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~ ~2 i/v Morbidity and Mortalit, U. S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE A PUBLIC HEALTH SERVICE Prepared by the For release October 16, 1964 COMMUNICABL DISEASE C R ATLANTA, GEORGIA 30333 PROVISIONAL INFORMATION ON SELECTED NOTIFIABLE DISEASES IN THE UNI DEATHS IN SELECTED CITIES FOR WEEK ENDED OCTOBER 10, 1964 EPIDEMIOLOGIC NOTES Meningococcol Infections There were 43 meningococcal infections reported during the 41st week, ending October 10, as compared to 29 for the 41st week in 1963. The cumulative number of reported infections during the first 41 weeks of 1964 is 2092, whereas 1871 were reported for the same period last year. Certain bases of the Armed Forces have been experiencing outbreaks of meningococcal meningitis among new recruits. One of these, Fort Ord, California, has reported 82 cases with 11 deaths among service personnel, and 7 cases with 1 death among dependents since January 1, 1964. The State of California reports 409 cases of meningococcal infections, including the Fort Ord cases, between January 1 and September 30, 1964. These cases have been scattered throughout the State. This is a slight increase over the number of cases reported for the same period last year. There has been some small increase noted in the percentage of sulfonamide-resistant strains in California. The majority of strains have been identified as group B, and the remaining strains were found to be group C. (Reported by Dr. Henry A. Renteln, Bureau of Com- municable Diseases, California State Department of Public Health.) Table 1. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES (Cumulative totals include revised and delayed reports through previous weeks) 41st Week Ended Cumulative. First 41 Weeks Disease October 10, October 12, Median Median 1964 1963 1959 1963 1964 1963 1959 1963 Aseptic meningitis ................ 68 59 --- 1,630 1,445 --- Brucellosis ...................... 8 9 9 335 295 481 Diphtheria ........................ 9 9 17 202 203 437 Encephalitis, primary infectious.. 134 23 --- 2,561 1,263 Encephalitis, post-infectious .... 4 --- 705 Hepatitis, infectious including serum hepatitis ................ 650 798 798 30,414 34,317 34,317 Measles ........................... 800 857 913 436,944 361,744 390,194 Meningococcal infections .......... 43 29 38 2,135 1,900 1,730 Poliomyelitis, Total ............ 2 24 35 93 347 1,027 Paralytic ...................... 2 20 26 75 296 661 Nonparalytic ................... 3 --- 11 35 -- Unspecified .................... 1 --- 7 16 --- Streptococcal Sore Throat and SCarlet fever .................. 5,153 4,610 --- 315,224 268,524 --- Tetanus ........................... 6 15 --- 220 219 --- Tularemia ......................... 2 4 --- 263 226 --- Typhoid fever ..................... 17 20 20 345 431 638 Rabies in Animals ................. 63 69 69 3,647 3,024 3,024 Table 2. NOTIFIABLE DISEASES OF LOW FREQUENCY Cum. Cum. Anthrax: 3 Psittacosis: Calif 1 36 Botulism: 11 Rabies in Man: 1 Leptospirosis: 36 Smallpox: Malaria: Penn 1 76 Typhus- Plague: Murine: Tex 1 22 R ky Mt. Spotted: d-1, Penn-1, Ala-1, Ga-2 211 Morbidity and Mortality Weekly Report ENCEPHALITIS SURVEILLANCE SUMMARY A total of 938 human cases of suspected arthropod- borne encephalitis have been reported to the Encephalitis Surveillance Unit thus far in 1964. Since final reporting of arthropod-borne encephalitis is on an annual basis, this represents a preliminary total based primarily on epidemic investigations. and several special reports. Since the establishment of the Encephalitis Surveillance Unit in 1955, the previous high total of arthropod-borne encephalitis for any one year was 625 cases, reported in 1956. Six discrete outbreaks of St. Louis Encephalitis and two mixed epidemics of Western Equine and St. Louis Encephalitis have occurred in the United States during 1964. The locations of the 1964 SLE epidemics as well as all States where SLE virus activity has been noted previously are shown on the map below. The current outbreak in New Jersey is of particular interest in that it represents the first time SLE activity has been noted in that State. Reports from States where outbreaks of encephalitis or arthropod-borne virus activity of unusual interest have been noted are summarized in this issue. 