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Morbidity and Mortality *r T j'f^IBfl~41 U. S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE PUBLIC HEALTH SERVICE Prepared by the s *MMl:ICABLEDIEAE EN^M 633-3311 For release December 11, 1964 ATLANTA, GEORGIA 30333 vol. 13, No. 49 PROVISIONAL INFORMATION ON SIL( TED NOTIFIABLL DISFASES IN 1HI LINII ID TAT' --A'R ON DEATHS IN SELECTED CITIES FOR WEEK ENDEDDECEMBER 5, 1964 BRUCELLOSIS SURVEILLANCE ANNUAL St IV.IARY EPIDEMIOLOGIC NOTES INFLUENZA Widely scattered reports only of influenza virus in- fections have been received during the fall months of 1964. Previously reported influenza foci have been limited geographically, most appear to have subsided. (See MMWR, Vol. 13, Nos. 40 and 44.) The late summer-early fall outbreak in Puerto Rico, from which type A2 virus was recovered, has gradually subsided although, in a few areas in the southern part of the Island some cases may still be occurring. In Oregon, there has been no evident extension of influenza-like illnesses in those areas in which sero- logically confirmed A2 infections were reported during the early fall. In Hawaii, the previously reported type B influenza outbreakss appear to have waned. Primarily affected were the younger age groups. Absenteeism up to 20 percent in some of the Oahu Island schools was observed. From clinical specimens provided by the Hawaii Department of Health, influenza type B has recently been isolated at CDC. Type B influenza has been serologically confirmed among students at the University of Maine, who were ill primarily in early October. Only 12 to 15 clinically recog- nizable cases occurred on the campus; there is little evidence of influenza in the adjacent community or in the State. Clinically specimens from suspect, mild cases in adjoining regions of central Maine were collected in late November but have not yielded viral agents in initial processing. (Continue to page 430) Table 1. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES (Cumulative totals include revised and delayed reports through previous weeks) 49th Week Ended -Cumulative. First 49 Weeks Disease December 5, December 7, Median Median 1964 1963 1959 1963 1964 1963 1959 1963 Aseptic meningitis ................. 38 35 --- 2,040 1,741 --- Brucellosis ....................... 8 6 11 380 343 556 Diphtheria ........................ 26 11 26 275 262 554 Encephalitis, primary infectious.. 30 --- 3,063 --- Encephalitis, post-infectious ..... 11 29 -.. 759 1,466 Hepatitis, infectious including serum hepatitis ................ 696 886 911 35,643 40,528 40,528 Measles ........................... 2,712 3,712 3,712 451,085 377,354 409,236 Meningococcal infections .......... 60 43 51 2,556 2,208 2,083 Poliomyelitis, Total .............. 1 6 19 114 423 1,299 Paralytic ...................... 4 11 88 362 846 Nonparalytic .................. 1 2 --- 14 44 --- Unspecified ................... --- 12 17 --- Streptococcal Sore Throat and Scarlet fever .................. 7,732 7,648 --- 368,470 317,263 --- Tetanus ........................... 7 5 --- 261 266 --- Tularemia ......................... 5 3 --- 309 272 --- Typhoid fever ..................... 4 16 16 419 515 776 Rabies in Animals ................. 