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:
AA00010654:00375

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


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Vol. 14, No. 20


E




Week Ending
May 22, 1965


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


PRESUMPTIVE SMALLPOX Washington, D.C.


A case _,presumptive smallpox has been admitted to
a hospit l-i the District of C lu ia, prompting an
extensive effe to confirt!rhe d gn is, to trace, vac-
cinate and e'ebablish sur1eill all possible con-
tacts. This rN ero o reside gp in the District of
Columbia and a klE j Maryland and Virginia.
The patient in s a 31-year-old resident of
Ghana who arrived by air in New York City from Accra,
Ghana, on May 7, 1965. She then proceeded directly to
Washington, D.C. The patient noted onset of malaise,
myalgia and possibly fever on May 17. On May 19, an
eruption was noted, beginning first on one arm and then


COr'TE\ rs
Presumptive Smallpox H.%-hin.nn, D.C .... 169
Botulism ,Hashinrt,jn ................ ... .. 170
Poliomyelitis Nebraska. . .. ....... 171
Salmonellosis Michigan . ..... 171




spread to involve the trunk and the other extremities during
the subsequent 48 hours. On May 20, the patient and her
husband took a cab to the emergency room of a Washington
hospital. In view of the possibility of smallpox, the
patient was transferred by ambulance to another hospital
with more adequate isolation facilities and the District
of Columbia Health Department was notified.


Table 1. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous weeks)
20th WEEK ENDED CUMULATIVE. FIRST 20 WEEKS
MEDIAN
DISEASE MAY 22, MAY 16, 1960-1964 MEDIAN
1965 1964 5 1960--1964
Aseptic meningitis ......... 20 36 29 548 551 485
Brucellosis ............... 8 10 10 87 149 149
Diphtheria ................ 1 10 6 75 98 190
Encephalitis, primary infectious. 31 45 --- 602 666 ---
Encephalitis, post-infectious *** 26 28 --- 315 351

Hepatitis, infectious including
serum hepatitis ........... 592 755 930 14,862 17,680 19,621
Measles ................. .. 9,234 26,945 19,186 191,175 337,914 283,157
Meningococcal infections 63 53 50 1,666 1,302 1,036
Poliomyelitis, Total ......... 2 1 8 10 26 123
Paralytic .*...............* 2 1 8 9 21 92
Nonparalytic --- 1 4
Unspecified ** ** ** *. --- 1 -

Streptococcal Sore Throat and
Scarlet fever ............ 7,884 8,366 6,821 209,910 211,156 179,578
Tetanus **.....*********... 8 5 --- 81 80 ---
Tularemia *....********** 7 4 --- 74 92 ---
Typhoid fever ............. 13 11 13 135 130 159

Rabies in Animals ....* '' 80 118 1 100 2,026 1,846 1,648

Table 2. NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax: .................................. 5 Rabies in Man: ............ ................ -
Botulism: ................................ 3 Smallpox: ............................... -
Leptospirosis: Iowa-1 ....................... 12 Trichinosis: Tenn. -1 ......................... 53
Malaria: Conn. 1, Pa. 1, Ore. -1. ................ 22 Typhus -
Plague: ................................. Murine: ...... ........................ 7
Psittacosis: .............................. 13 Rky. Mt. Spotted: NY Up-State-1, Md.-1, Tenn.-l, Va.-1 15


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iii








Morbidity and Mortality Weekly Report



PRESUMPTIVE SMALLPOX Washington, D.C.
(Continued from front page)