362 GEOGRAPHIC DISTRIBUTION OF SAINT LOUIS ENCEPHALITIS (TOTAL VIRUS ACTIVITY IN MAN AND ANIMALS REPORTED TO CDC SINCE 1955) History Of Virus Activity Within The Outbreaks 1964 363 Morbidity and Mortality Weekly Report STATE REPORTS New Jersey The New Jersey State Department of Health has reported the occurrence of 80 cases, including 6 deaths, of suspected encephalitis, which have occurred since early August. As shown in the epidemic curve below, a sharp increase in incidence occurred during early September reaching a peak during the weeks ended September 20 and 27 when 20 and 21 cases respectively occurred. All cases reside in either Camden or Burlington Counties, most in close proximity to the Delaware River. Of these, 51 have thus far shown serologic evidence of St. Louis Encephalitis infection. The age and sex distribution of the cases, presented in the following table, shows that the. majority of cases have occurred among females over the age of 40. (Reported by W. J. Dol.wr1.,, M. D., Director, Division of Preventive Diseases, New Jersey State Department of Health.) REPORTED ENCEPHALITIS CASES BY AGE AND SEX NEW JERSEY, 1964 AGE MALE FEMALE TOTAL 0-9 1 0 1 10.19 3 0 3 20-29 2 4 6 30-39 5 4 9 40-49 2 16 18 50-59 4 10 14 60-69 3 13 16 70.79 5 5 10 80-89 0 3 3 TOTAL 25 55 80 REPORTED CASES OF ENCEPHALITIS BURLINGTON AND CAMDEN COUNTIES, NEW JERSEY 1964 r- 8 15 22 29 5 12 19 26 3 8 15 22 29 5 12 19 26 3 10 WEEK OF ONSET OF ILLNESS I I Morbidity and Mortality Weekly Report Texas Hale County: Sixty-eight cases of suspected enceph- alitis have been reported thus far from Hale County, mid- June 1964. An additional 8 cases have occurred in immediately surrounding counties. More than 75 percent of the cases had onsets of illness between August 8 and September 5. In Hale County, the overall attack rate was 185 per 100,000, with higher attack rates noted in the younger age groups. Five deaths, all serologically con- firmed as WEE have occurred, all in children 2 years of age or less. WEE virus has been recovered from both brain and cerebrospinal fluid from one fatal case. There Harris County (Houston): Through October 10, 1964 a total of 711 suspected cases of encephalitis, including 33 deaths, have been reported from the Houston metropol- itan area. The epidemic appears to be essentially termi- nated with only 10 cases reported with onsets of illness since September 19. The age specific attack rates for the 227 cases with serologic evidence of recent SLE infection is shown in the table below. The lowest rate, 8.5, is found in the 0-9 year age group. There is a relatively uniform rate between the ages of 10 and 49 followed by a progressive rise with advancing age over 50. Thirty-one of the 33 deaths have occurred in individuals over 50 years have been 20 cases serologically confirmed as WEE and 4 confirmed SLE cases. Sera from 14 of the cases were negative for both SLE and WEE. Both the State Laboratory and the CDC Disease Ecology Section, Technology Branch, Greeley, Colorado have recovered WEE virus from mosquito pools of Cltez tarsalis collected in Hale County. (Reported by Dr. Van C. Tipton, Director, Communicable Disease Division, Texas State Department of Health and a team from the Communicable Disease Center.) of age. Serologic study has been performed on 547 cases thus far. Of these, 225 are classified as presumptive or confirmed SLE, 49 are negative