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Morbidity and Mortality m Wekl U. S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE PUBLIC HEALTH SERVICE Prepared by the r OMMUNICALEDS 633-3311 For release November 20, 1964 ATLANTA, GEORGIA 30333 Vol. 13, No. 46 PROVISIONAL INFORMATION ON SELECTED NOTIFIABLE DISEASES IN THE UNITED STATES AND ON DEATHS IN SELECTED CITIES FOR H II K ENDED NOVEMBER 14, 1964 EPIDEMIOLOGIC NOTES TETANUS A total of 5 cases of tetanus was reported for the week ended November 17. This brings to 249 the cumula- tive total for 1964; for the comparable period of 1963, 251 cases were reported. In 1963 there were 325 cases of tetanus reported in the United States. Although cases were reported from all areas of the country, the disease was more frequently reported in the southern States. Thirty-eight of the 1963 cases occurred in children under 1 year of age and 137 cases (42 percent) were in the age group, 50 years and over. The graph depicts reported tetanus in the United States during the years 1947-1963. Tetanus incidence has declined slowly despite extensive immunization, par- ticularly of children. Number of Coses 700 600 500 400 300 200 100 0 YEAR- 1947 49 '51 '53 Source: National Morbidity Reports 55 '57 Table 1. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES (Cumulative totals include revised and delayed reports through previous weeks) 46th Week Ended Cumulative. First 46 Weeks Disease November 14, November 16, Median Median 1964 1963 1959 1963 1964 1963 1959 1963 Aseptic meningitis ................ 45 23 --- 1,905 1,651 --- Brucellosis ....................... 6 9 8 358 326 520 Diphtheria ........................ 8 5 16 249 238 506 Encephalitis, primary infectious .. 56 3 --- 2,946 " EnLephal t i, post-infectious ..... 6 --- 735 1,399 Hepatitis, infectious including serum hepatitis ................ 623 793 817 33,713 38,292 38,292 Measles ........................... 1,539 1,885 2,565 443,732 368,873 399,815 Meningococcal infections .......... 46 30 41 2,391 2,097 1,952 Poliomyelitis, Total .............. 1 11 32 110 389 1,242 Paralytic ...................... 10 25 86 332 812 Nonparalyrc ................... 1 -- 12 40 -- Unspecified .................... 1 --- 12 17 --- Streptococcal Sore Throat and Scarlet fever .................. 6,436 6,356 --- 346,875 297,496 --- Tetanus .......................... 5 9 --- 249 251 --- Tularemia ........................ 2 1 --- 293 260 Typhoid fever ..................... 6 10 14 406 483 744 Rabies in Animals ................. 72 72 63 3,986 3,372 3,285 Table 2. NOTIFIABLE DISEASES OF LOW FREQUENCY Cum. Cum. Anthrax: 4 Psittacosis: 41 Botulism: 15 Rabies in Man: 1 Leptospirosis: Tenn- 96 Smallpox: Malaria: Conn 1, Mo 1, Fla 1, Wash 1 89 Typhus- Plague: Murine: Md 1 23 Rky Mt. Spotted: Ark 1 218 '59 61 63 '65 '- ---------~- r I I I 1 I l I I I I .... ~ ~L,~L~VII~,Y Morbidity and Mortality Weekly Report EPIDEMIOLOGICAL REPORTS SALMONELLOSIS Iowa From 12 to 45 hours after a picnic dinner in Clay County, 11 of the 24 in attendance began to experience symptoms of