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:
AA00010654:00417

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




Morbidity and Mortality



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

PUBLIC HEALTH SERVICE


-el


Prepared by the


I CMlMUIA* ISEASE I


For release December 4, 1964 ATLANTA, GEORGIA 30333 Vol. 13, No. 48
PROVISIONAL INFORMATION ON SELECTED NOTIFIABLE DISEASES IN THE UNITED STATES AND ON
DEATHS IN SELECTED (.ITIIS FOR NOVEMBER 28, 1964

DIPHTHERIA EPIDE Q 8 OTE .
Two hundred and forty-nine cases of diphtheria/ R.o ,E.,A IN THE UNITED STATES, 1920-1963
been reported in the United States thus far in 1964. here 2r0 \
were 251 cases during a comparable period in 1963 C I. 7,X
During all of 1963, 314 cases of diphtheria w e re /W.'
ported in the United States. This number is the lo est
recorded for any year and is a continuation of the dec e--
in cases since the 1921 peak of 207,000. During this
interval, the case rate has fallen from 201.4 per 100,000
to 0.17. There were 45 deaths due to diphtheria recorded
during 1963. (See fig. 1.) 0 1.- *oDur
Despite this tremendous decrease in incidence, and o I '
the introduction of antitoxin and antibiotics, the case- OF\ v."ro
fatality ratio has remained relatively constant. Since o4
1921, it has varied between 6 and 11 percent. However,
in 1963, the case-fatality ratio increased to 14.3 percent 0
resulting in the highest diphtheria case-fatality ratio ever 1920 190 1940 ER 1950 19 970
recorded as shown in figure 2. (See fig. 1 opposite and SourweNotiOnI MorbidtyReipots
fig. 2 on page 422.) (Please continue to page 422)

Table 1. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous weeks)
48th Week Ended Cumulative, First 48 Weeks
Disease November 28, November 30, Median Median
1964 1963 1959 1963 1964 1963 1959 1963
Aseptic meningitis ................ 39 27 --- 2,001 1,706 ---
Brucellosis ....................... 7 3 8 372 337 545
Diphtheria ........................ 2 5 13 249 251 527
Encephalitis, primary infectious.. 43 --- 3,028 I 4---
Encephalitis, post-infectious ..... 7 --- 748 ---
Hepatitis, infectious including
serum hepatitis ................ 554 557 912 34,959 39,642 39,642
Measles ........................... 2,272 2,327 3,582 448,373 373,642 405,590
Meningococcal infections .......... 41 26 37 2,496 2,165 2,030
Poliomyelitis, Total ............. 1 5 22 112 417 1,280
Paralytic ..................... 1 5 20 88 358 835
Nonparalytic ................... ---- 12 42 ---
Unspecified ................... --- 12 17 ---
Streptococcal Sore Throat and
Scarlet fever .................. 6,327 5,571 --- 360,736 309,615 ---
Tetanus .......................... 3 5 --- 253 261 ---
Tularemia ......................... 4 5 --- 304 269 ---
Typhoid fever ..................... 5 8 11 415 499 769
Rabies in Animals ................. 98 41 52 4,158 3,477 3,365
Table 2. NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax: 4 Psittacosis: 42
Botulism: 15 Rabies in Man: 1
Leptospirosis: 99 Smallpox:
Malaria: 90 Typhus-
Plague: Murine: 23
_Rky Mt. Spotted: Md. 1, La. 1 220


633-3311






Morbidity and Mortality Weekly Report


DIPHTHERIA (Continued from front page)
Diphtheria occurs more frequently in the South; and
in 1963, 56 percent of all cases were reported from the 16
Southern States as compared to 39 percent in the North-
east and North Central States and 5 percent in the Western
States.
An analysis of individual case reports to the CDC
Diphtheria Surveillance Unit shows that diphtheria re-
mains primarily a disease of children although adult
cases have increased from 18 to 26 percent of the national
total during the last 5 years. Since 1959, the attack rate
for nonwhites has remained 6 times greater than that in
the white population. In 1963, the case rate for whites
was 0.10 per 100,000; for nonwhites it was 0.67 per
100,000.
From reports received by the Diphtheria Surveillance
Unit, it is clear that the vaccine affords a high degree
of protection not only against acquisition of the disease
but also serves to protect against its serious complica-
tions. Death rarely occurs among adequately immunized
individuals or among those who have received a full
course of protection. (See fig. 3 below.)
Three recent outbreaks in California, Minnesota, and
New Mexico are described this week.


