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:
AA00010654:00376

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
F 5 o40/9.##J/y


Morbidity and Mortality


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

PUBLIC HEALTH SERVICE


Prepared by the


For release October 9, 1964


COM NICABLES DISES |CNE


634.5131


ATLANTA, GEORGIA 30333


SOC T13cG )c




voa 3. No.


PROVISIONAL INFORMATION ON SELECTED NOTIFIABLE DISEASES IN THE UNITED STATE
DEATHS IN SELECTED CITIES FOR WEEK ENDED OCTOBER 3, 1964


EPIDEMIOLOGIC NOTES


ENCEPHALITIS
A total of 71 cases of primary encephalitis was
reported for the week ended October 3. This brings to
2,426 the cumulative total reported in the United States in
1964. This total includes cases of encephalitis of un-
known etiology and cases of arthropod-borne encephalitis.
Although the outbreaks previously reported in Texas,
Kentucky, Illinois and Colorado have ended or are on the
wane, a new outbreak believed to be St. Louis Encepha-
litis has been noted in New Jersey.
A total of 64 cases including 5 deaths of encephalitis-


like illness has been reported from New Jersey. The
cases are geographically clustered along the border of
Camden and Burlington Counties near Philadelphia. The
initial cases developed in mid-August; the outbreak ap-
pears to have reached its peak in mid to late September.
The majority of the cases have occurred among females
over the age of 40. Preliminary laboratory results indicate
that at least some of the cases are due to St. Louis
Encephalitis virus. Further studies including mosquito
collections and ecologic studies are in progress.


Table 1. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous weeks)
40th Week Ended Cumulative. First 40 Weeks
Disease October 3, October 5, Median Median
1964 1963 1959 1963 1964 1963 1959 1963
Aseptic meningitis ................ 51 58 --- 1,562 1,386 ---
Brucellosis ...................... 8 8 9 327 286 467
Diphtheria ........................ 7 8 16 194 194 421
Encephalitis, primary infectious.. 71 27 --- 2,426 1,240
Encephalitis, post-infectious ..... 3 --- 701---
Hepatitis, infectious including
serum hepatitis ............... 737 884 884 29,744 33,519 33,519
Measles ........................... 718 805 930 436,144 360,887 389,283
Heningococcal infections .......... 37 38 38 2,092 1,871 1,688
Poliomyelitis, Total ............... 2 20 69 91 323 992
Paralytic ...................... 2 18 48 73 276 642
Nonparalytic .................. 2 --- 11 32 ---
Unspecified ...................... -- 7 15 -
Streptococcal Sore Throat and
Scarlet fever ................. 5,537 4,652 --- 310,068 263,914 ---
Tetanus ........................... 4 6 --- 214 204 ---
Tularemia ......................... 8 4 --- 261 222 ---
Typhoid fever ...................... 12 19 15 328 411 613
Rabies in Animals ................. 104 62 60 3,584 2,955 2,955

Table 2. NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax: 3 Psittacosis: 35
Botulism: 11 Rabies in Man: 1
Leptospirosis: NC-I, Ore-l 36 Smallpox:
Malaria: NJ-1, Ill-1, Penn-1, Ore-1 75 Typhus-
Plague: Murine: 21
SRky Mt. Spotted: NC-2, ND-1 206





Figure I
RUBELLA BY MONTH OF REPORT
FOR SELECTED STATES
SEPT 1963-AUG. 1964 COMPARED TO
AVERAGE MONTHLY REPORT, 1955-1963


250001 NORTH C


20000-


15000-
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aC

10000-
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0
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---- SEPT.
- 1955-


Figure / (cont.)


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5000-


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10000.


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CENTRAL

I \
1963-AUG. 1964
1963
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month


