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:
AA00010654:00357

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






Vol. 15, No. 42


WEEKLY

REPORT

Week Ending

October 22, 1966


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


EPIDEMIOLOGIC NOTES AND REPORTS
MEASLES Paterson, New Jersey

Only 109 cases of measles were reported in Paterson,
New Jersey (population 147,490) during 1965. This was
the smallest total in recent years and far below the
average of 1,084 cases per year reported for 1960 through
1964. Due to a change in reporting, complete data on
measles incidence are lacking for the first half of 1966.
%lhiiuivl measles incidence in Paterson during
August and September 1966 was seasonally low, it has
increased markedly in October. To date. 37 cases have
been reported this month, 34 of which are in students
attending 8 of the 43 public and parochial elementary
schools in the city.


I'll;id"I1 Inol Not. -aIr
Io ulisml m iT F CF al .
(uryit l'r itid s
Reported of
Post-i mmuni iaton i, .

1Io i5-ti 66 lnf u n i n ...... .. :'160

Representatives of the Paterson Board of Education,
of the City and State Health Departments, and of the
local Community Action Program are conducting a measles
susceptibility survey in 20 schools in the core area of
the city. Plans for an immunization program -if...._h the
(Continued on page 3:58)


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous weeks)
42nd WEEK ENDED CUMULATIVE. FIRST 42 WEEKS
MEDIAN
DISEASE OCTOBER 22, OCTOBER 23, 1961 1965 MEDIAN
1966 1965 1966 1965 1961-1965
Aseptic meningitis ......... .. 59 58 61 2,453 1,735 1,717
Brucellosis ........... ... 3 4 4 201 198 336
Diphtheria .......... ....... 5 4 8 156 122 213
Encephalitis, primary:
Arthropod-borne & unspecified ......... 58 68 --- 1.778 1,540 -
Encephalitis, post-infectious ....... 9 2 630 574 --
Hepatitis, serum .. ........ .. 37 698 744 1,128 27,465 35,06
Hepatitis, infectious .......... 680 25.713
Measles rubeolaa) ............... 633 784 981 192.121 243,982 391.530
Poliomyelitis, Total (including unspecified) 3 1 6 77 49 353
Paralytic .. ........... ... ... 2 5 70 39 301
Nonparalytic ..... ............. 1 7 -
Meningococcal infections, Total ......... 46 39 43 2.897 2,501 1,937
Civilian ........... ....... .... 46 34 2,616 2,314 -
Military ............ .. .. ..... 5 281 187 --
Rubella (German measles) ........ ... 244 --- -- 42.816
Streptococcal sore throat & Scarlet fever 6,619 6.160 5.395 339.279 316,951 273.991
Tetanus................. ...... 7 4 159 214 -
Tularemia ............ ... ...... 3 3 139 208
Typhoid fever ....... ... .. .. .. .... 11 16 14 319 354 445
Typhus, tick-borne (Rky Mt. Spotted fever) 2 --- 223 245 -
Rabies in Animals ............... 57 71 58 3.344 3.567 3.097

NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax: ........ . 5 Botulism: .. .. 8
Leptospirosis: Tex-1 .. ... ... 54 Trichinosis: ... ...... .84
Malaria: Calif-6. Fla-2, Ga-, Ind-. Kan-1, Mass-3, NYC-I, NC-2, Rabies in Man: ....... 2
Ore-2,Pa-7 ...........360 Rubella. Congenital Syndrome: .... 20
Psittacosis: ... ... .. .... 40 Plague: .. .. 4
Typhus, marine: Mass- ......................... 24 1


I=sa,6o








358


schools have been formulated in case a high percentage
of measles-susceptible children in kindergarten through
third grades is found.
A free community-wide immunization clinic for
indigent preschool children and others living outside the
core area will be conducted on October 30. An intensive
publicity campaign is underway to encourage non-indigent


OCTOBER 22, 1966


parents to have their children immunized by their private
physicians.

(Reported by Or. J. Allen Yaeger, Director, Paterson
Board of Health; Dr. William J. Dougherty, Director,
Division of Preventable Diseases, New Jersey Health
Department; and an EIS Officer.)