The clinical illness has been characterized by fever
(to 1030F) which persisted through May 24 (5 days after
the appearance of the eruption), and by a vesicular rash
with centripetal distribution involving primarily the trunk
and to a lesser extent the face and extremities. One such
lesion was observed on the soft palate and none were
seen on the palms and soles. The lesions were- somewhat
superficially placed, irregular in size and shape and
demonstrated some evidence of "cropping"; several
lesions evolved from macule to vesicule to scab in the
first four days of the eruption.
The patient received an apparently successful primary
vaccination in childhood. She was revaccinated in April,
1965, without apparent take. She has a valid international
vaccination certificate. She reported the possibility of
contact with a child with a rash sometime during the
month prior to her departure from Accra.
Fluorescent antibody results were positive for variola
in several specimens of vesicular fluid; similar studies
were negative for herpes and chickenpox. A skin biopsy
through one of the lesions revealed the presence of intra-
cytoplasmic inclusion bodies and no intraneclear inclusion
bodies. Complement fixation antibody studies performed
on the vesicular fluid were inconclusive. Isolation at-
tempts in embryonated eggs are in process and appear to
be highly suspicious for variola.
On the basis of the preliminary clinical, epidemiolog-
ical and laboratory evidence the case was considered to
be presumptive smallpox and extensive efforts have been
undertaken by the District of Columbia Department of
Public Health to minimize additional contacts with the
patient and to detect, vaccinate and place under surveil-
lance all persons who have come in contact with the pa-
tient. In addition to the strict isolation of the patient in a
private room, the floor on which the isolation room is lo-
cated has been closed to all visitors as well as to future
admissions. Discharges from that floor have also been
discontinued.
Tracing of contacts has led to the identification of
over 900 contacts who have been placed in one of three
categories of presumed risk. A total of 95 individuals are
known to have had direct contact with the patient since
May 13. Of these, 93 have been located, vaccinated and


placed under surveillance. These include the patient's
husband and friends, taxicab and ambulance drivers, per-
sonnel of both hospitals, the District of Columbia Depart-
ment of Public Health and the Communicable Disease
Center, and laundry workers handling potentially con-
taminated laundry.
An additional 683 persons have been identified as
indirect contacts of the patient. These include other
hospital patients on the same floor, patients recently
discharged from that floor, and visitors to that floor (before
quarantine measures were instituted), medical and nursing
staff not directly in contact with the patient, laundry
workers, housekeepers and para-medical personnel who
have been on the floor, and persons who were in the emer-
gency room of the first hospital visited on May 20. To
date, 599 of these 683 persons have been vaccinated and
placed under surveillance.
The third category consists of secondary contacts.
This includes the families and close associates of the
95 persons who had direct contact with the patient. More
than 150 persons have been identified, over half of whom
have been located and vaccinated.
The surveillance of the direct contacts includes both
daily temperature recording and clinical examination for
16 days following the last known contact or date of suc-
cessful vaccination. Indirect and secondary contacts have
been instructed to report any suspicious symptoms occur-
ring during the first 16 days after the last possible con-
tact. These are to be investigated immediately. All persons
in these categories will be contacted at the close of this
period to ascertain their well being.
The hospital where the case is now isolated offered
smallpox vaccinations to the entire staff on World Health
Day during April 1965. Approximately one-third of all
personnel responded and were vaccinated during this
program.
Health authorities in Maryland, Massachusetts, New
York City, North Carolina, Pennsylvania and Virginia are
being advised of direct and indirect contacts who are now
in their jurisdictions.
(Reported by Dr. Murray Grant, Director of Public Health,
Department of Public Health, Government of District of
Columbia, and a team from the Communicable Disease
Center.)


BOTULISM Washington


Five cases of clinical botulism and an additional
suspected case have occurred among seven persons from
Granger, Washington, who ate a common meal on the even-
ing of May 21, 1965. The onsets of illness ranged from
28 to 60 hours after consuming the dinner. A line listing
of the cases appears on opposite page
Eight foods were served at the involved meal: (1)
fried chicken; (2) boiled rice; (3) macaroni salad(con-


gaining boiled macaroni, hard boiled eggs, fresh cucumbers,
fresh onions, and mayonnaise); (4) canned fruit cocktail
mixed with jello; (5) canned, ripe, black, pitted olives;
(6) canned pork and beans (served unheated); (7) ice cream
(commercial) and (8) cake. The beverages were coffee for
the adults and powdered reconstituted soft drinks for the
children.
The food histories are tabulated on opposite page.


170







Morbidity and Mortality Weekly Report


( I i ii l
Case No. \-> Sex Onset Condition

1 .7 F -' \ .'
2 17 F "2 '" c're
3 14 F 5/ 2. Fair
4 18 F 5i 2: Fair
5 6 M 5/ 24 Good
6 37 M '1 -4 (i. oi
7 13 M Developed no illness


All of those with clinical botulism (cases 1-5) ate all
of the foods served. The suspect (case 6) who has very
mild -smptom- ate hurriedly and consumed only small
amounts of each food. The only individual without illness
(case 7) ate all foods except the pork and beans; how-
ever, the accuracy of this 13 year old boy's history is
open to que-tion.


