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:
AA00010654:00409

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



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Vol. 14, No. 27






Week Ending
July 10, 1965


U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE .BI H SERVICE


BOTULISM Idaho

Three cases of botulism, possibly related to a
commercially packaged luncheon meat, have been re-
ported from Twin Falls, Idaho. The three patients were
members of a teen-age concert group of 50 persons trav-
elling by chartered bus from the State of Washington
to New York City. The group arrived in Twin Falls on
Tuesday, June 22. One patient developed the illness on
June 24 and the other two became ill on June 25.
All three patients had gastrointestinal discomfort,
diplopia, muscular weakness and flushing of the cheeks.
Two of them experienced dryness of the mouth and also
suffered respiratory difficulty. A listing of the cases
appears at right.


CONTENTS
JUL I 965
Botulism Idaho. .. .
Paralri>w Poliom lI .........
Erratum .. . .


1 16 M Jun a, 52 hra X X X X

(Continued on page ff6)


Table 1. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous weeks)
27th WEEK ENDED CUMULATIVE, FIRST 27 WEEKS
MEDIAN
DISEASE July 10. July 4, 1960- 1964 MEDIAN
1965 1964
1965 1964 1960-1964
Aseptic meningitis ...... .... 32 33 33 756 796 734
Brucellosis ..... ......... *3 7 8 123 200 212
Diphtheria ........ ......... 2 5 5 85 143 222
Encephalitis, primary infectious 31 30 -- 801 973 -
Encephalitis, post-infectious 8 24 424 553 -
Hepatitis, infectious including
serum hepatitis ............... 471 552 552 18,644 22,000 24,185
Measles .................... 2,599 4,680 6,087 229,783 445,950 372,229
Meningococcal infections ...... 42 35 28 2,004 1,634 1,303
Poliomyelitis. Total 4 20 24 48 227
Paralytic ................ 4 14 18 37 162
Nonparalytic *.......**** --- 6 8 -
Unspecified .........*. --- 3
Streptococcal Sore Throat and
Scarlet fever .............* 4,304 3,987 3,424 248,745 255,384 210,661
Tetanus **........... 2 5 --- 119 128 ---
Tularemia ....*..* ....5 11 --- 123 155 -
Typhoid fever .. 5 13 15 192 189 261
Rabies in Animals ** ...... '' 45 81 70 2,503 2,484 2.110

Table 2. NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax: ................................... 6 Rabies in man: ....... ........................ 1
Botulism: Idaho-3 ............................ 11 Smallpox: .. .......... .................. 1
Leptospirosis: ................ ............ 17 Trichinosis: Mich.-l, NY Up.. d,-l, Pa.-1, Calif.-1 .. 65
Malaria: Mass.-l. Conn.-l ..................... 37 Typhus -
Plague: .................................. Murine: D.C.- .................... ....... 14
Psittacosis: .............................. .. 21 Rky. Mt. Spotted: N.J.-2. Kans.-I, Va.-2, N.C,-3 ...... 99
Cholera: ........ ........................ 1 Tenn.-3, W. Va.-1


_~ __ _


I~;ti"
;:";i'


COMMUNICABLE DISEASE CENTER







Morbidity and Mortality Weekly Report


July 10. 1965


BOTULISM Idaho (Continued)


The respiratory weakness experienced by patient 1
was severe enough to require a tank respirator. An
additional tank respirator was sent from another com-
munity for patient 2; however, her condition improved
and the respirator was not required. Routine hematologic
studies and urinalyses were normal in all cases. Serum
anticholinesterase determinations were normal for cases
1 and 2. Botulinps'antitoxin was administered to cases
1 and 2 on Ju/e 26 and June 27. All 3 patients began
to show impreveryent by June 27 and were completely
asymptomatic by June 30 .
During their'visit to Twin Falls, all members of the
concert group lived in a number of private homes. Since
none of the & patients resided in the same house, they
did not consume. any common breakfast' foods. The entire
concert group of 50q~te theire vening meals as a single
group, the food being supplied by various Twin Falls
families. None of the patients ate items of food at these
dinners other than those foods eaten by other members
of the group who did not become ill. Each of the resident
hosts, however, prepared sack lunches for the tour mem-
bers staying in their household.
On Wednesday, June 23, patient 3 shared his sack
lunch with patients 1 and 2. This lunch consisted of
two luncheon meat sandwiches, potato chips, celery,
radishes, bananas and milk. Patient 3, who developed
mild symptoms, ate only one bite of a half-sandwich
and passed it on to patient 2 because it did not "taste
right". The remainder of that half sandwich was consumed
by patient 2, who also noted a peculiar taste. One and
one-half of the sandwiches in the sack were consumed
by patient 3, who developed the most severe illness.
He noted a "mouldy" taste.


