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:
AA00010654:00442

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

FS' go/ : V/3 /

COMMUNICABLE DISEASE CENTER -










U.S.*- D





U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE PUBLIC
_4


Vol. 14, No. 31






Week Ending
August 7, 1965


.SERVICE


INSTITUTIONAL OUTBREAK OF PNEUMONIA

Washington, D. C.
Since July 2T a total of 62 cases of acute pneumonia,
18 of them associated with the isolation of Klebsiella
pneumoniae (Friedlander's bacillus), have occurred in a
large psychiatric hospital in Washington. D. C. There
have been eight deaths, most of which have occurred in
cases recognized as Klebsiella pneumonia early in the
outbreak. Postmortem examinations of six of the fatalities
have shown gross pathological findings consistent with a
bacterial pneumonia and Klebsiella pneumoniae has been
isolated from cultures of purulent material obtained from
lung specimens of each of these six cases. Klebsiella


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parirmo'iuar ha. al-o hleen i-olai'd ltom sputum or throal
swabs of 12 other pneumonia patients.
The hospital presently accommodates nearly 6,100
patients. Tho'e with acute pneumonia, however, have
been predominantly males, many of whom are associated
in a therap'. group of 700 male patients. The distribution
(Continued on page 266)


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous weeks)
31st WEEK ENDED CUMULATIVE. FIRST 31 WEEKS
MEDIAN
DISEASE AUGUST 7. AUGUST 1, 1960- 1964 MEDIAN
1965 1964 1960 -1964
Aseptic meningitis ......... 64 47 69 947 999 999
Brucellosis ............... 5 6 10 144 241 250
Diphtheria ............... 1 1 3 90 160 234
Encephalitis, primary infectious 35 42 941 1,125 -
Encephalitis. post-infectious 12 22 --- 481 629 ---
Hepatitis, infectious including
serum hepatitis .......... 515 532 694 20,786 24,239 26,800
Measles .............. 1,141 1,746 2,074 236.275 456,914 388,568
Meningococcal infections ...... 39 43 33 2,169 1,795 1,425
Poliomyelitis, Total 3 3 33 32 61 334
Paralytic . 2 3 24 25 50 239
Nonparalytic .. ............ 1 --- 7 8 --
Unspecified .............. ..- --- 3 -

Streptococcal Sore Throat and
Scarlet fever ........... 3,797 3,911 3,368 265 065 271,407 222,143
Tetanus ..... .............. 11 8 --- 149 151 -
Tularemia ................ 3 9 148 199 -
Typhoid fever ... 15 11 15 229 236 315

Rabies in Animals ** '. '.. 74 69 62 2.846 2,827 2,381
Notifications from New Mexico for
current week have not been received. NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax. ..... . .......... 6 Rabies in Man: ........................... 1
Botulism: ................................ 11 Smallpox: .............................. 1
Leptospirosis:... ..... ................... 22 Trichinosis: Colo.-l .. ....... ....... 72
Malaria: Mass.-1 ................. .......... 44 Typhus-
Plague: ................................. Murine: Texas-3 ............. .......... .. .. 21
Psittacosis: . . . ..... 27 Rky. Mt. Spotted: Ill.-, N.C.-3, Ala.-1, Ark.-, Ga.-2, 167
Cholera ................... ............ 2 Ky.-2. Ohio-2, Tenn.-2, Okla.-1








Morbidity and Mortality Weekly Report


INSTITUTIONAL OUTBREAK OF PNEUMONIA
(Continued from front page)


of cases according to age is consistent with the age dis-
tribution of the total population of inpatients; there have
been 49 male cases and 13 female cases. No widespread
minor illnesses have been reported in the hospital as a
whole either prior to or during the outbreak of acute pneu-
monia which appeared to reach its peak in the first week
of August.
Apart from the demonstration of Klebsiella pneu-
moniae in 18 cases, there has not been any other etiologi-
cal agent identified up to the present time. Serological
studies of acute and early convalescent serum specimens


from the first 32 patients have been undertaken. So far,
employing antigens for histoplasmosis, blastomycosis,
psittacosis, Q fever, mycoplasma, and adenoviruses, there
has been no suggestion of acute infection with any of
these agents.
Epidemiological and laboratory studies are continuing.
(Reported by Dr. Dale C. Cameron, Hospital Superintend-
ent, Dr. Murray Grant, Director of Public Health, District
of Columbia, and a team of CDC epidemiologists working
with the staff of the Hospital and the Department of
Public Health.)


