Morbidity and mortality

MISSING IMAGE

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:
AA00010654:00393

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 c(o/ q: I/




Morbidity and Mortality



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

PUBLIC HEALTH SERVICE


Prepared by the


I C M1MI L DI I ETE-


For release June 19, 1961 ATLANTA, GEORGIA 30333 Vol. 13, No. 24
PROVISIONAL INFORMATION ON SELECTED NOTIFIABLE DISEASES IN THE UNITED STATES AND ON
DEATHS IN SELECTED CITIES FOR WEEK ENDED JUNE 13. 1964

RABIES SURVEILLANCE SUMMARY ISSUE

RABIES


A total of 94 cases of rabies in animals was re-
ported for the week ended June 13. This brings to 2,216
the cumulative total thus far in 1964, an increase of 18
percent compared to the 1,871 reported for the compa-
rable period of 1963.
Of the 2,216 cases reported to date, the 7 states in
the West North Central region account for 713 (32 per-
cent), an increase of 268 (60 percent) compared to the
first 24 weeks of 1963. The principal stares contributing
to this rise are Minnesota, Iowa and Missouri, which
have reported 585 rabies in animals (26 percent of the
U.S. total). For the comparable period of last year,


these 3 states reported 362 cases.
The greatest rise reported cases occurred in the
East South tC(r8a vs. 156 cases), where
Tennessee 6AiE ,7 recent rise 1242 vs. 70


cases)
ported r
counting


Tennessee has re-
Iny other state, ac-
tional total.


As uassed'ln''he surveila summary elsewhere
in this sue the majority orep ted cases are wild-
life cases .'
No ca of hn rabi has been reported thus
far in 1964.


Table 1. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous weeks)
24th Week Ended Cumulative. First 24 Week
Disease June 13, June 15, Median June 13, June 15, Median
1964 1963 1959 1963 1964 1963 1959 1963
Aseptic meningitis ................ 39 37 --- 693 570
Brucellosis .................... .. 7 8 11 178 158 256
Diphtheria ........................ 12 6 7 134 129 298
Encephalitis, primary infectious .. 53 --- 853 9--
Encephalitis, post-infectious ..... 28 33 65 -97
Hepatitis, infectious including
serum hepatitis ................ 648 66, 660 20,263 22,3.3 22,344
Measles ........................... 12,377 12,224 13,202 395,173 319,225 340,473
Meningococcal infections .......... 49 48 38 1,406 1,363 1,258
Poliomyelitis, Total ........... 1 6 17 36 68 '03
Paralytic ...................... 1 5 1 28 ; 138
Nonparalytic ..................... 1 --- 7 3
Unspecified .................. --- 6
Streptococcal Sore Throat and
Scarlet fever .................. 6,485 4,856 -- 240,509 206,241-
Tetanus ........................... 8 9 -- 107 98
Tularemia ................*.......* 11 8 --- 129 10?
Typhoid fever ..................... 9 6 15 163 162 252
Rabies in Animals ................... 94 70 63 2,216 1,871 1,86:

Table 2. NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. (um.
Anthrax: 2 Psittacosis:
Botulism: 9 Rabies in Man:
Leptospirosis: Hawaii 1, Fla 1 12 Smallpox:
Malaria: Ky 1 42 Typhus-
Plague: Murine:
_Rky Mt. Spotted: NJ I, Mo 1


/V


634-5131








Morbidity and Mortality Weekly Report


RABIES SURVEILLANCE SUMMARY 1963

One case of human rabies was reported during 1963, the lowest total ever recorded. During the same period, 3,392 con-
firmed cases of animal rabies were recorded. This coral represents a slight increase over the 1962 figure. Rabies in
animals annual totals have shown a small increase since reaching an all time low in 1960. The 1963 increase was due to
epidemics in different wildlife hosts in certain geographic sections of the country. A long term review of human rabies and
a report on ihe surveillance of animal rabies follows.
HUMAN
The one case of human rabies reported during 1963 occurred in Pickens County, Alabama. The details are summarized
below.
U. S. HUMAN RABIES DEATH 1963

DATE NATURE OF INCUBATION LENGTH OF BITING
LOCALITY DIED AGE SEX EXPOSURE PERIOD ILLNESS TREATMENT ANIMAL
1. Pickens 9'4/63 52 F Unknown Unknown 7 days None Probably
County, dog
Alabama


A graph of human rabies since 1938 is shown below:


REPORTED HUMAN RABIES
BY YEAR
UNITED STATES, 1938-1963


* Provisional Total


YEAR


Source CDC, MMWR, Annual Supplements


A'


202








Morbidity and Mortality Weekly Report


During the period 1946 1963, human deaths from rabies totalled 218.
In this same period the greatest incidence occurred in children under 15 years of age with a peak in the 5-9 age group.
The age distribution of 154 deaths by 5 year age group is shown in the following graph.


Kvxv
x^


HUMAN RABIES DEATHS
BY 5-YEAR AGE GROUPS (154 CASES)
UNITED STATES, 1946-1963


\U


0 5 10 15 20 20


September represented the month during
month of exposure are shown below:



20.


