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:
AA00010654:00360

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

?-Sa ;/1 ~e Is.


COMMUNICABLE DISEASE CENTER
















U.S. DEPARTMENT OF HEALTH, EDUCATION, AND


EPIDEMIOLOGIC NOTES AND REPORTS
TYPHOID FEVER -Rockville, Maryland


On April 19, 1966, a 3-year-old child from Rockville,
Maryland, developed chills and fever accompanied by
pharyngeal injection and palpable anterior cervical nodes.
On April 21 the child was admitted to hospital because
of vomiting, diarrhea, and a temperature of 105*F. Treat-
ment with chloramphenicol was initiated on admission,
and a stool culture was subsequently reported to contain
Salmonella typhi, phage type C.
Epidemiological investigations revealed that the
household was exceptionally clean with a good municipal
water supply and sewage disposal. None of the other


Vol. 15, No. 28







Week Ending
SJuly 16, 1966



IC HEALTH SERVICE


CONTENTS

Epidemiologic Notes and Reports
Typhoid Fever Rockville, Maryland ............ 237
Recommendation of The Public Health Service Advisory
Committee on Immunization Practices Influenza
Vaccine Civilian Use 1966-67 . .... 238

members of the family had been ill, and none had recently
travelled away from the community. Four of the adult
members of the family had had typhoid fever in the past,
two while living in Greece and two in Albania. Three of
the four adults had been in this country for a number of
years, but the fourth was the 65-year-old maternal grand-
mother who had arrived in the United States from Athens,
(Continued on page 244)


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous weeks)
28th WEEK ENDED CUMULATIVE, FIRST 28 WEEKS
MEDIAN
DISEASE JULY 16, JULY 17, 1961-1965 MEDIAN
1966 1965 1966 1965 1961-1965
Aseptic meningitis .................. ... .57 33 49 862 807 792
Brucellosis .................... ....... 8 4 14 114 123 214
Diphtheria .... ........ ...... 3 3 84 87 151
Encephalitis, primary:
Arthropod-borne & unspecified ......... 33 25 718 826
Encephalitis, post-infectious ............. 14 16 483 441
Hepatitis, serum ....................... 23 703 19171 24792
Hepatitis, infectious .................... 489 512 607 17,857
Measles rubeolaa) ........... ...... ... 1.871 2.180 4.817 182,491 232.261 370.898
Poliomyelitis, Total (including unspecified) 1 2 11 30 26 114
Paralytic ..... ......................... 1 2 8 28 22 94
Nonparalytic ........................... -- 4 --
Meningococcal infections, Total .......... 38 39 38 2.397 2.041 1.513
Civilian .................. ............ 37 38 2.135 1.871 -
Military .............................. 1 1 262 170 -
Rubella (German measles) ................ 507 -- 39.438 -- -
Streptococcal sore throat & Scarlet fever .. 3.876 4.515 3,786 272,740 253,248 222.069
Tetanus .......................... ..... 7 6 --- 82 124 -
Tularemia ................ ........... 6 10 80 132 -
Typhoid fever .......................... 4 7 12 164 197 218
Typhus, tick-borne (Rky. Mt. Spotted fever). 14 15 --- 100 114 --

Rabies in Animals ................... ... 51 124 94 2,359 2,629 2.326

NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax: N.H.- .......... 4 Botulism: ........... ....... ......... .... 4
Leptospirosis: ......... ....................... 36 Trichinosis: Penn.-2, Ohio-i ................. ..... 56
Malaria: N.Y. City 1. P.nn.-3, Miss.-1, Fla.-1, Ariz.-l ... 161 Rabies in Man: .. ........ ... ....... ....... ...... 1
Psittacosis: Mass.4 ....... ...... 24 Rubella, Congenital Syndrome: ................. .. 18
Typhus, murine Texas- ............... ...... .. 13 Plague: N.Mex.-l* .......... ......... 2
*DELAYED REPORT








Morbidity and Mortality Weekly Report


JULY 16, 1966


RECOMMENDATION OF THE PUBLIC HEALTH SERVICE ADVISORY
COMMITTEE ON IMMUNIZATION PRACTICES



The Public Health Service Advisory Committee on Immunization Practices
meeting on May 16, 1966, issued the following recommendation regarding
influenza immunization and control in the civilian population.