RABIES IN ANIMALS AND MAN 1964

Annual Surveillance Summary


There were 4,784 laboratory confirmed cases of animal
rabies during 1964, which is 20 percent more than in 1963.
Substantially larger numbers of reports of fox and skunk
rabies accounted for this increase.
The incidence of animal rabies had dropped steadily
from 1946 to 1960, but since 1961 this trend has been re-


versed (Figure 1).The distribution of animal rabies through-
out the U. S. is shown in Figure 2. Only 4 States recorded
no cases of animal rabies, while 19 States reported a re-
duction and 28 States, an increase. The incidence of ani-
mal rabies in the U. S. from 1953 to 1964 is detailed in
Table 1.


Table 1
INCIDENCE OF RABIES IN THE UNITED STATES BY TYPE OF ANIMAL 1953-1964*


FARM OTHER
YEAR DOGS CATS ANIMALS FOXES SKUNKS BATS ANIMALS MAN TOTAL

1953 5,688 538 1,118 1,033 319 8 119 14 8,837
1954 4,083 462 1,032 1,028 547 4 118 8 7,282
1955 2,657 343 924 1,223 580 14 98 5 5,844
1956 2,592 371 794 1,281 631 41 126 10 5,846
1957 1,758 382 714 1,021 775 31 115 6 4,802
1958 1,643 353 737 845 1,005 68 157 6 4,814
1959 1,119 292 751 920 789 80 126 6 4,083
1960 697 277 645 915 725 88 108 2 3,457
1961 594 217 482 614 1,254 186 120 3 3,470
1962 565 232 614 594 1,449 157 114 2 3,727
1963 573 217 531 622 1,462 303 224 1 3,933
1964 409 220 594 1,061 1,909 352 238 1 4,784


*Data prior to 1960 from USDA, ARS. Subsequent data from PHS, CDC.


266


August 7. 1965


(Text continued on page S69)








Figure I.

CASES OF RABIES IN WILD AND DOMESTIC ANIMALS


1953-1964


TOTAL


WILD -




DOMESTIC


I.! I I I I I I I


'60


'61 '62


'63


'64


'65


Source: USDA, ARS and USPHS, CDC


8,000-





6,000-


4,000-





2,000-


1953


cs,









00


COUNTIES REPORTING ANIMAL RABIES 1964

.* POSITIVE STATES 46

S .,* POSITIVE COUNTIES- 1139

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** *.** *' *.*1**.* TOTAL CASES 4783

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Morbidity and Mortality Weekly Report


RABIES IN ANIMALS AND MAN-1964 Annual Surveillance Summary
(Continued from page 2'i;)


Dog rabies declined to the lowest level yet recorded,
being only 10 percent of the total. Just under one-third of
the dog rabies occurred in the four States on the U.S.-
Mexican border. Another 26 percent occurred in the four
contiguous States of Kentucky, Tennessee, Missouri, and
Illinois. These eight States have accounted for 62 percent
of the dog rabies reported in 1963 and 58 percent in 1964.
Wildlife rabies accounted for 75 percent of the total
animal rabies in 1964, foxes and skunks giving rise to over
S2 percent of this subtotal. There has been a substantial
increase in the incidence of bat rabies since the first con-
firmed case in 1953 (Figure 3). A total of 35 States re-
ported one or more cases of bat rabies during the year;
Mississippi reported 67, the largest number from any one


State prior to 1964. For 2 years Mi-~il-ilpi had been free
of animal rabies.
One human rabies death occurred in a 10-year-old
Minnesota boy, following the bite of a rabid skunk (MMARt,
Vol. 13, No. 38). This one case of human rabies had a
short incubation period of 20 days and despite 14 doses of
duck embryo vaccine, starting on the day of occurrence,
the patient died. This is not considered to be a case of
vaccine failure as experience has shown that rabies vac-
cine is usually effective in preventing rabies only when it
is given immediately after exposure and the incubation
period exceeds 30 days.

(Reported by the Zoonoses Surveillance Unit of CDC.)


