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F5 sl.o/; COMMUNICABLE DISEASE CENTER U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE EPIDEMIOLOGIC NOTES AND REPORTS ENCEPHALITIS Texas Corpus Christi, Nueces County During the first 3 weeks of August a total of 47 cases of encephalitis and other illnesses clinically diag- nosed as compatible with St. Louis encephalitis Iirus infection has been reported by the Corpus Christi-Nueces County Health Department. Initial sera from four patients with encephalitis had hemagglutination-inhibition tigers ranging from 1:40 to 1:640 for St. Louis encephalitis virus. Clinical, epidemiologic and viral studies are in progress. Mosquito control measures which were instituted in the beginningof the summer have been greatly intensified. (Reported by Dr. Van C. Tipton. State Epidemiolojist. Texas State Department of Health: aond Dr. William R. Vetzger, Director of Public Health and Welfare. Corpus Christi-'ucces County Health Department.) t'A\ TEA TS Ii,',hllnt)L,, i- I lic lm onl a lt i- x ........ .. R epo rt-,d ( ,- s Malaria 196. ..... InternationI \,'t,-- Quasr.ainin, fl ,.,ur Dallas \ total of 93 cai-es of clinical encephalitis have occurred in Dallas. Texa-. from the middle of Jul\ through August 23, 1916I. Six deaths hale been associated with the outbreak. In addition there have been 52 cases of aseptic meningitis. (C'otinuted on page 282) CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES (Cumulative totals include revised and delayed reports through previous weeks) 33rd. WEEK ENDED j CUMULATIVE. FIRST 33 WEEKS MEDIAN DISEASE i., i.. i :, ,i' .: -T 1961-1965 MEDIAN 1966 1965 1966 1965 1961- 1965 Br.j,- II Ji 14 i Diphtheria. . .. 4 6 5 112 95 165 Encephalitis, primary: Arthropod-borne & unspecified ......... 110 45 972 1,027 Encephalitis, post-infectious ......... 8 8 -548 507 Hepatitis, serum .. .......... 33 605 746 875 21 915 28,354 Hepatitis, infectious .............. 610 20.688 Measles rubeolaa) ................. ..... 693 665 1.183 187,665 238.074 383,740 Poliomyelitis, Total (including unspecified) 2 1 23 59 36 182 Paralytic ......... 2 1 22 54 31 155 Nonparalytic . .- 5 Meningococcal infections. Total ......... 33 25 26 2.602 2.217 1.665 Civilian . .. 29 24 2.334 2.037 Military ..... .... .......... ... 4 1 268 180 Rubella (German measles) .. .. .......... 228 -- --- 40.912 - Streptococcal sore throat & Scarlet fever .. 3.838 3,193 3,003 294.323 272,741 238.988 Tetanus. ....... ... .. 5 10 104 174 Tularemia ........ ... 8 5 105 160 Typhoid fever .... ................. 11 8 20 227 250 288 Typhus, tick-borne (Rky. Mt. Spotted fever) 5 13 165 189 - Rabies in Animals....................... 92 60 60 2.764 2.977 2.653 NOTIFIABLE DISEASES OF LOW FREQUENCY Cum Cum. Anthrax: ..... ...... 4 Botulism: .. .... 4 Leptospirosis: Hawaii-i, Tex-2 ..... .............. 45 Trichinosis: Ore- Ohio- ..... 63 Malaria: NYC-, Mich-3, Md-4, NC-I,NYUpS-, La-1, Fla-1, Calif-3 213 Rabies in Man: ............ ....... Psittacosis: Minn-1, Tex-1 ................. ........... 28 Rubella, Congenital Syndrome: Minn-2 ....... 20 Typhus murine' 14 Pl.iu, 1/. ** _ 282 Studies at the Texas State Department of Health lab- oratories revealed a fourfold increase in CF antibody titers for St. Louis encephalitis virus for 4 patients and initial titers of 1:10 or greater for 53 others. Presumptive virus isolates have been found in autopsy specimens from two patients and from pools of Culex quinquefasciatus mosquitoes. AUGUST 20, 1966 Principle control measures have been directed toward eliminating the mosquito reservoirs in the area. Mobile equipment, including aircraft, have been used to spray the entire city with malathion. (Reported by Dr. Van C. Tipton, State Epidemiologist, Texas State Department of Health; and Dr. Hal J. Dewlett. Director, Dallas City Health Department.) SALMONELLOSIS