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:
AA00010654:00432

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


F6 bc,(50 / 9 3 /



Morbidity and Mortality



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

PUBLIC HEALTH SERVICE


Pr. sred b* the


SCOM:UICBLE DISAE NT


For release July 24. 1964 ATLANTA, GEORGIA 30333 Vol. 13, No. 29
PROVI1lONAL INFORMATION ON SELECTED NO] IIABLE DIS AF' IN THE UNITED STATES AND ON
DEATHS IN SILICIHD CITIES IOR 'WFIK FNDI)I Jl LY 18, 1964
TETANUS New York State
On July 15, a 19-year-old Puerto Rican female was Investigation revealed that the patient left Puerto
admitted to a New York hospital with symptoms and signs Rico July 12, arriving in New York the same day. On each
of clinical tetanus. Despite tetanus antitoxin therapy she of the two days prior to her departure from Puerto Rico,
expired on July 16. Physical examination before death she had received an inoculation for an allergic condition.
failed to reveal any evidence of recent trauma with the This condition of long standing had prompted numerous
exception of an inoculation site in the left deltoid region. similar injections in the past, apparently without
A post-mortem examination also revealed no evidence difficulty.
of trauma or localized infection except for the inoculation She was not thought to have received any tetanus
site. A special dissection was made in the inoculation toxoid immunizations. Adequate information concerning
area and a small pocket of purulent material was found circumstances of the resumed offending inoculation and
deep in the deltoid tissues, presumably at the base of the the medicatio ncbe obtained.
inoculation tract. Bacteriologic examination of this mate-
rial revealed the presence of organisms morphologically (Reporte ert V.. Al Y .)., M.P.H., Director,
typical of Clostridium tetani, although final bacteriologic and J 44 Freitag, Vt.D. ce of Epidemiology,
identification is not completed as yet. A ew, tale Iept. o ealt
Table 1. CASES OF SPECIFIED NOTIFIABLE D -S: UNITED STA
(Cumulative totals include revised and delayed rep ta ough previous wees)
29th Week Ended Cumulat. F fst 29 Weeks
Disease July 18, July 20, Median Median
1964 1963 1959 1963 1 1963 1959 1963
Aseptic meningitis ................ 50 51 --- 879 759
Brucellosis ....................... 5 13 13 217 202 341
Diphtheria ........................ 3 1 4 152 144 319
Encephalitis, primary infectious.. 62 5 --- 1,068 87 -
Encephalitis, post-infectious ..... 21 --- 588 8
Hepatit is, infectious including
serum hepatitis ................ 563 632 647 23,115 25,424 25,426
Measles ........................... 2,639 3,522 3,730 425,158 348,248 374,955
Heningococcal infections .......... 39 37 37 1,650 1,550 1,447
Poliomyelitis, Total .............. 11 29 52 125 288
Paralytic ...................... 9 24 40 103 214
Nonparalytic ................... 1 --- 9 13 ---
Unspecified .................... --- 3 9 ---
Streptococcal Sore Throat and
Scarlet fever .................. 3,763 3,911 --- 263,397 225,980 ---
Tetanus ......................... 5 10 --- 135 136 ---
Tularemia ........................ 12 6 --- 176 152 ---
Typhoid fever ..................... 14 10 21 218 228 355
Rabies in Animals ................. 95 71 71 2,654 2,238 2,236

Table 2. NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax: 2 Psittacosis: 18
Botulism: 10 Rabies in Man:
Leptospirosis; N.J. 2 23 Smallpox:
Malaria: 48 Typhus-
Plague: Murine: 13
Rky Mt. Spotted: D.C.-1, Del-1, N.C.-4, Va-3, Ohio-3, 91
W.Va-1, Ga-1, Tenn-3, Calif-l


634.5131









Morbidity and Mortality Weekly Report


TICK PARALYSIS Arkansas


On the morning of May ;0, 196-4, a S8-year-old, white
male telephone lineman developed weakness and paralysis
of his left hand and arm. The previous night his wife had
found and attempted to remove a tick from his scalp.