15-


J F M A


K~i


30 35 40 45 50 55 60 65 70 75 80
Age

which the greatest number of exposure occurred. The 107 cases with known





107 HUMAN RABIES CASES
U.S.A. 1946-1963


By Mo


nth of Exposure


M J J A S u N U


Month


......... .......... ... ........ ..... ..` ` ` ` ` ` `


203









204


Morbidity and Mortality Weekly Report


A brcakdl.'wn ol the rance of incubation periods according to severity of exposure is shown in the following table:

INCUBATION PERIODS RELATED TO SEVERITY OF EXPOSURE IN 135 FATAL HUMAN RABIES CASES U.S., 1946-1963

Severe Superficial Unknown or
Exposure" Exposure Severity Not Reported TOTAL

No. of Cases 48 18 69 135
Median (days) 22 60 44 38
Range (days) 6.156 20.270 7-240 6-270
"Includes severe, multiple, deep, head or face bites
Source: CDC Data

The length of illness ranged from one to 20 days in 152 cases. The median was 4 days.
During the past 25-years, a definite change in the type of host exposure has occurred. Whereas domestic animals con-
stitutrd 100 per cent of exposures during the post war years, these animals caused about one-half of the rabies cases
around 10%0; thus wild animals have become an increasingly important source of human rabies cases.

FATAL HUMAN RABIES BY SOURCE OF EXPOSURE UNITED STATES, 1946- 1963

Dog or Fox, Skunk
Period No. of Cases Cat Exposure or Bat Exposure
Cases % Cases %
1946-1949 48 48 100 0 0
1950-1953 54 49 91 5 9
1954-1957 29 24 83 5 17
1958.1961 15 8 53 7 47
1962-1963 3 (Sources Unknown)
Total 149
Source: CDC Data


ANIMALS
A total of 3,932 laboratory confirmed cases of animal rabies was reported throughout the United Stares in 1963, an in-
crease of 206 cases as compared to 1%2.


INCIDENCE OF RABIES IN THE UNITED STATES BY TYPE OF ANIMAL 1953-1963*


FARM OTHER
YEAR DOGS CATS ANIMALS FOXES SKUNKS BATS ANIMALS MAN TOTAL
1953 5,688 538 1,118 1,033 319 8 119 12 8,835
1954 4,083 462 1,032 1,028 547 4 118 13 7,287
1955 2,657 343 924 1,223 580 14 98 4 5,843
1956 2,592 371 794 1,281 631 41 126 10 5,846
1957 1,758 382 714 1,021 775 31 115 5 4,801
1958 1,643 353 737 845 1,005 68 157 5 4,813
1959 1,119 292 751 920 789 80 126 7 4,084
1960 697 277 645 915 725 88 108 2 3,457
1961 594 217 482 614 1,254 186 120 3 3,470
1962 565 232 614 594 1,449 157 114 2 3,727
1963' 573 217 531 622 1,462 303 224 1 3,933
"Provisional Total
Sources: USDA, ARS and MMWR Annual Supplements



This rise appears due primarilh to a general increase in bat rabies and to an epidemic of rabies in raccoons in the
'outhrhast, as well as to an extension of a large epidemic of skunk rabies in the central part of the country, the emergence
of epidemic fox rabies in New Encland and increased concentration of dog rabies cases along the U.S. Mexico border.










Morbidity and Mortality Weekly Report



REPORTED CASES OF ANIMAL RABIES IN THE UNITED STATES
1940-1963


40' '42 '44 "46 '8' "50 '52
YEAR


'54 "56 'se "6 60 '6


Source, CDC, MMWR, Annual Supplements

Secular Trends
Animal rabies cases have declined since 1946, with a sharp drop from 1953 to 1960. Since 1960, however, a slight
increase is evident (see above). Despite this decreased incidence of animal rabies, about one-third of the counties in the
United States reported rabies in 1963, as well as in 1955.
Of note is the change in distribution of rabies in animal hosts, for the overall decrease is due to the reduced number
of cases in domestic animals (see below), particularly in dogs. Since 1960, rabies cases in wildlife have exceeded those
in domesticated animals. Nationwide, no progress in reducing the number of rabies cases in domestic animals has been
achieved for several years. On this basis, it appears that further reductions in the incidence of rabies will come only after
measures are found to control the disease in wildlife.
The incidence of fox rabies has declined during the past decade while that of skunk rabies has increased (see p. 204).
Since the initial isolation of rabies from an insectivorous bat in Florida in 1953, a large number of rabid bats have been
found throughout the United States, many in areas reporting few or no cases of rabies in other host species. In contrast,
the significant increase of raccoon rabies is the result of a highly localized epidemic, which first appeared in Florida and
has since moved slowly northward.


CASES OF RABIES IN WILD
AND DOMESTIC ANIMALS


1953-1963









^jl2.-


- .


DOMESTIC


I I I I 6 7 '5 '5 '6 '61---


Source: USDA, ARS, and USPHS, CDC


205


11.000.

10.000-

9.000-

8,000.

7.000.
-
S6.000

5,000.
E
4.000.

3.000

2,000

1.000


Total


8,000.





6,000


4,000-





2,000-


'62 '63


l


V


'53 '54 55 ''56 ''57 58 '59 '60 '61









Morbidity and Mortality Weekly Report


CASES OF RABIES IN TRADITIONAL WILDLIFE HOSTS


Foxes


YEARS


CASES OF RABIES IN EM

Raccoons


n0nnr nnnnfl '0i L
1953 '"Sd S "6 's "S *'9 "60 '61 *62 '6. '6d
YEARS


l9S, B54


Skunks


'55 59 '17 AM
YtARS


4


MERGING WILDLIFE HOSTS


Bats


400.


