Morbidity and mortality

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Morbidity and Mortality



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

PrtpOred b thI I MElrose 4-5131

For release September 8, 1961 Atlanta 22, Georgia Vol. 10, No. 35

Provisional Information on Selected Notifiable Diseases in the United States and on

Deaths in Selected Cities for Week Ended September 2, 1961


Poliomyelitis There was a substantial decrease in
the number of reported cases of poliomyelitis for the week
ending September 2. Sixty cases were reported during the
current week, 36 of which were paralytic. During the
previous week, the total was 74, including 58 paralytic.
The incidence of poliomyelitis remains well below
previous years as shown below:

POLIOMYELITIS CASES (CUMULATIVE) THROUGH 35TH WEEK

1961 1960 1959 1958 1957
Paralytic 417 1090 2828 1108 1229
Total 623 1582 4445 2281 3915


The tri-county area in New York Stare, which in-
cludes Onondaga, Madison and Oneida counties, continues
to be the only area with a concentration of paralytic polio-
myelitis. Through September 3, 43 paralytic cases have
occurred in this area. Of the 43 cases, 18 have occurred
in Onondaga County (13 in Syracuse), 14 in Madison
County, and 11 in Oneida County. In addition, there are
five nonparalytic cases in the area. The paralytic cases
have had onset as follows:


Week Ending: Jan-June 7/29 8/5 8/12 8/19 8/26 9/2 Total
Paralytic
Caoas 3 1 8 6 11 12 2 43


Table I. Cases of Specified Notifiable Diseases, United States
(Cumulative totals include revised and delayed reports through previous week)

Disease 35th Week Cumulative
(Seventh Revision of International Approxi-
Liste, 1955) First 35 weeks Since seasonal low week mate
Ended Ended seasonal
Sept. Sept. Median Median low
Weekly incidence low or sporadic 2, 3, 1951.-r .. Median 195"-.6 point
-- Data not available i96e 1 69 1966Ei 19,-6 1999-- to
Quantity zero 1959-60
Anthrax--------------------062 2 5 12 *
Botulism----------------------049.1 4 8 *
Brucellosis undulantt fever)---- 044 11 8 10 413 551 542 *
Diphtheria----------------------055 8 12 11 374 414 491 65 80 94 July 1
hEcephalitis, infectious------082 37 55 70 1,067 1,224 1,184 1,067 1,224 1,184 Jan. 1
Hepatitis, infectious, and
serum---------------..092,N998.5 pt. 1,003 689 247 52,826 25,503 14,037 68,033 32,975 19,994 Sept. 1
Malaria----------------------110-117 2 37 46 *
Measles-----------------.-------.-085 871 1,240 1,042 385,628 399,857 4.7,208 421,838 432,458 483,877 Sept. 1
Meningitis, aseptic----------340 pt. 203 126 --- 1,719 1,605 -- 1,719 1,605 -- Jan. I
Meningococcal infections---------057 30 20 21 1,515 1,535 1,687 2,171 2,264 2,438 Sept. 1
Poliomyelitis-------------------080 60 214 283 624 1,582 3,911 521 1,370 3,383 Apr. 1
Paralytic----------- 080.0,080.1 36 124 126 417 1,090 1,226 357 932 95L Apr. 1
onparalytic----------- -080.2 18 49 107 135 342 2,055 110 314 1,894 Apr. 1
Unspecified-----------------080.3 6 .,1 50 72 150 630 54 124 538 Apr. 1
Psittacosi--------------096.2 2 3 49 71 *
bies in man-------------------094 3 *
Btreptococcal sore throat,
including scarlet fever----050,051 2,718 2,890 --- 233,691 223,907 --- 14,480 --- -- Aug. 1
Typhoid fever-------------.-----040 30 20 27 510 522 650 396 392 470 Apr. 1
Typhue fever, endemic---..------101 26 51 *
Iables in animals---------------- 62 46 52 2,395 2,595 3,145 2,971 3,562 4,056 Oct. 1


