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:
AA00010654:00354

Related Items

Preceded by:
Weekly mortality index
Preceded by:
Weekly morbidity report
Succeeded by:
Morbidity and mortality weekly report

Full Text




COMMUNICABLE DISEASE CENTER


i Vol. 15, No. 13







Week Ending
i IApril 2, 1966





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


CURRENT TRENDS
MENINGOCOCCAL INFECTION

A total of 116 cases of meningococcal infection in
the United States was reported for the week ending April
2, 1966, six cases less than were reported during the
comparable week of 1965. The cumulative total of reported
cases of meningococcal infection for the first 13 weeks
of 1966 remains at levels slightly in excess of those
recorded in 1965, and substantially above the preceding
5-year median figures (Figure 1). Some decline from these
current seasonal high levels may be anticipated in the
coming weeks.
There has been an overall increase of 14.8 percent
in the total number of cases reported to date this year as


CONTENTS

Current Trends
Meningococcal Infection . ..... 109
Measles . .. . .. 111
Epidemiologic Notes and Reports
Paragonimiasis Arkansas . ..... 110
Diphtheria Detroit, Michigan . ..... 116




compared to the same period in 1965. In the past 5 weeks,
20 percent or more of all reported cases have occurred in
California.
(Reported by Investigations Section, Epidemiology Branch,
CDC.)
(Figure 1 on page 110)


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous weeks)
13th WEEK ENDED CUMULATIVE, FIRST 13 WEEKS
MEDIAN
DISEASE APRIL 2, APRIL 3, 1961- 1965 MEDIAN
1966 1965 1966 1965 1961-1965
Aseptic meningitis ................... 26 44 29 367 379 290
Brucellosis................... .......... 3 5 6 46 50 78
Diphtheria ........................... 6 5 34 57 85
Encephalitis, primary:
Arthropod-borne & unspecified .......... 23 29 297 389
Encephalitis, post-infectious ......... 14 17 209 187 -- -
Hepatitis, serum ................. ..... 27 816 845 296
816 845 10,311 13,805
Hepatitis, infectious .................... 646 816 845 9,206 13805
Measles rubeolaa) ....................... 9.133 10,949 15,679 94,133 116.815 145,414
Poliomyelitis, Total (including unspecified) 1 3 3 6 6 38
Paralytic ...................... ....... 1 1 1 5 4 33
Nonparalytic ....................... 2 2 -
Meningococcal infections, Total .......... 116 122 69 1,302 1,134 760
Civilian .................... ........ 100 104 1,125 1,045 -
Military ......... ............ ......... 16 18 177 89
Rubella (German measles) ................ 1,628 -- 17,182 -- -
Streptococcal sore throat & Scarlet fever 14,077 11.683 9,700 154,368 146,284 129.780
Tetanus ............... ... ..... .... 1 8 --- 25 50 -
Tularemia ............................. 1 2 47 54
Typhoid fever .......................... 8 11 5 68 89 89
Typhus, tick-borne (Rky. Mt. Spotted fever) -- 9 6 ---

Rabies in Animals....................... 133 142 88 1,089 1,318 1,011

NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax: ................ ................... ..... 2 Botulism: ..................... ...... 1
Leptospirosis: ........................ ............ 9 Trichinosis: Iowa-1................ ........ ...... 26
Malaria: NY City-1, IU.-1, Ga.-l, S.C.-I, Minn.-3, Ariz-2, P.R.-1 76 Rabies in Man: ........ .................... .....
Psittacosis: Texas-1 .............................. 13 Rubella, Congenital Syndrome: .............. ....... 9
Typhus, murine:..................................... 4 .................. ....


.F~5 yr~ i









Morbidity and Mortality Weekly Report



Figure 1
MENINGOCOCCAL INFECTIONS BY WEEK OF REPORT
1965, 1966 AND MEDIAN, 1961-65
UNITED STATES


APRIL 2, 1966


1961-65 MEDIAN


I I I 11 I I ,1I 1 I I I I I I I I I II I I I', .' I I 1., I 1, I 1 I
JAN FEB MAR APR MAY JUN JUL AUG SEPT OCT NOV DEC
MONTH


