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:
AA00010654:00404

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



CO5 UNICAB DISEASE CENTER
COMMUNICABLE DISEASE CENTER


/
j-


Vol. 14, No. 24







Week Ending
June 19, 1965


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


EPIDEMIOLOGIC NOTES


POLIOMYELITIS


A total of 3 cases of poliomyeliti-, including 2 with
paralysis, have been reported for the week ended June 19,
1965. The cumulative total for the first 24 weeks of 1965
is 19 cases, 15 of which are paralytic. In 1964, a total of
36 cases (29 paralytic) was reported for a similar period.
The numbers of reported cases for 1965 and the previous
4 years are shown in the table at right. A steady decline
in incidence continues to be noted.


CO \%7F\ r I
Measles Current Trends . 2
Influenza Immunization and Control 1 -6
Advisory Committee Recommendation

Poliomyelitis (Cumulated Weekly) Throug"
24th Week, 1961-1965

1965 1964 1963 1962 1961

Paralytic 15 29 59 135 138
Total 19 36 68 175 203


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 WEEKS
MEDIAN
DISEASE JUNE 19. JUNE 13, 1960-1964 MEDIAN
1965 1964
1965 1964 1960-1964
Aseptic meningitis ...... .... 37 39 36 656 693 642
Brucellosis ............... 6 7 10 111 178 183
Diphtheria ................ 1 12 7 80 134 204
Encephalitis, primary infectious 25 53 --- 710 850 ---
Encephalitis, post-infectious 16 28 --- 385 475 ---
Hepatitis, infectious including
serum hepatitis .......... 548 646 660 17,129 20,273 22,343
Measles ......... ........ 6,268 12,377 13,202 220,165 422,640 346,559
Meningococcal infections ...... 47 49 38 1,868 1,505 1,177
Poliomyelitis, Total ..... 3 1 7 19 36 175
Paralytic ..... .. 2 1 5 15 29 135
Nonparalytic **. ********* .1 --- 4 6 --
Unspecified ...*** ***... --- 1 -

Streptococcal Sore Throat and
Scarlet fever ............. 6,142 6,675 4,794 234,838 240,727 200,591
Tetanus *....************ 9 8 -- 102 109 ---
Tularemia .... * 11 12 --- 111 131-
Typhoid fever * 15 9 9 176 160 218
Rabies in Animals *'***.'.* 68 95 70 2,320 2,224 1,938

Table 2. NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax: .................................... 6 Rabies in Man: ........................... .... 1
Botulism: .................................. 8 Smallpox: .................................... 1
Leptospirosis: Md.-1, Ga.-1 .......... .......... 17 Trichinosis: NY Up-State-1, Mich.-l, Pa.-l .......... 56
Malaria: Calif.-2 ........................... 31 Typhus -
Plague: ................................. Murine: ................................ 8
Psittacosis: Md.-1, Texas-1 ...... .. ........... 18 Rky. Mt. Slotted: NY Up-State-1, N.J.-3, Md.-1, ... 48
Cholera: ..... t ........................... 1 Pa.-2, Ark.-1, Va.-3, Ohio-2, Ky.-1, Tenn.-1








Morbidity and Mortality Weekly Report




REPORTED CASES OF MEASLES BY FOUR-WEEK PERIODS


UNITED


1961


STATES, 1960-1965


1962


1963


Source: National Morbidity Reports




MEASLES CURRENT TRENDS


A total of 6,268 cases of measles was reported for
the week ended June 19. Thus far in 1965 there have been
220,165 cases, fewer than were reported during compar-
able periods in any of the preceding 5 years (See figure).
The seasonal decrease which began during the week
ended May 15 is continuing.
This year New England is the only area with a sub-
stantial increase in measles compared with last year. In


the Middle Atlantic, East North Central, East South Cen-
tral and Pacific States, reported measles is at the lowest
ebb in 5 years. Each of the other geographic divisions
(See table) has reported considerably fewer cases this
year than during recent years of peak incidence. Whether
or not the overall decrease in the number of reported cases
is related to the use of measles vaccines cannot be
determined at this time.