(Case No.
1 2 3 4 5 6 7

Chicken + + + + + + +
Rice + + + + + +
Macaroni .Sail:l + + + + + +
Fruit Salad + + + + + + +
Olives + + + + + + +
Pork and Beans + + + + + + -
Ice Cream + + + + + + +
Cake + + + + + + +


The pork and beans, the ripe olives and the fruit
salad were commercially canned products. Laboratory
studies are currently in prJorv -- in an attempt to ascer-
tain the involved food.
(Reported by Dr. Ernest A. .1.,,r, Chief of Ep,,I, r., '.,l,/y,
State Department of Health, Olympia, Washington.)


POLIOMYELITIS Nebraska


Two cases of paralytic poliomyelitis in' ludini, one
death have occurred in Morrill County, Nebraska. The
fir-t case became ill on May 9, 196tj, five days after
returning from a visit to Baja California, Mexico. Initial
symptoms of fever and nausea were followed by stiff
neck and flaccid paralysis of both lower extremities which
progressed rapidly to include the upper extremities and
respiratory musculature. The patient died on May 13. The
second case is an 11-month-old male cousin of the first
case and had onset of illness on May 12. This patient
has weakness of the left arm and left facial nerve.
Stool specimens from seven of eight -iblini-. of the


first case have yielded Type I poliovirus at the Virology
Laboratory, Department of Microbiology, University or
Nebraska, and confirmed as Type I at the CDC Kansas
City Field Station. Laboratory studies on specimens from
the second case are in process.
A mass vaccination progr.ini utilizing Type I oral
poliomyelitis vaccine from the CDC Epidemic Reserve,
will be conducted by the Nebraska Department of Health,
in Morrill County (population 7,000) and adjacent Scotts
Bluff County (population 34,000).
(Reported by Dr. E.A. Rogers, Director of Health, Nebraska
Department of Health.)


SALMONELLOSIS Michigan


During September, 1964, 9 of 11 persons partaking of
a picnic dinner became ill with gastroenteritis traced to
Salmonella typhi-murium phage type 2a. The onset of ill-
ness varied from 15 to 24 hours after the meal with symp-
toms of fever, chills, abdominal cramps, vomiting and
diarrhea. Salmonella typhi-murium phage type 2a was re-
covered from stool cultures of 7 of the 9 persons ill.
An epidemiologic investigation suggested that home-
made ice cream was the vehicle of infection. Salmonella
typhi-murium phage type 2a was recovered from samplesof
the ice cream mix. Raw eggs and home-pasteurized cream
were used in preparing the ice cream mix, which was un-
cooked prior to freezing. Samples of the raw cream, four
raw eggs, and chicken feed were submitted to the labora-
tory for culture. All of these were negative for salmonella.
However, because the sanitarian at the farm producing the


eggs used in making the ice cream had noted a sudden
drop in egg production just prior to the outbreak, the in-
vestigation was continued. Because of the low production,
the layers were rlauightered, and at the time of the slaugh-
tering, samples of the intestine and liver were collected
for culture. Salmonella ,yph i--murium phage type 2a was
isolated from the composite sample of the livers and from
3 culture swabs taken from stool contents. The authors
concluded that the raw eggs used in preparing the un-
cooked ice cream mix had been contaminated with salmo-
nella.

(Reported by Dr. Donald B. Coohon, EpdJemiolo:,. *;.
Morris L. V. French, Division of Laboratories, George
Rouman, Chief, Environmental Health Division, C.A.E.
Luval, M.D., Health Officer, and Madeline Heffron, Divi-
sion of Nursing, Vit hi.'un State Department of Health.)


171










172 Morbidity and Mortality Weekly Report


Table 3. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

MAY 22, 1965 AND MAY 16, 1964 (20th Week)


S Encephalitis Poliomyelitis Diphtheria
Aseptic
Meningitis Primary Post-Inf. Total Cases Paralytic
Area
Cumulative Cumulative Cum.
1965 1964 1965 1965 1.965 1965 1964 1965 1965 1964 1965 1965


UNITED STATES... 20 36 31 26 2 10 26 2 9 21 1 75

NEW ENGLAND.......... 2 3 3 1 1
Maine............... 1 1 -
New Hampshire....... -
Vermont............ -
Massachusetts...... 3 -
Rhode Island........ 1 1 -
Connecticut........ 1 2 -

MIDDLE ATLANTIC...... 2 4 7 1 1 4 4 4
New York City ...... 3 1 1 1 2
New York, Up-State. 2 2 2 1 2 2 -
New Jersey......... 1 1 -
Pennsylvania....... 2 1 2

