Morbidity and mortality

EPIDEMIOLOGIC NOTES AND REPORTS
SALM CITED WITH NONFAT DRY MILK

.r '. F. l vision of Epidemiologf of the
t D.. If Public Health inn -ligated
S.-r' '. rtiie due to Salmnelliiea c I/'-
b sick. The ca es .. Frr, i infant niales less than I;
I-- .I i rJ- dill. r. rrii areas of tihe sate, and
.i' > __,Ik\ I,,.-- .. r, I. .1 1" made from instant nonfat Jr\
i't,, .' i. ....4I surveillance data i- irlr._ S. niei-
1I.' I.-... 1965 this serotype had been
r, Ipr. .'fU L hin the United States. Of the 50.7b:2
isolations of salmonella from human sources reported be-
tween 1947 and 1964, only 13. or 0.02 percent, were S. new-
brunstick. In contrast, between April 1965 and January 1966


Bolm uarlis n n 1N %1 i.
Inotuli'm OIrd1.. ... un ..... .
('urr-nl Frond
\1"at'lep s -- 1966 ................ .. ..




there \iere 29 reported isolation- of ttili srt,ro\p f'ron
humans, a distinct increase suggesting the possihility of a
connmon source of infection.
Accordingly. State Health Departments reportni i sola-
tions of this organism were asked to submit epidenliologic
information about the cases to the ('ommunicable Disease
('Conti/,nd oIn paye I 3St)


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous weeks)

45th WEEK ENDED CUMULATIVE. FIRST 45 WEEKS
MEDIAN
DISEASE NOVEMBER 12, NOVEMBER 13, 1961-1965 MEDIAN
1966 1965 1966 1965 1961 -1965
Aseptic meningitis .. ........ 39 39 41 2,605 1.860 1.862
Brucellosis. .. .. ... ... 3 8 3 208 213 350
Diphtheria ...... ........... .... 2 5 7 169 140 236
Encephalitis, primary:
Arthropod-borne & unspecified .......... 24 48 1.879 1,689 -
Encephalitis, post-infectious .... ...... 4 6 -- 650 593
Hepatitis, serum ........ .. 37 1.239
Hepatitis, infectious ......... .... 584 527 805 27.660 29,184 37.499
Measles rubeolaa) .............. 716 1,235 1,903 194,274 247.629 397,137
Poliomyelitis. Total (including unspecified) 4 6 86 54 378
Paralytic ......................... 4 6 79 42 322
Nonparalytic ......................... 9
Meningococcal infections. Total ......... .43 45 38 3.021 2,632 2.067
Civilian .............. ........... .. 37 45 2,734 2,442
Military .............. ............. 6 287 190 -
Rubella (German measles) ............... 239 --- -- 43,564 -
Streptococcal sore throat & Scarlet fever 6.159 6.742 6.090 360,014 336,215 291,110
Tetanus ............... .. .. .... 2 6 168 234
Tularemia ................. ... ... 2 2 153 224 -
Typhoid fever .................... ... 5 6 10 340 383 473
Typhus. tick-borne (Rky. Mt. Spotted fever) 5 3 -- 235 252 -

Rabies in Animals .................. 43 87 58 3.521 3,772 3,300

NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum
Anthrax: .......... .... .. .. ........ 6 Botulism .. .......... 8
Leptospirosis: Ark.-l, Tex.-1 ...... .............. .. .. 60 Trichinosis: Cal.-l ..... ..... .......... 87
Malaria: Cal.-3, Fla.-2. I11.-1, Ky.-1, Md.-1, NC.-1, Pa.-2. 410 Rabies in Man: .. ................
Psittacosis: .... .... . 40 Rubella, Congenital Syndrome: Ore- .. 21
Typhus, marine: ...... ....... ...... .... .. .. 25 Plague: ...5
No Report From State of Washington Health Department Moving To New Quarters.








