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:
AA00010654:00450

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



COMMUNICABLE DISEASE CENTER



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Vol. 14, No. 35

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Week Ending
September 4, 1965


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


PLAGUE New Mexico


A fifth case of human plague, which proved fatal,
has occurred on the Navajo Reservation. The clinical
records and the postmortem reports indicate that this
was a case of bubonic plague terminating with secondary
plague pneumonia. The patient was a 14-year-old Indian
boy living near Red Rock, approximately 10 miles south
of Gallup and within 2 to 3 miles of the home of the first
human case reported (MMWR, Vol. 14, No. 30).
The boy was admitted to the Division of Indian Health
Hospital at Gallup at 5 p.m. on August 26 with a history
of headache, fever, and anorexia of sudden onset one day
previously. On admission the patient was disoriented


CONTENTS


PIAJrLu New Mexico ......
-:pidr-miolouic Note. and HRcport-
Lo'c i e idoilom co.'. .
( Cutmneoiu- Anthr,


ii rn' 10-
N 1. .U01


and .tuporou4. I. 1em,&lhtuLe'%-1 11, l bhut ph.yital
examination, in dI an X-raN of M if est, did not
elicit an\ definiE a oplog'. Blood/ixa nation showedd
a leucocytosis of 'l i301i0 a-' hift to the left.
A lumbar puncture N1viea nabnor finding-;.
By the next morning the patient seemed better.
However, at 2 p.m. he vomited and his temperature was


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous weeks)
35th WEEK ENDED CUMULATIVE, FIRST 35 WEEKS
MEDIAN
DISEASE SEPTEMBER 4, AUGUST 29, 1960-1964 MEDIAN
1965 1964 1965 1964 1960-1964
Aseptic meningitis ......... 68 57 94 1,181 1,234 1,358
Brucellosis ........ .............. 5 6 6 169 291 291
Diphtheria ......... ...... 3 4 101 174 254
Encephalitis, primary infectious 48 360 --- 1,107 1,819 --
Encephalitis, post-infectious 9 10 --- 527 676 -
Hepatitis, infectious including
serum hepatitis .......... 541 535 689 23,008 26,540 29,714
Measles .. ............... 468 704 781 238,930 460,784 394.271
Meningococcal infections .... 24 91 30 2,271 1,977 1,535
Poliomyelitis, Total ......... 1 2 37 36 71 473
Paralytic ....... .. 1 2 31 29 59 367
Nonparalytic ************ ---- 7 9 --
Unspecified ********** --- 3-
Streptococcal Sore Throat and
Scarlet fever ........... 3,534 3,878 2,994 280,202 287,366 233,691
Tetanus .........******... 5 4 --- 181 183
Tularemia ......... 9 7 --- 175 231 -
Typhoid fever .....* *** ***. .* 10 11 17 274 269 395
Rabies in Animals ...... '''47 101 46 3,096 3.169 2.614

NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax: ................................. 7 Rabies in Man: *.................... ....... 1
Botulism: ............. .................. 11 Smallpox: .............................. -
Leptospirosis: .............................. 27 Trichinosis: .............................. 74
Malaria: Okla.-I ........................... 55 Typhus-
Plague: N.M.-1.................. ............. 5 Murine: Tex.-l .. .....................** 22
Psittacosis: Va.-1 .................. .......... 32 Rky. Mt. Spotted: N.Y. Ups.-l, Pa.-4. Md.-1, N.C.-1
Cholera: ............................... 2 Tenn.-1, Va.-3 ....................... 209


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Morbidity and Mortality Weekly Report


