Morbidity and mortality

COMMUNICABLE DISEASE CENTER


adt


Vol. 15, No. 5







Week Ending
February 5, 1966


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


MALARIA CURRENT TRENDS


Through February 7, 1966, a total of 20 case reports
of malaria with onset in January 1966, had been received
by the Communicable Disease Center. All cases were
imported. Seventeen of the cases occurred in military
personnel, and 15 of these originated in South Viet Nam.
The species diagnosis in 14 of the 15 cases from South
Viet Nam was Plasmodium falciparum; P. malariae was
the species in the 15th case. The remaining 2 cases
were infected in Panama and Thailand, and the species
was P. vivax in both instances. One of the 20 military
patients infected in VietNam developed falciparum malaria
after discharge from the service. Each of the three civilian


Malaria Current Tren . .
Measles- Current
International Notes
Mercury Poisoning in ..j
Quarantine Measures
Epidemiologic Notes and Reports
Type B Influenza Massachusetts .


SERVICE




33
34

.. 35
40

S. 40


patients contracted his disease in West Africa. This
group included a ship's captain and a Peace Corps worker.
Additional case reports have brought the 1965 total
to 130 cases (MMWR, Vol. 15, No. 4). Ninety percent of
these additional cases had onset dates within the fourth
quarter of 1965; these cases reflect the increasing
(Continued on page 34)


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous weeks)
5th WEEK ENDED CUMULATIVE, FIRST 5 WEEKS
MEDIAN
DISEASE FEBRUARY 5, FEBRUARY 6, 1961-1965 MEDIAN
1966 1965 1966 1965 1961- 1965
Aseptic meningitis ... ..... .... ... 20 17 19 128 148 130
Brucellosis. .. ......... ... 2 4 16 19 23
Diphtheria................... ......... 2 2 9 12 15 31
Encephalitis, primary:
Arthropod-borne & unspecified ........... 24 24 --- 113 152
Encephalitis, post-infectious ............ 14 16 64 67
Hepatitis, serum ...... ........... .... 26 1 1,225 102 4021 5,321
Hepatitis, infectious ..................... 732 3,489
Measles rubeolaa) .......... ..... ...... 5,857 7.994 9,346 25.921 34,392 39.366
Poliomyelitis, Total (including unspecified) 4 1 19
Paralytic ........_..... .......... 3 16
Nonparalytic ...................... -
Meningococcal infections, Total .......... 62 63 64 356 316 269
Civilian ....... ....................... 58 54 326 302
Military............................ 4 9 30 14 -
Rubella (German measles) ................ 1,154 --- 4,173 -
Streptococcal sore throat & Scarlet fever .. 10,338 11.789 9,728 46,745 51,454 43,600
Tetanus ................................. 2 5 8 16 -
Tularemia........ ........ ..... ....... 1 2 17 33 -
Typhoid fever .......................... 6 6 6 25 33 34
Typhus, tick-borne (Rky. Mt. Spotted fever). 3 7 6 -

Rabies in Animals .................. 62 90 73 340 475 301

NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax: .................. ................ ...... Botulism: .......... ..... ... .. .. 1
Leptospirosis: ...................................... 1 Trichinosis: N.J.- 2 ..... ..... 16
Malaria: Va. -1 .................................... 26 Rabies in Man: ..... ..... ... .... ..
Psittacosis: Wise.- .................. ................ 6 Rubella, Congenital Syndrome: .. .. ... .. .. .
Typhus, marine: ..................... ............. ...............







Morbidity and Mortality Weekly Report


MALARIA CURRENT TRENDS
(Continued from front page)


numbers of returned servicemen with malaria acquired
in South Viet Nam.
During 1965 there has been a total of seven cases of
shipboard malaria reported; of these five were P. fal-
ciparum and two were P. malariae infections. Five ships


were involved and in all instances the infection was
acquired in West Africa.

(Reported by the Parasitic Disease Unit of the Surveil-
lance Section, CDC.)