386


Center. Of the 29 persons from whom S. new-brunswick was
isolated, 2 were lost to follow-up and 2 were clearly sec-
ondary cases following documented S. new-brunswick in-
fections in other household members. Twenty-five primary
cases thus were available for detailed epidemiologic study
of a possible common source of infection.
All persons had symptoms characteristic of salmonel-
losis, including fever, diarrhea, and vomiting. Eleven
patients required hospitalization ranging from 3 to 21 days,
and an additional 13 patients required the'care of a physi-
cian. The cases were geographically scattered throughout
the United States. Though illness occurred in all age groups,
there was a striking predilection for very young children.
Itemized dietary histories were impossible to obtain
because of the long interval between illness and investiga-
tion of some of the cases. Instead it was determined whether
any of a long list of food items "never," "occasionally,"
or "*ir. qr., l were consumed by the patient.
Powdered milk was the only item to have been con-
sumed with a greater frequency than could be expected.
Twenty of the 25 patients had ingested this product within
30 days of their illness. Many foods such as powdered
eggs. pork. shellfish, and chicken, often associated with
salmonella infections in the past, could be excluded by the
low frequency of exposure in this group. No exact figures
of consumption of powdered milk by American families were
available, but a survey of households with young children
in the Atlanta metropolitan area indicated that only 44 per-
cent of the families used nonfat dry milk during the entire
year of 1962. Thus, the fact that 80 percent of the S. new-
brunswick cases had consumed this product within 30 days
of illness seemed quite noteworthy. In addition, the hypo-
thesis that powdered milk was the vehicle of infection was


NOVEMBER 12, 1966


supported by the fact that several of the infected infants
had feeding problems and had a diet consisting almost
exclusively of nonfat dry milk.
As this product had not previously been implicated as
a source of salmonella infection, bacteriologic examina-
tions were performed on hundreds of shelf samples of many
brands of nonfat dry milk by a number of laboratories. The
same rare serotype, S. new-brunswick, was subsequently
isolated from many samples of instant nonfat dry milk pro-
duced by a single plant in the midwestern United States.
The organism was also isolated within the plant from the
equipment and from milk products. The product was re-
called from the market in April 1966, and a careful super-
vised cleanup and remodeling of the plant was instituted.
Inspection of powdered milk plants and bacteriologic
examination of their products for salmonellae have been
carried out extensively since that time by State Depart-
ments of Health and Agriculture, the U.S. Department of
Agriculture, and the U.S. Food and Drug Administration.
On November 2, 1966, the Borden Company instituted a
recall of Starlac Instant Nonfat Dry Milk from the market
because of salmonella contamination found by the Food
and Drug Administration. On November 9, 1966, the Kroger
Company similarly recalled Kroger Instant Nonfat Dry Milk
from the market because of contamination with Salmonella
cubana.
Investigation of illnesses with these serotypes for
possible association with powdered milk is being conducted
along with careful inspection of milk-drying plants by the
dry milk producers and regulatory agencies.

(Compiled by the Salmonella Unit, Bacteriology Section,
Epidemiology Branch, CDC.)


BOTULISM Indiana


Two cases of botulism have been reported in patients
who were hospitalized in Mishawaka, Indiana. on October
21, 1966. ,\ mother and her 5-year-old daughter had pre-
sented with symptoms of double and blurred vision, weak
neck muscles, and difficulty in swallowing and in walking.
These symptoms had begun on October 20, 3 days after a
meal which included steak, potatoes, gravy, home-canned
beets, and home-canned beans. The mother was treated
with 50,000 units of polyvalent (A and B) botulinus anti-
toxin, and the daughter, with 60,000 units over the first
21 hours. The mother pr..,,li., recovered and was dis-
charged October 26. The daughter has been slow in
recovering and was discharged November I although she
still has generalized weakness.


Samples of all leftover foods were obtained from the
home. Extracts made from the beets killed white mice
when injected intraperiotoneally, but had no effect when
the mice were simultaneously injected with polyvalent
antitoxin. Cultures of the beets yielded Clostridium bot-
ulinum, type A. Extracts made from the beans did not
kill mice and cultures were negative.


(Reported by Dr. A.L. Marshall, Jr., Director, Division of
Communicable Disease Control, Bureau of Preventive
Medicine, Indiana State Board of Health; Dr. Louis How,
St.Joseph County Health Officer; and Dr. Rafael Rabassa,
1 '. "' .*, I'" ... Mishawaka, Indiana.)