I I I I I I I I I I


PACIFIC


S O N D J F M A M J J A


I I I


--


1


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month








Morbidity and Mortality Weekly Report


Figure 2
RUBELLA BY MONTH OF REPORT
FOR SELECTED STATES
1955-1964


119,538


years


27,






NORTH CENTRAL


NORTHEAST


years


RUBELLA SURVEILLANCE SUMMARY


During the past winter and spring, the United States
experienced a major outbreak of rubella. (See MMWR Vol.
13, No. 12). Following its development in the eastern
United States, the epidemic spread to the Mountain and
Pacific regions in late spring. It appeared to be one of
the largest rubella epidemics in the United States in the
past 2 decades.
Rubella is not a nationally reportable disease. How-
ever, over 20 States have reported it on a monthly basis
since 1955 and many have kept records as far back as
1920. These form the basis of this report. Although only
a small fraction of the actual number of cases are re-
ported by local physicians, the broad trends of disease
occurrence are discernible.
The widespread occurrence of rubella this spring
resulted in an opportunity to study the epidemiology of
this disease, and surveys were instituted for this pur-
pose. A preliminary report on surveys conducted in
Doraville, Georgia and Kingston, Tennessee is pre-
sented in the section on Epidemiological Reports.
Figure 1 describes the monthly incidence of rubella
by geographic regions (States reporting are shaded on the
map). The incidence during the past winter season far


exceeds the average recorded in these States during the
past 9 years. The increased incidence is most evident in
the Northeastern, North Central and Southern States, less
marked in the Mountain States and least prominent on the
Pacific Coast. However, all States which request the re-
porting of rubella cases recorded an increased incidence
this year compared to 1963. In the Northeastern States, an
increasing number of cases was reported beginning in
January; the peak was reached in April. In the North
Central and Southern States, the outbreak appeared to
develop somewhat later but reached a peak at approx-
imately the same time as it did in the Northeast.
Figure 2 shows the cases of rubella reported month-
ly for each region for the past 10 years. In the North-
eastern, North Central and Southern States, the number
of cases during the peak month exceeds by 2 to 3 times
the maximum previously recorded during the past decade.
The last ,sinifkiant outbreak occurred in 1958 in most
areas and in 1959 on the Pacific Coast.
Longer term trends in rubella occurrence are shown
in Figure 3 for selected States. In general, epidemics
have occurred more or less synchronously in each of the
States at intervals of approximately 3 to 8 years.


351


4000-
3000-
2000-
1000-






Morbidity and Mortality Weekly Report


Figure 3
REPORTED RUBELLA FOR SELECTED STATES
1920 1964


200- ILLINOIS


O


200- COLORADO
O
0
0
0
o

- 800
cr
5 MASSACHUSETTS
J 600
i--



4O
400


S200
z
z



600. WASHINGTON


400-


200 A A \


1920 '24


'40 '44 '48 '52 '56 '60


YEARS


*Through July 1964


352









Morbidity and Mortality Weekly Report


EPIDEMIOLOGICAL REPORTS


RUBELLA ATTACK RATES BY AGE GROUP AND SEX
DORAVILLE, GEORGIA
TOTAL MALES FEMALES


Special epidemiological studies conducted in local
communities in Georgia and Tennessee provide a sharper
view of the pattern of the disease as it affected local
communities:


Doraville, Georgia
In the spring of 1964, the DeKalb County Health
Department and the CDC collaborated in the study of the
epidemic among elementary school children and their
families in the suburban Atlanta community of Doraville.
The 210 families (1014 persons) with children in this
school were contacted monthly to determine the frequency
of rubella-like illnesses in this population.
Cases of rubella in these families are shown by week
in the histogram below. The first recorded cases occurred
during the first week in March, gradually increased to a
peak in the period April 11 May 9, returning to baseline
levels by June 6.


Figure 4
RUBELLA BY WEEK OF ONSET
DORAVILLE, GEORGIA
JANUARY- JUNE 1964


16
UL
0
a:
w
9 12
z


4. -



0.:_ E E ===-


Weak Ended- 29 14 28
FEB. MAR.


I 25
APR


23 6 20
JUNE


Attack rates by age and sex are shown (table). The
attack rate was highest in the 5-9 year age Erou;. in
which approximately 50 percent of the children con-
tracted rubella. Older school-age children experienced
lower attack rates. The attack rate for pre-school children
was 37 percent; the attack rate for adults was 2.6 per-
cent. Between the sexes the difference in attack rates
was minimal.


At.ck Rate
Ag. Tt..l Pop. Ca... P., 100


0-4 87 32 36.8 48 19 39. 39 13 33.3
5-9 206 104 50.5 109 56 S1.4 97 48 49.5
10-14 208 59 28.4 104 23 22.1 104 36 34.6
15-19 78 9 11.5 48 6 12. 30 3 10.0
20+ 427 11 2.6 208 3 1.4 219 8 3.7
Unk...n 3 -
TOTAL 1014 215 21.2 522 107 20,5 492 108 22.0


Intervals between primary and secondary cases in
households is shown in the histogram below. Secondary
cases occurred predominantly between the 12th and 28th
day after the initial illness with a mean of 19.5 days.