MEASLES CURRENT TRENDS


During the first 4 weeks of 1966 a total of 20,064
cases of measles was reported. The comparable total for
1965 is 26,398. Figure 1 shows the range of incidence
of measles over the period 1954-1963. During this period
the highest total for the first 4 weeks of the year was
48,624 and the lowest was 26,921 (Figure 1). Measles
vaccine was first licensed for general use in March
1963 but it was not until 1964 that the quantity of vaccine
distributed had reached a level indicative of substantial
use.
STATES REPORTING MORE THAN 500 CASES
OF MEASLES
Weeks 1-4, 1961-1966

State 1961 1962 1963 1964 1965 1966

Wisconsin ..... 4,153 605 6,824 373 886 4,491
New York
(incl. NY City) 4.117 2,248 1,127 2,642 468 1,945
Illinois .............. 1,256 2.110 513 1,489 147 1,766
Tennessee. ... 779 2,144 649 1,219 936 1 '-.
Michigan .... .. 141 1,127 13,129 913 2,304 1,305
Texas 899 4,501 1,003 1,241 2,073 1,067
Pennsylvania 2,367 567 705 951 331 985
W. Virginia 429 bb0 1,02 b33 2,818 983
Kentucky 1,634 496 455 1,703 84 830
California 1,81 1,630 844 1,417 bUb 667
(Reported by the Childhood Virus Disease Unit, CDC.)


MEASLES REPORTED BY FOUR-WEEK PERIODS-UNITED STATES
EPIDEMIOLOGIC YEARS 1964-65 AND 1965-66
COMPARED WITH 10-YEAR PERIOD, 1954-1963


170I000

150,000,

130,000.

110.000.

90,000.

70,000

50,000

30.,000

10o00 -


-- Hghest Number, 1954-1963
---- Lowest Number, 1954-1963
i'c L, -:.L. a^.4.: *rC.


WEEK NUMBER


INTERNATIONAL NOTES
MERCURY POISONING IN GUATEMALA


An outbreak of central nervous system illness
involving 14 cases, with 8 deaths at the time of the first
report, occurred in the western highlands of Guatemala
in the region around Quetzaltenango in the summer of
1965. The cases had developed during the period July
to September 1965 in Indian families of a predominantly
farming population living in scattered groups in a remote
mountainous area. The crops grown include wheat, corn
and potatoes, while livestock consists of chickens, pigs
and a few horses and cattle. Corn is the main and pre-
ferred staple. Water comes from unprotected wells or
from shallow streams and there are virtually no sanitary


facilities. The illness was at first thought to be an
arthropod-borne encephalitis and, early in September,
assistance was sought from the Pan American Health
Organization by the Guatemalan Ministry of Health.
PAHO arranged for three investigators to visit the area
affected.
During the investigation, interviews with local health
officials, physicians, affected families and their neighbors
and a review of hospital records brought to light an
additional 31 cases with 12 deaths making a total of
45 cases of CNS illness causing 20 deaths for the whole
outbreak. All had a strikingly similar clinical picture.


FEBRUARY 5, 1966






FEBRUARY 5, 1966


Morbidity and Mortality Weekly Report


Table 1
INCIDENCE OF CNS ILLNESS AND DEATHS IN WESTERN GIUATEMALA
July October, 1965


Village
Community


Slguila . .
Panorama.........
Centro .........
La Union ........
Palomora ........
San Jos6 ........

Total ..........


