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:
AA00010654:00366

Related Items

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


This item is only available as the following downloads:


Full Text




COMMUNICABLE DISEASE CENTER


Vol. 14, No. 2


WEEKLY

REPORT


Week Ending
January 16, 1965


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


EPIDEMIOLOGIC NOTES
RABIES IN ANIMALS
There were 88 cases of animal rabies reported for the
week ended January 16, 1965; 70 cases were reported a
year ago. Twenty-three of this week's total were reported
from Tennessee. The cumulative total of animal rabies
cases thus far in 1965 is 180 as compared to 119 for the
similar period in 1964.
In 1964, 4,597 cases were reported for the entire year,
the highest total since 1958. A large number of these
cases represented fox rabies occurring in Tennessee and
and Virginia and skunk rabies in the midwest. The in-
creased reporting from Tennessee continues. Most of these
cases are located in the eastern counties. A special


Malaria Pennsylv ..

Salmonellosis C onia ... .

Shigellosis Geo 1 F .* .*


report on the epidemiological pattern and control measures
concerning fox rabies in this area will be included in a
future issue.


Table 1. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous weeks)
2nd Week Ended Cumulative, First 2 Weeks
Disease January 16, January 11, Median Median
1965 1964 1960 1964 1965 1964 1960 1964
Aseptic meningitis ................ 30 30 30 68 49 47
Brucellosis ...................... 2 4 6 10 7 14
Diphtheria ........................ 6 1 20 9 9 35
Encephalitis, primary infectious .. 33 43 --- 64 61
Encephalitis, post-infectious.... 19 6 --- 24 14 ---
Hepatitis, infectious including
serum hepatitis ................ 796 869 1,093 1,481 1.494 1,784
Measles ........................... 6,746 5,682 7,589 11,949 8,873 13,484
Menlngococcal infections .......... 77 56 56 127 93 98
Poliomyelitis, Total ............. 1 10 1 17
Paralytic .............. ..... 5 7
Nonparalytic .................. 1 --- 1---
Unspecified ........... ......- --- -
Streptococcal Sore Throat and
Scarlet fever .................. 9,931 8,734 7,928 18,598 15,544 14,905
Tetanus ........................... 5 6 --- 8 9 --
Tularemia ......................... 9 7 --- 13 16 ---
Typhoid fever ..................... 3 7 5 4 9 8
Rabies in Animals ................. 88 70 64 180 119 114

Table 2. NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax: Va.-1 1 Rabies in Man:
Botulism: Smallpox:
Leptospirosis: Trichinosis: 1
Malaria: Typhus-
Plague: Murine:
Psittacosis:1 Rky Mt. Spotted: N.C.-I, Va.-I 2








Morbidity and Mortality Weekly Report

OUTBREAK OF SHIGELLOSIS IN TWO MILITARY UNITS
CASES BY DAY OF ONSET AND UNIT
FORT BRAGG, NORTH CAROLINA


D CASES OCCURRING IN UNIT A

El CASES OCCURRING IN UNIT B.


SEPTEMBER


SHIGELLOSIS Fort
A total of 22 soldiers experienced febrile diarrhea,
subsequently proven to be due to shigellosi., in an out-
break involving 2 separate units at Fort Bragg, North
Carolina, during the period September 12-21, 1964. Four-
teen cases occurred in the "A" Battalion; 8, in the "B"
Battalion.
Illnesses were characterized by fever (99-102.8 F),
chills, headache, malaise, nausea, %omiting, cramps. and
diarrhea. Only one individual experienced bloody diarrhea,
and all responded promptly to treatment with oxytetracy-
cline. Epidemic curves, by unit, show that the outbreaks
occurred more or less simultaneously in the 2 units (see
figure below).
Although the 2 units concerned operate totally inde-
pendent mess halls, investigation into possible common
sources of infection revealed that 3 "A" Battalion cooks
had prepared food served at a "B" Battalion party on
September 12. The onl\ common food eaten by ill persons
who attended the party was potato salad; only one of the
3 cooks had participated in the preparation of this food.
Preparation of the salad to be served at the "B"
Battalion part had begun in the "A" Battalion mess hall
at about 10 a.m. on September 12. At about 11 a.m. the
finished product was placed in a large -erting tray and
refrigerated. At 3 p.m. all the foods including the salad,
were picked up at the mess hall, transported to the party,
and placed on the .,ering line. Serving began at 5 p.m.
and continued until 11 p.m. No refrigeration was provided
for the salad from 3 p.m. to 11 p.m. Left-o'er salad was
discarded.