and 273 are inconclusive, thus far. SLE virus has been recovered from 10 mosquito pools of Culex quinquefasciatus and from the blood of 2 wild birds (1 bluejay; 1 mockingbird). (Reported by Dr. Charles A. Pigford. Houston City-County Health Officer, and Dr. Van C. Tipton, Director, Com- municable Disease Division, Texas State Department of Health and a team from the Communicable Disease Center.) AGE SPECIFIC ATTACK RATES FOR CONFIRMED AND PRESUMPTIVE CASES OF ST. LOUIS ENCEPHALITIS Harris County, Texas, 1964 AGE CASES POPULATION (1000 s) RATE / 100,000 0-9 26 305 8.5 10-19 24 201 11.9 20-29 26 168 15.5 30-39 29 198 14.6 40-49 23 157 14.6 50-59 25 113 22.1 60-69 36 66 54.5 70-79 24 30 80.0 80+ 14 9 155.6 TOTAL 227 1244 18.2 364 Morbidity and Mortality Weekly Report Pennsylvania Two reported cases of encephalitis, one ser- ologically confirmed to be SLE have recently occurred in Bucks County. Both cases reside directly across the Delaware River from the epidemic area in New Jersey. (Reported by W. D. Schrack, Jr., M. D., Director, Division of Communicable Disease Control, Pennsylvania De- partment of Health.) Illinois Two outbreaks of St. Louis Encephalitis have been reported from southern Illinois. In addition, a single case of serologically confirmed Western Equine Encephalitis has occurred in central Illinois. 1) Eleven cases of confirmed SLE, including 2 deaths have been reported from McLeansboro. The dates of onset ranged from July 18 to September 3. Nine of the 11 cases occurred in persons over age 60. Dr. Robert Kokernot, Director of the Zoonoses Research Center of the University of Illinois reports that 31 of the first 50 pools of Culex pipiens studied to date have yielded SLE virus. SLE virus has also been recovered from the blood of 3 wild birds (2 sparrows; 1 catbird). 2) A total of 11 serologically confirmed cases of SLE including one death, have been reported from the Edwardsville-Alton area (northeast of St. Louis). The onset dates ranged between August 22 to September 24. 3) An isolated case of serologically confirmed WEE occurred in a 9 year old male from Urbana, Illinois who became ill on September 3. (Reported by Dr. Norman J. Rose, Chief, Bureau of Epi- demiology, Illinois Department of Public Health.) Florida Four serologically confirmed cases of Eastern Equine Encephalitis have been reported with onsets since June 1, 1964. The cases occurred in 4 widely scattered counties in the central and northern areas of the State. The ages of the cases were 5, 6, 17, and 38 years; 2 deaths occurred. The most recent case became ill on July 22. More than 80 cases of EEE in horses have been re- ported. The peak incidence occurred during June and July. Serologic or virologic confirmation has thus far been made in 15 cases. EEE virus has been recovered from pools of mosquitoes collected in 2 areas of the State where human cases occurred. (Reported by Dr. Charlton Prather, State Epidemiologist, Florida State Board of Health.) Colorado A total of 40 cases of suspected encephalitis including 2 deaths has been reported from Colorado. The onset dates range from July 20 through September 18. Though scattered cases have occurred in several areas of the State, small discrete outbreaks have occurred in Adams County (Suburban Denver), Lajunta and the Fort Collins area. Available data suggests no predilection for any age group. Confirmatory or presumptive serologic evidence of Western Equine Encephalitis has been obtained in 12 cases. Five cases show confirmatory or presumptive serologic evidence of St. Louis Encephalitis. Western Equine virus was isolated from 7 of 21 pools of Culex tarsalis mosquitoes collected in Weld County, Colorado between August 3 and September 2. A number of suspected cases among horses have occurred during 1964. Of fourteen paired horse sera studied thus far, 9 showed diagnostic titer rises to