Figure 2,
DIPHTHERIA-REPORTED CASE, DEATH AND CASE FATALITY RATES
UNITED STATES, 1920-1963


"OE USE
OF T-OID
\ I


9200 90 1940 9 190 9 1970
YEAR
SOURCE Notional Morbidity Rports


Figure 3.

DIPHTHERIA DEATHS, NON-FATAL CASES, AND CARRIERS
BY IMMUNIZATION STATUS

UNITED STATES, 1963


IMMUNIZATION
STATUS*
FULLY
0 LAPSED
0 INADEQUATE
O NONE
TOTAL
UNKNOWN STATUS


NO. DEATHS % NO. NON-FATAL CASES N. CAR
0 0 25 II 45
2 6 38 16 13
5 14 29 12 8
28 80 141 61 43


L 35
S 4


100 233
23


RIERS %
41
12
7
39


100 109
32


TOTAL REPORTED 39 256 141



Sources Diphtheria Surveillance Unit


*The criteria used in defining immunization status is as
follows:

Fully vaccinated A completed primary series (3 or
more injections) or completed primary series plus booster,
obtained within 4 years of case onset.
Lapsed A completed primary series, or a completed


primary series plus booster,obtained more than 4 years prior to
case onset.
Inadequate An uncompleted primary series, one or 2
immunizations involving diphtheria toxoid, at any time in
the past.
Unimmunized At no time prior to onset, had the patient
received diphtheria toxoid.


422







Morbidity and Mortality Weekly Report


DIPHTHERIA Minnesota


EPIDEMIOLOGIC REPORTS


During October an outbreak of 6 cases of diphtheria
occurred in a low income area in Minneapolis. Five cases
occurred among pupils in an elementary school. The sixth
case was from a nearby school. This sixth case had 2
siblings in the involved elementary school including a
brother in kindergarten. Cases were generally mild and
are shown below:

Age Sex Onset Immunization Status Severity Grade
5 F 10-1 None Moderate Kindergarten
5 F 10-8 None Mild Kindergarten
5 M 10-15 Inadequate Mild Kindergarten
6 M 10-16 Fully Moderate Grade I*
5 M 10-21 None Mild Kindergarten
7 M 10-22 Inadequate Moderate Grade III
*Attends a different school than the other cases but has a
sibling who is a known carrier in the kindergarten class where
the other cases occurred.

Extensive culturing of school and household con-
tacts, utilizing guinea pig virulence tests, by the Minne-
apolis Division of Public Health and the Division of
Medical Laboratories of The Minnesota Department of
Health revealed a total of 9 carriers. An additional 7
suspect carriers were discovered in whose cultures
suspicious bacilli were found, but whose virulence tests
were unsuccessful. In addition, in 3 individuals, non-
virulent C. diphtheriae were found. It is of interest that 4
of the carriers yielded Intermedius type organisms. This
type is not usually found in the Minneapolis area.
Three of the 6 cases had never been immunized, 2
had inadequate immunization and 1 had been fully immu-
nized. Among the 9 carriers, 3 were inadequately im-
munized, 3 had lapsed immunization and 3 were fully
immunized.

(Reported by D. S. Fleming, M.D., Director, Division of
Disease Prevention and Control, Minnesota Department
of Health, and C. B. Nelson, M.D., Chief, Section of
Acute Communicable Diseases, Minnesota Department
of Health.)