PLAGUE New Mexico
(Continued from front page)


then 104F. By 6 p.m. he was having hallucinations and
labored breathing; rales were noted in the chest and he
began coughing and producing a blood-streaked frothy
sputum. An X-ray examination showed a bilateral pulmonary
infiltration. Despite antibiotic therapy with penicillin
and streptomycin the patient died at 10:15 p.m.
On postmortem examination there was a bilateral
pleural effusion with edematous infiltration of both lungs;
there were also enlarged and hemorrhagic lymph nodes in
the right axilla. Smears from the lymph nodes showed gram
negative bi-polar rods; blood cultures and lung tissue
have since yielded isolates of Pasteurella pestis in the
San Francisco Plague Laboratory.
The other members of the boy's family, the father,
mother, grandmother, and four siblings, were all admitted
to the Hospital for surveillance and given chemotherapy
with sulfadiazine and streptomycin. None have developed
symptoms suggestive of plague and all have now been
discharged from the hospital.
Prairie dog "towns" in the vicinity of the patient's
home show evidence of a recent epizootic with heavy
rodent mortality. Specimens of fleas from the burrows are
under laboratory examination. The house and the immediate
surroundings have been treated with insecticide prior
to the return of the family.
Field investigations are continuing in the areas known
to be affected by the epizootic among prairie dogs. To
date, fleas collected from burrows in the Prewitt, New
Mexico, and Dilkon, Arizona, areas have yielded isolates
of Pasteurella pestis (MMWR, Vol. 14, No. 33). At Tinion,
New Mexico, near Torreon and around the home of the
fourth human case reported, an epizootic in progress has
yielded two recently dead prairie dog carcasses which
have proved positive for plague both by isolation of
Pasteurella pestis and by fluorescent antibody techniques.


LINE LISTING OF CASES OF PLAGUE New Mexico, 1965
Admitted
Case Sex Age Hospital Residence Laboratory Remarks
1 M 3 7 1 Red Rock P Bubonic. meningeal
localization; recovered
2 F 2 1/2 7/9 Gamerco C Bubonic; meningeal
localization; recovered
3 M 9 8/1 Prewitt C Bubonic; recovered
4 F 3 1/2 8/14 Tinion C Bubonic; recovered
5 M 14 8/26 Red Rock C Bubonic; terminal
pneumonic; died
P = Presumptive smears with bacilli morphologically compatible.
C Confirmed Pasteurella peatis isolated from culture.


Teams from the Health Departments concerned and
from the Fish and Wildlife Service are engaged in rodent
control operations in and around the centers of population
most at risk. Meeting places such as schools, trading
centers, and fair grounds are receiving priority attention.
Gassing and poisoning of rodents and dusting of premises
and burrows with insecticides are being carried out
according to the needs of the areas affected.

(Reported by Dr. Robert L. Zobel, Indian Health Service
Area Director, Albuquerque, New Mexico; Dr. Robert L.
Brutche, Medical Officer in Charge, .Public Health
Service Indian Hospital, Gallup, New Mexico; Dr. Dean
Tirador, Chief, Community Health Services, Windowrock
Field Office, Division of Indian Health, New Mexico;
Dr. T.M. Tomlinson, Associate Director, New Mexico
Department of Public Health, Sante Fe, New Mexico;
Dr. John Bourne, District Health Officer, District S,
New Mexico; the CDC Plague Station, San Francisco,
California; and a team from CDC.)


EPIDEMIOLOGIC NOTES AND REPORTS
COCCIDIOIDOMYCOSIS Canoga Park, California


On Monday, February 22, 1965, a group of 22 boys
playing "war games" dug a 6-foot-deep trench in an
empty lot near their homes in Canoga Park in the western
part of the San Fernando Valley in Los Angeles County.
Subsequently, between 7 and 31 days later, there were
27 infections later proved to be due to coccidioidomycosis
(Valley Fever), 26 of which were associated with illnesses
of varying severity.
Of the 22 children who played in the trench, 20
developed symptoms. These varied from fever and malaise
or erythema nodosum alone to a characteristic clinical
picture of fever, general malaise, chest pain, cough,


rash, and the subsequent development of erythema nodosum
after the acute symptoms subsided.
In addition to the 20 frank cases among boys who
played in the trench, there were 6 other associated clinical
cases. The mother of one boy who had played in the
trench shook out his clothes before putting them in the
washing machine. Her niece who was visiting the family
stood next to her when she shook the clothing. Both
developed coccidioidomycosis 25 days and 11 days later
respectively. Other mothers had put the children' clothes
straight into their washing machines. A man living opposite
the lot in which the trench was dug, and whose children


302


September 4. 1965








Morbidity and Mortality Weekly Report


were not present at the dihgini. filled in the trench. He
also developed the disease 10 days later.