73 80 64 4,233 3,557 3,425 Table 2. NOTIFIABLE DISEASES OF LOW FREQUENCY Cum. Cum. Anthrax: Ida. 1 5 Psittacosis: Ga 1 43 Botulism: 15 Rabies in Man: 1 Leptospirosis: Ark 1, Hawaii 1, Fla 1 102 Smallpox: Halaria:1ll I, N.C. 1, Calif 1 93 Typhus- Plague: Marine: 23 SRky Mt. Spotted: 220 ~C f _ ( . / Morbidity and Mortality Weekly Report INFLUENZA (Continued from front page) Serological diagnosis of A2 influenza as the cause of an atypical illness in a Loyola College (Baltimore) stu- dent in mid-fall was made by the Maryland State Depart- ment of Health Laboratory. There were no recognized associated cases, and no source for this isolated event has been uncovered. There has been no evident pattern in the sporadic activity of influenza viruses in the current season. Avail- able indices do not give evidence of either widespread or substantial amounts of "influenza-like" illness. SALMONELLOSIS IN THE UNITED STATES MONTHLY REPORT During October 1964, there were 1,848 human isola- tions of salmonella organisms reported to the Salmonella Surveillance Unit by State Health Departments and other participating laboratories. This represents a slight de- cline in the number of salmonella isolates from the peak summer months. Salmonella typhi-murium, was the most frequently isolated serotype. Salmonella infants was the second most frequently recovered serotype during the months of September and October. The unusually high frequency of this serotype reflects principally a large hospital outbreak in a northeastern city. The number of Salmonella derby isolations continues to decrease which mirrors the gradual waning of a large interstate hospital outbreak in the Northeast. Reported Isolates of Salmonellae from Human Sources October 1964 I Percent of Serotype Number Total . typhi-murium & S. typhi-murium var. copenhagen...... 473 25.6 S. infantis ................... 246 13.3 S. newport ........... ........ .. 137 7.4 S. heidelberg .................. 135 7.3 S. derby ................. ... 85 4.6 S. saint-paul .................. 74 4.0 S. enteritidis ................... 66 3.6 Other serotypes 632 34.2 Total ................... ... 1,848 100.0 (Kieported by the Salmonella Surveillance Unit, CDC) EPIDEMIOLOGIC REPORTS METHEMOGLOBINEMIA New York City Five infants in a newborn nursery developed methe- moglobinemia due to exposure to aniline dye. On October 13, a resident physician in a New York City hospital noticed that 2 infants in the newborn nursery had become cyanotic in appearance. Additional cases were searched for, andatotalof 5 infants were discovered to be cyanotic. A blood sample was taken from one of the affected infants which contained 67 percent methemoglobin. Following this, all of the cyanotic infants were treated with concentrated oxygen and intravenous methylene blue. It was observed that the diapers the cyanoric infants were wearing had been freshly labeled and a definite phenolic odor was noted. These diapers had been clearly labeled with heavy ink stain across the entire surface. Because of an urgent need for diapers, and contrary to regulation, these diapers had been autoclaved rather than boiled prior to use. The dye contained 30 percent aniline. The situation was remedied by boiling all of the diapers and no further cases occurred. (Reported by the Poison Control Center, Chemical Lab- oratory and Bureau of Preventable Diseases, Department of Health, New York City Editor's Note: There have been several previous out- breaks of methemoglobinemia in newborn infants due to cutaneous absorption of aniline dye in freshly stamped diapers. The first reported outbreak dates back to 1886, in London, England.