Seventeen cases of diphtheria with 3 deaths have
occurred in Los Angeles County from November 1 to
December 2, 1964. All of the cases are related to four
family groups. Four of the patients developed diphtheric
myocarditis. In addition to these known cases, 48 suspected
cases have been hospitalized either because of a clinical
appearance suggesting diphtheria or positive throat
cultures.

(Reported by Herbert Cowper, M.D., Chief, Acute Com-
municable Disease Division, Los Angeles County
Health Department, and Dr. Philip K. Condit, Chief,
Bureau of Communicable Diseases, California State
Department of Health.)


DIPHTHERIA New Mexico

One laboratory-confirmed case and 3 clinically diag-
nosed cases of diphtheria have occurred in Deming, New
Mexico, 65 miles north of the Mexico border. In addition,
at least 10 cases occurring in Palomas, Mexico are known
to New Mexico health authorities. Two of the Mexican
children expired while hospitalized in New Mexico and
1 of the Deming cases was fatal. All deaths occurred in
unimmunized children under 4 years of age.

The Pan American Sanitary Bureau is carrying out
extensive immunizations in the Palomas area and New
Mexico health authorities have established vaccination
clinics in Columbus (adjacent to Palomas) while private
physicians are vaccinating in Deming. No new cases
have occurred in the past 4 days.


(Reported by Dr. H. G. Doran, State Epidemiologist, New
Mexico Department of Public Health)


BOTULISM Kansas


On Wednesday, November 18, 177 teen-agers par-
ticipated in a music festival at Herndon, Kansas (pop-
ulation 321). Most of these visitors took their meals at
the Herndon school but several ate at the 2 local
restaurants.
On November 19, after returning to their homes, some
of the participants became ill. Clinical signs and symptoms
suggested botulism in 7 of the cases. Five of these 7
cases were hospitalized, 1 in Hayes, Kansas, and 4 in
Denver, Colorado. One of the 5 hospitalized patients died
and another continues to be confined to a respirator.


Sera from 3 of these patients were tested for botuliri"-
toxin by Laboratory Branch, CDC. The results of tL.
tests indicate that Clostridium botulinum type A was
the etiologic agent.
Investigations by the Kansas State Department i'
Health revealed that a common factor in each case was
the consumption of hamburgers at 1 Herndon restaurant.
No cases occurred in students who ate at the school or
the other restaurant in town. Nine students consumed
hamburgers at the restaurant in question. Seven of these
(Please continue to page 428)


423


DIPHTHERIA California









424 Morbidity and Mortality Weekly Report



Table 3. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

NOVEMBER 28, 1964 AND NOVEMBER 30, 1963 (48TH WEEK)


Asetic Encephalitis
Aseptic
Meningitis Primary Post-Inf. Poliomyelitis, Total Cases Poliomyelitis, Paralytic
Area
Cumulative Cumulative
1964 1963 1964 1964 1964 1963 1964 1963 1964 1963 1964 1963
UNITED STATES... 39 27 43 7 1 5 112 417 1 5 88 358

NEW ENGLAND.......... 1 2 1 1 2 9 1 2 9
Maine.............. 1 3 1 3
New Hampshire...... -
Vermont.............. 1 1
Massachusetts...... 1 3 3
Rhode Island....... 1 1 -
Connecticut........ 1 2 2 2 2

MIDDLE ATLANTIC...... 4 1 21 2 15 120 13 97
New York City...... 7 2 2 -
New York, Up-State. 1 1 2 10 9 9 6
New Jersey......... 2 11 3 4 2 3
Pennsylvania....... 1 1 2 107 88

EAST NORTH CENTRAL... 4 4 5 1 24 58 1 16 47
Ohio................ 2 1 4 4 8 2 4
Indiana.............. 9 4 1 6 3
Illinois........... 1 2 5 17 5 16
Michigan........... 1 3 20 2 20
Wisconsin........... 1 3 9 1 4