Population


t


500
400
269
200


1,722

3,091


Case petr
Number
1000
Cases a
Inhabitants


2.0
:17.5
29.7
10.0

h.7


14.5


Iu Deaths Death
Number
Super 1000 per case
Inhabitants Iatio (" )


.5 40
6.5 44
:~.;t 410


The illness began with weakness in the legs which
sometimes progressed to spastic paralysis with hyper-
flexion and a positive Babinski; in some instances the
arms were also involved. The lesions were symmetrical
without loss of sensory or sphincter function. Neither
fever nor malaise was a prominent symptom unless a
pulmonary complication developed. The involvement of
the legs was almost invariably followed in 4 to 7 days
by impairment of vision, usually progressing to total
blindness. Once established, there was no regression in
either the paralyses or the visual impairment. In fatal
cases there was a period of impaired consciousness
merging into coma before death.
All patients were of poor nutritional status. The
sexes were equally affected and the age distribution
ranged from 2 to 55 years with over half the cases being
under 10 years of age. The duration of illness varied and
most cases had difficulty in walking and impaired vision
for 1 to 4 weeks before coming to the hospital; patients
who died had remained in the hospital for periods ranging
from 1 week to 1 year before death.
The weeks of onset of 43 of the 45 cases occurring
in 1965, or of their admission to the hospital, ranged
from July 11 to September 19, 1965. There had been four
cases in 1964 and one in 1963, all of which occurred
during the same season of the year as the 1965 cases.
Thirty-eight of the 45 cases occurred in three villages in
the wheat-growing area; there was a high incidence within
given families, frequently affecting children under 10 but
never those who were breast feeding (Table 1). Both the
clinical and epidemiological evidence suggested a toxic
rather than an infectious origin.
Inquiry revealed that the families concerned par-
ticipated in a wheat co-operative whereby they received
each year, in May, a certain quantity of wheat seed
which was treated with the fungicide methyl mercury
dicyandiamide("Panogen 15"). The farmers were expected
to return, to the co-operative organization at the end of
the harvest, an amount of wheat equal to the quantity


of treated seed given to them the previous spring. They
had been warned not to eat the treated seed.
Several farmers' families had not heeded this warning
and had ground the panogen-treated v heat to make tortillas.
The distribution of illness among the members of the
families who admitted eating the treated wheat was
uneven. In one instance the first sign of illness in a
family using the wheat appeared one week after it was
eaten: in another it was 3 weeks later that the first
symptoms appeared. Certain other families who had
eaten the treated wheat suffered no symptoms at all.
presumably due to dilution of the meal from the treated
wheat with corn meal, or with wheat flour made from
untreated wheat.
Specimens of kidney, liver, spleen and brain obtained
from fatal cases of the illness in Guatemala have been
examined in the CDC Toxicology Laboratory and have
yielded amounts of alkyl mercury (9 to 20 ppm of Hg)
consistent with fatal mercury poisoning. Table 2 compares
the Guatemala findings with those of episodes of fatal
mercury poisoning in other countries. Examination of a
specimen of the treated seed contained 17 ppm expressed
in metallic mercury.
Table 2
CNS ILLNESS IN GUATEMALA
Comparative Results of Tissue Content
Estimations of Alkyl Mercury in Fatal Poisoning


Specimen


Guatemala
1965 in ppm


Other Countries
Range in ppm


Kidney . .... .18 3 to 51
Liver . ... .20 15 to 39
Spleen . ... .9 4.5*
Brain . ... 15 3 to 48
*One estimation only.
(Reported by the Department of Public Health, Guatemala
Ministry of Health; The Pan American Health Organi-
S.-';.* Zone Ill; and an EIS Officer.)
Reference: Bidstrup, P.L. (1964) Toxicity of Mercury and
Its Compounds, pp 74-87. Elsevier Publishing Company,
New York.