Massachusetts An outbreak of Salmonella cubana in aMassachusetts hospital has been found associated with a carmine dye used for the investigation of gastrointestinal disease in several patients. Investigation of the outbreak was initiated by the hospital when it was noted that S. cubana accounted for a disproportionate number of salmonella isolation from clinical specimens in the hospital bacteriology labora- tory. In 1965. this serotype represented 10.3 percent of salmonella isolations at the hospital as compared to 0.7 percent of the national total (Table 1). From January through July 1966, S. cubana accounted for 48.5 percent of the hospital isolates of salmonellae. Several of the patients with S. cubana infection developed symptoms of salmonellosis after admission to the hospital. Many of this group had been admitted because of chronic gastroin- testinal disease or feeding problems and had been given carmine powder for timing collection of fecal specimens, measurement of bowel transit time and demonstration of fistulae. Carmine powder from capsules prepared for ingestion and from opened and unopened pharmacy stocks was cul- tured and found to be heavily contaminated with Salmo- nella cabana. A preliminary quantitative culture revealed 105 salmonellae per gram. Samples of carmine powder from four other hospitals have been collected and ex- amined by the Massachusetts Departmentof Public Health; samples from two of these hospitals have been found positive for S. cubana. The powder in each instance was prepared from dried female insects of the species coccus cacti. Further investigation of the sources and use of this type of powder is underway. Year 1963 1964 1965 1966"* National* Total S. Per- Serotypes cubana cent lb,649 40 0.2 21,113 63 0.3 20,b65 145 0.7 10,507 95 0.9 'Data taken from Salmonella 1964, 1965. **January through July, 1966. Hospital Total S. Per- Serotypes cubana cent Survpillance, Annual Sunnmmarie Discussion: From the facts accumulated thus far, it would seem that carmine dye, particularly that prepared from the in- sect coccus cacti. should be carefully checked bacterio- logically to insure the absence of ip.iir.. micro- organisms before being administered to patients. This applies particularly to materials given to patients with impaired intestinal physiology who may be at greater risk of enteric infection. It should be pointed out that S. cu- bana has Group G salmonella antigens and may not be recognized as a salmonella in laboratories using only diagnostic antisera A through E. (Reported by David J. Lang, M.D., and Lawrence J. Kunz, Ph.D., Boston, Massachusetts; by A. Daniel Rubenstein, M.D., Director, Division of Hospital Facilities, Massa- chusetts Department of Public Health.) SALMONELLOSIS- Spokane, Washington During the last 2 weeks of July. 1966, an outbreak of salmonellosis associated with the consumption of barbecued chicken involved 24 different family groups in Spokane. Washington. Reports indicated that a total of 65 individuals became ill. 241 of whom were hospitalized: two deaths \ere associated with the outbreak. While all family groups purchased the barbecued chickens from supermarkets. 21 of 24 groups bought chickens from a single stand in a modern Spokane super- market. The dates of purchase ranged from July 11 to July 27; 22 of the groups bought their chickens between July 19 and Julyo 21. Investigation of the food handling operations and practices at the involved store revealed a number of deficiencies. The barbecuing oven was found to give internal (body cavity) bird temperatures of 150: the tem- perature of the meat itself was substantially less. The duration of barbecuing was variable, and some individuals complained that the meat was inadequately cooked. The holding oven (warmer) for cooked birds gave internal (body cavity) bird temperatures of 100-110", thus allowing bacterial