Two slices of luncheon meat were in each of the
sandwiches eaten. The two remaining slices from a 6
slice vacuum-sealed package were in a sandwich pre-
pared for another tour member residing in the same
household as patient 3. This member did not eat the
luncheon meat sandwich and did not become ill.
The luncheon meat suspected of being the source
of infection was sold in a vacuum-sealed plastic package
by a supermarket, under its own label. This luncheon
meat is prepared by a major meat-packing corporation.
It consists of scraps of pork, pork heart, pork tongue,
spices and preservatives; it is cooked and canned in
10-Y pound loaves. The cans are then shipped to a local
affiliate in Idaho where the cans are opened under re-
frigeration, the meat sliced and placed in 6-slice vacuum-
sealed packages. The packages are required to be kept
under refrigeration from the time of canning until sold in
the supermarket. Shipment of the package suspected of
contamination was direct from the affiliate plant in Idaho
to the supermarket in Twin Falls. So far as could be
determined, the package suspect in this outbreak was
properly refrigerated at all times.
The exact mode of contamination of the luncheon
meat could not be ascertained. Laboratory studies on
samples of the luncheon meat from other cans and vacuum-
sealed packages in the same consignment as the
suspected package are currently in progress at the
Communicable Disease Center and the Food and Drug
Administration laboratories in Washington, D.C.
(Reported by Dr. John A. Mather, Director of Preventive
Medicine, Idaho Department of Health and Dr. Luther
Thompson, South Central District Health Officer and a
CDC Field Epidemiologist.)


PARALYTIC POLIOMYELITIS 1964


Weekly poliomyelitis case reports are received at
the Communicable Disease Center from state and local
health departments through the National Morbidity
Reporting System. In addition, since 1958 surveillance
forms pertaining to each case have been submitted to the
Poliomyelitis Surveillance Unit, a preliminary form
which supplies basic epidemiologic data, and a follow-up
form which includes information on the extent of residual
paralysis and the results of laboratory studies. The
incidence of cases of poliomyelitis with residual pa-
ralysis at 60 days has been taken as the most reliable
index available to measure the national status of polio-
myelitis. I
During 1964 the final count of 91 paralytic polio-
myelitis cases in the United States was the lowest yet
recorded. This figure is less than one third of the total
reported in 1963, the previous record low year (Figure 1).
The distribution of cases was relatively uniform through-


out 1964 and did not show seasonal increased incidence
in the summer and fail months as in previous years
(Figure 1 and 2, page 227)
Geographically, the cases of paralytic poliomyelitis
during 1964 were scattered. The 91 cases were reported
from 83 counties; no county reported more than 2 cases
during any month (Figure 3, page 230).
In Table I the 91 paralytic cases are classified as
toage and inactivated poliomyelitis vaccine status. There
were 38 cases (42 percent) in the 0-4 age group, and
23 (25 percent) in the 5 to 14 year age groups. As in
preceding years the majority of cases were not adequately
vaccinated. Two thirds of the total had never received
any inactivated poliomyelitis vaccine and only 12.5
percent had received 4 or more doses of inactivated
poliomyelitis vaccine.
Table II classifies the 91 cases by age and oral
poliomyelitis vaccine status. A total of 8 cases occurred
(Continued on page 228)


226






July 10, 1965


Morbidity and Mortality Weekly Report


FIGURE 1


ANNUAL POLIOMYELITIS INCIDENCE RATES
UNITED STATES, 1935-1964


INACTIVATED


TOTAL


ORAL
VACCINE


*PARALYTIC CASES PRIOR TO 1951 ASSUMED TO BE 50% OF TOTAL.
SINCE 1951, CASES REPORTED AS UNSPECIFIED WERE PRORATED
AMONG PARALYTIC AND NONPARALYTIC CASES.
SOURCE Notionol Morbidity Reports
FIGURE 2


PARALYTIC POLIOMYELITIS REPORTED

TO POLIOMYELITIS SURVEILLANCE UNIT

1961-1964: BY DATE OF ONSET


SO I I 1I I I I I I I I I i I IhI I I I I I I I I I I I I I II I I I II I 1
WEEK 4 12 20 28 36 44 52 12 20 28 36 44 52 12 20 28 36 44 52 12 20 28 36 44 52
NUMBER


227


200-


180-


160-


_ 140-
I.

