Morbidity and mortality

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Material Information

Title:
Morbidity and mortality
Uniform Title:
Morbidity and mortality (Washington, D.C. : 1952)
Running title:
Weekly mortality report
Weekly morbidity report
Morbidity and mortality weekly report
Abbreviated Title:
Morb. mortal.
Physical Description:
25 v. : ; 27 cm.
Language:
English
Creator:
United States -- National Office of Vital Statistics
Communicable Disease Center (U.S.)
National Communicable Disease Center (U.S.)
Center for Disease Control
Publisher:
The Office
Place of Publication:
Washington, D.C
Publication Date:
Frequency:
weekly
regular

Subjects

Subjects / Keywords:
Communicable diseases -- Statistics -- Periodicals -- United States   ( lcsh )
Mortality -- Periodicals -- United States   ( lcsh )
Morbidity -- Periodicals -- United States   ( mesh )
Mortality -- Periodicals -- United States   ( mesh )
Statistics, Medical -- Periodicals -- United States   ( lcsh )
Statistics, Vital -- Periodicals -- United States   ( lcsh )
Genre:
federal government publication   ( marcgt )
statistics   ( marcgt )
periodical   ( marcgt )

Notes

Additional Physical Form:
Also issued online.
Statement of Responsibility:
Federal Security Agency, Public Health Service, National Office of Vital Statistics.
Dates or Sequential Designation:
Vol. 1, no. 1 (Jan. 11, 1952)-v. 25, no. 9 (Mar. 6, 1976).
Issuing Body:
Issued by: U.S. National Office of Vital Statistics, 1952-Jan. 6, 1961; Communicable Disease Center, 1961- ; National Communicable Disease Center, ; Center for Disease Control, -Mar. 6, 1976.
General Note:
Title from caption.

Record Information

Source Institution:
University of Florida
Rights Management:
All applicable rights reserved by the source institution and holding location.
Resource Identifier:
oclc - 02246644
lccn - 74648956
issn - 0091-0031
ocm02246644
Classification:
lcc - RA407.3 .A37
ddc - 312/.3/0973
nlm - W2 A N25M
System ID:
AA00010654:00355

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 DISEE
COMMUNICABLE DISEASE CENTER


Vol. 15, No. 26


..... ..'...
i.,


Week Ending
July 2, 1966


U.S. DEPARTMENT OF HEALTH,


ILIC HEALTH SERVICE


CURRENT TRENDS
POLIOMYELITIS Texas


For the week ending July 2, 1966, there were 13
cases of paralytic poliomyelitis reported to the CDC from
Texas, all of which were delayed reports. This brings the
total of reported cases from Texas for 1966 to 18. Of these
18 cases, 3 had onsets in January, one in April, 9 in May
and 5 in June. One case occurred in a 34-year-old man;
the other 17 were in children 4 years old or younger. A
first dose of trivalent poliomyelitis vaccine had been
given to the adult 2 days before onset and to two of the
children approximately 2 weeks before onset; none of the
18 had received attenuated live virus vaccine prior to the


S ... uEONTENTS

II.l ^-Texa .


Epidemiological Notes and Reports
Human Plague New Mexico ....
Viral Hepatitis Wisconsin .. ..


....... 2 17

. .. .. ... .2 1'S
. .. 2 19


outbreak. One had received two doses of inactivated virus
vaccine previously.
The cases were concentrated along the Rio Grande
River in the southeastern part of the State in seven Coun-
ties on or near the Mexican Border, but four cases have
been reported from Counties near the Gulf Coast.
(Continued on page 218)


