 year Area All 65 years and I year
Ages andoer Influenza All s and over Influenza All
All Ages Causes All Ages Causes


NEW ENGLAND:
Boston, Mass.---------
Bridgeport, Conn.-----
Cambridge, Mass.------
Fall River, Mass.-----
Hartford, Conn.-------
Lowell, Mass.---------
Lynn, Mass.-----------
New Bedford, Mass.----
New Haven, Conn.------
Providence, R. I.-----
Somerville, Mass.----
Springfield, Mass.----
Waterbury, Conn.------
Worcester, Mass.------

MIDDLE ATLANTIC:
Albany, N. Y.---------
Allentown, Pa.--------
Buffalo, N. Y.--------
Camden, N. J.---------
Elizabeth, N. J.------
Erie, Pa.----------
Jersey City, N. J.----
Newark, N. J.----------
New York City, N. Y.--
Paterson, N. J.-------
Philadelphia, Pa.-----
Pittsburgh, Pa.--------
Reading, Pa.-----------
Rochester, N. Y.-------
Schenectady, N. Y.----
Scranton, Pa.----------
Syracuse, N. Y.------
Trenton, N. J.--------
Utica, N. Y.-----------
Yonkers, N. Y.------

EAST NORTH CENTRAL:
Akron, Ohio-----------
Canton, Ohio----------
Chicago, Ill.----------
Cincinnati, Ohio------
Cleveland, Ohio-------
Columbus, Ohio-------
Dayton, Ohio----------
Detroit, Mich.-------
Evansville, Ind.------
Flint, Mich.----------
Fort Wayne, Ind.------
Gary, Ind.------------
Grand Rapids, Mich.---
Indianapolis, Ind.----
Madison, Wis.---------
Milwaukee, Wis.-------
Peoria, Ill.----------
Rockford, Ill.--------
South Bend, Ind.-------
Toledo, Ohio----------
Youngstown, Ohio------

WEST NORTH CENTRAL:
Des Moines, Iowa------
Duluth, Minn.---------
Kansas City, Kans.----
Kansas City, Mo.-------
Lincoln, Nebr.--------
Minneapolis, Minn.----
Omaha, Nebr.----------
St. Louis, Mo.--------
St. Paul, Minn.-------
Wichita, Kans.--------


752
256
41
28
27
65
39
20
23
51
45
18
52
41
46

3,389
61
30
159
32
36
48
53
98
1,758
52
482
199
66
109
30
30
59
21
21
45

2,820
68
37
787
183
228
143
97
379
47
55
51
42
64
164
40
146
48
32
37
110
62

887
63
27
44
126
26
141
61
237
77
85


458
146
31
22
17
30
27
13
13
26
31
9
33
28
32

1,970
34
16
90
18
21
30
34
49
1,033
33
271
100
46
69
14
21
35
10
16
30

1,609
41
19
438
99
139
78
55
193
31
30
32
20
47
87
23
85
28
18
28
72
46

527
45
12
26
74
18
84
33
141
46
48


SOUTH ATLANTIC:
Atlanta, Ga.-----------
Baltimore, Md.---------
Charlotte, N. C.-------
Jacksonville, Fla.-----
Miami, Fla.------------
Norfolk, Va.-----------
Richmond, Va.-----------
Savannah, Ga.----------
St. Petersburg, Fla.---
Tampa, Fla.------------
Washington, D. C.------
Wilmington, Del.-------

EAST SOUTH CENTRAL:
Birmingham, Ala.-------
Chattanooga, Tenn.-----
Knoxville, Tenn.-------
Louisville, Ky.--------
Memphis, Tenn.----------
Mobile, Ala.-----------
Montgomery, Ala.-------
Nashville, Tenn.-------

WEST SOUTH CENTRAL:
Austin, Tex.-----------
Baton Rouge, La.-------
Corpus Christi, Tex.---
Dallas, Tex.-----------
El Paso, Tex.-----------
Fort Worth, Tex.-------
Houston, Tex.-----------
Little Rock, Ark.-------
New Orleans, La.-------
Oklahoma City, Okla.---
San Antonio, Tex.------
Shreveport, La.--------
Tulsa, Okla.-----------

MOUNTAIN:
Albuquerque, N. Mex.---
Colorado Springs, Colo.
Denver, Colo.-----------
Ogden, Utah------------
Phoenix, Ariz.----------
Pueblo, Colo.-----------
Salt Lake City, Utah---
Tucson, Ariz.----------