EAST NORTH CENTRAL... 3 5 6 1 3 3 3
Ohio................ 2 3 2 2 1
Indiana............ 2 2
Illinois............ 1 1 1 --
Michigan............ 3 1 -
Wisconsin.......... 2 -

WEST NORTH CENTRAL... 1 3 1 1 2 1 2 18
Minnesota........... 1 3 1 1 7
Iowa................ .- -
Missouri........... 1
North Dakota....... -
South Dakota........ 7
Nebraska ........... 1 1 1 1 -
Kansas............... -

SOUTH ATLANTIC....... 1 3 2 3 11 8 15
Delaware........... -
Maryland ........... .
Dist. of Columbia.. 1 3
Virginia........... 1 2 -
West Virginia...... 1 1 1 -
North Carolina..... 1 5 2 -
South Carolina..... -
Georgia............... 1 1 8
Florida............ 1 1 1 4 4 3

EAST SOUTH CENTRAL... 2 11 1 2 1 10
Kentucky............. 9 -
Tennessee............ 1 -
Alabama............ 2 2 1 1 9
Mississippi........ I 1

WEST SOUTH CENTRAL... 1 5 1 1 3 1 1 3 1 1 19
Arkansas ........... .- 1 -1 2
Louisiana........... 3 2
Oklahoma............ ..
Texas.............. 1 1 1 1 3 1 1 3 1 15

MOUNTAIN ............. 3 3 3 2 3 1 -
Montana............ -
Idaho............. .
Wyoming............. .-
Colorado............. .... 1 1
New Mexico.......... .- 1 1 1 -
Arizona ............ 1 2 2 2 -
Utah............... 2 -
Nevada............. .

PACIFIC .............. 11 7 2 15 1 2 1 2 5
Washington......... 2 1 1 -
Oregon..... ...... .... .- 1 1 1
California......... 9 6 14 1 1 1 1 4
Alaska............... -
Hawaii .............. -


Puerto Rico 1 I 6









Morbidity and Mortality Weekly RepoIrt 173


Table 3. ( AS:C OF SPK( IF11) NOTIFIAHLF I)IFAS1 % UNITED STATES

FOR WEEKS FN)II)

MAY 22, 1965 AND MAY 16, 1964 (20th Wcck)-Continued


Brucel- Infectious Hepatitis Meningococcal
loss including Serum Hepatitis Infections Tetanus
Area Total 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... 8 592 321 246 14862 17680 63 1666 1302 8 81

NEW ENGLAND.......... 33 19 13 904 1856 3 83 36 4
Maine.............. 3 1 2 188 637 9 5 -
New Hampshire...... 9 7 2 83 135 5 1
Vermont............ 42 234 2 1 -
Massachusetts...... 14 8 6 342 363 28 15 3
Rhode Island....... 3 1 1 117 92 1 12 2 -
Connecticut......... 4 2 2 132 395 2 27 13

MIDDLE ATLANTIC...... 93 45 48 2552 4029 6 232 150 4
New York City...... 446 583 1 36 20 -
New York, Up-State. 42 18 24 1091 1799 2 59 43 2
New Jersey......... 28 17 11 432 737 1 68 50 -
Pennsylvania....... 23 10 13 583 910 2 69 37 2

EAST NORTH CENTRAL... 116 71 43 2865 2700 10 202 189 3 8
Ohio................ 35 23 12 860 705 1 57 53 1
Indiana............ 16 14 1 239 228 2 29 32 1 4
Illinois........... 14 7 6 548 466 51 41 1
Michigan........... 42 24 18 1047 1110 6 39 45 -
Wisconsin.......... 9 3 6 171 191 1 26 18 2 2

WEST NORTH CENTRAL... 7 32 13 13 1007 1012 3 89 72 3
Minnesota.......... 5 3 2 89 88 1 19 14 2
Iowa............... 5 8 4 2 397 151 1 5 3 -
Missouri........... 7 4 2 191 251 1 41 41 1
North Dakota....... 1 1 13 41 4 5 -
South Dakota....... 1 1 16 99 2 -
Nebraska.......... 3 30 20 9 4 -
Kansas............ 2 7 2 5 271 362 9 5 -

