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:
AA00010654:00380

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
^Wb f -rI t'7 T


Morbidity and Mortality/


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


PUBLIC HEALTH SERVICE


Prepared by the


I C *MUIC LM IES ETR


634-5131


NOV 136.1


For release November 6, 1964 ATLANTA, GEORGIA 30333 '4
PROVISIONAL INFORMATION ON SELECTED NOTIFIABLE DISEASES IN THE UNITED STATES AND ON
DEATHS IN SELECTED CITIES FOR WEEK ENDED OCTOBER 31, 1964


TYPHOID ISSUE


EPIDEMIOLOGIC NOTES


Influenza No major outbreaks of influenza documented
by virus isolation have been reported in the continental
United States as yet this season. However, scattered
clusters of febrile respiratory illness have recently been
reported from Oregon. Acute and convalescent sera from 5
clinically suspect cases of influenza have shown signif-
icant antibody rises to A2 influenza. Virus isolation
attempts are in progress.
A2 virus has recently been isolated from a case of
characteristic clinical influenza representing part of a
relatively widespread outbreak in Puerto Rico. This out-


break began in mid-August and extended through October.
(See MMWR, Vol. 13, No. 40). Serological evidence of
infection was demonstrated among a number of typical
cases from various parts of Puerto Rico.
An outbreak of respiratory disease in Hawaii has
been reported with school absenteeism up to 25 percent
in some areas. There is serological evidence of Type B
influenza infection in 3 cases from whom acute and
convalescent serum specimens were obtained. The Hawaii
State Department of Health Laboratory is continuing efforts
to isolate the etiologic agent.


Table 1. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous weeks)
44th Week Ended Cumulative. First 44 Weeks
Disease October 31, November 2, Median Median
1964 1963 1959 1963 1964 1963 1959 1963
Aseptic meningitis ................ 44 48 --- 1,801 1,587 -
Brucellosis ....................... 4 4 8 346 315 498
Diphtheria ........................ 10 10 13 234 226 481
Encephalitis, primary infectious.. 54 29--- 2,816 1,343
Encephalitis, post-infectious ..... 7 --- 726
Hepatitis, infectious including
serum hepatitis ................ 633 782 921 32,395 36,694 36,694
Measles ........................... 1,179 1,449 1,611 440,165 365,382 394,853
Meningococcal infections .......... 55 41 41 2,293 2,029 1,875
Poliomyelitis, Total .............. 3 9 38 107 372 1,180
Paralytic ....................... 1 5 23 83 316 764
Nonparalytic ................... 1 3 --- 13 39 --
Unspecified .................... 1 1 -- 11 17
Streptococcal Sore Throat and
Scarlet fever .................. 5,899 5,841 --- 332,510 285,050 ---
Tetanus ........................... 3 4 --- 239 232 -
Tularemia ......................... 3 10 --- 284 257 ---
Typhoid fever ..................... 5 13 23 362 464 705
Rabies in Animals ................. 90 83 57 3,854 3,241 3,178

Table 2. NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax: 4 Psittacosis: Ga-l 40
Botulism: 15 Rabies in Man: 1
Leptospirosis: Ga-1, Fla-l 94 Smallpox:
Malaria: N.Y. City-2, Calif-1 84 Typhus-
Plague: urine: 22
_Rky Mt. Spotted: Tenn-2 217
Figures for current week exclude missing reports from Maryland, Montana, and Washington


12~1
3 j

r





Morbidity and Mortality Weekly Report


TYPHOID FEVER


To date, 362 cases of typhoid fever have been re-
ported in the United States in 1964. There were 464 cases
during the corresponding period in 1963.
The accompanying graph shows the yearly incidence
of reported cases of typhoid fever in the United States


during the years 1942-1963. A continuous decline in in-
cidence is demonstrated. In 1942, 5,595 cases were re-
ported whereas in 1963, 566 cases are recorded. Outbreaks
of typhoid in Atlanta, Georgia and Aberdeen, Scotland are
described in this issue.


