Morbidity and mortality

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Vol. 14, No. 14




T


Week Ending
April 10, 1965


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U.S. DEPARTMENT OF HEALTH, EDUCATION, Al


SPECIr.L SlR VEIL


MENINGOCOCCAL INFECTIONS
Meningococcnl infections are continuing to be re-
ported with a frequency significantly elevated over the
preceding five years. The degree of increase in the first-
quarter of 1965 as compared to the same period last year
is evident in Table 1. This increase is quite general
throughout the country, although most marked in the two
northeast regions, New England, and the Middle Atlantic
States. Only the East North Central and East South Central
divisions have not shown marked increases.
The weekly incidence of reported cases for the first
quarter of 1965 is compared in Figure 1 with the 1960-64


t..P. PUBLIC HEALTH SERVICE


.;

CO'TE \TS
~ I\L, SLURVEILLANCE ISSUE

S .. 121
. . 128


median incidence. It is evident that a sharp increase in
the number of cases occurred in mid-February and has
continued to the present time at a level approximately
double the median figures.
(Continued on page 122)


Table 1. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous weeks)
14th Week Ended Cumulative. First 14 Weeks
Disease April 10, April 4, Median Median
1965 1964 1960 1964 1965 1964 1960 1964
Aseptic meningitis ................ 29 26 28 405 371 324
Brucellosis ........................ 4 9 13 60 100 100
Diphtheria ....................... 5 2 7 64 52 141
Encephalitis, primary infectious.. 28 42 --- 409 444 ---
Encephalitis, post-infectious ..... 14 25 --- 197 177
Hepatitis, infectious including
serum hepatitis ................ 719 859 938 11,007 12,977 14,697
Measles .......................... 11,906 23,528 19,197 128,441 168,942 166,302
Meningococcal infections .......... 75 58 55 1,212 875 767
Poliomyelitis, Total .............. 5 6 19 81
Paralytic ...................... 5 5 14 54
Nonparalyttc ................... --- 1 4 ---
Unspecified .................... --- 1
Streptococcal Sore Throat and
Scarlet fever .................. 11,523 11,855 9,021 157,775 151,240 133,336
Tetanus ........................... 1 6 --- 49 51 ---
Tularemia ......................... 1 3 --- 54 73 ---
Typhoid fever ..................... 5 8 13 95 88 108
Rabies in Animals ................ 116 111 99 1,434 1,142 1,112

Table 2. NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax: N.J.-l 4 Rabies in Man:
Botulism: 2 Smallpox:
Leptospirosis: 10 Trichinosis: 47
Malaria: N.Y. Up-State-1 12 Typhus-
Plague: Murine: Texas-1 5
Psittacosis: Wisc.-l 7 Rky Mt. Spotted: 6


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COMMUNICABLE DISEASE CENT
COMMUNICABLE DISEASE CENTER








Morbidity and Mortality Weekly Report


SPECIAL SURVEILLANCE ISSUE

MENINGOCOCCAL INFECTIONS (Continued)


As noted previously (Vol. 14, No. 8), the peak months
for meningococcal infections are generally March and
April. The current high level of the disease may therefore
be anticipated to continue for the next several weeks.
Rates for individual States during the first quarter of
1965 are shown in Figure 2. Highest rates are found gen-
erally on the West Coast and the Southeast, with lowest
rates in the Midwest.
Although not shown on the map, the rate in Louisiana
is twice as high as that for any other State (2.7 per
100,000). The reasons for this are not clear at this time
but, according to Dr. John M. Bruce, Chief, Section of
Epidemiology, Louisiana State Board of Health, the high
rate is not related to an excessive number of cases at
Fort Polk, Louisiana, or in the surrounding parishes.
In 1964, of 2700 cases of meningococcal infection
from 47 States in which data are available, 385 cases
(14.3%) were reported from military installations. States
in which 25 percent or more of total cases were from
military installations are listed in Table 2. Major military
recruit training centers are present in each of the States
listed.
Thus far in 1965, 81 cases or 7 percent of the total
reported, have been identified as occurring on military
installations. The States with the largest numbers of
military cases are again those listed in Table 2. This
total is significantly less than anticipated and stresses
the need for prompt and accurate identification and re-
porting.

