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:
AA00010654:00433

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


Prepared by the


I :- -LE DISA EC


For release April 10, 1964


ATLANTA, GEORGIA 30333


Vol. 13. No. 15


PRO'VIIO(NAL INFORMATION ON 511 I 1 1) NOTIFIABI. DIs1 A.SL IN THE UNITED STATES AND ON
)EAlFisi IN SILICTED ( IIl IS )R WEEK ENDI)EDAPRIL II, 1964 f


MENINGOCOCCAL MENINGITIS


A total of 98 cases of mltninlg.'o.O L.il mi. ,in.iti was
reported for the week ended April 11. Of this total, 37 were
reported from 3 Sraies, California reported 17, Kentucky 12,
and Missouri 8.
The 17 cases reported from California were from 8
separate counties stretching the entire I knerh of the State.
Kentucky's 12 new cases raises its 1'.0 cumulative
total to 31. Eight of the 12 cases this past week were
reported from Fort Knox; 3 of the 8 cases were fatal. The
retraining 4 cases, believed unrelated, were from scat-
tered areas of the State. A sulfa prophylaxis program was
held at Fort Knox.
Five of Missouri's 8 cases occurred ir Fr. Lc-onard
Wood personnel, 2 of the 5 were fatal. The rcm.uindr ol


cases were from scattered ir l -uri's
2i cases this year, 12 FT1r1' I trno tFiSr .irl


The '' cases raise il umulla hiE to 'ui or
the first 15 weeks. The 4 portF. 'or i-r I
week are about double the lyeat median r 1l. '/9- .I, but
the o10; i total to date is onl rniu -uin bo~oal.r trh
comparablet period of 1963. Thi A[ .um oaI.l 1
about 6 percent above the 5 year nih-ian.

Although the overall total is about the same as last
year, many States in the South and sijurheast as well as
Nfv Mexico and Californii hat shown notable irnreas-es
in cumulative ,'1m rotral case's.


Tible I. CASES OF SPECIFIED NOTIFIABLE DISEASES UNITED STATES
(Cumulative totals include revised and delayed reports through previous weeks)
15th Week Ended Cumulative. First 15 Week.
Disease April 11, April 13, Median Median
1964 1963 1959 1963 1964 1463 1959 1963

Aseptic meningitis ................ 41 22 --" 410 333
Brucellosis ....................... 6 6 10 106 93 1i8
Diphtheria ........................ 3 8 8 55 99 222
Encephalitis, primary infectious .. 31 .76 384
Encephalitis, post-infeLtious ..... 24 --- 19
Hepatitis, infectious including
serum hepatitis ................ 771 792 836 13,736 15,-89 15, 89
Heasles .... ...................... 26,935 17.542 17,542 167.27- 178,245 183,291
Heningococcal infections .......... 98 5! 51 901 898 852
Poliomyelitis, Total .............. 3 11 19 3 123
Paralytic ........................ 3 9 13 38 78
Nonparalytic ................... --- 5 2 --
Unspecified .................... --- 1 3
Streptococcal Sore Throat and
Scarlet fever .................. 11,322 7,.05 --- 162,480 146,Q75
Tetanus ........................... 4 4 --- 55 50 ---
Tularemia ................... ..... 3 4 --- 76 58 ---
Typhoid fever ..................... 6 13 11 95 106 139
Rabies in Animals ................. 109 100 100 1,250 1,056 1,208


Table 2. NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax: 2 Psittacosis: Ga.-l 13
Botulism: 6 Rabies in Man:
LepLospirosis: 6 Smallpox
Malaria: 27 Typhus-
Plague: Murine 2
Rky Mt. Spotted: Tenn.-l, Okla.-1 6


Figures For Current Week Exclude Missing Report From Alaska.


