Morbidity and mortality

COMMUNICABLE DISEASE CENTER


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


CURRENT TRENDS
INFLUENZA IN THE UNITED STATES


Type B influenza virus has been identified in two
more eastern States, Connecticut and Alabama. This
brings to 6 the total of States in which the etiology of
widespread or scattered outbreaks of febrile respiratory
illness has been identified as influenza B, either through
virus isolation or serological procedures (MMWR, Vol. 15,
No. 6). Following recent notifications of increased
amounts of febrile illnesses in one or more communities
in New Hampshire, Vermont, New York, New Jersey and
North Carolina, the respective State Health Departments
are similarly investigating these influenza-like outbreaks.
A total of 12 States in the eastern United States have


Current Trends
Influenza United States .. ...
Influenza Laboratory Findings .
Meningococcal Infections .
Epidemiologic Notes and Reports
Measles Mason County, Kentucky


............ 53
. 54
. 55


now confirmed the presence of influenza B or are inves-
tigating suspected influenza.
Pneumonia-influenza mortality data from 122 cities
in the United la.i.-- does not demonstrate any excess on
a national basis although the South Atlantic and East
South Central Divisions, where influenza has been
demonstrated, each show a slight increase above the
(Continued on page 54)


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous weeks)
7th WEEK ENDED CUMULATIVE. FIRST 7 WEEKS
MEDIAN
DISEASE FEBRUARY 19. FEBRUARY 20. 1961-1965 MEDIAN
1966 1965 1966 1965 1961-1965
Aseptic meningitis ................... 24 21 19 180 194 164
Brucellosis................. .... 4 5 23 26 39
Diphtheria. ....... ........ ...... 3 4 4 19 22 38
Encephalitis, primary:
Arthropod-borne & unspecified ........... 27 25 164 199 -
Encephalitis, post-infectious ............. 25 10 -- 101 86
Hepatitis, serum ................... 16 9 37 5 7,837
Hepatitis, infectious ............. ...... 718 9 4,907 5,620
Measles rubeolaa) ................ 7,444 9.355 11,139 40,455 51,984 62,180
Poliomyelitis, Total (including unspecified) 1 3 2 2 27
Paralytic ............... ..... 1 2 1 2 23
Nonparalytic .................... -
Meningococcal infections. Total .......... 107 110 49 547 496 377
Civilian ................... ......... 91 105 --- 477 476 -
Military ............................... 16 5 -- 70 20 --
Rubella (German measles) ...... ... 1.446 --- -- 7,042 -
Streptococcal sore throat & Scarlet fever .. 12,279 12.023 10,323 70,425 74,792 64,114
Tetanus. ................. .............. 4 4 15 24 -
Tularemia ................... ........ 4 1 --- 27 38 -
Typhoid fever .......................... 4 7 7 33 46 48
Typhus, tick-borne (Rky. Mt. Spotted fever). --- 7 6 --

Rabies in Animals. .................... ..71 85 65 503 659 445

NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax: .............. ........ .. Botulism: ....... .. ..... ... ..... 1
Leptospirosis: Iowa-4 ............... ..... ..... 7 Trichinosis: N.Y.C.- 1 ....... .... ......... 16
Malaria: Ohio- 1. Ill. 1. Ky. 1, Penn. -3, Puerto Rico- 1 41 Rabies in Man: .................. .....
Psittacosis: Tenn. 1 .. ... ... 7 Rubella. Congenital Syndrome ................... 2
Typhus, m urine: ... ... .. .. .. ..... ......... ....... .. ......... .. .


No. 7







.nding
. 19, 1966


,RVICE







Morbidity and Mortality Weekly Report


CURRENT TRENDS
INFLUENZA IN THE UNITED STATES
(Continued from front page)


"epidemic threshold"; in the South Atlantic Division
this increase is shown for the second week in succession.
Mortality in the New England division which barely
exceeded the "threshold" in the preceding week has now
dropped back to the expected seasonal level.
(Reported by the Influenza-Respiratory Disease Unit,
CDC.)