Figure 3.
CASES OF RABIES IN BATS 1953-1964


YEAR


269


August 7. 1965









Morbidity and Mortality Weekly Report


EPIDEMIOLOGIC NOTES


BAT RABIES Iowa

On the evening of June 8, 1965, a four-year-old boy
was riding his tricycle down the driveway of his aunt's
house when a bat fell or swooped from a nearby tree. As
this happened a car turned into the driveway and the bat,
swerving to avoid it, hit the boy on the back and clung to
his T-shirt. The boy grabbed the bat and flung it on to
the pavement, stunning it. The occupants of the car got
out; since the bat was still alive, they killed it using a
stick. The City Health Department was called and the
bat, described as being grey and brown in color, with a
body 3 to 4 inches long and with a wingspan of about 14
inches, was removed for laboratory tests.
The boy was taken to a physician who found two
superficial scratches on the boy's back in the lower
thoracic region. These scratches were washed with hydro-
gen peroxide and hyperimmune rabies serum was given.
On June 10 the Iowa State Hygiene Laboratory re-
ported that brain, brown fat, and salivary gland tissues
from the bat were all positive for rabies, using the flu-
orescent antibody technique. The same day the physician
gave the boy the first dose of a duck embryo rabies vac-
cine series.
No other person had had any direct contact with the
infected bat. Other bats had been seen flying in the
vicinity of the house the evening the boy was attacked.
There is a drainage tunnel which goes under the streets
nearby where bats are said to harbor, but none were found
in this tunnel when it was inspected. Further investiga-
tions are proceeding.
(Reported by Ralph H. Heeren, M.D., State Epidemiolo-
gist, and Carl Zymet, DVM, Asst. Public Health Veteri-
narian, Iowa State Health Department.)


CUTANEOUS ANTHRAX South Carolina
A case of cutaneous anthrax involving a 29-year-old
U.S. Customs inspector has been reported from Charleston,
South Carolina. On July 27 the inspector first noticed a
a small pimple on his right forearm and experienced head-
ache, stiff neck, and malaise. A few days later when the
pimple began to itch, it drew attention to several smaller
erythematous papule-like lesions several centimeters be-
low the initial pimple. On August 1, the patient squeezed
the pimple, which caused a small amount of thin bloody
discharge. Later that day he noted some firmness around
the affected area and developed chills and fever to 100
degrees. The following day the patient saw his private
physician.
By this time there was a thin brown crust on the fore-
arm, one centimeter in size, with a five millimeter ring of


erythema and some surrounding edema. Lymphangitis ex-
tended from the lesion half-way up the upper arm. Several
firm, pea-size nodules were palpated along the route of
the lymphangitis, but epitrochlear, axillary, and cervical
lymphadenopathy were not present.
Although the patient denied any known contact with
animals or plants, he said that he had inspected bales of
imported wool as recently as July 15. He vaguely recalls
being bitten by a fly in the area of the lesion, possibly
while working on July 15. On the basis of this history the
physician diagnosed cutaneous anthrax and treated the
patient with 750 mg. of tetracycline given every 4 hours.
During the next few days the patient's systemic symptoms
disappeared. The lesion itself did not show any significant
changes and a black eschar was never noted.
Although the prolonged incubation period and charac-
teristics of the lesion were not typical of cutaneous an-
thrax, the clinical story and the contact with wool are
consistent with the diagnosis. Laboratory studies have
failed to confirm the diagnosis but the patient had had
substantial antibiotic therapy prior to the collection of
laboratory specimens.
(Reported by Dr. G. E. McDaniel, Director, Division of
Disease Control, South Carolina State Board of Health;
Dr. E. K. Aycock, Charleston County Health Department;
and the Staff of the Investigations Section of CDC.)



ANIMAL ANTHRAX North Dakota
An outbreak of anthrax in cattle near the Turtle River
in Grand Forks County, North Dakota has been reported.
Nineteen head of cattle on six separate farms have died.
Three of these cases have been confirmed in the laboratory.
The first death occurred June 15, and the last known death
on July 31. All cattle affected have been on pasture re-
ceiving no supplemental feed with the exception of salt.
Evidence points to contaminated soil as the route of trans-
mission. No documented history of anthrax exists for the
area, although one individual recalled a diagnosis of
anthrax in a horse in 1929 on one of the involved farms.
No human cases have been reported. As two of the
animals were found dead in the River, some concern was
felt for a camp of diabetic children downstream from the
area; penicillin was administered, as a prophylactic, to
these children.
Samples of soil, salt, and river water are now being
studied in the laboratory.
(Reported by Robert Eelkema,D.V.M., M.D., Infectious
Disease Consultant. School of Medicine, University of
North Dakota, Grand Forks; Dr. James R. Amos, State
Health Officer; Mr. Kenneth Mosser, North Dakota State
Epidemiologist. Bismarck; and a team from CDC.)