YEARS


206


'*9 '60 'I T61 63 1M


1








Morbidity and Mortality Weekly Report


207


Specific Hosts
In 1965, 541 counties in 11 States reported 1,462 cases of skunk rabies as contrasted to the 1,449 cases in 479
counties in 24 States in 1962. Thereby, skunks continued to be the greatest single source of animal rabies in the United
States as they were during the 2 preceding years. The rabid skunk problem covers much of the central portion of tFe
country where larpe number of cases are reported from Iowa, Minnesota, Ohio, and Texas. California also reports large
numbers of rabid skunks.
Roccoon rabies is a local problem in the southeastern United States. An epidemic involving this host began in south-
ern Florida 4 years ago and has since moved northward at a slow, steady pace. It is now a major problem in parts of south
Georgia. Of the 1963 cases, '9 per cent occurred in Georgia and Florida. The remarkable character of this epidemic con-
tinues to be the well defined wave of cases which marks its advance along a broad front, in contrast to the usual diffuse
pattern of epidemic rabies.


RACCOON RABIES FLORIDA AND GEORGIA


1960 TOTALS /
Florida 22 cases --
Georgia no cases 'a

_"--2
1942 .OTALS


N"---






1961 TOTALS /, -
Florida 44 cases / --
Georgia no cases -
j7\


Fox rabies increased slightly from 594 cases in 1962 to 622 cases in 1963. The most important change occurred in
northern New England (Vermont, New Hampshire, and western Maine) and New York. These areas have long been rabies
free, but were involved in an extension of an epidemic which moved southeastward across the province of Quebec. The
rabid foxes from this new focus of infection account for the increased number of fox rabies cases in 1963.
Although dog rabies is similar in incidence to 1962, its geographic concentration is shifted. The areas of the United
States with the greatest concentration of enzootic and epizootic dog rabies are found along the Mexican border.In 1962 one-
sixth of all the rabid dogs found in the United States were in counties bordering Mexico. In this same area dog rabies
cases increased from 136 in 1962 to 180 in 1963: this is nearly one-third of the 573 cases in this host reported in the en-
tire country last year. Dog rabies was reported in Vermont and New Hampshire for the first time in nearly 4 decades last
year.
Rabid bats were diagnosed twice as frequently in 1961 as 1962, with cases reported from 36 States. Many of the 1963
cases were reported from western States. The 3 Pacific coast States reported 89, Arizona 26, New Mexico 18, and Nevada
11. As in the past, however, the distribution of bat rabies appears to be more diffuse than localized, with the number of
rabid bats reported correlating rather well with the current level of interest in that area.
There was no confirmed rabies in mice, rats, or wolves.













INCIDENCE OF RABIES IN THE UNITED STATES BY TYPE OF ANIMAL AND STATE, 1963


CATTLE HORSES SEEP I GOATS SWINE
I &MULES I


FOES


SKUNKS


RAC OPOS BOB COf wOLVES IOOD MUSK SQUIR RATS MICE
COONS SUMS CATS OTES I CHUCKS RAT IRELS


UN
KNOWN


OTHER ANIMALS


MAN


O1TALS


U U U U U U U U U U U ,U U U U U L U U U U u l U vU U U U i uul u- k-
0 Z


459 '7 44 I


622 20


303 A I


3933 10B


Alaamo I 3 21 I I 1 15
Alasho 6 2I I I 2
A..ona 26 5 B 3 2 26 1 M. I.o 75
Akonsoes 8 7 I 41 10 9 23 4 11 1 2 16 1 75 22
Cal.lorn.ao 866 I 6 5 145 4 1 5_ 307
Colorado I I 1 12 15
Connlec icu 0
Delowr 2 2
Di,6. o1 Columbio 0
Flaoda 3 I I 3 5 58 2 12 __ 85
Geogo 3 I I 5 1 70 1 3 85
Ho ii 0
Ih 3 3
Illinos 13 1 12 1 19 4 2 1 7 96 6 2 1 2 2 157 13
donoe_ I 16 3 4 I I 19 2 54
o-a 13 21 89 5 7 6 192 4 1 3 1 bodger, gr hog 143
Koanss 3 20 23
Kmetucky 71 5 17 2 22 1 1 3 122
Lo.eusano 9 3 41 1 54
Main. ______ I 2
Maylond 2 2
Mausachusit 6 *
Michlgan 4 6 9 1 27 3 50
innesrt 1 2 21 48 9 3 3 2 171 4 5 1 3 1 273 IS
Mumsa, mopp. _______ ______ ______ 0
01asoua 40 17 25 32 56 I1 3 3 17
Montona 1 I
Nebaruk 3 1 4 22 2 1 33
Nevado 11 11
No- Mompsh.I I I 12 3 1 ____ 1
New Jersey 16 16
Ne. Meaico 7 1 1 13 2 1 18 43
New Yok 7 6 10 2 1 40 12 2 8 1 quirrel monkey 89
North CoMolino 6 9 15
Noirh DOkora 6 8 19 1 38 7I ____ 2_
Oho 9 2 1 5 3 222 2 755 2 4 I g. hog 30 II1
Oklohomn 5 10 13 2 37 I 1 69
Onegon I I 15 17
Pennsylyon.a 6 4 5 4 6 I 3 29
Rhode Island _________ __ 0
Souih Carol.na 5 5 10
Souh Dokeoo 9 14 32 1 55 112
Ternn: 27 4 36 1 51 13 1 S 138
Texae 106 23 28 6 37 51 7 1 2 5 1 66 13 234 18 7 1 2 1 22 3 3 3 dnr ils. I coca tl 525 116
Utoh I____ 1 2 4
VeYrmni 1 11 2 14
Virginia 11 4 31 5 177 1 2 1 2 homasi.r 238
WaMshngton 20 20
West Virginia 42 21 7 I 2 35 I 4 1 113 I
W. cons.n 7 7 16 I I 8 17 1 I 5 ___ I hor.e.. 65
WyOm.ng 0
Purvio R.o 5 I 3 1 11 moIgooses 21
V,.g.I Illond ______ 0