EPIDEMIOLOGIC NOTES AND REPORTS
PARAGONIMIASIS Arkansas


A case of paragonimiasis in a 4-year-old Korean girl
living in the United States has been reported recently by
the Arkansas State Health Department.
Prior to leaving Korea in August 1965, the child had
been diagnosed as suffering from primary pulmonary
tuberculosis. This diagnosis had been made on X-ray
findings following a positive reaction to a tuberculin test.
After arriving in the United States, the child was
admitted to hospital in December 1964 for the treatment
of tuberculosis. At that time, further studies showed that
tuberculin tests gave negative results,asdid a series of
skin tests with histoplasmin, blastomycin and coccidiodin
antigens. Also, despite X-ray findings of right middle
lobe infiltration indicative of pulmonary tuberculosis,
smears and cultures obtained from gastric aspirates and
bronchial washings were all negative for acid-fast bacilli.
Nevertheless, anti-tuberculosis treatment was started and,
on discharge from hospital in March 1965, the child was
followed up as an out-patient.


Despite continuing medication for tuberculosis, X-ray
examinations showed a developing cavitary lesion in the
right middle lobe and, in August 1965, the child was
readmitted to hospital for a further assessment of her
condition. Clinically the child had remained asymptomatic
since discharge from hospital in March and was apparently
in good health. Skin reactions were again negative for tu-
berculosis; there was still no bacteriological confirmation
of the disease. On this occasion, however, an examination
of her sputum revealed ova of Paragonimus westermani.




(Reported by Dr. William L. Bunch, Jr., Acting Director,
Communicable Disease Control; Dr. J.T. Herron, State
Health Officer; and Mr. William B. Hope, Director of
Laboratories, all of the Arkansas State Board of Health;
and Dr. W. Duane Jones, Medical I'rectrur, Arkansa'
Tuberculosis Sanatorium.)


110







Morbidity and Mortali


Editorial Comment:
Paragonimiasis is extensively endemic in certain
countries in the Far East, particularly Korea, Japan,
Taiwan, the Philippines and parts of mainland (Chir,.
there are scattered foci in India, Africa and South America.
The disease does not occur naturally in the U.S.A.
The disease in man is acquired through eating
uncooked or lightly cooked infected freshwater crabs or
crayfish, which are the second intermediate hosts; man
and certain other mammals are the reservoir hosts with
some species of freshwater snails being the first inter-
mediate hosts. Infected reservoir hosts excrete the fluke
ova in the sputum or feces.
The life of the adult fluke in man lasts about 6 years.
In the absence of fresh infections the disease gradually


APRIL 2, 1966


CURRENT TRENDS MEASLES


During the 4-week period ending March 26, 1966,
there were 36,672 cases of measles reported, an increase
of 8,438 cases over the total notified during the preceding
4-week period. The comparable total for the third 4-week
period in 1965 was 44.351, which is 7,679 more than have
been reported in 1966 (Figure 2). Eleven States reported


more than 1,000 cases during the last 4 weeks: Wisconsin
(6,405), Texas (4.413), Illinois (2,678), New York (2,550),
California (2,288), Tennessee (.* .-w ,i. Michigan (2,223),
Ohio (1,325), Arizona (1,206), Iowa (1,103), and West
Virginia (1,007).
(Reported by the Childhood Virus Disease Unit, CDC.)


Figure 2
MEASLES REPORTED BY FOUR-WEEK PERIODS UNITED STATES
EPIDEMIOLOGIC YEARS, 1964-65 AND 1965-66
COMPARED WITH 10-YEAR PERIOD, 1954-1963


.............. 1964-65 Epidemiologic Year
- 1965-66 Epidemiologic Year


ity Weekly Report 111




subsides and in light or moderate infestations, the prog-
nosis is good. Recent developments in chemotherapy
indicate that bithionol is an effective agent in the cure
of paragonimnias is.


References:
Beeson, Paul B., and McDermott, 'alsh eods.): ( eil-l.i,-b
Textbook of Medicine. W. B. Saunders Company, Phildlpihii
& London, 1963, vol. 1, p. 111.

Gordon, John E. (ed.): Control of Communicable Di.,a, Uls in
Man. A P II A, New York, 1965, p. 160.

Yokogawa, Muneo, and others: Chemotherapy of paragonimiasis
with bithionol. Amer J Trop Med 12:859, 1963.


170,000.