During the first quarter of 1965, 106 strains of
Neisseria meningitidis were submitted to the Bacteriology
Section, Laboratory Branch of the Communicable Disease
Center for sulfonamide sensitivity testing; these results
are summarized in Table 3. All strains were from blood
or cerebrospinal fluid; all but a few strains were serogroup
B, the remainder being serogroup C. Thirty-three strains,
32 percent, required 1.0 mg percent or more of sulfadiazine
for inhibition when tested on inhibition free media. This
level is generally considered to determine sulfonamide-
resistance. Although most of the strains tested were
submitted from California, sulfonamide-resistant strains
were also submitted from Georgia, Louisiana, and Oregon.
This proportion of sulfonamide-resistant strains among the
total submitted is virtually identical to that found in
strains submitted in 1964 (Vol. 13, No. 50).

(Prepared in Investigations Section, Epidemiology Branch.
CDC)


TABLE 1
MENINGOCOCCAL IN FECTIONS
United States, First Quarter, 1964 and 1965

Percent
1965 1964 erc
Increase

United States 1,137 817 +39
New England 56 25 +124
Middle Atlantic 152 79 +92
East North Central 136 123 +11
West North Central 61 37 +65
South Atlantic 230 172 +34
East South Central 71 71 0
West South Central 179 118 +52
Mountain 52 34 +53
Pacific 200 158 +27

TABLE 2

MENINGOCOCCAL INFECTION IN
MILITARY PERSONNEL

1964 Cases st Quarter
1965 Cases
State .

0 0 CD
2 H M ILI

New Jersey 111 26 23.4 52 6 11.5
Missouri 75 41 54.7 32 15 46.9
South Carolina 59 28 47.5 34 14 41.2
Kentucky 74 28 37.8 26 5 19.2
Louisiana 139 38 27.3 94 8 8.5
California 565 141 25.0 164 12 7.3

TABLE 3

Minimum Inhibitory Concentration (MIC) of Sulfadiazine
for 106 Strains of N. meningitidis Submitted to CDC
During First Quarter, 1965

MIC, mg0
fMIC, mgn No. Strains Percent of Strains
Sulfadiazine

0.05 56 52.8
0.10 8 7.6
0.50 9 8.5
1.00 4 3.8
3.00 16 15.1
5.00 5 4.7
10.00 7 6.6
15.00 1 0.9

Totals 106 100.0


122







Morbidity and Mortality Weekly Report


Figure I.

MENINGOCOCCAL INFECTIONS BY WEEK OF REPORT

IST QUARTER, 1965 AND MEDIAN, 1960-64
UNITED STATES


120-
i

100-
IO-


80-

60-

40-

20-

0-


64Mein -
%
64 Median


J F 'M 'A M J A S 'O 0 N D


Figure 2.


MENINGOCOCCAL INFECTIONS IN THE UNITED STATES
REPORTED CASE RATES PER 100,000
I ST QUARTER, 1965


HAWAII


123










124 Morbidity and Mortality Weekly Report



Table 3. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

APRIL 10, 1965 AND APRIL 4, 1964 (14TH WEEK)


Encephalitis Poliomyelitis Diphtheria
Aseptic
Meningitis Primary Post-Inf. Total Cases Paralytic
Area
Cumulative Cumulative Cum.
1965 1964 1965 1965 1965 1965 1964 1965 1965 1964 1965 1965
UNITED STATES... 29 26 28 14 6 19 5 14 5 64

