Morbidity and mortality

COMMUNICABLE DISEASE CENTER


'I'>


Vol. 14, No. 36


. .r..


c44a


..I 'I


Week Ending
September 11, 1965


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


SERVICE


AN OUTBREAK OF VESICULAR STOMATITIS
New Mexico and Colorado

Starting early in Jul) an outbreak of %estcular sto-
matitis has affected horses and cow. In northern New
Mexico and southern Colorado. The Indiana type of %irus
has been isolated from sick animals in the affected area
by the USDA National Animal Disease Laboratory, in
Ames, Iowa.
Cases of suspected vesicular stomatitis in humans
began to be reported toward the latter part of July. A
total of 24 patients having some epidemiologic association
with infected animals has been investigated. Eight of these
had signs and symptoms compatible with a clinical


V''e icular Stomniiiit .
.1talement on NMeasle.- Imifln .
Hepcort"d L'1C-Is of Fr nvA.pVl]t
Reported Ca. of Inf.ectia
International Notes Quarar N


. *10
310
.311
.1 11


diagnosis of vesicular stomatitis. Four patients had
illnesses suggestive of the disease but which were not
clinically characteristic. In the remaining 12 patients
clinical signs and symptoms were not distinctive.
The eight clinically diagnosed cases had had direct
and continuing close contact with animals suffering from
vesicular stomatitis. The onset of symptoms in six of


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES
(Cumulative totals include revised and delayed reports through previous weeks)
36th WEEK ENDED CUMULATIVE, FIRST 36 WEEKS
MEDIAN
DISEASE SEPTEMBER 11, SEPTEMBER 5, 1960-1964 MEDIAN
1965 1964
1965 1964 1960-1964
Aseptic meningitis ........ .. 54 46 112 1,235 1,280 1,470
Brucellosis ............ 8 9 9 177 300 300
Diphtheria ................ 4 5 6 105 179 262
Encephalitis, primary infectious 48 234 --- 1,155 2,053 --
Encephalitis, post-infectious 4 6 --- 531 682
Hepatitis, infectious including
serum hepatitis ........... 495 568 682 23.503 27,108 30,396
Measles ..........* ...... 450 541 700 239,380 461,325 394,990
Meningococcal infections ...... 17 41 28 2.288 2,018 1,563
Poliomyelitis, Total ........* 2 2 31 39 73 504
Paralytic ............... 2 1 26 32 60 393
Nonparalytic .....* ** --- 7 9 ---
Unspecified .......***** 1 --- 4 --

Streptococcal Sore Throat and
Scarlet fever .. 4,371 3,957 2.987 284,573 291.323 236.651
Tetanus *........* *** 5 11 --- 186 194 --
Tularemia **..........**** 3 6 --- 178 237
Typhoid fever 7 14 20 281 283 406
Rabies in Animals *........ 63 81 63 3.159 3,250 1 2,681

NOTIFIABLE DISEASES OF LOW FREQUENCY
Cum. Cum.
Anthrax: ........ .. ....................... 7 Rabies in Man: ................... .......... 1
Botulism: .............. .................. 11 Smallpox: ........ ....................... .
Leptospirosis: Ohio-1 ........................ 28 Trichinosis: N.Y. Upstate-1, R.I.-1 ............... 76
Malaria: La.-l, Calif.-. ....................... 57 Typhus-
Plague: ................................. 5 Murine: ... ... .. .......... ...... ....... 22
Psittacosis: N.Y. City-1, Texas-1 ................ 34 Rky. Mt. Spotted: Ark.-2. Va.-2, S.C.-1, Tenn.-l ..... 215
Cholera: ............2 ..................... 2