Three other clinical cases occurred in girls agedl
8, 1I. and 14, none of whom had been associated with
the trench digging. One girl played in the field both tibelor
and after digging. Another is a sister of brothers who had
been digging and she may have had some contact with
their clothes. The third ,irl. who had no contact with the
field but lives within two blocks of it, was noted to have
a low grade fever early in March but no specific date of
onset was given. She developed erythema nodosum on
March 17.


One of the two asymptomatic boys has shown a skin
test conversion from negative to positive after the exposure
on February 22. Although his chest X-ray and CF test
are negative, he has been regarded as the 2L7h case. The
other child had a positive skin test on first examination
butall other tests were negative. He has not been recorded
as a case as he may have had unrecognized coccid-
ioidomycosi. previously.


Fi.urI 1 shows the epidemic curve for the J2 cases
of coccidioidomycosis directly associated with the
trench digging. The !maljoril of cases occurred within 9
to 13 daits after exposure. All have positive coccidiocin
skin tests; 12 have converted from nrit1ili\ to positive
skin tests while under observation. None of the patients
required hospitalization and to date none have shown
any dissemination of the disease. A follow-up clinic has
been established for these patients at the Canoga Park
Health Department.
Coccidioides immitis has been isolated from 6 of 36
soil samples collected from the trench and has also been
isolated from several samples taken from random areas
of the empty lot. Measures to eradicate the infection
from the field are in progress u-ing a fungicidal spray.
(Reported by Dr. Dean W. Gilman, Health Officer of the
West Valley Health Department, Van Nuys, California;
Dr. Paul F. Wehrle, Chief, Communicable Disease
Division, Los Angeles County Hospital, California;
Dr. Herbert Cowper, Acute Communicable Disease
Division, Los Angeles County Health Department,
California; and an EIS Officer.)




FIGURE I.


CASES OF

COCCIDIOIDOMYCOSIS BY DATE OF ONSET

CANOGA PARK, CALIFORNIA-1965


C3

0
I


w-


J4


I I i I


I I I I I I I I I
22 24 26 28 2
FEBRUARY


. I M


I I I I I I I I I I
8 10 12 14 16
MARCH


18 20 22 24 26
18 20 22 24 26


FIGURE EXCLUDES 3 CASES WITH UNKNOWN ONSET DATE


(Epidemiologic Notes and Reports Continued on Back Page)


to 5-
w
4 4-
LL.
o 3-

" 2-

Z I


303


September 4, 1965










304 Morbidity and Mortality Weekly Report


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

SEPTEMBER 4. 1965 AND AUGUST 29, 1964 (35th 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... 68 57 48 9 1 36 71 1 29 59 3 101

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

MIDDLE ATLANTIC...... 8 13 13 1 3 12 1 2 11 5
New York City...... 2 6 1 1 1 1 3
New York, Up-State. 2 1 4 9 8 -
New Jersey.......... 3 2 5 1 2 2 1 2 2 -
Pennsylvania....... 1 4 3 2

EAST NORTH CENTRAL... 17 5 8 1 .1 12 11 4
Ohio............... 2 2 5 2 2 I
Indiana............. 1 2 2 2
Illinois........... 6 1 3 1 1 5 5 -
Michigan........... 8 2 2 1 -
Wisconsin.......... 1 1 1

WEST NORTH CENTRAL... 8 7 9 3 8 5 7 4 18
Minnesota.......... 6 6 1 3 1 1 1 1 7
Iowa............... 1 1 2 2 1
Missouri........... 1 1 3 2 1
North Dakota....... 5 -
South Dakota....... 1 7
Nebraska........... 3 3 1
Kansas............. 1 1 1 1 1 1