growth to occur in the cooler meat after barbe- cuing. In addition, the barbecued birds were placed on the same surfaces as uncooked birds, and unpurchased birds were refrigerated and warmed again for sale the next day. Salmonella typhi-murium has been isolated from over 30 individuals associated with this outbreak, from three packaged, barbecued birds from the incriminated store. Morbidity and Mortality Weekly Report ENCEPHALITIS Texas (Continued from front page) Table 1 Incidence of Salmonella cubana among Salmonella serotypes I I and from left-oxer barbecued chicken and nrappinigs. An investigation of the poultry plant in western W'ashington which processes the chickens used in the barbecuing oper- ation rme\aled a modern, efficient plant. Of 27 en iron- mental swabs, including from the water o\orflo\I from the final chilling unit. 6 were positive for various ltpes of salmonella. As a result of the investigation, the barbecuing operations at supermarkets throughout Spokane haae been temporarily suspended by the Spokane(ity Health Depart- ment. Meetings are being scheduled with the manufac- 283 turers and dis-tributors of the barbecuing machines and an educational program will be drawn up for Ihose using these machines. \plpromxiately 25 case (, of gastroent(eritil have been identified in northern Idaho, all in person- who ingested barbecued chicken obtained from the same supermarkett in Spokane, \tashington. These cases are still under inxes- Sigation. (Reported b/y Dr. Ernest A. Ayer, ('Chit, Division of Epi- driiolog!i I iia.hington Stote Drpiertmiient of iHealth; and an kES Officrr.) CURRENT TRENDS REPORTED CASES OF POST-INFECTIOUS AND POST-IMMUNIZATION ENCEPHALITIS SECOND QUARTER ENDING JULY 1, 1966 (WEEKS 14-26) State Mumps Measles Chickenpox Other Specified Alaska ... ................. 1 Arkansas ................ 3 3 California .... ...... ...... ... 31 29 11 Influenza-1 Connecticut ................... ......... 1 1 Florida ............ ............. 17 2 4 Illinois .... ... ........ 7 3 1 Rubella-1 Louisiana ..... .... .................. 1 Maryland ............. 1..... M assachusetts ........................ i 7 Michigan .... ... .. ...... 13 5 4 Minnesota .............................. 5 3 1 Influenza-1. Herpes Simplex-2 New Hampshire .............. ... .. Influenza-1 New York, Upstate .................. 11 3 4 Pennsylvania ................ .. 13 9 3 Rubella-1 Tennessee .. ........ ..... 5 4 .Influenza-2. Herpes Simplex-1 T exas ........ .... ..... .. ....... 8 3 Utah ......... ............ .. ... 1 Herpes-1 \ ir. .. ... ... .. ... 4 1 Washington ....... ... ........... 8 Second Quarter Total 1966 ...... ............ 135 66 33 1965 .................................. 150 39 25 Cumulative Total (weeks 1-26) 1966 ...... ....... .... 241 128 61 1965 ............ .... 264 70 58 ...= Data not available. (States not reporting a case not listed) MALARIA 1966 Through July 1966, a total of 151 case reports of malaria with onset in the first 6 months of 1966 were received by the Malaria Surveillance Unit in the Parasitic Diseases Section of CDC. Imported malaria was respon- sible for 149 of the cases, 100 of which were in military personnel and 49 in civilians. Eight of the civilians were foreign visitors to the United States. South Vietnam was the country of origin of 91 of the military cases; for civil- ians, 29 cases originated in Africa and 11 in Asia. The remaining two malaria cases of the total 151 reported were probably introduced. The cases were in two children of one family in Kentucky with onsets on the same day; investigations to clarify the mode of transmission are continuing. The parasite species is known in 132 of the 151 cases. The distribution by species is shown in Table 2. Plasmodium vivar accounted for 57.6 percent of all cases. and P. falciparum for 33.3 percent. Of the military cases 38 percent were attributable to P. falciparum as compared to 24 percent of the civilian cases. (Continued on page 288) AUGUST 20, 1966 Morbidity and Mortality Weekly Report 284 Morbidity and Mortality Weekly Report CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES FOR WEEKS ENDED AUGUST 20, 1966 AND AUGUST 21, 1965 (33rd WEEK) ENCEPHALITIS HEPATITIS ASEPTIC Primary Post- Both AREA MENINGITIS BRUCELLOSIS including Infectious DIPHTHERIA Serum Infectious Types 1966 I 1965 1966 1 1966 1965 S 1966 1966 1965 1966 1966 1965 UNITED STATES... 