S 2, j 0/ ?* /L /3/ /







Morbidity and Mortality Weekly Report


September 11. 1965


AN OUTBREAK OF VESICULAR STOMATITIS
(Continued from front page)


the eightpatients occurred within 3 days of initial contact,
while the onsets in the other two patients occurred
respectively 8 and 11 days after contact with infected
animals. Four of these patients lived in New Mexico and
four in Colorado.
A severe diphasic illness which lasted approx-
imately 6 days was present in three of the patients with
clinically compatible illness. The first phase was marked
by general malaise, fever, and headache for 48 hours;
the second phase was characterized by vesicular lesions
on the lips,tongue, and the buccaland pharyngeal mucosa.
A fourth patient developed a vesicular lesion on the


right thumb, as well as swelling on the lips and buccal
mucosa.
Serological studies of sera, from the 24 human cases
which were investigated, are in progress.
(Reported by Dr. H. Gordon Doran, State Epidemiologist,
New Mexico Department of Public Health; Dr. C.S.
Mollohan, State Epidemiologist, Colorado State Depart-
ment of Public Health; Dr. R.L. Cleere, Director of
Public Health, Colorado State Department of Public
Health;Dr. M.D. Baum, Chief, Veterinary Section, Division
of Preventive Medical-Services, Colorado State Depart-
ment of Public Health; and an EIS Officer.)


THE IMPORTANCE OF MEASLES AND METHODS FOR
ACHIEVING HIGH LEVELS OF MEASLES IMMUNIZATION
IN THE COMMUNITY

Statement prepared by Public Health Service Advisory
Committee on Immunization Practice*


Recognizing the significance of measles as one of
the most important causes of serious morbidity in child-
hood, the Committee recommends that, with highly effective
vaccines available, every effort should be applied to
eradicating the disease in the United States. All children
presumed susceptible should be immunized.
Continuing "maintenance" programs aimed at vac-
cinating children about one year of age should be estab-
lished in all communities. Additionally, consideration
should be given to the concept of full immunization of all
children entering schools, nursery schools, etc. since
measles transmission in the community occurs principally
among children in such settings.
Widespread immunization may be achieved through
routine and intensive programs conducted in physicians'
offices and immunization clinics in both public health
and private medical practice. In some instances, mass
community-wide vaccination programs may prove practicable
in communities or segments of communities in which
immunization levels achieved through routine practice
are known to be low.

Community-wide, mass programs special comments:

If community-wide programs are conducted, cognizance
must be taken of the fact that such programs are necessarily
more complex than those involving oral polio vaccine,
for example, since measles vaccines must be parenterally
administered. Further, a febrile illness is expected to
occur in a proportion of those vaccinated between 6 and 8
days after vaccination.
The following points should be considered in a
community-wide program:
*(Committee membership is detailed on page 316)


1. The active participation of essentially all phy-
sicians who normally provide care for children is
requisite. Since febrile responses of varying
severity often accompanied b3 a rash are observed
approximately a week following live vaccine
administration in a proportion of those vaccinated,
the practicing physicians must be available to
respond to calls concerning these symptoms. If a
program were to be conducted on a weekend, for
example, a substantial number of calls might be
anticipated during the following weekend.
2. Since measles vaccine rrust be administered
parenterally, more medical personnel are required
for the conduct of the program than has been
required for oral polio vaccine programs.
3. For programs to be successful, a substantial
effort will be required to motivate a high degree of
interest among parents in the community. Despite
the high incidence of measles and the frequent
occurrence of complications, measles as a disease
generally engenders less concern than does
poliomyelitis.
4. The selection of the vaccine must be carefully
considered. Recommended schedules have pre-
viously been described by the Committee (Morbidity
and Mortality Weekly Report, Vol. 14, No. 5).
It should be noted parenthetically that although
a number of children may exhibit notable febrile
responses following live vaccine administration,
the present experience of private practitioners
indicates that for only a fraction of such febrile
responses is medical attention requested.
(Continued on back page)


310









Septrnmber 11. 1965


Morlidity and Mortality Weekly Report


T \lI iE 1


HEKPOTED CASES eOF VP0o1r II t' (t> \Nl) DPOSTIMMINIZ AlION .NCEIPillA 1. TIS
EI6HT H IEk P, h I(hI) ENDING b 14 .6


Arkansas ......
California. .. ...
Connecticut .
Florid .
Hawaii.........
Illinois ........
Louisiana ......
Maine ........

Minnesota .
New York, I'pstate.


Penns\lvanMt .... 3
Rhode Island ....
Tennessee .
Texas 2
argin.. .. .. ... 1


'.S. Total .

Puerto Rico ...
U.S. Cumulative
Total (teeks 1-32):
1965 .. ...... 312
1964 . 106


I/tit~l Ia 111"~


IMuolmps r,,,, >pII M tlP...t-

S 1
**N 7 3


i I .