* Rayner, W.: Cyanosis in Newly Born Children Caused by Aniline Marking Ink, Brit. Med. Journal 1:294, 1886. (Continued to page 436) BRUCELLOSIS SURVEILLANCE ANNUAL SUMMARY In 1963, as in each year since 1947, the number of reported human cases of brucellosis declined. During 1963, there were 407 humans, 4,364 swine, and 130, 450 cattle reported infected with brucellosis. The figure opposite depicts the remarkable decrease in reported human cases since 1947 when over 6,000 were recorded as compared to 1963 when only 407 cases were reported. A major reason for the decline in human cases of brucellosis has been a joint Federal-State bovine brucellosis eradication program initiated in 1934. With the decline of bovine infections, there has been a relative increase in the importance of swine as a source of human brucellosis. Geographic Distribution Brucellosis continues to be found in most parts of the country with 33 States reporting cases last year. As in previous years, the largest number of human cases was reported from the North CentralStates and California. Iowa reported 155 cases, the greatest number of human cases of any State in 1963. 430 Morbidity and Mortality Weekly Report REPORTED HUMAN BRUCELLOSIS ,or UNITED STATES, 1947-1963 .000o 4 e47 41 ? ? 00 St bh f 54 5s 56 7s o' bO SSoe3 o4s3s YEAR Epidemiologic Summaries Brucellosis surveillance reports for 257 of the 407 reported cases of human brucellosis were submitted by the States during 1963. Analysis of these shows that 122 cases occurred in packing-house workers, representing nearly 50 percent of the case histories containing oc- cupational information. Farm workers accounted for 44 additional cases (17 percent). There were 12 veterinarians (5 percent) among the group reported infected. Contact with infected swine accounted for the largest proportion of cases; 106 followed contact with swine alone, 38 with cattle alone and 38 with swine and cattle. Fifteen were attributed to raw milk ingestion, and 8 were due to accidental injuction of strain 19 brucellosis vaccine. (Surveillance Summary provided by the Veterinary Public Health Section, CDC.) HUMAN BRUCELLOSIS CASES 1963 BY OCCUPATION AND PROBABLE SOURCE OF INFECTION PROBABLE SOURCE OF INFECTION Cattle Sheep Other Cattle Sheep Packing- Raw Accidental Other Occupation Swine Cattle and or h e k Inoculation and Total house Milk Inoculation Swine Goat Not Stated Packing-house worker ................ .. 83 10 14 15 122 Rendering plant workers ............... 2 2 Stockyard worker ........ ....... ..... 1 1 2 Farm worker Livestock Farmers ....... ......... 17 17 8 1 1 44 Dairy Farmers ........................ 4 4 Farmers Unspecified .. .. .. .. 8 8 Housewives and Children ............ 5 1 4 10 11 31 Professional Veterinarians .................... 2 3 7 12 Other ......................... 1 1 1 3 Other Occupations Meat Associated .................. 3 4 7 Miscellaneous ................... 1 2 10 13 Not Stated ........................ 3 6 9 Total ........................... 106 38 38 1 15 15 9 35 257 Source: Epidemiologic Case Histories submitted to the Communicable Disease Center by various State Health Departments. 