Bragg, North Carolina
Unlike "B" Battalion, food histories on "-" Battalion
representatives did notelicit a single meal or food common
to all patients in this unit. Assuming that cases on
September 20 and 21 represent secondary. cases, based on
a 1 to 7 day incubation period for shigellosis, infections
in "A" Battalion probably. occurred during the period
September 10-11. All ill persons in "-" Battalion ate
one or more meals in the "A" Battalion mess hall during
this period. These dates include the da. on which "B"
Battalion held the party implicated as the source of
infection for this unit.

Rectal swabs yielded positive cultures for Shigella
sonnei (Group D) in 4 of 12 ill persons examined in "-"
Battalion. No positive cultures were obtained from 4 ill
persons examined in "B" Battalion; however. one of 36
asymptomatic individuals from this unit, who attended the
party. yielded a culture of Sh. .-onnei (Group D). Thecook
involved in salad preparation for the "B" Battalion party
was ihe only one of 10 cooks who %as positive for this
same organism.



(Reported by Vajor Llewelly J. Leglers, 1iC. Precentire
Medicine Officer, Captain Larry Mulkerin, VC, Group
Surgeon. and Captain A. T. Cramer, 4C, Group Surgeon.
U. S. Army John F. Kennedy Center for Special I warfare,
and Captain John F. Barlow, IC, and I Lt Charles J.
Harrell, USC, Womack Army Hospital Laboratory, Fort
Bragg, North Carolina.)


0-
DAY
OF ONSET








Morbidity and Mortality Weekly Report


MALARIA Pennsylvania


A case of malaria in a sailor occurring aboard a ship
docked at Philadelphia was reported by Pennsylvania and
Philadelphia health authorities in December, 1964.

A 14-Near-.,ld sailor aboard a Danish freighter first
became ill on December 8, 1964. This was eight days
prior to the date his ship reached Philadelphia. The
patient had daily episodes of chills, fever and diaphoresis.
He was given two penicillin injections for his fever.
Hi l .- mptom- persisted until the time he was hospitalized
in Philadelphia on December 16. On admission to the
hospital the onl. positive ph-.ical finding was a ques-
tionably enlarged spleen. Laboratory findine- were Hb.-
12 gm.i and \lBC-3.0'l). The peripheral blood smears
revealed the presence of Plairnodzumn fal i;parum. The
patient was treated with chloroquine.

He had no previous history of malaria though he had
traveled extensively around the world in areas endemic
for malaria. He had no recent injections except the peni-
cillin giwn for his fever. He stated that he took chloro-
quine as prophyla\i-. but could not recall if this was
once a week or once every two weeks.

The merchant vessel had a crew of 40 men. The ship
was completing a routine around-the-world trip. The ship
was carr %ine cocoa beans, timber and coffee from ports
in Htst Africa to the United State-. During the time the
ship called at the %cest African ports the crew was offered
chloroquine with their meals each Friday. Most of the
crew took the 'Irug in a regular manner. The crew noted
that mosquitoes were dense and bothersome in all the
VPo-t .frican ports, both on and off the ship. Mosquitoes
were noted on board the ship for one day after it left
H iet Africa but not after that time. In Philadelphia, each
crew member was interviewed and had blood drawn for a
peripheral blood smear and for a fluorezrent antibody test
for malaria antibody production. None of the crew had
experienced recent -\mptom- compatible with malaria
and all slides and fluore-tent antibod* tests were nega-
tive. The fluorescent antihody test for malaria antihod%
production was positive when tested with the serum of
the single case.