CURRENT TRENDS
MEASLES 1966


During the 42nd week (ending October 22, 1966), 633
measles cases were reported, a decrease of 48 cases
over the preceding week. The 41st and 42nd weeks repre-
sent the first 2 weeks of the current epidemiologic year.*
For the comparable weeks in 1965, totals of 872 and 782
measles cases were reported.
Counties reporting measles during the 41st week
(ending October 15, 1966) are shown in Figure 1. In the
District of Columbia and the 42 States for which informa-
tion is available, only nine counties reported 10 or more
cases of measles (Table 1). Together these nine counties
contributed 262 of the 681 cases reported during the 41st
week.
(Reported by the Childhood Viral Diseases Unit, Epidemi-
ology Branch, CDC.)
Editorial Note:
Data for county distribution of measles are available
through the cooperation of State Epidemiologists. Maps
*The current epidemiologic year for measles started with week
41 beginning October 9, 1966, and will close with week 40
ending October 7, 1967.


and analysis of county data will be included as a regular
feature in MMWR in order to draw attention to areas where
prompt and effective epidemic control programs, such as
those described in previous issues of MMWR (Vol. 14,
Nos. 42, 44, 48 and Vol. 15, Nos. 3, 6, 7, 8, 9), could be
expected to terminate outbreaks.

Table 1
Nine Counties with Highest Incidence of
Reported Measles for Week Ending October 15, 1966

Snohomish County, Washington .................. 71
Nevada County, California ....................... 60
Rutland County. Vermont ......................... 25
Galveston County, Texas ........................ 24
Gibson County, Tennessee ....................... 21
Spokane County, Washington ...................... 19
Detroit City, Michigan ........................... 16
King County, Washington ......................... 15
Maury County, Tennessee ........................ 11

Total ................................ .. 262


Figure 1
COUNTIES OR HEALTH DISTRICTS REPORTING MEASLES
WEEK ENDING OCTOBER 15, 1966


[ No cases reported
3 I or more ca&s. report d
SNumber rases reported hy statj
County distribution not available
at time of printing


Morbidity and Mortality Weekly Report




MEASLES Paterson, New Jersey (Continued)









OCTOBER 22, 1966


Morbidity and Mortality Weekly Report


EPIDEMIOLOGIC NOTES AND REPORTS
BOTULISM TYPE F California


The outbreak of botulism in California traced to
venison jerky (MMWR. Vol. 15, No. 41) has been presump-
tively identified as type F. Initially mice injected with an
extract of the food were protected by both type E and
type F antitoxin for 24 hours, but after 48 hours only mice
protected with type F antitoxin were alive. In repeat tests,
however, a fresh extract of the food killed all mice with
typical symptoms of botulism within 18 hours except those
receiving heated extract and those protected with type F
antitoxin. Bacteriological studies of the food to identify
and characterize the microorganism are in progress.
(Reported by the California State Department of Public
Health Laboratory and the Anaerobic Bacteriology Lab-
oratory, Laboratory Branch, CDC.)
Editorial Note:
Cross neutralization between type F and type E,
when type E antitoxin is in large excess, has been reported
previously. I With final confirmation of the organism, this
will become the second outbreak of type F botulism to
be documented. The first outbreak was observed on the
Danish Island of Langeland and involved homemade liver
paste.2 Among the five persons who ate the liver paste,
three had severe attacks of botulism, one died and one had


no symptoms. The organism isolated from the liver paste
was studied more extensively by Dolman and Murakami
and designated as Clostridium botuloinumn type IF.: The
organism was first demonstrated in the United States by
Eklund and Poysky in two different samples of marine
sediments collected off the coast of California and Ore-
gon. 1 Two additional demonstrations have been made from
marine sediments recently and pure cultures are being
studied.4 In addition, the organism was isolated from a
salmon (Oncorhynchus nerka) taken from the Columbia
River.5
REFERENCES:
1Eklund, M.W. and Poysky, F.: Clostridium botulinum type F
from marine sediments. Science 149:306. 1965.
2Moller, V. and Schelbel, I.: Preliminary report on the isola-
tion of an apparently new type of Clostridium botulinum. Acta.
Path. Microbiol. Scand. 4S:S0, 1960.
3Dolman, C.E. and Murakami, L.: Clostridium botulinum type
F with recent observations on other types. J. Infect. Dis.
109:107, 1961.
IEklund, M.W., Poysky, F., and Wieler, D.: Demonstration and
isolation of Clostridium botulinum type F from the Pacific
Coast of the United States. Presented at the Symposium in
Moscow, Russia, July 1966.
5Craig, J.M. and Pilcher, K.S.: Clostridium botulinum type F:
Isolation from salmon from the Columbia River. Science 153:
311, 1966.