INFLUENZA VACCINE -CIVILIAN USE- 1966-67


Influenza Prospectus 1966-67 United States

Influenza was reported in 49 of the 50 States during the
winter and spring of 1965-66 with laboratory confirmations
in 47. The season was noteworthy in that sometimes
sharp and extensive outbreaks both of types A and 'B
influenza occurred. Type A2 virus was recognized in most
of the western States while type B predominated east of
the Mississippi River, particularly in States along the
Atlantic Coast. In 20 States, activity of both types of
influenza viruses was demonstrated.


Although school absenteeism associated with type B
influenza was elevated in New England, and to a lesser
extent in other eastern States, correspondingly increased
industrial absenteeism was not observed. In areas where
type A influenza virus was responsible for widespread
disease, more indices of the total extent of involvement
were recognized: Increased industrial absenteeism often
accompanied that observed in schools, the number of
hospital admissions was elevated, and in the Pacific
division, pneumonia-influenza mortality was higher than
recorded since 1960, when type A influenza was last
widely prevalent.


In general, excess mortality attributable to pneumonia
and influenza was evident primarily in areas where A2
strains were predominant. Little evidence of excess
mortality was noted in areas where only type B strains
occurred.


Major antigenic changes were not demonstrated in the
type A2 and B influenza virus strains recovered during
the year, although minor variations were apparent. Since
evidence has not indicated a major alteration in anti-
genicity of either A or B strains in recent years, the
level of general population susceptibility to the cur-
rently prevalent strains is not considered to be high.


Because of the widespread recognition of both types A
and B influenza viruses in 1965-66 and the characteristics
of infecting strains, it is felt that relatively little influ-
enza activity will be recognized in 1966-67. It is a
reasonable expectation, however, that limited outbreaks
of type A2 influenza will occur in parts of the U.S. not
experiencing type A disease in 1964-65 or 1965-66.
Similarly, the possibility of some type B influenza is
recognized, particularly in the southwest.


Influenza Vaccine

Influenza vaccine has shown protective value when the
viruses incorporated in the vaccine have been anti-
genically similar to those causing the epidemic disease.
Exceptions to the apparent effectiveness of influenza
vaccine have occurred, however, when significant anti-
genic shift in the prevalent virus was recognized after
the vaccine had been formulated (for example, in 1947,
1957, and to a lesser extent in 1962). That influenza
vaccine diminishes mortality from influenza, in particular
among the aged and chronically ill, is a reasonable
assumption but one based upon inference.


Vaccine Usage

Annual influenza immunization is not currently indicated
for all individuals, but vaccine should be given regularly
to persons in groups which are known to experience high
mortality from epidemic influenza. Such groups include:


Chronically III

Persons of all ages who suffer from chronic debil-
itating disease, e.g., chronic and cardiovascular,
pulmonary, renal or metabolic disorders, in particular:

A. Patients with rheumatic heart disease, espe-
cially those with mitral stenosis.


238












B. Patients with other cardiovascular disorders
such as arteriosclerotic heart disease and
hypertension, especially those with evidence
of frank or incipient cardiac insufficiency.

C. Patients with chronic bronchopulmonary dis-
eases, as for example, chronic asthma, chronic
bronchitis, bronchiectasis, pulmonary fibrosis,
pulmonary emphysema, pulmonary tuberculosis.

D. Patients with diabetes mellitus and Addison's
disease.



Patients residing in nursing homes, chronic disease
hospitals, and other such environments should be
considered at particular risk since their more crowded
living arrangements may allow greater spread of
disease once an outbreak has been established.


Older Age Groups

During major influenza outbreaks, especially when
caused by type A virus, increased mortality has
regularly been recognized in persons over 45 years
of age and even more notably in those over age
65-this has been particularly notable when under-
lying chronic illnesses are also evident.