REPORTED CASES OF TYPHOID FEVER-UNITED STATES, 1942-1963


1,000



1942 '44 '46 '48 '50 '52 '54 '56 '58 '60 '62 '64

YEAR


TYPHOID FEVER Aberdeen, Scotland


Dr. J. H. F. Brotherston, Chief, Medical Officer,
Scottish Home and Health Department, has provided an
account of the typhoid epidemic which occurred in Aber-
deen in the spring of this year. The following is ab-
stracted from his report.
The first small group of 4 cases of typhoid fever
in Aberdeen was notified to the Medical Officer of Health
in the morning of May 20, 1964. The chart of dates of on-
set shows a peak about May 15 with no evidence of
secondary infections. It is consistent with continuation
of the primary source of infection for some days.
The last date on which infection probably occurred
was Saturday, May 23. The total number of patients ad-
mitted to hospital exceeded 500 of whom approximately
450 were from Aberdeen. Various other patients took ill
in adjoining county areas and a few even further afield.
All patients were connected directly with the original
source of the outbreak.
Although the first patients appeared quite ill, many
of the later patients showed little or no clinical illness.
The final number of accepted cases is therefore still
under review. It is expected to be about 400. One ac-
cepted case resulted in death in relapse. Another ac-


cepted case was fatal but probably not directly from
typhoid infection.
The patients who could give adequate histories
all gave a history of the consumption of canned or pre-
pared meat from one shop. This shop is mainly a super-
market selling packaged foods. It has a separate vege-
table counter and separate cold meat counter. The cold
meat counter had one mechanical slicer and the usual
knives and equipment.
The staff of the shop were themselves selectively
affected and showed a much higher incidence of typhoid
fever than the customers or the general population. Some
of the staff had shown symptoms on or about May 17 and
at least one stayed on duty up to May 23 although suf-
fering from symptoms consistent with mild typhoid fever.
These workers produced negative tests when investigated
on May 21.
The organism responsible for the outbreak was
uniformly of type 34. This type was practically unknown
in Great Britain previously.
Most of the patients had eaten corned beef but a
small number had eaten other canned meats sold at the
supermarket counter. Corned beef provided the largest
(Continued on Back Paqe)


390


6,000.


5,000.


4,000.


3,000.


2,000-







Morbidity and Mortality Weekly Report


TYPHOID FEVER Georgia


Fifteen cases of typhoid fever occurring over a 34-
day period were reported from the Atlanta, Georgia area.
On August 30, 1964, the apparent index case, a 6-year-old
boy, was admitted to Grady Memorial Hospital because of
fever, abdominal pain, and vomiting. Over the next 2
weeks, 14 additional children, ranging in age from 2 to
14 years, were admitted to the hospital with a febrile


illness and a variety of constitutional and gastroin-
testinal symptoms compatible with typhoid fever (See
table). Salmonella 'yjp: phage type E-1 was isolated from
each of the cases. The epidemic curve, based on day of
onset of symptoms (See graph), indicates a span of 34
days between the index case and the last symptomatic
case.


OUTBREAK OF TYPHOID FEVER BY DATE OF ONSET
ATLANTA, GEORGIA-1964


e DEATH


MTI


F7


".& ~ ~ ~ ~ _~ I _4--4----4


II 16 21


I26 31
26 31


I


10 15 20 25 30I I I Il
10 15 20 25 30


SEPTEMBER


Epidemiologic investigation revealed that all of the
cases were from 3 homes both geographically and socially
close to one another. Almost all of the children played
with one another frequently; however, there had been no
recent joint gatherings, picnics, or parties. The water
and milk supplies were not contaminated when tested.
All of the adults in these 3 households submitted stool
specimens. The only stool positive for S. typhi was from
a 49-year-old woman involved in child care and meal
preparation in one of the households. This woman had no
previous history of typhoid fever but she had experienced
malaise, headache, and myalgia without fever or gastro-
intestinal symptoms in early August. Local health authori-
ties believe she was either a missed case of typhoid or


a carrier. The exact mode of spread in this epidemic is
not clear, but all of the children played at one time or
another in a flooded culvert nearby where they might
urinate or defecate at times.
The majority of the children responded to therapy
with chloramphenicol; one case apparently responded to
the addition of steroid therapy. The only death was
case #4 (see table) a 4-year-old girl who developed
renal failure.