270


August 7, 1965








SUMMARY OF REPORTED CASES OF INFECTIOUS SYPHILIS


CASES OF PRIMARY AND SECONDARY SYPHILIS: By Reporting Areas July 1964 and July 1965 Provisional Data

Cumulative Cumulative
Reporting Area July Jan. Jul. Reporting Area July Jan. Jul.
1965 1964 1965 1964 1965 1964 1965 1964
NEW ENGLAND .............. 27 33 261 286 EAST SOUTH CENTRAL........ 209 214 1,656 1,008
Maine.......................... 3 1 4 Kentucky.................. 7 14 83 81
New Hampshire............ 3 22 6 Tennessee................ 42 42 343 258
Vermont................. 1 2 3 Alabama.................. 105 121 897 509
Massachusetts ............ 16 10 152 167 Mississippi............... 55 37 333 160
Rhode Island............. 1 3 10 11
Connecticut.............. 6 17 74 95 WEST SOUTH CENTRAL.......... 229 225 1,389 1,485
Arkansas................. 18 13 140 118
MIDDLE ATLANTIC........... 428 447 2,722 3,192 Louisiana................ 68 72 392 393
Upstate New York........ 61 57 299 394 Oklahoma................. 4 12 76 94
New York City............ 239 244 1,620 1,859 Texas.................... 139 128 781 880
Pa. (Excl. Phila.) ...... 9 18 91 81
Philadelphia ............. 22 27 154 194 MOUNTAIN .................. 49 40 335 319
New Jersey............... 97 101 558 664 Montana .................. 7 8 23
Idaho .................... 1 3
EAST NORTH CENTRAL........ 230 184 1,739 1,284 Wyoming.................. 2 7
Ohio..................... 50 46 370 312 Colorado................. 7 2 24 16
Indiana.................. 1 7 33 37 New Mexico............... 8 14 64 128
Downstate Illinois....... 16 11 128 86 Arizona.................. 28 15 188 117
Chicago.................. 88 73 708 509 Utah..................... 1 2 9 8
Michigan................. 69 43 449 312 Nevada ................... 5 39 17
Wisconsin................ 6 4 51 28
PACIFIC................... 184 166 1,207 1,323
WEST NORTH CENTRAL........ 42 40 293 295 Washington............... 5 8 47 43
Minnesota................ 8 5 59 72 Oregon.................. 3 2 21 39
Iowa .................... 4 5 14 19 California............... 174 153 1,122 1,223
Missouri................... 12 22 138 133 Alaska................... 1 1 5 7
North Dakota........ Hawaii............. 1 Hawaii........ 1 2 12 11
South Dakota............. 4 26 28
Nebraska.................. ... 15 1 45 24 U. S. TOTAL............... 1,966 1,999 13,548 13,322
Kansas.................... 3 3 10 19
TERRITORIES............... 60 71 461 486
SOUTH ATLANTIC............... 568 650 3,946 4,130 Puerto Rico.............. 56 63 449 466
Delaware................. 5 2 34 45 Virgin Islands........... 4 8 12 20
Maryland ................ 46 54 252 308
District of Columbia..... 36 48 288 441
Virginia................. 31 29 207 165
West Virginia............ 3 1 39 25
North Carolina........... 102 128 600 653 Note: Cumulative Totals include revised and delayed reports
South Carolina........... 61 83 488 525 through previous months.
GeorgiaJ................. 66 91 624 722
Florida.................. 218 214 1,414 1,246


..;;; ;;;;;;;;;;iiiIiiiii.......... ..


. _.. .... ..... ...