142 54 11 110 45 8 4 6 33 610 605 NEW ENGLAND ......... 9 3 3 3 22 29 Maine.............. 3 5 New Hampshire...... 2 Vermont ... ......- 2 Massachusetts...... 8 3 2 2 2 13 Rhode Island....... 1 3 1 Connecticut ....... 1 1 14 6 MIDDLE ATLANTIC...... 6 6 9 15 1 16 66 122 New York City...... 4 3 2 8 13 16 33 New York, Up-State. 1 1 4 18 34 New Jersey.......... 1 5 2 2 9 32 Pennsylvania....... 2 1 1 1 1 1 23 23 EAST NORTH CENTRAL... 8 10 15 10 2 3 152 100 Ohio................ 1 3 10 8 1 27 30 Indiana............ 1 7 5 Illinois............ 5 4 1 1 1 1 50 16 Michigan........... 1 3 3 1 1 1 66 42 Wisconsin.......... 1 2 7 WEST NORTH CENTRAL... 1 5 5 2 4 2 28 18 Minnesota........... 1 3 -- 5 5 Iowa............... 2 4 2 11 6 Missouri............ 11 2 North Dakota....... -2 2 2 South Dakota........ 1- - Nebraska............. 1 1 Kansas............. 2 4 SOUTH ATLANTIC....... 24 4 4 6 1 1 2 6 2 54 58 Delaware .......... 1 - Maryland........... 1 14 7 Dist. of Columbia.. 1 2 Virginia........... 2 2 2 3 1 7 14 West Virginia...... 15 5 9 North Carolina..... I 8 5 South Carolina..... 2 1 1 4 Georgia.............. 1 3 7 - Florida............ 6 1 3 1 3 11 17 EAST SOUTH CENTRAL... 12 10 2 4 3 1 38 59 Kentucky ........... 1 6 9 18 Tennessee.......... 2 1 1 1 3 1 17 19 Alabama............ 5 3 5 7 Mississippi........ 4 1 3 7 15 WEST SOUTH CENTRAL... 39 4 62 2 2 61 53 Arkansas........... 4 10 Louisiana........... 4 3 2 18 8 Oklahoma............ 1 2 Texas............... 35 4 59 -- 2 38 33 MOUNTAIN............ 1 4 5 25 29 Montana ........... 2 1 Idaho.............. 3 1 5 Wyoming............. 1 Colorado............ 1 4 2 14 New Mexico......... 1 .- 8 2 Arizona............. 8 4 Utah............... 1 3 3 Nevada ............ - PACIFIC.............. 43 11 5 4 1 10 164 137 Washington.......... 1 1 1 17 6 Oregon.............. 2 24 7 California.......... 42 9 3 3 1 10 119 123 Alaska.............. 3 - Hawaii............. I 1 1 Puerto Rico.......... I - - I - 21 25 - 1 2 Morbiditv and Mortality Weekly Report CASESS OF SPECIFIED NOTIFIABLE DISEASES: IGNITED STATES FOR WIIKS ENI)ED) AUGUST 20, 1966 AND AUGUST 21, 1965 (33rd WEEK) CONTINUED MEASLES (Rubeola) AREA NEW ENGLAND.......... Maine.............. New Hampshire...... Vermont........... Massachusetts ..... Rhode Island....... Connecticut ....... MIDDLE ATLANTIC...... New York City...... New York, Up-State. New Jersey......... Pennsylvania ....... EAST NORTH CENTRAL... Ohio. .............. Indiana ........... Illinois .......... Michigan .......... Wisconsin ......... WEST NORTH CENTRAL... Minnesota ......... Iowa............... Missouri........... North Dakota....... South Dakota....... Nebraska........... Kansas............. SOUTH ATLANTIC...... Delaware........... Maryland........... Dist. of Columbia.. Virginia........... West Virginia...... North Carolina..... South Carolina..... Georgia ........... Florida............ EAST SOUTH CENTRAL... Kentucky........... Tennessee ......... Alabama ........... Mississippi........ WEST SOUTH CENTRAL... Arkansas........... Louisiana ......... Oklahoma .......... Texas.............. MOUNTAIN............. Montana............. Idaho............. Wyoming............. Colorado .......... New Mexico......... Arizona............ Utah............... Nevada............. PACIFIC.............. Washington......... Oregon.............. California ......... Alaska............. Hawaii ............. 