(Reported by Dr. John McCroan, Director of Disease and
Disability Studies, Georgia Department of Public Health,
Dr. Malcom Neel, Director of Medical Services, Fulton
County Health Department, and a team from CDC).


Positive Culture
Onset _Clinical Picture of S. typhi
Case of Temperature Pulse Abdominal Type E-1
No. Age Sex House Symptoms >1010 >120 Pain Headache Diarrhea Blood Stool Comment
1 6 M A 8/25 + + + 0 0 + 0
2 14 M B 8/26 + 0 + 0 + + + Relapse 14 days after chloram-
phenicol. Readmitted 10/5
3 4 F A 9/3 + + + 0 0 + 0
4 4 F B 9/3 + + + + + + 0 Death in renal failure 9/10/64
5 5 M C 9/5 + + + + 0 + 0
6 8 F B 9/6 + 0 + + + + 0
7 8 F B 9/6 + 0 0 + + + +
8 10 M A 9/10 + +. + 0 0 + +
9 9 F B 9/8 + + + + 0 + 0
10 2 F A 9/10 + 0 + 0 0 0 +
11 6 M B 9/29 + + 0 + 0 + 0
12 11 M B 9/12 0 0 + + + + +
13 6 M B 9/22 + + 0 0 + + 0
14 3 M A 0 0 0 0 0 0 + No apparent symptoms
15 49 F B ?18/10 0 0 0 + 0 0 + Carrier or missed case


AUGUST


391









392 Morbidity and Mortality Weekly Report


Table 3. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

OCTOBER 31, 1964 AND NOVEMBER 2, 1963 (44TH WEEK)


SEncephalitis
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... 44 48 54 7 3 9 107 372 1 5 83 316

NEW ENGLAND.......... 2 1 1 2 8 2 8
Maine.............. 1 2 2
New Hampshire...... -
Vermont............. I 1
Massachusetts...... 1 3 3
Rhode Island....... 1 I -
Connecticut ........ 2 2 2 2

MIDDLE ATLANTIC...... 7 7 29 1 2 15 116 1 13 93
New York City...... 2 6 2 2 -
New York, Up-State. 3 5 1 1 10 9 1 9 6
New Jersey.......... 2 19 1 3 4 2 3
Pennsylvania....... 2 3 1 103 84

EAST NORTH CENTRAL... 7 6 10 1 1 23 56 15 45
Ohio................ 2 1 3 8 2 4
Indiana............. 1 8 8 4 5 3
Illinois........... 3 2 1 5 17 5 16
Michigan........... 1 4 4 19 2 19
Wisconsin.......... 1 1 3 8 1 3

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

SOUTH ATLANTIC....... 2 6 2 2 2 31 67 1 1 25 57
Delaware........... 1 I
Maryland........... --- --- --- --- 1 1 -- 1
Dist. of Columbia. -
Virginia........... 2 4 18 4 13
West Virginia...... 1 1 3 1 3
North Carolina..... 1 1 11 3 6 3
South Carolina ..... 3 7 3 6
Georgia............. 1 19 1 18
Florida............ 5 1 1 2 10 14 1 1 9 12

EAST SOUTH CENTRAL... 1 6 2 4 6 69 3 5 63
Kentucky............ -
Tennessee.......... 3 10 2 9
Alabama............ 1 3 3 2 51 2 2 46
Mississippi........ 3 2 1 1 8 1 1 8