JUtLY 1965 JULY 1964











272 Morbidity and Mortality Weekly Report


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

AUGUST 7, 1965 AND AUGUST 1, 1964 (31st 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... 64 47 35 12 3 32 61 2 25 50 1 90

NEW ENGLAND........... 4 1 1 2 2 1
Maine.............. 2 1 -
New Hampshire...... -
Vermont........... -
Massachusetts .... -
Rhode Island....... 1 -
Connecticut....... 1 -

MIDDLE ATLANTIC...... 9 2 13 1 2 8 1 1 8 5
New York City...... 1 3 1 1 1 3
New York, Up-State. 1 1 2 5 -- 5 -
New Jersey.......... 3 7 1 1 2 1 1 2 -
Pennsylvania....... 4 1 1 2

EAST NORTH CENTRAL... 5 4 2 1 10 9 3
Ohio............... 1 1 2 2 -
Indiana............. 1 2
Illinois............ 3 1 1 1 5 5 -
Michigan........... 1 3 1 -
Wisconsin.......... 1 1

WEST NORTH CENTRAL... 3 4 1 7 4 6 3 18
Minnesota.......... 2 3 1 1 I 1 7
Iowa............... l 2 2 1
Missouri........... 1 1 2 1 1
North Dakota....... -
South Dakota....... 7
Nebraska........... 3 3 1
Kansas............. I I 1 -

SOUTH ATLANTIC....... 4 6 5 3 1 1 19 1 1 14 23
Delaware........... I -
Maryland........... 1 1 1 1 1 1 -
Dist. of Columbia.. 3
Virginia........... 2 -
West Virginia...... I 1 -
North Carolina..... 9 5 2
South Carolina... 1 1 1
Georgia............ 11
Florida............. 2 4 3 1 7 6 6

LAST SOUTH CENTRAL... 7 5 1 1 4 1 3 1 16
Kentucky........... 4 5 -
Tennessee........... 2 -1 1 2 1 1 -
Alabama............ 1 2 2 1 15
Mississippi........ I

WEST SOUTH CENTRAL... 15 1 4 1 12 5 10 5 19
Arkansas............ -1 2
Louisiana........... 2 1- 1 2
Oklahoma............ 2 -- 2 -
rexas .............. 15 1 1 1 11 3 9 3 15

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

PACIFIC............. 16 21 7 5 3 3 3 3 5
Washington......... 2 1 2 -
Oregon... ........ 1 1 1 1
California.......... 11 17 5 5 1 2 1 2 4
Alaska............. 2 -
Hawaii.............. 2 2 -


Puerto Rico I I -- _7









Mlorbidity and Morlalit Weekly Report 273


CASES OF SP-( IFI-I) NOTIFIAHLI I)ISIASFS I NI 1l) STATES

FOR W'FKS I-NI)II)
AI'(.IIST 7, 1965 AND AUIG ; I 1. 1964 (31st WI '1 ) Continued


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


UNITED STATES... 5 515 238 250 20,786 24,239 39 2,169 1,795 11 149

NEW ENGLAND.......... 27 16 9 1,235 2,346 1 110 49 5
Maine.............. 2 1 1 227 763 16 5
New Hampshire...... 5 4 117 170 1 6 1 1
Vermont............. 69 301 6 1 -
Massachusetts...... 16 8 7 486 488 35 20 3
Rhode Island....... 2 1 1 150 125 14 7
Connecticut ....... 2 2 186 499 33 15 1

MIDDLE ATLANTIC...... 103 42 61 3,682 5,449 5 286 224 1 10
New York City...... 32 7 25 718 814 1 50 32
New York, Up-State. 30 17 13 1,443 2,436 1 77 65 4
New Jersey......... 23 9 14 690 972 1 76 76
Pennsylvania....... 18 9 9 831 1,227 2 83 51 1 6

EAST NORTH CENTRAL... 1 94 45 39 3,977 3,743 9 295 246 4 18
Ohio................ 24 6 10 1,109 986 4 79 64 1
Indiana............. 15 12 3 354 333 39 38 6
Illinois........... 1 13 7 4 747 661 3 78 63 2 7
Michigan............. 38 19 19 1,518 1,475 2 64 54 2 2
Wisconsin.......... 4 1 3 249 288 35 27 2

WEST NORTH CENTRAL... 3 17 11 6 1,266 1,325 109 112 1 11
Minnesota.......... 1 1 125 136 22 26 7
Iowa............... 3 5 4 1 461 187 7 6 1 2
Missouri........... 6 3 3 275 331 50 53 1
North Dakota....... 17 52 7 13
South Dakota....... 17 108 2 -
Nebraska............ 1 1 44 33 10 6 1
Kansas............. 4 3 1 327 478 11 8