NEW ENGLAND.......... 1 4 1 1 1 1
Maine............. I -
New Hampshire...... -
Vermont............ -
Massachusetts...... 1 3 1
Rhode Island....... 1 1 -
Connecticut........ -

MIDDLE ATLANTIC...... 3 3 11 2 1 4 4 3
New York City...... 1 5 1 1 1 2
New York, Up-State. 1 1 2 1 2 2 -
New Jersey.......... 3 1 1 -
Pennsylvania....... 1 2 1 1 1

EAST NORTH CENTRAL... 1 4 3 1 1 1 3
Ohio................ 1
Indiana............. 2
Illinois............ 1 1 -
Michigan........... 4 3 1 -
Wisconsin.......... -

WEST NORTH CENTRAL... 1 3 1 1 3 14
Minnesota.......... 1 2 1 1 4
Iowa............... 1 -
Missouri........... -- 1
North Dakota....... -
South Dakota....... 2 7
Nebraska........... -
Kansas.............. I 1

SOUTH ATLANTIC....... 3 5 1 3 8 5 1 12
Delaware........... -
Maryland...........
Dist. of Columbia.. 3
Virginia........... -
West Virginia...... -
North Carolina..... 4 1 1
South Carolina..... 1 -
Georgia............. 1 5
Florida............ 1 5 3 3 3 1 3

EAST SOUTH CENTRAL.. 4 3 1 -- 1 9
Kentucky........... 4 2 -
Tennessee.......... -
Alabama............. 1 1 8
Mississippi........ 1

WEST SOUTH CENTRAL... 3 3 1 1 1 18
Arkansas........... 1
Louisiana.......... 1 2 2
Oklahoma........... -
Texas............... 2 1 1 1 1 1 15

MOUNTAIN............. 2 3 2 2 2 1
Montana............. -
Idaho............... -
Wyoming............ -
Colorado............ 1 2 1 -
New Mexico......... -
Arizona............. 1 2 2 -
Utah................ 1 -
Nevada.............. -

PACIFIC.............. 12 7 3 7 1 1 1 I 4
Washington......... 1 1 1 -
Oregon............... 1 1
California......... 12 6 6 1 1 1 1 3
Alaska............. -
Hawaii............. -

Puerto Rico 1 6










Mlorbidity and Mortality Weekly Report


Tabhle (ASFS OF SPECIFIED) NOTIFIABLE DISEASES: UNITED) STATES

FOR %% II k I NI)lD

APRIL 10, 1965 AND APRIL 4, 1964 (14th WEEK) ( ONI INIl-l)


_____~ __ -


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...........
MichL an ...........
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.............


Brucel-
losis


Infectious Hepatitis
including Serum Hepatitis


Total Under 20 years
incl. unk. 20 years and over


Cumulative
Totals


4- + + I 4


11,007

645
134
56
36
238
80
101

1,933
355
857
291
430

2,132
676
166
413
757
120

718
66
287
134
10
8
19
194

1,149
49
247
13
274
195
95
34
42
200

857
306
341
121
89

996
146
175
32
643

674
53
122
25
117
126
126
100
5

1,903
163
158
1,457
113
12


12,977

1,446
511
121
175
284
63
292

2,910
395
1,334
518
663

1,940
518
154
316
838
114

776
56
113
194
35
81
18
279

1,269
29
240
26
188
227
231
40
29
259

922
416
309
125
72

918
109
182
56
571

845
77
66
32
236
141
189
78
26

1,951
202
202
1,441
61
45


Mcningoci c
Inec t ions'