3


V/








Morbidity and Mortality Weekly Report


IGRE 1
CURRENT U.S. POLIO INCIDENCE
COMPARED WITH YEARS 1955-1960, Aprl December, by week
VSI"AfA.L DtA sJLiD B NATOMU fIC V"ITIL STTIf.STnC
NO AOUUUNRIIeLE VIS"ASE CENTER


410,000 doses of type I oral poliovaccine were dis-
tributed at 36 clinics in the tri-county area from August
28 to 31. The vaccine, from the Public Health Service
epidemic reserve, was available without charge to all
persons over six months of age. Type 1 poliomyelitis
virus has been isolated from at least seven cases.
The six paralytic cases reported by Mississippi this
week include four from Adams County. Three of the four
are delayed reports with onsets in June and July. None
have had three doses of vaccine; three cases are unvac-
cinated and the other had received two doses. Of the four
Wisconsin cases, three are from Milwaukee County.

Coxsackie 85 In contrast to the low poliomyelitis
incidence is the large number of reported outbreaks of
aseptic meningitis and minor illnesses caused by Cox-
sackie B,. Last year few outbreaks of Coxsackie B5 were
reported. Epidemics of Coxsackie B, have recently been
reported and are continuing in scattered areas of New
Jersey (4 cases of pericarditis and many minor febrile
illnesses), in Woonsocket and scattered areas of Rhode
Island (57 aseptic meningitis cases and large numbers
of minor illnesses), in several towns in North Dakota
(see Epidemiological Reports), and in Fort Dodge, Iowa


(over 200 minor illnesses and many cases of aseptic
meningitis). Reports earlier this year had implicated
Coxsackie B, in an epidemic of pleurodynia (26 isolations)
in King George County, Virginia, in a family outbreak of
pleurodynia in Maryland (6 cases), in aseptic meningitis
in scattered areas of Pennsylvania (10 cases) and in
Illinois. Coxsackie B, has accounted for over 40 percent
of non-polio enterovirus isolates reported so far this year.

Hepatitis A total of 1,003 cases of hepatitis was
reported for the week ending September 2, 1961. The
number of cases has remained about the same for each of
the past six weeks. The cumulative total of cases re-
ported so far this year, 52,826, already exceeds the
highest annual total reported in the past. Clearly 1961
will be a record high year.


EPIDEMIOLOGICAL REPORTS

Plague New Mexico
A third case of plague with history of exposure in
New Mexico has been reported. The patient, a 23-year-old
lineman for a Power and Light Company worked in the
Pecos area, the site of exposure of the first reported case.
He experienced the onset of fever and severe headache on
August 4. Enlarged inguinal nodes suggested a diagnosis
of plague; the diagnosis was confirmed by an agglutina-
tion titer of 1:80 on the patient's convalescent serum
The patient made a rapid and complete recovery.
The two previous fatal cases of plague this year from
New Mexico involved a 38-year-old sawmill worker and a
38-year-old geology professor. Attempts to isolate bacilli
from wild animals in the area involved have so far been
unsuccessful.
Since 1900, there have been 533 cases of plague
reported in the U. S., 414 of which have occurred in Cali-
fornia. Sixty-five percent of the cases have been fatal.
The only States reporting plague cases since 1949 are
New Mexico 12 cases, California 3, Texas 1, and
Arizona 1. At the present time plague smolders in a
wild rodent reservoir.
(Reported by Dr. John B. Sherman, Director, Division of
Preventive Medicine, New Mexico Department of Public
Health)

Coxsackie B5 Aseptic Meningitis North Dakota
Twenty-five cases of a disease presenting as aseptic
meningitis have been reported from North Dakota. The
cases occurred in August in and around Bismarck (3
cases), Garrison (12 cases), Minot (6 cases), and Dick-
enson (4 cases). The clinical picture was characterized










Morbidity and Mortality Weekly Report 3

Table 2. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES, EACH DIVISION AND STATE, AND
PUERTO RICO, FOR WEEKS ENDED SEPTEMBER 3, 1960 AND SEPTEMBER 2, 1961

(]E place of occurrence. Numbers under diseases are category numbers of the Seventh Revision of the International Lists, 1955)