SOUTH ATLANTIC....... 60 26 31 2,130 2,274 5 423 376 37
Delaware........... 59 43 6 6
Maryland........... 10 2 8 392 434 39 25 1
Dist. of Columbia.. 27 37 8 12 -
Virginia............ 8 4 3 481 356 49 43 7
West Virginia...... 11 8 2 321 355 24 26 1
North Carolina..... 8 5 3 199 403 82 65 5
South Carolina..... 82 78 1 57 49 3
Georgia............ 6 5 1 84 55 53 52 4
Florida............ 17 2 14 485 513 4 105 98 16

EAST SOUTH CENTRAL... 28 12 14 1,473 1,701 2 171 156 1 21
Kentucky........... 8 4 2 519 671 68 53 6
Tennessee........... 5 2 3 512 574 1 50 51 1 6
Alabama............ 13 5 8 260 301 1 33 34 8
Mississippi........ 2 1 1 182 155 20 18 1

WEST SOUTH CENTRAL... 1 37 21 16 1,816 1,810 1 297 214 3 30
Arkansas............ 6 2 4 239 183 14 19 2 8
Louisiana.......... 5 2 3 307 416 1 166 105 4
Oklahoma........... 1 1 1 43 94 18 7 1
Texas............... 25 16 9 1,227 1,117 99 83 1 17

MOUNTAIN............. 17 4 4 1,213 1,475 3 68 64 3
Montana............ 2 1 1 89 134 2 -
Idaho.............. 162 181 8 3
Wyoming............. 1 1 35 45 1 5 5 -
Colorado........... 2 1 1 255 398 13 11 2
New Mexico.......... --- --- --- --- 257 208 --- 10 26
Arizona............. 9 246 340 16 5 1
Utah............... 3 2 1 162 127 2 12 6
Nevada............. 7 42 2 8

PACIFIC............... 132 61 70 3,994 4,116 13 410 354 1 14
Washington......... 12 3 8 317 458 32 26
Oregon............ 9 6 3 334 462 1 29 20 3
California......... 108 50 58 3,143 2,986 11 326 289 1 11
Alaska............. 3 2 1 168 129 1 16 7 -
Hawaii............. 32 81 7 12


Puerto Rico 48 37 11 834 609 5 30 3 27









274 Morbidilt and Mortality Weekly Report


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

AUGUST 7, 1965 AND AUGUST 1, 1964 (31st 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... 1,141 236,275 456,914 3,797 3 148 15 229 74 2,846

NEW ENGLAND.......... 29 36,615 16,424 348 1 4 3 35
Maine................ 8 2,772 2,873 23 3
New Hampshire...... 381 242 4 1
Vermont............. 1,245 2,287 3 29
Massachusetts...... 7 19,191 5,088 80 1 3 1
Rhode Island....... 4 3,892 1,906 37 1 -
Connecticut........ 10 9,134 u,028 204 1

MIDDLE ATLANTIC...... 145 14,348 51,738 161 3 39 2 115
New York City...... 59 2,215 15,186 5 -- 18 -
New York, up-State. 31 .,021 12,532 141 1 11 2 103
New Jersey.......... 40 2,477 12,130 6 2 4 -
Pennsylvania....... 15 5,635 11,890 9 6 12

EAST NORTH CENTRAL... 481 54,506 101,885 316 11 1 33 13 431
Ohio............... 15 8,785 19,490 17 1 8 8 224
Indiana ............ 50 1,784 22,558 113 4 9 2 42
Illinois........... 52 2,552 16,500 50 5 7 1 74
Michigan........... 136 26,064 28,642 98 1 4 2 43
Wisconsin.......... 228 15,321 1-,695 38 1 5 48

WEST NORTH CENTRAL... 3 16,321 30,051 134 15 1 7 17 590
Minnesota.......... 2 621 320 4 1 2 121
Iowa............... 22 8,962 23,203 13 1 2 165
Missouri........... 4 2,559 1,010 11 10 1 5 4 81
North Dakota ....... l 3,618 .,683 75 38
South Dakota....... I II? 13 2 2 3 44
Nebraska........... 449 812 1 2 33
Kansas............. NN Nri NN 29 2 4 108