Cumulat ive
1965 1964

1,212 875

63 26
8 2
4
1 1
21 13
11 2
18 8

159 85
25 12
37 29
54 23
43 21

143 135
41 41
19 24
35 28
25 31
23 11


Puerto Rico 33 21 10 332 238 3 13 1 10


123


Tetanus


1965

1


Cum.
1965

49

3

1

2



3

1

2



3
3



2
1















2
3









6
2
1
3
1






4


7
2
2

3

1
1












1










126 Morbidity and Mortality Weekly Report


Table 3. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

APRIL 10, 1965 AND APRIL 4, 1964 (14th WEEK) CONTINUED


Strept.
Measles Sore Th. & Tularemia Typhoid Fever Rabies in
Scarlet Fev. Animals
Area
Cumulative Cum. Cum. Cum.
1965 1965 1964 1965 1965 1965 1965 1965 1965 1965
UNITED STATES... 11,906 128,441 168,942 11,523 1 54 5 95 116 1,434

NEW ENGLAND.......... 1,887 25,732 6,944 1,363 I 18
Maine............... 62 1,936 879 106 -
New Hampshire...... 2 311 134 11 -
Vermont............. 19 377 1,444 2 17
Massachusetts...... 1,080 14,360 2,013 145 1 -
Rhode Island....... 194 2,855 533 78 -
Connecticut........ 530 5,893 1,941 1,021 1

MIDDLE ATLANTIC...... 536 4,962 23,843 1,007 2 13 10 50
New York City...... 68 480 7,910 36 6 -
New York, Up-State. 119 1,597 5,466 642 1 4 10 48
New Jersey......... 73 873 5,384 116 1 2
Pennsylvania....... 276 2,012 5,083 213 1 2

EAST NORTH CENTRAL... 2,937 24,122 37,622 1,534 1 1 13 18 155
Ohio................ 400 5,038 7,102 296 3 8 74
Indiana............. 98 989 9,148 194 4 4 12
Illinois........... 284 935 7,013 180 1 1 5 28
Michigan........... 1,662 12,849 9,553 620 3 13
Wisconsin.......... 493 4,311 4,806 244 1 2 1 28

WEST NORTH CENTRAL... 769 9,746 5,197 627 5 3 31 242
Minnesota.......... 43 313 120 18 9 62
Iowa................. 331 5,283 2,543 98 7 77
Missouri........... 197 1,442 459 52 3 3 3 34
North Dakota....... 165 2,426 1,636 254 2 10
South Dakota....... 1 55 3 24 1 2 15
Nebraska............... 32 227 436 2 17
Kansas............... NN NN NN 181 1 6 27

SOUTH ATLANTIC....... 1,104 15,474 15,619 1,198 20 1 23 7 211
Delaware........... 35 286 175 46 2 -
Maryland............ 50 552 1,825 220 8 2
Dist. of Columbia.. 5 20 283 9 -
Virginia........... 261 2,362 4,272 334 3 2 7 173
West Virginia...... 410 9,549 3,555 365 1 7
North Carolina..... 10 170 583 19 4 7 -
South Carolina..... 202 607 2,144 110 3 2 -
Georgia............. 33 430 130 36 10 16
Florida............. 98 1,498 2,652 59 1 1 13

EAST SOUTH CENTRAL... 863 7,546 22,134 1,850 13 12 23 434
Kentucky............ 175 953 10,253 260 3 5 2 30
Tennessee.......... 494 4,537 9,468 1,442 9 3 21 397
Alabama............ 136 1,492 513 48 1 2 7
Mississippi........ 58 564 1,900 100 2 -

WEST SOUTH CENTRAL... 1,491 17,605 28,296 788 9 13 18 232
Arkansas............ 44 825 458 3 5 5 3 34
Louisiana.......... 8 43 51 1 1 2 42
Oklahoma............ 9 111 403 23 3 1 6 43
Texas............... 1,430 16,626 27,384 761 5 9 113

MOUNTAIN............. 831 9,944 7,180 1,382 1 6 11 4 28
Montana........... 157 2,615 1,358 56 1 3
Idaho............... 165 1,511 907 224 -
Wyoming............. 76 485 51 19 1
Colorado............ 169 1,849 1,196 327 -
New Mexico......... 335 136 191 7 2 5
Arizona............. 49 389 2,750 138 3 2 20
Utah................ 205 2,676 412 424 1 5 -
Nevada............. 10 84 370 3 -