SOUTH ATLANTIC....... 69 42 25 1526 1690 9 329 269 1 23
Delaware........... 56 37 4 4 -
Maryland........... 10 2 8 297 328 32 20 1
Dist. of Columbia.. 18 28 4 9 -
Virginia........... 12 7 4 383 242 37 30 4
West Virginia...... 13 11 2 230 287 23 19 1 1
North Carolina..... 6 4 2 124 321 4 58 44 2
South Carolina..... 1 1 51 61 50 42 1
Georgia............ 3 3 55 39 3 44 26 3
Florida............ 24 15 8 312 347 2 77 75 11

EAST SOUTH CENTRAL... 29 17 11 1116 1234 6 123 117 2 14
Kentucky........... -. 6 4 1 390 539 1 54 42 1 2
Tennessee.......... 14 10 4 416 421 2 36 38 5
Alabama............ 9 3 6 170 168 22 20 1 6
Mississippi........ 140 106 3 11 17 1

WEST SOUTH CENTRAL... 44 22 22 1285 1281 8 242 172 1 13
Arkansas........... 4 1 3 179 139 12 10 4
Louisiana.......... 11 5 6 217 275 5 132 85 2
Oklahoma.......... 34 75 1 17 4 -
Texas.............. 29 16 13 855 792 2 81 73 1 7

MOUNTAIN ............. 36 17 7 901 1123 1 55 44 2
Montana............ 5 2 3 68 109 1 -
Idaho.............. 1 145 108 7 1 -
Wyoming............ 30 37 2 3 -
Colorado........... 13 11 2 179 315 1 13 9 1
New Mexico......... 9 1 171 169 8 19 -
Arizona............ 3 173 246 16 3 1
Utah............... 5 3 2 130 103 6 2 -
Nevada............ .. 5 36 2 7 -

PACIFIC.............. 1 140 75 64 2706 2755 17 311 253 1 10
Washington......... 10 5 4 226 299 2 24 19 -
Oregon............. 11 7 4 219 312 23 16 1 2
California......... 1 111 56 55 2105 2005 10 248 205 8
Alaska............. 7 7 139 85 3 9 6 -
Hawaii.............. 1 1 17 54 2 7 7 -

Puerto Rico 27 24 3 484 387 3 23 1 15









174 Morbidity and Mortality Weekly Report


Table 3. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

MAY 22, 1965 AND MAY 16, 1964 (20th Week)-Continued


Strept.
Measles Sore Th. & Tularemia Typhoid Fever Rabies in
Scarlet Fev. Animals
Area
Cumulative Cum. Cum. um.
1965 1965 1964 1965 1196 1965 1965 1965 1965 1965
UNITED STATES... 9234 191175 337914 7884 7 74 13 135 80 2026

NEW ENGLAND.......... 929 33199 11133 948 1 1 22
Maine.............. 74 2348 1760 122 1 1
New Hampshire...... 6 356 177 6 -
Vermont............ 100 778 1899 19
Massachusetts...... 376 18009 3117 171 1 1
Rhode Island....... 79 3585 1185 44 -
Connecticut......... 294 8123 2995 605 1

MIDDLE ATLANTIC...... 849 9110 39899 421 5 24 3 77
New York City...... 95 1037 12082 21 2 12 --
New York, Up-State. 286 2636 8895 250 6 2 71
New Jersey......... 109 1546 9453 74 2 -
Pennsylvania....... 359 3891 9469 76 3 4 1 6

EAST NORTH CENTRAL... 2752 38730 74456 781 3 7 3 19 9 289
Ohio............... 218 7262 14688 94 2 6 147
Indiana............ 53 1308 17732 87 2 2 4 1 22
Illinois........... 184 1718 12963 91 1 4 1 4 6 57
Michigan........... 1419 19947 19118 339 3 1 25
Wisconsin .......... 878 8495 9955 170 1 2 1 38

WEST NORTH CENTRAL... 776 14474 18808 311 1 7 3 21 378
Minnesota........... 44 515 225 10 3 80
Iowa............... 558 8050 13735 72 8 116
Missouri........... 91 2262 784 89 4 3 3 46
North Dakota....... 78 3196 3341 72 -- 1 17
South Dakota....... 5 75 3 10 1 2 28
Nebraska........... 376 720 1 21
Kansas............. NN NN NN 58 1 2 3 70

