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:
AA00010654:00389

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


FsCOMMUNICABLE D E
COMMUNICABLE DISEASE CENTER


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


CHOLERA District of Columbia

Reported this week from the District of Columbia is
the first recorded case of cholera in the United States in
over 50 years. Acquired as the result of laboratory ex-
posure, the infection has evidenced no further spread.
The patient, a 32 year old unimmunized male labora-
tory technician is employed in a research laboratory con-
ducting studies employing Vibrio cholerae. He had not
worked with the organisms for two weeks prior to June 1
when he assisted two other technicians in the injection
of 45 guinea pigs with a broth culture of V. cholera.
During the injection procedure, he noted broth leaking
from a small hole in a tube in the injection apparatus,
about 18 inches from his face. Four hours later, he as-


CO\ E%7is


Cholera District of Columbia . ...... 193
Smallpox %,.r-hinrtn, D. C. . ... 194
Salmonella Typhimurium Riverside, Calif. ... 194
Human Rabies Death West Va. . .... 195
Poliomyelitis Nebraska . ..... 195
Trichinosis Iowa . . .... 200



sisted in the anatomical dissection of specimens. At no
time, however, did he knowingly ingest infected material.
On the evening of June 3, he had a soft stool but
experienced no other symptoms. On return from work the
following evening, he passed the first of 5 to 6 soft stools.
Symptomatic medication appeared to have an effect in
diminishing the frequency of bowel movements.


Table 1. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous weeks)
23rd WEEK ENDED CUMULATIVE, FIRST 23 WEEKS
MEDIAN
DISEASE JUNE 12, JUNE 6, 1960-1964 MEDIAN
1965 1964 19 1960- 1964
Aseptic meningitis .... ...... 20 24 42 619 654 606
Brucellosis .. .............. 7 6 10 101 171 173
Diphtheria ............... 9 4 76 122 200
Encephalitis, primary infectious 23 39 --- 693 797 ---
Encephalitis, post-infectious 9 33 --- 361 445 ---

Hepatitis, infectious including
serum hepatitis .......... 547 622 683 16,549 19,627 21,683
Measles .. ............ 7,564 16,810 16,810 213,895 410,263 333,138
Meningococcal infections 42 56 38 1,819 1,456 1,139
Poliomyelitis, Total ......... 1 3 6 14 35 158
Paralytic .................. 1 2 6 11 28 121
Nonparalytic ....* 1 --- 3 6--
Unspecified ******** --- 1 ---

Streptococcal Sore Throat and
Scarlet fever ....... ...... 6,404 7,437 5,398 228,696 234,052 196,112
Tetanus .......****** ...4 10 --- 93 101 --
Tularemia ....... 14 9 --- 100 119
Typhoid fever ''''' ......9 4 11 162 151 204

Rabies in Animals ...' 67 97 73 2,252 2,129 1,858

Table 2. NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax: N.J.-1 ............................. 6 Rabies in Man: W. Va.- 1.......... ............ 1
Botulism: .................... ........... 8 Smallpox: ............ .................. 1
Leptospirosis: .................. ............ 15 Trichinosis: R.I. -1 ........................ 53
Malaria: N.Y. City- 1, Pa. -, Wash. ......... 29 Typhus-
Plague: ................................. Murine: .................... ........... 8
Psittacosis: .............................. 16 Rky. Mt. Spotted: Ill. 1, N.J. -2, Md. 1, Colo. 1, 33
Cholera: D.C. 1 ......................... 1 Va. Pa. 1, Tenn. -2, Ohio- 1








Morbidity and Mortality Weekly Report


CHOLERA District of Columbia
(Continued from front page)


With his family, he visited the New York area on the
weekend. However, beginning on Sunday evening, June 6,
the stools became more frequent and he felt somewhat
thirsty. Cultures were taken and he was hospitalized on
June 8.
Organisms cultured represent a strain of V. cholerae,
Inaba group, stated by the laboratory to be identical to
that used in research. Like other cholera strains, it is
considered to be susceptible to the effects of light and
dessication and is thought unlikely to survive more than
a few hours on an exposed surface.
The patient was placed on antibiotic therapy following
hospital admission; stool cultures have been negative for
5 successive days after treatment. The patient's family
was hospitalized for 5 days for observation and to obtain
cultures. All cultures have been negative. All laboratory
personnel and persons with household contact with the
patient in the District of Columbia, New Jersey and New
York have been located and cultures have been obtained.