Poliomyelitis 080 Brucel-
Menin- losis
Total Paralytic 080.0,080.1 gitis, (undu-
(Includes cases not specified by type) Nonparalytic aseptic lant
Area Cumulative, Cumulative, fever)
35th Week first 35 weeks 35th Week first 35 weeks 080.2 340 pt. 044

1961 1960 1961 1960 1961 1960 1961 1960 1961 1960 1961 1961

UNIED STAIS-------- 60 214 624 1,582 36 124 417 1,090 18 49 203 11

SENGAND---------------- 3 15 12 141 3 10 10 112 3 9
Maine-------------- 1 2 1 11 1 2 1 11 1
New Hampshire------------- 1 -
Vermont------------------ 2 1 2 1 -
Massachusetts-------------- 2 4 6 23 2 1 5 15 1 4 -
lbode Island--------------- 5 91 4 72 1 3 -
Connecticut--------------- 4 2 15 3 2 13 1 -
MIDDLE ATIANTIC------- 25 23 111 196 14 16 86 149 7 5 3 1
New York------------------- 20 16 71 117 10 9 52 84 6 5 1
ew Jersey---------------- 3 1 23 39 2 1 20 30 1 -
Pennsylvania-------------- 2 6 17 40 2 6 14 35 2 1
EAST NORTH CNTRAL------ 10 53 65 240 6 28 38 132 2 15 49 3
Chio------------------- 1 19 19 62 5 10 25 7 9 -
Indiana-------------------- 2 5 7 40 1 5 5 29 1 1
Illinois------------------ 1- 22 17 86 12 7 56 1 7 18 2
Michigan------------------- 2 5 12 41 1 4 10 19 1 1 18 -
Wisconsin-------------- 4 2 10 11 4 2 6 3 3 -
WEST NORTH CENTRAL------- 5 8 38 77 1 3 17 41 4 2 81 3
Minnesota----------------- 2 4 27 1 4 20 1 8 -
Iowa----------------- --- 1 1 12 11 5 2 1 1 73 2
Missouri------------------ 2 2 10 13 2 7 2 -
North Dakota--------------- 1 1 7 3 -
South Dakota------------- 3 1
Nebraska------------------- 1 4 6 1 3 5 1
Kansas--------------------- 2 1 7 10 1 3 3 1 -
SOUT ATIANTIC--------------- 3 33 121 261 26 91 187 3 6 2
Delaware---------------- 2 1 -
Maryland--------------- 4 21 21 4 21 18 -
District of Columbia----- 1 1 -
Virginia------------------- 1 8 9 1 6 7 -
West Virginia-------------- 8 14 27 6 9 22 2 -
North Carolina------------ 3 7 11 55 4 6 40 3 3
South Carolina----------- 8 11 94 7 9 62 1 -
Georgia-------------------- 27 9 20 7 1
Florida---------------- 5 26 46 4 18 31 1
EAST SOUTH CENTRAL------- 9 28 51 108 9 5 31 55 2 17 1
Kentucky--------------- 1 21 20 53 1 5 5 3
Tennessee------------------ 4 10 19 2 6 14 2 1
Alabama-------------------- 2 1 8 10 2 1 8 10 1 -
Mississippi---------------- 6 2 13 26 6 2 12 26 13
WEST SOUTH CENTRAL--------- 4 25 96 179 2 12 51 103 2 13 7 2
Arkansas------------------- 2 5 10 16 3 4 8 2 2 1
Louisiana---------------- 1 31 38 1 23 24 -
Oklahoma------------------- 3 8 5 2
Texas-------------------- 1 20 52 117 1 9 24 66 11 5 1
MOUNTAIN -------------------- 4 38 44 2 23 21 2 1
Montana-------------------- 3 13 2 9 I -
Idaho-------------------- 12 5 6 1 -
Wyoming----------------- 1 8 -
Colorado------------------- 1 6 6 1 6 5 -
New Mexico----------------- 1 3 4 I 1 1 1
Arizona------------------ 7 4 5 4 -
Utah---------------------- 1 7 4 4 1 -
Nevada--------------------- -
PACIFIC--------------------- 1 25 92 336 1 22 70 290 3 33
Washington----------------- 1 3 18 20 1 3 14 20 -
Oregon-------------------- 3 11 25 1 4 14 2 1 -
California----------------- 18 61 282 17 50 247 1 32 -
Alaska--------------------- 2 -
Hawaii--------------------- -- 1 2 7 1 2 7 -