Morbidity and Mortality Weekly Report




SALMONELLOSIS ASSOCIATED WITH NONFAT DRY MILK
(Continued from front page)







NOVEMBER 12, 1966


Morbidity and Mortality Weekly Report


CURRENT TRENDS
MEASLES 1966


For the 45th week (ending November 12, 1966). 716
measles cases were reported from 39 States.* This repre-
sents an increase of 12 cases over the preceding week
and a decrease of 519 cases from the total of 1,235 for
the 45th week in 1965. Michigan notified 96 cases, the
highest number for the 45th week, while Oregon and Texas
both reported more than 80 cases.
The 10 counties reporting 10 or more cases for the
44th week are listed in Table 1: the geographic distribu-
tion of counties and health districts reporting measles for
that week is shown in Figure 1.
Of the 2, 870 counties and health districts under sur-
veillance in the United States, 430 reported one or more
cases of measles during the first 4-week period (weeks
41 through 44, October 9 Noveber 5, 1966) of the 1966-67
epidemiological year. Thirty counties from 15 different
states reported 10 or more cases during at least one week
of the 4-week period; 10 of these counties notified 10 or
more measles cases at least twice during this period.
Snohomish and Spokane Counties in i, --lInl ,n, and Wayne
County in Michigan reported 10 or more cases each of the
4 weeks. Snohomish County recorded 95 cases for the 43rd

*The State of I i .,- ,, did not r-port by the time of publication.


Table 1
Counties Reporting Highest Number of
Measles Cases for Week Ending
November 5, 1966


County

Snohomish
Park
Spokane
King
Golden Valley
Parker
Milwaukee
Washington
Cameron
Wayne


State

Washington
Wyoming
Washington
Washington
North Dakota
Texas
Wisconsin
Oregon
Texas
Michigan


Number of Cases

60
14
42
41
20
10
14
12
11
10


week. the highest number reported for any week from a
single county during the 4-week period.


(Reported by the Childhood
miology Branch, CDC.)


Viral Diseases LUit, Epide-

('Continued on page 392)


Figure 1
COUNTIES OR HEALTH DISTRICTS REPORTING MEASLES
WEEK ENDING NOVEMBER 5, 1966


1 -


/ /




i 1---


51 7
.- C


Not No lit 1 I


- I
is




#41


_L17




6







-I.-


I r 'More Ca.s, HRported
'Number Casi" Rp lrt-d by St;t,
or Health Dir-trit


387


-~iw


S4


*H-

Hi i

-'y
--r "


-I


;', C


F -










I; Morbidity and Mortality Weekly Report



CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

NOVEMBER 12, 1966 AND NOVEMBER 13, 1965 (45th 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... 39 39 3 24 48 4 2 5 37 584 527

NEW ENGLAND.......... 3 1 2 33 24
Maine........ ....... 7 7
New Hampshire......- 1 2 -
Vermont ............ 1
Massachusetts...... 2 1 9 9
Rhode Island....... 1 5
Connecticut .......- 1 1 13 3

MIDDLE ATLANTIC...... 1 6 6 13 1 19 85 78
New York City...... 1 2 3 6 10 18 14
New York, Up-State. 1 2 1 2 20 36
New Jersey......... 4 5 5 19 10
Pennsylvania....... 2 2 28 18

EAST NORTH CENTRAL... 5 7 5 4 2 94 121
Ohio............... 1 1 24 30
Indiana............ 2 9 8
Illinois........... 2 4 2 1 2 21 30
Michigan ....:...... 3 1 34 48
Wisconsin .......... 2 1 1 6 5

WEST NORTH CENTRAL. 2 2 2 3 17 1 43 41
Minnesota.......... 2 1 1 3 2
Iowa............... 1 2 1 14 7 4
Missouri........... 30 20
North Dakota....... 2
South Dakota........ 1
Nebraska........... 1 1 8
Kansas............. 3 6