Pregnancy Some increased mortality, was observed
among pregnant women during the 1957-58 influenza A2
epidemic both in this country and abroad. Similar data
are not available for subsequent years and, therefore,
routine influenza immunization during pregnancy is not
recommended unless the individual also falls into one of
the above noted "high risk" categories.


Time of Vaccination

Vaccination should begin as soon as practicable after
September 1 and ideally should be completed by mid-
December. It is important that immunization be carried
out before influenza occurs in the immediate area since
there is a two-week interval before the development of
antibodies.



Vaccine Composition

Recently isolated influenza viruses show minor antigenic
alteration of both type A2 and B strains. Because these
variations have generally not been interpreted as being
of major significance, composition of the 1966-67 vaccine
is unchanged from that prepared for 1965-66. (See Poly-
valent influenza Vaccine Formulation- 1966-67).


239


Dosage and Schedule
Primary Immunization

Individuals not vaccinated since July 1963 when the
last major change in vaccine formulation was made
should receive an initial subcutaneous dose of
polyvalent vaccine followed by a second dose two
months later. It is to be pointed out, however, that
even a single dose can afford significant protection.
A second dose given as early as two weeks following
the first will enhance the protection.

Summary:
Adults and children over 10 years
1.0 mi. subcutaneously on two occasions as
specified above
Children 6 to 10 years*
0.5 ml. subcutaneously on two occasions as
specified above
Children 3 months through 5 years*
0.1-0.2 ml. of vaccine given subcutaneously
on two occasions, separated by one to two
weeks followed by a third dose of 0.1-0.2 ml.
about two months later.


Booster Immunization

Individuals vaccinated since July 1963 need receive only
a single booster of vaccine at the dose level specified
for the primary series. For those in the older age groups
who have previously experienced undue reactions to
influenza vaccine, a revaccination dose of 0.1 ml. given
by a careful intracutaneous injection can be expected to
give an antibody response which is somewhat comparable
to that induced by the 1.0 ml. subcutaneous dose. The
intracutaneous route is not recommended, however, for
use in other than these special cases.


Contraindication Since the vaccine viruses are pro-
duced in eggs, the vaccine should not be administered to
those who are hypersensitive to eggs or egg products.


*Since febrile reactions in this age group are common following
influenza vaccination, an antipyretic may be indicated.


Polyvalent Influenza Vaccine Formulation 1966-67

Type Strain CCA Units per ml.
A PR8 100
Al Ann Arbor.1 57 100
A2 Japan '170 62 100
A2 Taiwan. 164 100
B Maryland,1 59 -'i,
600


JULY 16, 1966


Morbidity and Mortality Weekly Report









240 Morbidity and Mortality Weekly Report



CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

JULY 16, 1966 AND JULY 17, 1965 (28th 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... 57 33 8 33 25 14 3 23 489 512

NEW ENGLAND........... 1 3 4 1 1 13 27
Maine............... 3 3
New Hampshire...... 2
Vermont............ -1
Massachusetts..... 1 2 3 1 1 5 17
Rhode Island....... 1 1 2 1
Connecticut........ 3 3

MIDDLE ATLANTIC...... 10 2 10 7 2 1 10 66 103
New York City...... 2 4 1 5 18 9
New York, Up-State. 1 3 1 19 38
New Jersey.......... 4 4 2 3 12 24
Pennsylvania. ...... 3 2 3 1 2 1 17 32

EAST NORTH CENTRAL... 4 4 1 2 5 2 1 90 95
Ohio............... 19 21
Indiana............. 1 1 9 14
Illinois........... 1 1 2 3 9 23
Michigan........... 3 4 -2 48 35
Wisconsin.......... 1 5 2

WEST NORTH CENTRAL... 3 1 2 1 24 33
Minnesota........... 3 1 1 2
Iowa............... 1 1 11 6
Missouri........... 7 22
North Dakota....... 1
South Dakota....... I- 1
Nebraska ........... 1 1
Kansas............. 3 2

SOUTH ATLANTIC....... 13 3 2 4 3 1 1 3 36 52
Delaware ........... -
Maryland............. 1 5 4
Dist. of Columbia.. 1
Virginia............ 2 1 1 1 8 7
West Virginia...... 4 5
North Carolina..... 2 1 1 5 4
South Carolina.... 1 3 3 3
Georgia............ 7 8
Florida............ 8 3 1 1 1 4 20