WEST SOUTH CENTRAL .. 2 10 23 8 22
Arkansas........... I 4 3
Louisiana.......... 13 13
Oklahoma............ 1 3 2
Texas.............. .- 7 6 6 6

MOUNTAIN............. 3 1 1 8 6 5 5
Montana ............ -- --- -- --- 1 --- 1 -
Idaho .............. 1 1 1 1
Wyoming............ 2 2
Colorado........... 1 1 1 1 1 1 1
New Mexico......... 1 3 1 -
Arizona............ 1 3 3
Utah............... -
Nevada............... -

PACIFIC.............. 20 17 2 5 3 21 3 18
Washington......... --- 1 --- --- --- 2 --- 2
Oregon............. 1 1 2 1 1
California......... 19 15 2 4 2 17 2 15
Alaska.............. -
Hawaii............ 1 -

Puerto Rico 5 4









lMorbidilt and Mortality Weekly Report 393


Table 3. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

OCTOBER 31, 1964 AND NOVEMBER 2, 1963 (44TH 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... 4 346 10 234 633 320 275 38 32,395 36,694 5 362

NEW ENGLAND.......... 2 44 50 24 22 4 2,945 4,124 16
Maine.............. 39 13 4 8 1 922 1,838
New Hampshire...... 4 1 2 1 230 487
Vermont............. 2 1 1 355 109 -
Massachusetts...... 2 5 18 13 5 663 1,071 7
Rhode Island....... 6 1 3 2 180 98 6
Connecticut........ 7 4 3 595 521 3

MIDDLE ATLANTIC...... 5 10 163 92 71 7,151 7,269 1 61
New York City...... 5 21 9 12 1,100 1,126 1 32
New York, Up-State. 2 71 40 31 3,098 3,131 10
New Jersey......... 2 34 14 20 1,212 1,075 2
Pennsylvania....... 3 3 37 29 8 1,741 1,937 17

EAST NORTH CENTRAL... 1 49 8 107 57 44 6 5,100 5,895 1 79
Ohio................ 5 37 19 13 5 1,339 1,619 19
Indiana............ 1 1 4 2 2 435 525 1 24
Illinois........... 1 28 6 19 10 8 1 947 1,240 22
Michigan.......... 6 1 46 26 20 2,025 2,248 11
Wisconsin.......... 9 1 1 354 263 3

WEST NORTH CENTRAL.. 142 2 34 32 16 13 3 1,754 1,619 1 29
Minnesota.......... 9 2 18 6 2 3 1 208 252 3
Iowa............... 88 6 4 2 284 301 4
Missouri............ 10 1 8 3 4 1 439 558 1 12
North Dakota ...... 2 2 62 71 2
South Dakota....... 17 2 1 1 130 108 1
Nebraska........... 13 4 1 1 48 109 3
Kansas............. 3 7 10 6 4 583 220 4

SOUTH ATLANTIC....... 1 36 6 60 33 15 15 3 3,035 3,722 68
Delaware........... 1 1 67 71
Maryland .......... --- -- --- --- --- --- 547 472 --- 6
Dist. of Columbia.. 2 2 63 104 -
Virginia........... 16 6 3 2 1 478 746 11
West Virginia...... 7 3 3 1 434 562 -
North Carolina..... 4 3 3 503 930 19
South Carolina..... 7 2 1 1 119 153 11
Georgia............ 12 3 29 5 2 3 99 161 5
Florida............ 1 4 3 24 7 2 5 725 523 16

EAST SOUTH CENTRAL... 1 18 2 25 42 23 19 2,225 3,413 34
Kentucky........... 6 6 2 4 784 976 10
Tennessee.......... 5 2 15 7 8 787 1,339 16
Alabama............. 4 2 18 17 13 4 432 538 6
Mississippi ....... 1 3 5 4 1 3 222 560 2

WEST SOUTH CENTRAL... 41 36 62 35 27 2,534 2,546 2 31
Arkansas............ 6 3 20 15 5 255 286 13
Louisiana ......... 4 10 11 3 8 618 521 5
Oklahoma............ 7 2 1 1 122 115 2 9
Texas.............. 24 23 29 16 13 1,539 1,624 4