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous weeks)
26th WEEK ENDED CUMULATIVE, FIRST 26 WEEKS
MEDIAN
DISEASE JULY 2, JULY 3, 1961-1965 MEDIAN
1966 1965 1966 1965 1961-1965
Aseptic meningitis ................... ... 43 31 38 765 742 706
Brucellosis. ............................ 2 3 7 96 116 193
Diphtheria............................. 1 3 3 77 82 138
Encephalitis, primary:
Arthropod-borne & unspecified ........... 27 26 648 770 ---
Encephalitis, post-infectious ........ 26 9 452 416 -
Hepatitis, serum ............ .. ........ 29 6503,
Hepatitisinefectious 506 5 l 473 651 1 18.187 I 23,666
Hepatitis, infectious ................... .506 16.952
Measles rubeolaa) ...... ... ... 2.718 3,020 7.200 178.559 227.487 359.673
Poliomyelitis, Total (including unspecified) 1 5 6 25 24 82
Paralytic .................. .......... 3 3 23 20 70
Nonparalytic ...................... 2 4 -
Meningococcal infections, Total .......... 40 39 39 2,330 1.960 1,448
Civilian .............................. 35 37 2.071 1,793 -
Military...................... .... ..... 5 2 259 167 -
Rubella (German measles) ............. .. 599 -- -- 38,387 -
Streptococcal sore throat & Scarlet fever .. 4,645 4,573 4.250 263.951 244,442 214,892
Tetanus .............. ... ...... ....... 4 9 71 117 -
Tularemia .............. ................ 2 3 68 117 -
Typhoid fever .......................... 7 7 11 153 184 184
Typhus, tick-borne (Rky. Mt. Spotted fever). 10 18 80 87
Rabies in Animals ...................... 68 64 73 2,240 2,460 2,157

NOTIFIABLE DISEASES OF LOW FREQUENCY


Anthrax: ... .. ... .. ....
L eptospirosis: ................................... ..
Malaria: Ky.-1, Ga.-2, S.C.-2, Calif.- ..................
Psittacosis: Texas-1 .. ............... .........
Typhus, murine: I11.-l .......... .............


Botulism : .. ...........
Trichinosis: Tenn.-1.......
Rabies in Man: .........
Rubella. Congenital Syndrome:


aid


Cum.
3
48
1
18








218 Morbidity and Mo




CURRE
POLIOMY
(Continued
Type I poliovirus has been isolated from stool speci-
mens from four patients and has been implicated by sero-
logic studies in two other patients.
The Texas State Health Department has provided
vaccine to extend existing immunization programs in
affected areas.
The additional 13 cases of paralytic poliomyelitis


rtality Weekly Report


JULY 2, 1966


ENT TRENDS
ELITIS Texas
From front page)
reported from Texas bring the national total of paralytic
poliomyelitis for 1966 to 23. The five cases outside Texas
were notified from the States of Georgia, Minnesota,
Mississippi, Oklahoma and .i-h,.rrgrn,.

(Reported by Dr. Van C. Tipton, Director, Communicable
Disease Division, Texas State Health Department.)


EPIDEMIOLOGICAL NOTES AND REPORTS
HUMAN PLAGUE New Mexico


On June 21, 1966, the New Mexico State Department
of Health Laboratory reported the isolation of Pasteurella
pestis from the lymph node aspirate of a 72-year-old man
hospitalized in the Albuquerque Veterans Administration
Hospital. This patient had been admitted to the hospital
on June 10 with pain and swelling in the right groin,
anorexia and severe prostration. Temperature on admis-
sion was 1020F and physical examination revealed an
acutely ill man who had a 5 x 8 cm. tender right inguinal
node with an area of cellulitis extending to 10 cm. around
the node.
The provisional diagnosis was staphylococcal adeni-
tis, and treatment was started using penicillin and erythro-
mycin, with a small dosage of tetracycline. Daily spikes
of fever as high as 1020F continued to occur, and by June
12 the inguinal lymph node had increased to 10 x 16 cm.
with further extension of the cellulitis. In view of the
failure to respond to treatment, the medication was changed
to chloramphenicol and cephalosporin, after which gradual
improvement took place. The area of cellulitis diminished
and the fever dropped to a lower level although it did not
disappear completely.
On June 16 the lymph node was aspirated and purulent
material obtained for culture. Gram negative organisms
were isolated from this material and identified as Pas-
teurella pestis on June 21. The patient was then given
streptomycin and subsequently showed rapid improvement.
The patient, who is a farmer-rancher living in the
community of Serveilleta in Rio Arriba County, has not
had any known contact with field rodents for some time.
He keeps rabbits as domestic pets, one of which died on
May 28 and the other on June 25. The cause of death is
unknown and the carcasses have not been found. There
has been no evidence of field rodent mortality in the area
around the patient's house.