TOTAL


573 17 1 217 8








Morbidity and Mortality Weekly Report


State Reports
In 1963. 45 States reported rabies cases, (see p. 208) compared to 39 in 1962. Connecticut, Rhode Island, Mississippi,
Wyoming, and Hawaii reported no rabies in 1963. New Hampshire and Vermont reported rabies for the first time since
national surveillance began in 1938.
Sizable increases in the number of rabies cases compared to previous years occurred in Arizona, Georgia, Kansas,
Nevada, New Hampshire, New Mexico, Oklahoma, South Carolina, Vermont, Virginia, and Washington. Texas reported the
largest number of cases during 1963. The 10 States reporting the largest number of cases during 1963 are listed below:

State Number of Cases
1. Texas 525
2. Iowa 343
3. Ohio 308
4. California 307
5. Minnesota 273
6. Virginia 238
7. Missouri 178
8. Illinois 157
9. Tennessee 138
10. Kentucky 122
All but 2 of these, Virginia and Illinois, were among the top 10 in 1962.

(Reported by Rabies Surveillance Unit, COr'.)



INTERNATIONAL NOTES

RABIES Canada

A 14-year-old Fort Huntington, Quebec girl died of rabies March 15, the first human case reported in Canada this year.
About February 15, while sleeping in her home, she was bitten on the face by a skunk. Awakened by her cries, the
father grabbed the skunk and threw it out the window; he was bitten on the hand. Rabies was not considered, and the inci-
dent was passed over at that time; no physician was called to examine the child.
On March 3, the girl experienced malaise and fever; she remained at home. A few days later, she bit her mother.
Because of the persistence of her fever and her unusual behavior, she was admitted to a local hospital for observation.
Her condition deteriorated. On March 12, her illness undiagnosed, she was transferred to a children's hospital in Montreal.
Rabies was diagnosed clinically. During her hospitalization in Montreal, the girl bit one of her nurses. The child died in
coma March 15; rabies was confirmed by laboratory examination of the brain specimen.
Rabies antiserum and rabies duck embryo vaccine were administered to the father, mother, and the nurse. They have
not developed symptoms of rabies.

(Reported by Dr. A. R. Foley, Epidemiologist, Quebec Department of Health).

Editor's Note: This is the only case of human rabies yet reported in Canada or the United States of America in 1964.








VENEREAL DISEASE SUMMARIES

GRANULOMA INGUINALE
A total of 196 civilian cases of granuloma inguinale was reported in the United States for the fiscal year ended June
30, 1963, compared to 203 cases reported the previous fiscal year.
Reported cases of granuloma inguinale rose rapidly during the :940's from 639 cases in 1941 to a peak of 2,403 cases
in 1949; case reports declined sharply after 1949 to the current low of 196 cases (see graph on the following page).


209









Morbidity and Mortality Weekly Report


2700-

2550-

2400-

2250-

2100

1950- GRANULOMA INGUINALE

1800- Reported Cases* USA

1650- By Fiscal Year
0
S 1500-
8
o 1350-

1200-
S1100- *Exclusive of Known
Military Cases
900

750-

600-

450-

300-

150-


'41 '42 '43 '44 '45 '46 '47 '48 '49 '50 '51 '52 '53 '54 '55 '56 '57 '58 '59 '60 '61 '62 '63



During 1963, 7 states and the District of Columbia reported 10 or more cases, accounting for 155 (79 percent) of the
196 cases:
State Cases
Florida 39
New York 26
Georgia 24
Virginia 17
District of Columbia 15
Texas 13
Alabama 11
Louisiana 10
In fiscal 1961, the male-female ratio of cases was 2.4 to 1; 90 percent of all 1963 cases were in non-white individuals.
Private physicians and institutions reported 12 percent of the cases; the remainder were reported by venereal disease
clinics and other public institutions.
(Rported by Venereal Dnseaie Rranch. CDC.)




INFECTIOUS SYPHILIS MAY
A total of 1,818 cases of infectious syphilis (primary and secondary) was reported for the month of May (see table
opposite page). This figure compares to the 1,952 cases reported for May, 1963, a decline of 7 percent.
The total for the first 5 months of 1964 is 9,330, compared to 9,198 cases reported for the comparable period of 1963.
This represents an increase of 1.4 percent for this period of time.


210





SUMMARY OF REPORTED CASES OF INFECTIOUS
MAY 1964 MAY 1963


SYPHILIS


CASES OF PRIMARY AND SECONDARY SYPHILIS: By Reporting Areas May 1964 and May 1963 Provisional data
Cumulative Cumulative
Reporting Area May Jan May Reporting Area May Jan May
_1964 1963 1964 1963 .1964 1963 1964 1963


NEW ENGLAND..............
Maine....................
New Hampshire...........
Vermont..................
Massachusetts............
Rhode Island.............
Connecticut..............

MIDDLE ATLANTIC..........
Upstate New York.........
New York City............
Pa. (Excl. Phila.).......
Philadelphia ............
New Jersey...............

EAST NORTH CENTRAL........
Ohio....................
Indiana..................
Downstate Illinois ......
Chicago .................
Michigan.................
Wisconsin................

WEST NORTH CENTRAL........
Minnesota...............
Iowa....................
Missouri.................
North Dakota ............
South Dakota.............
Nebraska.................
Kansas...................

SOUTH ATLANTIC.............
Delaware.................
Maryland.................
District of Columbia.....
Virginia.................
West Virginia...........
North Carolina...........
South Carolina...........
Georgia..................
Florida..................