120-
uJ

100-


0. 80-

uj
w
o 60-


1961


1962 1963


1964







Morbidity and Mortality Weekly Report


TABLE I


PARALYTIC


POLIOMYELITIS BY AGE GROUP AND INACTIVATED VACCINATION HISTORY
UNITED STATES, 1964


Age Doses of Inactivated Vaccine Total
Percent Deaths
Group 0 1V 2V 3V 4+V Unk. Cases

0-4 28 1 3 4 1 1 38 41.8 3
5-9 7 1 1 1 5 1 16 17.6 1
10-14 2 0 0 2 3 0 7 7.7 1
15-19 6 0 0 1 1 0 8 8.8 0
20-29 2 1 1 0 0 0 4 4.4 0
30-39 5 0 2 0 0 0 7 7.7 0
40+ 8 0 0 1 1 1 11 12.1 2

TOTAL 58 3 7 9 11 3 91 100.0 7
Percent
Doses 65.9 3.4 8.0 10.2 12.5 100.0



TABLE II

PARALYTIC POLIOMYELITIS BY AGE GROUP AND ORA L VACCINATION STATUS
UNITED STATES, 1964*

Doses of Oral Vaccine
Age Total
Age Monovalent Trivalent Ta
Group Cases
Unvaccinated
1 type only 2 types 3 types 1 dose 2 doses

0-4 29 4 (1) 1 (1) 2 2 (1) 0 38( 3)
5-9 9 1 2 (1) 2 2 0 16 ( 1)
10-14 3 0 0 4 0 0 7( 0)
15-19 4 3 (3) 0 1 (1) 0 0 8( 4)
20-29 3 1(1) 0 0 0 0 4( 1)
30-39 4 0 2 (2) 0 1 (1) 0 7( 3)
40+ 4 1 (1) 1 (1) 2 (2) 3 (3) 0 11 ( 7)

TOTAL 56 (0) 10 (6) 6 (5) 11 (3) 8 (5) 0 91 (19)
*<30 day cases are shown in parenthesis.


among individuals under 15 years of age who had pre-
viously received a primary series of oral poliomyelitis
vaccine, either 3 doses of monovalent vaccine or 2
doses of trivalent vaccine. Of the 8 cases, 6 had received
3 or more doses of inactivated vaccine in addition to
the oral vaccine. From the 6 cases in which virus isolation
was attempted, 2 poliovirus isolates, both type I, were
recovered.
Of the 91 paralytic cases, 19 occurred within 30
days following the administration of oral poliomyelitis
vaccine. Fifteen of these 19 cases were in the 15 year
and older age groups and constitute half of the total of
30 cases which had been reported in individuals of 15
years or older. These vaccine associated cases were


the subject of an inquiry in July, 1964, by a special
committee on oral poliomyelitis vaccine. 2. '
Because of the small number of paralytic cases,
special efforts were made to obtain specimens for virus
isolation and serologic study from all cases. Isolates
were obtained from 51 of 77 fecal specimens examined
for virus. Of these, 24 (47.0 percent) were type III, 21
(41.2 percent) type I, and 6 (11.9 percent) type II (see
Table II). This contrasts with the distribution of isolates
obtained during the period from 1958 to 1963 when type
I isolates accounted for between 60 and 89 percent of the
total each year and type III varied from 10 to 38 percent.
The proportional increase in type III isolates reflects,
in part, the lack of a major type I urban epidemic.