Puerto Rico------------------ 15 5 416 15 5 409 -









4 Morbidity and Mortality Weekly Report

Table 2. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES, EACH DIVISION AND STATE, AND
PUERTO RICO, FOR WEEKS ENDED SEPTEMBER 3, 1960 AND SEPTEMBER 2, 1961 Continued

(Wy place of occurrence. Numbers under diseases are category numbers of the Seventh Revision of the International Lists, 1955)


Diphtheria 055 Hepatitis, infectious, and
Encephalitis, serum 092,N998.5 pt. Measles
infectious
Area Cumulative, Cumulative,
35th Week first 35 weeks 082 35th Week first 35 weeks 085

1961 1960 1961 1960 1961 1960 1961 1960 1961 1960 i961 i960'


UNITED STAES-------- 8 12 374 414 37 55 1,003 689 52,826 25,503 871 1,240

NEW ENGLAND------------------ 6 10 1 2 61 23 1,524 770 54 75
Maine------------------ 2 95 46 5 4
New Hampshire------------- 10 4 116 25 6 2
Vermont--------------- 7 165 11 7
Massachusetts-------------- 5 7 1 2 37 12 588 387 28 46
Rhode Island-------------- 1 4 3 191 149 7
Connecticut---------------- 3 4 369 152 8 16
MIDDLE ATLANTIC----------- 1 19 13 10 16 157 88 7,320 2,898 148 187
New York------------------- 7 3 9 3 74 52 3,074 1,544 103 128
New Jersey----------------- 1 2 8 42 7 1,764 205 21 24
Pennsylvania--------------- 12 8 1 5 41 29 2,482 1,149 24 35
EAST NORTH CENTRAL--------- 1 15 35 11 9 186' 134 10,625 4,647 241 560
Ohio----------------------- 1 1 15 5 2 55 54. 3,585 1,572 24 37
Indiana------------------ 1 5 3 27 16 1,647 536 25 35
Illinois---------------- 10 4 2 1 27 18 1,838 941 73 16
Michigan------------------- 3 9 3 3 72 45 3,297 1,429 76 366
Wisconsin------------------ 2 1 5 1 258 169 43 106
WEST NORTH CETRAL----------- 31 21 2 2 86 23 5,209 1,820 20 20
Mfnnesota------------------ 20 5 17 4 1,136 205 1
Iowa----------------------- 1 5 26 6 1,509 309 4 -
Missouri------------------- 2 1 21 8 1,182 669 6 3
North Dakota--------------- 2 1 2 122 138 9 15
South Dakota--------------- 6 5 4 2 140 124 1 -
Nebraska------------------- 2 1 1 10 2 537 188 1
Kansas--------------------- 2 8 1 583 187 N1 NN
SOUTH ATLANTIC--------------- 3 7 77 119 3 99 63 6,544 3,025 80 49
Delaware---------------- 3 155 188 2
Maryland------------------ 1 1 1 5 4 613 308 17 3
District of Columbia------- 2 1 4 2 81 38 3 12
Virginia------------------- 15 12 11 8 1,039 605 19 9
West Virginia-------------- 1 4 18 8 1,225 566 23 15
North Carolina------------- 7 5 1 34 13 1,399 264 3 1
South Carolina------------- 5 37 2 328 47 6 -
Georgia ------------------ 3 20 20 6 3 604 198 4
Florida---------------- 7 26 40 19 22 1,100 811 9 3
EAST SOUT CETRAL ------ 1 28 41 3 4 148 83 7,912 3,669 52 68
Kentucky---------------- 8 1 36 21 2,328 1,371 4 9
Tennessee------------------ 3 6 2 50 29 3,148 1,204 42 56
Alabama-------------------- 12 20 25 16 1,391 787 1 -
Mississippi---------------- 1 5 14 3 2 37 17 1,045 307 5 3
WEST SOUTH CENTRAL------ 5 2 184 141 5 3 57 68 3,827 2,115 101 105
Arkansas------------------- 4 4 2 5 5 750 110 -
Louisiana------------------ 1 23 29 2 9 405 106 -
Oklahoma------------------- 5 7 1 1 3 7 261 264 -
Texas------------------- 4 2 152 101 2 2 47 47 2,411 1,635 101 105
MOUNTAIN------------------ 8 33 7 61 52 3,228 2,062 56 69
Montana-------------------- 2 3 5 286 85 5
Idaho---------------------- 11 2 3 1 237 249 2 3
Wyoming------------------ 5 3 5 134 22 -
Colorado------------------- 4 3 1 18 23 1,085 751 6 14
New Mexico--------------- 1 4 7 2 356 250 NN -
Arizona------------------- 3 10 12 489 471 26 28
Utah---------------------- 4 1 6 3 531 186 12 19
Nevada------------------- 1 12 6 110 48 10
PACIFIC-------- ------------- 6 1 5 9 148 155 6,637 4,497 119 107
Washington---------------- 14 20 737 504 8 11
Oregon------------------ 23 18 1,019 736 31 32
California---------------- 2 5 9 99 113 4,533 3,045 67 41
Alaska------------------.. 4 1 11 3 301 148 11 21
Hawaii------------- ------ 1 1 47 64 2 2