431 HUMAN BRUCELLOSIS-US 1963 r I -. I-- -) \ , J .. % i) -. ,. ='.=, ^% .~ 432 Morbidity and Mortality Weekly Report Table 3. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES FOR WEEKS ENDED DECEMBER 5, 1964 AND DECEMBER 7, 1963 (49TH WEEK) Aseptic Encephalitis Aseptic Meningitis Primary Post-Inf. Poliomyelitis, Total Cases Poliomyelitis, Paralytic Area Cumulative Cumulative 1964 1963 1964 1964 1964 1963 1964 1963 1964 1963 1964 1963 UNITED STATES... 38 35 30 11 1 6 114 423 4 88 362 NEW ENGLAND.......... 2 1 1 2 9 2 9 Maine............... 3 3 New Hampshire...... - Vermont............ 1 1 Massachusetts...... 1 3 3 Rhode Island..... 1 - Connecticut........ 2 2 2 2 MIDDLE ATLANTIC...... 1 2 13 2 2 15 122 1 13 98 New York City...... 1 6 1 2 1 2 - New York, Up-State. 1 1 1 1 10 10 1 9 7 New Jersey......... 1 3 3 .4 2 3 Pennsylvania....... 3 1 107 88 EAST NORTH CENTRAL... 4 1 5 1 24 58 16 47 Ohio............... 1 3 4 8 2 4 Indiana............ 1 9 4 6 3 Illinois........... 2 1 5 17 5 16 Michigan........... 1 3 20 2 20 Wisconsin.......... 1 1 3 9 1 4 WEST NORTH CENTRAL... 3 3 10 7 8 6 Minnesota.......... 3 1 3 4 2 4 Iowa............... 1 - Missouri........... 4 3 - North Dakota....... 1 1 1 - South Dakota ..... 1 1 Nebraska........... 1 1 1 Kansas............. 1 1 - SOUTH ATLANTIC....... 9 2 1 2 35 99 1 28 85 Delaware........... 1 I Maryland........... 1 1 1 1 Dist. of Columbia.. 1 - Virginia........... 2 4 21 4 16 West Virginia...... 1 3 1 3 North Carolina ..... 12 5 7 4 South Carolina..... 2 3 8 3 7 Georgia............ 3 21 3 20 Florida............ 7 1 2 11 38 1 9 33 EAST SOUTH CENTRAL... 5 2 1 6 73 5 67 Kentucky ........... - Tennessee.......... 1 -3 11 2 10 Alabama............ 3 2 2 53 2 48 Mississippi........ 1 1 9 1 9 WEST SOUTH CENTRAL... 4 3 1 1 10 27 1 8 26 Arkansas........... 1 4 3 Louisiana........... 14 14 Oklahoma ........... 3 1 2 1 Texas.............. 4 2 1 7 8 1 6 8 MOUNTAIN............. 1 3 9 6 5 5 Montana............. 1 1 - Idaho.............. 1 1 1I Wyoming............ 2 2 Colorado ........... I I 1 1 New Mexico......... 4 1 Arizona ............ 2 3 3 Utah ............... 1 - Nevada............. . PACIFIC.............. 19 17 1 7 1 3 22 1 3 19 Washington......... 2 1 2 2 Oregon ............. 1 2 1 1 California......... 16 15 1 7 1 2 18 1 2 16 Alaska............. . Hawaii............. 1 1 - Puerto Rico 5 4 Morbidity and Mortality Weekly Report 433 Table 3. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES FOR WEEKS ENDED DECEMBER 5, 1964 AND DECEMBER 7, 1963 (49TH WEEK) CONTINUED Infectious Hepatitis Brucellosis Diphtheria including Serum Hepatitis Typhoid Fever Area Under 20 years Age Cum. Cum. Total 20 years and over Unknown Cumulative Cum. 1964 1964 1964 1964 1964 1964 1964 1964 1964 1963 1964 1964 UNITED STATES... 8 380 26 275 696 320 314 62 35,643 40,528 4 419 NEW ENGLAND.......... 2 44 42 18 20 4 3,182 4,641 17 Maine............... 39 11 6 3 2 984 2,112 New Hampshire...... 6 2 2 2 252 565 Vermont............. 4 1 3 370 128 - Massachusetts...... 2 5 9 3 6 732 1,153 8 Rhode Island....... 8 4 4 210 109 6 Connecticut........ 4 2 2 634 574 3 MIDDLE ATLANTIC...... 8 10 135 50 85 7,780 8,052 68 New York City...... 5 35 8 27 1,236 1,267 34 New York, Up-State. 4 53 22 31 3,370 3,476 15 New Jersey......... 