SOUTH ATLANTIC....... 2 3 2 2 57 54
Delaware ........... 2
Maryland .......... 15 6
Dist. of Columbia.. 2 3
Virginia........... 1 1 8 13
West Virginia ...... 4 9
North Carolina..... 1 1 1 8 6
South Carolina..... 4
Georgia............ 7 2
Florida............ 1 2 9 13

EAST SOUTH CENTRAL... 4 3 1 1 3 32 42
Kentucky........... 3 1 1 14 19
Tennessee........... 1 10 15
Alabama............. 2 3 5 6
Mississippi........ 1 3 2

WEST SOUTH CENTRAL... 5 7 1 3 2 1 1 2 50 42
Arkansas.......... 3 3
Louisiana.......... 2 2 1 1 1 2 4 11
Oklahoma............ 2 2
Texas............... 1 5 2 2 1 41 28

MOUNTAIN............. 1 1 6 1 33 15
Montana ......... ... 1
Idaho .............. 10
Wyoming............ 4
Colorado............. 6 1
New Mexico ......... 9 2
Arizona............ 1 11 7
Utah................ 1 1 2
Nevada............. -

PACIFIC.............. 19 7 3 3 2 12 157 110
Washington......... -- --- --- --- -.- --- 7
Oregon............. 1 24 4
California......... 18 6 2 3 2 12 133 97
Alaska. ..............
Hawaii............. .

Puerto Rico.......... 33 25









389


Morhidity and Mortality Weekly Report


(ASES 1O SPECIFIED NOTIFIABLI DISEASES: NIT'I) STAllFS

FOR WEIKS ENDED)
NOVEMBER 12, 1966 AND NOVEMBER 13, 1965 (45th WEEK) CONTINUED


MEASLES (Rubeola)


AREA


UNITED STATES...

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.............
Hawai i


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


umu a
1966

194,274

2,434
260
80
302
810
72
910

18,238
8,340
2,585
1,899
5,414

69,510
6,383
5,759
11,447
14,808
31,108

8,986
1,660
5,358
566
1,233
40
129
NN


15,593
262
2,121
388
2,205
5,411
519
660
236
3,791

19,980
4,754
12,467
1,725
1,034

25,346
979
99
534
23,734

12,273
1,871
1,657
214
1,348
1,150
5,333
648
52

21,914
4,249
2,005
14,930
581
IAQ


77 ,167


ve
1965
247,629

37,066
2,873
382
1,344
19,346
3,950
9,171

15,669
2,647
4,252
2,916
5,854

57,680
8,958
2,073
3,037
26,962
16,650

16,942
723
9,145
2,622
3,881
115
456
NN


25,879
508
1,188
83
4,146
14,301
403
1,099
623
3,528

14,577
2,859
8,232
2,345
1,141

31,393
1,088
113
215
29,977

20,267
3,825
2,887
856
5,836
679
1,381
4,589
214

28,156
7,352
3,356
13,256
197


2,645


MENINGOCOCCAL INFECTIONS, T
TOTAL
Total
Cumulative
1966 ----966 1966
1966 196i
43 3,021 2,632 4

4 139 133
1 12 17


9
4
57
17
40

382
61
105
107
109

482
138
85
86
126
47

157
35
22
61
11
5
9
14


512
4
49
14
62
39
131
53
66
94

260
90
90
56
24

410
36
152
21
201

91
5
5
6
49
10
10
1
5

588
43
37
486
18


16


7
8
49
14
38

344
58
98
88
100

398
107
47
105
92
47

132
32
12
53
11
3
10
11

494
10
47
10
63
26
103
62
59
114

201
79
64
33
25

333
17
182
21
113

94
2
11
5
26
11
19
17
3

503
39
35
403
18


11


POLIOMYELIT[


1965


Paralyti
Cumul
1966

4


1 ri


c
at ivc


996 66
966

79 239

S 38
S7

1
5
23
23

10
4
S6


1 12






1
-
3


11
-3 14
11
3

2

S 4 67 2
1
- 1 -
- I -
4 64 2

30



S- 4

26



3 29
--- 2 -
17
1 7
2
- 3
-1 3


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


I


C I it









390 Morbidity and Mortality Weekly Report


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

NOVEMBER 12, 1966 AND NOVEMBER 13, 1965 (45th 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 Cum. 1966 Cum. 1966 Cum.
1966 1966 1966 1966 1966
UNITED STATES... 6,159 2 168 2 153 5 340 5 235 43 3,521