Puerto Rico----------------- 2 46 105 12 10 687 566 26

NN-Not rNOLrirable











Morbidity and Mortality Weekly Report 5


Table 2. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES, EACH DIVISION AND STATE, AND
PUERTO RICO, FOR WEEKS ENDED SEPTEMBER 3, 1960 AND SEPTEMBER 2, 1961 Continued

(1y place of occurrence. Numbers under diseases are category numbers of the Seventh Revision of the International Lists, 1955)

Strepto-
coccal Typhoid fever 040 Typhus
Malaria Meingeccocal ia- sore fever, Rabies in
infections cosis throat, endemic

Area etc. Cumulative,
110-117 057 096.2 050,051 35th Week first 35 weeks 101

1961 1961 1960 1961 1961 1961 1960 1961 1960 1961 1961 1960

UNITED STATES-------- 30 20 2 2.718 30 20 510 522 62 46

NEW ENGLAND------..... ----- 1 2 88 6 1 16 8 -
Maine------------------- 1 1 2 -
New Hampshire------------- 2 -
Vermont--------------- 1 -
Massachusetts------------- 2 14 5 1 10 3 -
Rhode Island--------------- 10 1 2 -
Connecticut------------ 1 60 3 3 -
MIDDC ATLANTIC------------- 4 4 73 2 57 37 5 7
New York----------------- 1 1 54 26 23 3 7
New Jersey---------------- 1 1 5 16 1 -
Pennsylvania-------------- 2 2 14 2 15 13 2 -
EAST NORTH CNTRAL---------- 8 7 184 9 6 68 69 7 9
Ohio----------------------- 2 2 9 4 3 22 18 2 1
Indiana------------------ 1 1 52 1 2 16 19 2 3
Illinois------------------- 3 1 28 2 1 24 19 2 -
Michigan ----------------- 1 3 60 2 4 8 1 5
Wisconsin---------------- 1 35 2 5 -
WEST NORTH CENTRAL--------- 4 34 1 1 28 29 23 8
Minnesota----------------- 1 1 5 1 8 3
Iowa---------------------- 12 1 5 7 1
Missouri------------------- 3 3 1 16 17 5 4
North Dakota----------- 9 -
South Dakota-------------- 1 3 2 2 -
Nebraska------------------ 1 2 1
Kansas------------------- 9 2 1 -
SOUTH ATLANTIC------------- -- 4 216 4 4 82 81 4 5
Delaware------------------ 1 1 -
Maryland----------------- 1 2 1 2 2 3 -
District of Columbia------ 9 6 -
Virginia------------------- 79 1 1 9 18 1
West Virginia------------- 43 1 9 6 1 4
North Carolina------------- 2 5 13 8 -
South Carolina------------- 18 1 6 10 -
Georgia------------------- 23 20 -
Florida------------------- 1 69 1 10 9 3 -
EAST SOUTH CENTRAL--------- 3 680 5 49 68 4 5
KentucKy------------------- 3 8 1 8 14 4 1
Tennessee------------------ 593 2 34 37 3
Alabama---------------- 2 2 6 12 1
Mississippi---------------- 77 1 5 -
WEST SOUTH CENTRAL----------- 1 2 614 6 1 117 158 16 9
Arkansas------------------- 1 1 1 18 37 4 3
Louisiana--------------- 2 1 14 53 1 -
Oklahoma----------------- 1 3 11 10 -
Texas---------------------- 1 609 4 74 58 11 6
MOURAIN ------------------- 6 582 1 2 45 29 -
Montana-------------------- 5 1 14 8 -
Idaho-------------------- 37 1 2 -
Wyoming------------------- 1 3 4 -
Colorado----------------- 6 195 6 -
New Mexico---------------- 139 1 9 7 -
Arizona------------------- 114 1 6 7 -
Utah--------------------- 88 2 1 -
Nevada-------------------- 3 4 -
PACIFIC--------------------- 3 3 247 1 48 43 3 3
Washington---------------- 37 7 4 -
Oregon--------------------- 9 7 -
California----------------- 2 3 154 1 41 32 3 3
ska ----- -- 47 1 -
Hawaii------------------ .