July 10. 1 b5


228








Jul3 10. 1965


Morbidity and Mortality Weekly Report


Table III
FREQUENCY OF POLI()\ AIR'S ISOLATES REt'(\ ERED FROM PARALYTIC ('C\%:E INITEI) STA'I E, 1.s-; I

Numbers of Cases Percent \ irue- Identilfieil Percent of
Residual Specimens of Cases Type Total Specified
Year Paralv-i- Suhmitt-d" Studied I II III Unk I II III


1958 3.;01 1,479 44.8 898 29 194 10 80.1 2.6 17.3
1959 5,472 2,775 50.7 1,881 10 228 23 88.8 0.5 10.8
1960 2,2 1b 1,072 48.3 603 1 219 2 73.3 0.1 26.6
1961 h29 481 58.0 231 6 145 0 60.5 1.6 37.9
1962 691 472 68.3 300 8 100 0 73.7 2.0 24.4
1963 336 242 72.0 160 6 31 0 81.2 3.0 15.7
1964 91 77 84.6 21 6 24 0 41.2 11.8 47.0

*Includes all paralytic cases on which one or more fecal specimens were examined for virus isolation. State and local health department laboratories
and laboratories in academic centers reported these results through State epidemiologists to the Poliomyelitis Surveillance Unit.





Table IV
NATIONAL IMMUNIZATION SURVEY FINDINGS
SEPTEMBER 1962, 1963, AND 1964
POLIOMYELITIS VACCINATION STATUS

Oral Poliovaccine Inactivated Poliovaccine
Age Group Percent Reporting 3 Doses Percent Reporting 3 or More Doses
1962 1963 1964 1962 1963 1964

1-4 5.7 28.7 46.8 72.6 67.7 60.9
5-9 5.7 33.6 56.4 85.8 84.3 80.9
10-14 5.2 34.0 57.7 86.2 85.2 82.6
15-19 4.1 28.2 49.8 79.2 78.8 77.7
20-29 3.7 21.4 38.4 55.0 55.4 54.9
30-39 4.3 23.1 41.9 44.7 43.8 43.5
40-49 3.8 19.8 37.4 23.9 26.3 28.0

1-49 4.6 26.4 46.2 61.3 60.7 59.3


A survey of the poliomyelitis vaccination status of
the U.S. population, conducted by the Bureau of the
Census in September, 1964, reveals that 46 percent
of the population had received 3 or more doses of oral
vaccine and 59 percent had received 3 or more doses of
inactivated vaccine (Table 4). During the past 3 years,
the proportion vaccinated with the oral vaccine has
risen sharply. During the same period of time the pro-
portion of persons who reported having received 3 or
more doses of inactivated poliomyelitis vaccine has
remained essentially stable, although with some decrease
in the youngest age groups. Previous trends in the use
of inactivated vaccine have been documented.4. s
With two immunizing agents available, an estimate


of the population presumably protected against polio-
myelitis would include both those who had received 4 or
more doses of inactivated vaccine and those who received
a primary oral vaccine series. Although a primary oral
vaccine series normally consists of 3 doses of monovalent
vaccine or 2 of the trivalent vaccine, it was possible
during the survey to ascertain the number of doses but
not the specific type of oral vaccine administered. The
proportion of persons "adequately immunized" based on
receipt of 4 or more doses of inactivated vaccine or 3 or
more feedings of oral vaccine is depicted in Figure 4.* A
more detailed cross-classification for those 1-4 and 5-9
years of age is presented in Table 5. Based on the defi-


229


(Continued on back page)


*Figure 4, page 231.








Morbidity and Mortality Weekly Report


FIGURE 3

GEOGRAPHIC DISTRIBUTION OF PARALYTIC POLIOMYELITIS
IN THE UNITED STATES, 1964


O


* REPORTED CASE

SOURCE: CDC POLIOMYELITIS SURVEILLANCE UNIT


TABLE V


NUMBER (in 000's)


OF CHILDREN AGE 1-4 AND 5-9 RECEIVING INACTIVATED AND ORAL POLIOVACCINE
NATIONAL IMMUNIZATION SURVEY 1964


Number of Total Number of OPV Doses
IPV Unknown
Ins Children 3 2 1 0
Inoculations
Age 1-4
4 or more 5,342 2,633 672 332 1,694 11
3 4,759 2,175 646 332 1,604 2
2 1,196 414 223 133 422 4
1 732 245 121 78 281 7
0 4,450 2,264 562 213 1,411 0
Unknown 111 28 3 0 11 69
TOTAL 16,590 7,759 2,227 1,088 5,423 93