204
1
6
3
122
7
65


2,257
291
1,317
53
147
449

927
223
25
63
369
228
19

237
64
14
99

24
22
14

2,797
39
225
241
114
18
427
381
504


2,487
244
1,400
66
325
452

826
165
22
49
375
183
32

190
31
17
76
4
9
25
28

2,521
19
224
297
122
22
371
279
418


EAST SOUTH CENTRAL........
Kentucky.................
Tennessee.............
Alabama......... ........ .
Mississippi..............

WEST SOUTH CENTRAL.......
Arkansas................
Louisiana...............
Oklahoma................
Texas.............. .....

MOUNTAIN..................
Montana..................
Idaho....................
Wyoming..................
Colorado.................
New Mexico.............
Arizona.................
Utah......................
Nevada..................

PACIFIC ...................
Washington...............
Oregon..................
California...............
Alaska...................
Hawaii ..................

U. S. TOTAL ...............


1,818


1,952


1,046
82
267
53
644

216
7
4
7
10
98
72
5
13


1,016
26
33
947
5
5

9,330


630
47
175
287
121


1,172
94
265
78
735


9,198


TERRITORIES................ 58 90 323 324
Puerto Rico.............. 56 88 312 317
Virgin Islands .......... 2 2 11 7




Note: Cumulative Totals include revised and delayed reports
through previous months.












1MIrbiditui and Mortalit i eeLkl e Reporl



l abli ( AN s OF SPH (IFIF) NOTIIFIABLE DISEASES L NITID STATES

FOR WIEKS ENDED

.J NI I4. 1964 AND ji NI IS, 1964 (21TH WEEK)


pt I En epha li t
\'-(pt l<---- i ---
Mcningiti Primary Pot-Inf. Poliomyelitis, Total Cases PlI aomyel t is, Paralytic
Cumulative Cumulative
196l 19b3 196. 1964 1964 1963 1964 1963 1964 1963 1964 1963
UNITED UTATES... 39 37 53 28 1 6 36 68 1 5 28 59

NEW ENGLAND ...... ... 2 2 1 1 1
M.r .............. -- 1 1
New Hamp-h r ......- -
Vermni.............. -
iL hu sc [ ...... -
RhIodt lik'nd....... -
C nnr t t ......... 2 1 -

MIDDLE ATLANTIC...... 6 15 4 1 5 8 1 5 6
iw Y'rl, Ciyv. ..... 2 3 1 -- 1 -
N,- York, Up-State. 3 2 4 1 2 5 1 2 5
~Nw Jersev......... 1 11 2 2 -
Prnnsylvana ....... 2 1 3 1

EAST NORTH CENTRAL... 6 7 4 9 3 16 3 13
Ohio............... I I 1 2 4 2 3
indiana ............ 2- 2 1
[llinois........... 3 9 1 6 1 5
Michigan ........... 2 3 3 3 3
Wi sLons in.......... I 1

WEST NIRTH CENTRAL... 3 4 2 2 1 1 2
M nnes.ta........... 2 1 2 2
1 owa. ............... -
Misi-,ur t........... l 2 I -
North Dakot ....... .
'ulth Dakota....... 2 -
'J'braska ........... .
Kansas ............. -

c.OUTH ATIANTIC....... 1 10 1 2 16 9 1 12 7
Delaware............ .. -
Maryland........... 1 1 -
Dist. of Columbia.. .
Virgnia.............. 1 1 2 1
West Virpinia ...... 1 1 1
North Carolina..... 7 2 3 2
South Carolina...... 1 2 2 -
Georgia.............. 1 1 l -
Florida ............. 7 I 4 3 1 4 3

EA'T SOUTH CENTRAL... 2 2 1 3 4 1 1 3
Kentucky............ 2 -
Tennessee ........... 1 1 1
Alabama............. 2 2 1 1
Mississippi........ 1 i I 1

WEST SOUTH CENTRAL... 5 5 1 2 14 1 2 14
Arkansa ........... 2
Louisiana.............. 2 12 1 12
Oklahoma........... 2 2 1 1 -
Te as .............. ... 4 3 1 1 2 1 2

MOUNTAIN............. 4 5 4 1 3 1
Montana............ .
Idah ................ 1
Wyomine ........ 2 2
rolorado. ...... 3 4 3 1 -
New Meu ico.... .. 1- -
Arizona...... .... I I -
itah.... .. ... I -
Nevada...... -

PACIFT ...... 16 9. 7 13 1 1 13 1 1 12
W'3 h inl i. n ...... 2 I -
'r n ............. l -- 1 1 1
Cal If rni ] ........ 12 9 5 13 1 11 1 10
Alassa .............
Hawu i .. .. ..

Puert. -i L L 0 4 4


212











Morbidity and Mortality Weekly Report 213


Table 3. CASES OF SPECIFIED NOTIFIABLE DISEASES. UNITED STATES

FOR WEEKS ENDED

JUNE 13, 1964 AND JLNE 15, 1963 (24TH WEEK) CONTINUED


Infectious Hepatitis
Brucellosis Diphtheria including Serum Hepatitis Typhuid Fever

Area Under 20 years Age
Cum. Cum. Total 20 years and over Unknown Cumulative Cum.