Figure 5
INTERVAL FROM FIRST FAMILY CASE
TO SUBSEQUENT FAMILY CASES
OF RUBELLA


', 4- r -$ l l- i l l I I l l I-I I I I- t
2 6 10 14 18 22 26 30 34 38 42
NUMBER OF DAYS BY TWO-DAY INTERVALS


The pattern of spread of the illness within class-
rooms is depicted in the histogram. Following onset of
the initial case in the classroom, an interval of 8 days
elapsed before a secondary wave of cases commenced.
Succeeding waves of cases occurred at approximately
2-week intervals.
Figures 6
INTERVAL FROM FIRST CLASSROOM CASE TO SUBSEQUENT CLASSROOM CASES
OF RUBELLA


353


Attok Rote
To.. Pop Co... P., 100


Attok Rote
TotI Pop. Co.. Pe. 100


i


n n


NUMBER OF DAYS 9B TWO-DaY INTERVALS


111111111--







Morbidity and Mortality Weekly Report


Kingston, Tennessee
Comparable data were obtained in a telephone
survey conducted in Kingston, Tennessee in April, by
the Tennessee Department of Public Health and the
Roane County Health Department. The table below


shows the attack rates in the population of 900 surveyed.
The attack rate was highest in the 5-9 age group (70.90%)
and lowest among adults. The overall attack rate was
25.8 per 100.


RUBELLA ATTACK RATES BY AGE GROUP AND SEX, KINGSTON, TENNESSEE

TOTAL MALES FEMALES
Attack Attack Attack
Total Rate Total Rate Total Rate
Age Pop. Cases per 100 Pop. Cases per 100 Pop. Cases per100
0- 4 69 30 43.5 36 15 41.7 33 15 45.5
5- 9 127 90 70.9 72 53 73.6 55 37 67.3
10-14 127 68 53.5 71 38 53.5 56 30 53.6
15-19 90 25 27.8 44 14 31.8 46 11 23.9
20+ 487 19 3.9 239 4 1.7 248 15 6.0
TOTAL 900 232 25.8 462 124 26.8 438 108 24.7


In those families with cases, 60 per cent of children
age 0-4 years and 8.5 per cent of persons 20 years and
over developed the illness.
The histogram below depicts the epidemic curve



CASES OF RUBI
TELEPHONE SUR
JAN


Week


of this outbreak. The peak incidence occurred approxi-
mately 6 weeks after the first case. The epidemic
lasted 13 weeks and was waning by early April.



Figure 7
ELLA BY WEEK OF ONSET
'VEY, KINGSTON, TENNESSEE
IUARY-APRIL 1964


7


MAR. APR.


354


JAN.


FEB.







Morbidity and Morta


Joint involvement is usually considered an un-
common complication of rubella. However, in the epidemic
in Kingston, joint symptoms were reported surprisingly
frequently. Some degree of joint involvement occurred
in 15 per cent of the cases. There was a slightly
higher incidence in females age 15 years and over.



FREQUENCY OF JOINT SYMPTOMS AMONG CASES OF
RUBELLA, KINGSTON, TENNESSEE


MALES FEMALES
No. No. No. No.
of with joint of with joint
Age Cases Symptoms Percent Cases Symptoms Percent
0.4 15 2 13.3 15 0 0.0
5-9 53 5 9.4 37 4 10.8
10.14 38 5 13.2 30 5 16.7
15.19 14 2 14.3 11 4 36.4
20+ 4 1 25.0 15 7 46.7
TOTAL 124 15 12.1 108 20 18.5


EPIDEMIOLOGIC NOTES (Continued)

INFLUENZA

Cases of influenza-like illness have been reported
with increasing frequency over the past six weeks from
the Commonwealth of Puerto Rico. Initially confined to
the San Juan area, the outbreak has now spread to most
sectors of the island. Clinically, the illness is typified
by a sudden onset of high fever, headache, malaise and
mild myalgia and lasts an average of 4-7 days.
The unusual occurrence of influenza-like illness at
this time of the year prompted efforts to attempt isolation
of the involved agent. Preliminary study of virus isola-
tions from throat washings taken from acute cases are
indicative of influenza, probably of the A2 sub-type.