WEST NORTH CENTRAL... 2 3 10 7 8 6
Minnesota........... 2 3 4 2 4
Iowa............... 1 1 -
Missouri........... 4 3 -
North Dakota....... 1 1 1 -
South Dakota....... 1 1
Nebraska........... I 1
Kansas.............. 1 1 1

SOUTH ATLANTIC....... 2 4 5 3 34 97 3 28 84
Delaware........... 1 3 1 1
Maryland ............ 1 1 1
Dist. of Columbia.. 1 1 -
Virginia............ 1 4 21 4 16
West Virginia .... 1 1 3 1 3
North Carolina..... 12 5 7 4
South Carolina ..... 3 8 3 7
Georgia............ 3 21 3 20
Florida............ 1 3 3 10 36 3 9 32

EAST SOUTH CENTRAL... 1 3 4 1 6 73 1 5 67
Kentucky........... 1 1
Tennessee.......... 1 1 3 11 1 2 10
Alabama............ 1 2 2 53 2 48
Mississippi ....... 2 1 9 1 9

WEST SOUTH CENTRAL... 7 4 10 26 8 25
Arkansas........... 4 3
Louisiana.......... 1 14 14
Oklahoma............ 3 3 1 2 1
Texas............... 6 1 7 7 6 7

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

PACIFIC.............. 17 9 3 4 3 21 3 18
Washington.......... 2 2
Oregon............. 1 2 1 1
California.......... 16 9 3 4 2 17 2 15
Alaska.............. -
Hawaii.............. 1 -

Puerto Rico 5 4









MIorbidily and Mortality Weekly Report 425


Table 3. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

NOVEMBER 28, 1964 AND NOVEMBER 30, 1963 (48TH WEEK) CONTINUED


Infectious Hepatitis
Brucellosis Diphtheria including Serum Hepatitis Typhoid Fever

Area Under 20 years Age
Cum. Cum. Total 20 years and over Unknown Cumulative Cum.
1964 1964 1964 1964 1964 1964 1964 1964 1964 1963 1964 1964


UNITED STATES... 7 372 2 249 554 251 258 45 34,959 39,642 5 415

NEI" ENGLAND.......... 2 44 51 22 27 2 3,140 4,532 17
Maine................ 39 10 7 2 1 973 2,053
New Hampshire...... 5 2 3 246 552
Vermont............ 366 125
Massachusetts...... 2 5 19 9 9 1 723 1,135 8
Rhode Island....... 8 8 202 107 6
Connecticut........ 9 4 5 630 560 3

MIDDLE ATLANTIC...... 2 8 10 114 55 59 7,658 7,839 1 68
New York City...... 5 27 10 17 1,201 1,223 1 34
New York, Up-State. 2 4 49 27 22 3,317 3,372 15
New Jersey......... 2 10 2 8 1,255 1,159 2
Pennsylvania....... 4 3 28 16 12 1,885 2,085 17

EAST NORTH CENTRAL... 49 10 103 55 38 10 5,588 6,346 1 81
Ohio................ 5 34 17 16 1 1,474 1,743 1 21
Indiana............ I 1 3 2 1 463 584 22
Illinois........... 28 8 19 10 9 1,057 1,321 23
Michigan........... 6 1 34 22 12 2,208 2,408 11
Wisconsin.......... 9 13 4 9 386 290 4

WEST NORTH CENTRAL... 3 158 2 36 42 22 18 2 1,930 1,770 30
Minnesota.......... 9 18 218 273 3
Iowa............... 99 6 4 2 341 317 4
Missouri........... 10 1 19 13 6 482 596 13
North Dakota....... 2 2 63 95 2
South Dakota....... 2 20 1 3 134 124 1
Nebraska........... 13 1 5 4 1 1 2 69 122 3
Kansas............. 1 5 7 13 4 9 623 243 4