~








36 Morbidity and Mortality Weekly Report



CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

FEBRUARY 5, 1966 AND FEBRUARY 6, 1965 (5th WEEK)


ENCEPHALITIS HEPATITIS
ASEPTIC Primary Post- Both
AREA MENINGITIS BRUCELLOSIS including Infectious DIPHTHERIA Serum Infectious Types
unsp. cases
1966 I 1965 1966 1966 1965 1966 1966 1965 1966 1966 1965
UNITED STATES... 20 17 2 24 24 14 2 2 26 732 918

NEW ENGLAND.......... 2 1 20 64
Maine............... 4 15
New Hampshire ...... 5
Vermont............. 1 9
Massachusetts..... 1 13 15
Rhode Island ....... 1 11
Connecticut........- 1 1 9

MIDDLE ATLANTIC...... 1 3 1 7 2 3 16 89 164
New York City ..... 2 1 5 1 10 15 23
New York, Up-State. 1 3 29 86
New Jersey.......... 2 15 15
Pennsylvania....... 1 1 3 1 30 40

EAST NORTH CENTRAL... 3 1 5 9 2 145 186
Ohio............... 3 2 45 58
Indiana............. 2 1 15 14
Illinois........... 1 30 55
Michigan........... 1 1 5 1 50 47
Wisconsin.......... 1 1 1 5 12

WEST NORTH CENTRAL... 1 2 1 2 50 60
Minnesota.......... 1 2 13 6
Iowa................ 21 29
Missouri........... 5 8
North Dakota....... 1 2 -
South Dakota....... -
Nebraska............. 1
Kansas............. 1 9 15

SOUTH ATLANTIC....... 3 3 4 3 1 2 2 71 81
Delaware ........... 2 2
Maryland ........... 1 7 33
Dist. of Columbia.. 1 1
Virginia ........... 1 3 29 11
West Virginia...... 4 17
North Carolina..... 1 1 1 1 1 9 9
South Carolina..... 2 2
Georgia ............
Florida............. 2 1 1 1 1 1 18 6

EAST SOUTH CENTRAL... 1 1 1 1 80 80
Kentucky............ 1 44 33
Tennessee.......... 1 1 1 19 22
Alabama............ 7 16
Mississippi........ 10 9

WEST SOUTH CENTRAL... 3 2 1 2 1 2 58 84
Arkansas........... I 9 15
Louisiana.......... 1 1 1 1 2 9 12
Oklahoma............. 1 2
Texas.............. 1 1 1 39 55

MOUNTAIN............. 1 51 39
Montana............ 1 9
Idaho............... -- 5 1
Wyoming............ 2
Colorado............. 1 7 11
New Mexico......... 23 4
Arizona............ 12 6
Utah............... 1 5
Nevada............. 2 1

PACIFIC............... 9 7 1 6 4 4 3 168 160
Washington.......... 1 13 11
Oregon............. 1 24 10
California.......... 8 6 6 2 4 3 130 122
Alaska............. 1 17
Hawaii.............. 1 11 -

Puerto Rico.......... 20 24








Morbidity and Mortality Weekly Report


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

FEBRUARY 5, 1966 AND FEBRUARY 6, 1965 (5th WEEK) -Continued


AREA



UNITED STATES...

NEW ENGLAND..........
Maine..............
New Hampshire......
Vermont...........
Massachusetts ......
Rhode Island.......
Connecticut........

MIDDLE ATLANTIC......
NewsYork 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.............


MEASLES (Rubeola)