2 24 8 16 1,279 1,181 2 Pennsylvania....... 4 3 23 12 11 1,895 2,128 17 EAST NORTH CENTRAL... 1 50 1 11 139 76 53 10 5,727 6,489 1 82 Ohio............... 5 34 22 11 1 1,508 1,777 21 Indiana............ 1 1 14 10 4 477 596 22 Illinois........... 1 29 1 9 32 15 17 1,089 1,341 23 Michigan........... 6 1 49 28 21 2,257 2,482 11 Wisconsin........... 9 10 1 9 396 293 1 5 WEST NORTH CENTRAL.. 6 164 36 23 14 7 2 1,953 1,798 1 31 Minnesota.......... 9 18 3 1 2 221 278 3 Iowa............... 4 103 4 1 1 2 345 320 4 Missouri........... 10 1 5 4 1 487 597 1 14 North Dakota ...... 2 2 63 98 2 South Dakota....... 1 21 3 134 137 1 Nebraska........... 13 5 69 123 3 Kansas............. 1 6 7 11 8 3 634 245 4 SOUTH ATLANTIC....... 39 11 76 45 22 19 4 3,297 4,078 1 95 Delaware........... 1 1 74 76 - Maryland........... 1 12 4 8 600 512 8 Dist. of Columbia.. 1 1 69 108 - Virginia........... 17 8 5 1 2 525 807 11 West Virginia..... 7 5 2 467 624 - North Carolina..... 4 1 6 3 3 536 1,039 20 South Carolina..... 7 4 3 1 151 164 12 Georgia............ 14 2 32 106 168 27 Florida............ 4 9 35 6 2 3 1 769 580 1 17 EAST SOUTH CNTRAL.. 18 30 46 29 17 2,418 3,678 1 43 Kentucky........... 6 14 12 2 847 1,101 10 Tennessee......... 5 2 18 11 7 860 1,405 19 Alabama ........... 4 23 12 5 7 474 590 1 8 Mississippi........ 3 5 2 11 237 582 6 WEST SOUTH CENTRAL... 1 46 1 39 78 45 30 3 2,804 2,761 35 Arkansas........... 6 3 13 5 8 286 299 15 Louisiana .......... 4 12 13 6 4 3 667 565 6 Oklahoma.......... 1 9 1 1 1 1 132 122 9 Texas.............. 27 23 51 33 18 1,719 1,775 5 MOUNTAIN............. 30 2 65 19 7 39 2,179 2,565 12 Montana............ 5 3 2 185 328 - Idaho.............. 8 8 307 432 - Wyoming............ 5 1 1 3 91 42 1 Colorado........... 19 2 1 16 573 518 - New Mexico........ 1 1 12 10 2 312 316 4 Arizona............ 2 1 10 10 475 585 7 Utah................ 26 6 3 3 185 326 - Nevada............. 1 51 18 - PACIFPC............. 23 13 27 123 47 76 6,303 6,466 36 Washington........ 13 20 10 10 640 1,070 2 Oregon............. 2 3 3 640 756 - California ........ 21 13 14 97 34 63 4,629 4,396 34 Alaska............. 3 3 278 201 - Hawaii.............. -. 116 43 Puerto Rico 13 1 1 932 842 13 434 Morbidity and Mortality Weekly Report Table 3. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES FOR WEEKS ENDED DECEMBER 5, 1964 AND DECEMBER 7, 1963 (49TH WEEK) CONTINUED Streptococcal Meningococcal Sore Throat and Rabies in Measles Meningitis Scarlet Fever Tetanus Tularemia Animals Area Cumulative Cum. Cum. Cum. 1964 1964 1964 1963 1964 1963 1964 1964 1964 1964 1964 1964 UNITED STATES... 2,712 60 2,556 2,208 7,732 7,648 7 261 5 309 73 4,233 NEW ENGLAND.......... 750 7 89 130 871 749 9 1 2 35 Maine.............. 103 1 7 19 217 64 28 New Hampshire...... 90 2 4 4 1 2 Vermont............. 4 6 36 25 2 4 Massachusetts...... 340 6 37 58 67 73 9 1 1 Rhode Island....... 90 11 12 51 60 - Connecticut........ 127 28 31 496 526 - MIDDLE ATLANTIC ..... 93 8 337 311 349 453 22 1 117 New York City...... 21 1 46 48 17 19 - New York, Up-State. 26 2 102 99 247 291 8 109 New Jersey......... 20 2 106 48 40 74 6 - Pennsylvania....... 26 3 83 116 45 69 8 1 8 EAST NORTH CENTRAL... 355 5 346 341 742 770 2 51 24 5 578 Ohio............... 68 2 91 98 77 105 14 2 290 Indiana............. 56 54 45 207 108 1 15 2 1 30 Illinois........... 12 92 70 6 128 1 14 14 3 114 Michigan........... 