4 or more 11,638 6,692 1,650 582 2,699 15
3 4,632 2,643 774 232 965 18
2 844 396 181 87 177 3
1 403 146 81 55 115 6
0 2,355 1,435 276 115 525 4
Unknown 228 18 8 5 6 191
TOTAL 20,100 11,330 2,970 1,076 4,487 287


230


July 10, 1965






FIGURE 4

POLIOMYELITIS IMMUNIZATION STATUS OF CHILDREN 1-4 AND 5-9
UNITED STATES, 1964


AGE 1-4


AGE 5-9


- ADEQUATELY IMMUNIZED: 4+ doses inactivated vaccine and/or 3 doses oral vaccine
D INCOMPLETELY IMMUNIZED: Some polio vaccine but not "adequately" immunized

D NOT IMMUNIZED: No vaccine

Source: 1964 U.S. Immunization survey











232 Morbidity and Mortality Weekly Report



Table 3. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

JULY 10, 1965 AND JULY 4, 1964 (27th 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... 32 33 31 8 24 48 18 37 2 85

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

MIDDLE ATLANTIC...... 7 8 3 1 5 5 4
New York City...... 4 1 1 2
New York, Up-State. 4 2 1 2 2 -
New Jersey......... 2 2 2 2 -
Pennsylvania....... 1 2 2

EAST NORTH CENTRAL... 2 5 4 2 1 7 6 3
Ohio............... I 2 2 1
Indiana............. 2
Illinois ........... I 1 3 1 1 4 4- -
Michigan............. 4 1 1 -
Wisconsn.......... -

EST NORTH CErTRAL... 1 2 1 4 3 4 2 18
Minnesota.......... 2 1 1 1 1 7
Iowa............... I I 1
Mi5 ouri ........... 2 1 1
North Dakota....... -
South Dakota....... 7
Nebraska.............. 3 3 1
Kansas............. 1

SOUTH ATLANTIC....... 1 4 17 12 1 22
Delaware............. -
Maryland........... -
DiEt. of Columbia.. 3
Virg inia........... -
West Virginia...... I -
North Carolina..... 8 4 1
South Carolina..... 1 1
Georgia ............ 1 1 11
Florida............. 3 6 5 6

EAST SOUTH CENTRAL... 6 2 5 4 3 1 13
Kentucky........... 6 3 -
Tennessee.......... 2 -
Alabama............. 2 2 -- 2 1 12
Mississippi........ 2 1

WEST SOUTH CENTRAL... 8 2 1 10 3 8 3 19
Arkansas............ 2
Louisiana........... 1 1 l [ 2
Oklahoma........... I -
Texas............... 6 2 9 2 7 2 15

MOUNTAIN............. 3 1 5 6 3 3 -
Montana............ -
Idaho............... -
Wyoming ............ 2 2 -
Colorado ........... 2 1 1 1 -
Neu Mexico......... 1 3 -
Arizona............. I 4 2 -
Utah ....... ...... -
Nevada............... -

PACIFIC.............. 15 13 3 2 3 2 3 2 5
Washington......... 2 2 -
Oregon.............. 1 1 1 I .- 1
California ......... 11 12 2 2 1 1 1 1 4
Alaska .............. -
Hawaii............... 3 -

Puerto Rico 6








Morbidity and Mortality Weekly Report


Table 3. CASES OF PH (II H) NOTIFIABLE DI~AC.i UNITED STATES

IOR WEEKS FNI)II)

JULY 10,1965 AND JULY 4, 196- (27th WEEK) Continued


Brucel- Infectious Hepatitis Meningococcal
loss including Serum Hepatitis Infections Tetanus
Area Total Under 20 years Cumulative
ncl. unk. 20 years and over Totals Cumulative Culm.
1965 1965 1965 1965 1965 1964 1965 1965 1964 1965 1965

UNITED STATES... 3 471 161 270 18,644 22,000 42 2,004 1,634 2 119

NEW ENGLAND.......... 34 12 19 1,134 2,199 2 99 46 5
Maine.............. 7 3 4 214 725 1 12 5
New Hampshire...... 3 1 104 159 5 1 1
Vermont............ 63 274 2 1 -
Massachusetts...... 14 4 10 436 459 34 19 3
Rhode Island....... 6 2 4 145 120 14 7 -
Connecticut........ 4 2 1 172 462 1 32 13 1