634-5131


F 5 2 .6 p 9: 13 /IS








Morbidity and Mortality weekly Helport


EPIDEMIOLOGICAL REPORT
JIMO.N WEED POISONING TENNESSEE


An unusual outbreak of stramonium food poisoning re-
lated to iim-on weed consumption was reported from Haw-
kins County, Tennessee. Fiue persons in all became ill
between 5 minutes and 5 hours after consuming tomatoes
which contained the alkaloid.
Fur minutes after caring, 2 adults became acutely
ill at the luncheon table with visual hallucinations,
,i,-oricn(taton. generalized weakness, blurred, vi-
sion, pronounLid thirst, .rrtigo and nausea. They were
hospitalized immediarl'-r. On physical examination, both
had dilated, sluggish% reactive pupils. Within 5 hours of
this meal, the 3 others sharing it had become ill with
similar, but milder, %' mproms.
The meal had consisted of fresh, sliced tomatoes,
-plit pea soup. spaght Ii, sweet milk, and cornbread. Both
the split pea soup and spaghetti had been served 2 days
earlier. they had been reheated for this meal.

One individual had consumed 3-1 2 slices of tomato
and 4 others had eaten 1 slice each of fresh tomato. Com-
mrcriallh canned tomatoes were used in the spaghetti.
In a telephone call from the hospital to Dr. Cecil B.
Tucker, Director, Division of Preventable Diseases,
Tennessee Stare Health Department, it was noted that the
tomatoes served at the meal had been "grown with jimson
weed." Immediate examination of the State Toxicology
files yieldedd a description of jimson weed poisoning, the
toxic principal being the alkaloids stramonium, hyoscya-
mine, scopolamine, and srropine, Certain that jimson weed
explained their symptoms, Dr. Tucker immediately tele-
phoned this information to their physicians.

A description of each of the cases follows:
Case 1: Five minutes after eating 3-1/2 slices of tomatoes,
a 48-year-old male developed blurred vision and experienced
vertigo when he attempted to stand. Within the next hour, he
experienced visual hallucinations (bugs and flowers). He at-
tempted to pick objects out of the air and twist imaginary door
knobs. He complained of extreme thirst, xerostomia, muscle
spasms in the lower extremities, and mild cramping abdominal
pain. When he presented to the emergency room, he was irra-
tional, continued to hallucinate, and was incontinent of urine.
His temperature was 990F., blood pressure 120 80. pulse 100,
and Iespiraitons 20. His face was moderately flushed and the
oral mucous membranes were drn. Both pupils were widely di-
lated and reacted sluggishly to light. The remainder of the gen-
eral physical and neurological examinations was unremarkable
except for slight twitching of the lower extremities. Routine
urinalysis and blood counts were normal.
The patient was started on oral pilocarpine after stramo-
nium was implicated as the etiological agent, receiving a total
of 10 mgm. during the night of admission. Rapid improvement
followed with return of a clear sensorium. The patient was a-
symptomatic at the time of his discharge on October 30.


Case 2: Within five minutes after eating one tomato slice, a
tO-year-old female cried our, "I'm going blind!" She became
drowsy and laid her head on the table for a few moments. When
she attempted to stand, her vision again became blurred and
she experienced marked vertigo. Mild nausea, abdominal cram-
ping pain, and vomiting followed within the hour. She com-
plained of extreme thirst and xerostomia, unrelieved by repeated
gulps of water. On arrival at the hospital, she was disoriented
and was having visual hallucinations. She was unable to walk
or sit without support. Her temperature was 990F., blood pres-
sure 130 80. pulse 88, and respirartons 22. Both pupils were
dilated and reacted sluggishly to light. She continued to com-
plain of blurred vision. The oral mucous membranes were dry.
There was moderate tenderness to abdominal palpation. The
remainder of the examination was normal. A sedimentation rare
of 42 mm. per hour was the only abnormal laboratory value.
She received the same treatment as Case 1 and was discharged
from the hospital 2 days after admission.