INTERNATIONAL NOTES QUARANTINE MEASURES

Immunization Information for International Travel
1963-64 edition Public Health Service Publication No. 384

SECTION 5

AMERICA
Dominica, page 38, Insert:
Delete previous information under smallpox and insert:


lity Weekly Report 355

Smallpox vaccination is required for all arrivals. All other
information remains the same.

Dominican Republic, page 38, Insert:
Cholera vaccination is required for all arrivals from in-
fected areas.


Egypt, U. A. R., page 25

Insert:

Smallpox vaccination is required for all arrivals from
infected areas.

Cholera vaccination is required for all arrivals from in-
fected areas, and from Burma, China (Taiwan), China
(mainland), East Pakistan, Hong Kong, India, Indonesia,
Korea (Republic), Macao, Malaya, Philippines, Sabah,
Sarawak, Thailand.

Yellow Fever The following countries and territories
are regarded as endemic zones or infected areas: Angola,
Bechuanaland, Burundi, Cameroon, Central African
Rep., Chad, Congo (Brazzaville), Congo, (Leopold-
ville), Dahomey, Ethiopia, Gabon, Gambia, Ghana,
Guinea, Ivory Coast, Kenya, Liberia, Mali, Mauritania,
Niger, Nigeria, Nyasaland, Northern Rhodesia, Por-
tuguese Guinea, Rwanda, Sao Tome and Principe, Senegal,
Sierra Leone, Somalia, Spanish Guinea, Sudan (south of
15* N latitude), Tanganyika, Togo, Uganda, Upper
Volta, Zanzibar. America: Bolivia, Brazil, British
Honduras, British Guiana, Colombia, Costa Rica, Ecuador,
French Guiana, Guatemala, Honduras, Nicaragua, Panama,
Panama Canal Zone, Peru, Surinam, Trinidad, Venezuela.

Guinea, page 27

Insert the information under REQUIRED:

Yellow Fever Except travelers from noninfected areas
staying less than two weeks.

ASIA

Aden Colony, page 43, Insert:

Yellow fever vaccination is required for all arrivals from
infected areas, 1 year of age and over.

India, page 47

In the note concerning yellow fever under Africa add
Uganda. Delete Southern Rhodesia. Delete Nyasaland and
insert Malawi. All other information remains the same.

Laos, page 49, Insert:

Under smallpox add, "and for travelers leaving the
country."









356 Ilorbidily and Mortalil) Weekly Report


Table 3. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

OCTOBER 3, 1964 AND OCTOBER 5, 1963 (40TH WEEK)


Asetic Encephalitis
Aseptic
Meningitis Primary Post-Inf. Poliomyelitis, Total Cases Poliomyelitis, Paralytic
Area
Cumulative Cumulative
1964 1963 1964 1964 1964 1963 1964 1963 1964 1963 1964 1963
UNITED STATES... 51 58 71 3 2 20 91 323 2 18 73 276

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

MIDDLE ATLANTIC...... 6 5 15 3 13 102 3 12 81
New York City...... 1 1
New York, Up-State. 1 5 1 10 8 9 5
New Jersey.......... 5 13 2 1 2 1
Pennsylvania....... 1 3 93 3 75

EAST NORTH CENTRAL... 6 16 18 1 6 18 52 6 13 42
Ohio................ 5 6 2 8 2 4
Indiana............ 1 1 2 6 4 2 3 3
Illinois........... 2 2 11 1 1 5 15 1 5 14
Michigan........... 2 8 3 3 19 3 2 19
Wisconsin.......... 2 6 1 2

WEST NORTH CENTRAL... 1 1 10 1 9 6 1 7 5
Minnesota........... 1 1 3 4 2 4
Iowa............... .
Missouri........... 5 1 -4 1 3 -
North Dakota ... 1 1 i
South Dakota....... 1 -
Nebraska ........... 1 1
Kansas............. 3 I -

SOUTH ATLANTIC....... 5 5 7 5 24 46 4 19 41
Delaware............ I 1
Maryland........... -I 1 -
Dist. of Columbia.. -
Virginia........... 4 3 1 8 5
West Virginia..... 1 1 1 3 1 1 3
North Carolina.... 2 10 3 6 3
South Carolina..... 2 6 2 5
Georgia............ 1 3 1 17 3 1 16
Florida............. 1 4 9 8 8 8