. .


1 .
I .


. .. 1 .
3 ..

..

I ."
.... . .
t:::-~ t -t


l','rt ii'l. -1.111 InfI irtrnt ii Mnt ibs


1(. i ..r.. < + 1 oi t tL I I I III t1U1(
Ni ynitit il l,!, \ i, .. .111...

. .. .

1. I I' .


. .


2 0
0 1


69 86 12
17 28 1 11


'Includes revsed asd delayed reports
"*Corresponding period in 1964


1 0 4
0 0 1


(States not reporting a case not listed)


TABLE 2
SUMMARY OF REPORTED CASES OF INFECTIOUS SYPHILIS AUGUST 1965 AND AUGUST 1964



CASES OF PRIMARY AND SECONDARY SYPHILIS: By Reporting Areas August 1964 and Auguat 1965 Provisional Data

Cumulative Cumulative
Reporting Area August Jan Aug Reporting Area August Jan Aug
1965 1964 1965 1964 1965 1964 1965 1964
NEW ENGLAND............... 52 34 313 320 EAST SOUTH CENTRAL........ 244 175 1,899 1,183
Maine................... 1 4 Kentucky................. 10 24 93 105
New Hampshire............ 1 1 23 7 Tennessee................ 38 35 381 293
Vermont.................. 2 3 Alabama.................. 123 84 1,020 593
Massachusetts............ 33 20 185 187 Mississippi.............. 73 32 405 192
Rhode Island............ 4 1 14 12
Connecticut.............. 14 12 88 107 WEST SOUTH CENTRAL........ 210 259 1,599 1,744
Arkansas................. 23 19 163 137
MIDDLE ATLANTIC.......... 460 451 3,182 3,643 Louisiana................ 75 81 467 474
Upstate New York........ 63 54 362 448 Oklahoma................. 9 8 85 102
New York City............ 248 252 1,868 2,111 Texas..................... 103 151 884 1,031
Pa. (Excl. Phila.)....... 17 29 108 110
Philadelphia............ 33 30 187 224 MOUNTAIN.................. 44 38 378 357
New Jersey................ 99 86 657 750 Montana.................. 1 3 9 26
Idaho..................... 4 5 3
EAST NORTH CENTRAL......... 266 216 2,005 1,500 Wyoming.................. 2 7
Ohio..................... 48 42 418 354 Colorado................. 1 4 25 20
Indiana................... 3 4 36 41 New Mexico ............... 11 13 75 141
Downstate Illinois....... 26 9 154 95 Arizona.................. 21 15 208 132
Chicago.................. 105 78 813 587 Utah..................... 1 10 8
Michigan................. 79 75 528 387 Nevada.................... 5 3 44 20
Wisconsin................. 5 8 56 36
PACIFIC................... 157 161 1,364 1,484
WEST NORTH CENTRAL........ 52 58 345 353 Washington................ 3 7 50 50
Minnesota................. 3 15 62 87 Oregon................... 5 7 26 46
Iowa...................... 6 20 19 California................ 146 145 1,268 1,368
Missouri................. 17 24 155 157 Alaska................... 1 5 8
North Dakota............. 1 Hawaii................... 3 1 15 12
South Dakota............. 6 5 32 33
Nebraska................. 16 12 61 36 U. S. TOTAL............... 2.056 1,960 15,602 15,282
Kansas...................... 4 2 14 21
TERRITORIES............... 89 87 550 573
SOUTH ATLANTIC............ 571 568 4,517 4,698 Puerto Rico............... 88 87 537 553
Delaware................. 10 15 44 60 Virgin Islands........... 1 13 20
Maryland................. 42 45 294 353
District of Columbia..... 43 56 331 497
Virginia................. 24 33 231 198
West Virginia............ 9 48 25
North Carolina............ 98 116 698 769 Note: Cumulative Totals include revised and delayed reports
South Carolina........... 80 74 568 599 through previous months.
Georgia.................. 95 74 719 796
Florida.................. 170 155 1,584 1,401


31 1


1 .