California
Reports from California indicate that nearly half
of the counties in the State appear to be affected by
influenza. In many of these counties school children are
predominantly involved; in others the illness is now
appearing in the adult population. The impact of the
outbreak has been increasingly substantiated by school
absenteeism of up to 40 percent and by absences through
illness from commercial and industrial concerns.
Type A2 influenza virus strains have been identified
in both northern and southern parts of the State, including
San Diego, Los Angeles and Sacramento Counties. In


other areas there has been serological identification of
type A infections.
(Reported by Dr. Henry Renteln, California State Depart-
ment of Public Health; and an EIS Officer assigned to
the California State Department of Public Health.)

Washington
Isolated school-centered outbreaks of an influenza-
like disease resulting in absenteeism considerably above
seasonal levels have recently been reported in Olympia,
Seattle, and Spokane. Type B influenza virus strains
have been recovered from typical cases in one inves-
tigation, carried out in an Olympia school, where a study
of unpaired acute-convalescent phase serum samples had
shown evidences of type B infection. Investigation of
the other outbreaks is underway.
(Reported by Dr. Ernest A. Ager, Chief, Division of
Epidemiology, State Department of Health, Olympia,
Washington; and an EIS Officer assigned to the State
Department of Health, Washington.)


INFLUENZA LABORATORY FINDINGS


Influenza viruses isolated in various geographic
areas of the world during the last several weeks have
been predominantly type B. Preliminary hemagglutination
inhibition tests to characterize these viruses have been
completed and, although clearly related to viruses iso-


lated in previous years, the tests suggest an antigenic
difference. It should be noted that extensive variation
among type B viruses has been observed for the past few
years, the significance of which is not clear at the pres-
ent time.


Table 1
HEMAGGLUTINATION-INHIBITION TESTS WITH CURRENTLY PREVALENT TYPE B INFLUENZA VIRUSES
Chicken antisera
Virus Strains
B/Maryland/1/59 B/Taiwan/2/62 B/Singapore/3/64 B Georgia l/65

B/Maryland/1/59* ................ 1280 <10 80 40
B/Taiwan/2/62 ................... 80 80 10 20
B/Singapore/3/64 .................. 1280 <10 80 40
B/Georgia/1/65 ................... 160 <10 20 80
B/Massachusetts/1/66 .... ........... 80 <10 10 20
B/Massachusetts/2/66 ............... 320 <10 10 20
B/Massachusetts/3/66............... 640 <10 10 40
B/Georgia/1/66 ................... 1280 <10 80 640
B/Georgia/2/66 ................... 160 <10 20 20
B G.-iurl.i '3/66 ........ .......... 1280 <10 80 640
B/Georgia/4/66 ................... 80 <10 10 20
B/Georgia/5/66 ................... 80 <10 10 20
B/Great Lakes/1-7/66 ............... 160 <10 20 80


*Type B influenza virus component in commercially prepared vaccines.


FEBRUARY 19, 1966












Homologous antiserum has been prepared with one of
the strains currently active in the United States (B/Geor-
gia/1/65, isolated in December) and typical results are
shown in Table 1, using a number of strains isolated from
cases in Massachusetts, Georgia and Illinois. It would
appear that these currently active viruses are not a
homogenous group with respect to their avidity for anti-
body and, until further tests are completed, it is not
possible to place them in their proper antigenic relation-


ship to earlier viruses. However, they are clearly unlike
the antigenic variant which appeared in Taiwan in 1962,
and they have been r.a.lils identified using antiserum of
high titer prepared with the B/Mar, Indl '1/59 virus, the
type B strain at present used in vaccine production in the
United States.

(Reported by the WHO International Influenza Center for
the Americas, Communicable Disease Center, Atlanta.)