Cose 3: A 42-year-old female are one tomato slice, fell
somewhat "goofy" approximately one hour after the noon meal,
and later experienced slight vertigo, xerostomia, generalized
weakness, and loss of appetite. When examined char evening,
she was found to have dilated, reactive pupils Because of the
mildness of her symptoms, she was not hospitalized but given
10 mgm. of pilocarpine orally at the emergency room. By the
following day, she was entirely a.ymptomaric.
Case 4: A 31-year-old male experienced only mild nausea.
diarrhea, and cramping abdominal pain approximately 5 hours
following the noon meal. He are one tomato slice. He was nor
hospitalized and received no medications.
Case 5: A 3-year-old boy are one tomato slice and remained
asvmptomatic until approximately 5 hours following the noon meal
when he developed blurred vision, vertigo, loss of appetite, and
visual hallucinations (crawling bugs). Later that evening, he
was observed to have dilared, reactive pupils. During the fol-
lowing day, he complained of abdominal pain with vomiting and
diarrhea. He was asymptomatic on the following evening. He
was not hospitalized and received no medications.

The tomato consumed at the meal was obtained from a
tomato plant grafted to the root of a jimson weed (Datura
stramonium). This had been done in an attempt to produce
a larger tomato, more resistant to cold.
Case Number I had become familiar with this grafting
procedure through a neighbor (not a victim). This neighbor
had attempted tomato grafting with several plants for 5
years, but had been successful only with the jimson weed.
He had only occasionally tasted tomatoes from these
plants. He never experienced ill effects.
The tomato consumed at the above meal was the first
to be eaten from Case Number I's plants. Following this
incident, it was learned that Case Number l's grafts were
made with an above-ground secondary branch of the jimson
weed, whereas the neighbor had always grafted the stalks
to the roots below ground.


12t,








Morbidity and Mortality Weekly Report


Tennessee health authorities conclude that this modi-
fication in technique may have accounted for the toxicity
of Case Number I's tomatoes.
One whole tomato was retrieved from Case Number
l's home and forwarded to the Tennessee Industrial Hy-
giene Laboratory. This was produced by the same grafting
technique but did not come from the same plant that
yielded the tomato consumed at the above meal. Three
tomatoes were also obtained from the neighbor's home
(grown by grafts made to the root stalks).
Case Number l's tomato yielded 4.2 milligrams of
stramonium alkaloids per 100 grams of tomato; the neigh-
bor's tomatoes yielded 1.9 milligrams per 100 grams.
The tested tomato would contain about 1.0 milligrams
of oral alkaloid per slice, according to calculations from
the laboratory results; since the ingested tomato was not
analyzed, direct comparison of dosage and sympromatology
is not possible

(Reported by W. L. Clark, M.D., Church Hill, Tenn.; R. H.
Jernigan. M.D., Kingsport, Tenn.; J. W. Erwin, M.D.,
Director. Sullivan County Health Department; Margaret
Daiidson, R..V. Public Health Nurse, Hawkins County;
and Cecil B. Tucker, M.D., Director, Division of Pre-
ventable Diseases, Tennessee State Health Department.)


Editor's Note: Numerous case reports of jimson weed poi-
soning have appeared in the medical literature; yet there
is no available report of the stramonium alkaloids being
transferred to a second plant grafted to the host jimson
weed.


The jimson weed (Datura stramonium), also known as
thorn apple, Jamestown weed, stink weed, devil's apple,
and apple of Peru, is a species of the Solanacea family to
which the red pepper, tobacco, tomato, and belladonna
plants belong. The plant is prevalent in this country and
in all temperate and tropical zones,flowering in late spring
and with the fruit ripening in early fall. All parts of the
plant are poisonous, especially the seeds. It is a rank-
scented, tall, branched plant which attains a height of
three to six feet with trumpet-shaped flowers and spinous
capsule which contains numerous black-brown seeds.1
The plant grows wild around barn yards, manure piles,
and road slides, and is readily available to the sampling
of inquisitive children. Mitchell2 reported that between
1950 and 1955, jimson weed intoxication accounted for 4
percent of pediatric patients admitted to the University of
Virginia hospital because of the accidental ingestion of
toxic substances. In this hospital this was approximately
the same frequency as intoxications due to lead, alcohol,
barbituates, and insecticides. Most cases result from the
plant's use in Jimson weed tea, reported to be an effective
treatment for asthma and other respiratory ailments.