MIDDLE ATLANTIC...... 75 24 51 3,269 4,994 2 266 196 8
New York City...... 21 5 16 622 725 45 27
New York, Up-State. 20 4 16 1,311 2,267 2 69 54 3
New Jersey.......... 12 4 8 599 895 73 69 -
Pennsylvania....... 22 11 11 737 1,107 79 46 5

EAST NORTH CENTRAL... 2 85 37 44 3,602 3,340 3 260 224 11
Ohio................ 15 7 8 1,023 888 1 71 61 1
Indiana............ 10 4 5 304 297 36 34 5
Illinois........... 1 6 2 4 662 576 65 55 3
Michigan........... 47 20 27 1,381 1,341 56 49
Wisconsin........... 1 7 4 232 238 2 32 25 2

WEST NORTH CENTRAL... 16 5 9 1,166 1,219 2 105 97 8
Minnesota........... 113 111 1 21 22 5
Iowa............... 5 2 1 436 175 1 7 6 1
Missouri........... 5 2 3 233 314 47 48 1
North Dakota ..... 17 45 7 10 -
South Dakota ...... 16 105 2 -
Nebraska........... 3 3 41 29 10 5 1
Kansas............. 3 1 2 310 440 11 6 -

SOUTH ATLANTIC...... 1 45 17 24 1,919 2,081 10 397 346 1 33
Delaware........... 59 41 5 6 -
Maryland.......... 9 5 4 365 407 38 23 1
Dist. of Columbia.. 2 1 1 25 33 6 12 -
Virginia............ 1 2 1 452 312 1 47 39 1 7
West Virginia...... 3 3 289 336 23 24 1
North Carolina..... 3 2 1 155 378 5 77 59 3
South Carolina..... 1 1 76 71 1 56 48 3
Georgia............ 1 1 66 48 51 44 4
Florida............. 24 7 14 432 455 3 94 91 14

EAST SOUTH CENTRAL... 32 12 15 1,335 1,528 7 161 143 18
Kentucky........... 13 5 4 457 635 3 66 48 4
Tennessee.......... 9 2 6 477 521 46 47 5
Alabama............ 9 5 4 231 246 30 30 8
Mississippi........ 1 1 170 126 4 19 18 1

WEST SOUTH CENTRAL... 51 19 31 1,600 1,626 3 287 202 21
Arkansas........... 3 2 1 219 173 14 17 4
Louisiana.......... 9 2 7 274 372 2 161 100 3
Oklahoma........... 38 87 17 6 1
Texas.............. 39 15 23 1,069 994 1 95 79 13

MOUNTAIN............. 25 6 5 1,120 1,353 1 61 57 2
Montana.............. 1 82 124 2 -
Idaho.............. 2 159 146 1 8 3 -
Wyoming............ 32 45 4 3 -
Colorado........... 4 2 2 227 371 13 11 1
New Mexico......... 7 2 2 240 193 10 22 -
Arizona............ 8 218 312 16 4 1
Utah ............... 3 2 1 156 121 6 6 -
Nevada............... 6 41 2 8 -

PACIFIC.............. 108 29 72 3,499 3,660 12 368 323 1 13
Washington.......... 7 6 286 423 28 25 -
Oregon............. 3 2 1 286 404 28 18 3
California......... 90 27 63 2,739 2,645 12 292 264 1 10
Alaska............. 7 1 160 115 13 6 -
Hawaii ............ I 1 28 73 7 10 -

Puerto Rico 22 20 2 698 518 1 4 30 18








234 Morbidity and Mortality Weekly Report


Table 3. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

JULY 10, 1965 AND JULY 4, 1964 (27th 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... 2,599 229,783 445,950 4,304 5 123 5 192 45 2,503

NEW ENGLAND........... 103 36,355 15,405 413 3 30
Maine............... 12 2,742 2,633 37 3
New Hampshire...... 1 377 235 39 1
Vermont............... 40 1,188 2,163 18 24
Massachusetts...... 29 19,109 4,698 60 2 -
Rhode Island....... 6 3,870 1,796 41 1 -
Connecticut........ 15 9,069 3,880 218 1