gastroenteritis. The median incubation period was 20 hours. The symptoms included nausea, vomiting, abdominal cramps, diarrhea, headache, back- ache, and fever. Two patients required hospitalization. All recovered after 2 to 14 days of illness; the median duration of illness was 6 days. All eleven ill ate deviled eggs; the 13 who remained well did not (see table below). SDid Not Consumed Food Consume Food A/R A/R Type of Food No. Ill % No. Ill % Deviled eggs 11 11 100 13 0 0 Goulash 24 11 45 0 0 0 Pumpkin pie 13 9 70 11 2 18 Tuna salad sandwich 8 5 62 16 6 37 Pork sandwich 5 3 60 19 8 41 Beef sandwich 6 5 83 18 6 33 Pressed ham sandwich 11 5 45 13 5 38 Pork and beans 10 6 60 14 5 37 Eight eggs were picnic, and stored in hard-boiled the night before the the cupboard overnight. The fol- lowing morning, the egg yolks were removed and mixed with salad dressing, then replaced in the sliced egg whites. They were covered in a plastic dish until con- sumed at the picnic. Salmonella manhattan was recovered from the stool cultures of 4 of the victims including the woman who prepared the eggs. They were the only patients cultured. The food handler's son, aged 10, did not eat the eggs; his culture was negative for the organisms. A 2-year-old daughter who did not eat the eggs was asymptomatic, but her culture yielded S. manhattan. She had neither recent illness nor a past history of salmonellosis. None of the food served at the picnic was available for laboratory examination at the time of the investi- gation. The eggs used for the picnic had been obtained from the farm across the road from the food handler; the farm belonged to the food handler's parents. Cultures of eggs, chickens, and pets (taken one month after the picnic) were negative for salmonella. (Reported by Ralph H. Heeren, M.D., Director, and Stan- ley L. Hendricks, D.V.M., Associate Director, Division of Preventable Diseases, Iowa State Department of Health.) Editor's Note: S. manhattan comprised one percent of all salmonella serotypes isolated from human sources during 1963. Isolations of this serotype were reported to the Communicable Disease Center by 28 States, from coast to coast. TYPHOID FEVER Aboard French Merchant Vessel A case of typhoid fever in a French seaman aboard a merchant vessel docked at Duluth, Minnesota was re- ported by Minnesota State Department of Health authori- ties. On August 9, a French seaman became ill on board ship with chills, fever, myalgia, back pain, and headache. The ship docked at Duluth on August 12 and the seaman was taken to a local hospital. Blood and stool cultures subsequently grew Salmonella typhi phage type E-l. Epidemiologic investigation indicated that the ves- sel, with a complement of 36 people, had been in Ham- burg, Germany on July 18 and had stored fresh water and food. On July 22, the vessel docked for 24 hours in Casablanca where the crew bought a basket of raw shell- fish which was consumed by 10 of the men. During the next 6 days there were 14 cases of diarrhea and abdominal cramps without nausea, vomiting, fever, or chills. All of the 