All have now been cultured on one or more occasions at
least 5 days after last contact with the patient; all cultures
are negative for V. cholera.
The last recorded cases of cholera in the United
States occurred in the summer of 1911,* when at least 8
vessels arrived in New York and Boston from cholera
infected Italian ports. Twenty-two cases, including 16
deaths were recorded among immigrants, mostly steerage
passengers on these boats. A single additional non-fatal
case occurred in a Staten Island man guarding the well
persons in quarantine.
*Weekly Public Health Reports, Vol. 26, Part I1, 1133, 2082,
1911
(Reported by Dr. Murray Grant, Director of Public Health,
District of Columbia Department of Public Health, Dr.
Harold T. Fuerst, Director, Bureau of Preventive Diseas-
es, New York City Department of Health and Dr. William
J. Dougherty, Director, Division of Preventable Disease
Control, New Jersey State Department of Health.)


SMALLPOX Washington, D.C.


No secondary cases of infection have been detected
among contacts of the case of smallpox reported from
Washington, D.C. (MMWR Vol. 14, Nos. 20, 21). The 16
day surveillance period among exposed contacts con-
cluded June 16. Virological and serological studies to
characterize further the virus isolated are in progress.
Although a response typical of the variola-vaccinia virus
group was obtained in fluorescent antibody examination;
intracytoplasmic inclusion bodies were seen in the skin


biopsy and pox lesions were observed after growth on egg
chorio-allantoic membrane, the patient's antibody response
is not consistent with an infection induced by the variola-
vaccinia virus group. Additional information pertaining to
the patient's contacts in Ghana is being sought.

(Reported by Dr. Murray Grant, Director of Public Health,
District of Columbia Department of Public Health, and
the Communicable Disease Center.)


SALMONELLA TYPHIMURIUM Riverside, California


The epidemic of Salmonella typhimurium gastroen-
teritis in Riverside, California (See MMWR, Vol. 14,
Nos. 21, 22) which began in mid-May has continued to
subside. Although transmitted through the municipal water
supply, the mechanism of contamination has not yet been
completely worked out.
By June 1, approximately 14,000 cases are estimated
to have occurred among the population receiving municipal
water. An additional 2.000 or more cases are thought to
have occurred during the same period among residents of
nearby communities who work in or have frequent contact
with Riverside. Since chlorination of the water supply on
June 2, at least 2,000 more cases are thought to have
occurred among Riverside residents as a result of second-
ary spread within the community.
From a random house-to-house survey of the com-
munity conducted on June 1, the over-all attack rate
among the 110,000 persons receiving municipal water in


their homes was 12.7 percent. Age specific attack rates
for this population were as follows:


Age Group Attack Rate (Percent)

Under 1 22.0
1-4 18.7
5-9 14.3
10-14 14.6
15-19 12.5
20-39 11.1
40-59 12.3
60+ 8.7


Geographical attack rates were not uniform throughout
the area receiving city water but did not appear to cor-
relate clearly with any distribution pattern in the supply.


194









195


Morbidity and Mortality Weekly Report



SALMONELLA TYPHIMURIUM Riverside, California
(Continued)


Because the water comes from numerous deep wells in
several locations and is distributed, nacording to demand,
both directly through the main pipe line, and indirectly
through a series of reservoirs, it has been difficult to
establish the pattern of distribution within the city.

Six water samples have been shown to contain Salmo-
nella typhiimiirium. These samples were obtained from
several reservoirs and several places in the distribution
system. Because the positive samples were found in
diverse locations and the cases themselves were widely
distributed, it is presumed that the source of contami-
nation must lie somewhere near one of the main sources
of water supplying the city. All of the main wells, how-
ever, have been functioning without known defects which
would permit contamination; no positive cultures have


been found in extensive samples taken from these sources.
As perplchin,, as the source of the contamination is
the complete absence of elevated coliform counts in
routine samples obtained daily from various points Thir.,iih-
out the city prior to and durinii the outbreak. Intensive
efforts are continuing to answer these questions.
As noted, the water has been chlorinated since
June 2; efforts are being made to minimize secondary
spread in the community.