2


I I








312 Morbidity and Mortality Weekly Report


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED

SEPTEMBER 11, 1965 AND SEPTEMBER 5, 1964 (36th WEEK)


SEncephalitis 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... 54 46 48 4 2 39 73 2 32 60 4 105

NEW ENGLAND........... 1 1 2 2 1
Maine.............. 1 I -
New Hampshire...... -
Vermont.............- -
Massachusetts...... 1 1
Rhode Island....... 1 -
Connecticut........ 1 1 -

MIDDLE ATLANTIC...... 6 7 6 3 12 2 11 5
New York City...... 1 1 1 1 1 3
New York, Up-State. 3 3 9 8 -
New Jersey.......... 2 3 1 2 2 2 2 -
Pennsylvania....... 1 3 1 2

EAST NORTH CENTRAL... 7 6 13 1 14 12 4
Ohio............... 3 3 1 2 2 I
Indiana............ 9 2 2 2
Illinois ............. 1 2 2 1 5 5 --
Michigan........... 3 1 1 3 2 -
Wisconsin.......... 2 1 1

WEST NORTH CENTRAL... 18 7 20 8 5 7 4 18
Minnesota........... 13 7 -- 11 1 1 7
Iowa............... 1 1 2 2 1
Missouri........... 4 2 1 3 2 I
North Dakota..... 10 -
South Dakota....... 7
Nebraska........... 3 3 1
Kansas............. 7 1 1 1 1 1

SOUTH ATLANTIC....... 4 1 2 2 1 20 1 15 29
Delaware............- -
Maryland............ 1 1 1 1 -
Dist. of Columbia.. 3
Virginia........... 2 1 1 -
West Virginia...... 1 -
North Carolina..... 1 1 9 5 2
South Carolina..... 1
Georgia............ i 1 14
Florida............ 1 2 8 7 9

EAST SOUTH CENTRAL... 1 2 1 5 1 4 1 17
Kentucky..........- -
Tennessee........ 1 1 1 3 1 2- -
Alabama............ 1 2 2 15
Mississippi........ 1 2

WEST SOUTH CENTRAL... 6 5 1 16 6 1 14 6 23
Arkansas........... 2
Louisiana.......... 2 1 1 1 5
Oklahoma........... 1 2 1 2 -
Texas.............. 4 4 1 14 4 1 12 4 16

MOUNTAIN............. 2 5 5 6 3 3 -
Montana............ 5 -
Idaho.............. --
Wyoming............ 2 2- -
Colorado............ 1 1 -1 -
New Mexico......... 1 3 -
Arizona.... ...... 1 4 2- -
Utah............... -
Nevada............. -

PACIFIC.............. 11 15 2 2 1 4 3 1 4 3 3 8
Washington.......... 2 3 1 2 2 2 2
Oregon............. 1 1 1 1 1 1 1
California......... 6 12 1 2 1 2 1 2 1 5
Alaska............. -
Hawaii............. 3 -

Puerto Rico 1 10









1Morlidil and Mortality Weekly Report 313


CASES OF SPEKIFII) N()TIFIAHII DIM ANI UNITED STA 1 s

()R W'IlKS INI)E)

SEPTI MBI R 11, 1965 ANI) SEPTEMBI K 5, 1964 (46th WEEK) C(ontinued


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... 450 239,380 461,325 4,371 3 178 7 281 63 3,159

NEW ENGLAND.......... 6 36,754 16,856 252 1 4 37
Maine.............. 1 2,790 2,987 16 3
New Hampshire...... 381 250 1
Vermont............. 1 1,257 2,318 15 30
Massachusetts...... 3 19,280 5,275 35 1 3 2
Rhode Island....... 3,899 1,923 18 1 -
Connecticut........ 1 9,147 4,103 168 1

MIDDLE ATLANTIC..... 49 14,695 52,112 85 3 51 4 127
New York City...... 26 2,359 15,314 4 2 25 -
New York, up-State. 5 4,119 12,687 65 13 4 115
New Jersey......... 8 2,547 12,195 14 1 6 --
Pennsylvania........ 10 5,670 11,916 2 7 12

EAST NORTH CENTRAL... 125 55,502 102,687 244 1 12 1 37 6 485
Ohio............... 8 8,861 19,612 7 1 9 2 252
Indiana............ 7 1,820 22,713 85 1 5 8 2 53
Illinois........... 24 2,677 16,611 51 5 10 1 78
Michigan........... 41 26,377 28,874 70 1 5 49
Wisconsin.......... 45 15,767 14,877 31 1 5 1 53