EAST SOUTH CENTRAL... 3 2 1 34 34
Kentucky ......... 17 18
Tennessee........... 10 10
Alabama............. 1 1 1 2 4
Mississippi........ 2 1 1 5 2

WEST SOUTH CENTRAL... 5 4 1 5 1 2 66 47
Arkansas.......... 10 4
Louisiana........... 1 2 18 11
Oklahoma............. 1 1 1 1
Texas............... 4 3 3 1 2 37 31

MOUNTAIN............. 1 2 4 26 10
Montana............ 1 1
Idaho............... 2
Wyoming............ -
Colorado........... 2 1 5
New Mexico......... 10 4
Arizona............ 1 7 3
Utah................ 3 1 2
Nevada.............

PACIFIC.............. 18 16 1 3 4 6 8 134 111
Washington ......... 2 1 2 17 9
Oregon............. 1 1 11 12
California......... 15 13 1 3 3 4 7 92 86
Alaska............. 10 3
Hawaii.............. 1 2 4 1

Puerto Rico........... 37 44


(II I I


III









Morbidity and Mortality Weekly Report 241


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED
JULY 16, 1966 AND JULY 17. 1965 (28th WEEK) CONTINUED


MENINGOCOCCAL INFECTIONS, POLIOMYELITIS
MEASLES (Rubeola) TOTAL Totl P c RUBELLA
Total Paralytic
AREA
Cumulative Cumulative Cumulative
1966 1966 1966 1965 1966 1966
1966 1965 966 1966 1965 1966 1965 1966 1966 1966
UNITED STATES... 1,871 182,491 232,261 38 2,397 2,041 1 2 1 28 507

NEW ENGLAND.......... 8 2,158 36,473 2 110 103 61
Maine................ 2 192 2,753 1 9 12 6
New Hampshire...... 65 378 9 5 2
Vermont............ 219 1,231 4 5 1
Massachusetts...... 4 748 19,131 1 43 34 24
Rhode Island....... 72 3,881 12 14 3
Connecticut........ 2 862 9,099 33 33 25

MIDDLE ATLANTIC...... 67 17,583 13,830 4 275 270 46
New York City...... 20 8,178 2,024 39 46 10
New York, Up-State. 33 2,242 3,914 3 79 72 36
New Jersey......... 6 1,856 2,341 1 77 73
Pennsylvania....... 8 5,307 5,551 80 79

EAST NORTH CENTRAL... 660 66,538 52,816 4 373 271 171
Ohio................ 14 6,226 8,694 2 100 71 4
Indiana............. 76 5,549 1,701 64 37 52
Illinois........... 94 11,189 2,405 1 73 72 22
Michigan............. 274 13,363 25,530 99 57 37
Wisconsin.......... 202 30,211 14,486 1 37 34 56

WEST NORTH CENTRAL... 47 8,522 16,222 1 132 106 1 1 6
Minnesota.......... 3 1,621 617 31 21 1
Iowa................ 22 5,229 8,935 21 7 1
Missouri............ 523 2,550 1 52 48 -
North Dakota....... 22 1,034 3,562 7 7 5
South Dakota....... 40 109 4 2 -
Nebraska........... 75 449 8 10 -
Kansas............. N N N NN 9 11 -

SOUTH ATLANTIC........ 161 14,338 24,048 10 399 401 1 72
Delaware.......... 7 250 498 4 5 -
Maryland............ 15 2,070 1,067 39 38 9
Dist. of Columbia.. 1 377 69 1 10 7 -
Virginia............ 32 1,939 3,930 50 47 30
West Virginia...... 56 4,968 13,230 1 16 23 14
North Carolina..... 14 389 369 4 99 78 -
South Carolina..... 26 641 993 45 56 1
Georgia............. 1 231 604 1 57 51 1
Florida............. 9 3,473 3,288 3 79 96 18