MENINGOCOCCAL INFECTIONS


An additional 107 cases of meningococcal infection
have been reported by State Health Departments this
week, bringing to 547 the total of cases reported through
the 7th week of 1966 (Table 2). The current reported
incidence ofmeningococcal infections is shown in Figure 1
and is compared to 1965 as well as to the median for
the period 1961-1965. The close approximation of the
present curve to that of last year indicates that a period
of continued high incidence may be expected for several
weeks to come.
Table 2
MENINGOCOCCAL INFECTIONS UNITED STATES
Total Cases Reported to CDC
1st Through 7th Week, 1964 to 1966

1964 1965 1966
United States ... 377 496(20)* 547(70)*
New England ... 10 29 36
Middle Atlantic ...... .. 46 73 79
East North Central 55 63 88
West North Central 17 19 27
South Atlantic ... 85 104 94
East South Central 29 27 40
West South Central 50 65 67
Mountain . ... 22 19 23
Pacific . ... 63 97 93
*Cases in Armed Forces reported through State Health Departments
The results of sulfadiazine sensitivity testing of
strains of meningococci submitted to the Communicable
Disease Center during 1965 and for the first 7 weeks of


1966 are shown in Table 3. The strains were submitted
from States in all geographic areas of the United States
and were isolated, with few exceptions, from the blood
or cerebrospinal fluid of civilian cases.
Over 90 percent of the typable strains have been in
serogroup B. During 1965, 65 percent of these strains
were inhibited at the level of 1 mgm percent of sulfa-
diazine or less; thus far in 1966, 51 percent of the strains
submitted have been inhibited at that level.
(Reported by Investigations Section, Epidemiology Branch,
and General Bacteriology Unit, Laboratory Branch, CDC.)


FIGURE 1
MENINGOCOCCAL INFECTIONS BY WEEK OF REPORT
1965, 1966 AND MEDIAN, 1961-65


40

10 1965
,2o-I .4


1961-65 MEDIAN


JAN FEB MAR APR MAY JUN JUL AUG SEPT OCT NOV DEC
MONTH


Table 3
MINIMUM INHIBITORY CONCENTRATION OF SULFADIAZINE AGAINST MENINGOCOCCI
Strains Submitted to the Communicable Disease Center

Total
M.I.C., mer' .05 .1 .5 1.0 3.0 5.0 10.0 15.0 >20.0 ota
Strains
Jan. Dec., 1965
# of Strains .................. .......... 96 31 66 29 46 23 30 10 8 339
Cumulative Percent . . ... 28 37 57 65 79 86 95 98 100 .

Jan. 1966 to Present
#of Strains ............................. 16 5 19 -- 5 6 13 2 12 78
Cumulative Percent . . ... 21 27 51 51 58 65 82 85 100


FEBRUARY 19. 1966


Morbidity and Mortality Weekly Report









56 Morbidity and Mortality Weekly Report



CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

FEBRUARY 19, 1966 AND FEBRUARY 20, 1965 (7th WEEK)


ENCEPHALITIS HEPATITIS
ASEPTIC Primary Post- Both
AREA MENINGITIS BRUCELLOSIS including Infectious DIPHTHERIA Serum Infectious Types
unsp. cases
1966 1965 1966 1966 1965 1966 1966 1965 1966 1966 1965
UNITED STATES... 24 21 27 25 25 3 4 16 718 829

NEW ENGLAND.......... 1 1 3 7 2 1 21 43
Maine.............. 6 7
New Hampshire...... 3 4
Vermont ............ 2 -
Massachusetts...... 1 1 5 1 6 16
Rhode Island....... 1 1 5
Connecticut........ 1 1 1 4 11

MIDDLE ATLANTIC...... 2 4 9 4 3 10 105 141
New York City...... 4 1 9 21 30
New York, Up-State 1 1 1 2 1 36 62
New Jersey.......... 2 4 12 18
Pennsylvania....... 3 2 1 36 31

EAST NORTH CENTRAL... 3 1 2 5 7 1 147 181
Ohio................ 2 1 1 27 35
Indiana............. 2 10 32
Illinois............ 3 6 18 40
Michigan........... 1 1 1 1 81 68
Wisconsin..........- 11 6