EAST SOUTH CENTRAL... 3 8 1 3 6 64 3 5 59
Kentucky.......... 8 -
Tennessee.......... 3 1 3 10 2 9
Alabama................. 3 2 47 3 2 43
Mississippi ....... 1 7 1 7

WEST SOUTH CENTRAL... 3 1 1 9 23 1 8 22
Arkansas........... i 4 3
Louisiana.......... 13 13
Oklahoma............. 2 2
Texas............... 2 1 7 6 1 6 6

MOUNTAIN............. 3 2 4 2 7 5 2 4 4
Montana............ 1
Idaho............... 1
Wyoming........... 1 12 2
Colorado........... 3 1 2 1 1 1 1
New Mexico......... 3 1 -
Arizona ............ .. I I 2 2 2 2
Utah................ .
Nevada.............

PACIFIC.............. 23 20 16 2 1 3 20 -3 17
Washington......... 3 2 2
Oregon............ 1 1 1 2 1 1
California......... 23 16 15 2 1 2 16 2 14
Alaska .............
Hawaii............. -

Puerto Rico 5 4









Morbidity and Mortality Weekly Report 357


Table 3. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED
OCTOBER 3, 1964 AND OCTOBER 5, 1963 (40TH WEEK) CONTINUED


Infectious Hepatitis
Brucellosis Diphtheria including Serum hepatitis Typhoid Fever
Area Under 20 years Age
Cum. Cum. Total 20 years and over Unknown Cumulative Cum.

1964 1964 1964 1964 1964 1964 1964 1964 1964 1963 1964 1964

UNITED STATES... 8 327 7 194 737 325 347 65 29,763 33,519 12 328

NEW ENGLAND.......... 2 45 44 22 20 2 2,734 3,654 14
Maine.............. 39 15 9 6 868 1,647 -
New Hampshire...... 1 1 212 397
Vermont........... 7 3 3 1 342 75 -
Massachusetts...... 2 5 14 7 6 1 599 987 6
Rhode Island....... 1 4 4 153 86 6
Connecticut........ 3 3 560 462 2

MIDDLE ATLANTIC...... 5 7 150 63 87 6,603 6,680 5 55
New York City...... 3 17 4 13 1,011 1,037 4 27
New York, Up-State. 2 60 18 42 2,872 2,901 10
New Jersey......... 2 22 8 14 1,128 978 1
Pennsylvania....... 3 2 51 33 18 1,592 1,764 1 17

EAST NORTH CENTRAL... 3 45 8 112 55 46 11 4,666 5,408 1 73
Ohio............... 3 28 14 11 3 1,234 1,499 19
Indiana .......... 1 1 16 8 8 408 484 21
Illinois........... 26 6 30 11 15 4 859 1,153 1 21
Michigan........... 6 1 29 17 12 1,833 2,029 9
Wisconsin.......... 3 9 9 5 4 332 243 3

WEST NORTH CENTRAL... 2 137 1 27 39 20 15 4 1,598 1,476 27
Minnesota........... 2 9 11 11 7 2 2 183 223 3
Iowa............... 85 9 3 4 2 246 270 4
Missouri .......... 10 1 9 6 3 394 526 10
North Dakota....... 2 2 58 61 2
South Dakota....... 16 1 2 6 2 4 126 104 1
Nebraska........... 13 4 42 95 3
Kansas............. 2 7 4 2 2 549 197 4

SOUTH ATLANTIC....... 33 4 45 70 30 37 3 2,804 3,412 66
Delaware........... 2 1 1 55 63 -
Maryland........... 9 6 3 524 422 6
Dist, of Columbia.. 1 1 51 95 -
Virginia........... 15 8 3 3 2 439 696 11
West Virginia...... 5 3 2 407 518 -
North Carolina..... 3 11 5 6 470 850 18
South Carolina..... 7 3 2 1 104 143 11
Georgia............ 12 21 5 2 3 85 148 5
Florida............ 3 4 17 26 10 16 669 477 15

EAST SOUTH CENTRAL.. 17 15 43 23 20 2,058 3,160 31
Kentucky........... 6 7 3 4 745 901 8
Tennessee.......... 5 2 15 11 4 719 1,220 15
Alabama............ 4 8 18 9 9 388 504 6
Mississippi........ 2 5 3 3 206 535 2