SOUTH ATLANTIC....... 2 6 3 1 20 1 15 29
Delaware........... 1 1 -
Maryland............. 1 1 1 1 -
Dist. of Columbia.. 3
Virginia............ -
West Virginia...... 1 1 1 1 -
North Carolina...... 9 5 2
South Carolina..... 1 3 1
Georgia.......... 1 1 14
Florida............ 1 2 8 7 9

EAST SOUTH CENTRAL... 5 1 5 1 4 16
Kentucky........... 5 -
Tennessee.......... 1 3 1 2 -
Alabama............ 2 2 15
Mississippi........ 1

WEST SOUTH CENTRAL... 5 5 1 2 14 6 12 6 3 23
Arkansas........... 1 2
Louisiana.......... 1 1 1 2 5
Oklahoma........... 2 2 -
Texas............... 4 5 1 1 13 4 11 4 1 16

MOUNTAIN............ 2 1 7 5 6 3 3 -
Montana............ 1 1 -
Idaho.............. -
Wyoming............ 4 2 2 -
Colorado........... 2 1 1 -
New Mexico......... 1 3 1 -
Arizona............ 1 1 4 2 -
Utah............. -
Nevada............ -

PACIFIC.............. 25 14 3 3 3 3 3 3 5
Washington......... 1 2 2 -
Oregon............. 1 1 1
California......... 21 14 3 3 1 2 1 2 4
Alaska.............. -
Hawaii............. 3 -

Puerto Rico 9










M1orbidity and Morlality Weekly R lporl 305


CASES OF SPECIFIED NOTIIHAHLE DI)I AlI S UNITED STA I I

FOR WEEKS INI)ID
MPTI MHI R 4, 1965 AND Al (.1 'I 29, 1964 (35th t II k) Continued


Brucel- Infectious Hepatitis M, ini n, ,,..Lt
losia 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... 5 541 242 276 23,008 26,540 24 2,271 1,977 5 181

NEW ENGLAND.......... 1 30 12 16 1,348 2,504 113 52 5
Maine.............. 3 1 2 251 804 16 5 -
New Hampshire...... 2 2 134 189 7 1 1
Vermont............ 1 1 73 315 6 1 -
Massachusetts...... 1 18 6 11 532 537 37 21 3
Rhode Island ...... I 156 130 14 8
Connecticut........ 5 2 3 202 529 33 16 1

MIDDLE ATLANTIC..... 91 39 52 4,104 5,925 297 251 11
New York City...... 26 4 22 806 899 51 35 -
New York, Up-State. 27 15 12 1,586 2,637 84 71 4
New Jersey......... 14 7 7 769 1,030 78 85 1
Pennsylvania....... 24 13 11 943 1,359 84 60 6

EAST NORTH CENTRAL... 1 114 52 55 4,387 4,153 5 318 264 21
Ohio............... 24 8 15 1,206 1,095 1 85 69 2
Indiana............. 10 4 6 391 357 41 40 6
Illinois........... 1 22 9 13 836 757 2 86 68 8
Michigan........... 50 29 21 1,681 1,637 2 69 59 2
Wisconsin.......... 8 2 273 307 37 28 3

WEST NORTH CENTRAL.. 2 24 9 13 1,365 1,428 4 117 118 16
Minnesota.......... 1 141 155 23 27 7
Iowa............... 5 2 3 501 211 7 6 3
Missouri........... 1 9 5 4 290 352 1 52 55 2
North Dakota....... 4 1 3 22 55 3 11 16
South Dakota....... I 17 116 3 -
Nebraska........... 3 2 52 35 10 6 2
Kansas............. 2 1 1 342 504 11 8 2