10 men who had eaten the raw shellfish experienced these symptoms. There was no more illness on board ship until August 9 when the crewman who was subse- quently diagnosed as having typhoid fever became ill. He was one of the 10 who had eaten the shellfish. All of the remaining crew and officers had stool cultures but no pathogenic organisms were uncovered. The hospitalized crewman was treated with chlorampheni- col and was asymptomatic within 3 days; however, his stool cultures were still positive for S. typhi at that time. A 2-week follow-up revealed no further infections of the crew, and the vessel was cleared to proceed to Rotterdam. (Reported by D. S. Fleming, M.D., Director, Division of Disease Control, Minnesota Department of Health, and an EIS Officer.) 406 Morbidity and Mortality Weekly Report 407 REPORTED CASES OF POST-INFECTIOUS ENCEPHALITIS FOR SEPTEMBER AND OCTOBER NINE WEEKS ENDING 9/5, 9/12, 9/19, 9/26, 10/3, 10/10, 10/17, 10/24, 10/31 REPORTED PRIMARY INFECTION Herpes Respiratory Pertussis REPORTING AREA Mumps Chickenpox Measles Rubella Influenza Simplex Syncitial Vaccinia Vaccine NEW ENGLAND Rhode Island 3 MIDDLE ATLANTIC New York, Upstate 1 1 Pennsylvania 2 1 EAST NORTH CENTRAL Illinois 5 1 SOUTH ATLANTIC Virginia 1 South Carolina 1 EAST SOUTH CENTRAL Tennessee 1 MOUNTAIN Montana 1 PACIFIC Washington 2 California 28 1 1 Hawaii 1 U.S. TOTAL 42 3 3 1 1 1 U.S. CUMULATIVE TOTAL* Through 10/31 436 60 174 34 10 10 1 1 1 Includes revised and delayed reports (States not reporting a case not listed) POST-INFECTIOUS ENCEPHALITIS - SEPTEMBER, OCTOBER A total of 26 cases of post-infectious encephalitis Of the 51 cases reported during the past 2-month was reported in September and 25 in October. This brings period, 42 were attributed to mumps. Such cases account to "2' the cumulative total of post-infectious encephalitis for 60 percent of all cases of post-infectious encephalitis cases reported for the first 10 months of 1964. (For recorded thus far this year. Since January, only one case earlier reports, see 1MM'R, Vol. 13, pp. 46, 102, 143, of encephalitis following smallpox vaccination has been 177, 219, 266, 293, and 331). recorded and one case following pertussis immunization. DISTRIBUTION OF POST-INFECTIOUS ENCEPHALITIS CASES DUE TO MUMPS, MEASLES AND OTHER CAUSES IN 1964, BY MONTHS* Month of Report Mumps Measles Other Total Cases January 26 3 2 31 February 40 6 6 52 March 39 19 11 69 April 69 51 21 141 May 60 46 13 119 June 63 26 28 117 July 64 15 21 100 August 33 5 9 47 September 22 2 2 26 October 20 1 4 25 CUMULATIVE TOTAL 436 174 117 727 * Includes revised and delayed reports. 408 11orlidity and Mortality WeeklI Report Table 3. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES FOR WEEKS ENDED NOVEMBER 14, 1964 AND NOVEMBER 16, 1963 (46TH 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... 45 23 56 6 1 11 110 389 10 86 332 NEW ENGLAND......... 3 1 1 2 8 2 8 Maine............... 2 2 New Hampshire.......- - Vermont............. 1 1 Massachusetts...... 1 3 3 Rhode Island....... 2 1 - Connecticut........ 1 2 2 2 2 MIDDLE ATLANTIC...... 