150,000


130,000


I 10,000


70,000


50,000


30,000


10,000


44 48 52 4 8 12 16 20 24 28 32 36 40
WEEK NUMBER









112 Morbidity and Mortality Weekly Report


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

APRIL 2, 1966 AND APRIL 3, 1965 (13th 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... 26 44 3 23 29 14 6 27 646 816

NEW ENGLAND.......... 1 2 1 3 1 2 33 52
Maine.............. 4 8
New Hampshire...... 1 3
Vermont............. 1
Massachusetts..... 1 1 1 3 1 12 25
Rhode Island ...... 1 1 9 11
Connecticut........ 7 4

MIDDLE ATLANTIC...... 4 5 6 14 2 11 102 127
New York City...... 3 2 3 9 4 20 33
New York, Up-State. 1 3 3 3 2 4 26 42
New Jersey......... -- 1 3 14 31
Pennsylvania ....... 42 21

EAST NORTH CENTRAL... 2 5 4 4 3 3 116 121
Ohio............... 1 1 17 38
Indiana............ 19 7
Illinois........... 2 1 1 1 1 14 35
Michigan........... 1 1 2 2 2 64 35
Wisconsin.......... 1 2 2 2 6

WEST NORTH CENTRAL... 1 1 1 2 I 37 70
Minnesota............. 6 7
Iowa.............. I 1 6 25
Missouri.............. 20 7
North Dakota......
South Dakota....... 1- -
Nebraska........... 1 1 2
Kansas............. 4 29

SOUTH ATLANTIC....... 2 3 1 2 1 1 70 127
Delaware........... -- 3 3
Maryland............. 17 31
Dist. of Columbia.. 1
Virginia........... 13 51
West Virginia.... 3 12
North Carolina.... 2 3
South Carolina ..... -
Georgia........ ..... 0 1
Florida............ 1 3 1 I 22 24

EAST SOUTH CENTRAL.. 6 4 1 1 3 72 32
Kentucky............ 2 1 22 4
Tennessee.......... 1 1 37 17
Alabama............. 2 3 3 6 3
Mississippi........ 2 7 8

WEST SOUTH CENTRAL.. 1 6 2 1 2 2 4 63 67
Arkansas........... 1 1 16 9
Louisiana........... 1 2 1 4 11 6
Oklahoma............ 3 3 1
Texas.............. 1 1 1 2 33 51

MOUNTAIN ............. 3 3 2 1 29 62
Montana ............ 2 4
Idaho............... 3 23
Wyoming ............ 3
Colorado........... 2 4 21
New Mexico.......... .- 5 3
Arizona ............ 2 1 1 5 6
Utah................ 1 5 5
Nevada.............. 1 2

PACIFIC.............. 7 15 1 4 5 2 7 124 158
Washington......... 1 1 5 14
Oregon............... 2 2 11 13
California ........ 7 12 1 4 3 2 6 102 127
Alaska ............. 3 4
Hawaii............. 3

Puerto Rico.......... 1 1 39 26









Morbidity and Mortality Weekly Report


CASES OF SPECIFIED NOTIFIABLE DISEASES. UNITED STATES

FOR WEEKS ENDED

APRIL 2, 1966 AND APRIL 3, 1965 (13th 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..........


MENING
MEASLES (Rubeola)

Cumulative
1966 1966 1965 1966

9,133 94,133 116,815 116

110 1,138 23,845 6
4 143 1,874
12 309
3 166 358
56 432 13,280 2
5 53 2,661 1
42 332 5,363 3

742 11,816 4,520 5
385 6,016 412
71 1,204 1,572 2
93 1,295 800 2
193 3,301 1,736 1

3,048 36,447 21,185 16
345 2,700 4,638 4
224 2,267 891 5
368 7,650 651 3
671 5,854 11,187 3
1,440 17,976 3,818 1

388 4,287 8,977 4
45 1,193 270 2
259 2,055 4,952
24 303 1,245 2
60 691 2,261 -
3 54 -
42 195
NN NN NN -

929 7,456 14,370 19
8 99 251 1
88 1,188 502 2
13 295 15 3
148 697 2,101 6
270 2,987 9,139
6 135 160
9 333 405 3
2 152 397 2
385 1,570 1,400 2

853 10,644 6,683 10
201 3,391 778 2
579 6,025 4,043 6
15 749 1,356 2
58 479 506

1,516 9,928 16,114 18
322 781 1
6 59 35 15
14 179 102
1,496 9,368 15,196 2

491 4,845 9,299 4
41 729 2,458 -
27 537 1,346 -
2 72 463 -
58 550 1,680 1
52 236 335 1
275 2,558 340 2
36 156 2,603 -
7 74 -

1,056 7,572 11,822 34
132 1,627 3,631 3
78 609 1,764 3
835 5,257 5,115 28
2 26 94 -
9 53 1,218 -
145 1,101 734 1