The patient was hospitalized where a physical exami-
nation demonstrated numerous old tick bites and 5 new
bites over the left scapular region. The examining physi-
cian located and removed from his scalp the remainder of
the tick which had been partially removed by his wife the
previous night. Neurological examination revealed weak-
ness of the flexor muscles of the left arm and opponents
function of the left thumb with paralysis and mild weak-
ness of extensor muscles as well. The patient remained
afebrile and a complete medical evaluation failed to re-
veal any underlying metabolic or neurologic disease.

The patient fully recovered within 36 hours after
complete removal of the ick-fromr his scalp,

(Reported by Willran L. Bvneie. Jr.. V.D.,AcLing I)rector.
Division of Commuticable Disease control Arkan.sas
State Board of Health; br. Thomas J. Raliey,' Vedical
Director, and 4rs. boris McGuire, Public iHepltk Nurre,
Pulaski County Health Department.) .


9

Editor's Note: The subject of tick paralysis has been
extensively reviewed.1'2 The usual clinical picture is
described as ascending flaccid paralysis beginning in the
lower extremities which may progress to complete paraly-
sis and death unless the tick is completely removed.
Isolated nerve palsies, as would appear to be present in
this case also have been described.

The illness occurs most frequently during the summer
months when exposure to ticks is most common; thus;
poliompeliris has been a major consideration in the dif-
ferential diagnosis. The absence of fever, muscle spasm,
and neck stiffness, the lack of spinal fluid abnormalities,
and the identification of the offending tick are usually
adequate to clarify this differentiation. Following removal
of the tick, recovery is dramatically rapid, with disap-
pearance of neurologic abnormalities usually within 2 days
and complete recovery within I week.

In the UInited States, most human cases have been
associated with bites from the wood tick, DOrmarentor
anderront, in the West and Northwest, and the dog tick,
Iermacrntoir raraabrlit, in the East.


The substance responsible for the paralysis has not
been identified but is believed to be a toxin originating
from saliva of the tick or from ova of the gravid female.
Thus, care should be taken to completely remove all
parts of the tick as rapidly as possible.


REFERENCES
1. Abbott, K. H.: Tick Paralysis: Review. Proceedings Mayo
Clinic, 18:39, Februa 1; F ebrua, February 24, 1960.

2. Sianbury, J. B., and Huyck, J. H.: Tick Paralysis: Critical
Review. Medicine. 24:219-242, September 1945.




ANTIMONY POISONING Illinois

A group of 35 pre-school age children all experienced
vomiting from 30 to 45 minutes after drinking a raspberry
flavored beverage at a Chicago Sunday school Halloween
party. Some children also became pallid, others dizzy.
Three were hospitalized for less than 24 hours. No fatali-
ties occurred.

Only this drink and potato chips were served. Because
of the rapid onset of symptoms, the premises were care-
fully inspected for evidence of insecticides, rodenticides,
and other toxic materials. None was found.

The investigators learned that the beverage had been
prepared by mixing the contents of several packages of the
raspberry powder with sugar and water in an old porcelain
roasting pan, and then refrigerated for 40 hours prior to
serving. No trace of chemical could be found in the powder
concentrate or in the potato chips. Antimony was detected
in the small quantity of remaining beverage and from acid
washings of the pan; insufficient quantity remained for
quantitative analysis. Accordingly. the Chicago Board of
Health laboratory workers repeated the entire procedure.
using the same roasting pan; 2.8 mg. percent antimony was
detected.

(Reported by Samuel L. Andelman. V.D.. 4.P.H., Commis-
sioner, Chicago Board of Health).


Editor's .\ore: Antimony is often contained in the binding
between the enamel and metal, especially in older uten-
sils. Apparently. the citric acid partially dissolved the
binding behind the pan's worn enamel coat, thus releasing
sufficient antimony to cause the symptoms experienced
by the children.