MIDDLE ATLANTIC...... 257 13,405 50,411 252 32 4 100
New York City...... 86 1,957 14,877 7 17 -
New York, up-State. 65 3,690 11,876 215 7 4 92
New Jersey......... 60 2,279 11,852 27 2 -
Pennsylvania....... 46 5,479 11,806 3 6 8

EAST NORTH CENTRAL... 1,100 51,931 99,340 385 9 1 26 6 352
Ohio............... 126 8,632 19,200 28 6 165
Indiana............. 15 1,678 22,209 110 3 9 1 34
Illinois........... 28 2,324 15,931 46 5 1 6 2 70
Michigan........... 438 25,293 27,793 159 3 2 39
Wisconsin.......... 493 14,004 14,207 42 1 2 1 44

WEST NORTH CENTRAL... 109 16,134 29,713 178 2 14 5 15 507
Minnesota.......... 614 305 1 I 4 101
Iowa................ 46 8,921 23,071 18 1 4 149
Missouri........... 25 2,513 1,001 38 2 10 4 1 70
North Dakota....... 38 3,528 4,519 97 3 27
South Dakota....... 109 5 5 1 2 37
Nebraska........... 449 812 29
Kansas............. NNl NN NN 19 2 1 94

SOUTH ATLANTIC........ 252 23,609 37,026 501 27 1 41 4 336
Delaware........... 4 495 375 4 -
Maryland............ 22 1,036 3,357 29 12 3
Dist. of Columbia.. I 64 352 1 -
Virginia........... 27 3,698 12,486 104 5 3 2 249
West Virginia...... 137 13,133 8,180 180 I 13
North Carolina..... 361 1,097 6 5 12 2
South Carolina..... 2 980 4,181 27 3 4 2
Georgia............ 2 598 155 4 14 2 2 32
Florida............. 57 3,244 6,843 150 1 3 35

EAST SOUTH CENTRAL... 103 13,261 66,273 774 15 1 19 10 600
Kentucky............ 52 2,373 18,199 142 3 6 2 58
Tennessee.......... 39 7,575 23,275 553 11 6 7 529
Alabama............ 2,252 18,150 39 -1 1 4 1 10
Mississippi........ 12 1,061 6,649 40 3 3

WEST SOUTH CENTRAL... 240 29,880 70,043 676 1 43 2 30 4 409
Arkansas........... 1 1,080 1,050 1 28 10 55
Louisiana.......... 1 91 93 13 1 5 1 63
Oklahoma............ 1 199 971 1 7 2 1 74
Texas............... 237 28,510 67,929 662 7 2 13 2 217

MOUNTAIN............. 264 18,826 17,157 579 2 12 13 1 47
Montana............ 42 3,583 2,712 12 1 2 3
Idaho............... 34 2,607 1,739 57 -- -
Wyoming............ 4 831 234 3 2 1 -
Colorado............ 81 5,422 2,986 171 2
New Mexico......... 37 652 379 157 -- 8 11
Arizona............ 36 1,146 6,340 94 4 1 30
Utah................ 30 4,393 1,808 78 1 8 1
Nevada............. 192 959 7 -

PACIFIC.............. 171 26,382 60,582 546 3 23 1 122
Washington.......... 10 7,169 19,875 42 2 4
Oregon.............. 14 3,095 7,944 6 3 3
California......... 103 12,456 31,304 471 3 16 1 113
Alaska............. 1 138 1,063 6 1 2
Hawaii.............. 43 3,524 396 21 1

Puerto Rico 63 2,096 5,080 2 3 11









Morbidity and Mortality \ eckly Report






Table 4. DEATHS IN 122 UNITED STATFS CITIES FOR WFEK NDFI) JULY 10. 1965


235


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

Al C ri, umnia Und, r All Cu t., s'n ur...,, II1nil r
A-.. .11 < cea and 1I year
Area All 65 years and 1 year Area All 65 years and I year
over Influenza All Ages and Influenza All
Ages and All Ages CauseAges and oveAll Ages causes
All Ages Causes All Ages ICauses