REFERENCES
1. Jennings, R.E.: Stramonium poisoning: review of the
literature and report of two cases. J. Pediat. 6: 657,
1935.
2. Mitchell, Joe E., and F.N. Mitchell: Jimson weed
(Datura stramonium) poisoning in children. J. Pediat.
47:227, 1955.
3. Goodman, L.S., andAlfred Gilman:The pharmacological
basis of therapeutics, The Macmillan Company, second
edition, New York, 1958, pages 552-553.


INFANT DEATHS IN 108 CITIES


The weekly average number of infant deaths in 108
cities for the four-week period ending April 11 was 748
as compared with an expected 726 weekly average.


NMBER
OF 8no
DEATHS
900TW


Total Deaths Under One Year of Age Recorded in 108 Cities

Week Ending
Week Ending -4 Week Weekly
3/21 3/28 4/4 4/11 Total Average

Observed 786 706 739 761 2,992 748
Expected 731 728 725 722 2,906 726

Excess 55 -22 14 39 86 22


DEATHS UNDER ONE YEAR OF AGE IN 108 US. CITIES
Ave,.w Number pr Week by Four-WeWk Periods


"Eperre l
_7
1 -Es---




C 3 ~


....... ..m


S96'_ '962 2i- ____
pr -a0 oe occc **C-CA.Autb m r o,1 ,t BmeNc


(See Table, page 131)


127


_X


-"


""


s


-










128 ~11orbidily andl Mortalil) 'eUrekly Keporl


Table 3. ( AM% OF- NPE( III l) NO lIFIABIE DIAE AM.. I N Iil) STATES

FI-R W I LK ~N NDFD

APRIL II 1964 AND APRIL 14. 196~ 1 15th WEEK)


Amptic Encephalati
A~rpftc ---- ---
Mrni n.it i Primarry Plt-lnf. Pi I omy l ti Total Cases P.lI i.,my-l1i l, Paralytic
Area
Cumulative Cumulative
16hi. 1963 96.. 16- 146. 1963 1964 1963 196,. 1963 1964 1963
UNITED STATES... 41 22 31 2. 3 19 43 3 13 38

NEW ENGAND........... 1 2 -
aine .............. -
New Hampshire...... -
Vermont.......... -
Massachusets..... 1 1 -
Rhode Island....... -
Connecticut........ -

MIDDLE ATLANTIC ...... 3 2 4 4 4 5 5
New York City...... I I -
New York, Up-State. 2 1 1 2 4 2 4
New .I r...ey........ 2 2 I -
Pennsylvania....... 1 3 1 -

EAST NORTH CENTRAL.. 4 10 10 2 1 12 2 1 10
Ohio................ 3 4 1 4 1 3
Indiana............. 2 -
Illinois........... 3 4 5 1 1 6 1 5
Michigan.............. I 1 2 .
Wisconsin......... -

WEST NORTH CENTRAL... 2 1 4 |
Minnesota............ 2 1 2 1 1
Iowa.............. -
Missouri........... 1 -
North Dakota....... .- .
South Dakota....... -
Nebraska ........... -
Kansas............. .- -

SOUTH ATANTIC...... 2 6 1 9 3 6 2
Delaware............ 2 -
Maryland ........... .
Dist. of Columbia.. .
Virginia........... I -
West Virginia...... -
North Carolina..... 3 4 2 1 2
South Carolina.... 1 1 -
Georgia ............. .. 1 1 I
Florida ............ 2 1 3 -

EAST SOUTH CENTRAL... 7 3 1 1 1 3 1 2
Kentucky .......... -
Tennessee.......... 1 1 1 1 l
Alabama.............. 2 I
Mississippi ........ 3 1 -

WEST SOUTH CENTAL... 6 3 2 2 9 1 9
Arkansas ........... -
Louisiana ......... 8
Oklahoma........... I -
Texas.............. 6 2 2 2 1 1 1