25(1








Morbidity and Mortality Weekly Report



POLIOMYELITIS CASES BY DATE OF REPORT
BAHAMAS, 1964


Cases
20-

18

16

14

12-

10

8-

6-

4-

2

0-
Week Ended:


21 28
March


Immunization Campaign Begun













l+ Nl7 t
\\ \\'IL"7.7

\\\ i..b


4


II 18
April


25 2 9 16 23 30
May


INTERNATIONAL NOTES


POLIOMYELITIS Bahamas

Bahamas has experienced a poliomyelitis epidemic from
March through May which totalled 53 cases, including 2
deaths; Type I polio virus was identified as the etiologic
agent.
The first case was clinically diagnosed on March 18,
but the authorities believe the outbreak began 3 weeks
earlier. A graph of the cases by date of report appears
above. Four cases were reported in late May and June; all
4 were delayed reports.
The cases occurred in areas near Nassau, on New
Providence Island. Of the first 28 cases reported, 2 were
fatal involving children, aged 2 and 5. One severe case
occurred in a 50-year-old patient. The remaining 25 cases
were mild, affecting children under 5 years of age.
Immunization commenced on the afternoon of April 2
and by April 6, approximately 70,000 of the 80-85,000 on
the island had been immunized. The second feeding of the
trivalent vaccine has been carried out; and 59,498 or 71.4
percent of the population in New Providence Island, and
45,077 or 93 percent of the population in the Out Islands
have been vaccinated.

(Reported by Dr. Ruth Puffer, Pan American Health Organi-
aation, Washington, D. C.)


INFECTIOUS HEPATITIS Costa Rica

The Province of Alajuela, in north central Costa Rica
experienced an increase in reported cases of infectious
hepatitis during 1963 which appears to be continuing
through this year. Annual totals of reported icteric in-
fectious hepatitis for 1962 and 1963 and for the period
January 1 through May 10 of 1964 are shown in the fol-
lowing table:


1962 1963 1964*
Population Rote per Rate per Rate per
(1961) Cases 100,000 Cases 100,000 Cases 100,000
Costa Rico total 1,286,705 225 17.4 371 28.8 254 17.5
Alajuela Province 223,143 44 19.7 164 73.5 152 68.1
Other Costa Rico 1,063,562 181 17.0 207 19.5 102 9.6
*Through May 10 only.


As will be noted, the incidence of infectious hepa-
titis in Alajuela Province in 1963 was over three times
that observed in 1962; the 1964 rate through May 10,
already approximates that for the whole of 1963. Whereas
Costa Rica as a whole has shown an increase in inci-
dence during this same period, it would appear that most
of this increase may be accounted for by Alajuela
Province.
(Continued on page 626)


251


I


I i











2.52 M1 rbildit and Mortalit y ee ly HKeport


Tablc 3. ( AN.S OF SPECIFIED NOl IFIABI.l 1)1% AI:M I NIlllD) s1ATF

FOR W IFK1 FNI)ID

JULY 18, 1964 AND JULY 20. 196i (29TH WEEK)


Aeptic Encephaliti
McnLngilll Fr na.ry P..r-In Pol ir.myrlt I It i I1 Ir a ..r, P Li .'.1 111 i ParaLytic
Arr,.I
'umulaTu v Cumulative
196hi 19h3 146< 14h4 1 'qb- '13 1 163 IT 1 l663 19h64 l63
UNIFTED STATES... 50 51 62 21 11 52 125 9 40 103

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

MIDDLE ATLANTIC...... 8 2 11 4 1 7 32 1 7 24
New York City...... 4 I
New York, UIp-State. 5 1 2 3 4 5 5
New Jersey........ 5 2 -- 2 -
Pennsvlv.ania....... 3 1 1 1 27 1 19

EAST NORTH CENTRAL... 9 10 6 3 2 6 21 5 14
Ohio................ 6 1 2 2 7 2 3
Indiana............ 1 2 1
Illinois........... 5 2 3 3 3 7 3 6
Michigan........... 3 2 3 3
Wisconsin.......... 2 2 -

WEST NORTH CENTRAL... 2 1 2 1 1 2 3 1 1 3
Minnesota......... 2 1 3 1 3
............... 1 -
Missouri........... 1 2 -
North Dakota....... -
South Dakota....... 1 -
Nebraska............ -
Kansas............ -