WEST SOUTH CENTRAL... 37 2 30 78 43 32 3 2,332 2,361 25
Arkansas........... 6 3 2 1 220 263 13
Louisiana......... 4 2 8 30 16 14 573 481 4
Oklahoma........... 7 1 1 110 105 4
Texas.............. 20 22 44 25 16 3 1,429 1,512 4

MOUNTAIN............. 1 30 3 52 5 5 42 1,785 2,152 1 9
Montana............ 6 3 2 1 158 282 -
Idaho.............. 19 19 252 351 -
Wyoming............ 2 1 1 57 25 1
Colorado........... 12 12 476 447 -
New Mexico......... 1 1 1 1 250 254 2
Arizona............ 2 2 10 10 395 495 1 6
Utah............... 1 26 2 2 146 281 -
Nevada............. 1 51 17 -

PACIFIC.............. 2 21 14 149 64 85 5,183 5,216 5 28
Washington......... 13 5 1 4 538 910 2
Oregon............. 2 10 1 9 553 636 -
California......... 2 19 1 123 55 68 3,807 3,497 5 26
Alaska............. 6 6 181 139 -
Hawaii............ 5 1 4 104 34 -

Puerto Rico 10 22 17 5 765 672 11









358 Morbidity and Mortality Weekly Report


Table 3. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED
OCTOBER 3, 1964 AND OCTOBER 5, 1963 (40TH WEEK) CONTINUED


Streptococcal
Meningococcal Sore Throat and Rabies in
Measles Meningitis Scarlet Fever Tetanus Tularemia Animals
Area --- ----
Cumulative Cum. Cum. Cum.
1964 1964 1964 1963 1964 1963 1964 1964 1964 1964 1964 1964
UNITED STATES... 718 37 2,092 1,871 5,537 4,652 4 214 8 261 104 3,584

NEW ENGLAND.......... 72 2 61 116 368 266 9 1 32
Maine.............. 13 5 17 77 14 27
New Hampshire...... 1 4 5 1 2
Vermont ............ 1 1 4 4 1 5 2
Massachusetts...... 44 24 54 16 69 9 1 1
Rhode Island....... 3 1 10 11 19 15 -
Connecticut......... 11 17 26 250 162 -

MIDDLE ATLANTIC...... 46 4 272 254 141 177 19 4 106
New York City...... 10 1 36 39 5 12 -
New York, Up-State. 16 75 81 110 123 7 2 100
New Jersey.......... 5 93 36 12 28 6 -
Pennsylvania........ 15 3 68 98 14 14 6 2 6

EAST NORTH CENTRAL... 116 4 294 286 469 316 1 39 20 11 515
Ohio................ 15 1 75 77 47 26 1 11 1 2 265
Indiana............. 30 1 47 41 145 72 9 2 22
Illinois........... 12 2 75 55 52 42 12 13 2 97
Michigan........... 20 67 85 155 122 6 1 5 52
Wisconsin.......... 39 30 28 70 54 1 3 2 79

WEST NORTH CENTRAL... 29 2 128 117 199 116 11 52 30 1,105
Minnesota.......... 1 29 23 9 6 1 2 12 338
Iowa............... 5 1 7 7 50 26 5 1 10 397
Missouri............ 57 34 18 25 3 26 5 171
North Dakota....... 20 1 18 13 110 54 55
South Dakota....... 3 3 5 7 3 1 15 1 80
Nebraska........... 6 24 1 34
Kansas............. N 8 11 5 2 1 8 1 30

SOUTH ATLANTIC........ 132 9 422 346 827 545 54 2 25 9 493
Delaware........... 6 4 3 1 -
Maryland............. 1 31 50 27 7 3 1
Dist. of Columbia.. 13 6 2 1 1 1 -
Virginia............ 4 3 50 76 128 149 7 1 6 5 258
West Virginia...... 67 1 33 18 246 219 1 30
North Carolina..... 3 72 62 16 7 13 6 5
South Carolina..... 50 18 5 33 4 2
Georgia............. 3 62 28 19 7 4 11 2 108
Florida............. 58 1 105 84 381 121 21 1 1 2 89