153 2 77 95 294 256 7 2 57 Wisconsin .......... 66 1 32 33 158 173 1 4 1 87 WEST NORTH CENTRAL... 128 2 145 134 247 356 17 59 18 1,271 Minnesota.......... 1 32 28 10 11 4 2 8 405 Iowa............... 30 9 7 58 54 6 1 5 450 Missouri........... 8 1 65 39 42 4 32 2 186 North Dakota........ 75 20 15 105 128 3 66 South Dakota........ 14 3 7 20 8 1 15 92 Nebraska........... 1 7 25 35 Kansas............. NN 9 13 54 113 2 9 37 SOUTH ATLANTIC....... 321 8 509 404 739 543 2 63 1 31 9 577 Delaware........... 7 4 9 - Maryland........... 5 3 41 57 90 24 1 4 3 Dist. of Columbia.. 1 1 17 8 6 5 1 - Virginia........... 51 2 63 86 255 200 1 8 7 8 309 West Virginia....... 245 35 21 271 248 I 36 North Carolina..... 12 87 77 7 19 15 7 5 South Carolina..... 57 23 30 45 5 2 Georgia............ 1 1 82 34 44 2 4 1 15 119 Florida............ 6 1 120 94 27 25 1 1 103 EAST SOUTH CENTRAL... 196 3 192 151 886 1,360 2 35 2 32 27 604 Kentucky........... 70 1 63 33 76 78 8 2 4 2 62 Tennessee........... 89 2 60 70 665 1,245 2 14 20 25 459 Alabama............ 33 43 25 95 15 8 3 20 Mississippi........ 4 26 23 50 22 5 5 63 WEST SOUTH CENTRAL... 205 8 237 202 809 747 29 106 10 605 Arkansas........... 2 33 14 2 1 8 65 2 145 Louisiana.......... 129 81 1 7 4 6 7 73 Oklahoma............ 14 1 15 35 55 23 1 20 94 Texas.............. 191 5 60 72 751 716 16 15 1 293 MOUNTAIN ............. 379 5 96 78 1,368 1,658 6 2 52 141 Montana............ 172 1 3 53 77 19 1 Idaho.............. 39 4 6 118 89 1 - Wyoming............ 9 5 7 51 257 2 10 - Colorado........... 27 1 22 21 387 592 8 New Mexico......... 58 4 39 4 326 417 1 52 Arizona............ 4 8 12 194 121 1 66 Utah............... 57 7 20 239 105 1 2 23 3 Nevada............. 13 10 5 11 PACIFIC .............. 285 14 605 457 1,721 1,012 1 29 3 2 305 Washington......... 90 48 40 650 267 3 - Oregon............. 33 25 33 24 30 1 I 11 California ......... 107 14 512 357 981 617 1 23 2 2 294 Alaska............. 7 13 9 63 " Hawaii ............. 55 13 14 57 35 2 - Puerto Rico 67 1 33 10 8 5 64 1 26 Morbidity and Mortality Weekly Report Table 4 (A). TOTAL DEATHS IN REPORTING CITIES 435 (Tables 4(A), 4(B), 4(C), and 4(D) will be published in sequence covering a four-week period.)o For weeks ending For weeks ending Area ___________Area _______ 11/14 11/21 11/28 12/5 11/14 11/21 11/28 12/5 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. ........... 245 27 21 22 50 39 20 20 55 71 16 61 28 61 63 38 140 40 31 39 77 82 1,664 41 404 189 52 104 27 51 70 50 24 33 74 39 735 135 224 129 85 390 33 43 43 24 58 142 41 138 25 33 38 104 69 41 22 24 158 29 105 60 227 52 45 222 39 34 27 51 16 17 18 39 56 13 41 25 49 41 28 139 46 34 36 72 119 1,706 45 506 214 58 94 17 32 50 60 37 30 73 35 767 175 177 123 65 353 29 42 36 28 59 162 22 116 24 35 45 98 56 57 22 32 124 36 111 76 256 67 50 176 38 29 17 42 35 26 16 38 66 13 55 34 58 34 26 117 30 22 42 59 67 1,608 35 594 113 55 113 18 28 53 20 22 31 59 33 719 142 186 108 75 352 38 33 41 35 56 160 55 117 31 34 30 95 64 35 19 28 133 20 108 47 189 49 32 287* 50 38 39 67 21 20 24 67 83 11 41 36 60 47 31 183 50 44 50 77 131 1,782 44 527 256 40 125 36 45 65 45 23 45 57 29 799 171 218* 144 60 354 41 42 57 33 60 175 37 152 39 30* 46 108 71 78 20 28 124 28 146 94 294 74 62 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. ............. 