REPORTED CASES OF POST-INFECTIOUS AND POST-IMMUNIZATION ENCEPHALITIS
THIRD QUARTER ENDING OCTOBER 1, 1966 (WEEKS 27-39)


State Mumps Measles Chickenpox Other specified

Alaska .. ...... ... ...... ...... 1
California ............ ................. 17 9 6
C onnecticut ........ ................. 2
Florida .... ............................... 10 1
Illinois ...................................... 9 Influenza-1
Iowa ....... .................... ... ... 1 3
Kentucky ........ ............ .. ...... 1
Louisiana ...... .. .. ......... ...... 1 1
Massachusetts ........... ........... 5
Michigan .............. .......... 12 6 Herpes-1
Minnesota ........... .......... .. .. 8 2 Influenza-3, Herpes-2
Montana .......... .. .................... 1
New Hampshire ... ... ........ ...... ......... 1
New York, Upstate ........... .. .............. 6 1
Pennsylvania ........ ........ ........ ... 10 2 1
Tennessee .......................... .... 3 1 Influenza-1, Herpes-1
Texas ................................. 4 2 Post-vaccinial-1
Vermont ......................... Herpes Simplex-1
Virginia ............ .. .............. ... ..... 2 1
Washington ......... .................. ......... 6 1 1

Third Quarter Total
1966 ........ .. .................... ... 99 30 9
1965 ..................... ........... ... 93 24 14
Cumulative Total (weeks 1-39)
1966 ......... ............... .... .. 343 159 70
1965 .... .. ....................... 357 94 72


359









Morbidity and Mortality Weekly Report


OCTOBER 22, 1966


SURVEILLANCE SUMMARY
1965-1966 INFLUENZA SEASON


Between December 1965 and May 1966, the presence
of influenza (type A and/or B) was identified clinically
and epidemiologically in 49 of the 50 States. Laboratory
confirmation was made in all but one State. As indicated
in Table 2, strains of A2 virus were isolated in 17 States
and serologically confirmed in 12 others, while strains of
B virus were isolated in 25 States and serologically con-
firmed in 16 others. Twenty-one States confirmed the
presence of both types A and B. Those areas affected by
both viruses usually experienced two waves of increased
influenza activity, although occasionally both types oc-
curred concurrently.
Influenza B, which appeared earlier than type A,
was first recognized in the northeast area of the country;
influenza A was first noted on the west coast(Figure 2).
Each virus type then spread centrally from its initial
focus, resulting in the widespread patterns of distribu-
tion noted in Figures 3 and 4.
Pneumonia influenza mortality reported to the Com-
municable Disease Center by 122 United States cities
showed minor excursions above the epidemic threshold
from mid-February to mid-May (Figure 5). The excess


F
STATES REPORTING PREDOI
BY WEEK OF
6



4
b-

0
W 2
z


0
4 II 18 25 I 8 15 22 29 5 12
DECEMBER JANUARY FEBRUAI
WEEK EN[
STATES REPORTING PREDOD
BY WEEK OF
6



4


SFLA
2
N


mortality was contributed almost entirely by California;
influenza mortality as indicated through school and in-
dustrial absenteeism, hospital admissions, and outpatient
visits, reached levels not exceeded since 1960 when
type A2 influenza also occurred in the State. In general,
other areas involved with type A2 influenza experienced
little excess mortality. In areas where type B virus was
most widespread, school absenteeism without an equiva-
lent rise in industrial absenteeism, hospital admissions,
and excess mortality was noted, r. fiei.rinr the younger
age group more commonly involved.
Influenza viruses isolated during the 1965-66 season,
of both type A2 and B, appear to form relatively homo-
genous groups when compared in reciprocal hemagglutina-
tion inhibition tests. Of major interest is the antigenic
relationship of currently prevalent strains to the viruses
which are used for the preparation of influenza virus vac-
cines. Of thetwo A2 vaccine components (A2 Japan/170/62
and A2/Taiwan/ l,64), all viruses isolated during the
past season showed a close relationship to the former
strain. Contemporary strains show a continued shift away
from the antigenic make-up of A2/Japan/305/57, one of