SOUTH ATLANTIC....... 101 24,246 37,860 343 28 2 46 6 392
Delaware............ 2 501 404 10 -
Maryland........... 18 1,125 3,387 43 1 15 2 13
Dist. of Columbia.. 1 73 353 12 -
Virginia........... 7 3,792 12,655 129 5 2 1 263
West Virginia...... 73 13,438 8,478 130 2 1 19
North Carolina..... 375 1,151 7 6 1 14 2
South Carolina .... 1,005 4,220 9 3 4 2
Georgia............ 612 177 3 14 2 1 41
Florida............ 3,325 7,035 3 1 52

EAST SOUTH CENTRAL... 51 13,537 67,205 825 18 23 13 634
Kentucky............ 5 2,405 18,397 89 3 6 1 63
Tennessee.......... 38 7,749 23,806 639 14 8 10 551
Alabama............ 7 2,288 18,320 44 1 5 2 L4
Mississippi........ 1 1,095 6,682 53 4 6

WEST SOUTH CENTRAL... 87 30,339 71,362 486 2 55 2 32 14 448
Arkansas........... 1,081 1,105 2 37 1 11 2 63
Louisiana.......... 3 102 97 2 5 65
Oklahoma............ 201 1,002 21 8 2 3 80
Texas............... 84 28,955 69,158 465 8 I 14 9 240

MOUNTAIN............. 87 19,403 18,012 573 1 15 4 19 3 58
Montana.............. 17 3,668 2,936 40 1 4 1 1 3
Idaho............... 17 2,739 1,852 54 -- -
Wyoming............. I 841 242 4 3 -
Colorado............ 8 5,570 3,126 264 -- 1 8
New Mexico......... --- 670 420 --- --- --- 9 --- 11
Arizona............. 23 1,239 6,493 106 1 6 2 35
Utah............... 20 4,473 1,963 105 8 1
Nevada............. 1 203 980 2 2 -

PACIFIC.............. 117 26,960 62,377 611 6 1 26 3 143
Washington........... 7,205 19,946 62 2 6
Oregon.............. 11 3,157 8,463 7 2 3 3
California......... 63 12,730 32,428 465 4 1 20 3 132
Alaska............. 5 154 1,077 17 2
Hawaii............. 38 3,714 463 60 1 -

Puerto Rico 18 2,231 5,517 2 2 5 12









275


Morliidity and Mortality Weekly Report






DEATHS IN 122 UNITED STATES CITIES FOR WEIK FNDFD Al (.1 7I 1965


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

All Causes Pneumonia Under All Causes Pneumonia Under
Area All 65 years and 1 year Area All 65 year and 1 year
Influenza All
Ages and overInfluenza All Ages and over Aflues n Aus
All Ages Causes All Ages Causes


NEW ENGLAND:
Boston, Mass.---------
Bridgeport, Conn.-----
Cambridge, Mass.-------
Fall River, Mass.-----
Hartford, Conn.--------
Lowell, Mass.---------
Lynn, Mass.-----------
New Bedford, Mass.----
New Haven, Conn.------
Providence, R. I.-----
Somerville, Mass.----
Springfield, Mass.----
Waterbury, Conn.------
Worcester, Mass.------

MIDDLE ATLANTIC:
Albany, N. Y.--------
Allentown, Pa.--------
Buffalo, N. Y.--------
Camden, N. J.--------
Elizabeth, N. J.------
Erie, Pa.------------
Jersey City, N. J.---
Newark, N. J.--------
New York City, N. Y.--
Paterson, N. J.-------
Philadelphia, Pa.-----
Pittsburgh, Pa.------.
Reading, Pa.---------
Rochester, N. Y.------
Schenectady, N. Y.----
Scranton, Pa.--------
Syracuse, N. Y.-------
Trenton, N. J.---------
Utica, N. Y.---------
Yonkers, N. Y.--------

EAST NORTH CENTRAL:
Akron, Ohio----------
Canton, Ohio----------
Chicago, Ill.--------
Cincinnati, Ohio------
Cleveland, Ohio-------
Columbus, Ohio--------
Dayton, Ohio---------
Detroit, Mich.--------
Evansville, Ind.------
Flint, Mich.---------
Fort Wayne, Ind.------
Gary, Ind.------------
Grand Rapids, Mich.---
Indianapolis, Ind.----
Madison, Wis.--------
Milwaukee, Wis.-------
Peoria, Ill.----------
Rockford, Ill.--------
South Bend, Ind.-------
Toledo, Ohio----------
Youngstown, Ohio------