(Reported by Dr. Sylvan Fish, Director, Communicable
Disease Section, Philadelphia Department of Public
Health, Dr. 1. F. Gratch, Epidemiologist. Pennsylvania
Department of Health, and an EIS Officer. Fluorescent
antibody tests for malaria antibody production were
performed by t illiam Collins, Ph.D., Laboratory for
Parasite Chemotherapy, NIH, Chamblee, Ga.)


SALMONELLOSIS California


An outbreak involving 14 cases of Salmonella newport
infection in a newborn nursery in a large California hospi-
tal occurred in August 1964. Epidemiological investigation
suggested that the outbreak began when a mother, subse-
quently found to be an a.-mptomatic carrier of S. newport,
delivered an infant, who shortly after birth, became ill
with symptoms of fever and bloody diarrhea. The infant's
stool culture was positive for S. newport. Approximately
48 hours follow ing this case, gastroenteritis occurred in
other infants and in a nursery attendant. Within 2 weeks
14 cases had been identified, 12 of which were sympto-
matic. There was 1 death. The attack rate for the nursery
population at risk was 10 percent.

During the course of the epidemic, attempts were
made to control the outbreak and to define the method of
dissemination within the nur-ery population. Initially, pre-
existing isolation techniques were strengthened and rein-
forced, and all infants suspected of having salmonellosis
were transferred from the nursery to the pediatric floor,
where more adequate facilities for patient isolation could
be implemented. Spread within the nursery continued how-
ever, and eventually the entire dolilery, maternity, and
nursery units were closed for 4 days. During this period,
a thorough cleansing, including -rubbing and even germi-
cidal fogging was performed. Since reopening, no new
cases have been identified.

All members of the nursery staff, including nurses,
aides, physicians, floor assistants, and dietary workers
submitted stool specimens for examination. In most in-
stances 2 or more specimens were obtained. One attendant
in the nursery was positive for S. newport. Cultures from
other individuals produced a %ariet* of isolates. One
specimen from a nurse yielded S. bi, kley, a specimen
from a dietar) worker on the tra\ line in the cafeteria
yielded S. tIyp/i-mairiuln, and a porter was found to be
carrying S. heidelberg. In addition, a kitchen worker,
father of one of the .y mptomatic infants, was found to be
excreting S. newport.

Further in\emtigation revealed that the nursery atten-
dant positive for S. newport had had direct contact with
all infant positive for S. newport, including the index
case, during the time she was first symptomatic No other
person had had contact with all cases.

(Reported by Philip K. Condit, M.D., Chief, Bureau of
Communicable Diseases, Henry A. Renteln, M.D., Head of
Special Surveillance Section, an EIS Officer assigned to
California State Department of Health; Herbert H. Cowper,
M.D., Chief, Division of Communicable Diseases, and
Caryl C. Carson, M.D., Ep,;icnri,!o.llit!. Los Angeles
County Health Department.)











20 Morbidity and Mortality Weekly Report



Table 3. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

JANUARY 16, 1965 AND JANUARY 11, 1964 (2nd WEEK)


Encephalitis Pollomvelitts Diphtheria
Aseptic
Meningitis Primary Post-Inf. Total Cases Paralytic
Area
Cumulative Cumulative Cum.
1965 1964 1965 1965 1965 1965 1964 1965 1965 1964 1965 1965
UNITED STATES... 30 30 33 19 1 6 9

NEW ENGLAND.......... 2 5 6 -
Maine........... .. -
New Hampshire ...... -
Vermont............ .
Massachusetts...... 1 4 -
Rhode Island....... i -
Connecticut........ 1 1 1 -

MIDDLE ATLANTIC .... 5 5 11 1 -
New York City...... I 4 -
New York, Up-State. 2 2 1 1 -
New Jersey.......... 2 6 -
Pennsylvania........ 2 1 -