WEST NORTH CENTRAL... 2 1 1 42 40
Minnesota........... 1 4 5
Iowa................. 4 7
Missouri ........... 29 9
North Dakota.......
South Dakota....... 2
Nebraska .......... -
Kansas............. 1 3 19

SOUTH ATLANTIC...... 5 1 5 4 5 2 77 100
Delaware........... 2 8
Maryland ........... 1 20 39
Dist. of Columbia.. 2 2
Virginia........... 2 1 15 8
West Virginia...... 1 15 18
North Carolina..... 7 10
South Carolina..... 1 4
Georgia............. 3 9
Florida............ 3 1 1 3 5 11 6

EAST SOUTH CENTRAL... 1 1 2 1 1 51 76
Kentucky........... 1 1 1 1 20 18
Tennessee............ 2 23 41
Alabama............ 13
Mississippi........ 8 4

WEST SOUTH CENTRAL.. 3 5 1 1 1 51 84
Arkansas........... 6 10
Louisiana.......... 2 1 9 16
Oklahoma............ 2
Texas............... 1 5 1 1 36 56

MOUNTAIN ............. 51 42
Montana............ 3
Idaho.............. 5 4
Wyoming............. 3 3
Colorado........... 8 9
New Mexico......... 20 8
Arizona............ 8 5
Utah................ 1 7 9
Nevada............. 1

PACIFIC.............. 9 6 5 2 7 1 5 173 122
Washington .........- 2 1 10 13
Oregon............. 9 5
California......... 7 5 5 2 5 1 4 149 99
Alaska.............. 3 3
Hawaii ............ 2 2

Puerto Rico.......... 2 8 23








NMorbidity and Mortality Weekly Report


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

FEBRUARY 19, 1966 AND FEBRUARY 20, 1965 (7th WEEK) Continued


AREA



U; lilrF : i-Ti

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..............


Puerto Rico...........


MEASLES (Rubeola)


1966 1966 1965

.... '; 5 ,1 6-

56 515 12,461
6 54 1,352
3 8 186
1 137 113
34 193 7,333
1 33 1,503
11 90 1,974

1,043 6,099 1,874
453 3,012 214
62 661 681
126 573 270
402 1,853 709

3,596 16,683 9,182
160 871 1,811
395 866 387
1,240 3,857 279
391 2,521 4,983
1,410 8,568 1,722

324 1,635 3,830
99 618 93
105 544 1,981
23 104 433
97 352 1,203
S 2 25
15 95
NN NN NN

488 3,377 7,395
2 43 102
110 631 231
50 179 10
55 275 1,060
162 1,573 5,216
4 41 110
132 110
S 34 185
105 469 371

530 4,850 2,592
95 1,867 171
401 2,796 1,771
10 91 452
24 96 198

563 2,796 5,961
13 37 572
4 29 11
12 33 41
534 2,697 5,337

281 1,755 4,115
31 286 1,327
54 278 644
21 102
39 188 612
11 15 86
132 896 114
14 67 1,205
4 25

563 2,745 4,574
198 834 1,447
24 244 818
336 1,630 1,842
1 8 49
4 29 418

53 432 208


MENINGOCOCCAL INFECTIONS, POLIOMYELITIS
TOTAL RUBELLA
TO Total Parlytic

19619 6 666 195 1966 1965 1966 1966



12 36 29 116
3 3 5 10
7 1 1
1 I 5
6 14 12 53
2 4 3
3 9 7 44

8 79 73 66
2 16 12 46
15 17 20
3 26 29 -
3 22 15

15 88 63 483
3 27 18 36
3 10 7 124
5 18 14 104
4 24 15 91
9 9 128

7 27 19 48
1 6 4 1
4 43
4 10 9
3 4
1 1

2 5 2

20 94 104 113
2 2
6 14 5 19
3
4 11 15 12
1 4 8 63
17 17 -
2 16 12 10
2 7 19
5 25 23 7