SOUTH ATLANTIC....... 70 43 27 2,375 2,497 5 439 394 2 41
Delaware............ 59 48 7 6 -
Maryland............ 15 8 7 431 476 42 26 1
Dist. of Columbia.. 2 1 1 34 43 8 12 -
Virginia........... 15 6 9 537 390 51 46 7
West Virginia...... 6 6 355 374 24 30 1
North Carolina..... 9 5 4 227 430 1 87 69 5
South Carolina..... 4 3 1 101 92 58 50 2 6
Georgia ............ 4 4 90 65 4 57 55 4
Florida............ 15 10 5 541 579 105 100 17

EAST SOUTH CENTRAL... 30 9 18 1,637 1,827 178 161 24
Kentucky........... 8 4 1 563 700 69 54 6
Tennessee........... 8 1 7 562 626 55 54 7
Alabama............ 10 3 7 296 329 34 35 9
Mississippi........ 4 1 3 216 172 20 18 2

WEST SOUTH CENTRAL... 1 33 14 18 2,004 2,026 3 304 227 2 42
Arkansas............ 1 2 2 269 199 14 20 1 9
Louisiana.......... 7 2 5 336 472 1 169 111 5
Oklahoma............ 48 101 1 19 8 1
Texas.............. 24 10 13 1,351 1,254 1 102 88 1 27

MOUNTAIN............. 17 7 3 1,305 1,614 2 72 66 3
Montana............ 3 2 1 96 141 2 -
Idaho.............. 172 208 8 3 -
Wyoming........... 2 1 38 50 5 5 -
Colorado............ 3 3 278 434 14 11 2
New Mexico......... 2 2 270 232 1 11 27 -
Arizona............ 6 272 362 16 5 1
Utah............... 1 1 172 137 1 14 7 -
Nevada............. 7 50 2 8 -

PACIFIC.............. 132 57 74 4,483 4,566 5 433 444 1 18
Washington.......... 5 5 346 486 33 29 -
Oregon............. 11 6 4 376 505 32 21 1 4
California......... 114 50 64 3,553 3,339 3 343 375 14
Alaska............. 171 141 2 18 7 -
Hawaii.............. 2 1 1 37 95 7 12

Puerto Rico 29 23 6 960 704 5 30 31









306 Morbidity and Mortality Weekly Report


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

SEPTEMBER 4, 1965 AND AUGUST 29, 1964 (35th 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... 468 238,930 460,784 3,534 9 175 10 274 47 3,096

NEW ENGLAND.......... 5 36,748 16,816 303 1 4 37
Maine............ 2,789 2,974 33 3
New Hampshire...... 381 248 1
Vermont............ 1 1,256 2,318 30
Massachusetts...... 4 19,277 5,255 36 1 3 2
Rhode Island....... 3,899 1,921 3 1 -
Connecticut........ 9,146 4,100 231 1

MIDDLE ATLANTIC...... 46 14,646 52,066 120 2 48 3 123
New York City...... 16 2,333 15,303 2 23 -
New York, up-State. 11 4,114 12,665 115 1 13 3 111
New Jersey.......... 15 2,539 12,183 1 5 -
Pennsylvania....... 4 5,660 11,915 3 7 12

EAST NORTH CENTRAL... 169 55,377 102,591 212 11 1 36 9 479
Ohio............... 5 8,853 19,605 13 8 5 250
Indiana............. 6 1,813 22,691 46 4 8 2 51
Illinois........... 28 2,653 16,600 27 5 1 10 77
Michigan........... 54 26,336 28,841 88 1 5 2 49
Wisconsin.......... 76 15,722 14,854 38 1 5 52

WEST NORTH CENTRAL... 9 16,427 30,215 45 5 23 9 5 630
Minnesota.......... 631 333 1 1 1 131
Iowa............... 1 8,977 23,306 13 2 1 178
Missouri........... 2 2,586 1,016 1 5 18 6 84
North Dakota....... 5 3,671 4,720 26 38
South Dakota ..... 1 113 28 3 2 47
Nebraska........... 449 812 1 33
Kansas............. NN NN NN 1 2 3 119