MOUNTAIN............. 1 31 3 37 7 8 22 1,957 2,323 10
Montana............. --- --- --- --- -- --- 170 303 ---
Idaho.............. 3 3 276 389 -
Wyoming............ 7 3 4 79 29 1
Colorado........... 15 15 516 477
New Mexico......... 1 1 3 3 269 279 2
Arizona............ 2 2 3 3 429 527 7
Utah............... 1 27 6 1 4 1 167 301 -
Nevada............. 1 51 18 -

PACIFIC............. 22 14 107 51 56 5,694 5,783 34
Washington........ --- --- 13 -- --- -- -- 563 1,000 --- 2
Oregon............ 2 2 2 584 690 -
California........ 20 1 96 44 52 4,188 3,883 32
Alaska............. 7 5 2 247 171 -
Hawaii............. 2 2 1 112 39- -

Puerto Rico 12 18 14 4 845 755 13








394 Morbidity and Mortality Weekly Report


Table 3. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

OCTOBER 31, 1964 AND NOVEMBER 2, 1963 (44TH 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... 1,179 55 2,293 2,029 5,899 5,841 3 239 3 284 90 3,854

NEW ENGLAND.......... 339 3 75 124 594 443 9 1 33
Maine............... 42 6 18 107 19 28
New Hampshire....... 154 1 2 4 15 2
Vermont............. 4 4 5 2
Massachusetts...... 67 1 31 58 55 72 9 1 1
Rhode Island....... 17 10 11 20 28 -
Connecticut........ 55 1 22 28 412 309 -

MIDDLE ATLANTIC...... 105 11 302 277 241 228 1 20 1 112
New York City...... 13 4 42 44 12 8 -
New York, Up-State. 54 2 86 86 170 146 7 1 106
New Jersey......... 12 3 99 41 34 36 6 -
Pennsylvania........ 26 2 75 106 25 38 1 7 6

EAST NORTH CENTRAL... 182 6 312 311 743 482 45 21 13 545
Ohio................ 15 4 81 82 83 77 12 1 8 278
Indiana............. 40 1 49 42 230 82 12 2 1 25
Illinois........... 16 80 62 109 64 13 13 3 105
Michigan........... 54 1 71 92 222 182 7 2 52
Wisconsin............ 57 31 33 99 77 1 3 1 85

WEST NORTH CENTRAL... 72 1 134 123 228 122 1 17 1 55 15 1,172
Minnesota.......... 1 29 24 10 5 1 4 2 10 368
Iowa............... 32 8 7 65 34 6 1 2 420
Missouri........... 5 60 36 2 8 4 1 29 2 177
North Dakota........ 26 1 20 13 109 62 56
South Dakota....... 2 3 7 23 9 1 15 82
Nebraska............ 6 6 25 35
Kansas............. NN 8 11 19 4 2 8 1 34

SOUTH ATLANTIC .......I 90 11 462 373 648 679 1 58 28 10 530
Delaware........... 1 6 4 30 5 -
Maryland........... --- --- 32 53 --- 8 --- 3 -- --- 2
Dist. of Columbia.. 1 16 7 3 4 1 -
Virginia............ 4 2 56 83 190 228 7 6 7 279
West Virginia...... 49 1 34 20 221 181 1 33
North Carolina..... 8 2 78 68 25 32 13 7 5
South Carolina..... 7 55 20 9 47 5 2
Georgia............ 4 5 72 30 34 2 4 13 1 114
Florida............ 17 113 88 136 172 1 24 1 2 95

EAST SOUTH CENTRAL... 88 4 181 144 1,322 1,063 31 30 16 502
Kentucky........... 10 1 58 31 143 24 8 2 1 57
Tennessee.......... 40 56 66 984 997 12 20 15 371
Alabama............. 6 3 43 24 97 10 6 3 17
Mississippi........ 32 24 23 98 32 5 5 57