EAST SOUTH CENTRAL... 250 19,152 13,354 1 210 161 2 59
Kentucky........... 100 4,653 2,387 79 67 8
Tennessee.......... 130 11,904 7,644 68 47 50
Alabama............ 8 1,622 2,252 1 44 28 1 1
Mississippi........ 12 973 1,071 19 19 I

WEST SOUTH CENTRAL... 267 23,252 29,985 7 350 288 1 1 1 23 2
Arkansas........... 966 1,080 1 32 14 -
Louisiana.......... 91 91 3 132 162 -
Oklahoma........... 2 467 200 18 17 1
Texas............... 265 21,728 28,614 3 168 95 1 1 1 22 2

MOUNTAIN............. 136 11,422 19,007 2 77 61 44
Montana............ 4 1,789 3,613 4 2 -
Idaho............... 53 1,454 2,636 5 8 3
Wyoming.............. 143 834 6 4 -
Colorado............ 9 1,172 5,475 2 40 13 17
New Mexico.......... 25 1,093 657 10 10 -
Arizona............. 33 5,182 1,168 8 16 20
Utah................ 12 546 4,422 6 4
Nevada............. 43 202 4 2 -

PACIFIC.............. 275 19,526 26,526 7 471 380 -- 1 46
Washington.......... 7 3,412 7,179 35 31 1 6
Oregon.............. 72 1,564 3,113 30 28 14
California......... 99 14,119 12,538 7 387 301 18
Alaska.............. 89 310 142 15 13 6
Hawaii.. 8R 121 13554 4 7 2


ii


Puerto Rico.......... 52 2,376 2,140 1 9 4









242 Morbidity and Mortality Weekly Report


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

JULY 16, 1966 AND JULY 17, 1965 (28th 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 Cumm 196 Cum. 1966 Cum. 1966 Cum.
1966 1966 1966 1966 1966
UNITED STATES... 3,876 7 82 6 80 4 164 14 100 51 2,359

NEW ENGLAND........... 544 2 1 4 1 1 47
Maine.............. 42 1 17
New Hampshire...... 5 13
Vermont............. 39 15
Massachusetts...... 92 2 1 1 1 2
Rhode Island....... 41 -
Connecticut ...... 325 3 -

MIDDLE ATLANTIC...... 153 1 11 33 22 3 162
New York City...... 6 1 4 15
New York, Up-State. 145 2 6 10 2 151
New Jersey......... NN 6 -
Pennsylvania....... 2 4 6 4 1 11

EAST NORTH CENTRAL... 267 7 12 24 1 6 10 332
Ohio................ 22 3 3 10 3 3 168
Indiana............. 16 1 3 1 73
Illinois........... 40 1 5 3 1 3 4 33
Michigan........... 127 2 4 28
Wisconsin.......... 62 1 6 3 30

WEST NORTH CENTRAL... 209 6 1 6 13 2 13 529
Minnesota.......... 1 1 4 120
Iowa............... 25 1 4 4 112
Missouri............ 11 4 2 5 1 1 171
North Dakota....... 108 2 13
South Dakota....... 12 1 1 51
Nebraska........... 2 1 1 1 16
Kansas ............ 50 2 2 1 1 46

SOUTH ATLANTIC....... 393 18 8 2 31 9 49 7 303
Delaware ........... 39 -
Maryland............ 48 1 1 7 1 15
Dist. of Columbia.. 1 1 -
Virginia........... 105 3 2 8 4 15 4 182
West Virginia...... 143 1 1 39
North Carolina..... 1 2 3 11 1 2
South Carolina..... 7 1 1 5 3 4 -
Georgia............ 3 6 1 1 1 4 2 48
Florida............ 48 7 5 32

EAST SOUTH CENTRAL... 735 2 7 2 17 19 3 11 3 297
Kentucky ........... 67 1 2 3 1 2 50
Tennessee........... 563 1 9 7 1 8 3 232
Alabama............ 74 3 4 5 1 1 12
Mississippi........ 31 2 2 2 2 4 3

WEST SOUTH CENTRAL... 531 2 18 1 28 2 15 1 6 8 492
Arkansas........... 1 2 1 21 1 1 2 1 53
Louisiana ......... 4 3 1 5 22
Oklahoma .......... 1 1 3 4 4 1 131
Texas.............. 529 2 11 1 1 5 6 286