SOUTH ATLANTIC....... 6 2 15 2 3 21 16 3 16 13
Delaware........... 1 2 -
Maryland............. 1 I -
Dist. of Columbia.. -
Virginia............ 2 1 2 2 I
West Virginia...... 1 1 1 1
North Carolina..... 2 8 3 4 3
South Carolina..... 2 3 2 2
Georgla............ 1 1 -- I -
Florida............ 2 11 3 8 6 3 7 6

EAST SOUTH CENTRAL... 1 5 19 1 4 17 2 15
Kentucky............ 3 19 -
Tennessee.......... 1 1 2 4 I 4
Alabama........... 2 2 11 1 9
Mississippi ....... 2 2

WEST SOUTH CENTRAL. 8 4 3 3 4 18 3 4 18
Arkansas........... 1 1 I
Louisiana.......... 1 1 1 13 1 13
Oklahoma ........... 1 ] -
Texas............... 7 2 I 2 3 4 2 3 4

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

PACIFIC............. 14 22 5 10 1 15 1 13
Washinton ......... 1 I i
Oregon............. I 1 2 1 1
California........... 14 21 5 8 12 11
Alaska.............. .
Hawvati .............

Puerto Rico 4 4











Morbidity and Mortaliiy Weekly Report 253


Table 3. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

JULY 18, 1964 AND JULY 20, 1963 (29TH 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... 5 217 3 152 563 239 279 45 23,115 25,424 14 218

NEW ENGLAND.......... 2 42 23 12 11 2,280 2,751 12
Maine.............. 39 4 3 1 748 1,274 -
New Hampshire...... 164 209 -
Vermont............. 2 1 1 285 37 -
Massachusetts ...... 2 3 6 3 3 471 802 5
Rhode Island....... 5 4 1 125 63 6
Connecticut........ 6 1 5 487 366 1

MIDDLE ATLANTIC...... 3 1 6 146 69 77 5,234 4,860 1 33
New York City...... 1 2 20 8 12 772 685 1 14
New York, Up-State. I 57 36 21 2,346 2,164 7
New Jersey......... 2 33 9 24 945 745 1
Pennsylvania....... 2 2 36 16 20 1,171 1,266 11

EAST NORTH CENTRAL... 25 1 7 82 30 38 14 3,496 4,124 6 56
Ohio................ 1 19 7 12 925 1,148 1 24
Indiana............ 1 4 3 1 311 380 2 12
Illinois........... 15 6 21 10 11 600 875 3 10
Michigan............ 4 1 1 24 10 14 1,403 1,539 7
Wisconsin........... 4 14 14 257 182 3

WEST NORTH CENTRAL... 1 100 21 19 11 8 1,256 1,171 16
Minnesota.......... 1 6 11 6 1 5 123 185 1
Iova................. 58 1 1 178 219 3
Missouri........... 8 5 3 2 321 446 6
North Dakota....... 2 2 2 2 49 29 2
South Dakota....... 13 1 106 63 1
Nebraska............ 11 32 86 -
Kansas............. 2 7 5 4 1 447 143 3

SOUTH ATLANTIC....... 2 21 1 30 57 25 32 2,187 2,625 3 47
Delaware............ 41 37 -
Maryland............. 7 3 4 420 318 1 3
Dist. of Columbia.. 1 1 34 74 -
Virginia............ 2 10 10 5 5 338 558 10
West Virginia...... 8 6 2 347 412 -
North Carolina..... 2 13 7 6 395 658 2 14
South Carolina..... 1 6 4 1 3 75 106 5
Georgia............. 6 20 1 1 52 111 1
Florida............ 3 4 13 2 11 485 351 14

EAST SOUTH CENTRAL... 1 12 6 32 10 22 1,593 2,549 1 22
Kentucky........... 3 4 1 3 641 734 6
Tennessee.......... 4 1 11 8 3 542 1,002 1 9
Alabama............. 3 3 13 1 12 268 396 5
Mississippi........ 1 2 2 4 4 142 417 2

WEST SOUTH CENTRAL... 21 24 37 18 16 3 1,716 1,741 1 12
Arkansas............ 4 2 2 176 192 1 5
Louisiana.......... 1 5 11 9 2 393 332 3
Oklahoma........... 3 1 1 91 87 3
Texas.............. 13 19 23 7 13 3 1,056 1,130 I