Puerto Rico---------------- 2 1 16 17 -








5 Morbidity and Mortality Weekly Report


NUMBER OF DEATHS IN


II I 1 I 9000
I I I T l I i T III i I III I


APR MAY


JAN FEB MAR


rl I I I I IT I I I IT I I I I T I I I I


The chart shows the number of deaths reported for
117 major cities of the United States by week for the cur-
rent year, a 5-week moving average of these figures
plotted at the central week, and an adjusted average for
comparison. For each region the adjusted average was
computed as follows: From the total deaths reported each
week for the years 1956-1960, 3 central figures were
selected by eliminating the highest and lowest figure
reported for that week. A 5-week moving average of the
arithmetic mean of the 3 central figures was then com-
puted with adjustment to allow for population growth in
each region. The average value of the regional increases
was 2 percent which was incorporated in the adjusted
average shown in the chart.
Table 4 shows the number of death certificates re-


JUN JUL AUG SEP OCT NOV DEC


ceived during the week indicated for deaths that occurred
in selected cities. Figures compiled in this way, by week
of receipt, usually approximate closely the number of
deaths occurring during the week. However, differences
are to be expected because of variations in the interval
between death and receipt of the certificate and because
of incomplete reporting due to holidays or vacations. If a
report is not received from a city in time to be included
in the total for the current week, an estimate is used.
The number of deaths in cities of the same size may
also differ because of variations in the age, race, and sex
composition of the populations and because some cities
are hospital centers serving the surrounding areas. Changes
from year to year in the number of deaths may be due in
part to population increases or decreases.


Table 3. DEATHS IN SELECTED CITIES BY GEOGRAPHIC DIVISIONS


(By place of occurrence and weekof filing certificate. Excludes fetal deaths. Data exclude figures shown In parentheses in table 4)

35u Percent Cuwlative, first 35 weeks
Area e 35th average
Sept. August week to 1 percent
2, 26, 1956-60 current change
1961 1961 ee
week