EAST SOUTH CENTRAL... 33 2 172 136 1,119 766 1 29 1 30 34 460
Kentucky............ 1 1 56 30 27 65 8 2 55
Tennessee.......... 26 55 61 998 650 1 11 1 20 3 340
Alabama............ 6 1 37 23 56 26 6 3 17
Mississippi......... 24 22 38 25 4 5 31 48

WEST SOUTH CENTRAL... 56 3 188 170 505 579 1 25 5 87 7 496
Arkansas........... 1 23 11 9 4 7 4 51 1 122
Louisiana........... 10 1 119 70 4 6 1 4 1 5 1 46
Oklahoma............ 1 1 10 31 8 9 19 83
Texas.............. 45 36 58 484 560 14 12 5 245

MOUNTAIN............. 87 2 73 60 1,064 1,026 5 43 2 124
Montana............ 49 3 24 24 18 1 1
Idaho.............. 5 3 6 37 45 -
Wyoming............. 5 4 3 10 2 8 -
Colorado........... 4 12 16 536 407 8
New Mexico.......... 1 29 4 243 277 1 48
Arizona............ 9 1 7 10 81 188 I 1 54
Utah................ 17 7 14 140 72 1 17 2
Nevada............. 2 1 10 3 3 11

PACIFIC .............. 147 9 482 386 845 861 1 23 3 7 253
Washington......... 28 2 33 30 244 295 2 -
Oregon............. 20 21 28 12 11 1 1 10
California......... 58 7 409 308 530 384 1 20 2 6 243
Alaska............. 10 7 12 23 24 -
Hawaii............ 31 12 8 36 147 1

Puerto Rico 163 30 7 7 4 59 24










Morbidity and Mortality Weekly Report


359


Tablc 4 (D). TOTAL DEATHS AMONG PERSONS 65 YEARS AND OVER IN RI P()OR N(, CITIES



(Tables 4(A), 4(B), 4(C), and 4(D) will be published in sequence covering a four-week period.)0


Area For weeks ending Area For weeks ending
9/12 9/19 9/26 10/3 9/12 9/19 9/26 10/3


NEW ENGLAND:
Boston, Mass.............. 131 132 116 142
Bridgeport, Conn........... 18 17 26 22
Cambridge, Mass............ 10 17 21 17
Fall River, Mass.......... 16 11 15 13
Hartford, Conn............ 31 34 30 17
Lowell, Mass.............. 14 9 8 15
Lynn, Mass................ 11 12 12 13
New Bedford, Mass.......... 10 23 18 11
New Haven, Conn........... 31 25 22 26
Providence, R.I........... 38 43 47 41
Somerville, Mass........... 9 9 5 12
Springfield, Mass.......... 34 15 27 30
Waterbury, Conn............ 16 21 18 12
Worcester, Mass............ 38 41 32 39

MIDDLE ATLANTIC:
Albany, N.Y.............. 40 25 18 30
Allentown, Pa............. 23 15 20 22
Buffalo, N.Y............... 74 73 84 79
Camden, N.J................ 19 17 16 23
Elizabeth, N.J............ 15 12 15 13
Erie, Pa.................. 18 24 18 27
Jersey City, N.J.......... 45 35 29 39
Newark, N.J................ 45 48 48 34
New York City, N.Y......... 847 857 903 837
Paterson, N.J............. 24 18 21 27
Philadelphia, Pa.......... 212 225 288 238
Pittsburgh, Pa............ 95 123 105 94
Reading, Pa............... 33 26 29 31
Rochester, N.Y............. 51 55 77 62
Schenectady, N.Y.,........ 16 15 12 14
Scranton, Pa.............. 32 19 20 17
Syracuse, N.Y.............. 33 48 28 33
Trenton, N.J.............. 28 25 20 30
Utica, N.Y................. 19 15 18 26
Yonkers, N.Y.............. 16 28 11 17

EAST NORTH CENTRAL:
Akron, Ohio............... 31 37 28 27
Canton, Ohio............... 21 22 23 15
Chicago, Ill.............. 372 348 377 355
Cincinnati, Ohio........... 94 119 104 80
Cleveland, Ohio............ 88 107 106 111
Columbus, Ohio............ 58 51 66 44
Dayton, Ohio.............. 40 32 52 43
Detroit, Mich............. 183 202 160 196
Evansville, Ind........... 12 22 33 31
Flirt, Mich............... 18 11 19 24
Fort Wayne, Ind........... 13 24 24 21
Cary, Ind................. 13 10 28 6
Grand Rapids, Mich........ 33 36 19 35
Indianapolis, Ind......... 80 98 78 66
Madison, Wis............... 41 16 17 8
Milwaukee, Wis............. 65 82 58 64
Peoria, Ill............... 18 12 11 14
Rockford, Ill............. 17 20 12 12
South Bend, Ind........... 9 25 27 24
Toledo, Ohio .............. 51 67 54 50
Youngstown, Ohio.......... 31 39 31 26