MOUNTAIN............. 18 2 34 6 28 1,432 1,677 2 7
Montana ............ 1 1 127 226 -
Idaho............... 5 5 157 267 -
Wyoming............. 45 24 1
Colorado ........... 15 3 12 410 355
New Mexico.......... 1 1 2 2 199 203 2 2
Arizona............. 2 1 10 10 327 396 4
Utah............... 14 -- 1 125 193 -
Nevada............ 1 42 13 -

PACIFIC.............. 1 15 14 133 58 75 3,921 3,926 13
Washington......... 13 5 1 4 441 691 1
Oregon.............. 2 25 19 6 435 503 -
California......... 1 13 1 100 38 62 2,844 2,609 12
Alaska.............. 122 95 -
Hawaii ........... 3 3 79 28 -

Puerto Rico 7 19 18 1 463 445 9










231 Morbidily and Morlalily weeklyy Report


Table 3. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED
JULY 18. 1964 AND JULY 20, 1963 (29TH WEEK) CONTINUED


Streptococcal
Meningucoccal Sore Throat and Rabieb in
rMeasles Meningitis Scarlet Fever Tetanus Tularemia Animals
Area ---- ---- ----- ---- ----
Cumulative Cum. Cum. Cum.
1964 1964 1964 1963 1964 1963 1964 1964 1964 1964 1964 1964
UNITED STATE'... 2,639 39 1,650 1,550 3,763 3,911 5 135 12 176 95 2,654

NEW ENGAND.......... 277 47 95 347 316 5 2 22
Maine.............. 71 5 16 16 51 2 20
New Hampshire...... I 1 4 19 1
Vermont ............ 28 1 3 15 -
Massachusetts...... 90 19 44 25 27 5 -
Rhode Island....... 38 7 9 18 27 -
Connecticut........ 49 14 19 288 177 -

MIDDLE ATANTIC...... 328 5 205 213 142 136 3 12 3 77
New York City ...... 96 28 30 5 6 -
New York, Up-State. 145 3 58 66 122 118 2 4 3 13
New Jersey......... 62 2 71 31 12 3 5 -
Pennsylvania....... 25 48 86 3 9 1 3 4

EAST NORTH CENTRAL... 664 8 237 244 303 197 1 22 1 15 20 366
Ohio............... 104 1 63 71 22 17 1 5 1 11 190
Indiana............ 75 1 36 31 48 14 3 1 2 19
Illinois........... 122 5 59 44 41 62 7 9 2 77
Michigan.......... 208 1 53 71 136 64 6 1 3 35
Wisconsin.......... 155 26 27 56 40 1 2 4 45

WEST NORT CENTRAL... 53 3 106 92 124 82 1 8 3 38 19 849
Minnesota......... 2 3 25 19 1 2 1 1 2 7 256
Iowa............... 10 6 5 17 31 1 3 1 7 304
Missour............. 52 31 2 21 4 133
North Dakota....... 38 11 4 76 46 45
South Dakota....... 3 5 12 1 1 2 6 1 69
Nebraska.......... 6 20 23
Kansas............. NM 6 8 18 2 1 8 19

SOUTH ATLANTIC....... 223 3 357 291 439 273 42 19 15 354
Delaware........... 20 6 2 8 4 -
Maryland............. 15 1 25 44 66 12 3 -
Dist. of Columbia.. I 12 4 7 -
Virginia........... 54 1 40 71 77 72 5 4 196
West Virginia...... 89 26 16 123 72 1 23
North Carolina .... 1 1 60 51 25 21 12 4 4
South Carolina..... 6 48 13 15 22 3 1
Georgia............ 2 46 22 2 1 1 11 6 75
Florida ............ 35 94 68 116 69 17 5 55

EAST SOUTH CENTRAL... 142 5 150 119 591 834 15 2 21 12 335
Kentucky............. 15 3 50 25 37 148 2 1 44
Tennessee .......... 121 1 50 53 518 615 8 2 14 11 276
Alabama........... 4 1 32 21 27 1 4 3 1 15
Mlsslsslppl........ 2 18 20 9 70 1 3 -