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.--------


654
209
53
24
30
33
27
19
23
55
67
7
36
33
38

3,077
39
42
146
49
31
35
66
75
1,508
34
530
156
51
98
29
33
63
34
29
29

2,375
65
56
667
127
179
111
84
326
48
39
37
35
56
164
23
111
40
31
18
105
53

727
43
19
46
122
22
125
64
193
51
42


374
103
25
14
22
17
20
12
18
31
43
4
23
18
24

1,751
21
26
79
21
18
15
37
39
867
14
320
81
30
54
19
20
33
18
23
16

1,322
30
35
363
83
86
56
44
185
36
26
24
14
36
80
9
63
23
26
12
63
28

423
28
12
18
66
18
67
45
116
34
19


*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.----------


Total


1,026
101
248
35
55
92
38
75
28
84
71
159
40

483
77
40
24
98
102
39
23
80

860
20
12
17
126
40
59
131
40
197
34
95
41
48

336
30
13
88
9
88
24
44
40

1,243
23
48
25
42
65
286
56
30
i03
50
97
150
39
133
64
32

10,781


5,973


87
9
24
4
4
5
3
7
I
3
3
23
1

40
6
4
1
7
15
1

6

72
2
2
2
8
9
4
8
6
17
1
5
3
5

20
3

4

5
2
3
3

77
1
9
1
6
2
25
2
1
3
3
11
6
1
3
2
1


696


Cumulative Totals
including reported corrections for previous weeks

All Causes, All Ages ------------------------- 342,498
All Causes, Age 65 and over------------------- 194,466
Pneumonia and Influenza, All Ages------------- 14,891
All Causes, Under 1 Year of Age--------------- 20,254


Week No.
27









236


Morbidity and Mortali


PARALYTIC POLIOMYELITIS 1964
(Continued from page 229)


nations above, 63 percent of children 1-4 years of age
have been "adequately immunized" and 81 percent of
children 5-9 years of age. Nine percent of the younger
group and 3 percent of the older are recorded as never
having received poliomyelitis vaccine of any type.

References
1. Poliomyelitis Surveillance Unit, Surveillance of Poliomyelitis in
the United States, 1958-61. Pub. Health Rep. December 1962,
Vol. 77, No. 12, p. 1011.
2. Oral Poliomyelitis Vaccine: Report of Special Advisory Committee
on Oral Poliomyelitis Vaccine to the Surgeon General of the Public
Health Service, July 17-18, 1964, JAMA 190:49 (Oct 5) 1964.
3. Henderson, D.A., Witte, John H., Morris, L. and Langmuir, Alex-
ander D.: Paralytic disease associated with oral polio vaccines.
JAMA 190:49 (Oct 5) 1964.
4. Sirken, M.S.: National participation trends, 1955-61, in the polio-
myelitis vaccination program. Public Health Rep. 77:661-670,
August 1962.
5. Morris, L.: Further analysis of national participation in the in-
activated poliomyelitis program 1955-61. Public Health Rep.
79:469-480, June, 1964.







ERRATUM, Vol. 14, No. 26, P. 217:


Poliomyelitis


The total number of cases of poliomyelitis reported
in the southwestern United States this year is 16 and
not 17. Oklahoma was named in error when in fact the
16 cases reported include 4 in Arizona, one each in
Louisiana, California and New Mexico, and 9 in Texas.


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ity Weekly Report July 10. 1965
UNIVERSITY OF FLORIDA

IIIIl IIIIIIIIIIIIIIIIIIIIIIlIIIIIlllllllllllll ll
3 1262 08864 2136
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. 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.
EDITOR: MMWR D.J.M. MACKENZIE, M.B..
F.R.C.P.E.
IN ADDITION TO THE ESTABLISHED PROCEDURES FOR REPORTING
MORBIDITY AND MORTALITY THE COMMUNICABLE DISEASE CENTER
WELCOMES ACCOUNTS OF INTERESTING OUTBREAKS OR CASES. SUCH
ACCOUNTS SHOULD BE ADDRESSED TO
THE EDITOR
MORBIDITY AND MORTALITY WEEKLY REPORT
COMMUNICABLE DISEASE CENTER
ATLANTA. GEORGIA 30333
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 15 DESCRIBED IN
VOL. 14, NO. 1.


UN1V OF FLUB
DOCUMENTS EBPT.






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