PACIFIC.............. 1,488 13,310 22,107 1,774 1 6 5 64
Washington.......... 312 3,943 8,301 349 1 -
Oregon.............. 157 1,921 2,522 15 1 1 1
California......... 791 5,906 10,282 1,209 3 5 63
Alaska.............. 3 97 870 19 -
Hawaii............. 225 1,443 132 182 1 -

Puerto Rico 96 830 2,145 11 3 4











1Morbiditv amid ortality Weekly Report






Tabcl 4. DEATHS IN 122 UNITED STATES CITIES FOR WI-IK FNI)DI) APRIL 10, 1965

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


______________ _________ ______ ____-- -- 4--- ---- ---4t--- 4c-


Area


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----------
Youngatown. 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.--------


Al I L i -,

All 65 years
Ages and over


Pnr urn. ,n a
and
Influenza
All Ages


lnd. r
1 year
All
Causes


Area


All 1 i. a,,. ,

All 65 years
Ages and over


P.,,u n. II.,s
and
Influenza
All Ages


4. 4 I4


812
282
49
29
28
59
29
26
25
57
79
16
56
23
54

3,592
55
28
153
43
35
38
72
109
1,762
45
617
230
51
114
26
39
42
48
36
49

2,596
59
56
734
175
173
121
72
395
36
51
50
26
61
171
36
111
36
29
28
116
60

825
66
35
38
129
32
119
74
235
73
24


480
156
28
17
18
25
19
14
21
33
52
13
38
16
30

2,029
30
16
84
24
17
30
34
55
996
27
346
117
24
68
16
27
31
33
25
29

1,474
32
29
394
103
92
63
50
214
31
16
29
14
49
91
18
74
23
18
15
79
40

534
46
24
19
82
24
83
41
150
49
16


51
16
2
2
2
8
4


3
6

3
1
4

194
1
2
13
3
2

4
5
96
2
30
11
2
10
2

2
5
1
3

143
3
2
42
6
12
9
4
17

6
5
2
3
11
3
3
4
1
3
4
3

47
4

6
9
2
2
10
7
6
1


*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. Pct rcburc, 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.----------


1,190
95
273
51
59
82
62
92
29
106
81
220
40

648
94
50
43
126
144
53
44
94

1,059
26
34
15
120
40
63
189
59
183
78
100
62
90

433
23
21
138
17
99
22
61
52

1,615
11
48
36
44
71
536
86
35
126
71
97
183
39
142
56
34


583
40
126
18
24
43
30
47
13
84
46
93
19

346
44
18
26
80
77
26
19
56

575
17
22
9
59
22
26
102
35
92
41
59
35
56

258
12
10
81
12
58
13
42
30

943
5
29
23
24
46
301
48
24
82
44
54
96
25
88
36
18


I'nhI. r
I year
All
Causes


73
4
14
4
7
1
5
10
3
3
5
15
2

39
8
6
1
3
11
3
1
6

67
1
2
1
9
7
4
10
1
8
5
9
6
4

24
2
2
8
2
6
1
3


111
1
3

5
2
42
6
1
7
7
9
12
1
10
I


Total 12,770 7,222 1 568 749

Cumulative Totals
including reported corrections for previous weeks

All Causes, All Ages ------------------------- 187,487
All Causes, Age 65 and over------------------- 107,241
Pneumonia and Influenza, All Ages------------- 9,278
All Causes, Under 1 Year of Age--------------- 10,959