(Reported by Dr. Philip Condit, Director, Division of
Communicable Diseases, California State Department of
Public Health, and Dr. Everett Stone, Director, Riverside
County Health Department, Riverside, California and a
team from the Communicable Disease Center.)


HUMAN RABIES DEATH West Virginia


The first recognized case of human rabies in the
United States for 1965 died in West Virginia on May 21,
1965.
The patient was a 60 year old white male, who became
ill on May 14 with pain in the right hand. The pain radiated
up the arm and became progressively more severe. By May
16, mild dysphagia was noted. The patient was admitted
to a hospital on May 18, at which time the dysphagia was
marked and there was pain over the entire right hemithorax.
Apprehension and restlessness were prominent symptoms.
No fever was noted. The admitting diagnosis was "suspect
rabies". Attempts to allay the patient's anxiety with
thorazine were not successful. The condition of the pa-
tient deteriorated steadily and death occurred on May 21.
Negri bodies were demonstrated on histologic ex-
amination of brain tissue at the hospital and at the West
Virginia State Health Department Laboratory. Further


confirmation of the diagnosis was made by mouse inoc-
ulation followed by FA examination of the brain tissue of
the inoculated mice at the State Health Department Lab-
oratory.
The history of exposure is unusual. The patient was
bitten on the right hand by a known rabid dog on June 13,
1963. He received 14 doses of rabies vaccine following
this exposure. There was no reported subsequent exposure
although the man was known to be a woodsman and hunter.
In fact, the patient stated that 6 or 7 months prior to onset
of illness he had shot a fox and turned in the head for
bounty; however, there is no record of this bounty payment.
(Reported by Chas. A. Jones, Chief, Medical Services,
VA Hospital, Clarksburg, W. Va.; J. Roy Monroe, Director
of Laboratories, West Virginia State Health Department,
and Dr. L.A. Dickerson, Acting Chief, Disease Control,
West Virginia State Health Department.)


POLIOMYELITIS Nebraska


A case of paralytic poliomyelitis involving a 4-year-
old male has been reported from South Sioux City (Dakota
County), Nebraska. The patient became ill on May 23,
1965, with fever and pharyngitis which progressed to a
bulbar type of paralysis. Cerebrospinal fluid examination
showed a pleocytosis. Attempts at viral isolation are
currently in progress.
This case is believed to be epidemiologically related
to the two cases of paralytic poliomyelitis previously
reported from Morrill County, Nebraska (MMWR, Vol. 14,


No. 20). In mid-April the patient's entire family visited
Morrill County, where the father was temporarily employed
as a construction worker.
Because of the two cases of type I poliomyelitis in
Morrill County an immunization program utilizing type I
oral poliovirus vaccine from the CDC epidemic reserve
was conducted there on June 6. A total of 2,408 doses of
vaccine were administered.
(Reported by E. A. Rogers, M.D., Director of Health,
Nebraska State Department of Health.)












196 Morbidity and Mortality Weekly Report


Table 3. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

JUNE 12, 1965 AND JUNE 6, 1964 (23rd WEEK)


Aseptic Encephalitis Poliomyelitis 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... 20 24 23 9 1 14 35 1 11 28 76

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

MIDDLE ATLANTIC...... 2 1 3 1 1 5 5 4
New York City...... 2 1 1 I 2
New York, Up-State. 1 2 -
New Jersey......... 1 1 2 2 -
Pennsylvania....... 1 1 1 2

EAST NORTH CENTRAL... 1 6 12 1 3 3 3
Ohio............... 5 2 2 1
Indiana............ 1 2 -- 2
Illinois........... 1 3 1 1 1 -
Michigan........... 5 2 -
Wisconsin.......... -

WEST NORTH CENTRAL... 1 4 1 4 18
Minnesota .......... 1 1 7
Iowa............... 1 1
Missouri........... 1 1
North Dakota....... -
South Dakota....... 7
Nebraska........... 3 3 1
Kansas ............. 1

SOUTH ATLANTIC....... 2 6 1 3 14 10 15
Delaware........... 1 -
Maryland........... 1 1 1 -
Dist. of Columbia.. 3
Virginia........... -
West Virginia...... 1 1 -
North Carolina..... 1 7 3 1
South Carolina..... 2 -
Georgia............ 1 1 8
Florida............. 1 3 3 4 4 3

EAST SOUTH CENTRAL... 4 3 1 3 2 11
Kentucky........... 4 2 -
Tennessee.......... -
Alabama............... 1 2 2 10
Mississippi ...... 1