Field r' li. ri of the rodent populations and
their fleas in the immediate neighborhood are now in
progress. Specimens of serum have been obtained from the
domestic rabbits and the patient's dogs for serological
study.
The Vector Control Division of the New Mexico State
Health Department is conducting an extensive rodent
surveillance program and isolates of P. pestis from both
prairie dogs, field mice and fleas have been obtained from
McKinley and Valencia Counties in New Mexico in the
past 3 months. Ectoparasite control programs have been
under way in these two Counties as well as in San Juan
County, New Mexico. Rodent control programs have been
under way in these two Counties as well as in San Juan
County, Santa Fe County, Bernalillio County, Colfax
County, and Rio Arriba County. These consist of dusting
prairie dog burrows with 5 percent malathion in areas of
known rodent mortality and in places where surveillance
has indicated that an epizootic may be expected. Camp-
ing areas in El Moro, the Navajo Dam State Park, Gaffy,
and Kit Carson Cave are being treated with malathion.
Prairie dog colonies where they occur in immediate prox-
imity to a human population concentration are being exter-
minated; other prairie dog concentrations are being observed
for evidence of mortality. In the cities of Gallup, Gamerco,
Grants, Rama, San Rafael, Milan, Bloomfield, Aztec,
Farmington and Blanco, ectoparasite control measures are
being instituted.




(Reported by Dr. T.M. Tomlinson, Associate Director, and
Mr. Bryan Miller, Chief of Vector Control, both of the
New Mexico State Department of Health; the CDC Plague
Laboratory in San Francisco, California.)


VIRAL HEPATITIS Madison, Wisconsin


Between April 1964 and August 1965, 22 cases of
viral hepatitis were recognized among nursing employees
at the Central Wisconsin Colony and Training School, a
State-operated institution for mentally retarded patients


near Madison. Figure 1 shows the twenty-two cases of
viral hepatitis by month of onset during the 17-month
period under study. The cases were scattered over this
period, although there appears to be some clustering in







Morbidity and Mortality Weekly Report


the spring and summer of 1964 and again in the corre-
sponding period of 1965.
The institution first admitted patients in June 1959,
and prior to 1961 there were no cases of viral hepatitis
among employees or patients. In 1961, three employees
developed infectious hepatitis, although contact with a
known case or exposure to a common source was not
demonstrated. In 1963 the Hospital at Central Colony
admitted a boy with infectious hepatitis from another
institution in order to provide isolation and nursing care.
There were no cases of hepatitis among employees or
patients for almost a year following that boy's transfer
to Central Colony.
As of June 1965 there were 588 resident patients and
337 nursing service personnel at Central Colony. Their
distribution is shown in Table 1. Housed in the Nursery
Building were 353 patients under 8 years of age; in the
Infirmary Buildinet were 219 patients of 8 years of age
and older. The latter patients were younger than those
generally living in similar institutions, only 6 of the 219
being over 30 years of age. At the time of the investigation,
16 patients were totally ambulatory; the remainder were
either toddlers or non-ambulatory. None of the patients
were used in any capacity as helpers in the wards.
From work records, it was possible to determine in
retrospect where each of the 22 cases among nursing
personnel had been assigned during the 2 months pripr to
her respective illnesses. Thirteen of the 22 cases, or


Table I
Distribution of Nursing Personnel and Patients
Central W isconsin Colony Madison. "Hisconsin


Personnel
Category
Numberof Nursing
Personnel ....
Number of
Patients ...