SOUTH ATLANTIC....... 1 39 65 41 17 23 1 3,252 4,012 94
Delaware........... 73 76 -
Maryland............ 1 8 4 3 1 588 504 8
Dist. of Columbia.. 68 108 -
Virginia........... 17 5 4 1 517 787 11
West Virginia ..... 5 4 1 460 613 -
North Carolina..... 4 1 7 1 6 530 1,027 20
South Carolina.... 7 5 1 4 147 161 12
Georgia............ 1 14 30 1 1 106 167 27
Florida............ 4 26 10 2 8 763 569 16

EAST SOUTH CENTRAL.. 18 30 43 23 19 1 2,371 3,609 42
Kentucky........... 6 11 8 3 832 1,058 10
Tennessee.......... 5 2 16 8 7 1 842 1,391 19
Alabama............ 4 23 12 5 7 462 579 7
Mississippi........ 3 5 4 2 2 235 581 6

WEST SOUTH CENTRAL.. 45 38 41 27 14 2,726 2,709 2 35
Arkansas........... 6 3 7 5 2 273 294 15
Louisiana.......... 4 12 6 5 1 654 554 1 6
Oklahoma........... 8 5 3 2 131 120 9
Texas.............. 27 23 23 14 9 1,668 1,741 1 5

MOUNTAIN ............. 30 2 37 7 2 28 2,114 2,519 12
Montana............ 4 4 180 327 -
Idaho.............. 7 7 299 426
Wyoming............ 3 1 1 1 86 38 1
Colorado...........* 9 9 554 499
New Mexico......... 1 1 6 5 1 300 309 4
Arizona............ 2 1 7 7 465 577 7
Utah............... 26 1 1 179 325 -
Nevada............... 1 51 18 -

PACIFIC................. 1 23 14 82 23 58 1 6,180 6,306 1 36
Washington........ 13 5 5 620 1,050 2
Oregon............. 2 6 3 2 1 637 746 -
California ........ 1 21 1 67 19 48 4,532 4,270 1 34
Alaska............. 4 1 3 275 197 -
Hawaii ............. 116 43


Puerto Rico 1 13 12 7 5 925 814 13








426 Morbidity and Mortality Weekly Report


Table 3. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED
NOVEMBER 28, 1964 AND NOVEMBER 30, 1963 (48TH WEEK) CONTINUED


Streptococcal
Meningococcal Sore Throat and Rabies in
Measles Meningitis Scarlet Fever Tetanus Tularemia Animals
Area
Cumulative Cum. Cum. Cum.
1964 1964 1964 1963 1964 1963 1964 1964 1964 1964 1964 1964
UNITED STATES... 2,272 41 2,496 2,165 6,327 5,571 3 253 4 304 98 4,158

NEW ENGLAND.......... 473 1 82 130 660 401 9 1 33
Maine............... 45 6 19 37 17 28
New Hampshire...... 95 2 4 5 2
Vermont............. 9 4 6 1 1 2
Massachusetts...... 175 31 58 86 75 9 1 1
Rhode Island....... 55 1 11 12 33 87 -
Connecticut........ 94 28 31 498 221 -

MIDDLE ATLANTIC...... 69 6 329 301 251 104 22 1 1 117
New York City...... 17 45 46 13 14 -
New York, Up-State. 37 3 100 93 170 50 8 1 109
New Jersey......... 10 104 48 33 18 6 -
Pennsylvania....... 5 3 80 114 35 22 8 1 8

EAST NORTH CENTRAL... 416 2 341 334 486 503 1 49 1 24 4 573
Ohio............... 44 1 89 95 100 102 1 14 1 2 290
Indiana............ 48 54 44 62 60 14 2 29
Illinois........... 18 1 92 67 48 45 13 14 1 111
Michigan........... 186 75 95 187 213 7 2 2 57
Wisconsin.......... 120 31 33 89 83 1 4 1 86