1966

5,857

95
8
1
8
48
2
28

687
415
33
27
212

2,017
135
58
385
350
1,089

273
64
108
31
68
1
1
NN

487

79
15
65
208
3
22
6
89

905
506
370
11
18

533
1
2

530

285
35
24
7
48

161
10


575
188
52
332
1
2


Puerto Rico.......... 30


Cumulative
1966 1965
25,921 34,392

365 8,860
39 1,067
5 156
117 101
104 5,192
29 1,027
71 1,317

3,919 1,176
1,964 138
429 388
329 202
1,197 448

10,393 5,993
604 1,157
403 266
2,151 197
1,655 3,199
5,580 1,174

983 2,481
408 51
274 1,198
65 256
225 863
2 23
9 90
NN NN

2,431 5,067
35 74
390 76
99 9
186 721
1,191 3,783
35 88
115 40
34 94
346 182

3,330 1,797
1,336 143
1,892 1,188
41 332
61 134

1,648 3,053
23 40
18 7
10 29
1,597 2,977

1,117 3,000
233 1,117
224 433
19 91
109 357
4 60
488 73
36 863
4 6

1,735 2,965
534 832
180 586
999 1,206
2 33
20 308

278 127


MENINGOCOCCAL INFECTIONS,
TOTAL Total


1966

62

1



1


6
1
2
1
2

10
2
1

3
4

4

2
1



1







1
4
2




3
1
1

6
2
4



10
2
2
2
4

1
1









10


9
1
9

I


I I


Cumulative
1966 1965
356 316

26 18
5
7 1
1
12 8
2 1
4 3

62 44
14 10
12 9
19 17
17 8

57 38
20 14
5 4
6 10
18 6
8 4

17 17
3 3
4
6 9
3
1

3 2

65 69
2
8 3
2
5 11
3 6
13 13
13 5
5 13
18 14

15 21
5 7
8 7
2 7


33 40
4 3
8 14
2 6
19 17

14 5
2


10 1
1
2
1
1 1

67 64
5
3 3
49 60
8 1
2


1966


1,154

193
S 5

-1
102
13
72

43
27
S 16



273
-
47
S 39
S 38
149

61

S 51

10




77

5

14
40

- 1

S 17

70
15
55


250
150
S 44
- 546
S46
8
2

-I


---








Morbidity and Mortality Weekly Report


38 CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

FEBRUARY 5, 1966 AND FEBRUARY 6, 1965 (5th 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... 10,338 2 8 1 17 6 25 7 62 340

NEW ENGLAND.......... 1,931 1 1 3
Maine.............. 250 -
New Hampshire...... 35 -
Vermont............ 77 3
Massachusetts...... 313 I -
Rhode Island....... 75 -
Connecticut........ 1,181 -

MIDDLE ATLANTIC...... 275 1 2 8 1 4 28
New York City...... 26 1 4- -
New York, Up-State. 249 1 2 3 26
New Jersey......... 1 2 -
Pennsylvania ....... 1 1 2

EAST NORTH CENTRAL... 983 3 1 6 4 39
Ohio............... 91 2 3 1 25
Indiana............. 169 1 1 4
Illinois........... 121 2
Michigan........... 405 I 1 2 4
Wisconsin.......... 197 1 1 4

WEST NORTH CENTRAL... 455 2 1 17 98
Minnesota.......... 7 4 18
Iowa ............... 126 2 18
Missouri........... 12 10 46
North Dakota....... 210 3
South Dakota........ 14 1 11
Nebraska............ 6 2
Kansas............. 80 2 -- -

SOUTH ATLANTIC....... 923 1 3 5 2 6 5 12 43
Delaware........... 22 -
Maryland ........... 244
Dist. of Columbia.. 1
Virginia........... 202 2 2 3 1 11 32
West Virginia...... 197 1 1 5
North Carolina..... 14 2 1 3
South Carolina..... 49 1 1
Georgia ............ 5 2 1 4
Florida............. 189 1 1 2

EAST SOUTH CENTRAL... 1,462 5 1 6 49
Kentucky ........... 112 2 5
Tennessee.......... 1,093 3 1 6 42
Alabama............. 95 2
Mississippi........ 162 -

WEST SOUTH CENTRAL... 1,001 1 1 1 1 16 63
Arkansas........... 4 2 5
Louisiana.......... 2 1 1 5
Oklahoma............ 13 I 2 4
Texas............... 982 1 12 49

MOUNTAIN............. 1,505 1 2 4
Montana............ 56 -
Idaho.............. 159 -
Wyoming ............ 72
Colorado............ 625 -
New Mexico......... 269 -
Arizona............. 106 1 3
Utah................ 211 1 1 -
Nevada............ 7 -

PACIFIC.............. 1,803 2 1 1 3 13
Washington......... 667 -
Oregon.............. 61 -
California......... 881 2 1 1 3 13
Alaska............. 102 -
Hawaii............. 92 -