igure 2
MINANT OR WIDESPREAD TYPE A
PEAK INCIDENCE


9 26 5 12 19 26 2 9
RY MARCH A
)ED
MINANT OR WIDESPREAD TYPE B
PEAK INCIDENCE


16 23 30 7 14 21
PRIL MAY


360


4 II 18 25 I B 15 22 29 5 12 19 26 5 12 19 26 2 9 16 23 30 7 14 21
DECEMBER JANUARY FEBRUARY MARCH APRIL MAY
WEEK ENDED


UTAH









OCTOBER 22, 1966


Morbidity and Mortality Weekly Report


Table 2
United States Influenza (Winter 1965-66) State Summary*

Division Peak GEOGRAPHIC EXTENT* Laboratory Confirmation
State Occurrence Isolation Serology


NEW ENGLAND
Massachusetts
Rhode Island
Connecticut
Vermont
New Hampshire
Maine
MIDDLE ATLANTIC
New York
New Jersey
(New York City)
Pennsylvania
SOUTH ATLANTIC
Georgia
Florida
North Carolina
Virginia
W. Virginia
Maryland
(Washington, D.C.)
Delaware
South Carolina
EAST NORTH CENTRAL
Illinois
Wisconsin
Michigan
Indiana
Ohio
EAST SOUTH CENTRAL
Alabama
Kentucky
Tennessee
Mississippi
WEST SOUTH CENTRAL
Texas
Oklahoma
Arkansas
Louisiana
WEST NORTH CENTRAL
Missouri
Nebraska
Kansas
Minnesota
North Dakota
Iowa
South Dakota
MOUNTAIN
Arizona
Utah
Nevada
Idaho
Montana
Wyoming
Colorado
New Mexico
PACIFIC
California
Alaska
Washington
Oregon
Hawaii


Jan late
Jan late
Feb mid
Feb late
Feb late
Mar early

Feb mid
Mar early
Mar late
Mar late

Dec early
Feb mid
Feb late
Feb late
Mar early
Mar mid
Mar late
Apr mid
May mid

Feb late
Mar early
Mar early
Mar mid
Mar late

Feb late
Mar mid
Mar mid
Apr mid

Mar mid
Mar late
Mar late
Mar late


Mar early
Mar mid
Mar late
Mar late
Apr early
Apr mid

Mar early
Mar early
Mar mid
Mar late
Mar late
Mar late
Mar late
Mar late

Feb late
Mar early
Mar mid
Mar mid
Mar late


Isolated B

Isolated A,B
Isolated B

Isolated A,B


Isolated A
Isolated A
Isolated B
Isolated B
Isolated A
Isolated B

Isolated A
Isolated B
Isolated A

Isolated A,B

Isolated B

Isolated A
Isolated B

Isolated A,B

Isolated A
Isolated A,B



Isolated A,B

Isolated B

Isolated B


Isolated A

Isolated B
Isolated B
Isolated B
Isolated A
Isolated A

Isolated B


Regional B






Regional B








Regional B

Regional B
Regional A



Regional
Regional B



Regional A,B




Regional B

Regional B

Regional A




Regional




Regional B




Regional B


Widespread B
Widespread B
Widespread B
Widespread B
Widespread B
Widespread B








Widespread B

Widespread B
Widespread B



























Widespread A
Widespread A



Widespread A


Widespread A
Widespread A




Widespread A
Widespread A,B
Widespread A,B
Widespread A
Widespread A


B

B
B

B

B
A2 B
B
A2.B
B

B
B

B

B
B
A2


A2, B
B
A2,B






B


A2
A2,B

A2, B


B
A2
A2

A2



A2

A2, B
A2

A2


A2, B
B
B
A2, B
A2


361


B
B
B
B
B
B

B
B
A


A,B
B
B
A, B
A,B



B

A,B
B
B
A
A, B

B

A,B
B

A, B
A, B
A



B
A,B
A,B
A,B

B

A
A

A
A, B
B
A
A,B

A, B
A,B
A, B
A,B
A


*Information from State Health Department Influenza Appraisal Summary, Research Institutions, University Centers and CDC
Respirovirus Laboratory
**Terms: Isolated influenza recognized in only a limited number of small, well-defined population units.
Regional influenza recognized in counties comprising less than 50 percent of the State's population.
Widespread influenza recognized in counties comprising more than 50 percent of the State's population.