TOTAL, 117 IPORING CITI--------------------- 11,074 10,517 10,312 +7.4 .02,711 406,878 -1.0

New nglan --------------------------(1 cities) 665 601 609 +9.2 24,693 25,436 -2.9
Middle Atlantic-----------------------------(20 cities) 3,083* 2,963 2,798 +10.2 114,836 112,769 +1.8
ant North Central--------------------------(21 cities) 2,435 2,191 2,223 +9.5 85,974 87,852 -2.1
West North Central--------------------------(9 cities) 737 761 735 +0.3 27,419 28,322 -3.2
South Atlantic--------------------------(11 cities) 908 908 868 +4.6 34,771 35,052 -0.8
Zast South Central-------------------------(8 cities) 521 480 472 +10.4 18,247 18,444 -1.1
West South Central------------------------ (15 cities) 1,041 922 956 +8.9 34,437 35,817 -3.9
Mountain------------------------------- (8 cities) 376 337 326 +15.3 12,862 12,705 +1.2
Pacific---------------------------------- (15 cities) 1,308* 1,354 1,325 -1.3 49,472 50,481 -2.0

*Includes estimate for missing reports.


r T i T i i i i T T i i T i i i T i i T











Morbidity and Mortality Weekly Report 7


Table 4. DEATHS IN SELECTED CITIES

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


35th 34th Cumulative, 35th 34th
week week Cumulative, week week native,
e ded first 34 weeks e k first 34 weeks
Area Sept. Aug. Area Sept. Aug.
2, 26, 2, 26,
1961 1961 1961 1960 1961 1961 1961 1960
1161 26 11 21 26,


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, .LU------------
Cincinnati, Ohio--------
Cleveland, Ohio---------
Columbus, Ohio-----------
Dayton, Ohio-------------
Detroit, Mich.----------
Evanville, 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.------------


231
40
35
21
44
26
16
24
41
68
9
34
25
51


43*
29
120
33
23
38
51
93
1,523
49
550
199
18
89
22
38
58
43
34
30


58
33
800
142
169
107
83
305
36
42
48
36
33
146
36
123
27
29
26
94
62


58
25
32
131
(15)
102
68


196
31
18
20
45
28
14
22
52
55
12
31
18
59


40
30
143
39
37
38
83
88
1,399
33
498
207
22
91
17
30
66
56
21
25


37
31
642
145
189
104
77
310
36
37
38
31
36
111
33
113
28
30
21
89
53

44
23
25
130
(21)
113
85


8,458
1,344
1,014
943
1,678
863
754
921
1,621
2,182
467
1,569
950
1,929


1,615
1,199
5,191
1,499
1,005
1,388
2,464
3,564
58,386
1,372
18,200
6,741
819
3,506
841
1,246
2,132
1,582
995
1,091

1,988
1,079
26,070
5,486
7,137
3,983
2,826
11,710
1,269
1,504
1,352
1,073
1,574
5,013
1,145
4,313
988
997
999
3,442
2,026


1,870
909
1,314
4,498
(960)
4,182
2,444


8,862
1,440
1,101
1,002
1,702
849
848
862
1,592
2,242
473
1,612
969
1,882


1,547
1,224
5,157
1,501
1,040
1,376
2,472
3,389
57,287
1,348
17,388
6,837
832
3,515
846
1,317
2,168
1,476
971
1,078


1,992
1,224
27,131
5,505
7,460
4,127
2,589
12,061
1,261
1,409
1,312
1,117
1,464
5,165
1,116
4,364
1,040
1,016
1,000
3,540
1,959

1,945
885
1,211
4,518
(918)
4,366
2,615


WEST NORTH CENTRAL-Con.:
St. Louis, Mo.------
St. Paul, Minn.---------
Wichita, Kans.----------

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:
3irmingham, Ala.--------
Chattanooga, Tenn.-----
Knoxville, Ten.--------
Louisville, Kr.------
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.---------

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


200
67
54


103
240
27
65
60
44
68
26
(45)
73
164
38


78
43
18
164
96
38
27
57


47
19
23
151
36
69
204
61
158
62
110
47
54


30
13
145
23
70
19
38
38


21
(41)
(36)
38*
52
497
89
30
86
56
91
163
(25)
105
49
31

(27)


252
57
32


111
227
40
47
85
45
71
34
(64)
40
173
35


91
35
26
61
109
46
39
73


22
25
19
118
30
46
147
72
165
77
103
51
47


42
18
94
15
66
16
47
39


12
(28)
(39)
30
59
519
91
37
101
56
77
174
(33)
122
39
37

(18)