MOUNTAIN ............. 1 3 1 2 1 -
Montana............ -
Idaho.............. I 1
Wy,,'m in. ........... -
Colorado............ 1 3 I 1 -
New Mexico........ 1 -
Arizona............ -
Utah............... -
Nevada ............ -

PAlIFIC .............. 16 9 2 8 9 8
W'a hi ng on......... 3 -- -
Olrev in ............. -
Califurnia ......... 9 9 2 8 7 6
Alaska .... ......... ... -
a ...........- -

Purr r Ric. 2- 2








Mlurbidilv and Mortality Weekly Reporl 129


Table 3 CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

APRIL II. 1964 AND APRIL I 1965 ( 15ih WEEK) Continued


Infectious hepatitis
Brucellosis Diphtheria including Serum Hepatitts Typhoid Fever

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

1964 1964 1964 196w 1964 1964 196- 1964 1964 1963 1964 1964

UNITED STATES... 6 106 3 55 771 357 348 66 13,736 15,489 6 95

NEW ENGLAND.......... 1 1 4 43 17 24 2 1,489 1,884 7
Maine............... 1 15 5 10 526 873 -
New Hampshire...... 121 126
Vermont............. -- 8 5 2 1 183 27 -
Massachusetts..... 1 1 3 6 2 4 290 561 4
Rhode Island....... 5 1 4 68 48 3
Connecticut........ 9 4 4 1 301 249 -

MIDDLE ATLANTIC...... 2 196 86 110 3,092 3,012 I 17
Neu York City...... 1 44 15 29 439 362 5
New York, Up-State. I 69 35 34 1,384 1,368 1 4
New Jersey......... 42 17 25 560 467 -
Pennsylvania....... 1 1 41 19 22 709 815 8

EAST NORTH CENTRAL... 1 15 6 122 64 42 16 2,052 2,431 2 21
Ohio............... 27 11 10 6 546 734 14
Indiana............ 1 15 4 11 169 219 1 3
Illinois........... 10 6 17 4 6 7 322 508 3
Michigan........... 1 2 55 43 12 893 839 1 I
Wisconsin .......... 2 8 2 3 3 122 131 -

WEST NORTH CENTRAL... 2 55 1 9 40 21 14 5 816 677 9
Minnesota.......... 2 1 2 9 4 1 65 114
Iowa................ 1 27 6 3 2 1 119 117 3
Missouri ........... 4 6 1 5 200 285 2
North Dakota....... 35 16 -
South Dakota....... I 10 5 2 3 86 15 1
Nebraska........... 10 18 54 -
Kansas.............. I 7 14 11 3 293 76 3

SOUTH ATLANTIC....... 6 11 83 41 36 6 1,354 1,659 2 20
Delaware............. I 1 30 25 -
Maryland............ .- 20 10 10 260 187 -
Dist. of Columbia.. 26 57 -
Virginia........... 2 17 4 8 5 205 362 4
West Virginia...... 10 8 1 1 237 243 -
North Carolina..... 1 16 11 5 249 452 9
South Carolina..... 3 2 I I 42 69 1 2
Georgia........... .- 2 6 2 1 31 61 -
Florida............ 1 2 15 6 9 274 203 1 5

EAST SOUTH CENTRAL... I 5 4 54 31 17 6 966 1,600 10
Kentucky........... I 1 22 13 4 5 428 480 5
Tennessee.......... I 21 11 9 1 330 619 4
Alabama............. 3 2 8 5 3 133 243 I
Mississipp ........ 1 1 3 2 1 75 258 -

WEST SOUTH CENTRAL... 1 5 10 7l 44 28 2 992 1,043 6
Arkansas ........... I 6 6 115 127 3
Louisiana.......... I 2 21 12 9 203 190 -
Oklahoma........... 1 6 4 1 1 62 59 3
Texas............... l 2 8 41 22 18 1 612 667 -

HOUNTAIN.............. I 1 1 55 18 9 28 920 1,087
Montana............. 8 4 4 85 169 -
Idaho............. 2 2 68 160 -
Wyoming............ 32 17
Colorado.......... 26 10 2 14 282 233
New Mexico........ 1 1 5 2 1 2 146 133 -
Arizona............ 8 8 197 244 -
Utah.............. 1 8 4 2 82 122 -
Nevada.............. I 2 ? 28 9 -