EAST NORTH CENTRAL... 3 2 3 -
Ohio ............... 2 2 -
Indiana............. .- -
Illinois...........- .
Michigan........... 1 2 1 -
Wisconsin .......... -

WEST NORTH CENTRAL... 1 5 1 2 4
Minnesota.......... -
Iowa................ I 1 1 -
Missouri............ 1 -
North Dakota........ -
South Dakota........ 1 1 2
Nebraska........... -. 1 1
Kansas............. -

SOUTH ATLANTIC....... 2 1 5 2 I 1 2
Delaware........... -
Maryland............ .
Dist. of Columbia.. -
Virgin a........... 1 2 1 -
West Virginia...... .
North Carolina...... 1 I 1 1
South Carolina..... 1 -
Georgia............ -
Florida............ 1 3 1

EAST SOUTH CENTRAL... I 3 1 1
Kentucky........... -
Tennessee ......... -
Alabama............. -
Mississippi........ 1

WEST SOUTH CENTRAL... 4 1 2 2
Arkansas........... -
Louisiana........... .- -
Oklahoma........... .
Texas............ .. 4 1 1 2 2

MOUNTAIN............. 1 2 1 -
Montana.............. 1 -
Idaho............... -
Wyoming............ 1 -
Colorado............ -
New Mexico......... -
Arizona............. -
Utah ............... -
Nevada ............ -

PACIFIC............... 13 15 2 7
Washington......... 1 -
Oregon............ -
California.......... 12 13 1 6 -
Alaska............... -
Hawaii............. 1 2 -

Puerto Rico -










Morbidity and Mortality Weekly Report 21


Table 3. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

JANUARY 16, 1965 AND JANUARY 11, 1964 (2nd WEEK) Continued


Brucel- Infectious Hepatitis Meningococcal
losis including Serum Hepatitis Infections Tetanus
Area JTotal Under 20 years Cumulative
incl. unk. 20 years and over Totals Cumulative Cum.
1965 1965 1965 1965 1965 1964 1965 1965 1964 1965 1965


UNITED STATES... 2 796 421 329 1,481 1,494 7- 127 93 5 8

NEW ENGLAND.......... 47 26 17 93 214 5 6 5 1
Maine.............. 4 1 2 19 84 1 1 -
New Hampshire...... 4 1 2 9 32 -- 1
Vermont............. 2 2 5 26 -
Massachusetts...... 28 18 8 39 38 3 4 1
Rhode Island....... 3 2 1 6 5 1 -
Connecticut........ 6 4 2 15 29 4

MIDDLE ATLANTIC...... 167 94 73 281 379 12 19 14 -
New York City...... 15 1 14 43 58 2 4 2
New York, Up-State. 109 74 35 140 190 2 5 6
New Jersey......... 17 6 11 38 40 5 6 -
Pennsylvania....... 26 13 13 60 91 3 4 6

EAST NORTH CENTRAL... 1 134 85 46 271 171 11 15 4
Ohio............... 33 23 9 88 84 6 8 2
Indiana............ 3 2 1 8 8 1
Illinois........... 31 17 12 54 12 3 5 1
Michigan........... 62 38 24 103 55 -
Wisconsin.......... 1 5 5 18 12 2 2 -

WEST NORTH CENTRAL... 63 32 30 109 96 4 8 1 2
Minnesota.......... 1 1 3 3 -
Iowa............... 35 21 13 65 16 -
Missouri........... 17 5 12 20 15 3 4 1
North Dakota....... 3 1
South Dakota....... 1 1 2 8 -
Nebraska............ 3 1 2 3 7 -
Kansas............. 6 4 2 16 46 1 1 -