Morbidity and Mortality Weekly Report


OCTOBER 22, 1966


1965-66 INFLUENZA SEASON (Continued)


the first viruses isolated after the emergence of Asian
influenza.
Type B viruses appear to be clearly distinguishable
from the vaccine strain B/Maryland /159. As a group,
the 1965-66 viruses appear closely related to the B/Colo-


rado/ 264 strain isolated during a limited outbreak of
type B influenza in the United States in 1964.

(Reported by the Influenza-Respiratory Diseases Unit,
Epidemiology Branch, CDC.)


Figure 3
DISTRIBUTION OF INFLUENZA A UNITED STATES 1965-66


ALASKA
HAWAII


Figure 4
DISTRIBUTION OF INFLUENZA B UNITED STATES 1965-66
SALASKA




-' ..... i r I

/ '- ... '.I.. -'- l> NEW YORK

*. ASHINGTON
I r r .. *-. /_ .0f' -- ,NE RK

SL oc





SNO ACTIVITY RECOGNIZED -
D ISOLATED CASES) OR OUTBREAKS)
REGIONAL INVOLVEMENT
WIDESPREAD INVOLVEMENT
[ UNCONFIRMED INFLUENZA-LIKE DISEASE


362









OCTOBER 22, 1966


1200-

1100-

1000-

900-

800-













WEEK NC
WK ENOEI
MONT
*0-


Morbidity and Mortality Weekly Report




Figure 5
PNEUMONIA-INFLUENZA DEATHS IN 122 UNITED STATES CITIES


363


ALL
CITIES


EPIDEMIC THRESHOLD---"-----
EXPECTED NUMBER


40 44 48 52 4 8 12 16 20 24 26 32 36 4 44 48 53 4 8 12 2i 20 24 28 32 36 40 44 48 52 4 8 12 16 20 24 28 32 36
S 2 30 28 22 22 21 1I 16 13 II 8 3 3 31 28 2 30 2 27 24 22 19 17 14 II 9 6 4 1 29 26 26 23 21 18 16 13 10
O N D J F M A M J A S 0 N0 J F M A M J J A S O N 0 F M A M J J A S
196 1964 196411965 196sl s


WN.
CENTRAL
10 CITIES


100-




40 44 46B 2 4 6 12 16 20 24 28 32
1965|1966


EN. 125-
CENTRAL
21 CITIES 100-

75-



25-

,, .I ..t ...l..J... 1 -1 ... I -I i l... -1 I ...I
40 44 46 52 4 I 2 12 20 24 28 32
1965 1966


E.S
CENTRAL
8 CITIES


200-

1 150o


~.^0-
PO -0


NEW
ENGLAND
14 CITIES








4044 41 2 4 6 12 I 20 2' 2 321 36
1965 1196


MIDDLE
ATLANTIC
20 CITIES










111 1sl


WK NO 40 44 46 52 4 6 12 16 20 24 2 32 4044 48 52 4 8 12 16 20 24 28 32 40 44 46 2 4 12 I6 20 24 26 32 36
1965ss 66 196S|1966 R9651966


MOUNTAIN
8 CITIES


100-

75.