10 40 27 217
6 22 8 132
10 12 84
2 5 7 1
2 3

18 67 65 1 6
5 4
5 14 26
2 8 1
13 46 27 6

3 23 19 1 130
2 1
21 1
I I
13 7 16
1 2 2
2 4 4 1 101
3 4
1 2

14 93 97 267
1 6 4 153
1 4 6 37
12 73 86 74
S 8 1 -
2 2

2 2


I









58 Morbidity and Mortality Weekly Report


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

FEBRUARY 19, 1966 AND FEBRUARY 20, 1965 (7th WEEK) Continued


SSTREPTOCOCCAL TYPHUS FEVER RABIES IN
SORE THROAT & TETANUS TULAREMIA TYPHOID TICK-BORNE ANIMALS
AREA SCARLET FEVER (Rky. Mt. Spotted)
1966 1966 Cum. 1966 Cum. 1966 Cum. 1966 Cum. 1966 Cum.
1966 1966 1966 1966 1966


UNITED STATES... 12,279 4 15 4 27 4 33 7 71 503

NEW ENGLAND .......... 1,603 1 2 1 1 1 2 1 4
Maine.............. 216 -
New Hampshire...... 34 -
Vermont............ 17 1 4
Massachusetts...... 372 1 2 1 1 -
Rhode Island....... 78 -
Connecticut........ 886 1 2 -

MIDDLE ATLANTIC...... 379 3 1 9 .- 1 8 47
New York City...... 41 3 1 5 -
New York, Up-State. 249 2 8 45
New Jersey......... NN 2 -
Pennsylvania....... 89 1 2

EAST NORTH CENTRAL... 1,232 2 8 6 6 55
Ohio ............... 112 3 3 1 31
Indiana............. 339 1 1 2 9
Illinois........... 193 1 3 1 3
Michigan........... 368 1 1 6
Wisconsin.......... 220 1 1 1 1 6

WEST NORTH CENTRAL... 378 1 1 2 1 2 1 21 137
Minnesota .......... 19 -- 5 26
Iowa............... 155 3 26
Missouri........... 34 1 1 1 1 8 59
North Dakota....... 95 3
South Dakota ....... 11 3 16
Nebraska........... 8 2
Kansas............. 56 2 1 1 2 5

SOUTH ATLANTIC....... 1,264 3 5 8 5 9 66
Delaware ........... 12 -
Maryland ........ 229 -
Dist. of Columbia.. 31 -
Virginia........... 367 2 5 1 8 53
West Virginia...... 381 1 1 -- 5
North Carolina..... 21 2 1 3
South Carolina..... 45 1 -
Georgia............. 12 2 1 1 6
Florida............. 166 1 2

EAST SOUTH CENTRAL... 1,499 8 1 2 12 75
Kentucky........... 107 2 1 11
Tennessee.......... 1,277 4 1 2 11 62
Alabama............ 7 2 -
Mississippi........ 108 -

WEST SOUTH CENTRAL... 1,181 1 3 1 2 1 10 90
Arkansas........... 6 1 1 1 8
Louisiana.......... 5 2 6
Oklahoma .......... 4 1 1 7
Texas.............. 1,166 1 1 8 69

MOUNTAIN.............. 2,477 2 5
Montana............ 68 -
Idaho.............. 282 -
Wyoming............ 16
Colorado............ 1,600
New Mexico......... 221 -
Arizona............. 55 4
Utah............... 234 -
Nevada............. 1-

PACIFIC.............. 2,266 1 3 1 1- 4 24
Washington......... 760 -
Oregon............. 40 -
California......... 1,353 1 3 1 1 4 24
Alaska.............. 60 -
Hawaii............. 53 -


Puerto Rico............ 7 I I I I I I I 1 1


--









Morbidity and Mortality Weekly Report


Week No. Table 4. DEATHS IN 122 UNITED STATES CITIES FOR WEEK ENDED FEBRUARY 19, 1966
7
(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 years and 1 year
Ages and over Influenza All 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.--------