SOUTH ATLANTIC....... 98 54 40 163 113 14 25 22 4 4
Delaware........... 3 1 2 3 1 1 -
Mar)l3nd........... 14 10 4 27 26 2
Dist. of Columbia.. 1 1 1 2 -
Virginia.......... 21 8 9 33 12 2 3 1
West Virginia...... 26 23 3 29 2 1 2 3
North Carolina..... 13 7 6 Z0 18 2 2 3
South Carolina..... 3 1 2 6 4 7
Georgia............ 9 9 18 4 5 9 1 3 3
Florida............ 8 3 5 26 45 3 8 5 1 1

EAST SOUTH CENTRAL.. 37 23 12 68 112 8 11 11 -
Kentucky........... 11 8 1 21 56 6 7 -
Tennessee.......... 13 10 3 22 32 2 5
Alabama........... 7 4 3 17 19 2 2 2
Mississippi........ 6 1 5 8 5 -

WEST SOUTH CENTRAL... 65 35 29 154 75 7 16 12
Arkansas........... 3 1 2 17 10 2 1
Louisiana.......... 7 2 5 17 6 3 4 3
Oklahoma............ 2 1 1 5 2 3 2
Texas............... 53 31 21 115 57 4 7 6 -

MOUNTAIN............. 1 53 15 9 95 98 3 3 9 -
Montana............ 3 1 2 7 11 -
Idaho.............. 16 25 6 1- 1
Wyoming............. 1 4 3 1 6 -
Colorado............ 2 1 1 3 19 3
New Mexico......... 15 6 3 21 11 3 3 5 -
Arizona............ 7 24 23 -
Utah............... 6 4 2 9 26 -
Nevada ............. 2- -

PACIFIC.............. 132 57 73 247 236 13 24 15 1 1
Washington......... 13 8 5 16 31 1 -
Oregon ............. 12 6 6 29 18 1 1 -
California......... 95 39 56 174 169 12 22 14 1 1
Alaska............. 12 4 6 28 13 1 -
Hawaii............. 5- -


Puerto Rico 2 1 1 2 3 -











22 Morbidity and Mortality Weekly Report


Table 3. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

JANUARY 16, 1965 AND JANUARY I1, 1964 (2nd WEEK) Continued


Strept.
Measles Sore Th. & Tularemia Typhoid Fever Rabies in
Scarlet Fev. Animals
Area
Cumulative Curm. Cum. Cum.
1965 1965 196. 1965 1965 1965 1965 1965 1965 1965
UNiTED STATES.. 6,746 11,949 8,873 9,931 9 13 3 4 88 180

NEW ENGLAND.......... 1,871 3,747 463 929 1 2
Maine............... 238 495 31 8 -
New Hampshire...... 29 87 5 17 -
Vermont ............ 1 20 107 9 1 1
Massachusetts...... 1,070 1,966 12 120 -
Rhode Island....... 278 362 15 36 -
Connecticut ....... 241 817 181 665 1

MIDDLE ATLANTIC...... 307 422 1,926 328 3 7
New York City ...... 39 67 37 26 -
New York, up-State. 123 157 282 206 3 5
New Jersey......... 5- 5- 458 3 -
Pennsylvania....... 81 144 449 53 2

EAST NORTH CENTRAL... 1,229 1,711 1,416 950 7 10
Ohio.............. 228 297 190 129 -
Indiana............ 21 53 323 81 1 3
Illinois........... 31 56 528 68 -
Michigan .......... 6:5 943 254 -47 2 2
Wisconsin.......... 254 382 121 225 4 5

WEST NORTH CENTRAL... ,75 825 224 387 1 1 24 36
Minnesota.......... 5 8 1 10 5 8
Iowa............... '72 430 45 105 8 12
Missouri............ 33 82 18 36 3 4
North Dakota........ 153 277 157 157 3 6
South Dakota....... 16 3 57 1 1
Nebraska........... 8 12 2 3 3
Kansas............. N. NIl NIl 20 1 1 I 2