2,230 194 79 225 773 72 887 17,925 8,247 2,508 1,844 5,326 68,161 6,326 5,646 11,317 14,183 30,689 8,661 1,639 5,303 529 1,075 40 75 NN 15,001 256 2,095 381 2,100 5,158 462 654 233 3,662 19,558 4,693 12,194 1,672 999 24,084 966 98 474 22,546 11,810 1,802 1,542 145 1,276 1,118 5,264 620 43 20,235 3,478 1,701 14,459 467 130 Puerto Rico.......... 42 2,599 36,722 2,786 381 1,246 19,269 3,897 9,143 14,532 2,282 4,084 2,512 5,654 55,046 8,843 1,801 2,602 26,240 15,560 16,391 625 8,971 2,580 3,654 112 449 NN 24,602 502 1,146 73 4,028 13,511 378 1,009 613 3,342 13,597 2,410 7,785 2,294 1,108 30,529 1,081 104 202 29,142 19,548 3,696 2,761 841 5,600 674 1,277 4,496 203 27,107 7,213 3,176 12,820 170 3,728 2,298 MENINGOCOCCAL INFECTIONS, TOTAL Cumulative 1966 1966 1965 113 112 S 9 16 9 7 Total 1966 - 1 - 1I - 10 5 - POLIOMYELITIS Py- RUBELLA Paralytic Cumulat ive 1965 1966 1966 1966 S23 - 3 S 15 16 -8 -1 1 -I 1 -1 3 -1 2 2 47 I -1 1 - 2 45 2 2 1 2 286 Morbidity and Mortality Weekly Report CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES FOR WEEKS ENDED AUGUST 20, 1966 AND AUGUST 21, 1965 (33rd WEEK) CONTINUED STREPTOCOCCAL TYPHUS FEVER RABIES IN SORE THROAT & TETANUS TULAREMIA TYPHOID TICK-BORNE ANIMALS AREA SCARLET FEVER (Rky. Mt. Spotted) 1966 1966 Cum. 1966 Cum. 1966 C 1966 umu. 1966 um. 1966 1966 1966 1966 1966 UNITED STATES... 3,838 5 104 8 105 11 227 5 165 92 2,764 NEW ENGLAND.......... 430 2 1 4 2 3 65 Maine.............. 35 1 23 New Hampshire...... 3 1 22 Vermont ............ 1 18 Massachusetts...... 52 2 1 1 1 2 Rhode Island....... 46 - Connecticut......... 294 3 1 - MIDDLE ATLANTIC..... 97 11 2 40 35 175 New York City...... 2 4 16 - New York, Up-State. 91 2 2 10 12 164 New Jersey.......... NN 1 7 10 Pennsylvania....... 4 4 7 13 11 EAST NORTH CENTRAL... 355 8 12 1 30 1 15 6 371 Ohio................ 8 3 3 1 15 8 180 Indiana............ 65 1 3 2 80 Illinois ........... 135 2 5 3 1 7 6 44 Michigan............ 86 2 4 30 Wisconsin.......... 61 1 6 37 WEST NORTH CENTRAL... 144 6 10 4 20 2 24 628 Minnesota......... 1 6 145 Iowa............... 19 1 1 5 5 130 Missouri........... 1 4 5 8 1 4 192 North Dakota....... 86 1 3 26 South Dakota....... 7 2 4 67 Nebraska........... 4 1 1 1 18 Kansas ............. 27 2 3 5 1 1 50 SOUTH ATLANTIC....... 397 2 27 9 40 2 74 7 355 Delaware ........... 1 -- I - Maryland........... 53 2 1 7 1 23 1 2 Dist. of Columbia.. 4 -- 2 - Virginia........... 66 4 2 8 21 195 West Virginia...... 124 1 I 1 43 North Carolina..... 6 1 4 2 3 1 17 3 South Carolina..... 41 1 1 7 5 Georgia............ 3 6 2 2 7 4 70 Florida............. 99 1 10 9 1 42 EAST SOUTH CENTRAL... 831 1 12 2 20 25 2 27 15 359 Kentucky........... 9 1 1 3 3 1 6 5 72 Tennessee.......... 741 1 2 10 11 1 16 7 264 Alabama............. 69 6 4 6 5 12 Mississippi........ 32 3 1 3 5 3 11 WEST SOUTH CENTRAL... 481 1 22 5 44 24 6 22 567 Arkansas........... 2 4 35 I 2 2 59 Louisiana.......... 5 3 7 3 30 Oklahoma........... 16 I 4 8 4 5 145 Texas............... 465 1 14 1 2 8 12 333 MOUNTAIN ............. 580 1 2 1 6 12 3 7 62 Montana............ 33 2 7 Idaho .............. 51 -- Wyoming............ 15 - Colorado ........... 184 1 2 3 2 8 New Mexico......... 130 1 2 1 11 Arizona............ 51 1 3 5 31 Utah ............... 116 1 2 3 1 1 Nevada.............- 1 1 4 PACIFIC .............. 503 14 3 4 32 1 8 182 Washington......... 5 11 8 Oregon............. 13 1 I 1 2 California......... 405 13 3 4 18 1 8 172 Alaska.............. 58- - Hawaii............. 22 2 Puerto Rico.......... 4 1 6 10 1 / I I I I I I I I Morbidity and Mlirlality W'ekl Report DEATHS IN 122 UNITED STATES CITIES FOR WEEK ENDED AUGUST 20, 1966 (By place of occurrence and week of filing certificate. Excludes fetal deaths) 287 All Causes Pneumonia Under All Causes Pneumonia Under Area All 65 years and 1 Yea Area All 65 years and 1 year Ages and over Influenza All Age. and over Influenza All 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.