PACIFIC:
Berkeley, Calif.-------
Fresno, Calif.----------
Glendale, Calif.-------
Honolulu, Hawaii-------
Long Beach, Calif.-----
Los Angeles, Calif.----
Oakland, Calif.--------
Pasadena, Calif.--------
Portland, Oreg.--------
Sacramento, Calif.-----
San Diego, Calif.------
San Francisco, Calif.--
San Jose, Calif.-------
Seattle, Wash.---------
Spokane, Wash.---------
Tacoma, Wash.----------


1,222
144
225
53
94
100
53
91
27
89
109
185
52

689
93
47
54
152
161
50
43
89

1,116
32
24
19
151
25
96
205
61
180
97
106
61
59

409
36
24
96
8
123
20
51
51

1,832
28
40
43
37
64
681
94
44
126
75
99
188
40
191
45
37


617
72
97
24
36
54
28
53
14
70
62
80
27

350
42
32
41
88
73
23
19
32

562
18
13
6
70
11
53
97
34
86
50
59
31
34

231
20
15
51
5
69
16
28
27

1,113
21
16
31
19
44
438
49
36
78
45
48
109
18
110
32
19


Total 1 13,116 7,437 462 699

Cumulative Totals
including reported corrections for previous weeks

All Causes, All Ages ------------------------- 613,374
All Causes, Age 65 and over------------------- 351,151
Pneumonia and Influenza, All Ages------------- 25,003
All Causes, Under 1 Year of Age-- ---------- 32,763


Week No.








Morbidity and Mortality Weekly Report


GASTROENTERITIS Oregon
(Continued from page 427)

was not refrigerated again before the 1:00 p.m. luncheon.
The chicken salad was found to be contaminated with
Clostridium perfringens with anaerobic colony counts of
60,000/gram and 11,400/gram on two occasions. The
organism has not yet been typed with Hobbs' sera. The
lot number of the cans used to make the chicken salad
could not be determined. However, the two remaining
sealed cans of dehydrated chicken which had different
lot numbers but were taken from the same shipment were
cultured and found to be negative. Other foods served
were cultured and also were negative.
On Saturday, October 15, a similar luncheon was
served to a large group of people in Oregon. The chicken
salad was prepared in the same manner but on the same
day as the luncheon. Salad not eaten at lunch was served
to a small group for dinner. There was no leftover chicken
salad. No reported illness followed the Saturday luncheon
or dinner.
(Reported by Dr. Edward L. Goldblatt, State Epidemiol-
ogist, Oregon State Board of Health; and Mr. Jon F.
Thompson, Senior Sanitarian, Mr. Ron Anderson, Sani-
tarian, Dr. C. J. Rademacher, Acting County Health
Officer, and several public health nurses, all of the Tri-
County Health Department, Portland, Oregon; and an
EIS Officer.)
Editorial Note:
In the first well-documented report of Clostridium
perfringens (C. ... '. i food poisoning in the United
States, which was published in 1945, chicken was incrim-
inated as the source of the contamination.1 Since then,
poultry fr.-,i. nil,. has been implicated on epidemiological
grounds as the cause of outbreaks. In addition, C. per-
fringens has been isolated from poultry in different food
surveys.2,3
This report of the Oregon luncheon offers presump-
tive evidence of C. perfringens food poisoning. Supporting
this are the classical food preparation history, the typical
epidemic curve, clinical features, incubation period, and
the isolation of C. perfringens from the chicken salad de-
spite the relatively low anaerobic colony counts. The food
histories indicated the chicken salad as a possible ve-
hicle of infection although too small a number of people
did not eat the salad to provide definitive evidence. Con-
sidering the ubiquity of this organism. it would have been
desirable to obtain C. perfringens isolates not only from
stools of the patients, and test them for specific serotypes.

References:
IMcClung, L. S.: Human food poisoning due to growth of Clos-
tridium perfringens (C. iwelchii) in freshly cooked chicken:
preliminary note. Bact. 50:229-31, 1945.
"Strong, Dorothy II., Canada, James C., and Griffths, Bertie B.:
Incidence of (lostridi um perfringens in American foods. Appl.
Micro. 11:42-14, 1963.
3McKillop, Elizabeth J.: BItcterial contamination of hospital
food with special reference to ('ostridium welchii food poi-
soning. J. Hiy 57:31-49. 1959.


DECEMBER 10, 1966 _0
0

0 i


THE MORBIDITY AND MORTALITY WEEKLY REPORT, WITH A CIRCULA-
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.
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 COM-
MUNICABLE 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.




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