SOUTH ATLANTIC....... 849 1,632 1,121 1,126 3 5 1 1 10 22
Delaware............ 39 51 II 5 -
Maryland............ 8 18 219 121 -
Dist. of Columbia.. 27 I -
Virginia........... 116 156 296 329 2 2 10 22
West Virginia...... 613 1,266 ,24 -07 -
North Carolina..... 23 50 31 15 1 1
South Carolina...... 17 71 48 1 2 -
Georgia ............ 6 11 4 17 -
Florida............. 4 6' 38 183 -

EAST SOUTH CENTRAL... 326 559 1,290 1,503 2 2 32 73
Kentucky............. 4 10 6"8 107 1 1 3 5
Tennessee.......... 4." 6 411 558 1,201 I I 28 65
Alabama............ 16 67 24 49 I 3
Mississippi........ 40 76 20 16 -

WEST SOUTH CENTRAL... 361 852 499 701 2 3 1 2 6 21
Arkansas............ 2 2 25 2 2 2 1 2 2 2
Louisiana.......... 1 1 4 6
Oklahoma............ 5 1 1 4
Texas~.............. 359 844 473 698 9

MOUNTAIN............ 767 1,288 502 2,166 I 2 3 4
Montana ............ 236 468 179 5 -
Idaho.............. 120 196 8] 193 -
Uyoming............ 34 5- 6 105 -
Colorado............ 105 181 66 1,037 -
New Hexico......... 33 47 6 18 -
Arizona............ 8 30 115 215 3 4
Utah................ 223 309 58 374 1 2 -
Nevada............. 3 3 11 -

PACIFIC.............. 561 893 1,432 1,841 1 1 2 5
Washington........... 136 141 556 433 -
Oregon............. 172 304 211 14 -
California......... 197 349 472 1,266 2 5
Alaska............. 7 .80 56 -
Hawaii............. 49 90 13 72 I

Puerto Rico 18 58 81 13 -










Morbidity and Mortality Weekly Report


Week No. Table 4. DEATHS IN 122 UNITED STATES CITIES FOR WEEK ENDED JANUARY 16, 1965
2
(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 1 year
Ages and over Inf Al Ages and over Influenza Au
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.------
ScheneLtady, N. Y.----
Scrant'n, 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--------
Daytl-n, 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, lowa------
Duluth, Minn.---------
Kansas City, Kans.----
Kansas City, Mo.------
Lincoln, Nebr.--------
Minneapolis, Minn.----
Omaha, Nebr.----------
St. Louis, Mo.--------
St. Paul, Minn.------
Wichita, Kais.--------


871
278
41
40
30
67
26
22
33
75
92
17
42
40
68

4,115
44
42
180
63
33
55
93
107
1,926
49
859
221
46
107
33
43
70
85
23
36

2,748
75
36
826
188
217
130
79
367
37
49
41
34
59
162
29
149
36
30
43
94
67

915
76
38
44
135
37
105
86
272
69
53


551
174
20
30
18
41
18
16
27
51
55
14
26
24
37

2,408
23
25
92
39
15
39
44
51
1,150
26
493
126
36
71
21
21
41
51
21
23

1,511
37
25
419
117
133
79
48
180
24
28
26
12
37
100
15
84
15
18
27
48
39

548
53
26
23
75
29
62
50
158
38
34


45
12
6

1
3

1
1
4
5
2

4
6

210
2

11
2
1
2
5
10
106
5
34
15

6
1
2
4
1

3

161
2
2
50
8
10
6
5
28

4
2
1
2
10
2
15
5

2
6
1

51
2
I
5
13
I
6

18
4
1


*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.--------
Chattanc.oea, Tenn.----
Knoxville, Tenn.-------
Louisville, Ky.--------
Memphis, Tenn.--------
Mobile, Ala.-----------
M.,-ntgpomery, Ala.-------
Nashville, Tenn.-------

WEST SOUTH CENTRAL:
Austin, Tex.---------
Baton Rouge, La.-------
Corpus Christi, Tex.---
Dallas, Tex.------------
El Paso, Tex.-----------
Fort Worth, Tex.-------
Hcuston, 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.-----------