1964 1964 196. 1964 1964 1964 1964 1964 196. 1963 196- 1964

UNITED STATES... 7 178 12 134 648 295 308 45 20,263 22,343 9 163

NEW ENGLAND .......... 2 9 42 60 27 32 1 2,095 2,476 10
Maine.............. 9 39 14 6 8 707 1,141 -
New Hampshire...... 1 1 148 173 -
Vermont............ I 259 30 -
Massachusetts ...... 2 3 23 11 12 427 736 5
Rhode Island....... 4 1 2 1 112 57 5
Connecticut ........ 17 8 9 442 339 -

MIDDLE ATLANTIC...... 3 5 164 89 75 4,589 4,271 3 28
New York City...... 1 29 12 17 674 582 1 12
New York, Up-State. 1 83 51 32 2,037 1,915 1 5
New Jersey......... 2 16 9 7 830 647 1
Pennsylvania....... 2 2 36 17 19 1,048 1,127 1 10

EAST NORTH CENTRAL... 3 22 6 89 40 41 8 3,076 3,583 2 37
Ohio............... 1 29 14 13 2 807 1,025 19
Indiana............ 1 4 1 3 270 347 1 8
Illinois........... 2 14 6 12 6 6 519 772 5
Michigan........... 2 36 18 18 1,252 1,272 1 4
Wisconsin.......... 1 4 8 1 1 6 228 167 1

WEST NORTH CENTRAL... 81 1 20 37 17 17 3 1,143 1,040 2 14
Minnesota........... 3 11 5 I 4 104 175 -
Iowa.............. 46 3 3 166 187 3
Missouri........... 5 14 5 7 2 286 405 1 6
North Dakota....... 2 1 1 42 29 1 1
South Dakota....... 12 1 104 49 1
Nebraska............ 11 I 1 25 75 -
Kansas............... 2 7 14 8 6 416 120 3

SOUTH ATLANTIC....... 15 2 27 46 22 21 3 1,904 2,354 33
Delaware.............. 41 31 -
Maryland........... 10 4 6 361 273 1
Dist. of Columbia.. i I 31 67 -
Virginia........... 6 3 2 1 281 510 7
West Virginia...... 10 7 2 1 318 378 -
North Carolina..... 1 9 3 6 356 596 11
South Carolina..... 4 3 1 2 69 88 3
Georgia............ 6 2 20 1 1 42 96 I
Florida............. 2 3 9 4 4 1 405 315 10

EAST SOUTH CENTRAL... 2 10 5 21 8 11 2 1,376 2,313 1 17
Kentucky............ 3 6 2 2 2 580 677 6
Tennessee........... 2 3 1 8 2 6 478 920 7
Alabama............. 3 2 4 3 1 199 341 1 3
Mississipp ........ I 2 3 1 2 119 375 1

WEST SOUTH CENTRAL... 18 16 51 22 25 4 1,481 1,485 10
Arkansas........... 4 4 1 3 161 166 4
Louisiana.......... I 5 13 5 8 324 274 2
Oklahoma............ 3 1 2 82 77 3
Texas............... 11 11 31 15 12 4 914 968 1

MOUNTAIN............. 1 14 1 34 7 3 24 1,292 1,500 3
Montana............ 2 1 1 114 212 -
Idaho.............. 4 4 137 236
Wyoming............. 42 21 -
Colorado........... 6 6 367 320 -
New Mexico......... 1 1 8 6 1 1 185 178 -
Arizona............. 1 12 12 291 351 3
Utah............... 1 11 2 1 1 115 172 -
Nevada............ 41 10 -

PACIFIC.............. 1 13 12 146 63 83 3,307 3,321 1 11
Washington....... 11 13 4 9 366 556 1
Oregon.............. 1 15 7 8 367 438 -
California.......... I 12 1 108 45 63 2,402 2,242 1 10
Alaska.............. 6 5 1 110 63 -
Hawaii ............. 4 2 2 1 62 22 -

Puerto Rico 4 15 13 2 361 353 8












214 Morbidily and Mortalily Weekly Report


Table 3. CASES OF SPECIFIED NOTIFIABLE DISEASES LINITED STATES

FOR WEEKS ENDED

JUNE 1i. 1964 AND JUNE 15. 1963 (24TH WEEK) CONTINUED


Streptococcal
Meningococcal Sore Throat and Rabies in
Measles Meningitis Scarlet Fever Tetanus Tularemia Animala
Area
Cumulative Cum. Cum. Cum.
1964 1964 1964 1963 1964 1963 1964 1964 1964 1964 1964 1964


UNITED STATES... 12,377 49 1,406 1,363 6,485 4,856 8 107 11 129 94 2,216

NEW ENGLAND........ 755 1 40 86 1,068 528 3 12
Maine.............. 133 5 15 162 5 -- 10
New Hampshire...... 21 4 18 7 1
Vermont ............ 71 1 3 1 6 1
Massachusetts...... 212 18 37 80 80 3 -
Rhode Island........ 107 1 3 9 94 30 -
Connecticut........ 211 13 18 713 400 -

MIDDLE ATLANTIC...... 1,470 10 138 184 403 288 1 8 2 51
New York City...... 302 3 26 24 18 17
New York, Up-State. 361 2 50 58 277 194 2 1 48
New Jersey......... 418 4 19 26 43 47 1 4 -
Pennsylvania........ 389 1 43 76 65 30 2 1 3

EAST NORTH CENTRAL... 3,016 4 204 225 683 584 1 11 1 11 14 299
Ohio............... 292 59 62 84 64 2 1 7 159
Indiana........... 516 33 27 93 49 1 1 2 17
Illinois........... 540 1 45 40 93 72 4 1 7 1 68
Michigan........... 1,220 46 69 279 310 1 3 1 2 25
Wisconsin.......... 448 3 21 27 134 89 1 1 2 30