50-


.J...Inds..Indsul...In.I...l..J..J..si










364 Morbidity and Mortality Weekly Report



CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

OCTOBER 22, 1966 AND OCTOBER 23, 1965 (42nd WEEK)


ENCEPHALITIS HEPATITIS
ASEPTIC Primary Post- Both
AREA MENINGITIS BRUCELLOSIS including Infectious DIPHTHERIA Serum Infectious Types
unsp. cases
1966 1965 1966 1966 1965 1966 1966 1965 1966 1966 1965
UNITED STATES... 59 58 3 58 68 9 5 4 37 680 698

NEW ENGLAND........... 1 5 3 1 1 1 3 26 43
Maine.............. 9 5
New Hampshire...... 3
Vermont............. 1
Massachusetts...... 1 2 2 1 1 1 1 7 18
Rhode Island....... 2 2 3 3
Connecticut........ 1 1 4 16

MIDDLE ATLANTIC...... 8 8 9 9 1 21 104 101
New York City...... 4 4 5 3 11 36 25
New York, Up-State. 1 1 1 1 3 25 20
New Jersey.......... 1 3 2 3 6 17 29
Pennsylvania....... 2 1 2 1 1 26 27

EAST NORTH CENTRAL... 8 9 15 12 2 1 1 114 150
Ohio................ 2 1 12 5 1 27 50
Indiana............ 1 1 2 4 8 8
Illinois........... 2 5 1 1 1 22 10
Michigan........... 2 1 2 1 47 76
Wisconsin.......... 1 1 1 -- 10 6

WEST NORTH CENTRAL... 3 3 5 11 1 55 28
Minnesota .......... 3 3 1 1 5 11
Iowa............... 4 13 2
Missouri........... 2 28 9
North Dakota....... 1
South Dakota....... 1 2
Nebraska........... 1 1 5 3
Kansas............. 3 4 3

SOUTH ATLANTIC........ 6 6 2 2 2 1 1 69 80
Delaware........... 1 1 1 1 8
Maryland ........... 1 14 15
Dist. of Columbia.. 2 2
Virginia........... 2 1 9 17
West Virginia...... 1 4 9
North Carolina..... 1 1 9 18
South Carolina..... 2 2
Georgia ............ 7 -
Florida............ 5 1 1 2 21 9

EAST SOUTH CENTRAL... 7 5 1 5 2 38 51
Kentucky ........... 8 17
Tennessee........... 5 1 1 4 19 20
Alabama............ 4 4 11
Mississippi........ 2 1 2 7 3

WEST SOUTH CENTRAL... 4 2 1 6 2 2 2 1 36 44
Arkansas........... 3 1 5 4
Louisiana.......... 1 1 6 12
Oklahoma ........... 2 1
Texas.............. 4 2 2 2 1 2 1 23 27

MOUNTAIN............. 2 3 26 38 35
Montana.. .... .... 7 5
Idaho.............. 3 1
Wyoming ............
Colorado........... 3 26 16 8
New Mexic o......... 2 10 6
Arizona............ 1 9
Utah............... 6
Nevada .... ....... -

PACIFIC .............. 2 18 1 10 5 1 1 10 200 166
Washington......... 3 1 1 22 16
Oregon ............. 1 1 1 32 19
California......... 18 16 1 8 4 1 10 145 111
Alaska. ............ 1 3
Hawa i ........ .. 1 -- 17












Morbidity and Mortality Weekly Report


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

OCTOBER 22. 1966 AND OCTOBER 23, 1965 (42nd 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..........


MENINGOCOCCAL INFECTIONS,
MEASLES (Rubeola) TOTAL

Cumulative Cumulative
1966 1966 1965- 1966 1965

633 192,121 243,982 46 2,897 2,501

19 2.346 36,932 2 127 128
1 226 2,828 10 16
80 382 9 7
12 278 1 1,301 4- 7
1 789 19,315 1 51 46
72 3,943 15 14
3 901 9.163 1 38 38

54 18,151 15,162 7 354 321
14 8,316 2,488 1 50 54
26 2,575 4,195 2 99 92
6 1,868 2,714 2 105 82
8 5.392 5,765 2 100 93

103 69.156 56.581 8 459 364
5 6,370 8,921 6 129 97
9 5,743 1,998 80 45
27 11,411 2.827 81 102
36 14,636 26,695 1 122 78
26 30,996 16,140 1 47 42

27 8,771 16,714 3 154 128
2 1,645 705 1 35 29
5,327 9,068 22 12
2 535 2,600 2 60 52
23 1,147 3,773 11 11
40 115 5 3
77 453 8 10
NN NN NN 13 11