SOUTH ATLANTIC....... 57 24,513 38,180 609 29 2 55 7 425
Delaware........... 502 409 11 4 -
Maryland............ 7 1,156 3,398 46 15 2 19
Dist. of Columbia.. 2 76 354 13 -
Virginia........... 9 3,841 12,695 101 6 4 2 273
West Virginia...... 32 13,571 8,567 221 3 21
North Carolina..... 381 1,156 9 6 15 2
South Carolina..... 1,010 4,248 15 3 2 8 2
Georgia............ 2 616 192 1 14 2 2 48
Florida............. 5 3,360 7,161 192 4 1 60

EAST SOUTH CENTRAL... 16 13,652 67,495 764 2 20 1 25 7 675
Kentucky........... 2,424 18,434 8 3 6 1 68
Tennessee.......... 5 7,807 24,035 599 2 16 8 6 578
Alabama............. 9 2,310 18,342 58 1 6 15
Mississippi........ 2 1,111 6,684 99 1 5 14

WEST SOUTH CENTRAL... 58 30,671 71,872 533 2 68 39 9 486
Arkansas........... 1,084 1,124 2 44 13 2 74
Louisiana.......... 104 104 3 5 2 69
Oklahoma........... 203 1,018 4 10 4 1 90
Texas.............. 58 29,280 69,626 529 11 17 4 253

MOUNTAIN............ 40 19,623 18,480 436 15 24 1 66
Montana.............. 5 3,707 3,018 37 4 1 5
Idaho............... 2 2,772 1,915 59 -
Wyoming............ 2 843 251 2 3 1 -
Colorado............ 11 5,615 3,196 157 9
New Mexico.......... 2 676 449 29 9 1 12
Arizona............ 8 1,291 6,617 33 11 39
Utah................ 10 4,516 2,044 117 8 1
Nevada............. 203 990 2 2 -

PACIFIC............. 68 27,273 63,069 512 8 4 34 6 175
Washington......... 7,217 19,966 50 2 4 7
Oregon.............. 17 3,203 8,599 7 4 1 5 5
California........... 33 12,899 32,903 348 4 1 24 6 161
Alaska.............. 7 177 1,089 27 2
Hawaii............. 11 3,777 512 80 1 -

Puerto Rico 22 2,344 5,838 23 6 13









3:07


Morbidity and Mortality Weekly Report






DEATHS IN 122 UNITED STATES CITIES FOR WEEK ENDED sI I IM lHIH 4, 1965


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

All Causes Pneumonia Under All Causes Pneumonia Under
Area All 65 years and I year area All 65 years and year
Ages nd over Influenza All Ages and over Influenza All
Ages and over e Ages and overs Caues
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.--------


649
203
41
23
21
56
22
24
28
39
64
15
42
16
55

2,889
27
23
138
27
38
42
57
75
1,509
25
428
163
35
97
21
33
52
39
30
30

2,307
59
32
688
144
187
100
59
312
38
41
32
35
31
140
38
127
32
28
36
103
45

754
54
17
33
116
25
116
72
226
51
44


395
117
23
14
11
32
13
20
19
18
42
11
26
8
41

1,697
15
14
89
19
24
29
36
31
886
16
239
91
25
63
11
18
32
15
24
20

1,265
34
18
353
77
101
51
39
175
26
22
16
17
12
87
20
73
19
18
19
58
30

428
34
12
20
72
16
65
41
112
32
24


*Estimate based on average percent of divisional total.