REPORTED CASES OF MEASLES BY GEOGRAPHIC DIVISION, WEEKS 1-26, 1960-65

Geographic Division 1960 1961 1962 1963 1964 1965*

New England .......................... 37,105 34,349 53,665 13,174 15,129 35,644
Middle Atlantic ........................ 50,669 72,818 80,680 36,525 49,622 12,280
East North Central ..................... 111,153 99,864 57,964 141,255 98,383 48,405
West North Central ..................... 7,756 12,919 14,804 19,249 29,383 15,894
South Atlantic ......................... 18,316 37,522 26,193 30,035 36,730 22,559
East South Central ..................... 29,954 26,360 33,676 16,707 65,829 12,832
West South Central ..................... 49,580 14,419 67,471 19,329 69,629 29,110
Mountain................................ 19,867 15,640 24,079 26,131 16,818 17,890
Pacific ............................... 46,611 45,782 57,891 32,821 59,747 25,551

Total ............................ 371,011 359,673 416,423 335,226 441,270 220,165

*Preliminary figures through week 24.


202


100,000


80,000


60,000


40,000


1960


1966









Morbidity ani Mortality Weekly Report


RECOMMENDATIONS FOR INFLUENZA IMMUNIZATION AND CONTROL IN THE CIVILIAN POPULATION- 1965-66


The Public Health Service Advisory Committee on
Immunization Practices met on June 11, I4.ii:, and issued
the following recommendations regarding influenza immu-
nization and control in the civilian population.

1. Influenza Prospectus 1965-66 United States
Influenza was confirmed in a majority of States in
the eastern two-thirds of the country during the 1964-65
season. Although widespread in some areas, the level of
involvement was generally low and excess pneumonia-
influenza mortality was only modestly elevated. Most
States in the Far \%e-t were unaffected.
Numerous strains of Type A2 virus were isolated
and subsequently characterized as showing a drift in anti-
genic constitution from previous -, viruses. There was,
however, no major antigenic change. A few strains of Type
B influenza virus were recovered from discrete outbreaks
recognized in the West.
Based on available morbidity and mortality data the
1964-65 influenza experience in the United States was
limited. The last major epidemic of Type A illness oc-
curred in 1962-63 and on the 1\est Coast in 1963-64. In
view of influenza's two to three year periodicity, increased
amounts of influenza may be expected in the coming sea-
son. Areas that were most involved in 1964-65 might expect
a lesser amount of disease in 1965-66.
Although Type A viruses may predominate in 1965-66,
the presence of Type B influenza in the U.S. and its prev-
alence in Europe in 1964-65, increases the expectation of
Type B outbreaks in 1965-66 in the U.S.
2. Vaccine Efficacy
Influenza vaccine has consistently shown a substan-
tial protective value when the viruses incorporated in the
vaccine were antigenically similar to those causing the
epidemic disease. Exceptions to the vaccines' apparent
effectiveness have occurred in instances when the prev-
alent virus underwent a major antigenic shift after vaccines
had been formulated. Careful study goes into the annual
design and updating of the composition of influenza vac-
cines. The final selection of components reflects the best
judgement regarding a potent, contemporary vaccine.
That influenza vaccine prevents mortality from in-
fluenza, particularly among the aged and chronically ill,
is based upon inference. It is presumed that vaccine pro-
tection demonstrated in studies among younger persons is
similar among the aged and chronically ill, the group at
particular risk of death should they acquire the disease.
It is further assumed that such protection against clinical
disease serves to protect them also against mortality as-
sociated with epidemic influenza.
3. High Risk Groups
Annual immunization is generally recommended for
for persons in groups who experience high mortality from
epidemic influenza. Such groups include:


(a) Persons at all age.- who 'ufllir from chronic de-
bilitating disease, e.g., chronic and curdih ni-, i.
lar, pulmonary, renal or metabolic dia-ordtr-, in
particular:
1. Patients with rheumatic heart dile:is espe-
cially those with mitral stenosis.
2. Patients with other cardiovascular disorders
such as arteriosclerotic heart disease and hy-
pertension, especially those with evidence of
frank or incipient cardiac insufficiency.
3. Patients with chronic bronchopulmonary dis-
ease, for example, chronic asthma, chronic
bronchitis, bronchiectasis, pulmonary. fibrosis,
pulmonary emphvyema, pulmonary tuberculosis.
4. Patients with diabetes mellitus and Addison's
disease.
(b) Persons in older age groups. During three suc-
cessive recent epidemics a moderate increase in
mortality has been demonstrated among persons
over 45 years and a marked increase among those
over 65 years of age.
(c) Pregnant women It is to be noted that some in-
creased mortality was observed among pregnant
women during the 1957-58 influenza A2 epidemic
both in this country and abroad. It has not, how-
ever, been demonstrated in subsequent years.
(d) Patients residing in Nursing Homes, Chronic Dis-
ease Hospitals, and other such environments
should be considered at particular risk since their
more crowded living arrangements may allow for
greater spread of disease once an outbreak has
been established.
4. Time of Vaccination
Vaccination should begin as soon as practicable after
September 1 and ideally should be completed by mid-
December. It is important that immunization be carried out
before influenza occurs in the immediate area since there
is a two week interval before the development of anti-
bodies.
5. Vaccine Composition
Recent isolates of the Type A viruses demonstrate a
continued alteration in antigenic structure. Accordingly,
it will be noted that a more recent strain of influenza A2
has been added. The antigenic composition of the vaccine
for the 1965-66 season is as follows:

Type Strain CCA Units per ml.
A PR8 100
A, Ann Arbor/1/57 100
A2 Japan/170/62 100
A2 Taiwan/1/64 100
B Maryland/1/59 200
600

(Continued on page 208)


203;











204 Morbidity and Mortality Weekly Report


Table 3. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

JUNE 19, 1965 AND JUNE 13, 1964 (24th WEEK)


SEncephalitis 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... 37 39 25 16 3 19 36 2 15 29 1 80

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

MIDDLE ATLANTIC...... 7 6 7 4 1 5 5 4
New York City...... 2 2 2 1 1 1 2
New York, Up-State. 2 3 2 2 2 -
New Jersey......... 2 1 4 2 2 -
Pennsylvania....... 1 1 2 2

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

WEST NORTH CENTRAL... 2 2 4 2 4 1 18
Minnesota.......... 1 2 I 1 7
Iowa....;.......... I
Missouri........... 2 1 1
North Dakota....... -
South Dakota....... 7
Nebraska............ 1 3 3 1
Kansas.............. I

SOUTH ATLANTIC....... 1 1 9 14 10 18
Delaware........... 1 -
Maryland........... 1 1 1- -
Dist. of Columbia.. 3
Virginia........... 1 5 -
West Virginia...... 1 -
North Carolina..... 1 1 7 3 1
South Carolina..... -
Georgia............ 1 1 8
Florida............. 1 4 4 6

EAST SOUTH CENTRAL... 2 3 2 1 12
Kentucky........... 2 -
Tennessee........... -
Alabama............ 2 2 1 11
Mississippi.......... 1

WEST SOUTH CENTRAL... 7 6 1 2 4 2 4 2 19
Arkansas............. 1 2
Louisiana........... 1 1 1 2
Oklahoma.............. 2 1 1- -
Texas............... 6 4 1 3 1 3 1 15

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

PACIFIC.............,.... 17 14 3 5 2 5 2 2 5 2 5
Washington......... 2 2 2 3 2 3 -
Oregon............. 1 1 1 1 1
California......... 15 12 3 5 1 1 1 1 4
Alaska............. .
Hawaii............. -