1 3 22 1 15 117 1 13 94 New York City...... 4 2 2 - New York, Up-State. 1 3 10 9 9 6 New Jersey.......... 15 3 4 2 3 Pennsylvania....... 3 I 104 1 85 EAST NORTH CENTRAL... 5 1 7 1 1 23 58 1 15 47 Ohio................ 1 1 1 4 8 2 4 Indiana............. 2 8 4 5 3 Illinois........... 1 2 5 17 5 16 Michigan........... 2 1 2 3 20 2 20 Wisconsin.......... 1 1 3 9 1 1 4 WEST NORTH CENTRAL... 1 1 6 2 1 10 7 1 8 6 Minnesota.......... 1 1 3 4 2 4 Iowa............... 1 1 - Missouri............ 1 4 3 - North Dakota...... 2 1 1 1 - South Dakota....... 1 1 1 1 Nebraska........... 2 1 1 1 Kansas............. 1 1 1 - SOUTH ATLANTIC....... 7 4 6 2 5 33 75 4 27 64 Delaware........... I 1 Maryland............ 1 2 1 1 1 1 Dist. of Columbia.. 1 - Virginia........... 3 4 18 4 13 West Virginia...... 1 3 1 3 North Carolina...... 1 12 4 1 7 4 South Carolina..... 1 3 7 3 6 Georgia............ 2 2 21 2 20 Florida............. 5 3 1 4 10 19 3 9 16 EAST SOUTH CENTRAL... 1 3 4 1 6 71 1 5 65 Kentucky ........... 1 2 4 - Tennessee.......... 1 3 10 2 9 Alabama............ 1 2 53 1 2 48 Mississippi......... 1 8 1 8 WEST SOUTH CENTRAL... 5 1 1 2 10 26 2 8 25 Arkansas........... 4 3 Louisiana........... 1 1 14 1 14 Oklahoma............. 1 1 3 1 1 2 1 Texas............... 4 7 7 6 7 MOUNTAIN............. 2 1 1 8 6 5 5 Montana................ 1 1 1 Idaho............... 1 1 1 1 Wyoming............ 2 2 Colorado........... 1 1 1 1 New Mexico......... 3 1 - Arizona............. 3 3 Utah................ - Nevada............ - PACIFIC.............. 20 8 8 2 3 21 3 18 Washington.......... 1 1 2 2 Oregon............. I 1 2 1 1 California.......... 19 6 7 2 2 17 2 15 Alaska............. - Hawaii............... - Puerto Rico - Morbidity and Mortality Weekly Report 409 Table 3. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES FOR WEEKS ENDED NOVEMBER 14, 1964 AND NOVEMBER 16, 1963 (46TH 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... 6 358 8 249 623 276 300 47 33,713 38,292 6 406 NEW ENGLAND.......... 2 44 44 19 24 1 3,036 4,351 17 Maine............... 39 12 6 6 948 1,963 New Hampshire...... 5 1 3 1 236 522 Vermont............ 5 3 2 364 118 - Massachusetts...... 2 5 10 4 6 690 1,102 8 Rhode Island....... 6 1 5 188 102 6 Connecticut........ 6 4 2 610 544 3 MIDDLE ATLANTIC...... 1 6 10 112 50 62 7,407 7,560 2 66 New York City...... 5 24 10 14 1,153 1,183 33 New York, Up-State. 2 47 24 23 3,202 3,250 2 14 New Jersey......... 2 8 1 7 1,239 1,117 2 Pennsylvania....... 1 4 3 33 15 18 1,813 2,010 17 EAST NORTH CENTRAL... 49 1 9 142 66 63 13 5,360 6,157 1 80 Ohio................ 5 23 14 6 3 1,399 1,678 1 20 Indiana............. 1 1 14 7 4 3 456 557 23 Illinois........... 28 1 7 44 14 30 1,013 1,296 23 Michigan........... 6 1 52 30 22 2,124 2,344 11 Wisconsin.......... 9 9 1 1 7 368 282 3 WEST NORTH CENTRAL... 3 150 34 43 22 16 5 1,844 1,689 30 Minnesota........... 9 18 213 262 3 Iowa................ 2 95 14 5 5 4 324 309 4 Missouri........... 10 1 13 6 6 1 455 576 13 North Dakota....... 2 2 63 79 2 South Dakota....... 17 2 2 1 1 133 114 1 Nebraska........... 