823
294
41
25
30
64
28
22
28
50
73
20
63
26
59

3,652
48
42
152
47
27
42
82
138
1,862
33
555
229
73
93
25
32
63
45
36
28

2,739
52
30
781
206
218
140
94
404
39
42
41
39
39
145
21
130
38
32
56
115
77

963
54
39
59
161
42
99
77
311
84
37


512
168
24
21
17
36
8
17
22
31
46
14
44
22
42

2,163
29
32
96
24
15
29
49
67
1,085
20
322
141
47
67
16
17
38
29
24
16

1,562
34
18
415
135
128
86
60
210
25
19
25
18
24
81
12
68
27
20
36
73
48

597
39
26
30
98
31
59
50
186
59
19


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

Total


1,349
193
292
43
60
103
49
94
48
108
100
194
65

747
104
74
58
183
138
34
53
103

1,209
47
27
23
156
41
90
222
56
214
87
118
51
77

467
45
14
119
24
120
24
60
61

1,654
18
49
32
42
61
461
97
44
133
90
100
243
36
146
57
45

13,603


7,885 716


Cumulative Totals
including reported corrections for previous weeks


All Causes, All Ages -------------------------
All Causes, Age 65 and over--------------------
Pneumonia and Influenza, All Ages-------------
All Causes, Under 1 Year of Age---------------


93,875
54,293
4,429
4,891








Morbidity and Mortality Weekly Report


EPIDEMIOLOGIC NOTES AND REPORTS
MEASLES Mason County, Kentucky



A measles immunization campaign was conducted in
Mason County, Kentucky, during November and December,
1965 (MMWR, Vol. 14, Nos. 44 and 48). Including the
345 doses of live attenuated measles vaccine given in the
initial phase of the campaign on November 2 and 3, a
total of 702 doses had been given throughout the County
by the end of December. This total includes over 90
percent of the susceptible elementary-school-age children.

During the second week in December an outbreak of
measles started in a school in the village of Aberdeen,
Brown County, Ohio, just across the river from \is -\ Ill,
in Mason County. Most of the service and shopping
facilities for these two communities are in Maysville
and there is considerable mixing of both populations.
As the school outbreak in Aberdeen progressed, the
sickness absentee rate went up from an average of 20
to 50 students each day, the first and second grades
being heavily affected in the early part of January. The
kindergarten of 50 children was not affected by the
outbreak; 20 of these children live in Maysville and had
been immunized during the November campaign. The
remaining 30 kindergarten children who lived in Aberdeen
either had had measles or been immunized against it by
their private physicians at the time of the Maysville
campaign. Despite this outbreak in Aberdeen and the
close association between the two communities, no
further cases of measles occurred in Maysville,
Measles was again introduced into Mason County
during December and 14 cases occurred subsequently
among school and pre-school children in the Minerva
School District. A pre-school child who was incubating
measles came to live in this school district; this child
infected a pre-school sibling and an aunt who was a
second grade student. Thereafter, four other students in
the first and second grades, five older children in the
same school and three of their siblings of pre-school
age, all developed measles. None of these 14 children
had been immunized. Following this episode no additional
cases have been reported to date in Mason County.

(Reported by Mr. J.R. Sills, Administrator, Mason County
Health Department; Dr. Joseph W Skaggs, Kentucky
State Health Department; and an EIS Officer.)


THE MORBIDITY AND MORTALITY WEEKLY
TION OF 15,300. IS PUBLISHED AT THE
CENTER, ATLANTA. GEORGIA.


FEBRUARY 19, 1966



U.
0
REPORT, WITH A CIRCULAR.
COMMUNICABLE DISEASE
LU '


CHIEF. COMMUNICABLE DISEASE CENTER DAVID J. SENCER, M.D.
CHIEF, EPIDEMIOLOGY BRANCH A.D. LANGMUIR. M.D.
ACTING CHIEF. STATISTICS SECTION IDA L. SHERMAN, M.S.
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 INVES.
TIGATIONS WHICH ARE OF CURRENT INTEREST TO HEALTH OFFICIALS
AND WHICH ARE DIRECTLY RELATED TO THE CONTROL OF
COMMUNICABLE 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.


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