WEST SOUTH CENTRAL... 305 1 151 153 519 647 14 5 56 14 384
Arkansas........... 19 10 5 3 33 4 97
ouisiana.......... 1 1 103 63 2 6 3 1 31
Oklahoma........... 2 7 29 11 13 2 18 4 67
Texas.............. 302 22 51 506 628 6 4 6 189

MOUNTAIN............. 214 3 62 52 730 888 4 1 27 1 94
Montana............ 66 3 17 30 16 -
Idaho............... 29 3 4 46 68 -
yomi ng............ 3 4 16 11 1 4 -
Colorado............ 17 11 12 296 359 6
ew exico.......... 8 3 26 4 183 255 1 44
Arizona............ 37 5 8 97 92 1 1 43
Utah............... 50 6 14 75 73 1 1 7 -
Nevada.............. 7 8 3 1

PACIFIC .............. 433 11 335 291 568 538 13 9 173
Washington ......... 18 25 21 9 66 1 -
Oregon............. 157 2 20 20 7 16 1 5
California......... 234 8 273 231 519 404 11 8 168
Alaska ............. 6 1 7 11 8 18 -
avaii................ 18 10 8 25 34 1 -

Puerto Rico 51 26 5 6 9 2 46 14










Morbidity and Mortality Weekly Report




Tabic 4 (A) TOTAL IIATHS IN REPORTING CITIES


255


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


Area For weeks ending a For weeks ending
7/Area 711 7/18 6/27 1 Area 7/11 7/18
6/27 1 7/4 | 7/11 7/18 _____6/27 7/4 7/11 7/18


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 WayT, Ind. ..........
Gary, Ind. ................
Grand Rapids, Mich. .......
Indianapolis, Ind. ........
Madison, Wis. ............
Milwaukee, Wis. ...........
Peoria, Ill. ..............
Rockford, Il ............
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. ............


243
53
38
26
37
22
28
29
61
69
10
49
34
63


59
36
151
34
32
34
57
133
1,740
36
471
228
46
104
23
31
60
53
27
42


79
34
766
134
210
99
65
345
44
61
31
48
27
139
33
113
28
23
42
102
60


53
21
39
126
19
113
70
260
72
53


196
30
35
24
60
18
17
35
48
65
15
26
29
45


24
31
118
46
26
48
59
70
1,520
32
579
178
70
93
18
30
69
55
34
19


45
40
651
140
224
126
59
411
33
39
45
28
46
154
20
106
20
26
39
101
54


37
19
33
107
16
109
51
180
72
43


245
57
19
28
50
28
33
19
53
59
16
53
25
50


72
21
161
46
30
40
81
120
1,805
38
531
210
46
91
22
50
67
36
40
30


77
43
943
169
225
124
92
356
35
47
32
46
51
194
55
157
18
32
26
87
58


65
23
52
157
48
143
91
243
77
48


195
54
29
21
61
15
21
24
50
65
8
42
32
55


51
31
121
35
32
49
60
106
1,530
37
533
173
54
104
20
26
46
51
27
25


49
36
688
171
179
106
93
348
32
51
28
28
36
141
35
117
30
24
32
109
51


66
32
29
107
21
102
70
199
$6
52


SOUTH ATlANTIC:
Atlanta, Ga. ..............
Baltimore, MH. ............
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. .............
Port 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. ..............


133
276
28
72
69
67
98
36
80
81
166
42


103
46
44
95
128
49
46
92


26
27
35
151
39
71
180
53
188
69
103
54
47


34
17
106
14
88
18
52
39


16
51
39
42
68
475
104
37
165
49
96
178
26
145
64
29


123
237
28
58
70
58
64
35
83
53
196
33


96
74
31
164
95
25
52
70


39
22
26
147
26
46
151
29
138
78
85
49
40


16
18
150
17
81
17
38
37


18
50
43
37
59
395
129
30
82
56
97
191
32
105
43
45


112
264
31
55
84
38
70
48
80
59
191
48


76
52
25
98
137
45
27
92


32
40
33
133
37*
62
187
56
198
69
107
50
66


38
22
139
16
74
17
58
51


17
57
30
48
82
575
128
52
103
54
82
166
38
128
45
37


San Juan, P.R. .............. (---) (--) (--) (--)


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.....