75 15,473 25,438 8 492 471
3 260 506 4 9
5 2,116 1,170 48 45
384 78 1 14 9
9 2,197 4,121 4 60 57
29 5,369 14,020 35 25
5 505 396 2 127 96
658 1,058 50 62
S 234 617 63 58
24 3,750 3,472 1 91 110

15 19,862 14,207 1 251 193
4,736 2,714 1 89 77
14 12,398 8,026 85 61
1 1,699 2,341 54 33
1,029 1,126 23 22

135 24,976 31,164 6 392 324
971 1,085 35 16
99 110 3 146 180
9 503 210 2 21 20
126 23,403 29,759 1 190 108

22 12,109 19,982 1 89 87
3 1,841 3,764 1 5 2
4 1,629 2,832 5 9
2 170 852 6 5
1,321 5,715 48 24
2 1,139 679 10 11
5 5,317 1,357 10 16
4 645 4,577 17
2 47 206 5 3

183 21,277 27,802 10 579 485
105 3,921 7,295 3 43 37
19 1,868 3,315 36 34
46 14,793 13,106 7 479 388
11 551 190 17 18
2 144 3,896 1 4 8

51 2,966 2,531 1 15 10


1966

3


POLIOMYELITIS
RUBELLA
Total Paralytic

Cumulative
1965 1966 1966 1966

1 70 7 44

S 27



S 10I
10

Si

10
8
2


____ ~ -~ 11 ____


365


3 79
8
1 8
2 19
- 12
32

- 1 12
1 3











7
2
5
4
- I-




6


2
-




2 59 I 2

1 -
- -6
2 57 2

10
1
2





1










366 Morbidity and Mortality Weekly Report


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

OCTOBER 22, 1966 AND OCTOBER 23, 1965 (42nd 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... 6,619 7 159 3 139 11 319 223 57 3,344

NEW ENGLAND .......... 841 4 1 10 3 3 79
Maine.............. 40 25
New Hampshire...... 26 -- 1 27
Vermont............ 6 1 23
Massachusetts...... 168 2 1 6 1 1 4
Rhode Island....... 72
Connecticut........ 529 2 -- 4 2 -

MIDDLE ATLANTIC...... 178 1 14 1 53 41 1 201
New York City...... 6 5 22 1
New York, Up-State. 142 2 1 12 13 1 188
New Jersey......... NN 2 7 12
Pennsylvania....... 30 1 5 12 16 12

EAST NORTH CENTRAL... 522 1 19 18 39 17 8 439
Ohio................ 28 4 3 19 9 192
Indiana............. 93 4 8 4 4 97
Illinois........... 127 1 4 6 4 8 2 63
Michigan........... 176 5 6 1 38
Wisconsin.......... 98 2 1 6 1 49

WEST NORTH CENTRAL... 246 1 12 16 1 29 4 19 756
Minnesota.......... 5 1 3 7 175
Iowa............... 93 2 5 2 147
Missouri........... 5 6 10 1 14 3 3 230
North Dakota....... 104 1 2 39
South Dakota...... 11 2 4 84
Nebraska ..........- 2 2 22
Kansas............. 28 1 2 7 1 1 59

SOUTH ATLANTIC....... 1,115 32 1 12 6 62 107 7 429
Delaware........... 9 -- 1 2
Maryland............ 217 3 1 2 1 10 26 3
Dist. of Columbia.. 2
Virginia........... 218 6 2 13 31 3 222
West Virginia...... 225 1 1 1 50
North Carolina..... 8 4 3 6 27 4
South Carolina..... 44 2 1 2 13 5
Georgia............ 7 7 3 4 16 2 93
Florida............ 387 10 3 12 1 57

EAST SOUTH CENTRAL... 1,064 18 1 22 1 41 39 5 426
Kentucky........... 21 2 2 10 9 1 90
Tennessee.......... 858 3 12 1 20 24 4 295
Alabama............ 107 7 4 6 6 20
Mississippi........ 78 6 1 4 5 21

WEST SOUTH CENTRAL... 666 3 40 1 61 1 32 8 7 678
Arkansas........... 6 4 1 47 1 3 2 2 78
Louisiana.......... 4 1 10 3 10 1 43
Oklahoma .......... 74 1 3 7 9 5 2 171
Texas............... 582 1 23 4 10 1 2 386