Nursery Infirmary
Building Buildings


Hospital Total


59 percent, were among employees who had worked only
in the Nursery Building. Nineteen of the 22, or 86 percent.
worked at some time in the Nursery Building. 2 had
known contact with a prior case, and the third worked
only in the Infirmary Buildings. Thus, compared to the
number of personnel usually assigned to those buildings,
a disproportionate number of the 22 cases were among
personnel who had work assignments in the Nursery
Building.
During the period of study, there were 10 cases of
viral hepatitis among patients at Central Colony, all of
whom were housed in the Nursery Building. Two were
icteric cases, and 8 had anicteric illnesses with liver
function tests showing high transaminase values.
In June 1965, a random sample of patients and em-
ployees was chosen from the Nursery Building, the
(Continued on page ...


Figure 1
CASES OF VIRAL HEPATITIS AMONG NURSING SERVICE PERSONNEL


J F M A M


J J A S 0
1964


N D J F M A M J J A S
1965


MONTH OF ONSET OF ILLNESS


Table 2
Serum Transaminase Values Among Patients and Employees
Central Wisconsin Colony-Madison, Wisconsin


Location


S-GPT Values

Number Sampled <40 40-99 100+


JULY 2, 1966


219


Patients ................... ... .. Nursery Building 68 34 (50%) 23 (34%) 11 (16%)
Infirmary Buildings 25 18 (72%) 7 (28%) 0

Employees .. .............. .. Nursery Building and Hospital 31 29 (94%) 2 ( 6 0) 0


1


2-



nF











Morbidity and Mortality Weekly Report



CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

JULY 2, 1966 AND JULY 3, 1965 (26th 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...


43


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

MIDDLE ATLANTIC...... 2
New York City......
New York, Up-State.
New Jersey.......... 1
Pennsylvania .......

EAST NORTH CENTRAL... 2
Ohio................ -
Indiana............ -
Illinois .......... 2
Michigan.............
Wisconsin...........

WEST NORTH CENTRAL... 1
Minnesota ..........
Iowa................ 1
Missouri............
North Dakota.......
South Dakota.......
Nebraska ..........
Kansas ............

SOUTH ATLANTIC........ 2
Delaware............
Maryland ...........
Dist. of Columbia..
Virginia........... -
West Virginia...... 1
North Carolina.....
South Carolina.....
Georgia............. -
Florida............. 1

EAST SOUTH CENTRAL... 9
Kentucky ...........
Tennessee.......... 3
Alabama.............
Mississippi........ 6

WEST SOUTH CENTRAL... 8
Arkansas ...........
Louisiana..........
Oklahoma ...........
Texas............... 8

MOUNTAIN.............
Montana............
Idaho............. -
Wyoming ............
Colorado...........
New Mexico..........
Arizona ............
Utah................ -
Nevada .............

PACIFIC.............. 19
Washington...........
Oregon.............
California......... 14
Alaska .............. -
Hawaii ............. 5