WEST NORTH CENTRAL... 411 3 87 80 135 90 1 6 1 26 37 713
KMnnesota.......... 30 1 19 16 3 14 1 8 212
Iowa................ 268 1 5 4 56 18 2 1 20 257
Missouri........... 6 44 28 18 1 2 1 16 6 116
North Dakota....... 107 8 4 54 56 2 38
South Dakota........ 4 3 1 57
Nebraska........... 5 19 1 20
Kansas.............. .N 1 6 5 1 1 1 1 8 13

SOUTH ATLANTIC....... 769 11 326 254 542 312 1 39 1 18 12 303
Delaware............ 14 4 2 1 6 -
Maryland............ 59 23 40 245 8 2 -
Disc. of Columbia.. 3 9 4 10 2 -
Virginia............ 358 1 36 63 191 113 5 1 4 6 186
West Virginia...... 155 2 22 13 51 1 1 19
North Carolina..... 3 3 56 39 28 19 12 4 3
South Carolina..... 54 2 48 13 34 29 3 1 1
Georgia............ 2 2 44 16 2 3 1 10 4 54
Florida............. 121 1 84 64 31 81 1 15 40

EAST SOUTH CENTRAL... 1,627 4 133 108 875 853 1 14 2 19 9 298
Kentucky............ 240 3 46 24 57 96 2 1 3 42
Tennessee........... 602 45 46 770 665 1 7 12 5 242
Alabama............ 762 1 25 21 2 6 4 3 1 14
Mississippi........ 23 17 17 46 86 1 2 3 -

WEST SOUTH CENTRAL... 1,400 5 131 138 563 499 10 4 37 7 321
Arkansas........... 5 13 8 2 2 2 19 s0
Louisiana.......... 6 4 95 57 1 2 3 1 1 30
Oklahoma........... 24 1 5 27 42 1 1 15 3 51
Texas.............. 1,365 18 46 520 494 5 2 4 160

MOUNTAIN............. 584 2 53 43 1,087 921 1 3 2 18 2 82
Montana............ 87 3 33 40 2 10 -
Idaho............... 34 1 2 3 71 91 -
Wyoming............ 2 3 1 1 13 1 4 -
Colorado........... 97 1 11 11 487 444 4
New Mexico........... 60 21 3 207 186 1 1 39
Arizona............ 163 3 7 125 92 1 39
Utah............... 141 5 12 163 55 1 I 4 -
Nevada............. 8 3 -

PACIFIC............. 2,345 9 294 245 1,129 781 2 13 11 137
Washington......... 398 2 23 18 197 93 1 -
Oregon............. 364 18 15 10 5 1 2
California......... 1,545 7 240 199 892 602 1 11 10 135
Alaska............. 11 6 6 10 30 -
Hawaii............. 27 7 7 20 51 1 1- -


Puerto Rico 152 1 17 41 16 13 31 I 1 11









Morbidity and MIortality Weekly Report





T.ibl 4 (D)) TOTAL D[A'IHS AM()N(, PERSONS 65 YEARS AND OVIR IN RIPORTIN( (IT11S



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


215


Area For weeks ending Area For weeks ending
Area 5/30 6/6 [ / 5/23 5/3 Area6/6T 6/13
5/23 5/30 6/6 6/13 5/23 5/30 6/6 6/13


NEW ENCLAND:
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, III..............
Cincinnati, Ohio...........
Cleveland, Ohio............
Columbus, Ohio.............
Dayton, Ohio...............
Detroit, Flich.............
Evansville, Ind...........
Flint, Mich...............
Fort Wayne, Ind...........
Cary, Ind.................
Grand Rapids, Mich.......
Indianapolis, Ind.........
Madison, Wis..............
Milwaukee, Wis............
Peoria, Ill ...............
Rockford, IIl.............
South Bend, Ind...........
Toledo, Ohio...............
Youngstown, Ohio...........

WEST NORTH CENTRAL:
Des Moines, Iowa.........
Duluth, Minn..............
Kansas City, Kans........
Kansas City, Mo...........
Lincoln, Nebr............
Minneapolis, Ilinn........
Omaha, Nebr...............
St. Louis, Mo.............
St. Paul, Minn...........
Wichita, Kans.............


140
26
19
14
30
16
17
18
25
37
4
28
15
37


18
24
63
21
19
26

46
939
15
275
126
36
57
21
22
27
27
22
23


33
17
373
68
95
75
44
197
19
27
26
22
33
75
16
91
17
15
27
67
35


38
19
25
75
16
69
40
145
27
33


91
28
25
25
26
-5
23
14
20
41
12
32
16
39


30
17
63
28
12
30
33
47
960
15
251
105
29
66
14
17
36
18
26
25


32
18
376
81
107
50
50
191
23
23
22
11
27
76
21
50
14
8
26
68
30


31
18
19
80
17
70
40
137
43
20


168
17
22
27
29
20
19
11
19
34
8
28
14
37


25
26
94
30
11
28
44
42
923
19
280
97
28
65
19
17
38
14
19
20


33
22
325
93
114
58
52
173
28
21
26
15
39
68
14
87
20
17
26
61
44


35
18
14
79
15
69
47
113
36
34


163
33
13
11
21
24
18
17
26
27
7
22
12
35


22
31
83
25
24
30
33
37
919
30
203
93
28
80
12
41
34
16
20
20


26
23
399
92
105
76
42
195
22
19
29
12
44
96
27
67
17
16
25
59
51


34
16
14
67
22
79
55
149
39
37


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..............

MOUNT N:
Albuquerque, N. Mex ......
Colorado Springs, Colo...
Denver, Colo..............
Ogden, Utah ............
Phoenix, Ariz...........
Pueblo, Colo..............
Salt Lake Cit:., Utah.....
Tucson, Ar ...............

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..............

San Juan, P.R..............