PAC1FIC.............. 6 1 6 104 35 68 1 2,055 2,096 1 5
Washington......... 1 6 10 5 5 212 346 1 1
Oregon............. I 13 2 10 1 215 312
California......... 5 79 26 53 1,520 1,380 4
Alaska.............. .. --- -- --- --- --- --- 61 46 ---
Hawaii........... .. 2 2 47 12

Puerto Rico 3 20 14 6 193 199 5









130 Morbidity and Mortality Weekly Report


Table 3. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED
APRIL 13, 1964 AND APRIL II, 1963 (---- 15th WEEK) Continued


Streptococcal
Meningococcal Sore Throat and Rabies in
Measles Meningitis Scarlet Fever Tetanus Tularemia Animals
Cumulative Cum. Cum. Cum.
1964 1964 1964 1963 1964 1963 1964 1964 1964 1964 1964 1964
UNITED STATES... 26,935 98 901 898 11,322 7,405 4 55 3 76 109 1,250

VNE ENGLAND........... 658 26 62 1,425 909 1 4
Maine............... 100 2 10 47 71 1 2
New Hampshire...... 5 2 3 1 1
Vermont............ 124 1 2 26 I
Massachusetts...... 190 13 28 250 169 -
Rhode Island....... 108 2 6 135 73 -
Connecticut........ 131 8 14 964 585 -

MIDDLE ATLANTIC..... 2,567 14 90 111 533 557 1 3 25
New York City...... 765 5 17 13 41 52 -- -
New York, Up-State. 558 4 33 37 353 297 3 24
New Jersey......... 646 14 19 80 106 -
Pennsylvania........ 598 5 26 42 59 102 1 1

EAST NORTH CENTRAL... 4,167 7 143 147 1,459 1,132 5 8 15 130
Ohio................ 1,293 3 45 43 299 160 1 1 9 68
Indiana............ 420 1 25 17 62 147 1 8
Illinois........... 891 1 29 24 215 195 2 5 5 24
Michigan........... 794 1 32 44 576 410 I I 12
Wisconsin.......... 769 1 12 19 307 220 I 18

WEST NORTH CENTRAL... 1694 10 50 55 506 209 1 3 21 44 402
Minnesota.......... 18 2 10 10 34 13 1 16 120
Iowa............... 1405 2 2 140 55 1 1 1 13 139
Missouri........... 16 8 26 24 56 13 2 13 5 76
North Dakota ....... 195 3 1 150 100 3 20
South Dakota...... 3 44 10 7 34
Nebraska............ 60 4 13 8
Kansas............. NN 5 2 82 18 6 5

SOUTH ATLANTIC ....... 2380 17 197 184 1347 315 2 22 13 6 196
Delaware........... 17 2 1 15 6 -
Maryland ........... 214 1 15 26 219 38 -
Dist. of Columbia.. 20 2 7 3 14 4 -
Virginia........... 566 2 18 47 186 134 1 2 3 3 140
West Virginia...... 635 2 16 9 412 8
North Carolina..... 61 2 33 29 26 31 *- 7 3 2
South Carolina..... 360 6 29 12 79 19 3 *
Georgia............ 2 17 11 6 1 1 7 2 21
Florida............ 507 60 46 390 82 1 8 1 25

EAST SOUTH CENTRAL... 5197 19 95 76 2018 962 1 8 16 8 191
Kentucky............ 1908 12 31 19 181 49 1 1 1 25
Tennessee.......... 1494 4 34 33 1616 860 3 11 8 160
Alabama............ 35 1 17 11 4 25 3 3 6
Msissisippi........ 1760 2 13 13 217 28 1 1 -

WEST SOUTH CENTRAL... 5933 8 77 103 983 698 8 3 14 18 203
Arkansas........... 226 1 7 5 9 8 2 2 3 3 46
Louisiana.......... 3 5 65 46 3 20
Oklahoma........... 53 3 18 74 16 10 2 22
Texas............... 5651 2 2 34 900 674 3 1 1 13 115