WEST SOUTH CENTRAL ... 3 3 2 1 4 2 1 4 2 19
Arkansas........... 2
Louisiana......... 1 1 1 1 1 2
Oklahoma........... 1 -
Texas.............. 3 3 1 3 1 3 1 15

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

PACIFIC.............. 8 8 2 2 2 2 2 5
Washington ......... 1 1 1
Oregon.............. 1 1 1
California......... 5 8 2 1 1 1 1 4
Alaska ............. -
Hawaii............. 2 -

Puerto Rico 6











Morbidity and Mortality Weekly Report 197


Table 3. ( AStS OF SPI(IFIFD NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED
JUNE 12, 1965 AND JUNE 6, 1964 (23rd WEEK) Continued


Brucel- Infectious Hepatitis Me -in1.1on0L L ta
losis 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... 7 547 225 264 16,549 19,627 42 1,819 1,456 4 93

NEW ENGLAND.......... 36 14 19 1,003 2,035 2 92 39 5
Maine.............. 2 2 197 693 9 5 -
New Hampshire...... 4 3 94 147 5 1
Vermont............ 3 3 45 258 2 1 -
Massachusetts ..... 15 7 7 383 404 1 31 18 3
Rhode Island....... 5 4 130 108 1 14 2 -
Connecticut........ 7 2 5 154 425 31 13 1

MIDDLE ATLANTIC...... 88 31 57 2,863 4,438 6 245 166 1 6
New York City .. 20 3 17 533 645 1 43 23 -
New York, Up-State. 26 11 15 1,181 1,973 4 64 48 2
New Jersey......... 23 7 16 518 814 69 53
Pennsylvania....... 19 10 9 631 1,006 1 69 42 1 4

EAST NORTH CENTRAL... 119 60 52 3,196 3,001 10 232 200 8
Ohio............... 26 16 9 927 778 1 62 58 1
Indiana............ 9 4 4 268 265 2 33 33 4
Illinois........... 37 19 17 624 522 3 61 45 1
Michigan........... 40 18 22 1,172 1,216 3 48 46 -
Wisconsin.......... 7 3 205 220 1 28 18 2

WEST NORTH CENTRAL... 6 20 8 12 1,086 1,106 5 98 84 1 4
Minnesota.......... 4 4 100 99 19 18 2
Iowa............... 5 2 2 415 163 5 4 1 1
Missouri........... 1 5 3 2 213 272 2 46 44 1
North Dakota....... 1 1 15 42 1 5 8
South Dakota....... 16 104 2 -
Nebraska........... 1 1 33 24 1 10 5 -
Kansas........... 7 4 3 294 402 1 11 5 -

SOUTH ATLANTIC....... 52 31 18 1,689 1,855 8 356 316 1 26
Delaware........... 57 41 4 4 -
Maryland........... 10 9 1 322 351 3 35 23 1
Dist. of Columbia.. 1 1 21 30 1 5 10 -
Virginia........... 10 3 6 413 278 1 42 35 1 5
West Virginia...... 7 7 255 308 23 20 1
North Carolina..... 5 1 4 139 344 1 65 53 2
South Carolina..... 2 1 62 66 1 52 46 2
Georgia............. 2 1 1 60 41 45 42 3
Florida............ 15 9 5 360 396 1 85 83 12

EAST SOUTH CENTRAL... 1 22 12 9 1,217 1,363 135 131 14
Kentucky........... 6 5 420 582 58 45 2
Tennessee......... 1 10 4 6 442 470 43 45 5
Alabama ........... 4 2 2 196 195 23 24 6
Mississippi........ 2 1 1 159 116 11 17 1

WEST SOUTH CENTRAL... 51 28 21 1,422 1,430 6 270 184 1 17
Arkansas.......... 10 7 3 203 157 13 13 4
Louisiana.......... 15 7 8 246 311 3 151 91 2
Oklahoma ........... 34 79 17 4 -
Texas............... 26 14 10 939 883 3 89 76 1 11

MOUNTAIN............. 45 2 1 1,008 1,238 1 59 51 2
Montana............ 4 1 74 112 1 -
Idaho .............. 4 156 133 7 1 -
Wyoming ............ 31 42 1 4 3 -
Colorado........... 1 1 196 339 13 10 1
New Mexico......... 30 216 177 10 21 -
Arizona............ 5 195 281 16 3 1
Utah............... 1 1 135 113 6 5 -
Nevada............. 5 41 2 8 -