WEE. (Reported by Dr., C. S. Mollohan, Chief, Division of Epidemiology, Colorado State Department of Public Health and a team from the Communicable Disease Center Disease Ecology Section, Technology Branch, Greeley, Colorado.) Tennessee Four cases of suspected encephalitis, including one death, have been reported from Memphis. The dates of onset were between August 20 to September 21. All occurred among elderly Negroes living in one sector of the city. Thus far, one case has been serologically con- firmed as SLE. SLE virus has been recovered from 2 mosquito pools of Culex quiquefasriatus-pipiens collected in Memphis during the period September 8 through 11. (Reported by Dr. Cecil B. Tucker, Director, Division of Preventable Diseases, Tennessee Department of Public Health.) 365 Morbidity and Mortality Weekly Report Indiana A total of 19 cases of suspected encephalitis in- cluding 2 deaths have been reported from southern In- diana. Fourteen of the cases occurred in Vanderburgh County (Evansville) and 5 cases were from adjacent counties (Warrick, Gibson, and Posey). The onset dates of the cases ranged from August 21 through September 30. A peak occurred during the first half of September. Most of the cases (including both deaths) have occurred in persons above the age of 40. Thus far, 8 cases have been serologically confirmed as SLE. Further laboratory studies are in progress. (Reported by Dr. A. L. Marshall, Jr., Director, Division of Communicable Disease Control, Indiana State Board of Health.) Kentucky Thirty-two cases of suspected encephalitis, in- cluding one death, were reported in Boyle County (Dan- ville) during August and September. A peak incidence occurred in early September. The most recent case be- came ill on September 22. To date, sera from 13 cases show presumptive evidence of recent SLE infection. SLE virus has been recovered from one mosquito pool of Culex pipiens. An additional 10 cases of suspected encephalitis, including one with presumptive serologic evidence of SLE, have been reported from adjacent counties. (Reported by Dr. William McBeath, Director, Preventive Medicine and Epidemiology and Mr. Clifford Todd, Epidemiologist, Kentucky State Department of Health.) MEASLES Bonin Islands An epidemic of measles afflicted 117 of the 203 residents of one of the Bonin (Ogasawara) Islands in the Northern Pacific during June and July 1963. The index case was a 16-year-old girl who had returned from Guam, where she attended school, and where she had been ex- posed to measles. Within 14 days following the appearance of her rash, secondary cases occurred. No deaths were reported in the epidemic. The only complication occurred in a 16-year-old girl who exhibited bizarre behavior for the 2 weeks after her illness with measles. The distribution of cases according to age groups is shown in the following table. This was the first measles epidemic in at least 18 in this community. (Abstracted from report in U.S. Navy Medical News Letter, Vol. 43, No. 7, April 3, 1964 by Dr. D. A. Passick; and Captain Jack W. Millar, Director, Preventive Medicine Provision, Department of the Navy, Bureau of Medical & Surgery, Washington, D.C.) Total Age Pop. in No. Attack % Total Cumulative Group Age Group Cases Rate Cases % 0-4 5-9 10-14 15-19 20-24 25-29 30-49 50> 22 29 36 26 10 6 47 27 30 25 35 25 6 2 3 1 91 86 97 96 60 33 6 4 17 21 30 21 5 2 3 1 203 117 58% 100% 366 TOTAL 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 October 10 was 11,038 as compared with an expected weekly average of 11,020. TOTAL DEATHS RECORDED IN 10 U.S. CITIES A'.ror Num.b p. W..k by Fur-W, k Pfrtodf NUMSER ----- r OF DEATHS ,NFLLJCNLA Ag I ,JatENUCZA B l i2X. I CC Oh Jfk ,,a 0!,-.!.. Week Ending 4 Week Weekly 9/19 9/26 10/3 10/10 Total Average Observed 11,164 11,051 10,835 11,102 44,152 11,038 Expected 10,875 10,964 11,065 11,177 44,081 11,020 