MOUNTAIN............. 879 2 36 32 1742 1334 2 4 5 50
Montana............ 124 1 89 50 1 -
Idaho............... 117 1 1 171 179 -
Wyoming............ 1 1 20 65 1 1
Colorado........... 151 7 7 699 545 -
New Mexico......... 10 2 18 2 386 237 1 I 25
Arizona............ 380 2 6 157 123 4 25
Utah............... 96 1 11 220 129 2
Nevada............. 1 6 3 6 -

PACIFIC.............. 3460 21 187 128 1309 1289 6 49
Washington.......... 798 1 16 11 33E 497 -
Oregon ............. 318 2 11 6 41 38 -
California ......... 2340 17 150 105 895 696 6 9 49
Al ska ............ --- --- 5 4 --- 41 -
Hawaii ............. 4 1 5 2 31 17 -

Puerto Rico 238 I 9 I 19 1 6








131


Morbidity and Mortality Weekly Report





Tahbl (() TOTAL DEATHS 'NDER I YEAR OF AGE IN REPORTING CITIES



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


For weeks ending For weeks ending
Area 3/ 1 { Area 4
3/21 3/28 4/4 4/11 3/21 3/28 / 4/4 6111


NEW ENGLAND:
Boston, Mass.............. 19 16 18 18
Bridgeport, Conn.......... 2 3 2 -
Cambridge, Mass........... 2 -
Fall River, Mass.......... 3 -
Hartford, Conn............. 4 1 8 6
Lowell, Mass............. I I- 3
Lynn, Mass................ I -
New Bedford, Mass........ 1 2
New Haven, Conn............ 6 2 3 6
Providence, R............ 7 7 4 3
Somerville, Mass.......... 2 1 -
Springfield, Mass......... 4 1 5
Waterbury, Conn............ I
Worcester, Mass........... 1 2 4

MIDDLE ATLANTIC:
Albany, N.Y............... 3 2 4 3
Allentown, Pa............. 1 2 3 4
Buffalo, N.Y............... 4 9 10 8
Camden, N.J.............. 4 3 4 4
Elizabeth, N.J............ 1 I -
Erie, Pa.................. 2 1 1 3
Jersey City, N.J.......... 6 2 5 4
Newark, N.J. .............. 5 23 7 3
New York City, N.Y........ 95 90 77 104
Paterson, N.J............. 3 4 3 3
Philadelphia, Pa.......... 28 16 28 44
Pittsburgh, Pa............ 15 7 11 5
Reading, Pa............... 4 2 2 1
Rochester, N.Y............ 5 8 2 1
Schenectady, N.Y.......... 4 5 3
Scranton, Pa.............. 3 3 -
Syracuse, N.Y.............. 3 4 6
Trenton, N.J.............. 4 2 7 2
Utica, N.Y................. I I
Yonkers, N.Y.............. 2 3 3

EAST NORTH CENTRAL:
Akron, Ohio................ 2 1 3 2
Canton, Ohio............... 2 2 2 -
Chicago, Ill.............. 51 37 47 45
Cincinnati, Ohio........... 12 12 4 13
Cleveland, Ohio........... 14 16 14 6
Columbus, Ohio............. 14 10 15 6
Dayton, Ohio............... 1 8 7 4
Detroit, Mich............. 26 20 23 25
Evansville, Ind ........... 4 3 2 2
Flint, Mich............... 2 5 3 3
Fort Wayne, Ind........... 6 1 -
Gary, Ind................. 2 4 8 3
Grand Rapids, Mich........ 4 2 5 3
Indianapolis, Ind......... 8 11 12 8
Madison, Wis............. 2 3 6 2
Milwaukee, Wis............ 7 10 4 13
Peoria, Ill .............. I 3 8
Rockford, Ill....... ..... 1 I 2
South Bend, Ind........... 1 6 3
Toledo, Ohio.............. 55 6 2
Youngstown, Ohi............ 4 4 5

WEST NORTH CENTRAL:
Des Hoines, Iowa........... 5 2 4 7
Duluth, Minn............... I 1 2
Kansas City, Kans......... 6 2 5 4
Kansas City, Mo............ 8 10 5 6
Lincoln, Nebr ............ 1 2 3
Minneapolis, rinn ......... 8 6 7 8
Omaha, Nebr.............. 8 3 4 3
St. Louis, Mo.............. 22 11 6 17
St. Paul, Minn............ 6 3 7 7
Wichita, Kans............. 5 3 3 9


I.