8,276
2,310
1,616


3,977
8,683
1,244
2,007
2,682
1,765
2,757
1,136
(2,432)
2,369
6,759
1,392


3,023
1,645
963
4,052
3,993
1,412
1,101
2,058


1,193
965
780
4,364
1,237
2,243
5,824
1,969
5,900
2,632
3,609
1,792
1,929


1,110
562
4,035
591
2,899
590
1,716
1,359


600
(1,552)
(1,179)
1,403
1,924
17,546
3,395
1,162
3,740
2,189
3,085
6,869
(1,228)
4,575
1,629
1,355
(1,177)


8,696
2,464
1,622


4,174
8,891
1,386
2,139
2,599
1,438
2,754
1,217
(2,539)
2,328
6,802
1,324


3,006
1,641
1,012
4,021
3,970
1,440
1,226
2,128


1,226
989
859
4,430
1,361
2,382
5,974
2,034
6,420
2,651
3,609
1,914
1,968


1,094
582
4,195
579
2,723
575
1,726
1,231


594
(1,597)
(1,372)
1,452
1,934
17,880
3,369
1,202
3,883
2,042
3,184
6,989
(1,240)
4,845
1,660
1,447
(1,240)


*Estimate based on average percentage of divisional total.

() Figures shown in parenthesis are from cities which have
been reporting less than five years and hence are not in-
cluded in Table 3.


I




UNIVERSITY OF FLORIDA


3 1262 08864 0031


Morbidity and Mortality Weekly Report


by fever, malaise, headache, stiff or tender neck, nausea,
and myalgia. There was no associated pleurodynia or
rash. None of the cases was fatal. Many illnesses were
observed in family contacts of the aseptic meningitis
cases. The Communicable Disease Center Laboratory in
Kansas City isolated Coxsackie B, from the outbreak.
The age distribution of the 25 cases of aseptic meningitis
and 19 minor illnesses among family contacts is shown
below:
0-14 years: 24
15-29 7
30-44 6
45 plus 7
(Reported by Mr. Kenneth Mosser, Director of Division of
Preventable Diseases, North Dakota State Health Depart-
ment and a team from the Kansas City Field Station of
the Communicable Disease Center).

Hepatitis in Zoo Employees -Florida
An outbreak of 6 cases of infectious hepatitis among
37 employees at the Crandon Park Zoo, Miami, Florida,
has been reported. A baby chimpanzee is the possible
common source of infection.
All 6 of the following reported cases have had close
contact with the chimpanzee. The 4 girls were summer
employees responsible for its daily care, feeding and for
laundering its soiled diapers. The 2 men are regular em-
ployees responsible for the cleaning of its quarters.

CASES OF INFECTIOUS HEPATITIS IN ZOO EMPLOYEES

DATE OF ONSET AGE SEX RACE
8/7/61 19 F W
8,7/61 18 F W
8/7/61 16 F W
8/17/61 17 F W
8/17/61 28 M W
8. 23/61 23 M W



The chimpanzee arrived in Miami from Liberia on
June 15, 1961, and was received by the Zoo on July 6,
1961. The only illness the animal was reported to have
had was a mild upper respiratory infection about the
middle of July.
Blood and stool specimens are being collected from
the patients for laboratory confirmation of the diagnosis,
and virus isolation will be attempted.The chimpanzee was
transferred to the Yerkes Laboratories of Primate Biology,
Orange Park, Florida, for laboratory studies and possible
virus isolation.
(Report submitted by L. B. Clayton, M.D., M.P.H., Di-
rector, Division of Research, Dade County Department of
Public Health, Miami, Florida and W. R. Stinger, M.D.,
M.P.H., Director, Division of Epidemiology, Dade County
Department of Public Health, Miami, Florida).


QUARANTINE MEASURES
Immunization Information for International Travel
No Changes Reported





FOR SOURCE AND NATURE OF MORBIDITY DATA SEE
LAST WEEK'S MORBIDITY AND MORTALITY WEEKLY


REPORT




--V OF FL L 8


SEPSTOR


U.S EPOSITrORY


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