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


31 2 27 26 26 1 3 29 506 473

S1 2 4 24 22
6 2
1

1 2 4 8 10
1 2
8 6

4 2 4 2 16 90 111
2 1 2 12 21 25
1 1 2 34 35
1 1 1 12 21
1 1 1 1 23 30

1 2 5 5 3 1 57 79
3 2 9 30
3 4 9
S I 2 18 9
1 1 1 23 23
1 1 1 3 8

1 1 2 26 15
4
1 8 4
2 9 5
2


4 4

3 5 2 2 1 3 66 51
3 1
1 11 11
2
1 1 1 15 9
5 7
3 7 2
S 1 1 1 4
3 6 2
1 1 2 18 13

1 3 3 3 26 38
6 8
1 1 1 3 11 15
7
2 2 -- 9 8

9 1 4 4 1 43 39
2 -- 4 2
2 -- 1 7 5
1
8 1 4 32 32

-2 -- 17 16
1
4
-
6 8
3 1
2 4
2 1 2


13 9 4 7 9 157 102
1 2 1 7 2
2 9 12
10 7 3 6 9 140 84
S1 2
I 2

20 33


220










Morbidity and Mortality Weekly Report


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

JULY 2, 1966 AND JULY 3. 1965 (26th WEEK ) -CONTINUED


AREA


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.............


MEANS


1966

In


40

5

10

25

79
28
31

20

1,088
64
141
53
469
361

79

50
6
23


NN

223
3
29
3
87
63
10
4

24

182
24
137
4
17

389
11
1
4
373

223
15
50
4
34
1
66
53


415
65
104
241
2
3


Puerto Rico .......... 61


MENINGOCOCCAL INFECTIONS, POLIOMYELITIS
LES (Rubeola) TOTAL Tt RUBELLA
Total Paralytic
Cumulative Cumulative Cumulative
1966 1965 1966 1966 1965 1966 1965 1966 966 1966



2,136 36,252 2 107 97 64
189 2,730 8 11 3
65 376 9 5 9
218 1,148 3 2 5
743 19,080 42 34 29
72 3,864 12 14 -
849 9,054 2 33 31 18

17,393 13,242 6 266 263 73
8,106 1,871 2 38 45 -- 19
2,150 3,719 1 76 67 -- 54
1,846 2,219 1 74 73
5,291 5,433 2 78 78

65,108 50,831 5 366 258 221
6,135 8,506 97 70 13
5,378 1,663 1 64 36 39
11,056 2,296 2 72 66 24
12,866 24,855 2 99 56 74
29,673 13,511 34 30 71

8,390 16,025 128 103 1 6
1,613 614 31 20 -
5,165 8,875 18 6 1
512 2,488 51 47 2
987 3,490 7 7 2
38 109 4 2 1
75 449 8 10 -
NN NN 9 11 -

14,027 23,565 8 383 386 1 107
240 491 4 5 1
2,044 1,014 1 38 38 9
374 63 9 6 1
1,866 3,879 49 45 23
4,879 12,996 12 23 38
368 361 2 95 72 -
612 978 1 44 55 -
230 596 1 56 51 1 -
3,414 3,187 3 76 91 35

18,718 13,159 5 207 153 1 52
4,548 2,322 2 79 64 11
11,661 7,536 2 68 46 38
1,563 2,252 42 28 3
946 1,049 1 18 15 -

22,686 29,640 4 340 284 5 19 3
966 1,079 3 31 14 1
88 90 1 129 159 -
461 198 18 17 1
21,171 28,273 162 94 5 18 2

11,081 18,562 74 60 51
1,736 3,541 4 2 -
1,370 2,573 5 7 -
133 827 5 4 -
1,130 5,341 38 13 15
1,063 615 10 10 -
5,093 1,110 8 16 36
517 4,363 6 -
39 192 4 2 -

19,020 26,211 10 459 356 1 1 22
3,389 7,159 35 28 1 10
1,448 3,081 29 28 6
13,883 12,353 10 376 280 1 5
191 137 15 13 1
109 3,481 4 7- -
2,283 2,033 7 4 2










222 Morbidity and Mortality Weekly Report


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

JULY 2, 1966 AND JULY 3, 1965 (26th 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... 4,645 4 71 2 68 7 153 10 80 68 2,240

NEW ENGLAND .......... 898 2 1 1 4 1 44
Maine.............. 33 15
New Hampshire...... 8 12
Vermont........... 15
Massachusetts...... 159 2 1 1 1 1 2
Rhode Island....... 11 -
Connecticut........ 687 -- 3 -