WEST NORTH CENTRAL... 18 16,445 30,222 260 23 1 10 2 650
Minnesota .......... 4 635 333 1 1 3 134
Iowa................ 1 8,978 23,306 17 2 9 187
Missouri........... 1 2,587 1,017 13 18 1 7 2 86
North Dakota....... 9 3,680 4,726 163 1 39
South Dakota....... 2 115 28 1 2 1 48
Nebraska........... 1 450 812 1 2 35
Kansas............. NN NN NN 65 2 2 121

SOUTH ATLANTIC....... 54 24,567 38,238 506 29 1 56 9 434
Delaware........... 502 409 11 4 -
Maryland........... 1 1,157 3,402 39 15 2 21
Dist. of Columbia.. 1 77 354 1 -
Virginia........... 6 3,847 12,697 127 6 4 1 274
West Virginia...... 35 13,606 8,590 149 3 21
North Carolina..... 3 384 1,160 15 6 15 2
South Carolina..... 1,010 4,250 27 3 8 2
Georgia............ 1 617 194 1 14 1 3 2 50
Florida............ 7 3,367 7,182 136 4 4 64

EAST SOUTH CENTRAL... 59 13,711 67,586 1,043 20 1 26 11 686
Kentucky........... 34 2,458 18,442 210 3 6 3 71
Tennessee.......... 21 7,828 24,110 719 16 1 9 8 586
Alabama............ 1 2,311 18,348 58 1 6 15
Mississippi........ 3 1,114 6,686 56 5 14

WEST SOUTH CENTRAL... 75 30,746 71,939 537 2 70 39 7 493
Arkansas........... 1,084 1,124 2 46 13 74
Louisiana.......... 104 105 1 3 5 69
Oklahoma........... 203 1,018 1 10 4 3 93
Texas.............. 75 29,355 69,692 535 11 17 4 257

MOUNTAIN............. 26 19,649 18,538 942 15 24 3 69
Montana............. 4 3,711 3,027 23 4 1 5
Idaho.............. 1 2,773 1,923 37 -.
Wyoming........... 843 260 5 3 1 -
Colorado........... 5 5,620 3,217 287 9
New Mexico......... 1 677 450 442 9 2 14
Arizona............ 5 1,296 6,624 75 11 1 40
Utah............... 10 4,526 2,047 73 8 1
Nevada............. 203 990 2 -

PACIFIC.............. 38 27,311 63,147 502 8 34 3 178
Washington.......... 1 7,218 19,973 51 4 7
Oregon............. 10 3,213 8,620 6 4 5 1 6
California......... 20 12,919 32,934 335 4 24 2 163
Alaska............. 1 178 1,089 8 2
Hawaii............. 6 3,783 531 102 -

Puerto Rico 12 2,356 5,930 5 6 13








314 Morbidity and Mortality Weekly Report


CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES

FOR WEEKS ENDED
SEPTEMBER II, 1965 AND SEPTEMBER 5, 1964 (36th WEEK) Continued.


Brucel- Infectious Hepatitis Meningococcal
losis including Serum Hepatitis Infections Tetanus
Area Total Under 20 years Cumulative
incl. unk. 20 years and over Totals Cumulative Cum.
1965 1965 1965 1965 1965 1964 1965 1965 1964 1965 1965

UNITED STATES... 8 495 230 244 23,503 27,108 17 2,288 2,018 5 186

NEW ENGLAND.......... 28 13 14 1,376 2,540 1 114 55 5
Maine.............. 4 3 255 814 16 5 -
New Hampshire...... 4 2 2 138 198 7 1 1
Vermont............ 1 1 74 317 6 1 -
Massachusetts...... 11 3 8 543 546 1 38 22 3
Rhode Island....... 1 1 157 134 14 9 -
Connecticut........ 7 4 3 209 531 33 17 1

MIDDLE ATLANTIC...... 77 32 45 4,181 6,039 3 300 256 11
New York City...... 15 6 9 821 922 51 35 -
New York, Up-State. 22 8 14 1,608 2,665 2 86 71 4
New Jersey.......... 23 9 14 792 1,050 1 79 88 1
Pennsylvania....... 17 9 8 960 1,402 84 62 6