13 4 5 4 1 53 113 3 Kansas.............. 1 4 7 9 6 3 603 236 4 SOUTH ATLANTIC....... 1 37 2 68 46 20 22 4 3,144 3,891 1 93 Delaware............ 2 1 1 70 72 Maryland.......... 1 1 7 3 4 564 489 8 Dist. of Columbia.. -. I 65 106 - Virginia........... 1 17 4 10 3 5 2 501 774 11 West Virginia...... 4 2 2 445 593 - North Carolina..... 4 1 5 3 2 518 989 19 South Carolina..... 7 4 1 1 2 129 156 1 12 Georgia............ 12 1 30 2 2 105 166 27 Florida............ 4 25 11 6 5 747 546 16 EAST SOUTH CENTRAL... 18 4 30 32 16 16 2,305 3,541 2 41 Kentucky............ 6 12 6 6 813 1,036 10 Tennessee.......... 5 2 14 7 7 816 1,372 2 19 Alabama............. 4 4 23 2 2 446 559 7 Mississippi........ 3 5 4 1 3 230 574 5 WEST SOUTH CENTRAL... 1 43 1 37 50 27 23 2,626 2,623 32 Arkansas........... 6 3 8 4 4 263 290 14 Louisiana........... 4 1 11 8 3 5 637 540 5 Oklahoma........... 7 1 1 126 118 9 Texas.............. 1 26 23 33 20 13 1,600 1,675 4 MOUNTAIN............. 31 3 34 7 5 22 2,030 2,431 12 Montana............ 171 310 Idaho.............. 6 6 286 413 - Wyoming............ 2 2 82 34 1 Colorado............ 5 5 530 493 New Mexico......... 1 1 10 4 4 2 286 297 4 Arizona............ 2 2 8 8 447 548 7 Utah................ 27 3 1 1 1 177 318 - Nevada............. 1 51 18 - PACIFIC.............. 22 14 120 49 69 2 5,961 6,049 35 Washington......... 13 15 6 7 2 604 1,023 2 Oregon.............. 2 14 6 8 605 717 - California......... 20 1 83 32 51 4,370 4,088 33 Alaska............. 6 5 1 266 179 - Hawaii............. 2 2 116 42 Puerto Rico 12 14 11 3 883 776 13 410 Morbidity and Mortality Weekly Report Table 3. CASES OF SPECIFIED NOTIFIABLE DISEASES: UNITED STATES FOR WEEKS ENDED NOVEMBER 14, 1964 AND NOVEMBER 16, 1963 (46TH 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... 1,539 46 2,391 2,097 6,436 6,356 5 249 2 293 72 3,986 NEW ENGLAND.......... 352 2 78 127 607 478 9 1 33 Maine............. 65 6 19 66 13 28 New Hampshire...... 50 2 4 1 12 2 Vermont............ 8 4 6 20 11 2 Massachusetts...... 94 31 58 63 87 9 1 1 Rhode Island....... 81 10 11 57 20 - Connecticut........ 54 2 25 29 400 335 - MIDDLE ATLANTIC...... 71 4 316 292 204 228 1 22 1 1 1 113 New York City...... 9 44 45 15 16 - New York, Up-State. 30 2 93 92 131 146 1 8 1 107 New Jersey.......... 8 1 103 44 20 25 6 - Pennsylvania....... 24 1 76 111 38 41 8 1 1 6 EAST NORTH CENTRAL... 270 11 332 319 535 595 1 47 1 23 5 556 Ohio................ 18 3 88 85 66 85 12 1 4 282 Indiana............. 40 1 52 42 111 116 1 14 2 1 29 Illinois........... 13 6 89 66 78 79 13 14 107 Michigan............ 120 1 72 93 201 191 7 2 53 Wisconsin........... 79 31 33 79 124 1 1 4 85 WEST NORTH CENTRAL... 77 2 137 127 308 211 17 56 17 1,209 Minnesota.......... 1 29 25 8 23 4 2 7 379 Iowa..........:..... 17 8 7 60 84 6 1 4 434 Missouri............ 2 1 62 36 34 8 4 30 2 181 North Dakota........ 47 20 14 169 76 3 60 South Dakota....... 7 3 7 17 14 1 15 1 85 Nebraska........... 3 6 25 1 35 Kansas.............. NN 1 9 13 19 6 2 8 35 SOUTH ATLANTIC....... 125 9 482 389 684 573 1 61 29 8 543 Delaware............ 6 4 2 3 - Maryland............ 