SOUTH ATLANTIC:
Atlanta, Ga.----------
Baltimore, Md.--------
Charlotte, N. C.-------
Jacksonville, Fla.-----
Miami, Fla.-----------
jorfolk, 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.---------


1,061
121
210
49
62
97
62
72
37
73
62
183
33

541
84
56
31
87
109
54
27
93

1,012
22
35
17
140
41
60
185
41
180
77
103
42
69

379
33
13
141
20
83
16
37
36

1,553
16
39
57
44
64
519
73
33
86
62
96
221
34
133
42
34


Total 11,145 6,239 1 391 653

Cumulative Totals
including reported corrections for previous weeks

All Causes, All Ages ------------------------- 434,693
All Causes, Age 65 and over------------------- 245,569
Pneumonia and Influenza, All Ages------------- 18,125
All Causes, Under 1 Year of Age--------------- 25,864


WEEK NO. 35


" "








308


CUTANEOUS ANTHRAX New Jersey


The case of cutaneous anthrax notified from New
Jersey during the week ended August 14 occurred in July
in a laborer of a gelatin manufacturing company. On
July 16, the patient injured his knee on the door of an
autoclave used to sterilize burlap bags in which raw
bones are imported. A lesion resembling a boil developed
at the site of injury over the next several days. On July
19, the patient was first seen by the company physician
and placed on antibiotic therapy. Inguinal lymphadenopathy
was noted.
When the lesion became worse the following day,
the patient returned for further consultation. The lesion
was excised at this time. Smears and cultures were neg-
ative for Bacillus anthracis. Histological examination
of the excised tissue revealed what appeared to be a
"typical eschar." The presence of some non-specific
bacillary forms were noted in the tissues but fluorescent
antibody studies of the excised material were equivocal
due to the small numbers of organisms seen. The failure
to isolate B. anthracis from the lesion is believed to be
due to the preceding antibiotic therapy.
The plant receives dry bones from South America and
India, but the bones on hand at the time of injury were
all from India. These bones are collected from the open
plains of India from cattle that have died of natural
causes. Seventeen of 20 samples of bone in storage at
the plant were positive on culture for B. anthracis. In
addition, three samples of dust collected from a conveyor
between the warehouse and the processing area were
positive on culture.
The plant has no previous history bf anthrax oc-
curring in its workers. About 20 years ago, a bacteriological
survey was made of the plant which failed to yield B.
anthracis.
The last case of cutaneous anthrax associated with
imported bones in the United States occurred in 1957.
This involved a stevedore handling sacks of bones im-
ported from India.


(Reported by Dr. William J. Dougherty, Director, Division
of Preventable Disease Control, New Jersey State
Department of Health; and a team from CDC.)


September 4, 196! __



--r>=---,
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0-


THE MORBIDITY AND MORTALITY WEEKLY REPORT. WITH A CIRCULAR
TION OF 14.000 IS PUBLISHED AT THE COMMUNICABLE DISEASE
CENTER ATLANTA. GEORGIA.
CHIEF. COMMUNICABLE DISEASE CENTER JAMES L. GODDARD. M.D
CHIEF. EPIDEMIOLOGY BRANCH A.D. LANGMUIR. M.D.
ACTING CHIEF. STATISTICS SECTION IDA L. 5HERMAN. M.S.
CHIEF. SURVEILLANCE SECTION D. A. HENDERSON. M.D.
EDITOR MMWR D.J.M. MACKENZIE. M.B..
F.R.C.P.E.

IN ADDITION TO THE ESTABLISHED PROCEDURES FOR REPORTING
MORBIDITY AND MORTALITY. THE COMMUNICABLE DISEASE CENTER
WELCOMES ACCOUNTS OF INTERESTING OUTBREAKS OR CASE IN
INVESTIGATION WHICH ARE OF CURRENT INTEREST TO HEALTH.
OF OFFICIALS AND WHICH ARE DIRECTLY RELATED 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 30333
NOTE THE DATA IN THIS REPORT ARE PROVISIONAL AND ARE BASED
ON WEEKLY TELEGRAMS TO THE CDC BY THE INDIVIDUAL STATE
HEALTH DEPARTMENTS. THE REPORTING WEEK CONCLUDES ON SAT-
URDAY: COMPILED DATA ON A NATIONAL BASIS ARE RELEASED ON
THE SUCCEEDING FRIDAY.


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