NEW ENGLAND.......... 999 4 1 11 3 2 83
Maine.............. 32 25
New Hampshire...... 13 28
Vermont............ 5 2 25
Massachusetts...... 121 2 7 1 4
Rhode Island....... 50 -
Connecticut........ 778 2 4 2 1

MIDDLE ATLANTIC...... 129 14 1 56 2 44 205
New York City...... 13 5 1 25 1
New York, Up-State. 81 2 -- 12 13 192
New Jersey......... NN 2 7 13
Pennsylvania....... 35 5 12 2 18 12

EAST NORTH CENTRAL... 694 20 19 2 41 19 6 462
Ohio ............... 65 4 3 1 20 9 194
Indiana............ 66 4 9 4 3 106
Illinois ........... 124 4 6 1 5 10 2 68
Michigan........... 346 6 6 1 41
Wisconsin .......... 93 2 1 6 53

WEST NORTH CENTRAL... 432 1 14 1 19 31 4 16 806
Minnesota.......... 10 3 1 1 5 191
Iowa............... 165 2 5 3 154
Missouri.......... 6 1 8 10 15 3 2 238
North Dakota....... 157 1 2 46
South Dakota....... 13 1 4 4 93
Nebraska........... 2 2 23
Kansas ............. 81 1 2 7 1 61

SOUTH ATLANTIC....... 747 32 12 65 109 4 451
Delaware........... 12 2 --
Maryland........... 90 3 2 11 26 3
Dist. of Columbia.. 16 2 -
Virginia........... 131 6 2 15 31 232
West Virginia...... 223 1 1 53
North Carolina..... 15 4 3 6 27 4
South Carolina..... 71 2 1 13 5 -
Georgia ............ 7 7 3 4 18 96
Florida............ 182 10 12 4 63

EAST SOUTH CENTRAL... 941 22 23 43 3 42 5 445
Kentucky........... 96 2 2 10 9 3 100
Tennessee.......... 666 5 13 22 24 2 304
Alabama............ 120 8 4 6 1 7 20
Mississippi........ 59 7 4 5 2 2 21

WEST SOUTH CENTRAL... 601 1 42 1 67 2 36 9 7 710
Arkansas........... 11 4 50 4 2 1 79
Louisiana.......... 10 4 10 1 48
Oklahoma........... 91 3 7 9 6 3 174
Texas............... 499 1 25 1 6 2 13 1 2 409

MOUNTAIN............. 837 2 9 17 4 1 94
Montana............ 34 2 7
Idaho .............. 85
Wyoming.......... 49 3 -
Colorado........... 306 2 4 2 18
New Mexico......... 98 1 2 1 1 16
Arizona............ 151 1 5 41
Utah............... 111 2 5 3
Nevada............. 3 1 9

PACIFIC.............. 779 18 3 40 1 2 265
Washington......... --- 11 --- --- 15
Oregon ............. 30 1 -- 1 4
California......... 721 17 3 26 1 2 246
Alaska............. 220 -
Hawaii A


53 16 1 18


Puerto Rico.........


1 2










Morbidity and Mortality Weekly Report






DEATHS IN 122 UNITED STATES CITIES FOR WEEK ENDED NOVEMBER 12, 1966

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


Week No.


Al I 1 .