PACIFIC.............. 114 39 75 3,065 3,161 4 332 285 11
Washington.......... 16 10 6 265 353 25 21 -
Oregon............. 9 1 8 252 352 25 18 2
California.......... 86 27 59 2,386 2,294 3 264 233 9
Alaska............. 3 1 2 144 104 1 11 6 -
Hawaii............. .- 18 58 7 7 -

Puerto Rico 29 24 5 581 426 3 26 17











198 Morbidity and Mortality Weekly Report


Table 3. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

JUNE 12, 1965 AND JUNE 6, 1964 (23rd WEEK) Continued


Strept.
Measles Sore Th. & Tularemia Typhoid Fever Rabies in
Scarlet Fev. Animals
Area
Cumulative Cum. Cum. Cum.
1965 1965 1964 1965 1965 1965 1965 1965 1965 1965
UNITED STATES... 7,564 213,895 410,263 6,404 14 100 9 162 67 2,252

NEW ENGLAND.......... 682 35,210 13,318 509 1 26
Maine............. 120 2,617 2,318 61 3
New Hampshire...... 1 370 201 14 -
Vermont............. 134 1,025 1,998 21 21
Massachusetts ...... 218 18,718 3,897 114 1 1
Rhode Island....... 35 3,762 1,456 31 -
Connecticut........ 174 8,718 3,448 268 1

MIDDLE ATLANTIC...... 839 11,609 46,171 377 1 28 5 88
New York City...... 148 1,445 13,792 17 1 15 -
New York, up-State. 229 3,181 10,388 251 6 4 80
New Jersey......... 145 1,935 10,808 43 2 -
Pennsylvania....... 317 5,048 11,183 66 5 1 8

EAST NORTH CENTRAL... 2,467 46,250 89,976 714 8 1 22 5 321
Ohio............... 303 8,160 17,520 91 6 165
Indiana............. 26 1,508 20,442 73 2 1 7 2 26
Illinois........... 164 2,146 14,951 118 5 4 1 61
Michigan........... 1,136 23,211 24,391 354 3 2 30
Wisconsin............. 838 11,225 12,672 78 1 2 39

WEST NORTH CENTRAL... 398 15,420 27,584 187 2 10 1 4 21 437
Minnesota.......... 22 590 266 17 1 1 2 87
Iowa................ 298 8,479 21,525 43 1 1 4 130
Missouri........... 32 2,404 822 2 1 6 3 4 61
North Dakota....... 44 3,396 4,160 107 4 22
South Dakota....... 2 104 3 4 1 31
Nebraska........... 447 808 1 25
Kansas............. NN NN NN 14 2 6 81

SOUTH ATLANTIC ...... 476 21,968 35,016 764 1 25 1 36 9 311
Delaware........... 9 468 337 6 3 -
Maryland........... 34 932 3,223 235 10 3
Dist. of Columbia.. 2 54 346 17 -
Virginia........... 114 3,473 11,760 179 1 4 1 4 6 239
West Virginia...... 163 12,245 7,686 132 1 1 10
North Carolina..... 28 295 1,066 3 4 10 2
South Carolina..... 10 947 4,028 15 3 4 1 2
Georgia............ 1 585 152 19 14 2 26
Florida............ 115 2,969 6,418 158 2 1 29

EAST SOUTH CENTRAL... 325 12,573 62,082 811 14 1 16 11 566
Kentucky........... 20 2,249 17,495 46 3 6 3 50
Tennessee.......... 186 7,152 21,422 698 10 1 4 8 506
Alabama............ 100 2,151 16,597 31 1 3 7
Mississippi........ 19 1,021 6,568 36 3 3

WEST SOUTH CENTRAL... 529 28,688 66,461 537 9 32 4 24 8 362
Arkansas........... 1 1,054 1,030 7 19 8 1 50
Louisiana.......... 4 77 82 1 1 3 1 59
Oklahoma........... 1 167 889 2 1 6 2 67
Texas................. 523 27,390 64,460 535 1 6 3 11 6 186