;OCOCCAL INFECTII
TOTAL

Cumulativ


r


1966
302

64
6
7
2
26
5
18

132
23
32
41
36

188
51
29
38
54
16

67
15
II
27
3
2
3
6

214
2
21
6
29
8
41
30
34
43

111
53
33
19
6

205
12
84
7
102

41
3
1
1
22
6
7

1

280
16
12
237
12
3


2


1,


3NS,



1965
134

56
7
3

20
10
16

152
23
35
52
42

138
35
18
37
25
23

61
13
1
32
3
2
4
6

229
3
21
4
26
15
35
34
32
59

71
26
21
18
6

185
10
100
16
59

42

7
2
9
6
11
5
2

200
14
16
164
4
2

3


POLIOMYELITIS
RUBELLA
Total Paralytic
Cumulative
1966 1965 1966 6 1966
1966
1 3 1 5 1,628

225
11


S 92
10
107

143
48
S 93



512
42
74
91
84
221

S 53

S 44

S- 6




I 1 1 170
3
9

35
32

-- 31
1 1I 1
60


55
79



3 2



-1



S 16

15

2 82
4


-1 1 267
-1 84
S 39
1 131
5
S
8
I











114 Morbidity and Mortality Weekly Report


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

APRIL 2, 1966 AND APRIL 3, 1965 (13th WEEK) CONTINUED


STREPTOCOCCAL TYPHU
SORE THROAT & TETANUS TULAREMIA TYPHOID TICK
AREA SCARLET FEVER (Rky. Mt
1966 1966 Cum. 1966 Cum. 1966 Cum. 1966
1966 1966 1966
UNITED STATES... 14,077 1 25 1 47 8 68

NEW ENGLAND.......... 1,893 2 1 1 3
Maine .............. 195 -
New Hampshire...... 40
Vermont............. 3 -
Massachusetts...... 326 2 1
Rhode Island....... 106 -
Connecticut........ 1,163 1 3

MIDDLE ATLANTIC...... 537 4 16
New York City...... 15 3 -1 7-
New York, Up-State. 410 3
New Jersey......... NN 3
Pennsylvania....... 112 1 1 3

EAST NORTH CENTRAL... 1,884 1 12 2 11
Ohio ............... 191 3 5
Indiana............ .516 1 3 1 2
Illinois........... 274 5 1
Michigan........... 497 1
Wisconsin .......... 406 1 2

WEST NORTH CENTRAL... 754 1 3 7
Minnesota.......... 18
Iowa................ 279 2
Missouri........... 11 1 1 4
North Dakota....... 349 -
South Dakota....... 11
Nebraska........... 14
Kansas............. 72 -- 2 -

SOUTH ATLANTIC....... 1,680 1 7 6 3 13
Delaware... ...... 71
Maryland............ 192 2 4
Dist. of Columbia.. 12 -
Virginia... ........ 584 2 1 6
West Virginia...... 306 1 1
North Carolina..... 20 2 1
South Carolina..... 243 1 -
Georgia............ 6 1 3
Florida ........... 246 3 1

EAST SOUTH CENTRAL... 2,238 1 12 5
Kentucky........... 223 2 1
Tennessee............ 1,793 6 3
Alabama............. 109 1 4 -
Mississippi........ 113 -

WEST SOUTH CENTRAL... 1,105 7 11 3
Arkansas.......... 1 9
Louisiana.......... 4 1
Oklahoma........... 58 I
Texas.............. 1,046 3 1 1

MOUNTAIN.............. 2,049 1 6
Montana............. 105 -
Idaho............... 185 -
Wyoming ............ 66 -
Colorado............ 1,106 2
New Mexico......... 277 -
Arizona .......... 63 1
Utah............... 246 1 3
Nevada ........... .

PACIFIC................. 1,937 3 1 4
Washington.......... 9.26 926
Oregon............. 30 1
California......... 855 3 1 3
Alaska............. 83 -


Puerto Rico......._. 11 1 10 3










Morbidity and Mortality Weekly Reporl







DEATHS IN 122 UNITED STATES CITIES FOR WEEK ENDED APRIL 2. 1966


(By place of occurrence and week of filing certificate. Excludes fetal deaths)