Puerto Rico -











Morhidity and Mortality Weekly Report 205t


Tabcl 3. ( A4-. OF SPECIFIED N01 IHABI I DISEASES: UNI II1) STATES

H)R VX Ik K NI)DFI)

JUNE 19, 1965 AND JUNF 13, 1964 (24th WI' 'K) Continued


Brucel- Infectious Hepatitis Meningococcal
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... 6 548 269 248 17,129 20,273 47 1,868 1,505 9 102

NEW ENGLAND.......... 28 15 10 1,031 2,095 2 94 40 5
Maine.............. 2 1 1 199 707 1 10 5 -
New Hampshire..... 5 4 99 148 5 1
Vermont............ 45 259 2 1 -
Massachusetts...... 15 10 5 398 427 1 32 18 3
Rhode Island....... 2 1 132 112 14 3 -
Connecticut........ 4 3 158 442 31 13 1

MIDDLE ATLANTIC ...... 106 48 58 2,969 4,599 5 250 176 1 7
New York City...... 23 8 15 556 674 43 26 -
New York, Up-State. 29 13 16 1,210 2,056 64 50 2
New Jersey......... 30 14 16 548 830 1 70 57 -
Pennsylvania....... 24 13 11 655 1,039 4 73 43 1 5

EAST NORTH CENTRAL... 100 55 40 3,327 3,090 5 237 204 1 9
Ohio................ 23 11 10 950 807 1 63 58 1
Indiana............ 13 8 5 281 269 1 34 33 1 5
Illinois........... 1 7 3 4 631 534 61 46 1
Michigan........... 49 30 19 1,252 1,252 3 51 46 -
Wisconsin.......... 8 3 2 213 228 28 21 2

WEST NORTH CENTRAL... 1 23 15 6 1,109 1,143 3 101 87 2 6
Minnesota.......... 1 11 9 2 111 104 19 19 2 4
Iowa............... 4 1 2 419 166 5 5 1
Missouri............ 6 4 1 219 286 1 47 44 1
North Dakota....... 15 42 2 7 8 -
South Dakota....... 16 104 2 -
Nebraska............ 33 25 10 5 -
Kansas............. 2 1 1 296 416 11 6 -

SOUTH ATLANTIC....... 2 70 30 36 1,759 1,901 9 365 327 2 28
Delaware............ 57 41 4 4 -
Maryland............ 8 3 5 330 361 1 36 23 1
Dist. of Columbia.. 21 31 5 10 -
Virginia........... 2 16 8 5 429 281 3 45 36 5
West Virginia...... 13 3 10 268 318 23 22 1
North Carolina..... 9 6 3 148 353 3 68 56 2
South Carolina..... 5 3 1 67 69 52 48 1 3
Georgia............. 60 42 45 44 3
Florida............ 19 7 12 379 405 2 87 84 1 13

EAST SOUTH CENTRAL... 28 16 12 1,245 1,385 9 144 135 1 15
Kentucky............ 11 8 3 431 589 3 61 48 1 3
Tennessee.......... 6 3 3 448 478 2 45 45 5
Alabama............ 9 4 5 205 199 4 27 25 6
Mississippi........ 2 1 1 161 119 11 17 1

WEST SOUTH CENTRAL... 2 49 26 23 1,471 1,481 4 274 189 2 19
Arkansas............ 4 1 3 207 161 13 13 4
Louisiana.......... 6 1 5 252 324 2 153 95 2
Oklahoma............ 1 3 2 1 37 82 17 5 1 1
Texas............... 1 36 22 14 975 914 2 91 76 1 12

MOUNTAIN............. 25 5 4 1,033 1,272 1 60 53 2
Montana............ 3 1 77 114 1 2 -
Idaho.............. 156 137 7 2 -
Wyoming.............. 31 42 4 3 -
Colorado........... 7 2 4 203 345 13 11 1
New Mexico......... 3 2 219 185 10 21 -
Arizona............. 2 197 293 16 3 1
Utah............... 10 145 115 6 5 -
Nevada.............. 5 41 2 8 -

