Morbidity and mortality

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

xml version 1.0 encoding UTF-8
REPORT xmlns http:www.fcla.edudlsmddaitss xmlns:xsi http:www.w3.org2001XMLSchema-instance xsi:schemaLocation http:www.fcla.edudlsmddaitssdaitssReport.xsd
INGEST IEID EZ5WXKWU7_E9821R INGEST_TIME 2013-02-07T17:32:18Z PACKAGE AA00010654_00416
AGREEMENT_INFO ACCOUNT UF PROJECT UFDC
FILES