44
143
17
47
42
17
44
13
64
27
87
22


52
39
18
70
52
16
13
39


19
12
13
64
10
27
74
21
109
35
51
22
41


9
14
75
14
55
14
35
24


13
27
28
14
38
287
38
19
67
33
36
108
20
76
33
20

(---)


53
115
21
23
48
25
47
13
58
30
:5
17


38
18
18
77
72
18
13
58


17
17
13
49
17
26
78
31
79
34
55
27
26


19
10
55
10
58
5
22
27


8
24
35
23
28
255
42
29
62
36
40
92
20
79
29
27

:---)


OCurrent Week Mortality for 108 Selected Cities

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


36
108
15
21
48
32
36
20
56
33
93
24


41
22
21
40
48
28
10
48


15
16
11
69
17
25
78
28
87
33
50
14
43


9
15
68
4
46
10
15
21


11
24
20
12
48
287
40
21
64
33*
47
113
20
92
38
28

(---)


11,254
355
701
6,166


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

NOTE: All deaths by place o occurence.





UNIVERSITY OF FLORIDA



3 1262 08864 2920


Morbidity and Mortality Weekly Report


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

Thu weickh average number of deaths among persons

65 \ears and over in 108 cities for the four-week period

ending June 13 was 6,177 as compared with an expected

weekly average of 6,4A1.


Summary of Deaths Among Persons 65 Years and Over


Week Ending
4 Week Weekly
5 '23 5 30 6'6 6 '13 Total Average

Observed 6,311 6,131 6,101 6,166 24,709 6,177
Expected 6,517 6,458 6,402 6,349 25,726 6.431

Excess -206 -327 -301 -183 -1,017 -254



OEATI5 AGE 65 ond OVER n I. US. CITIES
oAe. ens, pw oa roF w. S R d.


Off
MIM

AOF .



'3a










r 1























T E MORBIDITY AND MORTALITY WEEKLY REPORT. WITH A CIRCULA-
L ATION OF i000 is PUBLIC SHED BY THE COMMUNICA a LE DISEASE
CENTER ATL ANTA G RG IA

















CHCEF. COMMUNICABL 6 DISEASE CENTER JAMES L. GODDARD. M.D.
-r


















-CHEF EPIDEMIOLOGY RANCH A. D. LANGMUtR, M D.
















CHIEF. STATISTICS SECTION R_ E. SERFLING. PH.D.
ASST. CHI E STATISTICS SECTION 1 L, SHERMAN MS
CHIEF, SURVEILLANCE SECTION D. A. HENDERSON. M.D.
EDITOR M .WR L. K. ALTMAN. M.D.

IN ADDITION TO THE ESTABLISHED PROCEDURES FOR REPORTING
(See Table, page Sf6)

















THE MORBIODIT AND MORTAILITV lWEEKLY REPORT, WITH CIRCULA-



LION OF TY AND PMOlTAIT.ED Y TnE CCOMMUNICA DISEASE CDENTSE




WELCOMES ACCOUNTS OF INTERESTING OUTBREAKS OR CASES. SUCH
ACCOUNTS SHOUL-D 3F ADDRESSED TO:
CLAWRENTNCE K ALTMANTA, OM.D.EDITOR









MORBIDITY AND MOR'ALITY WEEKLY REPORT
CHIEF, COMMUNICABLE DISEASES CENTER JM L DD M
CHIEF, A PIDEMOLO BR IACH LN30UIR.M.
CHIEF, S*TATITICS SECTION p. E. SERFLING. PH.O.
AoTS. CTHE, STAT IONAL DATA ARE BASED ON ERELN EE S
EDITOR MIIDR L. K. ALTMA M. D.





IN A ION TO THE STABLIQUAND PROCEDURE REP N
WELCOME S ACCOUNT O N NTRUC STIN OF ARIOuS BR ORA CLIT. CUES
ACCOUNTS SHOULD BE *ADDREkSSED TO:
LAWRENCEE K. ALTMAW, M.D., EO1TOR
MORBIDOIT AND MORT*ALITY IWHEKLT REPORT



MCOAMN AIN CRO STATITCS SECTION C ONMUNICABL
E T ANTA, -EOR ED AIarEL PE A EGIA
HOlES THEIc PRBVISION*AL DOATA IRIE BASED ON *EE'LT TELE.
limiWS TOr TM COTL KI M CABLE. ODISEASE CENTER 9' '.E 1-O'OLDUAL
TATE HNi*iETN DECAITMENTS.
SYMOLS* -- D ATA NOT AAIA*BLE*
-UANTITYV ZER
PROCEDURE1 FOR CONSTRUCTION OF A(OUS MO R'L C uBES
A* BE OBTAINED FRQPIOM STATIStICS SECTION, COMMUNICaBLE DES-
3 SI CEI.F.' '--RLiC .E*Lr 5EwIcE US DEOANTMENT O0
.EA..' EDUC3',. AN- K ELFAaE ATL~TA GEORGIA 30313


DCUMENT PT







U S DEPOSITORY


21 l


iC
X




A*
=-_.






cru

I .
9!


-"i
' 0



m

0o

915




Full Text
xml version 1.0 encoding UTF-8
REPORT xmlns http:www.fcla.edudlsmddaitss xmlns:xsi http:www.w3.org2001XMLSchema-instance xsi:schemaLocation http:www.fcla.edudlsmddaitssdaitssReport.xsd
INGEST IEID E7UE1WSSG_4L42MS INGEST_TIME 2013-02-07T17:37:21Z PACKAGE AA00010654_00393
AGREEMENT_INFO ACCOUNT UF PROJECT UFDC
FILES