MOUNTAIN............. 823 17,318 15,427 1,343 1 10 13 4 41
Montana............ 110 3,337 2,423 45 1 2 3
Idaho............... 133 2,359 1,598 78 -
Wyoming............ 11 805 228 13 1 1 -
Colorado........... 259 4,868 2,657 524 1 2
New Mexico......... 34 578 271 222 8 2 8
Arizona............ 83 990 5,867 129 4 1 27
Utah............... 190 4,191 1,432 330 7 1
Nevada............. 3 190 951 2 -

PACIFIC.............. 1,025 24,859 54,228 1,162 1 1 18 4 100
Washington.......... 199 7,042 19,077 175 2 -
Oregon............. 59 2,941 6,598 16 4 2
California.......... 633 11,737 27,198 907 1 1 11 3 96
Alaska............. 3 128 1,040 5 1 2
Hawaii............. 131 3,011 315 59 1 -

Puerto Rico 89 1,746 4,523 24 3 10











Morbidity and Mortality Weekly Report


199


Week No. Table 4. DEATHS IN 122 UNITED STATES CITIES FOR WEEK ENDED JUNE 12, 1965
23
(By place of occurrence and week of filing certificate. Excludes fetal deaths)

All Causes Pneumonia Under All Causes Pneumonia Under
Area All 65 years and 1 year Area All 65 years and I year
Influenza All Influenza All
Ages and over CausAges and over Ages Causes
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.--------


740
263
31
22
28
43
29
28
19
51
75
12
47
32
60

3,277
55
38
138
53
24
37
53
91
1,655
50
504
199
47
96
27
57
53
42
30
28

2,532
64
36
686
176
202
112
82
346
44
47
46
36
44
160
45
106
52
28
44
117
59

862
73
35
45
107
38
104
81
252
70
57


462
167
18
15
19
21
20
25
13
28
49
8
24
19
36

1,911
28
22
80
31
14
25
30
34
942
27
313
104
30
69
12
35
38
30
24
23

1,433
39
23
370
112
103
62
39
200
28
25
32
12
27
85
27
71
30
17
30
67
34

519
50
25
21
63
25
71
49
143
38
34


*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, Hawaift ---..
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.----------


1,173
126
259
36
93
64
71
85
31
88
75
190
55

594
78
45
47
148
126
46
25
79

1,113
38
31
38
122
27
77
226
57
189
69
117
52
70

422
34
16
143
21
105
18
43
42

1,582
17
40
46
43
73
507
81
34
116
63
75
219
31
148
56
33


Total 12,295 6,929 434 762


Cumulative Totals
including reported corrections for


previous weeks


All Causes, All Ages ------------------------ 296,406
All Causes, Age 65 and over------------------- 168,773
Pneumonia and Influenza, All Ages------------- 13,332
All Causes, Under 1 Year of Age--------------- 17,342


'





UNIVERSITY OF FLORIDA

llli l11111111 11liIH IIIIllll ll 1 11111 111
3 1262 08864 2425


Morbidity and Mortality Weekly Report


TRICHINOSIS Iowa


Reported from Iowa are 12 cases of trichinosis
infected from summer sausage manufactured in Minnesota.
The cases constitute a portion of the outbreak originally
described in the MMWR (Vol. 14, No. 10) in which 18
Minnesota residents from 5 families were affected.
The Iowa cases were members of 9 families. Their
onsets ranged from the first week in December to the last
week in January, approximately the same period as the
Minnesota cases. Prominent clinical manifestations in-
cluded nausea, vomiting, abdominal cramps, myalgia and
periorbital edema. Eosinophilia ranged from 5 to 28
percent.
As previously noted, the sausage was produced from
USDA inspected pork butts and beef rounds by a local
locker company. The pork butts were allegedly boned and
frozen, and subsequently thawed, ground, placed in
natural beef casings and smoked at 1000F for three days.
Possible mechanisms to explain the contamination in-
cluded contamination of the sausage in the-grinder,
inclusion of a fresh rather than frozen pork butt or inade-
quate freezing of the pork.


(Reported by Ralph H. Heeren, M.D., Director, Division
of Preventable Diseases, Iowa State Department of Health.)


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 IDA L. SHERMAN,'M.S.
CHIEF. SURVEILLANCE SECTION D. A. HENDERSON. 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 SrOULD 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-
MEN TS. 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


UNIV OF FL LIB.
DOCUMENTS DEPOT.






U.S. DEPOSITORY


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