EAST NORTH CENTRAL... 85 44 36 4,472 4,254 2 320 272 3 24
Ohio............... 24 11 11 1,230 1,117 1 86 70 2
Indiana............ 6 2 3 397 361 41 42 6
Illinois........... 21 11 9 857 784 1 87 69 2 10
Michigan........... 33 20 13 1,714 1,684 69 62 1 3
Wisconsin.......... 1 274 308 37 29 3

WEST NORTH CENTRAL... 4 30 15 14 1,395 1,460 1 118 121 1 17
Minnesota.......... 141 162 23 28 7
Iowa............... 4 3 1 1 504 212 1 8 6 1 4
Missouri........... 10 7 3 300 363 52 56 2
North Dakota....... 1 1 23 55 11 16 -
South Dakota....... 17 116 3 1 -
Nebraska........... 5 1 4 57 39 10 6 2
Kansas............. 11 5 6 353 513 11 8 2

SOUTH ATLANTIC...... 2 66 26 36 2,441 2,553 4 443 401 41
Delaware........... 59 48 7 6 -
Maryland........... 7 1 6 438 483 42 26 1
Dist. of Columbia.. 2 2 36 43 1 9 12 --
Virginia........... 1 29 10 17 566 396 1 52 46 7
West Virginia...... 3 2 1 358 381 24 31 1
North Carolina..... 1 7 4 3 234 439 2 89 69 5
South Carolina..... 4 4 105 94 58 50 6
Georgia............ 1 1 91 70 57 60 4
Florida............. 13 5 6 554 599 105 101 17

EAST SOUTH CENTRAL... 43 24 18 1,680 1,877 2 180 167 24
Kentucky........... 21 16 4 584 718 69 54 6
Tennessee.......... 10 6 4 572 648 2 57 54 7
Alabama............ 10 1 9 306 333 34 35 9
Mississippi........ 2 1 1 218 178 20 24 2

WEST SOUTH CENTRAL... 2 41 24 17 2,045 2,078 1 305 231 1 43
Arkansas........... 4 2 2 273 209 14 20 1 10
Louisiana.......... 1 7 5 2 343 484 169 114 5
Oklahoma........... 48 101 19 8 1
Texas............... 1 30 17 13 1,381 1,284 1 103 89 27

MOUNTAIN............. 17 4 5 1,322 1,635 72 66 3
Montana............. 6 4 1 102 143 2 -
Idaho............... 1 173 212 8 3 -
Wyoming............ 38 50 5 5 -
Colorado........... 1 1 279 441 14 11 2
New Mexico......... 1 1 271 234 11 27 -
Arizona............ 6 278 368 16 5 1
Utah............... 2 2 174 137 14 7 -
Nevada............. 7 50 2 8 -

PACIFIC.............. 108 48 59 4,591 4,672 3 436 449 18
Washington......... 14 7 6 360 494 33 30 -
Oregon............. 12 5 7 388 513 32 21 4
California.......... 72 30 42 3,625 3,414 3 346 379 14
Alaska............. 10 6 4 181 153 18 7 -
Hawaii............. 37 98 7 12 -

Puerto Rico 28 21 7 988 710 5 31 4 35









3 I


Morbidity and Mortality Weekly ReHporr






Week No. Table 4. DEATHS IN 122 UNITED STATES CITIES FOR WIFK ENDED SIPT1 I MlI H II, 1965


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


I I 11__ I --


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----------
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.---------


AlI CILIut


All
Ages


65 years
and over


Pneumornia
and
Influenza
All Ages


under
1 year
All
Causes


Area


All tauh.'

All 65 years
Ages and over


Pnirum-n I d
and
Influenza
All Ages


1 + + .1'1 '1I


679
226
32
34
27
43
20
15
30
53
56
13
50
27
53

2,969
48
36
149
34
38
46
58
95
1,448
32
448
164
35
109
33
23
72
41
33
27

2,290
69
22
646
150
168
118
67
340
40
38
40
32
54
120
41
111
41
31
26
81
55

722
49
29
33
121
19
109
65
198
69
30


400
116
20
19
19
22
14
12
20
30
33
10
37
16
32

1,747
27
22
86
21
21
27
38
37
854
20
262
98
19
69
15
16
40
27
29
19

1,274
44
11
336
89
91
64
34
188
26
25
24
15
35
68
16
64
26
14
21
50
33

424
29
18
18
76
15
60
35
112
46
15


*Estimate based on average percent of divisional total.