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 Chriati, 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.............


San Juan, P.R.............. 3 -


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.....


9
18
9
6
5
5
6
2
1
3
33
3


5
5
2
9
8
6
6
2


2

1
16
6
4
15
3
16
1
8
2
4


2
2
6

6
1
2
3



6
2
4
1
32
4

8
4*
6
15
3
6

2


12,122
537
761
6,822


NOTr All .drlh by place ol of urrenc


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








132 Morbidity and Mlo




INTERNATIONAL NOTES
POLIOMYELITIS Chile
Duurinr the first week of February an outbreak of
poliomyelitis began in Santiago Province. The outbreak
reached its peak with a weekly total of 28 cases in the
third week of that month and then declined. As of March 2
a total of 71 confirmed cases had bi.-n reported.
The decrease was attributed to the rapid mass vac-
cination carried out by the National Health Service
throughout Santiago Province, which immunized 164,-31
children in the agr range 3 months to 3 years. A break-
doan by age of the cases shows that 25 percent were
under 1 year of age, 29 percent between 1 and 2 years
and 22 percent between 2 and 3 years. The great majority
of cases thus occurred in children under 3 years. The
age distribution is similar to that observed in the epi-
demic of 1961. Of the cases 80 percent were unvaccinated,
10 percent were inadequately immunized and 10 percent
had received the prescribed 2 doses of trivalent vaccine.
Most of those in the last-mentioned group had completed
their vaccination more than one year before the outbreak.
Type I poliovirus was isolated from many patients. No
type II or type III virus was isolated. From the rest of
the country only isolated cases have been reported.
(Reported in Weekly Epidemiological Report, Pan Ameri-
can Sanitary Bureau, WHO, April I, 1964.)


rta


UNIVERSITY OF FLORIDA

HIlII lllllllllllillIIlillllll
3 1262 08864 3027
lily Weekly Report




In addition to the established procedures for reporring morbidity
and mortality, the Communicable Disease Center welcomes
accounts of interesting outbreaks or cases. Such accounts should
be addressed to:

Lawrence K. Altman, M.D., Editor
Morbidity and Mortality Weekly Report
Communicable Disease Center
Atlanta. Georgia 30333



Nores- These prov.,sonol data are based on weeLly telegroms to the Communi-
cable 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
StatisticE Section, Communicable Disease Center, Public Health Service.
U. S. Department of Health, Education, and Welfare, Atlanta, Gearga 30333.


I C ,UyNM Qr FT- L'B





'U O EPOSITORY


QUARANTINE MEASURES
Immunization Information for International Travel
1963-64 Edition
Public Health Service Publication No. 384
The following information should be added to the list of
Yellow Fever Vaccination Centers in Section 6:
Page 75


Gastonia, North Carolina


Center:


Gaston County Health Department
615 N. Highland Street
Tel: 864-4331


Clinic Hours:

Fee:


Tuesday, 2:00 p.m.

Yes


The Morbidity and Mortali,r Weekly Report, with a circulation
of 11,000 is published by the Communicable Disease Center,
Atlanta, Georgia.
Chief, Communicable Disease Center James L. Goddard, M D.
Chief, Epidemiology Branch A. D. Langmuir, M.D.
Chief, Statistics Section R. E. Serfling. Ph.D.
Asst. Chief, Statistics Section I. L. Sherman, M.S.
Chief, Surveillance Section D. A. Henderson, M.D.
Editor, MMWR L. K. Altman, M.D.


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