MIDDLE ATLANTIC...... 223 9 1 32 3 20 4 150
New York City...... 10 3 14 -
New York, Up-State. 213 1 1 6 2 9 4 142
New Jersey......... NN 1 6 1 8 -
Pennsylvania ...... 4 -6 3 8

EAST NORTH CENTRAL... 281 7 = 12 23 4 9 311
Ohio................ 24 3 3 9 3 4 161
Indiana............ 43 1 3 1 70
Illinois ........... 107 1 5 3 1 1 28
Michigan........... 2 4 3 26
Wisconsin.......... 107 -1 6 1 26

WEST NORTH CENTRAL... 93 1 6 5 13 1 2 21 492
Minnesota .......... 3 1 -- 2 112
Iowa............... 29 1 4 4 106
Missouri........... 6 1 4 2 5 1 1 7 164
North Dakota....... 20 1 3 11
South Dakota. ...... 5 1 50
Nebraska .......... 5 1 1 1 11
Kansas............. 25 2 2 1 3 38

SOUTH ATLANTIC....... 486 1 18 7 29 5 39 6 288
Delaware ..........- -
Maryland............ 158 6 3 14
Dist. of Columbia.. -
Virginia........... 176 1 3 2 9 2 11 3 174
West Virginia...... 97 1 1 37
North Carolina..... 2 1 2 3 10 1
South Carolina..... 20 1 1 5 -
Georgia............ 6 1 1 3 2 45
Florida............ 33 7 4 1 31

EAST SOUTH CENTRAL... 600 4 15 3 18 1 8 5 292
Kentucky........... 13 1 2 2 1 1 49
Tennessee.......... 538 9 1 7 1 7 4 228
Alabama ........... 3 3 4 5 12
Mississippi........ 46 2 4 3

WEST SOUTH CENTRAL... 483 2 16 2 22 12 5 12 475
Arkansas........... 2 1 16 1 1 2 52
Louisiana.......... 1 4 1 3 4 1 22
Oklahoma........... 14 I 2 3 4 3 127
Texas............... 469 1 9 1 4 6 274

MOUNTAIN ............. 1,028 1 4 8 1 1 43
Montana............. 22 1 7
Idaho ...... ...... 58 -
Wyoming ............ 9 -
Colorado........... 688 1 3 1 1 7
New Mexico......... 113 I 6
Arizona............. 59 1 1 21
Utah................ 79 1 3
Nevada.............- 1 2

PACIFIC.............. 553 8 2 2 14 10 145
Washington......... 71 1
Oregon ............. 7 1 I
California......... 433 7 2 2 10 10 144
Alaska ........... 14 -
Hawaii.............. 1. 28 2-
Puerto Rico......... 4 1 28 6 8









Morbidity and Mortality t eekl Report






DEATHS IN 122 UNITED STATES CITIES FOR WEEK ENDEDJULY 2, 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 f year
Ages and over Infenz Ages and over n na
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, 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.--------