WEST NORTH CENTRAL:
Des Moines, Iowa------
Duluth, Minn.---------
Kansas City, Kans.----
Kansas City, Mo.------
Lincoln, Nebr.--------
Minneapolis, Minn.----
Omaha, Nebr.---------
St. Louis, Mo.--------
St. Paul, Minn.-------
Wichita, Kans.--------


662
237
27
22
25
39
23
19
27
36
62
13
54
22
56

2,773
36
33
145
35
21
45
58
67
1,432
31
365
190
35
78
15
39
63
23
33
29

2,401
52
30
704
166
201
101
58
329
46
63
50
22
52
136
42
100
24
46
40
84
55

784
63
29
35
115
33
119
67
227
51
45


390
133
19
13
19
20
12
13
20
24
30
7
33
18
29

1,563
20
23
83
14
15
29
34
30
790
16
216
90
23
45
10
27
44
14
20
20

1,284
25
20
347
94
95
52
28
177
22
35
29
10
36
82
18
62
10
31
23
51
37

447
35
15
15
70
21
69
34
132
32
24


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


988
104
231
56
60
76
56
71
23
62
59
161
29

520
73
37
34
87
125
49
32
83

1,075
40
29
23
144
34
53
193
43
186
76
134
52
68

361
40
12
111
32
90
19
37
20

1,518
16
40
43
41
66
530
56
37
119
58
76
201
41
122
38
34


58
7
14
5
3
2
1
4
1
1
6
12
2

49
14
3
3
5
9
4
1
10

84
1

5
12
3
1
18

16
5
10
10
3

37
3
2
14
2
7

7
2


Total 11,082 6,002 371 698

Cumulative Totals
including reported corrections for previous weeks

All Causes, All Ages ------------------------- 389,242
All Causes, Age 65 and over------------------- 220,317
Pneumonia and Influenza, All Ages------------- 16,489
All Causes, Under 1 Year of Age--------------- 23,121


31st WEEK










Morbidity and Mortality Weekly Report


UNIVERSITY OF FLORIDA



3 1262 08864 2151


August ", 1965


TH-E MORBIDITY AND MORTALIT% WEEKLY REPORT. WITH A CIRCULA-
TION OF 14.000 IS PUBLISHED AT THE COMMUNICABLE DISEASE
CENTER ATLANTA GEORGIA.


CHIEF. COMMUNICABLE DISEASE CENTER
CHIEF EPIDEMIOLOGY BRANCH
ACTING CHIEF. STATISTICS SECTION
CHIEF I SURVEILLANCE SECTION

EDITOR MMWR


JAMES L. GODDARD. M.D.
A. D. LANGMUIR, M.D.
IDA L. SHERMAN. M.S.
D. A. HENDERSON. M.D.

D.J.M. MACKENZIE. M.B..
F.R.C.P.E.


"N ADDITION TO THE ESTABLISHED PROCEDURES FOR REPORTING
MOORBIDITY AND MORTALITY THE COMMUNICABLE DISEASE CENTER
AELCOME-5 ACCOUNTS OF INTERESTING OUTBREAKS OR CASE IN-
VEJTICA TIONS WHICH ARE OF CURRENT INTEREST TO HEALTH
OFFICIALS AND WHICH ARE DIRECTLY RELA TED TO THE CONTROL OF
COMMUNICABLE DISEASES SUCH COMMUNICATIONS SHOULD BE AD-
DRESSED TO

THE EDITOR
MORBIDITY AND MORTALITY WEEKLY REPORT
COMMUNICABLE DISEASE CENTER
ATLANTA. GEORGIA 3033

NOTE THE DATA IN THIS REPORT ARE PROVISIONAL AND ARE BASED
ON 'iEEILY TELEGRAM TO THE CDC BY THE INDIVIDUAL STATE
-EA.LTH DEPARTMENTS THE REPORTING WEE CONCLUDES ON SAT-
JRDAY. COMPILED DATA ON A NATIONAL BASIS ARE RELEASED ON
THE SUCCEEDING FRIDAY[ .


30
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DOCUMENTS DEPOT.








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