PACIFIC.............. 119 59 59 3,185 3,307 9 343 294 11
Washington......... 4 4 269 366 1 26 23 *
Oregon............. 9 4 4 262 367 27 18 2
California......... 97 50 47 2,483 2,402 7 271 240 9
Alaska............. 2 2 146 110 1 12 6 -
Hawaii............. 7 1 6 25 62 7 7 -

Puerto Rico 26 20 6 608 452 3 26 1 18











206 Morbidity and Mortality Weekly Report


Table 3. CASES OF SPECIFIED NOTIFIABLE DISEASES; UNITED STATES

FOR WEEKS ENDED

JUNE 19, 1965 AND JUNE 13, 1964 (24th 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... 6,268 220,165 422,640 6,142 11 111 15 176 68 2,320

NEW ENGLAND........... 434 35,644 14,073 796 1 2 26
Maine............... 51 2,668 2,451 97 3
New Hampshire...... 3 373 222 5 -
Vermont............ 36 1,061 2,069 13 21
Massachusetts...... 146 18,864 4,109 96 1 1
Rhode Island....... 39 3,801 1,563 37 1 1 -
Connecticut........ 159 8,877 3,659 548 1

MIDDLE ATLANTIC...... 671 12,280 47,641 335 3 31 4 92
New York City...... 149 1,594 14,094 8 2 17 -
New York, Up-State. 178 3,359 10,749 234 6 4 84
New Jersey......... 106 2,041 11,226 50 2 -
Pennsylvania....... 238 5,286 11,572 43 1 6 8

EAST NORTH CENTRAL... 2,155 48,405 92,992 611 8 2 24 9 330
Ohio................ 203 8,363 17,812 91 6 165
Indiana............. 94 1,602 20,958 68 2 1 8 2 28
Illinois........... 48 2,194 15,491 116 5 1 5 5 66
Michigan............ 876 24,087 25,611 242 3 1 31
Wisconsin.......... 934 12,159 13,120 94 1 2 1 40

WEST NORTH CENTRAL... 474 15,894 27,995 174 2 12 4 14 451
Minnesota........... 6 596 296 1 2 89
Iowa............... 358 8,837 21,793 56 1 1 131
Missouri........... 61 2,465 828 2 2 8 3 1 62
North Dakota....... 45 3,441 4,267 64 1 23
South Dakota...... 4 108 3 6 1 2 33
Nebraska........... 447 808 -- 25
Kansas............. NN NN NN 46 2 7 88

SOUTH ATLANTIC....... 591 22,559 35,785 626 25 3 39 7 318
Delaware........... 13 481 351 39 1 4 -
Maryland........... 25 957 3,282 119 2 12 3
Dist. of Columbia.. 1 55 349 8 -
Virginia........... 97 3,570 12,118 138 4 4 2 241
West Virginia...... 383 12,628 7,841 179 1 1 11
North Carolina..... 6 301 1;069 8 4 10 2
South Carolina..... 10 957 4,082 42 3 4 2
Georgia............. 2 587 154 8 14 2 1 27
Florida............. 54 3,023 6,539 85 2 3 32

EAST SOUTH CENTRAL... 257 12,832 63,709 792 1 15 2 18 5 571
Kentucky........... 36 2,287 17,735 10 3 6 2 52
Tennessee........... 185 7,337 22,024 710 1 11 2 6 2 508
Alabama............ 24 2,175 17,359 30 1 3 1 8
Mississippi........ 12 1,033 6,591 42 3 3

WEST SOUTH CENTRAL... 422 29,110 67,861 610 7 39 1 25 21 383
Arkansas.......... 20 1,074 1,035 1 5 24 1 9 3 53
Louisiana .......... 8 85 88 1 3 3 62
Oklahoma........... 2 169 913 5 1 7 2 2 69
Texas.............. 392 27,782 65,825 604 1 7 11 13 199