All Causes Pneumonia Under All Causes Pneumonia Inder
SyeardC Area All 65 and I year
Area All 65 years and year Area A 65 years Influenza All
Ages and over Influenza Ages and over Al
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--------
C.lumhus, Ohio---------
Dayton, Ohio----------
Detroit, Mich.---------
Evansville, Ind.------
Flint, Mich.-----------
Fort Wayne, Ind.------
Gary, Ind.------------
Grand Rapids, Mich.---
Indianapolis, Ind.----
Madison, Wis.---------
Milwaukee, Wis.-------
Peoria, Il1.----------
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.--------


739
240
44
34
23
57
25
23
25
48
63
17
48
41
51

3,482
38
35
156
56
30
55
76
114
1,846
49
453
188
45
106
24
43
59
45
27
37

2,620
57
34
828
152
233
133
70
356
44
45
38
23
47
153
26
121
33
36
31
102
58

955
72
15
42
131
31
138
88
291
89
58


*Estimate based on average percent of divisional total.


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, Calii*-------
Seattle, Wash.---------
Spokane, Wash.---------
Tacoma, Wash.-----------


1,198
130
260
41
67
79
49
84
39
87
87
236
39

617
102
45
28
135
159
33
27
88

1,180
41
41
30
144
39
92
248
52
181
72
114
57
69

501
67
23
158
13
98
21
57
64

2,127
31
41
48
48
117
756
102
45
177
70
117
207
47
184
79
58


650
64
125
21
43
42
22
48
15
67
60
126
17

329
52
19
17
75
93
14
12
47

611
29
24
15
61
19
57
120
31
87
39
60
27
42

319
42
15
106
9
57
16
38
36

1,363
23
21
35
28
64
480
68
31
125
47
77
121
31
110
59
43


i I


Cumulative Totals
including reported corrections for previous weeks

All Causes, All Ages ------------------------- 173,839
All Causes, Age 65 and over------------------- 101,204
Pneumonia and Influenza, All Ages------------- 8,634
All Causes, Under 1 Year of Age--------------- 8,906


Week No.









116 Morbidity and Mo




EPIDEMIOLOGICAL NOTES AND REPORTS
DIPHTHERIA Detroit, Michigan



A fatal case of diphtheria in a 4-year-old boy was
diagnosed post-mortem on February 1, 1966, in Detroit,
Michigan. The child had been ill for 4 days with sore
throat, mild cough and other symptoms of an upper res-
piratory infection, but on the evening of the fifth day he
had become weak, limp and lethargic. He was taken to a
hospital where he developed respiratory distress and
died in the emergency room. At autopsy a pharyngeal
membrane was noted, cultures of which were positive
for virulent Corynebacterium diphtheriae.
The investigation conducted by the Detroit City
Health Department uncovered eight asymptomatic carriers
of C. diphtheria, all of whom reside in the lower socio-
economic area of the city. In the home where the fatal
case had lived, cultures of specimens from the father
and an unrelated 22-year-old boy were positive for C. diph-
theriae. The four older siblings of the fatal case attend a
neighborhood school which had been involved in the large
Detroit diphtheria epidemic of 1956-57.* Nose and throat
cultures of all the students who attend the school revealed
that one 6-year-old boy, who lives 1'Z blocks from the
index family, was a carrier of diphtheria. Four of his 10
siblings also gave positive cultures. There was no history
of direct contact among members of the two families. The
eighth asymptomatic carrier was discovered through a
routine throat culture which was positive for C. diphtheria.
This 15-year-old boy had had diphtheria during the 1956
diphtheria epidemic in Detroit. All asymptomatic carriers
were treated with diphtheria toxoid and penicillin until
all laboratory tests were negative.
Through the immunization program sponsored by the
Health Department, 99 percent of the children attending
the neighborhood school received diphtheria toxoid.
Clinics were organized to immunize the general public in
the area involved; during the first three evenings approx-
imately 5,000 people received diphtheria toxoid. The
immunization program has been extended to clinics and
schools throughout the city.
(Reported by Dr. John J. Hanlon, City-County Health
Commissioner, Detroit-Wayne County, Michigan; Dr. Paul
T. Salchow, Medical Director, Herman Kiefer Infectious
disease Hospital, Detroit, Michigan; and an EIS Officer
and WHO Fellow, CDC.)


Reference:
*Moore, Helen A.: Diphtheria in the United States in 1956.
Public Health Report 73:439, May 1958.


irtality Weekly Report


THE MORBIDITY AND MORTALITY WEEKLY REFCO-
TION OF 15.600, IS PUBLISHED AT THE C 3-..
CENTER, ATLANTA, GEORGIA.


APRIL 2, 1966 <~ 1c




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




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