All 65 years
Ages and over


and
Influenza
All Ages


1 year
All
Causes


Area


and
65 years and
and over Influenza
nd overAll Ages
All Ages


I 1 I *1 1 1 1


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.--------


673
208
43
24
17
50
37
12
25
41
70
10
51
27
58

2,846
34
33
153
27
26
47
57
89
1,361
34
540
112
42
82
22
24
65
33
32
33

2,639
55
39
797
144
194
133
91
357
38
52
63
15
89
162
41
117
34
29
31
98
60

728
52
8
34
170
31
102
54
157
69
51


429
123
30
19
9
32
22
7
18
28
42
8
32
18
41

1,701
21
19
89
22
16
29
34
43
803
19
329
53
29
53
17
17
47
19
21
21

1,515
32
22
444
83
96
78
52
188
26
34
42
9
64
88
24
75
22
15
22
63
36

460
31
7
16
111
21
63
30
101
49
31


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


1,043
136
257
42
43
47
50
84
27
70
67
179
41

622
95
42
16
164
101
64
43
97

1,058
40
38
26
143
35
70
167
40
187
67
105
50
90

357
31
29
121
16
73
29
42
16

1,201
12
36
23
36
65
344
112
21
65
57
68
132
34
131
35
30


I year
All
Causes

51
1C
12

3


4
3

5
12
2

36
5
2

16
2
4
2
5

77
5
4
5
10
3
3
12
2
13
4
7
5
4

20
1
1
6

8

3
1

52

I
1
I
6
1
11
11
2
4
2


Total i 11,167 6,517 389 615

Cumulative Totals
including reported corrections for previous weeks

All Causes, All Ages ----------------------- 562,476
All Causes, Age 65 and over------------------- 322,459
Pneumonia and Influenza, All Ages------------- 23,213
All Causes, Under 1 Year of Age-------------- 30,024


1 I















MEASLES 1966 (Continued from pIge 387)

Poterson, New Jersey
)Durln October 1966, 47 cases of measles were re-
ported tronim of New Jersey's 21 counties. The largest
inumiber of c(-es was reported from the cit of Paterson
(MM\l\R. Vol 1.1. O. I By October 20. :37 cases ere
knowNn o I he Paterson Board of Health. 34 of which occurred
amon f g udents attending eight of the cit\'s public and
parochial schools. The majority of the cases were re-
pored from thie lo er soc economic area of Paterson.
)n October 30) aonimunization campaign was con-
duelI d 1b lthe- Paterson Board of Health in a circumscribed
lower socioeconomli arrao of he city. Representatives
from the Stateo Board of Health and the local Community
Action Program participated in an intensive door-to-door
campaign to reach families, :n this area. Radio. newspaper,
and sound truck publicity were also utilized. Within the
target area of the campaign, 1.200 children were immunized.
Eighty percent of the families who came to the immuniza-
tion clinic indicated that they were motivated to come as
a result of direct personal contact with the organized
health workers and volunteers.
In addition, the Paterson School system hias distri-
buted 3.30S questionnaires on measles susceptibility
among kindergarten through third grade students in the
schools located within the defined geographic area. Of
the 2,362 forms returned, 1,359 were from students with a
history of measles or vaccination. while 1,023 or 42.9
percent, of the forms were from children considered to be
susceptible. A concentrated effort is now being made by
40 health department employees and community volunteers
to visit the homes of the 9'26 children whose families did
not respond to the questionnaire. Their function is to
gather the necessary information preparatory to a school
immunization program and to stimulate participation in the
program.
(Reporled by Dr. J. Allen Yeager, Director, Paterson Board
of IHealth: Dr. William .. Pouyherty, Director of Prevent-
able Disease Control, \ew Jersey State Department of
Health.)





ERRATUM: Vol. 15, No. 44, p. 378
The date in the title of the Measles County Map should
be October 29, not November 5.


NOVEMBER 12, 1966 SaS


U.
S---10
o^=

THE MORBIDITY AND MORTALITY WEEKLY REPORT, WITH A CIRCULA-
TION OF 15.600. IS PUBLISHED AT THE COMMUNICABLE DISEASE
CENTER, ATLANTA, GEORGIA
CHIEF, COMMUNICABLE DISEASE CENTER DAVID J. SENCER, M.D.
CHIEF, EPIDEMIOLOGY BRANCH A.O. LANGMUIR. M.D.
ACTING CHIEF, STATISTICS SECTION IDA L. SHERMAN, M.S.
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 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.


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U.S. DEPOSITORY



LL U.S, DEPOSITORY


Morbidity and Mortality Weekly Report


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