-------- 678 256 39 22 22 54 18 20 26 43 60 8 42 24 44 2,972 46 43 140 40 28 37 42 93 1,458 34 412 212 54 102 18 42 60 46 26 39 2,388 61 40 650 201 189 126 71 307 46 43 36 42 41 141 32 122 33 21 47 92 47 780 41 20 38 147 27 98 75 224 72 38 396 147 19 16 14 28 10 15 17 22 31 4 31 14 28 1,685 26 27 69 21 20 23 22 45 817 24 234 111 38 63 13 24 37 26 19 26 1,303 35 20 345 116 99 73 38 150 28 23 23 23 22 79 14 72 22 11 27 56 27 473 27 13 16 87 21 63 43 130 53 20 *Estimate based on average percent 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.---------- 1,113 134 229 38 59 85 46 86 34 72 88 187 55 552 79 44 34 80 123 47 39 106 1,084 31 30 23 169 40 82 172 52 179 58 119 70 59 406 47 24 115 18 87 22 49 44 1,470 16 41 34 53 87 434 90 33 108 57 81 217 27 113 41 38 Total j 11,443 6,304 363 677 Cumulative Totals including reported corrections for previous weeks All Causes, All Ages ------------------------- 421,655 All Causes, Age 65 and over------------------- 242,765 Pneumonia and Influenza, All Ages------------- 18,378 All Causes, Under 1 Year of Age--------------- 22,127 Week No. of divisional total. 288 Morbidity and Mortality Weekly Report MALARIA 1966 continued d front pau/e 283) Table 2 Cases of Malaria by Parasite Species United States- January-June, 1966* Species Total Percent P. .i'ra ...... .. 76 57.6 P. filcipar .... ...... 44 33.3 P. m/ial riac ... ... 1 0. '. orale / .. ... ....... 4 3.0 Mixed infections .... ... 7 5.3 132 100.0 *Prhliminar i .I ta During the past decade the incidence of imported malaria has increased considerably. For example in the full year 1959 there were 60 cases, and in 1964 and 1965, 168 and 15-1 cases, respectively. Already in the first 6 months of 1966 there have been 149 imported cases. No concomitant rise. however. has been seen in the number of ca es acquired in the United States. At most, four such cases occurred in any one year since 1959 and all but two of these could he defined as sporadic. The number of induced cases* likewise has shown no increase in recent years, not more than one or two cases having been reported in any one year between 1959 and 1964, and no cases since 1964. *Malaria infection acquir.-d through artificial mean., i.e., blood transfusions, common si. ringle etc. INTERNATIONAL NOTES QUARANTINE MEASURES Cholera Iraq An outbreak of cholera has been reported by Iraq. \ valid certificate of vaccination against cholera is required for entrance into the country. The certificate \\ill be required also by countries visitedd or transited within 5 days (of departure from Iraq. This includes the United States. ERRATUM, Vol. 15, No. 31, p. 262: In the article entitled "Current Trends Plague." the second sentence in the third paragraph should read: "The family did raise domestic rabbits, some of which died shortly after the patient became ill." AUGUST 20, 1966 _==< u-----(D 0__0 i----0 THE MORBIDITY AND MORTALITY WEEKLY REPORT, WITH A CIRCULA- TION OF 15,600. IS PUBLISHED AT THE COMMUNICABLE DISEASE CENTER. ATLANTA. GEORGIA. CHIEF, :r' .'., ,_'- DISEASE CENTER DAVID J. SENCER, M.D. CHIEF, F i1"'i .L : BRANCH A.D. LANGMUIR, M.D. ACTING CHIEF, STATISTICS SECTION IDA L. SHERMAN, M S. IN ADDITION TO THE ESTABLISHED PROCEDURES .ri MORBIDITY AND MORTALITY, THE COMMUNICABLE ':: i f' WELCOMES ACCOUNTS OF INTERESTING OUTBREAKS OR CASE INVES- TIGATIONS WHICH ARE OF CURRENT INTEREST TO HEALTH OFFICIALS AND WHICH ARE DIRECTLY RELATED TO THE CONTROL OF COM- MUNICABLE DISEASES. SUCH COMMUNICATIONS SHOULD BE ADDRESSED 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 SATURDAY; COMPILED DATA ON A NATIONAL BASIS ARE RELEASED ON THE SUCCEEDING FRIDAY. >t 20 0 r 9 Wr Mn o - ,C) - ift U.S DEPOSITORY C m -I om m !In .r |
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