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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. o' og So? Wn U.S. DEPOSITORY LL U.S, DEPOSITORY Morbidity and Mortality Weekly Report tuii > Ul 14 Z n |