Excess 289 87 -230 -75 71 18 III1{n IIIMI 1111nI (See Table Page 371) INTERNATIONAL NOTES QUARANTINE MEASURES Immunization Information for International Travel 1963-64 Edition Public Health Service Publication No. 384 SECTION 5 Senegal, page 31, Insert: Under smallpox add "Six months of age and over." Spanish Guinea, page 34 Delete all information related to yellow fever. Tunisia, page 35 Under smallpox delete "and from Italy." ASIA Sabah, page 53, Insert the country and add the following: Smallpox vaccination is required for all arrivals from in- fected areas. Cholera vaccination is required for all arrivals from in- fected areas, 1 year of age and over. Yellow fever vaccination is required for all arrivals from infected areas by air, 1 year of age and over. Syria, page 54 Delete all information related to yellow fever. Union of Soviet Socialist Republics, page 55 and 62 Delete previous information under smallpox and insert: Smallpox vaccination is required for all arrivals except China (mainland), North Korea, Mongolian People's Repub- lic and countries in North America, Europe and Oceania. Under cholera delete previous information and insert: A certificate is required from arrivals from infected areas, 1 year of age and over. EUROPE Albania, page 56 Delete previous information under smallpox and insert: Smallpox vaccination is required for all arrivals except China (mainland), North Korea, Mongolian People's Re- public, North Vietnam, countries in Europe, North America and Oceania. This exemption is extended to travelers who have been resident for more than 14-days in these countries immediately before arrival in Albania. (Continued on page 372) / I III BUY ~PtAOYOF OCOJYC **COCU~A1EO RYWO ll0 BO E.flMENCE -- 367 l Imr-1 I y rr ,7 'I I I" 368 Morbidity and Mortality Weekly Report Table 3. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES FOR WEEKS ENDED OCTOBER 10, 1964 AND OCTOBER 12, 1963 (41ST WEEK) 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... 68 59 134 4 2 24 93 347 2 20 75 296 NEW ENGLAND........... 3 2 1 2 6 1 2 6 Maine.............. 2 2 New Hampshire...... . Vermont............. 1 1 Massachusetts...... 1 2 1 3 1 3 Rhode Island....... 2 - Connecticut........ 2 2 MIDDLE ATLANTIC...... 11 4 86 1 8 13 110 7 12 88 New York City...... 2 3 1 1 - New York, Up-State. 4 4 10 8 9 5 New Jersey......... 3 78 2 1 2 1 Pennsylvania....... 2 5 1 8 101 7 82 EAST NORTH CENTRAL... 11 8 13 1 1 18 53 1 13 43 Ohio................ 4 1 3 2 8 2 4 Indiana............. 1 4 6 4 3 3 Illinois........... 4 3 5 1 1 5 16 1 5 15 Michigan........... 1 4 3 19 2 19 Wisconsin.......... 1 2 6 1 2 WEST NORTH CENTRAL... 9 3 9 9 6 7 5 Minnesota.......... 1 3 3 4 2 4 Iowa .............- 3 - Missouri......... 2 4 3 North Dakota..... 1 1 1 South Dakota....... - Nebraska............ 1 1 - Kansas ............. 8 3 1 SOUTH ATLANTIC....... 3 1 7 1 13 25 59 1 10 20 51 Delaware.............- 1 - Maryland............ 1 1 1 1 1 Dist. of Columbia.. 1 1 1 - Virginia........... 1 7 15 5 10 West Virginia...... 1 2 1 3 1 3 North Carolina..... 10 3 -6 3 South Carolina..... 3 6 1 -3 5 Georgia............. 2 1 19 2 1 18 Florida............ 1 4 2 9 10 2 8 10 EAST SOUTH CENTRAL... 3 8 1 6 65 1 5 60 Kentucky .......... 6 - Tennessee.......... 3 10 2 9 Alabama............ 2 1 1 2 48 1 2 44 Mississippi........ 1 1 7 -1 7 WEST SOUTH CENTRAL... 6 3 1 -- 9 23 8 22 Arkansas........... 1 4 3 Louisiana.......... 1 13 13 Oklahoma............ 2 2 2 Texas.............. 3 3 7 6 6 6 MOUNTAIN............. 8 11 1 8 5 1 5 4 Montana............. 1 1 Idaho.............. 1 1 1 1 1 1 Wyoming............ 1 2 2 Colorado............ 6 9 1 1 1 1 New Mexico......... 3 1 - Arizona............... 1 2 2 Utah................ 2 - Nevada............. -. PACIFIC.............. 22 22 7 2 3 20 3 17 Washington......... 1 2 2 2 Oregon................. 1 2 1 1 California.......... 