MOUNTAIN............. 572 17,890 16,011 1,101 10 13 1 42
Montana............ 72 3,409 2,510 8 2 3
Idaho.............. 88 2,447 1,632 74 -
Wyoming............ 15 820 230 3 1 1 -
Colorado........... 228 5,096 2,754 565 2
New Mexico.... .... 21 599 331 169 8 1 9
Arizona............ 39 1,029 6,030 71 4 27
Utah................ 109 4,300 1,573 211 7 1
Nevada............. 190 951 -

PACIFIC.............. 692 25,551 56,573 1,097 1 2 3 20 7 107
Washington......... 74 7,116 19,475 106 2 -
Oregon............. 40 2,981 6,962 6 3 2
California.....,... 307 12,044 28,743 739 1 2 3 14 7 103
Alaska............. 3 131 1,051 50 2
Hawaii ............. 268 3.279 342 196 1

Puerto Rico 148 1,894 4,675 23 3 10











Morbidity and Mortality Weekly Report






Table 4. DEATHS IN 122 UNITED STATES CITIES FOR WEEK FUNDED JUNE 19, 1965

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


207


All Causes Pneumonia Under All Causes Pneumonia Under
Area All 65 years and 1 year Area All 65 years anfd 1 year
Ages and over Influensa All Ages and over Inflenza All
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.--------


718
221
51
28
37
45
25
24
30
55
53
12
53
25
59

3,014
45
31
164
36
23
44
64
85
1,508
33
413
181
42
120
24
34
53
49
25
40

2,435
57
38
675
161
188
90
97
322
32
49
42
44
50
158
31
135
40
29
43
93
61

781
68
26
40
132
16
103
54
224
64
54


424
128
33
21
20
26
14
20
23
21
30
7
34
13
34

1,651
21
20
93
22
15
25
36
33
824
18
207
96
25
76
17
19
31
30
16
27

1,315
35
23
336
100
104
46
47
158
22
29
20
28
34
82
16
84
23
16
24
52
36

443
43
20
24
78
7
51
23
125
44
28


*Estimate based on average percent of divisional total.


SOUTH ATLANTIC:
Atlanta, Ga.-----------
Baltimore, Md.---------
Charlotte, N. C.-------
Jacksonville, Fla.-----
Miami, Fla.------------
Norfolk, Va.----------
Richmond, Va.----------
Savannah, Ga.---------
St. Petersburg, Fla.--
Tampa, Fla.------------
Washington, D. C.----
Wilmington, Del.-------

EAST SOUTH CENTRAL:
Birmingham, Ala.------
Chattanooga, Tenn.-----
Knoxville, Tenn.------
Louisville, Ky.*------
Memphis, Tenn.---------
Mobile, Ala.----------
Montgomery, Ala.-------
Nashville, Tenn.-------

WEST SOUTH CENTRAL:
Austin, Tex.*----------
Baton Rouge, La.------
Corpus Christi, Tex.--
Dallas, Tex.------------
El Paso, Tex.----------
Fort Worth, Tex.------
Houston, Tex.---------
Little Rock, Ark.------
New Orleans, La.-------
Oklahoma City, Okla.---
San Antonio, Tex.------
Shreveport, La.--------
Tulsa, Okla.-----------

MOUNTAIN:
Albuquerque, N. Mex.---
Colorado Springs, Colo.
Denver, Colo.----------
Ogden, Utah------------
Phoenix, Ariz.---------
Pueblo, Colo.----------
Salt Lake City, Utah---
Tucson, Ariz.---------

PACIFIC:
Berkeley, Calif.-------
Fresno, Calif.---------
Glendale, Calif.-------
Honolulu, Hawaii-------
Long Beach, Calif.----
Los Angeles, Calif.----
Oakland, Calif.--------
Pasadena, Calif.-------
Portland, Oreg.--------
Sacramento, Calif.-----
San Diego, Calif.------
San Francisco, Calif.--
San Jose, Calif.-------
Seattle, Wash.---------
Spokane, Wash.---------
Tacoma, Wash.----------


