Morbidity and mortality

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


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/






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


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, 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.


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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


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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


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