WEST NORTH CENTRAL:
Des Moines, Iowa.......... 33 42 39 43
Duluth, Minn............. 19 8 25 6
Kansas City, Kans........ 10 16 14 14
Kansas City, Mo........... 73 70 81 66
Lincoln, Nebr............. 17 21 15 9
Minneapolis, Minn......... 87 72 76 60
Omaha, Nebr............... 38 35 32 35
St. Louis, Mo............. 110 111 123 123
St. Paul, Minn............ 31 41 47 56
Wichita, Kans............. 30 36 43 17

*Estimate based on average percent of divisional total.
Totals for previous weeks include reported corrections.

NOTE: All deaths by place of occurrence.


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..............
Bator 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.............


"Current Week Mortality for 108 Selected Cities

4(A) Total Mortality, all ages...................
4(B) Pneumonia-Influenza Deaths, all ages........
4(C) Total Deaths under 1 Year of Age.............
4(D) Total Deaths, Persons 65 years and over.....


10,834
347
748
5,929





3 1262II IIII08II6IIIll 4 2Il 7Ill 5ll 55
3 1262 08864 2755


Morbidity and Mortality Weekly Report


SUMMARY OF DEATHS AMONG PERSONS 65 YEARS
AND OVER IN 108 U.S. CITIES


The weekly average number of deaths among persons
65 years and over in 108 cities for the four-week period
ending October 3 was 5,952 as compared with an expected
weekly average of 6,256.





Week Ending 4 Week Weekly

9/12 9/19 9/26 10/3 Total Average

Observed 5,607 6,157 6,114 5,929 23,807 5,952
Expected 6,185 6,228 6,278 6,332 25,023 6,256

Excess -578 -71 -164 -403 -1,216 -304


DEATHS or AGE 65 and OVER in 108 U.S CITIES
A..rg. NMumb. p. WOWf by Fau Wok ee lod

NUMBER


OF
DEATHS


WO ----------- --------- -------- ---------









'*on -.- ---- -- --- B '- -




,, I *_ 1 1


*a- -LACE 0o -CWi-*lrh cf


Malaya, page 49, Insert:

Under smallpox add, 6 months of age and over. Under
cholera add, 1 year of age and over. Under yellow fever
add, 1 year of age and over.

Nyasaland, page 29, Insert:

Delete Nyasaland and insert Malawi.

Cholera vaccination is required for all arrivals from in-
fected areas by air, 1 year of age and over, and from India
and Pakistan.

Rwanda, page 30

Under yellow fever add "Travelers leaving Rwanda are
required to possess a certificate for entry to receptive
areas."

Rhodesia (Southern), page 30, Insert:

Under smallpox add "Certificate required from all travel-
ers arriving from Northern Rhodesia and Malawi."




THE MORBIDITY AND MORTALITY WEEKLY REPORT, WITH A CIRCULA-
TION OF 12.000 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 I. L. S-.ERMAN M.S.
CHIEF. SURVEILLANCE SECTION 0. A. MENDEREON. M.D
ASSISTANT EDITOR, MMWR PAUL STO~LL.E e. 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
NOTES: THESE PROVISIONAL DATA ARE BASED ON WEEKLY TELE-
GRAMS TO THE COMMUNICABLE DISEASE CENTER BY THE INDIVIDUAL
STATE HEALTH DEPARTMENTS.
SYMBOLS:-.-DATA NOT AVAILABLE
QUANTITY ZERO
PROCEDURES FOR CONSTRUCTION OF VARIOUS MORTALITY CURVES
MAY BE OBTAINED FROM STATISTICS SECTION. COMMUNICABLE
DISEASE CENTER. PUBLIC HEALTH SERVICE, U.S. DEPARTMENT OF
HEALTH, EDUCATION. AND WELFARE. ATLANTA. GEORGIA 30333.


NCuIV F FL LIB
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