Week No.
14


127










Morbidity and Mortality Weekly Report


INTERNATIONAL NOTES



PLAGUE Bolivia


In January March 1965, an outbreak of bubonic
plague occurred in six villages of Sopachuy Canton, Tomina
Province, Chuquisaca Department, Bolivia. Of a total of
76 cases infected in the villages of Socabon, Llave Kasa,
Horcas, Tabla Mayu and Sunchu Mayu, 32 were pestis
minor and 17 were fatal septicemic cases. These villages
are situated west of Sopachuy, in an area of about 7 square
miles, along a quebrada which opens at the origins of the
Horcas River. The Horcas River joins other rivers to form
a tributary of theAzero River. Each of the villages consists
of a few houses surrounded by grain fields. Although the
terrain is mountainous, and only a small percentage is
under cultivation, the principal crops are corn and wheat
which attract wild rodents. The affected area is some 138
miles southeast of the city of Sucre, but southwest of
Padilla and of the two areas in which an outbreak occurred
in April August 1964. Measures taken by the health
authorities include chemoprophylaxis, treatment of patients,
spraying of houses with DDT, quarantine, and estab-
lishment of permanent surveillance.


(Reportedin the Pan American Health Organization weekly
Epidemiological Report of April 7, 1965).






PLAGUE CONTINUES TO HARASS VIET NAM


New outbreaks of plague were reported in several
places in Khan-Hoa Province on the central Viet Nam
coast with one death. For the entire country, out of 71
suspected cases during the month of March, 25 were con-
firmed and four persons died of the disease. A vaccination
campaign is now in progress.





POLIOMYELITIS Nicaragua


A total of 72 cases of poliomyelitis has been reported
to 31 March, in Nicaragua. One case was reported in
January in the Department of Carazo, followed by 20 cases
in February in the Departments of Chinandega, Esteli,
Leon and Managua, and 34 cases in the first three weeks
of March in these five departments and those of Boaco,
Chontales and Matagalpa. Oral vaccine is being admin-
istered to the age group 1-4 years.


(Reportedin the Pan American Health Organization weekly
Epidemiological Report of April 7, 1965).


THE MORBIDITY AND MORTALITY WEEKLY REPORT. WITH A CIRCULA-
'-ON OF 1 .0.'0 IS PUBLISHED BY THE COMMUNICABLE DISEASE
CENTER. ATLANTA. GEORGIA 30333.
CHIEF. COMMUNICABLE DISEASE CENTER JAMES L. GODDARD. M.D.
CHIEF. EPIDEMIOLOGY BRANCH A. D. LANGMUIR. M.D.
CHIEF. STATISTICS SECTION R. E SERFLING. PH.D.
AEST. CHIEF. STATISTICS SECTION IDA L. SHERMAN, M.S.
CHIEF SUR EILLANCE SECTION D. A. HENDERSON. M.D.
ASSISTANT EDITOR MMAR PAUL D. STOLLEY. M.D.
IN ADDITION TO THE ESTABLISHED PROCEDURES FOR REPORTING
MORBIDITr AND MORTALITY. THE COMMUNICABLE DISEASE CENTER
WELCOMES ACCOUNTS OF INTERESTING OUTBREAKS OR CASES. SUCH
ACCOUNTS SHOULD BE ADDRESSED TO
THE EDITOR
MORBIDITY AND MORTAL ITY WEEKLY REPORT
COMMUNICABLE DISEASE CEN T ER
ATLANTA. GEORGIA 30333
NOTE THESE PROVISIONAL DATA ARE BASED ON WEEKLY TELE-
GRAMS TO THE CDC BY THE INDIVIDUAL STATE HEALTH DEPART-
MENTS. T-E REPORTING WEEK CONCLUDES ON SATURDAY. COMPILED
DATA ON A NATIONAL BASIS ARE RELEASED ON THE SUCCEEDING
FRIDAY.
SYMBOLS---DATA NOT AVAILABLE
QUANTITY ZERO
-IE CONSTRUCTION OF THE MORTALITY CURVES IS DESCRIBED IN
VOL. 14. NO. I.


*NIV OF Fl -V



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U.S. DEPOSITORY


128


IIIIIVERSITY OF FLORIDA


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