11,085
376
802
5,979


NOTT All deabhs by place of occurrence.


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




UNIVERSITY OF FLORIDA


11111111111111121
3 1262 08864 2813


Morbidity and Mortality Weekly Report


TOTAL DEATHS REPORTED IN 108 CITIES


Tht. teckl\ average number of total deaths in 108
citis for the four-aeek period ending luly 18 was 11,3'8
as compared vih an expected c weekly average of 11,X)4.





TOTAL DEATHS REPORTED IN 108 CITIES


Week Ending 4 Week Weekly

6 27 7 4 7 11 7 18 Total Average

Observed 11,632 10,584 12,213 11,085 45,514 11,378
Expected 11,069 11,021 10,981 10,946 44,017 11,004

Excess 563 -437 1,232 139 1,497 374


TOTAL DEATHS RECORDED IN I0 U S CITIES
A,.sug* Mr -. We. b. iu. S. P.f


W.Uearq


0'


DCoErT


rlose


*LstJa a
1


S.. T, a.


(See Table, page 255)


SInternational .%ote.s continued from page 261)


The 1964 cases have occurred in the Cantons of

Grecia, Palmares and San Ramon; 59 percent were under
20 years of age, 23 percent in the 20-39 age group. The
principal mode of transmission is considered to be person-
to-person spread.
I Reported In Weekly Epidemiological Report, Pan American
Sanitary Bureau, WHO, July 8, 196..)

QUARANTINE MEASURES

Immunization Information for International Travel
1963-64 Edition
Public Hralth Scricie Iubli nation o. 384

The following Information should be added to the list of
Yellow Fever Vaccination Centers in Section 6:

Page 69


City:
Center:
Clinic Hours:
Fee:


SN.l OF FL LB.

us DEPOSITOy





SU.S DEPOSITORY


El Cenrro, California
Imperial Counry Health Center
Friday 2:00 p.m.
Yes


THE MOPBIDITl 4ND MORTALITY rEE*L. V REPORT. fITm A CIRCULA-
TIDN Or I 1 000 IS PUBLISHED BY THE COMMUNICABLE DISEASE
CENTER. ATLANTA. GEORGIA.
CHIEF. COuMUNICABLE DiSE SE CENTER JAMES L. GODDARD.M.D.
C-IEF. EPIDEMIOLoGV BRANCH A. D. .ANGMUIR. M.D.
C"IErF STATISTICS SECTION R. E. IERFLING. PH.D.
AsST. CHIEF. STATISTICS SEC TION 1. L. SHERMAN. M.S.
CHIE. SURvEILLANCE SEC TIOl D. A. pIENDEISON. M.D.
EDI TOR. u *R L.. K. ALTMAN. M.D.
IN ADDITION TO THE ESTABLISHED PROCEDURES FOR REPORTING
MORBIDI'T AND uORTALITV. THE COMMUNICABLE DISEASE CENTER
WELCOMES ACCOUNTS Or INTERESTING OUTBREAKS OR CASES. SUCH
ACCOUNTS SHOULD BE ADDRESSED TO
LA. RENCE .. ALTMAN. M.D., EDITOR
MCRBIDITY iND MORTALITY WEEKLY REPORT
COMMUNICABLE DISEASE CENTER
ATLANTA. GEORG IA 303)3
NOTES T.ESE PROVISIONAL DATA ARE BASED ON WEEKLY TELE-
GRAMS TC THE COMMUNICABLE DISEASE CENTER EB THE INDIVIDUAL
STATE HEALTH DEPARTMENTS.
MBOLS DATA NOT AAILABL.E
QUANTITY ZERO
PROCEDURES C01 CONSTRUCTION OF VARIOUS MORTALITY CURVES
MA' BE OBTAINED FROM STATISTICS SECTION. COMMUNICABLE
DISEASE CENTER. PUBLIC mEALTM SERVICE. U.S. DEPARTMENT Or
HEALTH. EDUCATION. AND WELFARE. A-LANTA. GEORGIA 30333.


235


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