1,072
109
241
47
88
54
49
84
27
68
79
188
38

567
81
50
40
112
104
42
35
103

1,080
37
27
20
153
35
71
196
58
170
93
101
67
52

334
28
16
91
12
76
19
49
43

1,426
14
50
39
42
62
462
46
38
114
86
73
164
27
120
57
32


Total 11,427 6,201 379 744

Cumulative Totals
including reported corrections for previous weeks

All Causes, All Ages ------------------------- 307,840
All Causes, Age 65 and over------------------- 174,984
Pneumonia and Influenza, All Age------------- 13,710
All Causes, Under 1 Year of Age-------------- 18,086


Week No.
24


'





UNIVERSITY OF FLORIDA

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3 1262 08864 2110


Morbidity and Mortality Weekly Report


INFLUENZA (Continued from page 203)


6. Dose and Schedule of Vaccination
(a) Primary Series Individuals not vaccinated since
July 1963 when the last major change in vaccine
formulation was made should receive an initial
subcutaneous dose of polyvalent vaccine followed
by a second dose two months later. It is to be
pointed out, however, that even a single dose can
afford significant protection. A second dose given
as early as two weeks following the first will
enhance the protection.

Summary:
Adults and children over 12 years
1.0 ml. dose subcutaneously on two occasions
as specified above


Children 6 to 12 years*
0.5 ml. dose subcutaneously on two occasions
as specified above


Children 3 months to 5 years*
0.1 0.2 ml. of vaccine given subcutaneously
on two occasions separated by one to two
weeks followed by a third dose of 0.1 0.2 ml.
about two months later.

(b) Revaccination Individuals vaccinated since July
1963 need receive but a single booster of vaccine
at the dose level specified for the primary series.
For those in the older age groups who have pre-
viously experienced undue reactions to influenza
vaccine, a revaccination dose of 0.1 ml. given by
careful intracutaneous injection can be expected
to give an antibody response which is somewhat
comparable to that induced by the 1.0 ml. subcuta-
neous dose. The intracutaneous route is not rec-
ommended, however, for use in other than these
special cases.
(c) Contraindication Since the vaccine viruses are
produced in eggs, the vaccine should notbe admin-
istered to those who are hypersensitive to eggs or
egg products.

















*Since.febrile reactions in this age group are common follow-
ing influenza vaccination, an antipyretic may be indicated.


THE MORBIDITY AND MORTALITY WEEKLY REPORT. WITH A CIRCULA-
TION OF 13000 IS PUBLISHED BY THE COMMUNICABLE DISEASE
CENTER ATLANTA. GEORGIA 30333.
CHIEF COMMUNICABLE DISEASE CENTER JAMES L. GODDARD. M.D.
CHIEF. EPIDEMIOLOGY BRANCH A. 0. 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
ELCOME-S ACCOUNTS OF INTERESTING OUTBREAKS OR CASES. SUCH
ACCOUNTS SHOULD BE ADDRESSED TO
THE EDITOR
MORBIDITY AND MORTALITY WEEKLY REPORT
COMMUNICABLE DISEASE CENTER
ATLANTA. GEORGIA 30333
NOTE THESE PROVISIONAL DATA ARE BASED ON WEEKLY TELE-
GRAMS TO THE CDC BY THE INDIVIDUAL STATE HEALTH DEPART-
MENTS. THE REPORTING WEEK CONCLUDES ON SATURDAY; COMPILED
DATA ON A NATIONAL BASIS ARE RELEASED ON THE SUCCEEDING
FRIDAY.
SYMBOLS---DATA NOT AVAILABLE
QUANTITY ZERO
THE CONSTRUCTION OF THE MORTALITY CURVES IS DESCRIBED IN
VOL. 14. NO. I.


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