1,287
139
297
44
83
97
66
85
45
92
65
218
56

732
116
72
61
134
153
43
48
105

1,193
39
59
31
147
42
80
241
63
183
67
102
65
74

401
36
15
114
21
100
17
47
51

1,765
17
42
57
50
72
572
122
37
129
72
94
209
36
135
68
53


643
64
157
15
29
45
36
48
14
70
38
100
27

366
59
31
32
72
62
20
28
62

602
24
25
14
86
15
48
108
36
83
32
63
28
40

226
17
9
63
11
59
9
26
32

1,040
11
26
39
24
44
324
77
27
77
45
55
120
21
78
40
32


Total 14,027 7,895 701 827


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---------------


28,458
16,070
1,365
1,723










Morbidity and Mortality Weekly Report


unIVERSIT Y OF FL ORDA


I3Ull 1II 262 0886ll llll
3 1262 08864 2524


SHIGELLOSIS Georgia

An outbreak of shigellosis involved 220 students of
a total enrollment of 526 in a Georgia public grade-school
over the period November 20-22. The disease was char-
acterized by malaise, high fever, bloody diarrhea, nausea
and vomiting.
Epidemiologic investigation revealed that 205 of the
220 students reported ill had eaten in the school caf-
eteria on November 20. Stool cultures were positive for
Shigella flexneri 6 in over 40 students and teachers and
in 3 food handlers. The principal food handler involved in
preparation of the subject meal had felt ill that day and
went home after completing her work, complaining of
diarrhea. Her 4-year-old child was also ill with diarrhea
the same day and they both subsequently had positive
stool cultures for Shigella flexneri 6. Her duties in pre-
paring the luncheon meal consisted of cutting vegetables,
opening cans of tuna fish, and mixing the ingredients of
a tuna fish salad, believed to be the probable vehicle of
infection.
(Reported by Robert J. Walker, Jr., M.D., Director of
Public Health, District No. 34, and John E. McCroan,
Ph.D., Chief Epidemiologist, Georgia Department of
Public Health, Atlanta, Georgia.)


THE MORBIDITY AND MORTALITY WEEKLY REPORT, WITH A CIRCULA-
TION OF 13,000 IS PUBLISHED BY THE COMMUNICABLE DISEASE
CENTER, ATLANTA. GEORGIA 30333.
CHIEF. COMMUNICABLE DISEASE CENTER JAMES L. GODDARD, M.D.
CHIEF. EPIDEMIOLOGY BRANCH A. D. LANGMUIR, M.D.
CHIEF, STATISTICS SECTION R. E. SERFLING, PH.D.
ASST. CHIEF. STATISTICS SECTION 1. L. SHERMAN, M.S.
CHIEF, SURVEILLANCE SECTION D. A. HENDERSON. M D.
ASSISTANT EDITOR, MMWR PAUL D. STOLLEY, M D
IN ADDITION TO THE ESTABLISHED PROCEDURES FOR REPORTING
MORBIDITY AND MORTALITY. THE COMMUNICABLE DIsEASE CENTER
WELCOMES ACCOUNTS OF INTERESTING OUTBREAKS OR CASES, SUCH
ACCOUNTS SHOULD BE ADDRESSED TO:
THE EDITOR
MORBIDITY AND MORTALITY WEEKLY REPORT
COMMUNICABLE DISEASE CENTER
ATLANTA. GEORGIA 30333
NOTE: THESE PROVISIONAL DATA ARE BASED ON WEEKLY TELE-
GRAMS TO THE CDC BY THE INDIVIDUAL STATE HEALTH DEPART.
MENTS. THE REPORTING WEEK CONCLUDES ON SATURDAY: COMPILED
DATA ON A NATIONAL BASIS ARE RELEASED ON THE SUCCEEDING
FRIDAY.
SYMBOLS: --DATA NOT AVAILABLE
QUANTITY ZERO
THE CONSTRUCTION OF THE MORTALITY CURVES IS DESCRIBED IN
VOL. 14, NO. 1. JANUARY 15. 1965.


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