4 2 36 53 111 19 3 2 Dist. of Columbia.. 16 8 3 1 1 1 - Virginia............ 20 57 86 170 153 7 6 4 285 West Virginia...... 74 35 20 219 218 1 2 35 North Carolina..... 3 78 72 13 14 15 7 5 South Carolina..... 2 1 56 22 31 35 5 2 Georgia............. 4 2 81 33 21 5 4 14 1 116 Florida............. 18 4 117 91 114 125 1 25 1 1 98 EAST SOUTH CENTRAL... 87 1 184 145 1,134 1,401 32 30 20 533 Kentucky............ 8 1 61 31 110 273 8 2 1 58 Tennessee.......... 60 56 67 898 1,055 12 20 19 401 Alabama............ 3 43 24 54 18 7 3 17 Mississippi........ 16 24 23 72 55 5 5 57 WEST SOUTH CENTRAL... 142 5 221 189 597 554 1 28 101 14 567 Arkansas........... 3 30 14 8 5 8 61 2 137 Louisiana.......... 2 1 127 74 11 11 4 6 4 61 Oklahoma............. 13 33 22 1 20 2 92 Texas............... 140 1 51 68 556 538 1 15 14 6 277 MOUNTAIN............. 131 2 82 73 1,201 1,470 6 49 2 141 Montana.............. 63 1 3 29 53 19 1 Idaho.............. 16 3 6 120 66 1 - Wyoming............ 5 7 86 160 2 10 - Colorado........... 13 1 15 20 408 657 8 New Mexico ......... 1 33 4 204 304 1 52 Arizona............ 2 8 11 125 124 1 1 66 Utah............... 36 7 18 229 105 1 20 1 3 Nevada............. 1 10 4 1 11 PACIFIC .............. 284 10 559 436 1,166 846 1 27 3 5 291 Washington......... 109 2 45 39 316 303 3 - Oregon............. 20 21 32 25 40 1 1 10 California......... 105 8 473 340 743 486 1 22 2 5 281 Alaska............. 2 7 12 13 17 - Hawaii............. 48 13 13 69 -- - Puerto Rico 127 32 1 9 10 61 25 Morbidity and Mortality Weekly Report Table 4 (B). REPORTED PNIUMONIA.INfLUENZA DEATHS IN REPORTING CITIES (Tables 4(A), 4(B), 4(C), and 4(D) will be published in sequence covering a four-week period.)o 411 For weeks ending For weeks ending Area Area 10/24 10/31 11/7 11/14 10/24 10/31 11/7 11/14 NEW ENGLAND: Boston, Mass.............. 16 7 11 7 Bridgeport, Conn.......... 2 1 5 1 Cambridge, Mass............ 5 7 - Fall River, Mass.......... 2 I - Hartford, Conn............ 1 Lowell, Mass.............. 1 2 2 4 Lynn, Mass................ 3 1 2 1 New Bedford, Mass......... 2 2 1 New Haven, Conn............ 1 3 Providence, R.I........... 2 3 - Somerville, Mass.......... 2 2 2 Springfield, Mass.......... 10 9 3 5 Waterbury, Conn........... 1 1 Worcester, Mass............ 6 3 3 9 MIDDLE ATLANTIC: Albany, N.Y............... 1 1 1 Allentown, Pa............. 4 1 5 Buffalo, N.Y.............. 6 4 6 7 Camden, N.J............... 4 4 2 1 Elizabeth, N.J............ 3 1 Erie, Pa.................. 2 3 4 1 Jersey City, N.J.......... 4 5 8 6 Newark, N.J................ 10 3 8 6 New York City, N.Y......... 64 57 53 56 Paterson, N.J............. 3 6 4 4 Philadelphia, Pa.......... 17 12 20 16' Pittsburgh, Pa............ 6 8 6 5 Reading, Pa............... 1 3 4 1 Rochester, N.Y............. 14 5 12 11 Schenectady, N.Y.......... 1 1 1 Scranton, Pa.............. 5 2 1 Syracuse, N.Y.............. 1 Trenton, N.J............... 1 2 3 1 Utica, N.Y................ 12 5 5 7 Yonkers, N.Y.............. 1 2 1 EAST NORTH CENTRAL: Akron, Ohio................ 1 1 I Canton, Ohio............... 4 8 6 3 