WEST NORTH CENTRAL... 160 3 143 133 216 236 17 2 59 26 1,253
Minnesota.......... 1 2 32 27 12 18 4 2 14 397
Iowa............... 16 1 9 7 60 71 6 1 5 445
Missouri........... 14 64 39 5 1 4 1 32 2 184
North Dakota........ 128 20 15 90 56 1 63
South Dakota....... 1 3 7 7 19 1 15 3 92
Nebraska........... 6 25 2 35
Kansas............. NN 9 13 40 71 2 1 9 1 37

SOUTH ATLANTIC........ 245 8 501 401 625 573 61 30 13 566
Delaware........... 1 7 4 4 4 -
Maryland........... 1 2 38 57 53 8 3 1 3
Dist. of Columbia.. 16 8 1 1 I 1 -
Virginia........... 25 2 61 86 187 196 7 7 9 299
West Virginia...... 183 35 21 160 178 1 36
North Carolina..... 15 3 87 76 23 33 15 7 5
South Carolina..... 5 57 22 27 28 5 2
Georgia............ 81 34 5 21 4 14 2 119
Florida............. 15 1 119 93 165 105 25 1 1 102

EAST SOUTH CENTRAL... 81 2 189 148 1,084 871 32 30 30 577
Kentucky........... 1 1 62 32 11 35 8 2 2 60
Tennessee.......... 66 1 58 69 951 766 12 20 21 434
Alabama............ 12 43 24 96 59 7 3 1 20
Mississippi........ 2 26 23 26 11 5 5 6 63

WEST SOUTH CENTRAL... 169 3 229 196 427 716 1 29 1 106 15 595
Arkansas........... 31 14 5 8 8 65 1 143
Louisiana .......... 129 80 4 2 4 6 4 66
Oklahoma............ 1 14 34 1 23 1 20 1 94
Texas.............. 169 2 55 68 417 683 1 16 1 15 9 292

MOUNTAIN.............. 362 5 91 76 1,372 1,061 6 50 141
Montana............ 46 1 3 31 86 19 1
Idaho.............. 39 4 6 166 78 1 -
Wyoming............ 5 7 83 56 2 10 -
Colorado........... 10 5 21 20 671 413 8
New Mexico......... 160 35 4 154 238 1 52
Arizona............ 18 8 11 99 80 1 66
Utah............... 86 7 20 168 103 1 21 3
Nevada ............. 3 10 5 7 11

PACIFIC .............. 297 11 591 446 1,206 1,106 1 28 3 9 303
Washington......... 98 48 40 335 407 3 -
Oregon.............. 59 25 33 19 15 1 I 11
California......... 94 11 498 348 789 594 22 2 9 292
Alaska............. 3 7 12 23 68 -
Hawaii............. 43 13 13 40 22 1 2 -

Puerto Rico 99 32 10 12 6 1 64 25







Morbidity and Mortality Weekly Report





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



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


427


Area For weeks ending Area For weeks ending

_11/7 11/14 11/21 11/28 11/7 11/14 11/21 11/28


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


156
28
12
15
31
11
10
17
32
32
9
24
24
39


29
27
94
17
18
21
48
47
1,009
21
238
89
43
70
11
21
23
16
26
20


39
25
337
94
99
79
39
190
26
22
25
14
22
87
13
71
16
17
24
68
37


38
13
15
77
17
72
59
105
47
23


132
23
24
15
23
14
14
13
23
33
8
25
19
35


16
18
91
28
16
18
36
51
1,000
31
274
112
41
61
12
20
35
29
24
17


46
19
395
104
93
63
33
197
21
19
22
15
41
86
12
67
16
17
31
63
33


38
15
10
72
19
63
44
155
42
29


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:
BLrmin hai, 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..............


68
116
18
29
48
32
45
15
54
48
100
19


53
29
24
64
49
18
18
52


15
10
13
45
13
40
89
25
85
39
58
27
23


20
13
90
15
55
7
31
27


9
32
20
26
71
320
60
21
101
26
60
135
22
94
33
38


oCurrent Week Mortality for 108 Selected Cities

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


10,410
424
651
5,797


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

NOTE: All deaths by place of occurrence.