I I I I ) I I


9


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








Morliility and Mortality Weekly Report






DEATHS IN 122 UNITED STATES CITIES FOR WEEK ENDED FEBRUARY 5, 1966


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

All Causes Pneumonia Under All Causes Pneumonia Under

Area All 65nd ars1 year Area All 65 years I na 1 ar
a Influenza All nAge flueza All
Ages and over nfluenz Ages and over A Ages auses
Ages an over 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, 111.---------
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.--------


887
284
54
36
25
59
33
27
38
73
75
15
62
30
76

3,594
58
35
149
48
35
53
79
76
1,867
41
551
209
59
114
37
29
51
41
25
37

2,731
70
36
824
137
204
140
89
393
33
55
43
17
64
155
45
127
36
32
42
113
76

906
63
27
39
148
25
147
73
267
83
34


545
164
37
23
16
34
21
22
30
36
52
8
38
18
46

2,089
37
25
93
22
20
37
44
36
1,068
27
303
111
42
83
26
20
33
17
19
26

1,549
48
21
427
82
123
69
57
227
18
28
27
6
47
83
23
77
19
22
28
69
48

573
45
15
24
87
20
91
39
174
60
18


*Estimate based on average percent


SOUTH ATLANTIC:
Atlanta, Ca.-----------
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.----------


1,141
145
200
59
63
100
67
73
34
103
75
172
50

588
84
56
29
89
137
49
40
104

1,288
35
32
33
157
47
84
236
51
242
95
146
65
65

432
29
26
115
20
104
23
53
62

1,593
21
43
25
54
78
430
96
37
115
111
93
203
39
169
44
35


Total 13,160 7,621 576 666

Cumulative Totals
including reported corrections for previous weeks

All Causes, All Ages ----------------------. 66,862
All Causes, Age 65 and over------------------- 38,646
Pneumonia and Influenza, All Ages------------- 3,073
All Causes, Under 1 Year of Age--------------- 3,462


Week No.


& srr


of divisional total.







Morbidity and Mortality Weekly Report


FEBRUARY 5, 1966


QUARANTINE MEASURES


Immunization Information for International Travel
1965-66edition Public Health Service Publication No. 384

The following change should be made in the list of Yellow
Fever Vaccination (:nters in Section 6:
Page 72

Delete
City Anchorage, Alaska
Center Health Center, Greater Anchorage
Health District, 217 E. St.,
Telephone: BR 6-3351
Clinic Hours Mon. Fri. 8-11:30 a.m.
1-4 p.m.
Fee Yes


Add
City Anchorage, Alaska
Center Greater Anchorage Area
Borough-Health Department
217 E. Street
Telephone: 272-6467
Clinic Hours Mon. -Fri. 8-11:30 a.m.
1-4 p.m.
Fee Yes




EPIDEMIOLOGIC NOTES AND REPORTS
TYPE B INFLUENZA Massachusetts


Infection with type B influenza virus has been con-
firmed, in representative cases, in outbreaks of febrile
illness occurring in eastern Massachusetts (MMWR, Vol.
15, No. 3). Recovery of two strains of type B virus and
identification of greater than four-fold increases in com-
plement fixing (CF) antibody titers in three additional
instances has been reported. Preliminary tests show these
type B influenza virus strains to be similar to those re-
covered in the United States in 1964-65.


(Reported by Mrs. Joan Daniels, Chief, Virology Labora-
tory, Institute of Laboratories, Massachusetts Department
of Public Health; and the Respirovirus Unit, CDC.)


THE MORBIDITY AND MORTALITY WEEKLY REPORT, WITH A CIRCULA-
TION OF 1 ,300. IS PUBLISHED AT THE COMMUNICABLE DISEASE
CENTER, ATLANTA. GEORGIA.
CHIEF, COMMUNICABLE DISEASE CENTER AVID 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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