MOUNTAIN ............. 677 1 1 5 8 3 44
Montana............ 6 1 2 7
Idaho.............. 93 -
Wyoming ........... 7 -
Colorado........... 339 1 3 2 7
New Mexico......... 81 1 1 6
Arizona............ 79 1 1 22
Utah............... 72 1 3
Nevada.............. ... 1 2

PACIFIC.............. 367 2 12 1 3 17 6 153
Washington......... 21 2 1
Oregon............. 11 1 1 -
California......... 265 2 11 1 3 12 6 152
Alaska.............. 24 -
Hawaii.............. 46 -
Puerto Rico.......... 6 1 31 6 8










Morbidity and MortalilE WeeklN Report






DEATHS IN 122 UNITED STATES CITIES FOR WEEK ENDED JULY 16, 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 1 year Area All 65 years and I year
Ages and over Influenza All Ages 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.V---
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.--------


755
260
57
22
29
48
16
33
28
59
53
12
56
29
53

3,997
50
41
180
34
30
27
90
96
2,049
82
680
258
58
107
31
44
60
56
31
43

2,864
77
44
822
169
240
135
76
407
40
51
27
26
53
204
37
137
44
30
61
121
63

964
57
30
40
165
15
111
54
336
78
78


464
136
35
17
19
27
6
27
17
39
31
6
42
21
41

2,492
29
25
112
17
23
21
51
49
1,274
24
441
145
39
63
21
29
42
34
22
31

1,654
46
29
450
107
129
83
47
233
24
19
14
13
34
114
15
98
24
16
43
78
38

623
44
19
24
107
9
60
29
224
49
58


*Estimate based on average percent of divisional total.


SOUTH ATLANTIC:
Atlanta, Ca.---------
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.----------


1,204
133
294
38
53
83
76
84
39
68
52
238
46

632
96
54
32
144
124
41
44
97

1,171
31
65
27
150
57
80
189
63
199
90
110
51
59

420
47
19
120
19
108
28
45
34

1,524
17
32
35
33
63
498
77
41
143
57
101
153
47
149
44
34


Total 13,531 7,904 549 679

Cumulative Totals
including reported corrections for previous weeks

All Causes, All Ages ------------------------- 362,417
All Causes, Age 65 and over------------------- 209,633
Pneumonia and Influenza, All Ages------------- 16,353
All Causes, Under 1 Year of Age--------------- 18,717


Week No.
28









244


EPIDEMIOLOGIC NOTES AND REPORTS
TYPHOID FEVER Rockville, Maryland
(Continued from front page)



Greece, during the first week of January 1966. She had
had typhoid fever in 1943 while living in Athens. Rectal
swab cultures were reported negative for all of the mem-
bers of the family except for the grandmother whose cul-
ture revealed three colonies of S. typhi, phage type C.
The 3-year-old child made an uneventful recovery and
was discharged after 10 days in the hospital. Two of the
adult family associates were in the restaurant business in
another city, and the health officer there prohibited them
from handling food until three rectal swab cultures were
checked and found negative for S. typhi.

(Reported by Dr. Ernest H. Joy, Communicablt Disease
Division, and Dr. Roy P. Lindgren, Health Officer, Mont-
gomery County Health Department, Rockville, Maryland.)



Editorial Note:
This case is rather characteristic of the experience
with typhoid fever in this country at the present time.
Between 400 and 500 cases of typhoid fever are reported
each year, most of which can be traced either to a carrier
or to travel to a foreign endemic area. Older women are
particularly likely to become long-term carriers after infec-
tion with S. typhi.







ERRATUM, Vol. 15, No. 27, p. 227:


In the 1965 Annual Surveillance Summary of paralytic
poliomyelitis, the titles of the two figures should be
reversed. Figure 1 should read "Paralytic Poliomyelitis,
1965 61 Cases by County, United States" and Figure 2
should read "Paralytic Poliomyelitis Cases by Date of
Onset, 1961-1965."


JULY 16, 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 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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