Chicago, Ill.............. 33 31 17 35 Cincinnati, Ohio........... 12 5 3 3 Cleveland, Ohio............ 3 6 4 4 Columbus, Ohio............ 4 3 4 3 Dayton, Ohio.............. 3 2 3 3 Detroit, Mich............. 22 9 8 11 Evansville, Ind........... 3 5 2 2 Flint, Mich............... 1 - Fort Wayne, Ind........... 7 2 1 2 Gary, Ind................. 3 4 2 4 Grand Rapids, Mich........ 8 1 9 Indianapolis, Ind......... 8 4 4 2 Madison, Wis............... - Milwaukee, Wis............ 4 2 5 Peoria, Ill............... 1 1 - Rockford, Ill............. 4 4 2 2 South Bend, Ind ........... 1 5 2 1 Toledo, Ohio.............. 4 10 1 5 Youngstown, Ohio........... 1 WEST NORTH CENTRAL: Des Moines, Iowa........... 1 3 3 - Duluth, Minn............... - Kansas City, Kans.......... 2 5 1 31 Kansas City, Mo............ 8 4 3 6 Lincoln, Nebr............. 2 3 1 Minneapolis, Minn......... 1 3 Omaha, Nebr................ 3 1 5 3 St. Louis, Mo.............. 9 7 2 8 St. Paul, Minn............ 3 1 1 - Wichita, Kans............. 4 5 2 4 *Estimate based on average percent of divisional total. Totals for previous weeks include reported corrections. NOTE: All deaths by place of occurreace. SOUTH ATLANTIC: Atlanta, Ga.............. 5 5 6 6 Baltimore, Md............ 4 4 4 7 Charlotte, N.C............ 1 2 2 1 Jacksonville, Fla........ 1 1 1 3 Miami, Fla.............. - Norfolk, Va.............. 4 8 7 1 Richmond, Va.............. 3 4 6 3 Savannah, Ga............. 4 5 2 2 St. Petersburg, Fla...... 2 7 7 2 Tampa, Fla............... 7 7 7 5 Washington, D.C.......... 5 10 22 9 Wilmington, Del.......... 2 4 5 EAST SOUTH CENTRAL: Birmingham, Ala.......... 2 2 1 1 Chattanooga, Tenn ........ 5 2 2 Knoxville, Tenn.......... 2 1 6 Louisville, Ky.......... 13 15 10 19 Memphis, Tenn............ 5 10 12 7 Mobile, Ala............... 2 1 2 Montgomery, Ala.......... 3 3 1 Nashville, Tenn........... 5 3 3 7 WEST SOUTH CENTRAL: Austin, Tex............... 6 4 5 4 Baton Rouge, La.......... 1 3 2 Corpus Christi, Tex...... 1 Dallas, Tex............... 2 6 3 2 El Paso, Tex............ 2 4 1 2 Fort Worth, Tex.......... 1 4 3 1 Houston, Tex.............. 5 6 4 5 Little Rock, Ark......... 3 5 2 1 New Orleans, La.......... 21 7 6 6 Oklahoma City, Okla...... 1 - San Antonio, Tex.......... 7 3 3 2 Shreveport, La........... 3 5 8 3 Tulsa, Okla.............. 4 2 4 3 MOUNTAIN: Albuquerque, N. Mex...... 3 1 4 3 Colorado Springs, Colo... 2 2 2 1 Denver, Colo.............. 7 3 2 2 Ogden, Utah............... 2 1 3 2 Phoenix, Ariz............ 7 1 7 7 Pueblo, Colo............. 3 - Salt Lake City, Utah..... 1 1 1 3 Tucson, Ariz ............. 1 1 2 1 PACIFIC: Berkeley, Calif.......... - Fresno, Calif............ 4 2 2 3 Glendale, Calif.......... 2 - Honolulu, Hawaii......... 4 1 Long Beach, Calif........ 2 - Los Angeles, Calif....... 15 16 23 11 Oakland, Calif.......... 2 5 5 2 Pasadena, Calif........... - Portland, Oreg............ 2 1 1 Sacramento, Calif........ 2 1 5 1 San Diego, Calif......... 5 4 2 2 San Francisco, Calif ..... 6 2 3 7 San Jose, Calif.......... 