21 20 7 2 2 16 2 14 Alaska............... . Hawaii............... . Puerto Rico 5 4 Morbidity and Mortality Weekly Report 369 Table 3. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES FOR WEEKS ENDED OCTOBER 10, 1964 AND OCTOBER 12, 1963 (41ST 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... 8 335 9 202 650 348 256 46 30,414 34,317 17 345 NEW ENGLAND.......... 2 44 55 27 24 4 2,789 3,774 14 Maine.............. 39 13 10 3 881 1,698 - New Hampshire...... 5 2 3 217 416 - Vermont ........... 4 1 3 346 82 - Massachusetts...... 2 5 23 9 13 1 622 1,016 6 Rhode Island.........- 153 89 6 Connecticut........ 10 5 5 570 473 2 MIDDLE ATLANTIC..... 5 1 8 139 71 68 6,741 6,819 2 57 New York City..... 1 4 18 6 12 1,029 1,060 2 29 New York, Up-State. 2 64 38 26 2,936 2,940 10 New Jersey......... 2 23 9 14 1,151 1,014 1 Pennsylvania...... 3 2 34 18 16 1,625 1,805 17 EAST NORTH CENTRAL... 3 48 8 119 69 46 4 4,785 5,517 4 77 Ohio............... 2 5 25 11 11 3 1,259 1,529 19 Indiana............ .- 1 1 4 1 3 412 501 2 23 Illinois................ 1 27 6 41 29 11 1 900 1,167 1 22 Michigan.......... 6 1 37 22 15 1,870 2,075 1 10 Wisconsin.......... 9 12 6 6 344 245 3 WEST NORTH CENTRAL... 3 140 27 30 14 15 1 1,628 1,519 27 Minnesota.......... .- 9 11 5 3 2 188 233 3 Iowa............... 2 87 3 1 2 249 271 4 Missouri........... 10 1 7 3 4 401 534 10 North Dakota....... 2 2 1 1 59 67 2 South Dakota....... 16 2 3 3 129 108 1 Nebraska............ 13 4 3 1 1 1 45 101 3 Kansas............. 1 3 7 8 5 3 557 205 4 SOUTH ATLANTIC ....... 33 4 49 65 35 30 2,869 3,492 2 68 Delaware........... 7 2 5 62 67 - Maryland............ .- 9 4 5 533 432 6 Dist. of Columbia.. 6 5 1 57 98 - Virginia........... 15 13 7 6 452 716 11 West Virginia....... 6 6 413 525 North Carolina..... 3 8 4 4 478 866 1 19 South Carolina..... 7 5 2 3 109 145 11 Georgia............ 12 4 25 1 1 86 151 5 Florida............ 3 17 10 4 6 679 492 1 16 EAST SOUTH CENTRAL.. 17 4 19 24 17 7 2,084 3,227 31 Kentucky........... 6 2 2 749 919 8 Tennessee.......... 5 2 16 9 7 735 1,253 15 Alabama............. 4 4 12 2 2 390 514 6 Mississippi....... 2 5 4 4 210 541 2 WEST SOUTH CENTRAL.. 2 39 30 46 25 19 2 2,378 2,420 4 29 Arkansas........... 6 5 3 2 225 273 13 Louisiana........... 4 8 8 2 6 581 488 1 5 Oklahoma........... 7 7 7 117 111 3 7 Texas.............. 2 22 22 26 13 11 2 1,455 1,548 4 MOUNTAIN ............ 30 3 48 13 3 32 1,833 2,201 1 10 Montana............ 5 2 2 1 163 287 - Idaho.............. 7 7 259 359 - Wyoming............ 1 1 58 27 1 Colorado............ 14 3 1 10 490 457 - New Mexico......... 1 1 6 6 256 259 2 Arizona............ 2 2 14 14 409 507 1 7 Utah............... 26 1 1 147 288 - Nevada............. 1 51 17 - PACIFIC.............. 21 14 124 77 44 3 5,307 5,348 4 32 Washington ........ 13 7 1 6 545 928 2 Oregon............. 2 7 4 3 560 654 - California......... 19 1 93 61 32 3,900 3,586 4 30 Alaska............. 17 11 3 3 198 142 - Hawaii............. 104 38 - Puerto Rico 1 11 16 11 5 787 693 1 12 370 Morbidity and Mortality Weekly Report Table 3. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES FOR WEEKS ENDED OCTOBER 10, 1964 AND OCTOBER 12, 1963 (41ST 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... 800 43 2,135 1,900 5,153 4,610 6 220 2 263 63 3,647 NEW ENGLAND........... 105 3 64 117 338 248 9 1 1 33 Maine.............. 7 1 6 17 22 13 1 28 New Hampshire...... 1 1 4 2 Vermont............ 3 4 4 12 1 2 Massachusetts...... 28 24 54 42 44 9 1 1 Rhode Island....... 28 10 11 19 14 - Connecticut........ 38 2 19 27 243 176 - MIDDLE ATLANTIC...... 59 7 279 255 204 153 19 2 108 New York City...... 14 1 37 39 7 8 - New York, Up-State. 25 4 79 82 155 85 7 2 102 New Jersey......... 9 93 36 20 30 6 - Pennsylvania....... 11 2 70 98 22 30 6 6 EAST NORTH CENTRAL... 169 5 299 294 431 341 3 42 20 5 520 Ohio............... 18 75 79 43 42 1 12 1 2 267 Indiana............. 