692
256
41
21
23
38
21
25
38
51
44
15
36
29
54

3,296
33
36
138
38
31
50
60
92
1,711
38
429
190
52
146
30
34
71
47
27
43

2,899
74
42
874
154
237
133
81
393
46
61
47
40
68
172
29
132
45
36
40
121
74

866
68
32
30
120
35
121
97
249
68
46


431
150
23
13
17
19
12
17
28
35
29
10
21
15
42

1,895
20
22
80
23
21
27
33
39
970
24
242
112
35
95
17
21
40
29
20
25

1,729
42
22
492
100
125
75
54
265
31
31
30
22
45
94
16
84
28
25
25
74
49

518
44
25
18
73
25
78
49
146
41
19


40
13
6
1
1
3
1
2
1
2
3

1
5
1

142
1
2
9

3
3
8
7
55
2
23
11
1
9


5
1
1
1

169
5
3
48
7
14
12
7
21
1
5
4
2
5
9
3
8
6
2
1
4
2

42
2

2
3

4
7
17
3
4


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


1,153
113
273
48
68
104
54
87
24
76
55
212
39

578
88
23
42
132
127
55
35
76

1,112
42
30
32
143
38
72
191
69
166
102
101
57
69

377
33
20
105
16
90
26
43
44

1,474
21
52
34
43
71
440
68
34
119
67
102
183
38
110
51
41


Total 12,447 7,132 401 690

Cumulative Totals
including reported corrections for previous weeks


All Causes, All Ages -------------------------
All Causes, Age 65 and over-------------------
Pneumonia and Influenza, All Ages-------------
All Causes, Under 1 Year of Age---------------


336,002
194,076
15,279
17,431


Week No.
26









224 Morbidity and Mo





VIRAL HEPATITIS Madison, Wisconsin
(Continued from page 219)

Infirmary Buildings and the Hospital, and serum trans-
aminase (S-GPT) values were determined. The data from
this survey are shown in Table 2. Among patients in the
Nursery 3Buildrn 11 of the 68 under study, or 16 percent,
had S-GPT values over 100. Only 34 of the 68, or 50
percent, had S-GPT values under 40. Among patients in
the Infirmary Buildings, none of the 25 patients in the
survey had S-GPT values over 100, and 18, or 72 percent,
had values under 40. Among 31 nursing service employees
in the survey, 20 or 94 percent, had values under 40, and
only two employees had values between 40 and 99.
Thus, a higher proportion of elevated serum transaminase
values was found among Nursery Building patients than
among Infirmary Building patients or among nursing
personnel.
There are three factors which indicate that a reservoir
of viral hepatitis existed among young mentally retarded
patients in one building of Central Colony. These are: a
disproportionate number of the 22 employees affected had
worked in that building during the 2 months prior to onsets
of their respective illnesses; all 10 of the known hepatitis
cases were among resident children housed in the building;
and a higher proportion of abnormal S-GPT values was
found among patients in that building compared to other
areas of the institution.
Because of the early awareness of hepatitis cases
among the nursing personnel, immune globulin was admin-
istered to approximately 50 employees in June and July
1964. Another group of 300 employees received immune
globulin between April and June 1965. The amount of
globulin administered to each recipient was 2 ml. In
addition, during April 1965, 110 patients housed in the
Nursery Building were given immune globulin in a dosage
of 0.01 ml. per pound of body weight. At present, all
newly-hired employees receive 3 ml. of immune globulin.
It is planned that all persons having working contact with
subsequent cases will receive 3 ml. of immune globulin.

Editorial Note:
The reservoir of viral hepatitis probably existed in
the form of anicteric disease among the mentally retarded
children under 8 years of age. This situation may have
provided a continuous opportunity for transmission of
the disease to nursing personnel whenever irregularities
in hygiene occurred. The necessary routine required in
handling young, severely retarded children makes such
exposures unavoidable, and the occurrence of 22 cases
among nursing service personnel was probably a result of
exposure through working contact in one building.

(Reported by Dr. John B. Toussaint, Clinical Director,
Central Wisconsin Colony and Training School, Madison,
Wisconsin; Dr. Josef Preizler, State Epidemiologist,
Wisconsin State Board of Health; and an EIS Officer.)


rtality Weekly Report


JULY 2. 1966


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 O LANGMUIR, M.D.
ACTING CHIEF. STATISTICS SECTION IDA L SHERMAN, M.S
EDITOR: MMWR D JM. MACKENZIE, M.B..
FR 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 COM-
MUNICABLE DISEASES, SUCH COMMUNICATIONS SHOULD BE ADDRESSED
TO: ____THEGA
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 DEPARTMENT T THE REPORTING WEEK CONCLUDES
ON SATURDAY: COMPILED DATA ON A NATIONAL BASIS ARE RELEASED
ON THE SUCCEEDING FRIDAY,


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