SOUTH ATLANTIC....... 681 20122 30110 1061 21 31 12 279
Delaware........... 6 435 300 38 3 -
Maryland ........... 37 845 2803 196 9 2
Dist. of Columbia.. 7 45 336 14 -
Virginia........... 146 3084 9573 209 3 3 8 218
West Virginia...... 280 11428 6816 290 I 9
North Carolina..... 8 247 995 9 4 7 -
South Carolina..... 30 863 3707 50 3 4 1
Georgia............ 21 559 144 16 11 2 2 23
Florida............ 146 2616 5436 239 2 2 25

EAST SOUTH CENTRAL... 453 11597 48443 1048 14 1 15 14 529
Kentucky........... 33 2100 16805 48 3 6 1 41
Tennessee.......... 312 6597 18228 941 10 3 10 478
Alabama ............ 89 1984 7088 29 1 1 3 7
Mississippi........ 19 916 6322 30 3 3 3

WEST SOUTH CENTRAL... 1032 26646 58466 713 2 17 2 18 16 324
Arkansas........... 5 1044 950 1 8 8 1 47
Louisiana.......... 4 68 70 1 2 2 55
Oklahoma........... 17 155 767 52 4 1 2 3 61
Texas.............. 1006 25379 56679 661 1 4 1 6 10 161

MOUNTAIN............. 734 15166 12825 1264 1 8 12 1 34
Montana............ 94 3095 2078 33 1 3
Idaho.............. 84 2058 1373 71 -
Wyoming............ 12 720 125 10 1 -
Colorado........... 279 4061 2251 700 1
New Mexico......... 16 524 242 200 7 6
Arizona............ 69 762 5092 97 4 23
Utah............... 177 3770 1062 151 1 7 I 1
Nevada............. 3 176 602 2 -

PACIFIC.............. 1028 22131 43774 1337 2 12 3 94
Washington......... 283 6363 15826 253 1
Oregon............. 119 2697 4961 13 2 3 2
California......... 473 10315 21753 959 7 3 91
Alaska............. 8 120 980 100 1
Hawaii ............. 145 2636 254 12 -

Puerto Rico 91 1460 3795 18 2 3 1 9










175


Morbidity and Mortality Weekly Report






Table 4. DEATHS IN 122 UNITED STATES CITIES FOR WIFK INDD) MAY 22, 1965


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

AlI C.iu s Pnum.,na linti r Al I t u~n ~Ple Iur,.,,,l. r
I I and 1l year
Area All 65 years and l year Area All 65 years Inluenza yAl
Ages and over Influenza All Ages and over A Ae ue
e a 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.--------


665
193
43
22
33
51
23
16
22
40
68
14
42
38
60

3246
37
48
136
39
28
41
59
121
1659
33
503
150
45
97
36
52
62
38
34
28

2605
85
31
715
160
214
108
83
352
48
39
43
57
55
153
36
131
34
32
55
117
57

795
71
23
30
109
22
112
81
233
74
40


19
3
5

1





2

3

5

143

3
2
2
3
1
3
9
74
1
12
5
2
13

1
1
2
5
4

72
1
3
23
4
2
1

21


3
1
3


5


4
1


26
2

3
2
2
1
6
5
3
2


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


Total


1113
112
270
40
84
54
52
96
28
75
71
173
58

623
97
55
38
146
127
36
32
92

1029
35
29
26
133
33
90
198
64
163
77
103
50
28

387
42
17
120
14
98
20
48
28

1568
22
47
32
45
62
506
91
33
103
65
103
201
31
121
60
46


,,,,, .,,,,.,.,. ,,. .,,,,,,., ,, ,,,, I 4 4lll .,,,, ^ llll~lllll~llllllllllll ll. nnnn nnn


12031


46
5
6
1
2
2
4
1
3
5
9
4
4

25
1
3
3
7
5

5
1

36
2


1
2
1
6
3
5
1
4
9
2

12
1
4
2

3

1
1

41

1



20
2

1
3
2

3
4

5


805


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


260,924
148,809
12,131
15,220


Week No.
20


" '










Morbidity and Mortality Weekly Report


UNIVERSITY OF FLORIDA


3 1111I262 0884 II 25111111111165ll
3 1262 08864 2565


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. GOODARD, M.D.
CHIEF. EPIDEMIOLOGY BRANCH A. D LANGMUIR. M.D.
CHIEF. STATISTICS SECTION R. E. SERFLING. PH.D.
ASST. CHIEF. STATISTICS SECTION IDA L. SHERMAN* ,M.S.
CHIEF SURVEILLANCE SECTION D. A. HENDERSON. MD.
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,


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