MOUNTAIN .............. 1,021 2 6 14 3 2 89
Montana............ 81 2 7
Idaho .............. 59
Wyoming ........... 30
Colorado............ 380 2 3 2 18
New Mexico......... 230 1 2 1 1 14
Arizona............. 89 1 4 1 39
Utah............... 151 2 4 3
Nevada.............. 1 I 8

PACIFIC.............. 966 1 18 3 1 39 1 5 247
Washington......... 324 II 1 14
Oregon.............. 26 1 1 4
California......... 574 1 17 3 1 25 1 4 229
Alaska............. 2 -
Hawaii......... .. 40 -
Puerto Rico.......... 7 1 45 1 15 1 17


I


I I I I I I t I I











Morbidity and Mortality Weekly Report






DEATHS IN 122 UNITED STATES CITIES FOR WEEK ENDED OCTOBER 22. 1966


367


(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 1 year Area All 65 years and f I year
Age and over Influenza All Age and overInfluenza 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..--------


694
216
48
30
20
58
17
15
38
47
75
7
40
15
68

3,317
46
35
142
47
30
57
80
106
1,708
46
402
227
45
97
21
52
74
44
28
30

2.644
80
39
751
166
207
124
87
316
51
45
38
37
51
179
39
150
46
33
48
104
53

880
61
27
49
120
21
109
101
274
69
49


442
135
33
19
14
30
11
10
25
31
46
5
28
11
44

1,926
23
18
81
31
18
35
39
50
990
26
239
125
34
66
14
27
43
23
24
20

1,499
47
24
415
100
119
69
50
164
31
21
22
22
28
90
20
97
29
21
26
72
32

547
41
20
27
72
16
74
78
159
39
21


*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.-----------


1,216
149
286
48
60
79
53
76
43
80
69
236
37

637
97
39
24
158
130
46
36
107

1,064
34
26
27
127
59
68
200
46
160
96
108
54
59

345
34
19
114
19
41
17
56
45

1,593
17
53
38
39
77
538
82
24
121
60
96
158
35
168
54
33


Total 12,390 7,036 457 720

Cumulative Totals
including reported corrections for previous weeks

All Causes, All Ages ----------------------- 526,932
All Causes, Age 65 and over------------------- 301,884
Pneumonia and Influenza, All Ages------------- 21,918
All Causes, Under 1 Year of Age--------------- 28,089


Week No.









368 Morbidity and Mo





EPIDEMIOLOGIC NOTES AND REPORTS
RESPIRATORY DISEASE-Panama and Canal Zone


An outbreak of respiratory illness in the Republic
of Panama as well as in the Canal Zone began in early
July and continued through the month of August. Comple-
ment fixation studies from two cases confirmed a fourfold
rise in antibody to influenza A2, but further lab charac-
terization has not yet been accomplished.
A review of the record for numbers of outpatient
clinic visits related to upper respiratory illness reveals
that peaks in occurrence in the past six years have been
associated with isolation of type A or B influenza virus
(Table 3).

Table 3
Upper Respiratory Illnesses Reported to Outpatient
Clinics in the Canal Zone 1961-1966

Month 1961 1962 1963 1964 1965 1966


January
February
March
April
May
June
July
August



September
October
November
December


158
155
138
88
257
536**
128
103



125
216
357
255


140
118
206
181
144
158
315
359*
(through
Aug. 22)


*Type A influenza isolated during epidemics of upper res-
piratory illness.
**Type B influenza isolated during epidemic of upper res-
piratory illness.
f solution of Type A influenza made during a localized out-
break of respiratory illness among a group of soldiers.


(Reported by the Division of Preventive Medicine, Canal
Zone, Sidney B. Clark, M.D., Chief, Andries de Boer,
M.D., Epidemiologist, and an EIS Officer assigned to the
Zone.)


Editorial Note:
The seasonal distribution of the recent outbreak is
in keeping with past experience in this geographical
region where influenza generally occurs near the onset of
of the heavy rainfall months (1M I. or June).


irtality Weekly Report


OCTOBER 22, 1966


33
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SITI
U--.S DEPOSITORY


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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