WEST SOUTH CENTRAL... 116 6 215 183 571 614 27 1 98 15 540
Arkansas........... 15 3 27 12 2 8 58 1 131
Louisiana.......... 2 126 74 4 5 4 1 6 3 53
Oklahoma ........... 1 1 12 31 13 24 1 20 2 89
Texas.............. 98 2 50 66 554 583 14 14 9 267

MOUNTAIN............. 59 1 78 72 772 1,252 6 1 48 6 135
Montana............ --- --- 1 3 --- 76 --- --- 18 --- 1
Idaho............... 18 3 6 102 44 1 -
Wyoming............ 8 5 7 86 128 2 1 10 -
Colorado............ 15 14 20 228 463 8
New Mexico......... 30 4 168 285 1 1 52
Arizona............ 6 1 8 11 66 98 1 5 61
Utah............... 12 7 18 122 158 1 20 2
Nevada............. 10 3 11

PACIFIC.............. 128 12 534 422 780 958 26 3 14 285
Washington......... -- --- 40 38 --- 252 --- 3 -
Oregon............. 18 21 32 14 17 1 1 10
California......... 76 11 453 328 690 534 21 2 14 275
Alaska............. 3 7 12 13 60 -
Hawaii.............. 31 1 13 12 63 95 1 -

Puerto Rico 98 32 9 9 11 1 60 25








Morbidity and Mortality Weekly Report





Table 4 (D). TOTAL DEATHS AMONG PERSONS 65 YEARS AND OVER IN RI POR TING CITIES



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


395


Area For weeks ending Area For weeks ending

110/10 10/17 10/24 10/31 10/10 10/17 10/24 10/31


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.,.......
Scrinton, 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............


129
23
13
13
35
22
8
22
27
33
14
26
17
43


34
33
85
30
22
25
34
49
1,010
14
271
131
27
64
16
25
34
23
25
18


39
23
401
87
127
60
50
163
28
12
23
22
28
97
29
82
18
13
22
72
33


21
14
25
102
13
86
44
144
59
38


SOUTH ATLANTIC:
141 Atlanta, Ga.............. 40 58 63 49
14 Baltimore, Md............. 115 107 140 133
23 Charlotte, N.C............ 13 18 17 20
13 Jacksonville, Fla........ 24 22 34 28
33 Miami, Fla............... 31 50 45 38
16 Norfolk, Va.............. 25 32 21 26
17 Richmond, Va............. 43 40 44 58
20 Savannah, Ga............. 10 7 22 14
32 St. Petersburg, Fla...... 57 39 37 64
46 Tampa, Fla............... 33 36 32 26
11 Washington, D.C.......... 74 86 77 82
24 Wilmington, Del.......... 26 18 22 30
13
46 EAST SOUTH CENTRAL:
Birmingham, Ala.......... 46 43 43 51
Chattanooga, Tenn........ 19 22 31 26
27 Knoxville, Tenn.......... 15 25 18 34
25 Louisville, Ky............ 43 40 84 86
78 Memphis, Tenn............ 50 52 62 54
25 Mobile, Ala.............. 16 23 16 22
17 Montgomery, Ala.......... 14 10 12 21
23 Nashville, Tenn........... 50 46 53 56
36
34 WEST SOUTH CENTRAL:
)88 Austin, Tex............... 12 30 27 24
21* Baton Rouge, La.......... 17 28 18 19
274 Corpus Christi, Tex...... 11 4 8 5
112 Dallas, Tex.............. 53 58 86 65
41 El Paso, Tex.............. 9 12 12 23
.64 Fort Worth, Tex.......... 40 28 44 39
18 Houston, Tex............. 103 84 85 81
34 Little Rock, Ark......... 31 23 32 38
26 New Orleans, La.......... 83 93 88 82
17 Oklahoma City, Okla...... 42 51 41 33
21 San Antonio, Tex......... 45 51 65 59
20 Shreveport, La........... 20 28 24 18
Tulsa, Okla............... 11 27 43 43