--





il3 126IIIIIIllll2 084 IIII2I II
3 1262 08864 2706


Morbidity and Mortality Weekly Report


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

The weekly average number of deaths among persons
65, years and over in 108 cities for the four-week period
ending November 28 was 6,201 as compared with an ex-
pected weekly average of 6,761.


Observed
Expected

Excess


11 '7

6,255
6,655
-400


Week

11 14

6,173
6,725
-552


Ending

11,21

6,578
6,797
-219


11 28

5,797
6.867
-1,070


4-Week
Total

24,803
27,044

-2,241


Weekly
Average

6,201
6,761
-560


EATHS at AGE 65 and OVER in 10 U.S. CITIES
A-rog NumbA p. Ae. by Fui Mrlmk PloeMf


p Iv LACU o 0 u r


-cA- A" -01 41 R I.. S .rh


(See Table, page 427)


BOTULISM Kansas
(Continued from page 423)


ate the sliced dill pickle served on the hamburger and 2
did not. All cases occurred in the individuals who also
consumed the pickles. The sliced dill pickles served on
the hamburgers were home-canned by the proprietor of
the restaurant. None of the suspected pickles were
available for laboratory examination.
Only 2 previously recorded outbreaks of botulism in
the United States have been attributed to pickles. One
occurred in the State of Washington in 1925 and the second
in California in 1942. In both cases, home-canned dill
pickles contaminated with type A botulinum toxin were
found to be the source.


(Reported by Dr. Don E. W'ilcor, Division of Disease
Prevention and Control, Kansas State Department of
Health, and Dr. Cecil S. Mollohan, Epidemiology Section,
Colorado State Department of Public Health.)


THE MORBIDITY AND MORTALITY WEEKLY REPORT. WITH A CIRCULA-
TION OF 12.000 15 PUB LISTED By THE COMMUNICABLE DISEASE
CENTER, ATLANTA. GEORGIA 30333.
CHIEF, COMMUNICABLE DISEASE CENTER jAMES L. GODDARD. M.D.
CHIEF. EPIDEMIOLOGY, BRANCH A. D. LANGMUIR. M.D.
CHIEF. STATISTICS SEC TION R. E. SERFLING. P-.D.
ASST. CHIEF, STATISTICS SECTION I.L. SHERMFAN. M.S.
CHIEF. SUR. EILLANCE SEC TION D. A. HENDERSON. M.D.
ASSISTANT EDITOR. MMWR PAUL D. STOLLEY. M.D.
IN ADDITION TO THE ESTABLISHED PROCEDURES FOR REPORTING
MORBIDITY AND MORTALITYV THE COMMUNICABLE DISEASE CENTER
WELCOMES ACCOUNTS OF INTERESTING OUTBREAKS OR CASES. SUCH
ACCOUNTS SHOuLD BE ADDRESSED TO
THE EDITOR
MORBIDITY A ND MORTALITY WEEKLY REPORT
COMMUNICABLE DISEASE CENTER
ATLANTA. GEORGIA 30333
NOTES THESE PROvISIONAL DATA ARE BA5ED ON WEEKLY TELE-
GRAMS TO THE COMMUNICABLE DISEASE CENTER BY THE INDIVIDUAL
STATE HEALTH DEPARTMENTS.
SYMBOLS ---DATA NOT AVAILABLE
QUANTITY ZERO
PROCEDURES FOR CONSTRUCTION OF VARIOUS MORTALITY CURVES
MAY BE OBTAINED FROM STATISTICS SECTION. COMMUNICABLE
DISEASE CENTER. PUBLIC HEALTH SERVICE. U.S. DEPARTMENT OF
HEALTH. EDUCATION. AND WELFARE. ATLANTA. GEORGIA 30333


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