35 2 49 41 71 69 1 10 2 22 Illinois........... 8 2 77 58 63 49 12 13 97 Michigan............. 68 1 68 87 153 136 1 7 1 52 Wisconsin.......... 40 30 29 101 45 1 3 3 82 WEST NORTH CENTRAL... 15 1 129 119 183 163 1 12 52 13 1,118 Minnesota.......... 1 29 23 4 16 1 2 3 341 Iowa............... 5 7 7 71 35 5 1 7 404 Missouri........... 3 57 34 32 12 1 4 26 171 North Dakota....... 3 1 19 13 43 25 55 South Dakota....... 3 3 6 17 12 1 15 1 81 Nebraska........... 6 25 34 Kansas............. NN 8 11 16 63 1 8 2 32 SOUTH ATLANTIC........ 85 7 429 351 528 567 54 1 26 9 502 Delaware........... 6 4 10 4 - Maryland........... 2 1 32 50 84 12 3 1 Dist. of Columbia.. 13 6 5 1 1 1 - Virginia........... 2 1 51 78 69 143 7 6 4 262 West Virginia...... 71 33 19 196 247 1 2 32 North Carolina..... 3 1 73 63 8 15 13 1 7 5 South Carolina..... 5 2 52 18 35 35 4 2 Georgia........... 1 63 28 21 3 4 11 1 109 Florida............. 2 1 106 85 100 107 21 1 2 91 EAST SOUTH CENTRAL.. 71 3 175 137 954 954 29 30 17 477 Kentucky........... 4 56 30 17 117 8 2 55 Tennessee.......... 63 1 56 62 932 785 11 20 8 348 Alabama............ 4 2 39 23 1 19 6 3 17 Mississippi........ 24 22 4 33 4 5 9 57 WEST SOUTH CENTRAL... 43 7 195 172 476 516 25 1 88 10 506 Arkansas........... 23 11 1 6 7 1 52 4 126 Louisiana.......... 2 3 122 70 1 2 4 5 2 48 Oklahoma........... 10 31 31 10 19 1 84 Texas.............. 41 4 40 60 443 498 14 12 3 248 MOUNTAIN............. 104 73 63 1,131 811 1 6 43 1 125 Montana............ 38 3 59 57 18 1 Idaho.............. 5 3 6 106 84 1 1 - Wyoming............ 5 4 25 32 2 8 - Colorado........... 20 12 19 574 266 8 New Mexico......... 15 29 4 61 159 1 48 Arizona............ 11 7 10 119 85 1 1 55 Utah............... 15 7 14 187 128 1 17 2 Nevada............. 10 3 11 PACIFIC.............. 149 10 492 392 908 857 1 24 3 5 258 Washington.......... 48 2 35 31 179 247 2 - Oregon............. 18 21 28 8 11 1 10 California......... 61 8 417 312 536 369 1 21 2 5 248 Alaska ............ 5 7 12 21 58 - Hawaii............. 17 12 9 164 172 1 - Puerto Rico 90 30 7 10 6 59 24 Morbidity and Mortality Weekly Report Table 4 (A). TOTAL DEATHS IN REPORTING ( ITIEs (Tables 4(A), 4(B), 4(C), and 4(D) will be published in sequence covering a four-week period.)o 371 Area For weeks ending Area For weeks ending Area 9 /26 10/3 10/10 Area 10/3 10/10 9/19 9/26 10/3 10/10 __9/19 9/26 10/3 10/0 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. ........... 241 31 24 15 57 16 18 26 49 64 13 29 27 59 44 24 141 47 24 37 57 96 1,502 35 403 217 32 96 25 28 71 44 23 38 66 30 682 178 197 106 62 366 35 33 33 20 47 172 26 121 27 39 40 108 70 75 13 34 126 30 114 70 196 60 62 195 40 30 24 52 17 17 24 42 64 9 44 30 56 35 28 140 34 32 26 61 96 1,587 34 497 191 44 111 22 25 53 35 19 22 58 40 700 176 204 114 94 332 45 43 41 40 39 135 36 110 32 20 41 97 56 51 34 38 148 28 118 60 222 72 57 258 33 23 18 34 22 18 20 52 67 16 61 23 58 54 30 132 37 22 42 75 69 1,471 39 435 175 50 89 20 28 52 51 36 29 52 25 688 152 206 99 78 359 43 48 39 14 48 144 13 123 20 22 31 96 47 70 13 41 108 39 113 54 221 87 36 274 44 27 27 66 24 21 26 49 59 8 43 21 57* 30 34 143* 48 37 35 59 115 1,723 41 487 185 50 109 28 38 66 34 33 33 78 30 718 149 190 116 81 353 38 50 31 31 54 145 37 116 26 24 22 97 48 53 22 43 151 21 108 69 235 57 39 SOUTH ATLANTIC: Atlanta, Ga. .............. 164 108 126 103 Baltimore, M. ............ 238 249 243 218 Charlotte, N.C. ........... 26 33 52 38 Jacksonville, Fla. ........ 50 66 58 67 Miami, Fla. ............... 100 73 54 64 Norfolk, Va. .............. 59 37 53 49 Richmond, Va. ............. 78 78 71 88 Savannah, Ga. ............. 41 38 26 26 St. Petersburg, Fla. ...... 70 65 59 70 Tampa, Fla. ............... 65 45 79 58 Washington, D.C. .......... 233 197 155 180 Wilmington, Del. .......... 41 50 38 48 EAST SOUTH CENTRAL: Birmingham, Ala. .......... 116 93 74 94 Chattanooga, Tenn. ........ 