28 MOUNTAIN:
25 Albuquerque, N. Mex...... 18 14 13 15
399 Colorado Springs, Colo... 9 6 12 19
97 Denver, Colo.............. 69 77 66 59
114 Ogden, Utah............... 6 8 7 7
58 Phoenix, Arfz............ 45 39 60 28
52 Pueblo, Colo.............. 9 8 7 12
181 Salt Lake City, Utah..... 24 24 20 30
24 Tucson, Ariz.............. 21 15 32 25
24
27 PACIFIC:
12 Berkeley, Calif.......... 12 8 11 12
27 Fresno, Calif............ 35 19 22 32
85 Glendale, Calif........... 28 19 29 22
23 Honolulu, Hawaii......... 9 13 17 14
78 Long Beach, Calif........ 42 31 52 32
12 Los Angeles, Calif....... 263 300 280 289
18 Oakland, Calif........... 23 89 48 59
29 Pasadena, Calif.......... 25 20 29 13
67 Port land, Oreg............ 65 57 70 59
25 Sacramento, Calif........ 38 40 36 25
San Diego, Calif......... 62 58 48 45
San Francisco, Calif ..... 103 81 105 107
37 San Jose, Calif.......... 19 24 21 32
25 Seattle, Wash............ 87 82 71 92
27 Spokane, Waslr........... 34 37 22 33
69 Tacoma, Wash.............. 32 23 27 27
30
70
40*
.19
43 oCurrent Week Mortality for 108 Selected Cities


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


11,531
454
733
6,385


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

NOTE: All deaths by place of occurrence.




UNIVte-KIJY OF FLORIDA

SIl2lllIi llllll IlllIIIII Bllll Illlll II 1111
3 1262 08864 2862


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 31 was 6,398 as compared with an expected
weekly average of 6,491.



Week Ending 4-Week Weekly
10/10 10/17 10/24 10/31 Total Average
Observed 6,113 6,448 6,648 6,385 25,594 6,398
Expected 6,395 6,458 6,523 6,589 25,965 6,491
Excess -282 -10 125 -204 -371 -93


NUMBI
OF
DEATH


FPIod N


DEATHS at AGE 65 and OVER in 108 U.S. CITIES
A-Iomge NumD pew MW Ik by Faou W.M PR-lodn

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(See table page 395)


TYPHOID FEVER Aberdeen, Scotland
(Continued from page 390)


item of trade at this counter and on a busy day the con-
tents of 4 or more 6-lb. cans would be used. These were
opened, displayed and sliced according to the customer's
need. They were generally cut into 2 pieces, one-half
being displayed in the window while the other half was
cut on demand. In this way, it was possible to postulate
that contamination of the contents of a can could be con-
veyed by equipment, or by handling, to other foods on
the same counter.
A review of some recent outbreaks in Great Britain
showed that similar though much smaller occurrences
could possibly be traced to canned meat and that the
mechanism of contamination could be the negative pres-
sure induced during the cooling process and the possible
entry of pathogens if present in the cooling water.*
Concurrent information revealed that cooling water
might be specifically contaminated by typhoid organisms.
It was therefore decided as a matter of British Govern-
ment policy to instruct the withdrawal from trade of the
products of certain factories between certain dates. This
was done throughout Great Britain.
Although the advice was issued that unnecessary
journeys into and out of Aberdeen City should be avoided
during the time when the epidemic was at its worst, this
advice was withdrawn as the epidemic wave collapsed in
the third week of June. There has been no reason to issue
any further warning and as mentioned earlier in this re-
report secondary cases had been conspicuous by their
absence.
The British Government appointed a committee to
investigate the origin of this outbreak. The report of the
committee has not yet been presented.
*Lancet, June 13, 1964, Editorial: Epidemics of Typhoid
Fever.


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