3 4 2 4 Seattle, Wash............. 3 2 4 1 Spokane, Wash........... 1 1 Tacoma, Wash............. 1 2 - oCurrent Week Mortality for 108 Selected Cities 4(A) Total Mortality, all ages................... 11,335 4(B) Pneumonia-Influenza Deaths, all ages........ 425 4(C) Total Deaths under I Year of Age............ 738 4(D) Total Deaths, Persons 65 years and over..... 6,336 312208I64ll ll 2722 3 1262 08864 2722 Morbidity and Mortality Weekly Report SUMMARY OF PNEUMONIA AND INFLUENZA DEATHS The week) average number of pneumonia-influenza deaths for the four-week period ending November 14 was -60 as compared with an expected weekly average otf 4l. Week ending 4 Week Weekly 10'24 10 31 11 17 11 14 Total Average Observed 511 457 448 425 1841 460 Expected 457 468 480 492 1897 474 Excess 54 11 32 67 -56 14 PNEUMONIA INFLUENZA DEA THS in OB U.S. CITIES t-O e arunDA r per HeeA b~ FO*r LeeA Pralloa 1 T I P l a A- ---- Voo a 50o 0 No '- .'. ._ --- : .' *ni-tr* ^^.A-t14 (See table, page 411) INTERNATIONAL NOTES QUARANTINE MEASURES POLIOMYELITIS Jamaica An outbreak ot clinical poliomyelitis occurred in urban Kingston, Jamaica beginning September 2, 1964. Since that date, 23 cases of poliomyelitis have been re- ported, all in children under age 3, with the exception of 2 cases age 6. Only one of the victims had been pre- t\ously vaccinated having had one dose of trivalent oral vaccine in 1962. There have been 3 fatalities; Type I poliovirus was isolated from one of these fatal cases. Trivalent oral polio vaccine is being administered in an effort to halt the epidemic. There have been no new cases reported since November -. IReported by Dr. Charles W'edderburne. Chief, Medical Officer, Vinistry of Health, Kingston. Jamaica, and Dr. Donald Luck, Epidemiologist. Vinistry of Health, Kingston, Jamaica.) THE MORBIDITY AND MORTALITY t AEEFL. REPORT. FAITH A CIRCULA- TION OF 12,0O0, iS PUBLISHED B I TIE COMMIUNICA BLE DISEASE CENTER. ATLANTA, GEORGIA 30333. CHIEF. COMMUNICABLE DISEASE CENTER JAMES L. GODDARD. M.D. C -IEF. EPIDEMIOLOGv BRANCH A. D LANGMUIR. M.D. C-IEF STATISTICS SECTION R. E. SERFLING. PM.D A55T. CH-IEF. STATISTICS SEC TION I. L. SHERMAN. ;1.5. .*-HIEF EuR.EILLANCE SEC TION A. HENDERSON. M.D. ASSISTANT EDITOR. Ma, .kfR PAUL. STOLLEY. M.D. IN ADDITION TO TmE ESTABLISHED PROCEDURE- FOR REPORTING MORBIDIT V AND MORTALITY. TI-E COMMUNICABLE DISEASE CENTER AE L.COIMES ACCOUNTS OF INTERESTING OUTBREAKS OR CASES. SuCm ACCOUNTS SmHOULLD BE ADDRESSED TO THE EDITOR MORBIDITY AND MORTAL .ITV WEEK LY REPORT COMM'JNIC AbLE DISEASE CENTER ATLANTA. GEORGIA 30333 NOTES TH-ESE PIRO. ISIONAL DATA ARE BASED ON WEEKLY TELE- GRAMS TO T-TE COMMuNICABLE DISEASE CENTER BV Ti-E I INDIIDuAL STATE HEALTH- DEPARTMENTS. SYMBOL ---DATA NOT AVAILABLE QUANTITY ZERO PROCEDURES FOR CONSTFuCTIDN OF \lARI OU MORTALITY CuR.ES MAY BE OBTAINED FROM STATISTICS SECTION. COMMUNIC A LE DISEASE CENTER. PUBLIC HEALTH SERVICE. U.S. DEPARTMENT OF H-EALTH. EDUCATION. AND WELFARE. ATLANTA. GEORGIA 30333. DUNIV OF FL LIB DOCUMENTS DEPT U S DEPOSITORY 412 n 0 0 C a c a s: a 'n m a wfl C 3In - 0 m0 m mo P m C |
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