61 30 36 30 Knoxville, Tenn. .......... 46 28 32 19 Louisville, Ky. ........... 133 137 112 80 Memphis, Tenn. ............. 161 133 128 113 Mobile, Ala. .............. 38 39 56 43 Montgomery, Ala. ........... 38 20 39 29 Nashville, Tenn. .......... 115 95 104 104 WEST SOUTH CENTRAL: Austin, Tex. .............. 36 43 25 23 Baton Rouge, La. .......... 34 15 30 28 Corpus Christi, Tex. ...... 22 43 22 24 Dallas, Tex. .............. 138 118 128 121 El Paso, Tex .............. 34 39 25 31 Fort Worth, Tex. .......... 53 74 75 77 Houston, Tex. ............. 199 196 192 202 Little Rock, Ark. ......... 59 74 59 60 New Orleans, La. .......... 183 157 170 188 Oklahoma City, Okla. ...... 81 85 63 84 San Antonio, Tex. ......... 107 102 111 89 Shreveport, La. ............ 33 51 46 51 Tulsa, Okla. ............... 50 44 66 30 MOUNTAIN: Albuquerque, N. Mex. ...... 29 28 32 33 Colorado Springs, Colo. ... 28 19 30 19 Denver, Colo. ............. 115 114 115 111 Ogden, Utah........... ...... 15 20 9 12 Phoenix, Ariz. ............ 76 84 78 86 Pueblo, Colo. .............. 7 15 13 14 Salt Lake City, Utah....... 51 58 45 50 Tucson, Ariz. ............. 43 57 44 46 PACIFIC: Berkeley, Calif. .......... 24 18 22 15 Fresno, Calif. ............ 56 47 47 53 Glendale, Calif. .......... 48 33 32 37 Honolulu, Hawaii............ 30 31 30 34 Long Beach, Calif. ........ 48 57 56 61 Los Angeles, Calif. ....... 559 484 521 463 Oakland, Calif. ........... 37 108 129 32 Pasadena, Calif. .......... 34 23 29 37 Portland, Oreg. ........... 99 116 100 90 Sacramento, Calif. ........ 67 70 63 69 San Diego, Calif. ......... 74 97 91 98 San Francisco, Calif. ..... 225 196 190 181 San Jose, Calif. .......... 40 40 45 41 Seattle, Wash. ............ 118 104 145 | 153 Spokane, Wash. ............. 45 62 44 i 53 Tacoma, Wash. ............. 37 39 43 42 OCurrent Week Mortality for 108 Selected Cities 4(A) Total Mortality, all ages................... 4(B) Pneumonia-Influenza Deaths, all ages........ 4(C) Total Deaths under 1 Year of Age............. 4(D) Total Deaths, Persons 65 years and over..... 11,102 419 708 6,123 NOTF: All deaths by place of occurrence. *Estimate based on average percent of divisional total. Totals for previous weeks include reported corrections. UNIVERSITY OF FLORIDA 1111111111 08864ill IU I2 81111111111111 II i111111 3 1262 08864 2888 Morbidity and Mortality Weekly Report INTERNATIONAL NOTES QUARANTINE MEASURES (Continued from page 367) Guernsey, Alderney, and Sark, page 58 Delete previous information under smallpox and cholera and insert: No certificate normally required. Liechtenstein, page 60 Smallpox vaccination is required for arrivals from in- fected areas and from all countries in Africa (except Algeria, Libya, Morocco, Tunisia, United Arab Republic,) in America (except Canada, the United States of America) and Asia (except Israel, Jordan, Lebanon, Syria, Turkey.) Luxembourg, page 60 Under smallpox add: "And from all countries in Africa, Asia and America (except Canada and the UnitedStates of America.) Netherlands, page 60 Under smallpox add: "And from all countries in Africa, Asia and America (except Canada and the United States of America.) Switzerland, page 62 Smallpox vaccination is required for arrivals from infected areas and from all countries in Africa (except Algeria, Libya, Morocco, Tunisia, United Arab Republic,) in America (except Canada, the United States of America) and Asia (except Israel, Jordan, Lebanon, Syria, Turkey.) Sc r C 3 i5 , W n : a a 0E D 3 'n an rN D L_^l^E^ o~r~- 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. SERE LING. PH.D. ASST. CHIEF, STATISTICS SECTION I. L. SHERMAN. M.S. CHIEF. SURVEILLANCE SECTION 0. A. HENDERSON, M.D. ASSISTANT EDITOR, MMWR PAUL D. STOLE 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. 372 O -n m Om0 m'f m o |
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