SOUTH ATLANTIC:
Atlanta, Ga.-----------
Baltimore, Md.---------
Charl'tit 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.----------


969
95
192
29
47
60
71
88
38
59
79
171
40

513
62
37
37
137
87
39
35
79

961
29
21
28
140
26
65
165
49
166
78
95
42
57

360
22
20
114
21
85
14
55
29

1,135
9
34
19
31
57
345
40
39
68
54
87
130
26
111
53
32


I year
All
Causes


Total 110,598 5,929 1 316 586

Cumulative Totals
including reported corrections for previous weeks


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


445,359
251,508
18,443
26,479


' '












316 Morbidity and Mo





Statement prepared by Public Health Service Advisory
Committee on Immunization Practice*
(Continued from page 310)

5. Since, in general, 90 percent of persons beyond
15 years of age will have experienced measles,
the program should be directed to those with no
history of measles, between the ages of 12
months and 15 years with particular emphasis on
the most susceptible, the preschool children.


* COMMITTEE:


Dr. James L. Goddard
Dr. Donald A. Henderson
Dr. Ernest A. Ager


Chairman
Secretary


Dr. Gordon C. Brown
Dr. Geoffrey Edsall
Dr. David T. Karzon
Dr. Arthur Lesser
Dr. Theodore A. Montgomery
Dr. Roderick Murray
Dr. Paul F. Wehrle











INTERNATIONAL NOTES QUARANTINE MEASURES


Immunization Information for International Travel
1963-64 edition-Public Health Service PublicationNo. 384


Page 53 Saudi Arabia
Delete information concerning cholera and insert the
following: Vaccination against cholera is required for all
arrivals. In addition, persons arriving from infected areas
must also possess a certificate showing that prior to
to arrival they had spent fike days in an area free of
cholera (time spent on board a vessel may be considered
as a period spent in a cholera-free area.)


All other information remains the same.


reality Weekly Report


September 11, 1965


THE MORBIDITY AND MORTALITY WEEKLY REPORT. WITH A CIRCULA-
TION OF 14 000. IS PUBLISHED AT THE COMMUNICABLE DISEASE
CENTER. ATLANTA. GEORGIA.
CHIEF COMMUNICABLE DISEASE CENTER JAMES L. GODDARD, M.D.
CHIEF. EPIDEMIOLOGY BRANCH A.D. LANGMUIR. M.D.
ACTING CHIEF. STATISTICS SECTION IDA L. SHERMAN. M.S.
CHIEF. SURVEILLANCE SECTION D. A. HENDERSON. M.D.
EDITOR MMWR O.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
WELt.COMES ACCOUNTS OF INTERESTING OUTBREAKS OR CASE IN-
VESTIGATIONS WHICH ARE OF CURRENT INTEREST TO HEALTH
OFFICIALS AND WHICH ARE DIRECTLY RELATED TO THE CONTROL OF
COMMUNICABLE DISEASES. SUCH COMMUNICATIONS SHOULD BE AD-
DRESSED 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 WEE HEALTH DEPARTMENTS. THE REPORTING WEEK CONCLUDES ON SAT-
URDAY: COMPILED DATA ON A NATIONAL BASIS ARE RELEASED ON
iTHE SUCCEEDING FRIDAY.


n-


- 5
0




B m
a-$
W L


I .CS MENTS ITp-






U.S DEPOSITORY


o9
W 0
0 o
_1
u. 0

o 40



z
__

xml version 1.0 encoding UTF-8
REPORT xmlns http:www.fcla.edudlsmddaitss xmlns:xsi http:www.w3.org2001XMLSchema-instance xsi:schemaLocation http:www.fcla.edudlsmddaitssdaitssReport.xsd
INGEST IEID E33TZP7R3_P7GFT6 INGEST_TIME 2013-02-07T18:25:27Z PACKAGE AA00010654_00396
AGREEMENT_INFO ACCOUNT UF PROJECT UFDC
FILES