24 21 51 46 16 60 53 56 69 76 479 572 92 92 24 48 79 127 62 62 87 100 171 212 26 30 118 137 46 51 29 33 oCurrent Week Mortality for 108 Selected Cities 4(A) Total Mortality, all ages.................... 12,946 4(B) Pneumonia-Influenza Deaths, all ages........ 488 4(C) Total Deaths under I Year of Age............ 778 4(D) Total Deaths, Persons 65 years and over..... 7,148 NOTF: All deaths by place of occurrence. -_ I 1------_L *Estimate based on average percent of divisional total. Totals for previous weeks include reported corrections. UNIVERSITY OF FLORIDA Il1 l III 0 4 2811111111111111 3 1262 08864 2698 Morbidity and Mortality Weekly Report TOTAL DEATHS REPORTED IN 108 CITIES The weekly average number of total deaths in 108 cities for the four-week period ending December 5 was 11,589 as compared with an expected weekly average of 12,068. TOTAL DEATHS RECORDED IN lOB U.S. CITIES Awarog M umbI r r W"m by Four WhL Prolp. 'jLl, r 44 AAsUERM 0' DF~arF Week Ending 4-Week Weekly 11.'14 11-'21 11,28 12.,'5 Total Average Observed 11,079 11,914 10,416 12,946 46,355 11,589 Expected 11,881 12,014 12,135 12,243 48,273 12,068 Excess -802 -100 -1.719 703 -1.918 -479 ,,.oco ----- ---- --- ^ --- ,ron f ' IN Df '- " = ; --I -lllllll ll-llII -1 1 IIII1,I, ;;; F;Il l I r II I I I I N Ililillilll::; *Y OCCmEuC ,.. ' EPIDEMIOLOGIC NOTES (Continued from page 430) ANTHRAX Idaho This week a case of anthrax was reported from Idaho in a 48-year-old male butcher who developed a cutaneous lesion on a finger from which Bacillus anthracis was cul- tured. During the days preceding his illness, he had dressed a number of deer brought to him by local hunters. Investigations are in progress to trace the meat with which he had contact in an attempt to identify the source of infection. There have been no reported cases of anthrax among deer or other animals in Idaho during this or recent years. The last human case reported from this State was a suspect cutaneous lesion in a meat packing house employee in 1956. This is the fifth human case of anthrax reported this year. (Reported by Dr. John A. Mather, Director, Division of Preventive Medicine, Idaho Department of Health.) o 5' U S )EPOSITORV THE MORBIDITY AND MORTALITY WEEKLY REPORT, WITH A CIRCULA- TION OF 12.000 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. ASST. CHIEF, STATISTICS SECTION 1. L. SHERMAN, M.S. CHIEF. SURVEILLANCE SECTION D. A. HENDERSON, M.D. ASSISTANT EDITOR, MMWR PAUL D. STOLLEY. M.D. IN ADDITION TO THE ESTABLISHED PROCEDURES FOR REPORTING MORBIDITY AND MORTALITY, THE COMMUNICABLE DISEASE CENTER WELCOMES ACCOUNTS OF INTERESTING OUTBREAKS OR CASES, SUCH ACCOUNTS SHOULD BE ADDRESSED TO: THE EDITOR MORBIDITY AND MORTALITY WEEKLY REPORT COMMUNICABLE DISEASE CENTER ATLANTA, GEORGIA 30333 NOTES: THESE PROVISIONAL DATA ARE BASED ON WEEKLY TELE- GRAMS TO THE COMMUNICABLE DISEASE CENTER BY THE INDIVIDUAL STATE HEALTH DEPARTMENTS. SYMBOLS:---DATA NOT AVAILABLE QUANTITY ZERO PROCEDURES FOR CONSTRUCTION OF VARIOUS MORTALITY CURVES MAY BE OBTAINED FROM STATISTICS SECTION, COMMUNICABLE DISEASE CENTER. PUBLIC HEALTH SERVICE, U.S. DEPARTMENT OF HEALTH, EDUCATION. AND WELFARE, ATLANTA, GEORGIA 30333. 436 .N. ,arA 4, C ~lfl.A0 .s ....tUI 0 C c a * a |o -- z Sa m n 5 an5 I 2 -. r 0 o o3 "lb 0 -- '~- "-" I .:, I II. ,. I ..L. _ |
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